Decoding dementia: recognising early signs and what actions to take

Maree McCabe, AM, CEO of Dementia Australia offers expert advice on how to spot dementia early on, and what to do next.

Early signs of dementia can be subtle and may not be immediately obvious.

There are common symptoms, but it is rare that they all occur. Early symptoms also vary a great deal. Usually, people first seem to notice that there is a problem with memory, particularly in remembering recent events.

Other common dementia symptoms include:

• Changes in planning and problem-solving abilities
• Difficulty completing everyday tasks
• Confusion about time or place
• Trouble understanding what we see (objects, people) and distances, depth and space in our surroundings
• Difficulty with speech, writing or comprehension
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgement
• Withdrawal from work or social activities
• Changes in mood and personality

Sometimes people fail to recognise that these symptoms indicate that something is wrong. They may mistakenly assume that such behaviour is a normal part of the ageing process or symptoms may develop gradually and go unnoticed for a long time. Sometimes, people may refuse to act even when they know something is wrong.

Don’t assume it’s dementia

Everyone at some time in life experiences the occasional memory lapse. Occasional memory lapses and forgetfulness are normal. Changes to memory and thinking that interfere with someone’s normal social or working life are concerning.

Some conditions such as strokes, depression, alcoholism, infections, hormone disorders, nutritional deficiencies and brain tumours have symptoms similar to dementia. These can often be treated.

Early diagnosis is helpful

It is important to talk to a doctor when symptoms first appear.

If symptoms are not caused by dementia, early diagnosis will be helpful to treat other conditions.

If the symptoms are caused by dementia, early diagnosis will help the person access treatment, support and information sooner. They can understand how to live well with dementia, plan for the future and take control of their life.

Where to begin

The best place to start is with a health professional. It will be helpful to take to the appointment:

• A list of memory, thinking or behaviour changes that are of concern, including when the changes were first noticed and how often they are noticed
• A list of medications
• A trusted family member or friend, to provide additional information, if necessary

To make a diagnosis, it is common for an assessment to be done and different tests may be ordered depending on the outcome of the assessment. The health professional may also refer the person to a medical specialist such as a geriatrician, neurologist or neuropsychologist.

Such an assessment might include the following:

• A detailed medical history provided if possible by the person with the symptoms and a close relative or friend. This helps to establish whether there is a slow or sudden onset of symptoms and their progression.
• A thorough physical and neurological examination, including tests of the senses and movements to rule out other causes of dementia and to identify medical illnesses which may worsen the confusion associated with dementia.
• Laboratory tests including a variety of blood and urine tests called a “dementia screen” to test for a variety of possible illnesses which could be responsible for the symptoms. The dementia screen is available through a doctor.
• Neuropsychological testing to identify retained abilities and specific problem areas such as comprehension, insight and judgement.
• Other specialised tests such as a chest x-ray, ECG, or CT scan.
• A mental status test to check the range of intellectual functions affected such as memory, the ability to read, write and calculate.
• Psychiatric assessment to identify treatable disorders which can mimic dementia, such as depression, and to manage psychiatric symptoms such as anxiety or delusions, which may occur alongside a neurological disorder.

Seeking a diagnosis for someone else

If you know someone who may need to speak to their health professional, but who is resisting making an appointment, you could:

• Talk to the person’s health professional for advice.
• Call My Aged Care on 1800 200 422 to request an Aged Care Assessment (for someone aged over 65, or aged over 50 for Aboriginal or Torres Strait Islander people).
• Call the National Dementia Helpline on 1800 100 500 An interpreter service is available and the Helpline operates 24 hours a day, seven days a week, 365 days a year. More information at dementia.org.au/helpline.