I’m A Neuropsychologist: 13 Soft Signs Of Dementia You Shouldn’t Ignore

August 8, 2023

As we grow older, many of us begin to worry about whether we will develop dementia—an umbrella term related to changes in cognition that impact one’s ability to live on their own.

There are several types of dementia out there, and knowing what some warning signs of each are can be helpful when evaluating changes in your own self or others. Being aware of these signs can also help you catch developing dementia early, which may allow you to slow disease progression.

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This type of dementia is the most well-known and most diagnosed. We hear about Alzheimer’s dementia often—in the news, from friends or family navigating a diagnosis, or from those looking for early signs. Although memory change is often the focus of dementia, Alzheimer’s can present itself in very different ways.

For some people, they may begin to make mistakes with their medication management. This could lead to a series of hospitalizations that look like other issues but are actually related to mismanagement of this ability.

You may notice they begin to repeat themselves in conversation or often struggle to find the words they want to say.

Another sign that may go unnoticed is that someone may start to get into minor car accidents due to changes in their perception of space, forgetting routes they take, or getting lost because they forget where they were headed in the first place.

Lastly, unlike those with other types of dementia, individuals with Alzheimer’s usually do not think they have problems with their thinking. They may become defensive about changes that seem obvious to others. Therefore, family members are usually the first to notice these changes rather than the person who has the cognitive issues.

To recap, some soft signs that could indicate Alzheimer’s dementia include:

1. Mismanaging meditation
2. Getting into car accidents or getting lost driving
3. Repeating onseself in conversation or struggling to find the right words
4. Getting defensive about memory challenges

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Lewy Body Dementia is the second most diagnosed dementia, and it’s closely related to Parkinson’s Disease. What sets it apart from Parkinson’s disease is that with BLD, cognitive changes begin before noticeable changes in motor movements, or they begin within the same year as motor changes. Examples of common motor changes can include tremors, rigidity, or slowness in walking.

Some soft signs of LBD include fluctuating alertness during the day. This can look like a person starting to take naps more frequently than in the past, and they may seem tired despite said naps.

Additionally, if someone sleeps with them, the partner may notice symptoms of REM sleep disorder which causes individuals to move around in their sleep. At times this can even involve accidentally hitting their partner during sleep, and having increased nightmares.

They may also begin to develop visual hallucinations of well-formed things, like people or animals they have lost. Other soft signs include changes to autonomic function such as having constipation, sweating more frequently, or feeling cold more often.

Beginning to have issues with balance may lead to more frequent falls. Another soft sign of LBD is a reduced sense of smell (but with that said, a reduced sense of smell can be a common sign of several types of dementia).

To recap, some soft signs that could indicate LBD include:

1. Walking more rigidly or with a tremor
2. Struggling with balance
3. Fluctuating alertness during the day
4. Moving around a lot during sleep and having more nightmares
5. Having hallucinations
6. Having a reduced sense of smell

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Out of all the dementias, Frontotemporal Dementia has the widest variety of potential initial symptoms. In general, though, behavior changes are a key marker of FTD. These changes usually occur earlier in age (40-65) vs. Alzheimer’s where symptoms can present slightly later.

Behavior changes can be more impulsive, such as spending excessive money or developing addictions to porn, gambling, or video games later in life that are not consistent with past behaviors.

FTD can also make a person seem more withdrawn. They may stop participating in aspects of life they used to enjoy. We also see them stop talking as much in conversation, show childlike characteristics, and demonstrate a lack of empathy toward others. These changes can often be mistaken for psychiatric issues like depression or mania, but the key here is that these behaviors are new in older age.

There is another subtype of FTD that involves greater changes to language than Alzheimer’s. In this case, if a person initially has changes to their ability to engage in conversation and has word-finding issues, but their memory still presents as functional, it can indicate that language variant FTD may be present.

To recap, some soft signs that could indicate FTD include:

1. Sudden changes in behavior in older age (spending more money, developing addictions)
2. Having a sudden lack of empathy toward others
3. Developing slow, childlike characteristics

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While there is not enough space to discuss every dementia out there, the biggest thing to remember is that just because you have a lapse in your memory one day, forget a name on occasion, or have trouble finding the word you want to say in conversation from time to time, it does not always mean you are developing dementia.

Many factors in our everyday lives can impact our thinking sporadically such as poor sleep, not eating enough, getting too much sun exposure, missing a medication dose, having an infection, etc.

If you show any of the signs discussed above, you should seek a trusted primary care doctor, neurologist, or neuropsychologist to assess the root cause of the change. It is also important to remember that early detection can lead to a better and safer quality of life, and can allow for important decisions about someone’s end-of-life care before they lose their capacity to make those decisions themselves.

Furthermore, when we detect dementia early, we can intervene to provide support to both the person impacted by the disease and their care team, which usually involves several family members. Not intervening early in the disease process can lead to caregiver burden and burnout.

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