Dementia is common in older adults, and visible symptoms can be challenging for individuals or caregivers to cope with as they progress. However, subtle symptoms may appear before a person is diagnosed. Understanding these signs and symptoms of early dementia may be helpful, as knowledge of them could increase access to prevention efforts and treatment.  

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What is dementia? 

Dementia isn't a disorder but a group of symptoms commonly found in neurological conditions like Alzheimer's disease, brain injury, tumors, or Huntington's disease. It is characterized by symptoms like memory loss, diminished cognitive functioning, impaired judgment, and confusion, among others. 

Alzheimer’s disease and related dementias in the U.S.

According to the Centers for Disease Control and Prevention (CDC), roughly 5.8 million people in the US have Alzheimer's disease and related dementias. Dementia typically presents in individuals over 65 years, but early-onset dementia may emerge in individuals as young as their 30s. 

Symptoms of the early stages of dementia are hard to recognize

Dementia progresses with time, and its early stages may not always be easy to recognize. For example, memory loss incidents may begin mildly and might be attributed to stress or being overwhelmed in daily life. Changes in mood or personality may present similarly to those experienced in mental health conditions like anxiety and depression. 

Why is it important to recognize the early stages of dementia? 

Identifying dementia in its early stages allows for prompt assessment and intervention, which potentially has a more significant impact on an individual's ability to manage symptoms, slow the progression of dementia, and improve the overall quality of life for themselves and their loved ones. Early intervention involving a combination of medications, therapy, and lifestyle changes may be more effective in some cases. 

Early diagnosis of dementia may also:

• Cultivate better awareness and education among individuals with dementia and their families, reducing stigma and increasing support
• Provide more treatment options and potential opportunities for individuals to participate in research studies or clinical trials to develop new therapies
• Allow individuals and their families the opportunity to make important decisions early on regarding practical matters like care, legal and financial matters, and living arrangements, which may reduce stress and uncertainty for all those coping with the diagnosis  

Memory loss and other signs and examples of early stage dementia

People may experience dementia differently, and symptoms of dementia can vary depending on several factors, including which part of the brain is affected, the individual's lifestyle, and their environment. Although symptoms often present differently between individuals, there are early warning signs of dementia that people might notice in everyday life, including the following. 

Memory loss

Difficulty handling everyday tasks

People in the early stages of dementia may have trouble completing familiar tasks, such as the following examples: 

• Following a recipe
• Managing finances and household bills
• Operating the microwave, radio, or TV
• Driving to a familiar location

Confusion or disorientation

Individuals with early-stage dementia might become disoriented to time, place, or familiar surroundings. For example, they may: 

• Struggle to remember where they are or experience confusion as to how they got there
• Lose track of the time, day of the week, or the season— but figure it out later
• Misplace familiar names

Trouble with language or communication

The early stages of dementia may affect how an individual communicates. A person with dementia may:

• Have trouble finding the right words or forget simple words that label or describe an item 
• Have difficulty following conversations and staying focused
• Struggle with expressing thoughts coherently
• Experience difficulties with reading or writing

Changes in mood or personality

Shifts in mood, uncharacteristic behaviors, and relationship changes might emerge during the early stages of dementia. A person living with symptoms of dementia might:

• Have increased irritability and anger
• Experience anxiety and difficulties coping with stress
• Experience depressed mood and feelings of hopelessness
• Lose interest in previously enjoyed activities 
• Isolate and withdraw from relationships or social engagement

Changes in behavior

With changes in mood and personality may come changes in behaviors. A person may exhibit uncharacteristic behaviors in the early stages of dementia, such as the following: 

• Loss of trust in people close to them or suspicions that individuals are hiding or keeping information from them
• Pacing, restlessness
• Wandering
• Poor judgment or risky behaviors
• Aggression
• Decreased personal hygiene

Addressing the early signs of the early stages of dementia

In some cases, people in the early stages of dementia may not recognize their symptoms as potentially serious but a normal part of the aging process. Others may be in denial out of fear and uncertainty around the changes happening to them. 

If you suspect your loved one is in the early stages of dementia, approaching the conversation can be challenging. Below are some tips for family members and caregivers on how to address early signs of dementia with a loved one. 

Decide where and when you'd like to initiate the conversation

Choose a calm, comfortable setting at a time when there will be minimal distractions to reduce potential anxiety for both the person and those they love. Approach the topic with warmth and reassurance to help them ease into it. 

Use clear, simple language

Communicate respectfully and non-judgmentally. Use straightforward sentences and avoid complex or abstract language. For example, you might gently ask them if they've been feeling any different or have noticed changes in their memory, cognitive functioning, or emotional state. 

If you think it would be well-received, mention examples of behaviors you've noticed or are concerned about. Give them time to process the information and respond. Let them know you're coming from a place of concern and support. 

Listen actively and validate their feelings

Focus, patience, and empathy can be parts of active listening. When engaged in the conversation, show genuine interest in their thoughts, emotions, and experiences by maintaining comfortable eye contact and nodding to indicate you understand where they're coming from. Empathy and reassurance can convey that they are understood and supported. Ask them more about their thoughts and feelings if you don’t understand them, and try to avoid believing you know what is best for them. 

