Early symptoms of dementia

Expert reviewer Professor Graham Stokes, Bupa Global Director of Dementia Care
Next review due September 2020

There are several different types of dementia. They all have different symptoms in the early stages. Alzheimer’s disease is the most common type of dementia and tends to come on very slowly. Vascular dementia may come on suddenly after a stroke or it may worsen in steps, after a series of ‘mini-strokes’. Because the types of dementia vary, there is no single list of early symptoms of dementia to look out for. But this section will give you an idea of what to look out for in general.

Relatives are often the first to notice that something is wrong. You’re right to be concerned if forgetfulness seems to be getting worse or the person you know well doesn’t seem to be themselves. It is important to get a proper diagnosis, which means making sure they see their GP. This may not be easy if they think nothing’s wrong, but it’s worth persevering. Early diagnosis has several benefits, not least treatment that may slow the disease. It is also possible that symptoms are caused by a different, treatable medical condition.

What are the early symptoms of dementia?

Some of the possible early signs of dementia are things that we all do from time to time. If someone forgets a person’s name, or what they went into a room for, it doesn’t mean they have dementia. But if someone is becoming increasingly forgetful, has difficulty managing, or doesn’t seem to be the person they were, it can be a cause for concern.

There are four main types of dementia and they have different early symptoms. Some types develop more slowly than others. After a diagnosis, a relative of a person with dementia may look back and realise with hindsight that something has been wrong for a while.

Early symptoms of Alzheimer’s disease

Alzheimer’s disease tends to come on very slowly. In the early stages, people begin to find it difficult to learn new things. For example, you may find you have to keep explaining how to use the new microwave whereas before, your relative wouldn’t have had trouble picking that up. Getting confused about what day or time it is can be another early sign.

Early symptoms of vascular dementia

Vascular dementia symptoms can come on quickly, typically after a stroke or series of ‘mini-strokes’. The exact symptoms will depend on which part of the brain was affected by a lack of blood supply. Emotional difficulties are often the first signs. People may become short tempered or cry more easily, for example. This is usually followed by more typical signs of dementia such as memory loss or confusion.

Early symptoms of dementia with Lewy bodies (DLB)

Dementia with Lewy bodies (DLB) can have very specific early symptoms. These may include having very detailed visual hallucinations – seeing things that aren’t there. People with Lewy body dementia symptoms also tend to be much less alert at some times than others. Later, people develop more typical signs of dementia.

Early symptoms of frontotemporal dementia

Frontotemporal dementia symptoms tend to come on very slowly. There are three different types and early signs depend on the type it is. People may:

  • become less inhibited and start behaving oddly and inappropriately
  • speak more hesitantly and have difficulty understanding long sentences
  • begin to forget words, what things are called or what they’re used for

Other potential causes of symptoms

Confusion doesn’t always mean dementia. Older people can become suddenly confused because of an untreated infection or dehydration, for example. Other causes include constipation or medicines they may be taking. Some symptoms of depression can also appear similar to dementia.

Likewise, memory loss doesn’t always mean dementia. As we get older, our memory naturally starts to get a little worse. We may become slower to learn new information and recall old information.

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When to suspect dementia

If you’re worried that a relative’s memory is getting worse, it’s worth seeking help. Dementia becomes more common as we get older, but it can also happen in younger people, so age should not stop you raising the issue.

As dementia is so varied, no one can give you hard-and-fast rules about when to see a doctor. But there are some changes that should ring alarm bells:

  • new types of forgetfulness that are getting worse - this means memory lapses that stand out, such as forgetting your way around a familiar house
  • not knowing or understanding information that was previously understood
  • emotional changes – becoming more friendly or withdrawn, less interested in life or more easily angered
  • unusual behaviour, such as walking aimlessly, agitation or restlessness
  • showing signs of mental ill health, such as depression, anxiety or feeling persecuted (paranoia)

There is no set time to wait. You don’t need to rush to the GP the first time someone forgets a word. However, when dementia is the problem, it usually takes some time before you realise something is wrong. So don’t feel that you’re bothering the doctor.

