Is It Just Forgetfulness? The Early Signs Of Dementia You Shouldn’t Ignore

Forgetting where you left your keys or taking a little longer to recall someone’s name is not necessarily a sign of dementia. But when forgetfulness becomes frequent, interferes with everyday life, and is accompanied by confusion, repetition, or changes in behaviour, it may be time to look beyond normal ageing.

As the world observes World Alzheimer’s Day every year on September 21, Dr Nahid Suraiya Islam, Department of Neuropsychiatry, at Guwahati Neurological Research Centre (GNRC),  says recognising the early signs of dementia is important because timely assessment can help identify the condition and, in some cases, uncover causes that can be treated.

“Dementia is a disease condition that affects the brain. It affects brain cells and, most importantly, memory and other cognitive functions. A person starts forgetting things, and memory loss becomes a prominent feature,” she says.

Dementia, however, is not a single disease. Alzheimer’s disease is one form of dementia and, according to Dr Islam, the most common type.

“Dementia is an umbrella term. Alzheimer’s disease is one type of dementia,” she explains.

Dementia can have several causes. Dr Islam points to Alzheimer’s disease, stroke and severe head injuries among them. Brain tumours and other neurological conditions can also be associated with dementia.

When Forgetfulness Becomes A Concern

Forgetfulness is a part of normal ageing. People may occasionally forget a name, misplace an object or take longer to remember something.

The difference becomes more significant when memory loss begins to affect a person’s ability to function.

“With age, everyone forgets things to some extent. As we grow older, we may sometimes take longer to recall a name or remember where we have kept something,” Dr Islam says.

With dementia, however, the problem becomes more pronounced. A person may repeatedly misplace important objects, forget where they put them, struggle to plan or complete familiar tasks, or begin doing everyday activities differently than before.

A person who was once organised may suddenly become careless about routine tasks or personal hygiene. Repeatedly losing keys or other belongings, especially when it happens frequently, can be a warning sign.

Getting lost is another concern.

“Another important warning sign is getting lost. A person may go outside and then be unable to find their way back,” she says.

Repetition can also become noticeable. A person may ask the same question repeatedly, repeat the same statement or forget that they have already eaten.

Behavioural changes may accompany memory problems. Someone who was previously sociable may become withdrawn. Others may become unusually agitated, angry or absent-minded. Sleep patterns may also change.

“These are signs that should not be ignored,” Dr Islam says.

Not Every Case Of Forgetfulness Is Dementia

One reason diagnosis can be complicated is that dementia-like symptoms can have other causes.

In middle age, prolonged stress, anxiety or depression can sometimes produce symptoms that resemble dementia. Dr Islam refers to this as “pseudodementia”.

“A person may have symptoms like dementia. They may forget things, become absent-minded, speak less or forget what you have told them. But it could be because of stress, and sometimes there may be underlying depression,” she says.

That is why simply assuming that forgetfulness is dementia can be misleading.

A proper clinical assessment is needed. Dr Islam says this may involve psychological assessment, blood tests and clinical evaluation.

“Some people come and truly forget things; they don’t remember where they kept them. But when we assess clinically, it is very important for a person to get a detailed evaluation done,” she says.

Blood tests can also help doctors look for other possible causes. Severe hypothyroidism, vitamin deficiencies and electrolyte disturbances are among the conditions mentioned by Dr Islam.

She points to low sodium as one example where sudden forgetfulness may not necessarily indicate dementia.

“We often see that they are forgetting things and everyone thinks that dementia has started. But in such a short time, we may realise that something else is happening, and then we see that the sodium has decreased and become very low,” she says.

Such causes may be reversible when the underlying problem is treated. Depression, anxiety and stress can also be addressed.

Alzheimer’s disease and dementia resulting from conditions such as stroke or severe head injury are different. Dr Islam says these conditions may not be completely reversible, but treatment can help manage symptoms and slow progression.

Alzheimer’s Often Begins Quietly

One of the difficulties with Alzheimer’s disease is that its early signs can appear relatively minor.

“Alzheimer’s dementia onset is very slow. It starts with small mistakes, misplacing things, or repetition. The person may become a little clumsy or confused,” Dr Islam says.

As the condition progresses, memory problems can become more pronounced and confusion and personality changes may develop.

Early recognition therefore matters.

Dr Islam says treatment may not completely cure Alzheimer’s disease, but intervention at an early stage can help slow its progression and improve quality of life.

Dementia Does Not Belong To One Age Group

Dementia can occur at different ages, although it is more commonly seen in older people.

Dr Islam says the condition is most common after 60, and particularly after 65. However, cases can occur much earlier.

“We see some patients who have a dementia onset even at the age of 48 or 50 years, and at that time, as clinicians, we need to be very careful that something else is not causing it,” she says.

This makes a thorough evaluation particularly important in younger patients.

Family history can also play a role.

“When there is a family history of dementia, there is a genetic loading,” Dr Islam says. “But it is not always the case.”

In other words, having a family history does not mean that a person will necessarily develop dementia.

The Message Is Not To Panic

For families, the first signs of dementia can be frightening. But Dr Islam says fear should not prevent people from seeking medical advice.

“If someone has such symptoms or if someone feels that they are a little disorganised, or they have a relative with such a problem, there is definitely nothing to be afraid of,” she says.

She advises people to approach an appropriate healthcare professional, which may include a physician, neurologist, psychiatrist or psychologist, depending on the symptoms and circumstances.

“The earlier we do the intervention, the better results we obviously get,” Dr Islam says.

The key message on World Alzheimer’s Day, therefore, is not that every forgotten key is a warning of dementia. It is that persistent changes in memory, behaviour and everyday functioning should not simply be dismissed as part of getting older.

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