Dementia: Recognizing the Signs

Many conditions have symptoms similar to dementia. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumors can cause dementia-like symptoms. Many of these conditions can be treated, so it is important to differentiate dementia from other conditions.

For a dementia diagnosis, the best place to start would be with the person’s general practitioner. Getting a correct diagnosis at the beginning stages is very important for early treatment, support and planning for the future. A complete medical assessment might identify a treatable condition, or it might confirm the presence of dementia and whether or not it is Alzheimer’s, or another dementia-related disease, or cognitive impairment.

Example  At 79 years old, Laura had never worn make up and she never wore pants–only dresses. She answered her door one day wearing orange polyester pants, a white see-through blouse, no camisole underneath, and powdered Jell-O rubbed onto her cheeks imitating rouge.  When asked by her visiting granddaughter where she was going, she replied that she was on her way to “catch a fellow”. Was this the first noticeable sign that something was amiss? Looking back, the granddaughter realized there were other signs. But they had been attributed to “just getting older”.

The early signs of dementia are very subtle and vague. Often they might not be immediately obvious. They can vary, but there are some common early symptoms.

Memory Loss  It’s normal to occasionally forget appointments and remember them later.   A person with dementia might forget things more often or not remember them at all.

Difficulty with tasks  People can get distracted and they might forget to serve part of a meal.  A person with dementia might have trouble with all the steps involved in preparing a meal.

Disorientation  A person with dementia might have difficulty finding their way to a familiar place or feel confused about where they are, or think they are back in some past time of their life.

Language problems  Everyone has trouble finding the right word sometimes, but a person with dementia might forget simple words or substitute inappropriate words, making sentences difficult to understand. They might also have trouble understanding others.

Abstract thinking  Managing finances can be difficult for anyone, but a person with dementia might have trouble knowing what the numbers mean or what to do with them.

Poor judgement  Many activities require good judgement.  When this ability is affected by dementia, the person might have difficulty making appropriate decisions, such as what to wear in cold weather.

Spatial skills  A person with dementia might have difficulty judging distance or direction when driving.

Misplacing things  Anyone can temporarily misplace a wallet or keys.  A person with dementia might not know what the keys are for.

Changes in mood, personality, behavior  Everyone becomes sad or moody from time to time.  Someone with dementia can have rapid mood swings–for no apparent reason.  They can become confused, suspicious or withdrawn.  Some can become disinhibited or more outgoing.

Loss of initiative  It is normal to tire of some activities.  Dementia might cause a person to lose interest in previously enjoyed activities or require cues prompting them to become involved.

Six types of assessments can help to confirm or exclude a diagnosis of dementia. These are medical history, physical examination, laboratory tests, cognitive testing, brain imaging and psychiatric assessment.  After considering the person’s symptoms and ordering tests, the doctor might offer a preliminary diagnosis or refer the person to a neurologist, geriatrician or psychiatrist.

Sometimes, your friend or family member might refuse to visit the doctor to ask about their symptoms.  You can take a number of actions to get support including talking with other caregivers who might have had to deal with similar situations, or by contacting your local Alzheimer’s or dementia association at 479 783-2022, or calling Arkansas Alzheimer’s Caregiver Helpline at  501 913-1878.


Melissa Curry is a certified dementia practitioner manager and assisted living administrator at Methodist Village Senior Care. For additional information or for caregiver dementia training, call 479 414-2093, or email

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