Dementia is complicated and it’s not something you can diagnose yourself. There is more information about the benefits of a proper diagnosis in the section: What to do if you suspect dementia.

What to do if you suspect dementia

If you’re concerned that someone close to you has dementia, they need to see their GP. This isn’t always easy, but it’s the only way to diagnose dementia. There are several good reasons for getting a proper diagnosis.

  • It may not be dementia – there can be other medical causes of some of these symptoms.
  • Early diagnosis may result in a better response to treatment.
  • Having dementia diagnosed in the early stages can help avoid a crisis occurring, such as an accident in the home or serious problems with finances.

Having dementia diagnosed will help you and others to understand what is happening to your loved one and why they’re behaving as they are. In turn, this will help you to cope with potentially frustrating situations.

Encouraging a loved one to visit the GP

It can be difficult to convince someone you think has dementia to see their doctor. They may not understand why you want them to go and they may not want to. They may not have noticed that anything is wrong. Or they suspect that they have memory problems but are frightened to have this confirmed. Most older people say they would want to know if they had dementia, but when it actually happens, it takes a bit of getting used to.

If your relative refuses to go to the doctor, you can still contact their GP to say you’re worried about them. Without the patient’s permission, the GP can’t give you any details about their case, but they can listen to information that you give them. If you agree, the GP can then speak to the patient to tell them you’re worried about them and try and persuade them to come in to the surgery.

It may help to persuade your relative if you explain to them that:

  • you want the best for them
  • there are treatments that can help
  • early treatment can delay the progression of dementia
  • the sooner treatments are started, the more likely they are to work well

You know your relative best and what they are likely to respond to. Many people are more inclined to help others than themselves. So if all else fails, you could try asking them to do it for you – to help stop you worrying about them.

You may find it helpful to read our page about the pros and cons of early dementia diagnosis.

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Related information

    • Alzheimer’s dementia. BMJ Best Practice. bestpractice.bmj.com, last updated February 2016
    • Psychiatry. Oxford Handbook of Geriatric Medicine (online). Oxford Medicine Online. oxfordmedicine.com, published July 2012
    • Evaluation and formulation of dementia. Practical Dementia Care (online). Oxford Medicine Online. oxfordmedicine.com, published July 2012
    • Overview of dementia care. Practical Dementia Care (online). Oxford Medicine Online. oxfordmedicine.com, published July 2012
    • Assessment of dementia. BMJ Best Practice. bestpractice.bmj.com, last updated August 2016
    • Henneges C, Reed C, Chen Y, et al. Describing the sequence of cognitive decline in Alzheimer’s disease patients: results from an observational study. J Alzheimers Dis. 2016; 52(3):1065–80. doi: 10.3233/JAD-150852
    • Organic Illness. Oxford Handbook of Psychiatry (online). Oxford Medicine Online. oxfordmedicine.com, published December 2015
    • Vascular dementia. PatientPlus. patient.info/patientplus, last checked October 2014
    • Frontotemporal dementia. BMJ Best Practice. bestpractice.bmj.com, last updated October 2015
    • Frontotemporal dementia. PatientPlus. patient.info/patientplus, last checked September 2014
    • Definitions and Overview. Practical Dementia Care (online). Oxford Medicine Online. oxfordmedicine.com, published July 2012
    • Can I speak to a GP about someone else's health? NHS Choices. www.nhs.uk, last reviewed July 2015
    • Assessment of memory deficit. BMJ Best Practice. bestpractice.bmj.com, last updated February 2016
  • Reviewed by Graham Pembrey, Lead Health Editor, Bupa Health Content Team, September 2017
    Expert reviewer Professor Graham Stokes, Bupa Global Director of Dementia Care
    Next review due September 2020

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