Identifying dementia (changes in memory and thinking that interfere with daily life) as early as possible is important. It can help people find treatments to reduce their symptoms or slow the progression of the underlying brain condition. Early diagnosis of dementia also gives people the option of participating in a clinical trial and receiving a new intervention that might help.
Dementia can initially present as memory loss, as is often seen in people with Alzheimer’s disease (the most common form of dementia). But there are a number of other potential symptoms, depending on the cause of dementia. Some people become increasingly unable to control their emotions or may experience changes related to behavior, personality, mood, or movement. These changes are not a normal part of aging, as noted by the National Institute on Aging — many people live into old age without developing dementia.
Here are some possible early signs and symptoms of four different types of dementia — Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal disorders.
Alzheimer’s disease involves changes in parts of the brain that affect memory, thought, and language. These changes can begin years before any symptoms develop, according to the Centers for Disease Control and Prevention (CDC).
In the early stages of Alzheimer’s, people may still be able to function in daily life but tend to experience memory lapses — such as forgetting commonly used words or the location or familiar objects. While close family and friends may notice these changes, it may be difficult for others to notice early Alzheimer’s symptoms. But doctors can diagnose the condition using diagnostic tests.
Early signs of Alzheimer’s disease may include:
Difficulty finding the right word or name
Difficulty with tasks at work or in social settings
Forgetting things you just read or heard
Misplacing valued objects
Increased difficulty with planning or organizing
Since early signs of Alzheimer’s can be easy to miss, many people don’t get a diagnosis until they reach the middle or moderate stage of the disease. This stage features more pronounced signs of dementia and can last for several years, according to the Alzheimer’s Association, such as:
Forgetting about life events
Forgetting basic information like address or phone number
Confusion about the current time or location
Becoming emotionally volatile or withdrawn
Changes in sleep patterns
Difficulty getting dressed
Wandering or getting lost
Becoming suspicious, delusional, or compulsive in thoughts and behaviors
People with middle-stage Alzheimer’s typically require assistance with daily activities, and may need growing levels of assistance as the condition progresses.
Vascular dementia (also known as vascular cognitive impairment) occurs when blocked or damaged blood vessels deprive brain cells of the oxygen and vital nutrients they need. It may account for 5 to 10 percent of all dementia cases, according to the Alzheimer’s Association.
Vascular dementia also often coexists with other forms of dementia such as Alzheimer’s, a condition known as mixed dementia.
Symptoms of vascular dementia may be most noticeable immediately after someone has a major stroke that blocks blood flow to the brain. These sudden changes can include:
Confusion
Disorientation
Difficulty speaking or comprehending speech
Difficulty walking or balance problems
Repeated small strokes or other damage to smaller blood vessels in the brain can lead to more subtle but noticeable impairments. This type of vascular dementia may occur gradually, worsening after each small stroke. Symptoms of vascular dementia in this situation can include:
Difficulty making judgments and planning
Uncontrolled laughing and crying
Difficulty paying attention
Difficulty functioning in social situations
Trouble finding the right words
Lewy bodies are abnormal clumps of a protein called alpha-synuclein in the brain, which can cause Lewy body dementia (LBD).
Lewy body dementia tends to affect people ages 50 and older, and often starts with mild symptoms. But as the disease progresses, people experience difficulty with thinking and movement, and often require assistance with all daily functions in the period before their death, according to the National Institute on Aging.
There are actually two types of Lewy body dementia: dementia with Lewy bodies and Parkinson’s disease dementia. Over time, people with either kind of dementia may develop similar symptoms, although cognitive symptoms tend to develop more slowly in Parkinson’s disease dementia.
Symptoms of Lewy body dementia can include:
Visual hallucinations that may include shapes, animals, or people
Sound, smell, or touch (tactile) hallucinations
Episodes of drowsiness or long periods of staring into space
Movements that resemble those in Parkinson’s disease, such as slowed movement, rigid muscles, tremor, or a shuffling walk
Cognitive problems similar to those in Alzheimer’s, such as confusion, memory loss, or difficulty paying attention
Acting out dreams while asleep, known as rapid eye movement (REM) sleep behavior disorder
Poor regulation of automatic bodily functions (autonomic nervous system), which can cause dizziness, falls, or incontinence (loss of bladder or bowel control)
Depression
Loss of motivation or interest
Frontotemporal disorders (FTD), commonly called frontotemporal dementia, are caused by damage to neurons in the frontal (front) and temporal (side) lobes of the brain, potentially causing affected areas to atrophy (shrink and lose brain cells).
Frontotemporal disorders are rare and typically affect people at a younger age than other types of dementia. About 60 percent of people living with FTD are between the ages of 45 and 64, according to the National Institute on Aging.
In the early stages of frontotemporal disorders, people may have only one symptom. But as more parts of the brain become affected, other symptoms may develop. Symptoms can vary significantly from person to person, but there are clusters of symptoms that tend to occur together.
Extreme changes in behavior and personality are the most common group of symptoms seen in frontotemporal disorders, and can include the following:
Inappropriate social behavior that becomes progressively worse
Loss of interpersonal skills, including empathy
Lack of inhibition or judgment
Loss of motivation or interest
Repetitive compulsive behavior
Problems with personal hygiene
Overeating or other changes related to eating habits
Eating inedible objects (or putting them in mouth)
Some people with frontotemporal disorders experience problems with speech and language. These symptoms can include:
Difficulty finding the right word or naming objects
No longer knowing the meaning of words
Making mistakes in sentence construction
Using simple, two-word sentences
In rare cases, frontotemporal disorders cause movement symptoms similar to those of Parkinson’s disease or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease). These symptoms may include:
Tremor
Rigidity
Muscle spasms
Coordination problems
Difficulty swallowing
Muscle weakness
Difficulty walking
Early symptoms of dementia can vary depending on the specific condition that’s causing cognitive problems. The sooner a person’s symptoms are recognized, the more likely they are to be eligible for certain treatments or a clinical trial that may lead to future treatments.
