When someone is concerned either about themselves, a family member or friend, one of the first questions they ask is “what are the warning or early signs of dementia?” The answer isn’t straightforward as each person will experience dementia in their own way and the symptoms and rate of progression will vary from person to person. This makes perfect sense as everyone has their own personality, values and life experiences. But what I didn’t appreciate until Mum got ill, is that the type of dementia a person has, will also have a fundamental impact on the earlier symptoms they experience and the care and support they will need.
What are the early stages of dementia?
While everyone is different, the biggest factor in the early symptoms a person experiences is the type of dementia they have, as each type affects a different part of the brain. For example in Alzheimer’s disease, the first part of the brain to be affected is the hippocampus, which plays a role in the formation of new memories and so one of the main earlier symptoms is memory lapses and forgetfulness. However the hippocampus isn’t as affected in the earlier stages of dementia with Lewy bodies and so day to day memory usually remains fairly intact.
So below is a summary of the more common earliest symptoms a person may experience.
- Short term memory loss, which can lead to people repeating questions.
- Mislaying items or getting lost in familiar surroundings.
- Struggling to find the right words or follow conversations.
- Problems with judgement, planning and decision making.
- Losing track of the day and /or time of day.
- Mood changes becoming more withdrawn and anxious.
There are many types of vascular dementia which all progress differently, however common earlier symptoms include:
- Problems with concentration, thinking, organisation and planning which result in difficulty performing daily tasks.
- May become anxious, depressed or more emotional than usual.
Changes or ‘fluctuations’ in cognition (awareness and concentration). The person will swing from a state of alertness to appearing drowsy and/or confused, as well as having a reduced attention span.
- Problems with planning and organisation, resulting in difficulty performing daily tasks.
- Recurrent visual hallucinations, such as seeing shapes, colours, people or animals that aren’t there or conversing with deceased loved ones.
- Problems with movement, such as stiff joints, similar to Parkinson disease.
- Repeated falls and fainting.
- Sleep disturbances.
There are 3 types of frontotemporal dementia –
- Behavioural variant FTD (bvFTD) causes problems with behaviour such as a lack of social awareness and/or obsessive behaviour.
- Semantic dementia (SD) and Progressive nonfluent aphasia (PNFA) cause problems with language so someone will have difficulty finding the right words or understanding the meaning of words.
Many people associate memory loss as the primary symptom of dementia but this often isn’t the case. Whilst more people are becoming aware of dementia, in particular Alzheimer’s disease, it is important that people also know about the lesser known types of dementia. An understanding, particularly of the earlier symptoms, is crucial in being able to properly describe the symptoms to get an early, accurate diagnosis and to be able to provide relevant care.
As each type of dementia progresses and more of the brain becomes damaged, the symptoms become more similar. Yet, the impact of the disease in the earlier stages, differ greatly depending on the type of dementia a person has. I think it is easiest explained with one simple statement ‘same destination, different journey’.