15 Warning Signs of Dementia You Shouldn’t Ignore

Symptoms can vary widely from person to person. Here are some telltale indicators

Rachel Nania,

AARP

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En español

Published November 20, 2024

illustration of woman sitting in armchair looking out window

Jon Krause

You’re running late because you can’t find your keys. Of course, they’re buried in your bag.

You walk into the living room to retrieve something important. What was it again?

An acquaintance greets you in the grocery store. Her name escapes you.

Moments of forgetfulness can happen at any age, and according to the National Institute on Aging (NIA), may happen even more as you age. Still, memory lapses can provoke anxiety for older adults who are often left wondering whether it’s all normal or a sign of something more serious.

“It’s important for people not to be too upset at every little cognitive change,” says John Dickson, M.D., a neurologist at Massachusetts General Hospital in Boston.

Still, research suggests many are. Results from a 2019 National Poll on Healthy Aging found that nearly half of respondents ages 50 to 64 are worried about developing dementia. Similarly, a 2021 survey from AARP found that nearly half of adults 40 and older think it’s likely they will get dementia. In reality, about 1 in 9 Americans 65 and older has dementia, according to the Centers for Disease Control and Prevention.

While dementia is not inevitable, it is important to know the warning signs so that you or a loved one can get evaluated if there are concerns, Dickson says.

Here’s what to look out for.

What is dementia?

Dementia is an umbrella term for a decline in mental ability that interferes with daily life. It can diminish focus, attention, language skills, problem solving and visual perception. Dementia can also make it difficult for a person to control emotions and can even lead to personality changes. More than 55 million people worldwide have dementia, according to the World Health Organization.

Video: 5 Signs of Dementia

15 warning signs of dementia

1. Short-term memory loss. It’s one thing to forget the name of the actor who starred in the movie you went to see with friends yesterday. It’s another to forget you went to see a movie with friends yesterday. “Those more significant lapses” — especially when it comes to recent events — are concerning, says Judith Heidebrink, M.D., a neurologist and clinical professor at University of Michigan Health.

Short-term memory loss can be a common symptom of Alzheimer’s disease, the most common type of dementia, Dickson says. “That’s because the short-term memory-forming center of the brain, called the hippocampus, is affected early in the disease process.”

2. Word loss. We’ve all experienced a time or two when your brain can’t find the right word, even though it’s on the tip-of-the-tongue. That can be normal, says Heather Whitson, M.D., a professor of medicine at Duke University School of Medicine and director of the Duke Center for the Study of Aging and Human Development. But if it’s happening a lot and you find that a person is substituting in words that don’t fit the conversation, that’s worrying.

For example, Whitson says, a person might want to ask, “Have you seen my jacket?” But when they can’t find the word for jacket, they ask, “Have you seen my shirt?”

Another warning sign is difficulty joining, following or completing conversations. “Those types of communication skills can be an early symptom,” Heidebrink says.

3. Difficulty multitasking. If you’re someone who has always put out a Thanksgiving dinner without a hitch, and suddenly you find that staple side dishes are missing from the spread, the rolls are burned and dinner is delayed by two hours, that could signal something more serious is at play. “If it just doesn't seem like it's happening well, or it's happening with a lot more effort, that would be a sign that there are executive function issues,” Whitson says.

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4. Repetition. “If a person is being told by family or friends that they are repeating questions or repeating stories and statements in a short timeframe, without seeming to realize that they just told the person that, or they just asked that same question and it was answered, that's a red flag,” Whitson says.

5. Personality changes. A sudden and routine loss of interest in family, friends, work and social events can be a warning sign of dementia. “People may feel less comfortable in social situations — holding a conversation, remembering the conversation — so they may start to withdraw from social situations,” Heidebrink says.

A 2023 study published in the Journal of Alzheimer’s Disease found that apathy may be a sign that someone is progressing from mild cognitive impairment (MCI) — symptoms of memory loss or thinking problems that are not as severe as dementia — to Alzheimer’s disease. Acting increasingly anxious, confused, fearful or suspicious may also be a sign of dementia, according to the Alzheimer’s Association.

6. New sleep behaviors. While Whitson says sleep issues can be “very common” among older adults, some sleep behaviors, such as sleepwalking, are not a normal part of aging. “It's important to know that there are some types of dementia that are associated with altered sleep behavior — acting out dreams or talking in your sleep, when that wasn't something that the person used to do,” Whitson says.

7. Worsening sense of direction. Changes in sense of direction can also occur with dementia, Dickson says, and this can manifest in things like difficulty driving and getting lost in familiar environments.

“Sometimes it's just a loss of confidence,” Heidebrink adds. “People will start to restrict their driving to very familiar, close destinations, sort of low-speed, low-traffic situations, or good weather only.”

8. Depression. A new and sudden onset of depression later in life can be a warning sign of dementia, Dickson says. According to the Alzheimer’s Association, up to 40 percent of people with Alzheimer’s disease suffer from significant depression.

Depression may not just be a symptom of dementia but also a potential precursor. A 2023 study published in JAMA Neurology found that dementia risk more than doubled for adults previously diagnosed with depression.

9. Confusion about time and place. If someone forgets where they are, or can’t remember how they got there, that’s a red flag. Another worrisome sign is disorientation about time — for example, routinely forgetting what day of the week it is, says Jason Karlawish, M.D., a neurologist and professor of medicine at the University of Pennsylvania Perelman School of Medicine and codirector of the Penn Memory Center.

10. Difficulty with visual or perceptual tasks. Tripping over something because you don’t recognize that it’s in the way, or not being able to make sense of the time on a clock could be warning signs of dementia, Heidebrink says. Difficulty with balance, trouble reading and problems judging distance or distinguishing color and contrast can also be early indicators, the Alzheimer’s Association says.

