Spot the 8 subtle signs of dementia – from tantrums to word salads

FORGETFULNESS and memory loss – both things that come to mind when we think of dementia.

But did you know there are other early warnings that a loved one is suffering the devastating disease that strikes one in 11 people over the age of 65?

Snapping more often, napping in the day and walking differently are just some examples that have nothing to do with memory blips.

An estimated 982,000 people are living with dementia, the charity Alzheimer’s Research UK says, and this number is expected to top 1.4million by 2040.

Despite it affecting so many families, nearly one in four of us have no idea how dementia impacts people, found a 2023 survey for the charity.

Dementia is an umbrella term for a range of neurological conditions affecting the brain, the most common of which is Alzheimer’s.

Dr Henk Swanepoel, the lead neuropsychologist at Cygnet Health Care, says: “Over time, nerve cells are destroyed, causing damage to the brain. This results in a significant deterioration in cognitive function not due to the usual ageing process.

“Symptoms of Alzheimer’s typically first appear around the sixties or older but it can develop before 65, seen as early-onset Alzheimer’s. There is no way to be sure how quickly dementia will progress.”

So here are some lesser-known early signs to look out for . . . 

1. TEMPER TANTRUMS

SNAPPY or aggressive?

New traits such as becoming more withdrawn or anxious can be an early sign of dementia, while potential aggression tends to develop over time.

Abbas Kanani, superintendent pharmacist at online pharmacy Chemist Click, says: “You may notice increased agitation, aggression in the form of shouting or screaming, verbal abuse and sometimes physical abuse.”

In some types of dementia, like frontotemporal, changes to behaviour such as a loss of empathy and sense of humour, or becoming angry, can be signs too.

The NHS recommends keeping a diary of incidents to see if there are any triggers that upset your partner.

Abbas says: “You could monitor whether some behaviours happen at a certain time of day, whether the person may be finding their environment too noisy or cluttered, or whether these changes happen when a person is asked to do something they may not want to do.”

2. BLAME GAME

HAS your partner accused you of something, perhaps in an uncharacteristic manner?

Dr Henk says: “Patients are often paranoid, for instance believing someone is stealing from them or their spouse is being unfaithful.”

It can extend to other relatives or situations, too, for example blaming grandchildren for breaking something.

Abbas adds: “They may also experience delusions, have unusual beliefs not based on reality — or hallucinations, hearing or seeing things that do not exist.”

3. TRIP UP

YOU might put it down to clumsiness but Dr Henk says falls, slipping and tripping can be symptoms of dementia.

“Or a person is seen to be shuffling as opposed to lifting the legs when walking,” he adds.

Chemist Click’s Abbas explains that dementia affects the brain’s ability for spatial and depth perception.

He adds: “Someone with dementia may find it difficult to recognise objects or misinterpret visual information. They may become unsteady and have trouble with coordination as motor skills such as sitting, standing and walking begin to decline.”

A person’s ability to react quickly during a fall also breaks down.

4. BIG SPENDER

YOUR loved one may be able to pay for the paper each day, or lunch out, but have you noticed them making financial mistakes with their bills?

A one-off may not be something to worry about, but research shows that money problems may be one of the first signs of dementia.

More complicated tasks such as balancing a bank account become harder to do, even if daily spending is in control.

This may be because symbols, including numbers, become harder to recognise.

Researchers at the New York Federal Reserve found that in the five years before a dementia diagnosis, a person’s average credit scores may start to weaken, and missed payments rise. Individuals with dementia may also have poor judgment when dealing with money.

5. WORD SALAD

HAVE you noticed your conversations with a loved one don’t go as smoothly as before?

Dr Henk says: “We often notice that a patient might be struggling to follow a discussion or conversation, or they are unable to find the right words.”

This can be accompanied by frustration.

People with dementia may also ask the same question over and over, and forget newly learned information, acting as though it is the first time they have heard it.

Dr Henk says: “In Alzheimer’s, the disease is known to attack the hippocampus, the area in the brain where new memories are stored. Therefore a person will not be able to hold a train of thought.”

6. UNEASY FEELINGS

IF your loved one appears lost, does not know what is happening or is uneasy, it could be a sign of dementia.

Dr Henk says: “As brain cells are progressively damaged and memory declines, orientation to the environment gets affected.

“A person might believe they are still in a geographical area when they aren’t, or that they are in a relationship that does not exist any more.”

7. NAP TIME

AS dementia develops, the brain has to work harder, which could lead to your loved one needing more time to sleep.

Abbas says: “Remembering names, conversations and places takes extra mental effort and this can cause brain fatigue and, as a result, people with dementia tend to require more rest.”

Plus, poor sleep at night, caused by dementia, can leave someone exhausted and wanting to sleep more in the day.

Abbas adds: “People with dementia are also more likely to engage less in stimulating activities and this can leave them feeling bored and increase their levels of sleepiness.”

8. BAD HABITS

YOUR loved one may be paying less attention to grooming and not smell as clean as usual.

They could be neglecting to brush their teeth, without you noticing, leading to bad breath and maybe dental pain.

Some studies indicate that a specific type of bacteria found in the mouth, porphyromonas gingivalis, is linked to patients who suffer from Alzheimer’s, as well as rheumatoid arthritis.

Dr Smita Mehra, principal dentist at The Neem Tree Dental Practice, says: “Prevention is key when it comes to reducing the chance of the porphyromonas gingivalis bacteria growing within oral cavities.

“Patients should regularly see their dentists for check-ups and hygiene visits, to stay on top of treatments and to avoid any worsening of the condition by reducing the bacterial count.

“For patients in more developed stages of the disease, a chaperone or family member should be present during dental appointments or check-ups and regular appointments should be scheduled with the dentist.”