Dementia is not just about forgetting names or misplacing keys. While memory loss is a hallmark of some forms of the condition, early signs can manifest in surprising ways, affecting personality, social skills, and even basic judgment. Recognizing these subtle shifts is crucial, as early diagnosis allows for better management and planning.
The Spectrum of Dementia Symptoms
Dementia isn’t a single disease but an umbrella term for various cognitive impairments. The way it presents depends on the specific type. Frontotemporal dementia (FTD), for example, often starts with personality and behavioral changes, while dementia with Lewy bodies can cause hallucinations or odd fixations. Alzheimer’s disease, though often associated with memory loss, can also begin with difficulties in language or visual processing.
Subtle Behavioral Changes That Signal Trouble
Katherine Rankin, a neuropsychologist at the University of California, San Francisco, emphasizes that any significant deviation from a person’s normal behavior should be investigated. Here are ten unexpected early signs to watch for:
1. Trouble With Driving and Increased Falls
Sudden difficulties with driving or a noticeable increase in falls are red flags. Falls aren’t just accidental; they can be early symptoms of brain disorders like progressive supranuclear palsy.
2. Losing the Ability to Read Social Cues
Sarcasm and lies are part of everyday interactions, but people with FTD or Alzheimer’s may struggle to recognize them. FTD patients are particularly prone to missing deceptive cues, while Alzheimer’s patients still retain that ability.
3. Disregard for Social Norms and the Law
An abrupt change in behavior — such as stealing or breaking the law — can be an early sign of dementia, even if it occurs in someone who has always been law-abiding.
4. Reduced Gaze and Reading Difficulties
People with Lewy body dementia may exhibit a “reduced gaze,” appearing to stare more often. They may also skip lines while reading, which is a symptom they themselves may not notice.
5. Confusion About Everyday Objects
Forgetting how to use common objects, not just their names, can be a sign of Alzheimer’s disease. A person might know what a fork is but struggle to remember its purpose.
6. Inappropriate Behavior and Loss of Empathy
Sudden outbursts of rudeness or insensitivity, without remorse, can indicate frontotemporal dementia. The ability to read social cues and understand why certain behaviors are unacceptable deteriorates early in the disease.
7. Compulsive Behaviors and Rituals
Extreme hoarding or obsessive rituals, like buying multiple copies of the same item, can be early symptoms of frontotemporal dementia.
8. Difficulty Managing Money
Increasing trouble with finances, such as balancing a checkbook or paying bills, is a classic early sign of Alzheimer’s disease. This isn’t a normal part of aging; it’s a symptom of cognitive decline.
9. Difficulty Forming Words
Sudden problems with fluent speech, despite other cognitive abilities remaining intact, can indicate primary progressive aphasia, a rare form of dementia.
10. Personality Shifts
Uncharacteristic behavior, such as increased irritability, apathy, or disinterest in hobbies, can also be a sign of dementia.
Why Early Recognition Matters
Dementia doesn’t always begin with memory loss. Different brain areas can be affected first, leading to a wide range of initial symptoms. If you or a loved one exhibits any of these changes, it’s essential to consult a healthcare provider. Early detection allows for timely intervention, support, and planning for the future.
