Identifying the initial symptoms of dementia is a critical step for families and healthcare providers, as early detection allows for interventions that can delay severe progression and help maintain quality of life. While memory loss is a well-known red flag, experts highlight several other, often overlooked, early warning signs that are equally important to recognise.
Beyond Memory Loss: The Overlooked Early Indicators
The Alzheimer's Society in the UK emphasises that while there is currently no cure for dementia, spotting the early signs remains vital. An early and accurate diagnosis is becoming increasingly important with the advent of new disease-modifying treatments in clinical trials. Furthermore, there are many ways to support people to live well with the condition.
According to insights shared by The New York Times and reported by Surrey Live, there are five symptoms frequently experienced in the early stages that can easily be missed. It is crucial not to dismiss these signs if they persist over time or occur in combination.
1. Shifts in Personality and Behaviour
Research led by Professor Angelina Sutin from Florida State University found that personality changes often precede noticeable cognitive decline. The study noted decreases in traits like extroversion, agreeableness, and conscientiousness, with these shifts accelerating as dementia progresses. In practical terms, this might manifest as social withdrawal or a shrinking circle of friends, changes that can be easier for loved ones to spot than subtle memory lapses.
2. New Difficulties with Driving
Struggling behind the wheel can be one of the earliest signs of cognitive decline, potentially emerging years before other symptoms. Professor Ganesh Babulal, a neurology expert at Washington University in St. Louis, explains that driving engages multiple cognitive systems. Any impairment can increase accident risk. While other age-related issues like poor vision may be a factor, new or worsening driving problems warrant attention.
3. A Deteriorating Sense of Smell
A diminished sense of smell is a common early indicator of neurodegenerative diseases like Alzheimer's, dementia with Lewy bodies, and Parkinson's. The olfactory system can be compromised years or even decades before other symptoms appear. Unlike hearing or vision loss, which are risk factors, smell loss is a direct early sign. The nature of the loss varies: in Alzheimer's, smells are detected but not correctly identified, while in Parkinson's and Lewy body dementia, they may not be perceived at all.
4. Significant Sleep Disturbances
While sleep issues are common in older age, drastic changes can be a warning sign. Waking up repeatedly at night or struggling to stay awake during the day could signal dementia. In Alzheimer's, areas like the brainstem that regulate sleep are among the first affected. In dementia with Lewy bodies and Parkinson's, a condition called REM sleep behaviour disorder may develop, where a person physically acts out dreams, sometimes violently. Neurologist Ronald Postuma clarifies this is distinct from sleepwalking and is often reported by a concerned partner.
5. Unexplained Financial Problems
When financial troubles coincide with other behavioural changes, they can be an early signal of dementia. It is not that money issues cause the disease, but sudden problems with judgement and brain function can manifest financially. This might include forgetting to pay bills, making uncharacteristically impulsive purchases, or placing trust in unreliable individuals. Neurologist Winston Chiong notes that managing finances involves multiple brain regions, making it one of the first domains where cognitive problems become evident, particularly in frontotemporal dementia.
The Importance of Proactive Action
Recognising these five signs—personality changes, driving difficulties, loss of smell, sleep disturbances, and financial mishaps—provides a broader toolkit for early detection. If you or a loved one are experiencing several of these symptoms persistently, seeking a professional health evaluation is a crucial next step. Early diagnosis opens the door to support, planning, and potential future treatments, helping individuals and families navigate the path ahead with greater confidence and resources.
