Early Signs of Dementia and When to See a Doctor

Noticing changes in your own memory, or in someone you love, can be frightening. This page can help you decide when to make a doctor’s appointment and how to prepare for it. It cannot tell you whether anyone has dementia. Only a qualified clinician can diagnose dementia, and many conditions that cause memory problems are not dementia at all. Please do not rely on online quizzes or self-tests.

What are the early signs of dementia?

The Alzheimer’s Association describes 10 early signs. It pairs each one with a typical age-related change for comparison. In our own words:

One sign alone does not mean dementia. The point is a change from what is normal for that person, especially one that makes everyday life harder.

How is normal aging different from dementia?

The National Institute on Aging (NIA) says many older adults notice they recall things more slowly, or sometimes misplace things or forget a bill. These are usually signs of mild forgetfulness. Dementia is not a normal part of aging. Serious memory problems make everyday activities hard, such as driving, using the phone or finding the way home.

The NIA suggests talking with a doctor if someone:

• Asks the same questions over and over
• Gets lost in places they used to know well
• Has trouble following recipes or directions
• Becomes more confused about time, people and places
• Stops taking care of themselves, such as eating poorly, not bathing or behaving unsafely

Some people have mild cognitive impairment (MCI). That means more memory or thinking problems than others their age, while still managing day-to-day life. The NIA says MCI may be an early sign of Alzheimer’s, but not everyone with MCI develops it.

What else can cause memory problems?

Many things besides dementia can affect memory, and some get better with treatment. The NIA lists:

• Thyroid, kidney or liver problems
• Medicine side effects
• Depression and anxiety
• Low vitamin B12 or not eating enough healthy food
• Sleep problems
• Alcohol or drug misuse
• Infections, blood clots or tumors in the brain
• Head injury, such as a concussion
• Major stress or grief, such as retirement or losing a spouse

Hearing and vision problems can also be mistaken for confusion; see our hearing guide. This is why a medical check matters. According to the Alzheimer’s Association, doctors often order blood work to check for thyroid problems, vitamin deficiencies and infection. Good sleep and treating depression are worth raising too.

Sudden confusion is an emergency

Confusion that comes on quickly, over hours or days, needs urgent medical care. It may be delirium. The VA describes delirium as a medical emergency and advises calling the person’s health care provider right away or calling 911. Signs include:

• Ups and downs in the ability to think clearly
• Trouble paying attention
• Disorganized thinking
• Being unusually sleepy, or unusually restless and agitated

This can happen to anyone, including people who already live with dementia. According to the NHS, common causes include infections (urinary tract infections are common in older people and people with dementia), stroke, low blood sugar in people with diabetes, head injury and some medicines. While you wait for help, stay with the person and reassure them with short, simple words. Do not ask lots of questions, and note any medicines they take.

How do I prepare for the doctor’s appointment?

A good appointment starts with good notes. The Alzheimer’s Association suggests bringing:

1. A list of changes in memory, mood and behavior, with specific examples and roughly when they started
2. Past and current health problems, including any family history of memory problems
3. All prescriptions and over-the-counter medicines
4. Any vitamins or supplements
5. Your questions, such as what tests will be done, how long they take and when results will come

It also helps to bring a family member or friend who knows the person well. The NIA explains that doctors may ask both the person and a family member about health, medicines, daily activities and changes in behavior. Doctors may also:

• Give tests of memory, problem solving, attention, counting and language
• Order blood, urine and other tests to look for other causes
• Check for depression or other mental health conditions
• Order brain scans such as CT or MRI
• Refer to a specialist, such as a geriatrician, neurologist, geriatric psychiatrist or neuropsychologist

The NIA notes that a cognitive assessment is a required part of the Medicare Annual Wellness Visit, which can be a natural time to raise concerns. Even the brief tests doctors use are not enough on their own to diagnose dementia. They are a first step toward a fuller evaluation, and diagnosis may take more than one visit. The NIA advises that people with memory problems return to the doctor every 6 to 12 months.

Raising the subject kindly

If you are worried about someone else, choose a calm, private moment. Talk about specific things you have noticed, framed as concern for their health rather than criticism. Suggesting a general check-up can feel less alarming. Include the person in decisions and speak to them as the adult they are. Our communication tips may help.

Talk with a doctor

If you notice changes in memory, thinking, mood or everyday abilities that are new and keep happening, make an appointment with a primary care doctor. For sudden confusion, call 911 or the person’s health care provider right away. Getting checked early means treatable causes can be found and, if it is dementia, there is more time to plan and find support. Look after yourself through this too; see our caregiver self-care guide.

This page is general information, not medical advice. See our medical disclaimer.