Dementia: Early Warning Signs

Memory lapses are common among older adults, but they can cause anxiety among those who may wonder if the lapses are just normal signs of aging or signs of dementia.

A 2019 National Poll on Healthy Aging found that nearly 50 percent of respondents ages 50 to 64 were concerned about developing dementia, an umbrella term for a gradual decline in mental ability.

Dementia is a neurodegenerative disease that causes the death of neurons in the brain or spinal cord, which leads to a loss of memory, reasoning, and language. While there are different types of dementia, the most common dementia is Alzheimer’s disease, which researchers believe develops due to amyloid plaques and tangled fibers in the brain, and a loss of connections between nerve cells. An estimated 7.4 million Americans are living with Alzheimer’s disease, according to a 2026 report from the Alzheimer’s Association.

Biological changes due to Alzheimer’s can begin in the late 50s, a condition known as early-onset or younger-onset dementia. This is long before memory loss or overt symptoms appear.

A 2026 Mayo Clinic study found that Alzheimer’s-related signs may appear in two distinct “windows” long before the disease is diagnosed:

1. The first window occurs in the early 60s and involves cognitive decline and the accumulation of amyloid plaques, which are aggregates of abnormal proteins that form in the spaces between nerve cells.

2. The second window occurs in the late 60s or early 70s and is characterized by a buildup of tangled tau protein, brain atrophy, and changes in blood-based biomarkers.

“Knowing when these biomarkers start to change, and when they relate to cognitive impairment, helps point us to the ages when prevention screening could have the greatest impact,” Dr. Jonathan Graff-Radford, chair of Behavioral Neurology at Mayo Clinic and senior author of the study, said in a press release.

Researchers have described the buildup of amyloid plaques and tau tangles as the “trigger and bullet” in the development of Alzheimer’s disease.

Warning Signs of Dementia

Dementia is not inevitable, and older adults should not “be too upset at every little cognitive change,” Dr. John Dickson, a neurologist at Massachusetts General Hospital in Boston, told AARP.

Some dementia symptoms are subtle, such as “not using things for their correct and intended purpose,” Dr. Whitson told AARP. For example, a person might eat with a spoon rather than a fork, or pour wine into a beer glass.

While other signs of dementia are not-so-subtle, such as delusions or hallucinations —“particularly visual hallucinations, like seeing people or animals that aren’t there,” Dr. Dickson told AARP.

Dr. Dickson added that recognizing the warning signs of dementia is important for a timely evaluation of you or a loved one. Some of the signs to look out for include:

Short-term memory loss

It’s not unusual to forget where you parked your car in the store’s parking lot. However, forgetting the next day that you went somewhere at all is cause for concern.

According to Dr. Judith Heidebrink, a neurologist and clinical professor at the University of Michigan Health, short-term memory loss is a common symptom of dementia because the hippocampus, the part of the brain that stores short-term memories, is affected early in the disease process.

Difficulty holding conversations and remembering words

Sometimes older adults find themselves searching for the right word for something, even though it’s right on the tip of the tongue.

The problem comes when it keeps happening, and people replace words that don’t fit the conversation, according to Dr. Heather Whitson, a professor of medicine at Duke University School of Medicine and director of the Duke Center for the Study of Aging and Human Development. For example, someone might ask, “Have you seen my jacket?” But when that individual cannot find the word for “jacket,” Dr. Whitson said the person asks, “Have you seen my shirt?”

Along with the loss of words, Dr. Heidebrink mentioned that another early symptom of Alzheimer’s is difficulty joining, following, and completing conversations.

Personality changes

A sudden loss of interest in family, friends, work, and social activities from someone who was once outgoing and energetic may serve as an early warning sign of dementia. These individuals may eventually begin to isolate themselves from others.

“People may feel less comfortable in social situations—holding a conversation, remembering the conversation—so they may start to withdraw from social situations,” Dr. Heidebrink told AARP.

They may also begin to withdraw because of depression, another red flag of Alzheimer’s. The Alzheimer’s Association reports that up to 40 percent of people with Alzheimer’s disease suffer from significant depression.

Financial missteps

One of the first things to watch for when someone is developing dementia or Alzheimer’s disease is trouble managing finances, according to the National Institute on Aging (NIA).

“There’s a lot of reasoning and memory that go into financial tasks, and so [money management errors] can certainly be an early way that people experience changes,” Dr. Heidebrink told AARP.

According to the NIA, signs of money problems can include difficulties with the following:

A worsening sense of direction and time

Losing a grip on daily activities, such as driving, reading, and judging distances, is an early symptom of dementia. Several examples that serve as “red flags” include:

• Changes in judgment and decision-making that can affect everything from managing finances to an individual’s appearance and self-care abilities, the Alzheimer’s Association says.

• Forgetting where you are and how you got there.

• Forgetting what day of the week it is, which is an example of disorientation about time, is a worrisome sign, according to Dr. Jason Karlawish, a neurologist and professor of medicine at the University of Pennsylvania Perelman School of Medicine and co-director of the Penn Memory Center.

When it comes to time, Dr. Heidebrink added that another warning sign is not being able to make sense of the time on a clock.

What to do if you notice symptoms

If you are concerned about any changes in your thinking and memory, or those of a loved one, medical experts recommend talking with your doctor as soon as possible.

“There are many possible causes of these changes,” Dr. Heidebrink told AARP. “Not every case where someone is experiencing these changes is automatically Alzheimer’s disease, for example. There could be other causes—a medication side effect, a metabolic hormone imbalance, something else that could be treatable.”
If your doctor thinks you might have Alzheimer’s or another kind of dementia, your doctor might try some different approaches to help diagnose it, including:

For a more comprehensive evaluation and accurate diagnosis, your doctor might refer you to a specialist, like a neurologist or a geriatric psychiatrist.

Source Links:

https://www.aarp.org/health/conditions-treatments/dementia-warning-signs/
https://www.huffingtonpost.co.uk/entry/age-early-dementia-sgns_uk_69f1c878e4b0e475dfdda443?ncid=APPLENEWS00001
https://newsnetwork.mayoclinic.org/discussion/at-what-age-does-alzheimers-disease-begin-mayo-clinic-study-points-to-changes-decades-before-symptoms/