Memory loss is the most well-known symptom of dementia, especially Alzheimer’s. But experts say there are other warning signs that can indicate early brain changes, which are very important in those types of disease in which forgetfulness is not the main symptom.
Like occasional memory lapses, These problems can also be attributed to age- or health-related changes (or just a bad day), so experts stress that they are not necessarily isolated signs of dementia.
When combined, They could be a sign that it’s time to see a doctor.
1. Economic problems
People with dementia may have money problems or have their creditworthiness compromised years before memory loss or other cognitive symptoms appear. They may forget to pay bills, for example, or not be able to stick to a budget.
“One of the reasons why financial mismanagement can be a sensitive indicator is its complexity,” because it involves the interaction of several brain regions, said Winston Chiong, a professor of neurology at the University of California, San Francisco.
Finances can be one of the first areas where cracks begin to appear in a person’s cognition.
Making poor financial decisions is of particular concern to those with frontotemporal dementia, a relatively rare form in which judgment is impaired very early in the disease. Some people with this condition make large, impulsive purchases. Others trust people they normally wouldn’t, increasing the risk of scamming.
“People with frontotemporal dementia are less sensitive to potential negative consequences,” Chiong explained. Because of this, they have greater “susceptibility to different types of manipulation,” or are “more likely to be wasteful or careless with money.”
2. Sleep problems
Sleep disorders become more common as people age, and older adults tend to have lighter sleep, go to bed and wake up a little earlier than they used to, which is completely normal. But if drastic changes occur in a person’s habits, such as starting the day at 3 a.m., or being unable to stay awake during the day, it may be a sign of dementia.
“Some regions of the brain, such as the brain stem, that are very important in regulating sleep-wake cycles, are the first to be affected by Alzheimer’s,” confirmed Joe Winer, professor of neurology and neurological sciences at Stanford University. —. So years before someone shows any signs of memory symptoms” they may experience changes in their sleep patterns.
One change that can occur with Lewy body dementia — another type of progressive brain disorder — is that a person begins to act out their dreams. The same is true for Parkinson’s disease, which is related to dementia with Lewy bodies. Normally, our muscles become paralyzed during REM sleep, which is when we tend to have the most vivid dreams. In both of these neurodegenerative disorders, toxic proteins attack the brainstem cells that control sleep paralysis.
Ronald Postuma, professor of neurology and neurosurgery at McGill University, said this condition, called REM sleep behavior disorder, is not just walking or talking in your sleep. In his clinic, patients usually come after their “bed partner has told them that they were being hit, yelled, screamed during their dreams.”
3. Personality changes
In a study published last year, lResearchers found that people with dementia experience slight declines in extroversion, agreeableness and awareness before showing signs of cognitive decline. Those personality changes accelerated as more dementia symptoms appeared, said Angelina Sutin, a professor of behavioral sciences and social medicine at Florida State University, who led the study.
Although the research was conducted using a standardized personality test, there are some changes in everyday behavior to watch for. A decrease in extroversion, for example, may look like a more withdrawn person or a narrowing of their social circle.
It’s easier to notice that someone “doesn’t go out as often anymore” “We have to recognize how much his memory has diminished,” said Sutin.
Some of these personality changes occur spontaneously, as a consequence of brain damage. In the case of frontotemporal dementia, for example, decreased agreeableness, which makes a person less trusting and friendly, is related to decreased brain volume in the frontal cortex, a key component of the disease.
Other times, changes may arise because of cognitive symptoms. For example, a person with Alzheimer’s appears less conscientious, is increasingly disorganized, or has difficulty completing work or household tasks as their memory declines.
4. Difficulties driving
Along with managing finances, driving is one of the most complex cognitive behaviors that people perform every day. Ganesh Babulal, an associate professor of neurology at Washington University in St. Louis, has shown in his research that problems behind the wheel can appear years earlier than in other places.
Driving “is the definitive mix of the cognitive system. And if something doesn’t work, unfortunately the driver loses control and runs the risk of having an accident,” Babulal explained.
Cognitive impairment can manifest itself in the form of scratches on the car, a minor crash (or almost one), or running red lights. People also brake or accelerate suddenly or take corners too quickly. As a result, Babulal said, they may stop driving as much — especially at night, in bad weather or during rush hour — or may feel reluctant to drive with grandchildren or other passengers in the car.
Of course, other physical problems that can appear with age, such as vision problems, neuropathies or medication side effects, affect driving.
If you notice worrying changes in someone’s ability, it may be worth having the car key conversation.
5. Loss of smell
The parts of the brain that control the olfactory system are among some of the first areas damaged in Alzheimer’s disease and Lewy body dementia; This is also the case with Parkinson’s disease. Many people with these diseases begin to lose their sense of smell years, or even decades, before other symptoms appear.
Unlike hearing and vision loss, which may be risk factors for dementia but are not thought to be caused by the disease itself, loss of smell appears to be one of the earliest manifestations of neurodegeneration.
Different types of brain diseases seem to affect people’s sense of smell in different ways. For example, people with Alzheimer’s tend to be able to detect a smell, but may misidentify it.
“They say, ‘What a nice smell. It smells so sweet. It must be gasoline,’” Postuma said. In contrast, he added, those with Parkinson’s and Lewy body dementia tend to be “skeptical that they are sensing a smell.”
