The simple early signs of dementia tend to be around memory and confusion or lack of understanding. These are the classic and common signs and tend to be seen in later onset dementias, which are more typical.


Problems with memory are about the individual’s ability to recall something from their memory. It might be a word, name a place or more every day things such as the PIN number for their cashpoint card. Stress can cause temporary problems with processing thoughts, so we have all had those situations when we have walked into the kitchen and wondered what we came for. All we have to do is return to a certain point, to have the memory triggered and then we can go back to the kitchen what we went for in the first place. When somebody’s memory is forgotten, there is no retracing steps, the memory has completely gone because that part of the brain is damaged. Sometimes people can have a “false memory”, with family legends being retold all the time, the person with dementia can remember the retelling of the story, but not the original happening the story. Therefore watching somebody struggle with word finding difficulties or other forms of memory recall one of the common signs.


Another common sign is general confusion, which is linked to problems with memory, but it’s more to do with an ability to process information than to recall it. This can be things like difficulty handling money, so understanding what each of the coins are worth to pay for things in a shop. People commonly handover notes rather than coins, because the coins are too confusing and then they end up collecting a lot of change, because they don’t use it. A classic example that is given in terms of sequencing in relation to problems of dementia is the making of a cup of tea. There are things that need to be done in order in order to make a cup of tea, and although the order of some things don’t matter, if someone pours water on to a tea bag in a cup and then afterwards boils the kettle, all they have is a soggy teabag but no tea. Then offer what happens is the milk is put away in the cupboard and the box of teabags put away in the fridge.


People can also display changes in mood or personality, which can be out of character, this impart is a response to their world that for them seems to have changed, but it’s because they have changed.


The diagnosis of dementia is the process of diagnosing that there is a deterioration in the functioning of the brain, and it all depends on which part of the brain is affected will impact on how that presents. Although memory and understanding of the common signs, there can also be rarer presentations to do with visual spatial awareness and hearing. This can mean that when somebody tries to sit down in a chair, they place their body too far away, and land on the floor because they were close enough to a chair when they lowered their body down. They might also walk differently because they think the ground is either closer to them or further away than it actually is.


People can have hallucinations and either see or hear things that are not there, so maybe looking at something or seemingly hearing something and therefore talking about it as though it’s there, because it’s real to them. There are some specific dementias where hallucinations are common, in particular with Lewy body dementia, people commonly hallucinate animals.


The key issue is that something has changed, something is different. There can be lots of explanations why something is changed, it could be stress, it could be infection or it could be depression and until the diagnosis process is complete it will not be clear the reason for the change. Dementia is always a deteriorating condition, which means something must have changed in order for the deterioration to take place. Dementia is generally diagnosed once the other possibilities for the change and eliminated, leaving dementia as the only or most likely answer. The older someone is the greater their risk, therefore the more likely they are to be considered to have dementia when something changes. What this means is the diagnosis process can be very challenging for people with early onset dementia, as it would be unlikely that this would be one of the things that’s considered, as a more likely answer would be something different from dementia.


The short answer the question had you know somebody has a dementia is to investigate when something changes and find out why.