While forgetting to pay the occasional bill or misplacing your keys may be normal signs of aging, it’s important to recognize the warning signs of a more serious condition like dementia.
Dementia, which is not a disease in itself but rather a common set of symptoms that applies to multiple diseases, affects around 10.9% of adults older than age 65. By age 85, that number rises to 33.4%. With dementia so prevalent, how do we know what to watch out for in ourselves and our older loved ones?
In this article, Ability Central shares the most common symptoms of dementia, including how these symptoms change as someone goes through dementia’s three stages.
We answer your most frequently asked questions about dementia, including:
What are the symptoms of dementia?
What are the stages of dementia?
Why does dementia affect everyday activities?
Can dementia be prevented?
When should I talk to a doctor about dementia concerns?
How is dementia diagnosed?
Where can I get more information about dementia?
What are the Symptoms of Dementia?
Because dementia is not a singular condition, someone’s symptoms depend on the type of dementia they have and which parts of the brain their dementia affects. Plus, most dementias have three stages—early, middle, and late—with their own sets of symptoms.
As we mentioned in What is Dementia? 8 Things You Should Know, the most common symptoms of dementia are memory loss, difficulty communicating, mental health problems, and behavioral or personality changes.
Later in this article, we’ll break down the most common physical, cognitive, and psychological changes associated with the five main types of dementia.
What are the Stages of Dementia?
Most dementias carry three stages: early, middle, and late-stage dementia. These may also be called mild, moderate, and severe dementia.
No two people experience the stages the same way. Some symptoms may start out mild and slowly grow worse over time. Others may come on suddenly and worsen rapidly. The key to getting the most out of life with dementia is early recognition and treatment.
Early-Stage Dementia
Because symptoms start out so subtly, someone with early-stage dementia might not notice anything is wrong. Typically, family members, colleagues, or friends notice someone’s early dementia symptoms first.
Early-stage dementia symptoms include difficulties with:
Memory
Making plans
Thinking clearly
Following conversations
Orientation (getting lost or not recognizing their surroundings)
Vision or depth perception
Mood changes, particularly anxiety, depression, and fear
People with dementia have the most control over their thoughts and future plans in the earliest stages, so it’s important to use this time to make legal and financial plans. To learn more about these critical planning steps, see The 9 First Steps to Take After a Dementia Diagnosis.
Middle-Stage Dementia
In the middle stage, dementia symptoms are noticeable and may impact someone’s independence. They may need more help completing day-to-day activities and setting routines. Middle-stage dementia tends to be the longest stage, lasting about two to four years.
Thinking, memory, and behavioral problems become more apparent in the middle stage. In addition to worsening early-stage symptoms, middle-stage dementia symptoms include difficulties with:
Recognizing faces, even of well-known friends and family members
Routines and everyday actions, like using the toilet
Finding the right words or repeating themselves in conversation
Forgetting what they’re saying mid-sentence
Confusion about their location, including the time of day
Wandering and getting lost, even in familiar places like their home or neighborhood
Mental health, particularly apathy (not caring about things), anxiety, and major depression
Delusions, or strongly believing in things that aren’t true
Hallucinations, usually visual rather than auditory (especially common in Lewy body dementia)
Managing emotions and reactions
Sleep, like difficulty falling asleep or waking up in the middle of the night thinking it’s morning
Agitation, restlessness, screaming, or shouting, often with no obvious cause
Movement, like slowed walking or a higher risk of falling
Inappropriate behavior, like blurting out offensive things or taking off their clothes in public
People in the middle stage of dementia may struggle with losing their independence. They may lash out, get upset easily, or have other personality changes. Someone with middle-stage dementia may need more day-to-day help or professional care, and adjusting to these new routines can be hard on the person, their family, and their caregivers. It’s important to stay patient and understanding during this stage for those reasons.
Late-Stage Dementia
In the final stage of dementia, lasting about one to two years, someone’s symptoms severely impact their life. Eventually, most people with late-stage dementia need full-time care through home assistance or a memory care facility.
Late-stage dementia symptoms include:
Significant memory problems, including forgetting things that just happened
Time shifting, or believing they’re in an earlier time of their life, like childhood
Problems recognizing even the most familiar people and places, like their spouse, their home, or their own reflection
Language problems, like no longer speaking their second language, speaking only a few words at a time, or not speaking at all
Loss of bladder control (incontinence)
Difficulty understanding nonverbal communication, like gestures or facial expressions
Severe depression and apathy
Delusions that get more extreme or outlandish
Hallucinations, both auditory and visual
Aggression, even toward caregivers or loved ones
Difficulty completing everyday actions, like eating, washing, dressing, or using the toilet
Difficulty maintaining a healthy weight, if they have trouble eating or swallowing
Physical problems, like walking slowly, shuffling, or falling frequently
Often late-stage dementia’s biggest problem is altered perception, when someone doesn’t recognize their surroundings, the people taking care of them, or where they are in time. Someone in the final stage of dementia may think they’re back in their childhood years or that doctors or caregivers are trying to hurt them. This can be extremely distressing, not just for the person with dementia, but for the people who love them.
