Identifying Signs of Dementia in Loved Ones

How to tell the difference between normal aging behaviors and acts that suggest a cognitive issue may be to blame.

Caring for older individuals can be challenging and it can be especially difficult to know when new behaviors and interactions signal that a loved one is suffering from a condition beyond the normal aging process.

ROUTINE FORGETFULNESS

First, let’s be clear that everyone forgets things sometimes. This includes not remembering where you left your cell phone or keys or other belongings or even forgetting the name of someone who you were introduced to five minutes ago. Normal aging can bring about these routine memory problems more frequently as brain processing speeds decline and multitasking becomes more taxing. There are, however, signs that medical professionals have identified that can help caregivers distinguish between normal characteristics of aging and the possibility of dementia or another cognitive issue.

The presence of these signals suggests the person should be assessed by a healthcare professional. Lisa Weitzman, director at the Benjamin Rose Institute on Aging, outlines certain situations that can help someone decide what to do if you start to see new behaviors from aging family members, friends, or even colleagues.

UNDERSTANDING THE LANGUAGE

Before offering guidance, though, it’s important to clarify a few helpful terms to understand about the brain and aging.

• Dementia is an umbrella term for all cognitive diseases, such as Alzheimer’s, fronto-temporal dementia, dementia with Lewy bodies disease, etc.

• A geriatric assessment performed by a trained medical professional can diagnose specific cognitive diseases and can include evaluation of physical, cognitive, affective, social, financial, environmental, and spiritual components that influence health.

• Mild cognitive impairment can be associated with regular aging characteristics, or it can be a precursor to dementia. Signs of mild cognitive impairment can suggest it’s time to evaluate what’s happening in the brain with regards to plaque buildup.

• If a disease is diagnosed as being early stage, it means that the disease has not progressed beyond the beginning stages. Earlier diagnoses can offer more pharmaceutical interventions that can slow the progression of the disease.

• In contrast, early diagnosis means the condition was just recently diagnosed, it doesn’t reflect how much the disease may have progressed. In fact, the disease may have just been diagnosed, but it may be fairly far along.

INTERPRETING THE SIGNS

Here are six situations that describe behaviors that you might experience with older individuals who you are in contact with, whether you are their caregiver, or friend or family member. The recommendations may help you decide whether it’s time to suggest a geriatric assessment for a loved one or to consider another step, such as having an aging individual’s vision examined or testing for a urinary tract infection.

• My mom can’t remember the words for certain common activities and things.

Losing your ability to find the right word and not being able to communicate well and quickly can be a normal sign of aging. For instance, your mom forgets the word for tennis, but it comes back to her as she’s describing the match she watched on television last night.

However, if she never recalls the term and she’s displaying similar language lapses more often, it may be a dementia issue.

• My father keeps losing track of where he is while telling stories and sometimes, he goes back to a conversation that we were having 10 minutes earlier.

These occurrences could be characteristics to worry about if they are a new problem. If he’s always been easily distracted in these ways, it’s not a sign of something new happening in the brain.

However, if suddenly he is all over the place, that can suggest a cognitive problem and he should be assessed.

• My aunt lives nearby but won’t come to our family holiday celebrations anymore.

As we age, most of us become wearier of social obligations and that’s generally normal aging. There could be issues with transportation or other explanations for your aunt to be rejecting these invitations. However, if she is withdrawing from all social activities and rejecting most interactions that she used to embrace, cognitive problems may be at play. Withdrawal is a significant marker. Your aunt may be aware that she is repeating herself and not remembering people’s names and therefore is trying to keep herself out of those situations.

• I found a small garden tool in my mother’s refrigerator.

This is only really a cause to worry if this type of thing happens more than once. Everyone can misplace something or put it away in the wrong place because their mind is thinking about something else at that moment.

However, not being able to remember that you left something in the wrong place over and over may suggest cognitive disfunction.

• My dad couldn’t find the vet he’s been driving to for 10 years.

This is a sign that he is getting confused in his own daily life. If someone is getting lost and forgetting where they are this indicates it’s time for an assessment. Other common problems that could signal issues with executive function include not paying bills, not following up on doctor appointments, failing to fill prescriptions, and not going to the grocery store.

• My uncle is telling me about investments he’s making with his friend and he’s never mentioned investing or even finances to me until a month ago.

This can become a really big issue because one of the earliest signs of cognitive decline has to do with money and numbers. These problems can show themselves through a lack of awareness of finance safety, not understanding the value of money, or even with difficulty paying the bills or other problem-solving activities.

Finally, Weitzman said there’s one additional thing to pay attention to, and that is how caregivers are feeling. If a longtime caregiver is suddenly feeling exhausted and frustrated after engaging with the individual that suggests changes may be occurring and it may be an appropriate time to bring the aging individual in for an assessment.

Please reach out to one of our advisors to discuss caring and planning for aging individuals in your life.