Subtle signs of dementia

Many people are familiar with the early signs of dementia, with the most noticeable being confusion and forgetfulness, but there are more subtle signs that your loved one is in an early stage of dementia. 

Many of these can be mistaken for signs of a mental health issue, such as depression, or as a natural part of ageing.

‘What are you talking about?’ moments

Dementia does not progress in a steady and predictable way. To begin with, your loved one may have moments every now and then where they seem confused or disjointed from reality. 

This can include:

• They might say something strange or muddled that makes you say, “What are you talking about?” before they snap out of it
• Likewise, they may do something out of the ordinary with no logical reason, or their reasoning is confused
• You notice these occurrences happen more at times when they are particularly tired, stressed or upset

Becoming childlike

People with early dementia can appear to regress in age, in both their memories and behaviour. As well as talking increasingly about the past, you may notice your loved one become quite childlike.

They may become difficult and irrational, particularly with their attitude to responsibility and authority as they begin to lose their reasoning and problem-solving abilities. 

Childlike behaviours could include:

• They start to treat you as if you were their parent
• They use expressions like, “You’re telling me off,” and, “Why should I?” that you would expect to hear from a child, and even have tantrums. This can be a sign that they are losing the cognitive ability to see others’ perspectives or understand actions and consequences
• Conversely, they may become far more meek and mild than usual. Any change in personality could be an early sign of dementia
• They become clingy and dependent

Treating others badly

Some, but certainly not all, people with dementia can become apathetic towards others as the disease progresses.

If your loved one has been starting to treat people badly, it could be a sign of dementia. Look out for signs such as:

• Coming across as cold or rude
• Being critical or making hurtful jokes
• Treating you like a servant
• Not respecting personal space. They get too close when they are talking or invade your privacy
• People they know are becoming one-dimensional characters, sometimes mentally categorised into good and bad people 

If this behaviour is because of dementia, it is part of the illness and they are not doing it intentionally.

Taking risks

Dementia can cause people to show risky, even dangerous behaviour. Damage to the brain, particularly to the frontal lobe, can affect a person’s ability to ‘filter’ what they say and do. They can become reckless, easily bored and in need of thrills to feel fulfilled, without much fear of consequences.

You may notice:

• Dents and scratches appearing on their car, or you see them driving more recklessly
• Stealing small items like an ornament from a charity shop or a glass from a restaurant. Items from friends’ homes may pop up in their house
• Crossing the road without looking
• Talking to strangers much more than usual
• Becoming much more outgoing
• They are smoking or drinking more than usual
• A shorter attention span

Revealing secrets

As mentioned above, damage to the brain, including dementia, can cause people to lose their inhibitions. This can make people loose-lipped as they find it harder to differentiate between what they should and shouldn’t say. It can even feel like it is out of their control, as their mouth is working faster than their brain and they may say things unintentionally that they later regret.

This can be:

• Telling you private information that they’d usually keep to themselves or oversharing
• Revealing long-buried secrets that they’d never spoken about before
• Gabbling, particularly when they are nervous
• Telling the truth all the time, even to detriment. For example, instead of being tactful, saying something insulting as it is their honest opinion
• Getting carried away with stories and elaborating them with details you know aren’t true

Their home is messy

Lack of self-care can also be a sign of depression, mental health or even addiction issues. It can also be a sign of early dementia, as the person becomes muddled and less able to cope with everyday tasks.

You may notice:

• Their house is untidy and/or unclean
• Objects have been put in strange places, like their keys are in the fridge or they’re putting dirty laundry in the dishwasher
• They are wearing the same clothes for days on end
• They appear unclean and dishevelled
• Their fridge is full of rotting food

Contrariwise, somebody who was never previously particularly into housework may become fixated on keeping things clean and orderly. As well as being a sign of OCD, obsessive behaviours and rituals can be a sign of dementia.

Conversations are more difficult

Dementia can affect a person’s language abilities. You may notice that conversations with your loved one are becoming more difficult and flowing less freely, for reasons such as:

• They don’t understand when you make jokes or use sarcasm
• They find it hard to find the right word (this is called aphasia) or what they’re trying to say is jumbled
• They repeat the same stories and questions
• Conversations have become one-sided. This could be because they can’t recall what they have been doing or because they don’t seem interested in what you have to say. They might dismiss you very quickly
• They don’t seem fully present and have a glassy, vacant look in their eyes

They stop using household appliances

Somebody with dementia can forget how to work everyday household items. You might see that:

• They are using old gadgets rather than new ones, such as they’re listening to cassette tapes again instead of using their phone for music, or the hob rather than the microwave. People with dementia often lose more recent memories first, but can still remember older ones very well
• They make excuses or pretend they have lost interest in things they can’t remember how to work
• They phone you to ask how to work things that they were fine with before
• They think items are broken when they aren’t. An example scenario could be they say their lights aren’t working when actually they are dimmed right down, or their computer isn’t working because they’re trying to use the TV remote to turn it on

Appearing drunk

As with the ‘What are you talking about?’ moments, people with dementia can have episodes of being extremely confused that come and go. You might arrive while they are having one of these episodes and think they are drunk, as they are showing symptoms such as:

• Confusion
• Forgetfulness
• Moodiness and aggression
• Being dreamy and absent
• Slurred speech
• Impulsivity

Irregular sleep

Dementia can mess with a person’s natural body clock and their ability to tell and manage time.

Strange behaviours can include:

• Irregular sleep. They may start to have insomnia, or sleep more in the day and less at night
• Sleeping a lot more
• Doing things at odd times, like putting their pyjamas on at two in the afternoon
• Asking you what the time is instead of looking at the clock themselves
• Becoming obsessive about checking the weather forecast