If you are a caregiver, friend, or family member of someone with late-stage dementia, it’s critical to take care of your mental health. Learn more about finding a support group or other options for caregivers in Long-Term Planning for People With Dementia.
Why does Dementia Affect Everyday Activities?
Dementia and the diseases that cause it are progressive and neurodegenerative, meaning they cause brain damage that gets worse over time. These conditions can completely change someone’s lifestyle or personality. This includes forgetting even the “simplest” tasks that we do without thinking, like swallowing, speaking, or remembering.
The reason for this is nerve damage in the brain. Nerve cells, their connections to the brain, or the blood vessels that feed the brain break down, damaging the parts of the brain that control these tasks. For example:
Damage to the hippocampus, common in Alzheimer’s disease, affects memory and information retention.
Damage to the amygdala, common in late-stage Alzheimer’s disease, affects emotions, fear, and the fight-or-flight response.
Damage to the frontal lobe, common in most forms of dementia, makes it harder to recognize people, places, and objects.
Damage to the brain’s blood vessels, the cause of vascular dementia, can have wide-reaching symptoms, but the most common are difficulties with concentration, planning, and clear thinking.
Damage to the frontal or temporal lobes, the cause of frontotemporal dementia, affects someone’s interest in activities or being social, behavior management (impulse control), and language.
The type of brain damage and severity of symptoms depends on someone’s type of dementia. To learn more about the different kinds of dementia, see What is Dementia? 8 Things You Should Know.
Can Dementia be Prevented?
While dementia cannot be 100% prevented, the best way to limit your risk of developing the disease is to understand and treat common risk factors like obesity, heart disease, or substance abuse.
In addition, researchers have identified a few ways for older adults to improve and maintain their cognitive function, or in other words, exercise their brains. These include:
Reading
Playing board games or video games
Crafting
Learning a new hobby, like crochet or embroidery
Practicing tactile skills, like building with Legos or clay-working
Working or volunteering
Committing to regular social time with friends and family
Getting regular exercise, especially outdoors
To learn more about dementia risk factors, see What is Dementia? 8 Things You Should Know.
When Should I Talk to a Doctor about Dementia Concerns?
If you’re worried about forgetfulness and other symptoms in yourself or a loved one, never hesitate to bring your concerns to your doctor. A good rule of thumb is that if your symptoms are interfering with your everyday life, it’s time to talk to someone about a diagnosis.
Seeing a doctor as soon as possible is the key to making the most out of life with dementia. Early detection and treatment can help people maintain their independence for as long as possible. It’s the best way to have more time to manage financial and long-term care decisions, make lifestyle changes, and spend time with family and loved ones.
To learn more about what to do when diagnosed with dementia, see The 9 First Steps to Take After a Dementia Diagnosis.
How is Dementia Diagnosed?
A dementia diagnosis often means diagnosing an underlying condition like Alzheimer’s or Huntington’s disease. A good place to start is with your general practitioner, primary care provider, or family doctor. They will provide the first round of testing, then possibly refer you to specialists like neurologists for additional testing.
Common tests for dementia include:
Cognitive and neuropsychological tests, which measure thinking ability and skills like memory, reasoning and judgment, language, concentration, and orientation.
Neurological evaluations, which evaluate memory, visual perception, problem-solving, language skills, attention difficulties, movement, sensory input (smell, taste, hearing, etc.)
Brain scans, like CT, MRI, and PET scans. These pictures of the brain help doctors identify things like protein structures, damage from a stroke, and patterns of brain activity.
Lab tests to rule out other conditions, like blood tests, spinal fluid examinations, or tests for vitamin amounts and thyroid function.
Psychiatric evaluations, to get a full picture of mental health.
To learn more about dementia treatment, see The 9 First Steps to Take After a Dementia Diagnosis.
Where Can I Get More Information about Dementia?
To connect with doctors, nonprofits, and research organizations, use the Ability Central Service Locator tool. This nationwide database provides contact information for organizations that serve people with disabilities like dementia.
In addition, check out Ability Central’s other resources on dementia:
Additional Information
The content provided in this article is for informational purposes only and is not intended as a substitute for legal, medical, or other professional advice. While we strive to provide accurate and up-to-date resources, some information may become outdated or incomplete. Always consult with your provider about personal medical concerns.
