A question that I am often asked is: “How do I know if I have dementia?” Since the prevalence of dementia is increasing, people are worrying more about developing the condition, especially if they have already experienced dementia in their family and have witnessed the consequences.
I tend to reply reassuringly: “When was the last time you forgot or lost something?” We are all forgetful, hardly a day will pass without me losing my car key or forgetting my phone charger. Mild forgetfulness is normal, and it’s always worse if we are stressed, upset, tired or simply having a bad day.
Have you ever gone into a room to get something and then forgotten what you went in to get? My guess is that you have; and that you might have struggled to recall what you were intending to do, and then remembered, if not immediately, later the same day.
For a person with Alzheimer’s, or another form of dementia, it would be likely that they would not remember what they had gone into the room to do, or even that they had gone into the room for any specific reason. Typically, they might get involved in doing something totally unrelated to their original intention. This would be a more worrying sign indicating a type of memory loss related to organic changes in the brain.
I remember a very clear example of this happening on an occasion when I was visiting a woman in the early stages of Alzheimer’s. Engaged in our conversation about her family, she went upstairs to fetch a photograph album to show me. Twenty minutes later, when she had not returned, her husband went to find her. She was contentedly folding clothes in their bedroom, unaware that we were waiting for her to come back downstairs. She had no recollection of having gone to fetch the album, or, indeed, that I was in the house.
Difficulty with word-finding is another common symptom of dementia that can also be an everyday experience for most people at some time. That sense of having the name of a film, actor, city or artist on the ‘tip of your tongue’ but it just won’t come is an occurrence that many will identify with, and word-finding can get harder with increasing age. However, that is quite different from struggling to name an everyday object, such as a spoon, cup or kettle, which might be the case for a person with dementia.
With early dementia, a person might substitute specific words with generic colloquialisms, such as ‘thingy’ and ‘whatsit’ and ‘thingamabob’.
One person with Alzheimer’s who I worked with told me, in perfect detail, how he had been on holiday with his sister. He described the journey, how they caught the train and arrived at their destination town and then caught a cab to ….. and he couldn’t tell me where. He was able to say; “It’s a place … a building, where you stay when you are on holiday … you sleep there ….” He was trying to recall the word ‘hotel’ but his brain just wouldn’t retrieve it for him, even though he could describe exactly what the purpose of a hotel is.
It is unlikely that a person with normal forgetfulness would not remember or be able to retrieve an everyday word such as ‘hotel’.
Alzheimer's disease causes a profound problem with recent memory. New experiences do not get properly processed and stored, meaning that the person with dementia loses these memories quickly. It’s as if the immediate past just didn’t happen and providing cues and a context often will not help.
One of the tests frequently used to screen for dementia is to be told three words and then, after a few minutes, to be asked to recall these words. Prompting – by saying, for example, one of the words was a fruit – will often enable a person without dementia-related memory loss to recall the word. A cue of this kind is less likely to work for a person with dementia.
Some other common early signs of dementia include: frequent repetition, poor judgment, faulty decision-making, difficulty with handling money and paying bills, disorientation in time and place, problems with carrying out every-day tasks, getting lost in familiar surroundings.
For a person with dementia, these symptoms will become more frequent and pronounced over time, whereas a person with ‘normal forgetfulness’ will not decline significantly. Making an occasional bad decision or not being able to immediately know what day it is when you are on holiday - when every day it is the same and which day it is doesn’t matter - are not indications, in themselves, of dementia.
If, however, you feel that your memory is progressively deteriorating, or you are experiencing other cognitive difficulties, the first step is to consult your GP. There are many possible reasons for poor memory – for example, depression, anxiety, vitamin deficiency, thyroid problems, side-effects of medications can all lead to memory problems. Your GP will test for a range of causes of your problems,
Seeking help early enables treatable conditions to be remedied, and, if the diagnosis is dementia, there are some drugs that can boost memory function and enable life quality to be maintained.
If you have any questions about the early signs of dementia and when to seek help, please do get in touch: firstname.lastname@example.org