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Dementia Overview (cont.)

What are early signs and symptoms of dementia?

Symptoms of dementia vary considerably by the individual and the underlying cause of the dementia. Most people affected by dementia have some (but not all) of these symptoms. The symptoms may be very obvious, or they may be very subtle and go unrecognized for some time. The first sign of dementia is usually loss of short-term memory. The person repeats what he just said or forgets where she put an object just a few minutes ago. Other symptoms and signs are as follows:

Early dementia symptoms and signs

  • Word-finding difficulty: May be able to compensate by using synonyms or defining the word
  • Forgetting names, appointments, or whether or not the person has done something; losing things
  • Difficulty performing familiar tasks: Driving, cooking a meal, household chores, managing personal finances
  • Personality changes (for example, sociable person becomes withdrawn or a quiet person is coarse and silly)
  • Uncharacteristic behavior
  • Mood swings, often with brief periods of anger or rage
  • Poor judgment
  • Behavior disorders: Paranoia and suspiciousness
  • Decline in level of functioning but able to follow established routines at home
  • Confusion, disorientation in unfamiliar surroundings: May wander, trying to return to familiar surroundings
  • Difficulty or inability to multitask

What are intermediate signs and symptoms of dementia?

  • Worsening of symptoms seen in early dementia, with less ability to compensate
  • Unable to carry out activities of daily living (for example, bathing, dressing, grooming, feeding, using the toilet) without help
  • Disrupted sleep (often napping in the daytime, up at night)
  • Unable to learn new information
  • Increasing disorientation and confusion even in familiar surroundings
  • Greater risk of falls and accidents due to poor judgment and confusion
  • Behavior disorders: Paranoid delusions, aggressiveness, agitation, inappropriate sexual behavior
  • Hallucinations
  • Confabulation (in conversation, filling in memory gaps with false information)
  • Inattention, poor concentration, loss of interest in the outside world
  • Abnormal moods (anxiety, depression)

What are the signs and symptoms of late or severe dementia?

  • Worsening of symptoms seen in early and intermediate dementia
  • Complete dependence on others for activities of daily living
  • May be unable to walk or move from place to place unassisted
  • Impairment of other movements such as swallowing: Increases risk of malnutrition, choking, and aspiration (inhaling foods and beverages, saliva, or mucus into lungs)
  • Complete loss of short- and long-term memory: May be unable to recognize even close relatives and friends
  • Complications: Dehydration, malnutrition, problems with bladder control, infections, aspiration, seizures, pressure sores, injuries from accidents or falls

The person may not be aware of these problems, especially the behavior problems. This is especially true in the later stages of dementia.

Depression in elderly people can cause dementia-like symptoms. About 40% of people with dementia are also depressed. Common symptoms of depression include depressed mood, loss of interest in activities once enjoyed, withdrawal from others, sleep disturbances, weight gain or loss, suicidal thoughts, feelings of worthlessness, and loss of ability to think clearly or concentrate.

People with irreversible or untreated dementia present a slow, gradual decline in mental functions and movements over several years. Total dependence and death, often from infection, are the last stages.

When to seek medical care if you think you or someone you know may have dementia?

A person affected with dementia may not be aware he or she has a problem. Most people with dementia are brought to medical attention by a caring relative or friend. Any of the following warrant a visit to the person's health care professional.

  • Marked loss of short-term memory
  • Behavior or personality changes
  • Inappropriate or uncharacteristic behavior
  • Depressed mood
  • Marked mood swings
  • Inability to carry out daily tasks such as bathing, dressing, feeding, using the toilet, or household chores
  • Carelessness in personal hygiene
  • Persistent word-finding difficulties
  • Persistent or frequent poor judgment
  • Persistent or frequent confusion or disorientation, especially in familiar situations
  • Inability to manage personal finances

Which specialties of doctors treat dementia?

In addition to the patient's primary care doctor, neurologists, gerontologists, neuropsychologists and some psychiatrists may diagnose and treat patients with dementia. If the patient has a potentially treatable cause like an infection or tumor, various other specialists may be consulted.

Medically Reviewed by a Doctor on 6/20/2016

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