Early signs of dementia and when to consider care

For individuals with aging or ailing loved ones, it can be difficult to decipher the signs that it's time for professional care.

While there are certain symptoms that come with natural aging, it's important to be able to recognize signs of a more serious issue like dementia.

"The early signs are very subtle. Think about putting a pot of water on the stove and turning it all the way up. There's a point where it's not boiling and a point when when it is boiling, but in between, there's a time in there where it's simmering — not quite boiling, but not resting quietly," said Melanie Bunn, a nurse and dementia training specialist for Dementia Alliance of North Carolina. "What I mostly look and listen for are things that are different for this person. If your mom has always managed the checkbook, and now she's paying bills more than once, that worries me. I'm looking for something that's different in this person."

In addition to personality and memory changes, other early signs of dementia include challenges in problem solving, new problems with speaking or writing, apathy, poor judgment and difficulty with familiar tasks.

While the most common type of dementia is Alzheimer's disease, it's far from the only kind of dementia.

"Dementia is a syndrome, so saying someone has dementia is like saying somebody has an infection — you don't know if that means strep throat or pneumonia. Alzheimer's disease is one type of dementia, but there are lots of different subtypes of Alzheimer's disease," said Bunn. "In this field, things change, and the technology is advancing so quickly, but right now Alzheimer's disease is the most common dementia."

According to Bunn, one of the biggest misconceptions about dementia is that its most noticeable symptom is memory loss. While this is a common symptom, memory changes alone don't represent the whole picture of early dementia.

In some types of dementia, like Lewy body dementia, changes in movement are one of the first signs. This can include tremors, stiffness or flat expressions. Other types of dementia include Huntington's disease and Parkinson's disease.

"When the brain starts changing, symptoms can show up anywhere. In addition to memory loss, people also show changes in language and the ability to get their words out," said Bunn. "Another major sign is the loss in understanding of abstraction. Some people have told me the very first thing they noticed was a family member's sense of humor changed. Someone who used to have a great sense of humor suddenly doesn't understand jokes anymore."

"The prefrontal cortex, that's the frontal lobe, has all those executive functions, like impulse control and decision-making," said Bunn. "When you see problems with driving, problems managing money, problems managing appointments — that's when you know that executive function might be an issue."

For those whose loved ones begin showing signs of early dementia, professional care can help. While some of these symptoms don't necessarily indicate dementia, it's best to speak with a doctor to determine what could be behind behavioral changes.

For people moving into a caregiving role, there are a number of steps and resources that can help ease the transition.

"Build a team of people who can help you and help plan next steps. The other thing that makes a difference is letting go of being right. Realize that the person living with dementia is doing the best he or she can and not to try to change them or fix them," said Bunn. "Dementia doesn't have to take away the relationship you have with the other person, so it's all about matching what the person is able to do and managing what your expectations are."

Since conditions can change day-to-day, a person with dementia might be able to walk and get the mail one day, but struggle to do so the next. Since dementia changes how chemicals in the brain function, it's important to be fluid and patient, understanding every experience with dementia will be different.

Planning as far ahead as possible can help make the journey a little bit easier.

"There are years of things changing before that moment, and those years of changing are when we can really make changes," said Bunn. "We can make a difference early on in how we manage money, the plans we have in place for care, how we can optimize their health — by planning early, you can potentially change that person's trajectory."