Memory loss is the symptom everybody worried about Alzheimer's disease or other forms of dementia seems to focus on. After all, it's distressing -- and increasingly obvious. Yet there are other common symptoms of Alzheimer's or dementia that can turn up even earlier, researchers say.
Sometimes, according to memory experts, even doctors miss early dementia signs because they're focused on memory loss to the exclusion of other symptoms.
In fact, in 2011 Spanish researchers found that more than a third of adults who go on to develop early-onset Alzheimer's (the kind that appears before age 65) have the following symptoms early in the disease, even before memory loss is apparent. These symptoms can also be the first to appear among adults who develop Alzheimer's after age 65.
Of course, if you notice any of these symptoms, it's important to have them checked out by a doctor, psychologist, or other expert in cognition and the brain.
Early sign of dementia #1: Personality change
A warm, friendly loved one may seem to morph into a bit of a grouch -- at first occasionally, and then increasingly. A gregarious person still jokes and talks a lot but begins to say inappropriate things or make odd accusations. A mild-mannered loved one begins cursing. All of these are examples of the kinds of personality changes that can predate memory loss in someone with dementia. Often, it's only later that friends and family look back and realize that behaviors they found off-putting or upsetting weren't intentional but related to the Alzheimer's.
Early sign of dementia #2: Problems with executive functioning
Trouble carrying out basic, familiar tasks can creep up slowly but surely. The person may, for example, have difficulty doing something that involves multiple steps, like following written directions or instructions. A longtime cook may avoid complicated recipes. A hobbyist may simplify the form of his or her craft.
Other hallmark trouble areas: making plans and not following through, whether for a vacation or an activity. Not tracking bills. Not being able to solve simple problems, such as mending a broken piece of machinery he or she could once fix easily.
Early sign of dementia #3: Vision problems
Problems with depth perception or visual-spatial coordination can precede memory problems. The person may have trouble driving or even walking well without tripping on stairs. It can be hard to judge distances or see contrasts between like colors, which can lead to accidents. In a more severe example of a perception problem, the person may not recognize himself or herself in a mirror or when passing his or her reflection in a building or window on the street.
Early sign of dementia #4: Language problems
Word retrieval and getting out the right words can become apparent before friends and family notice the more common communication problem of repeating stories or questions. For example the person having trouble may stop in the middle of a sentence, unable to think of the next word. (This can happen to anyone, but when it's a sign of dementia, it happens with alarming frequency, and sometimes the person isn't even aware of doing it.) Or the wrong word may come out -- "mouth cleaner" for "toothbrush" or "picture stick" for "TV remote control."
Early sign of dementia #5: Social withdrawal
Early in Alzheimer's disease and other dementias, the person is often well aware that something is amiss, even if he or she isn't exactly sure of the source of the problem. It can be frightening to feel that you're not quite in control of your faculties all of the time. This can cause the person to use more and more energy to stay in self-command. That leaves less energy to interact with others. Sometimes the person isn't even aware that he or she seems to be losing interest in friends and family, because he or she is concentrating so hard on just getting through the day.
Social withdrawal can also be caused by a desire to avoid embarrassment or by depression -- which often develops alongside dementia.