11. Financial missteps. Money problems may be one of the first noticeable signs of Alzheimer’s disease and related dementias, according to the NIA.

“There's a lot of reasoning and memory that go into financial tasks, and so [money management errors] can certainly be an early way that people experience changes,” Heidebrink says.

According to the NIA, signs of money problems can include difficulties with the following:

Counting change
Paying for a purchase
Calculating a tip
Balancing a checkbook
Understanding a bank statement

12. Changes in judgment. People with dementia may experience changes in judgment and decision making that can affect everything from their appearance to their financial wellbeing, the Alzheimer’s Association says.

A recent study led by researchers at the University of Southern California looked at brain images from 97 adults over the age of 50 and found that people who had brain changes associated with early stages of Alzheimer’s were more vulnerable to financial scams. While not a single, definitive indicator, “assessing financial vulnerability in older adults could help identify those who are in the early stages of mild cognitive impairment or dementia, including Alzheimer’s disease,” researcher Duke Han said in a news release.

13. Misplacing things. We all lose our keys, reading glasses, that important piece of mail you meant to hold onto. But putting things in unusual places, or misplacing something and not being able to retrace your steps, can be an early warning sign of dementia, according to the Alzheimer’s Association.

It’s easy to lose track of things, especially when adjusting to a new routine, like retirement, Whitson says. What’s more concerning is if you find what you’re looking for, but have no recollection of putting it there in the first place.

“If you’re frequently finding that you just have no memory of being in that room with that [missing object], to me, that is more alarming, because that suggests that something with short-term memory is not registering,” Whitson says.

14. Misusing items. Another subtle symptom “is not using things for their correct and intended purpose,” Whitson says. For example, eating with a spoon when you would usually select a fork, or pouring wine into a beer glass.

15. Hallucinations. Delusions or hallucinations can be a symptom of dementia — “particularly visual hallucinations, like seeing people or animals that aren't there,” Dickson says.

Most common types of dementia

These conditions are the leading causes of dementia. People can also have mixed dementia, a combination of two or more types, such as Alzheimer’s and vascular dementia.

Alzheimer’s disease. Alzheimer’s is characterized by amyloid plaques and tangled fibers in the brain and by a loss of connections between nerve cells. Damage initially appears in the hippocampus, an area of the brain involved in memory formation, and gradually spreads. Nearly 7 million Americans 65 and older are living with Alzheimer’s disease, according to 2024 statistics from the Alzheimer’s Association.

Vascular dementia. The second most common type of dementia results from damage to the vessels that supply blood to the brain. It tends to affect focus, organization, problem-solving and speed of thinking more noticeably than memory. It’s estimated that 5 to 10 percent of people with dementia have vascular dementia.

Lewy body dementia. Abnormal protein deposits in the brain, called Lewy bodies, interfere with brain chemistry and lead to problems with behavior, mood, movement and thinking. More than 1 million people in the U.S. have been diagnosed with Lewy body dementia, according to federal statistics.

Frontotemporal disorders. Degenerative damage to the brain’s frontal and temporal lobes is the most common cause of dementia in people age 65 and younger. Symptoms might include apathy; difficulty communicating, walking or working; emotional changes; and impulsive or inappropriate behaviors. According to UCSF Health, frontotemporal dementia affects an estimated 1 in 5,000 to 10,000 people.

Additional sources: National Institute on Aging, Mayo Clinic

What to do if you notice symptoms

If you’ve noticed changes or have any concerns related to your thinking and memory, or that of a loved one, it’s important to call a doctor sooner than later, health experts say.

8 ailments that can mimic dementia

Any number of treatable conditions can cause dementia-like symptoms. Some of the most common:

Alcohol abuse
Anxiety, depression or stress
Blood clots, brain infections or tumors
Delirium
Head injuries
Kidney, liver or thyroid problems
Side effects of medication
Vitamin deficiencies

Hearing loss can also be mistaken for dementia, Whitson says. “Sometimes, if somebody is repeating a question, it might be because they didn't hear the answer before," she explains.

Source: National Institute on Aging

A big reason: “There are many possible causes of these changes,” Heidebrink says. “Not every case where someone is experiencing these changes is automatically Alzheimer's disease, for example. There could be other causes — a medication side effect, a metabolic hormone imbalance, something else that could be treatable.”

If the changes are due to dementia, an early diagnosis has benefits. For example, there are newly approved medications that may slow the progression of Alzheimer’s disease, and research suggests the drugs work better in the beginning stages of the disease. Plus, an early diagnosis makes individuals eligible for a wider variety of clinical trials, the Alzheimer’s Association points out.

You can start with your primary care provider, who may refer you to a specialist, like a neurologist or geriatric psychiatrist, for a more thorough evaluation and definitive diagnosis.

How is dementia diagnosed?

Some methods doctors use to help diagnose dementia:

Cognitive and neurological tests assess language, math, memory, problem-solving and other types of mental functions.
Blood tests, though relatively new and not yet widely available, can measure levels of beta-amyloid and p-tau217, hallmarks of Alzheimer’s disease.
Brain scans such as MRI or PET imaging can spot changes in brain structure and function. These tests also can identify strokes, tumors and other problems that can cause dementia.
Mental health evaluations can determine whether a mental health condition is causing or affecting the symptoms.
Genetic tests may be helpful if symptoms appear before age 60. Early-onset Alzheimer’s is strongly linked to genetics, according to the Mayo Clinic. Talk with a genetic counselor before and after getting tested.