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Dementia Signs That Worry Doctors Most

Dementia symptoms to watch out for and why they're so worrisome, according to doctors.

A surprisingly high 5.8 million Americans live with dementia according to the Centers for Disease Control and Prevention. "Dementia is the loss of cognitive functioning — thinking, remembering, and reasoning — to such an extent that it interferes with a person's daily life and activities. Some people with dementia cannot control their emotions, and their personalities may change," the National Institute on Aging states. While diagnosing dementia can be a challenge at times, particularly in the early stages, there are signs to watch out for that indicate someone has the condition. Dr. Dalia Lorenzo, neurologist at Baptist Health's Miami Neuroscience Institute says, "Many of the signs of dementia can be subtle and of insidious onset. It is not unusual for the signs to be attributed to the mild forgetfulness that can accompany normal aging and truth be told, early on, it can be difficult to distinguish what accompanies normal aging from what will develop into the progressive neurodegeneration that we know as Alzheimer type dementia. Many times, doctors are left with watchful waiting to see how the symptoms evolve over time." Eat This, Not That! Health talked to experts who explained signs that worry doctors the most. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


First Thing Doctors Will Do is Eliminate Other Possible Diagnoses

A mature man having a medical exam done in the doctors office.

Dr. Lorenzo states, "In my experience, many of the people that come to me reporting memory difficulties, trouble concentrating and other cognitive issues have a relatively benign explanation for their complaints. Big offenders in this first stage of eliminating possible diagnoses include things like:

Medications that cause side effects that affect cognitive functions. This also includes recreational substances such as alcohol, 'downer' type drugs, cannabis. Now that cannabis is being used so much more frequently by people trying to treat a myriad of conditions, we are starting to see what is called cannabis encephalopathy among heavy users. This is associated with severe and long-lasting memory impairment and changes in the structure of the brain similar to what happens in an Alzheimer's dementia patient.

Pseudodementia. There has been such an upswing in people who are depressed and anxious with everything that's going on with Covid, and it is well known that one of the cardinal symptoms for depression includes trouble concentrating and forgetfulness. 

Poor sleep. Whether it be volitional such as people 'burning the candle at both ends' or due to insufficient sleep in people with a sleep disorder, such as obstructive sleep apnea or chronic insomnia [or snoring bed partner!], sleep is crucial for the brain to recharge and to function at its optimal capacity. "



CT scan of brain with red area for hemorrhagic stroke

According to Dr. Lorenzo, "Subtle or not-so-subtle signs on the neurologic examination suggest there may have been a stroke at some point. Things like slight weakness of one arm compared to the other, loss of sensation on one side of the body compared to the other. There is a type of progressive neurodegeneration called vascular dementia where many small tiny strokes accumulate, leaving damage in areas of the brain that look like microscopic potholes [termed 'etat crible' historically]. People may not even be aware that they had this kind of stroke because the symptoms of each individual stroke may be mild and last for just a few hours or just a few days. In these cases, it is important to have treatment focused on stroke prevention and control of risk factors that lead to further strokes in order to halt further damage."

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Changes in Personality

Elderly couple arguing.

"This is of particular concern to neurologists for two reasons," Dr. Lorenzo explains. "First of all, because the degeneration of areas of the brain occur asymmetrically in dementias, patients can start to show problems in one cognitive realm [ie. Planning and strategizing] while still appearing to be completely normal in terms of their day-to-day functioning. For example, patients with frontotemporal dementia can start to exhibit behavior such as poor decision-making, loss of empathy, compulsive behaviors, overeating before they are even identified as having dementia later as the condition worsens. As you can imagine, this can lead to terrible problems socially, at work, at home and with potential legal repercussions. The second reason that neurologists are so concerned about personality changes preceding memory changes is because of the possibility of frontotemporal dementia. We are very used to hearing about Alzheimer type dementia, which is more common and, in general, first presents with short-term memory difficulties. In frontotemporal dementia, there is a more aggressive neurodegeneration that affects the brain and these patients will have a shorter lifespan than patients with Alzheimer type dementia."

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How Lack of Sleep is Connected to Dementia

Sad Woman Lying On Bed

Dr. Lorenzo explains, "Although most people think of sleep as seven hours of downtime and their 24-hour day, the truth is that sleep has a very important function in refreshing and recharging the brain. For the majority of the population, purposeful curtailment of sleep hours is seen as a good way to squeeze a few more hours of work and play in the day. But the studies say otherwise. We know that people who get less than six hours of sleep nightly have a higher risk of developing dementia later in life." 

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Normal Aging Versus Dementia

Tired mature woman take off glasses suffering from headache

Dr. James Dan, geriatric clinical advisor and member of the Senior Helpers Board of Directors, says, "The single most important differentiator of dementia vs 'normal aging' are what we often call 'benign senescent forgetfulness', which is considered to be a 'normal' age-related memory phenomenon in which the individual still has the ability to learn. Patients with normal aging can learn if they 'forgot' something, whereas dementia patients struggle with relearning what they forgot. Essentially, that is the distinction."

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When is it Time to Seek Medical Attention?

Doctor and senior woman wearing facemasks

"Seeing medical attention should be a priority when there is an inability to learn or relearn a task, trouble with recent memory/memory loss, withdrawal from long, enjoyed social activities (i.e. family events, game night with friends, etc.) or if any of the previously mentioned warning signs are apparent. In such cases, I would recommend that an individual be evaluated by a medical professional," Dr. Dan states.

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Slowing Down the Process of Dementia


Dr. Dan explains, "The current pharmaceutical panoply is not as effective as physicians would like, offering treatment that only maybe can slow down inevitable deterioration, at best. On the other hand, activities like socialization, challenging the intellect with tasks like word games (such as Scrabble where the brain's muscle memory is stimulated), math games, jigsaw puzzles (that encourage critical thinking skills and hand-eye coordination), etc. can help the mind stay active and can be useful in slowing down mental deterioration." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Heather Newgen
Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more about Heather