When 76-year-old Mike Davis started forgetting to water his usually well-tended plants, he knew something wasn’t right. After seeing his doctor and undergoing an evaluation, Mike was diagnosed with mild cognitive impairment, a potential precursor to dementia. His story is not uncommon – nearly 7 million Americans are living with Alzheimer’s, the most common form of dementia, and many more may be undiagnosed. Globally, dementia is the seventh leading cause of death, according to the World Health Organization. Understanding dementia, recognizing its symptoms, and knowing what other conditions can mimic it is crucial for early detection and proper care.
What is Dementia?
Dementia is an umbrella term for changes in the brain that cause a loss of cognitive functioning – thinking, remembering, and reasoning – severe enough to interfere with daily life. It can manifest in many ways, from diminished focus and language skills to impaired judgment and altered visual perception. Dementia can also lead to changes in mood, behavior, and personality.
Alzheimer’s disease accounts for 60-80% of dementia cases, but there are several other types, including vascular dementia, Lewy body dementia, and frontotemporal disorders. It’s also possible to have mixed dementia, a combination of two or more types. Regardless of the specific diagnosis, it’s essential to see a medical expert who can conduct a thorough evaluation if you suspect dementia in yourself or a loved one.
Early Warning Signs and Symptoms
The onset of dementia is usually gradual, and the early signs can be subtle. Here are ten common warning signs to watch for:
- Difficulty with everyday tasks, like keeping track of bills or following a recipe
- Repeating questions or stories in the same conversation
- Trouble finding the right words or following discussions
- Getting lost while driving or not recognizing familiar places
- Uncharacteristic mood changes, like increased anxiety, confusion, or suspicion
- Confusion about time, date, or current events
- Frequently misplacing items or putting them in odd places
- Poor judgment with money or neglecting personal hygiene
- Withdrawal from hobbies, social activities, or work projects
- Forgetting long-term memories or important life events
A 53-year-old woman diagnosed with posterior cortical atrophy (PCA) recalls her early symptoms: “The words would not come out right—the word would be in my brain, but the wrong word would come out. And it was such a challenge for me to learn new things.” For Dan Miller, it started with typing difficulties and trouble drawing certain letters, even though he could recognize them.
These personal accounts highlight how dementia symptoms can manifest differently for each individual. If you notice a persistent pattern of changes like these in yourself or someone you love, it’s important to bring it up with a doctor.
Medical Conditions That Can Mimic Dementia
Before rushing to a dementia diagnosis, it’s crucial to rule out other medical problems that can cause similar cognitive symptoms. Some common culprits include:
- Medication side effects or interactions, especially in older adults taking multiple prescriptions
- Respiratory infections, including COVID-19, which can cause sudden confusion (delirium)
- Urinary tract infections, which may not present with typical symptoms in seniors
- Sleep disorders like insomnia or sleep apnea that disrupt the brain’s normal functioning
- Dehydration, which is common in older adults and can lead to confusion
- Normal pressure hydrocephalus, a buildup of fluid in the brain that’s often misdiagnosed
Other potential medical issues that can mimic dementia symptoms include heart, lung, liver, or kidney disorders, thyroid problems, vitamin deficiencies, some cancers, chronic pain, and depression. Many of these conditions are highly treatable, and the cognitive symptoms often resolve with proper care.
That’s why it’s so important to get a comprehensive medical workup if you suspect dementia. As geriatric psychiatrist Dr. James M. Ellison notes, “It’s very important for clinicians and patients to recognize that dementia is not a normal expected part of aging. Everyone deserves a good workup to identify treatable and reversible conditions.”
The Role of Subjective Cognitive Decline
Recent research has also highlighted the importance of subjective cognitive decline (SCD) – self-reported memory concerns – as an early indicator of future cognitive impairment and dementia. A study published in JAMA Psychiatry found that SCD was a significant predictor of mild cognitive impairment, Alzheimer’s disease, and all-cause dementia, even after accounting for genetic predisposition.
On average, SCD preceded these conditions by several years: 4.4 years for mild cognitive impairment, 6.8 years for Alzheimer’s, and 6.9 years for all-cause dementia. These findings emphasize the importance of monitoring SCD in older adults and taking memory concerns seriously, even if standard cognitive tests are normal.
Dementia is a life-altering diagnosis, but early detection is key to getting the best possible care and support. By understanding the warning signs, knowing what other medical issues can cause similar symptoms, and advocating for thorough evaluations, we can improve outcomes for those affected.
If you notice persistent changes in memory, thinking, behavior, or mood in yourself or a loved one, don’t brush it off as normal aging. Talk to your doctor about your concerns. Early detection may result in years of having a better quality of life. Remember, it’s never too early to get checked. Being proactive about your cognitive health can make all the difference in getting the care you need to navigate the challenges of dementia with support and dignity.