Noticing changes that come with aging can feel unsettling, especially when memory or thinking seems different than before. Not every lapse is a warning sign, but certain patterns deserve attention because they can affect daily life. Dr. Gregory Day, a behavioral neurologist and dementia specialist at Mayo Clinic, describes dementia as “a change in memory and thinking.” He adds, “So, something that is different than before, and for me to consider it dementia, it has to interfere with everyday life.”
Catching problems early matters because it can help people and their caregivers plan ahead, weigh treatment choices, and access therapies that may slow progression in some forms of dementia. Dr. Stephanie Nothelle, a geriatrician and associate professor at the Johns Hopkins School of Medicine, says early signs can “cover a wide range,” but some tend to show up sooner than others. One of the most recognized is short term memory loss that goes beyond occasional forgetfulness. “I think what people often think about is short term memory loss, and that really is common,” Nothelle explains.
What separates routine distraction from something more concerning is how often it happens and whether it disrupts normal routines. Nothelle notes it is not about a one off blank moment, but more like “talking with someone and then, a few hours later, not remembering the details of that conversation.” Dr. Jori Fleisher, an associate professor of neurological sciences at Rush University, adds that people with short term memory issues may repeat themselves in conversations and ask “the same questions.” When loved ones notice the same story retold multiple times or the same question resurfacing minutes later, it can be a clue worth discussing with a clinician.
Another early area is executive function, which involves planning, organizing, and keeping track of steps in a task. Nothelle describes executive function as “the part of the brain responsible for planning.” She gives a practical example of planning a dinner, which includes juggling timing, groceries, preparation, and details that used to feel manageable. “If you have a complex task, for example you have to plan a dinner and you have trouble doing everything involved, there is all that little logistics and things to keep track of when planning something like a dinner,” she says. If that kind of planning starts to fall apart in a way that is new and persistent, it can signal a change that needs evaluation.
Personality and mood shifts can also appear earlier than many people expect, and they can be confusing because they do not always look like memory loss. Nothelle says, “Another way I have seen it manifest is that people will have changes in mood or personality.” Someone who was once outgoing may become withdrawn, or a typically reserved person may become unusually uninhibited. Apathy and impulsivity can show up too, and Nothelle emphasizes these are not just quirks of getting older, saying, “All of these are just reflections of subtle changes in the brain.” When close family members say someone feels like a different person, that observation can be important.
Language changes are another common reason people seek medical advice, especially when word finding becomes frequent and disruptive. Day points out that the occasional struggle to recall a name can happen to anyone. “An occasional difficulty finding a name is fine,” he says, adding that it can also be normal to forget the name of a common object from time to time. The concern is when it becomes frequent and starts interrupting conversation, as Day explains, “When it is inconsistent, it is not a worry, but when it is an everyday thing and maybe even when it interrupts conversation, that is a sign of much more pronounced word finding difficulties that would require an evaluation.” If someone regularly stops mid sentence, substitutes incorrect words, or avoids speaking because it feels hard, it is worth noting.
The article also highlights a risk people do not always connect to cognition, which is increased vulnerability to financial scams. Fleisher warns, “Something we have to be really, really aware of, and that unfortunately is becoming more and more common, is susceptibility to financial scams.” People with dementia can be at higher risk, and scammers often target older adults with increasingly sophisticated tactics. Because shame can keep families quiet, the message is to treat it as a safety issue rather than a personal failing. If a loved one is suddenly making unusual transactions or falling for schemes they once would have dismissed, it can be a reason to check in on their cognitive health.
While there is no cure for dementia, lifestyle changes can help reduce risk and may slow progression, according to the experts cited. Fleisher notes that even when genetics play a role, “even in people where there is a genetic component, there is good evidence that all of the following still has an impact, and maybe an even bigger impact.” Day stresses the connection between overall health and brain health, saying, “The biggest things I think about, we should be screening for high blood pressure, cholesterol, blood sugar problems, and treat or address those problems when they exist.” Sleep quality matters too, including recognizing and treating sleep apnea. He recommends doable steps and adds, “You do not have to start doing everything all at once,” suggesting, “Start a 20 minute walk three times a week, you do not have to start training for a marathon.”
For families living with a diagnosis, the goal is often to preserve independence and quality of life for as long as possible. Fleisher says, “We want to use everything we have available to slow progression so that people can live longer and better.” She pushes back on the idea that dementia automatically means life stops being meaningful, saying, “There are countless examples of people living well with dementia.” She also addresses the fear many people feel, explaining, “I think the stigma of getting this diagnosis and that it is ‘the end,’ that is not the situation we are in today.” That perspective can help families focus on support, routine, safety, and connection instead of only loss.
In general terms, dementia is not a single disease but an umbrella term for a set of symptoms that affect memory, thinking, behavior, and the ability to manage everyday activities. Alzheimer’s disease is the most common cause, but vascular dementia, Lewy body dementia, and frontotemporal dementia are also significant, and each can show a different pattern of early symptoms. Clinicians often evaluate concerns by taking a detailed history, reviewing medications, screening mood and sleep issues, and using cognitive tests, and they may order blood work or brain imaging to rule out other causes. It is also important to remember that depression, thyroid problems, vitamin deficiencies, medication side effects, and sleep disorders can mimic cognitive decline, which is why professional evaluation matters.
If you have noticed persistent changes like repeated questions, worsening planning skills, unusual personality shifts, frequent word finding trouble, or new vulnerability to scams, talk with a healthcare professional and share what you are seeing in the comments.