Involve them in the decision-making process

If you are looking to discuss the next steps for assessment and treatment, give them a sense of control and autonomy. Empower them by offering choices and involving them in the decision-making process. 

Offer to go with them for an assessment

If the individual agrees to get help, offer to accompany them to their appointments for support. Use words of encouragement like, "There are plenty of causes for these symptoms; It may be helpful to find out so we can start working on it," or "No matter what they say at the doctor's, I'm here to support you." 

Getting a dementia diagnosis

How one obtains a diagnosis may rely on several variables. However, some people begin by reporting symptoms to a primary care physician who can then provide a referral to a neurologist, mental health specialist, psychologist, or other professional specializing in memory and cognitive assessment. Others may be referred to a geriatrician specializing in caring for older adults. 

The first treatment steps may include a physical examination, lab tests, and bloodwork. The physician may ask about family history and the types, severity, and frequency of symptoms the client is experiencing. They may also request an interview with close family members or friends to provide more perspective into their loved one's symptoms. 

After the first steps, a specialist may administer cognitive tests to measure the individual’s reasoning, memory, attention, and language skills. They may also take neurological tests to measure reflexes, balance, eye movements, and sensory capabilities. 

Doctors may administer brain scans to assess brain functioning and rule out other possible causes, such as stroke. The client may complete a psychiatric evaluation to determine their psychological state and rule out other mental health conditions that might be causing dementia symptoms. 

How to support a loved one with early dementia

When a loved one has been diagnosed with dementia, their healthcare provider(s) may provide immediate family members or caregivers with resources and education about the type of dementia they have been diagnosed with and what symptoms they can expect as the condition progresses. Regularly communicate with your loved one's healthcare team, including doctors, therapists, and social workers, for ongoing guidance and support in managing their dementia. 

Tips to support a person with dementia

Below are several tips for supporting a loved one:

• Create a consistent daily schedule, including regular mealtimes, self-care, activities, and rest periods. Help them stay as organized as possible with a calendar or notebook to record to-do lists and appointments. This process may help them be more secure and reduce confusion and anxiety. 
• Ensure the living space is safe, well-organized, and free of hazards that could pose a risk to your loved one. 
• Work with your loved one to make plans for future care, financial matters, and legal decisions to make sure their wishes are respected as the disease progresses. 

Below are a few tips on how to cultivate better well-being for your loved one during this time:

• Encourage independence by allowing your loved one to participate in tasks and activities to the best of their ability, helping as needed. Encourage them to remain involved in decision-making to maintain a sense of autonomy.
• Encourage them to eat a nutritious diet, get sufficient rest, engage in physical activity, and stay socially active. Involve them in daily activities like cooking, gardening, and caring for the home.
• Encourage your loved one to stay connected with friends, family, and their community to combat a sense of isolation. Doing so may promote emotional well-being and cognitive stimulation. 
• Because communication can be challenging for people with dementia, find ways to communicate effectively with your loved one. Remain calm and reassuring, use clear and straightforward language, and avoid arguing or correcting them if they become confused or agitated. 
• Try to change the home as little as possible to avoid confusion. For example, don't move the furniture or rearrange the rooms unless it's a safety concern. Keep meaningful objects and pictures around to create comfort and security.
• Effectively caring for another may also involve paying attention to your own needs. Take care of yourself by eating nutritious foods, staying physically active, and getting quality rest. Consider stress-relieving activities like meditation, spending time in nature, or mindful breathing. 

Remaining socially active can also help individuals cultivate better mental health. Make time to meet with friends or engage in activities you enjoy. Join a caregiver support group to share experiences and tips. If you need a break, ask for help from other family members, friends, or professional caregivers. 

Support through the early symptoms of a person with dementia

The early stages of dementia may be difficult to recognize. However, education and awareness can help individuals identify early dementia, get support, and begin the path to treatment for a loved one. At times, caregiving can be overwhelming and draining if one doesn’t seek help and care for one’s own needs. While a caregiver may be focusing on their loved ones, caring for one’s own health can be an integral part of supporting a loved one with dementia. 

Some caregivers may find that therapy helps them cope with stress and learn to handle challenging situations more effectively. It may also help in processing the often emotionally painful realities of dementia. Despite its benefits, however, some people don't seek help from a mental health professional. Challenges associated with caring for a loved one with dementia can create scheduling and accessibility obstacles when seeking in-person care. 

Some caregivers may find virtual therapy an accessible alternative to traditional, in-office treatment. Virtual therapy through platforms like BetterHelp offers individuals more flexible scheduling options and eliminates geographical barriers that might make it challenging to find treatment. Through an online platform, clients can choose between phone, video, or live chat sessions and choose a session time that works for them, including outside of standard business hours if needed.  

iCBT for caregivers of those with Alzheimer’s disease or dementia

A growing body of research shows that programs such as internet-based cognitive behavioral therapy (iCBT) can be highly effective in reducing caregiver depression, anxiety, and stress while promoting better overall well-being.