Early stage of dementia

Many older adults worry about dementia. The aging process normally includes some forgetfulness, but dementia is quite different.

Normal forgetfulness

  • reduced ability to multitask. The aging brain simply needs to slow down and do one thing at a time. It may take longer to do things, but they do get done.
  • slower recall. An older adult might not remember a word or event right away, but will eventually. It might take a few minutes, or hours, but the memory will surface.

Dementia is more disorienting
It involves the inability to make new memories. It’s like a blank slate. The memory just isn’t there. The event didn’t stick. Dementia also involves losing the ability to do even common activities, such as use a phone or make change. Tasks that require multiple steps will become increasingly difficult.

The early stage of dementia can be one of confusion, fear, and depression. Even if there is no formal diagnosis, the person with the memory issue often senses that something is wrong. And he or she may still have enough self-awareness to understand the consequences of a disease such as Alzheimer’s. It’s equally likely that the person may not recognize their own decline. They just don’t recall recent events. It’s nothing they are doing on purpose. It’s not like they can “try harder.” They can’t. The memories simply don’t form.

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Common symptoms of early dementia

Below are some common signs of the early stage of dementia. (Most people at this stage show at least some of these symptoms.)*

Memory and thinking skills

  • Problems with numbers (adding, subtracting, paying bills on time, balancing the checkbook)
  • Problems with planning and organizing
  • Forgets recent events
  • Loses things
  • Easily distracted


  • Trouble finding words or names
  • Repeats questions or stories soon after saying them

Behavior and mood

  • May become depressed, withdrawn, or irritable

Daily self-care

  • Eventually needs help with household affairs, such as cooking and cleaning (signs of a possible problem: scorched pots or moldy food in the refrigerator)
  • May have trouble taking medications as directed
  • May get lost or confused when driving or walking, even in familiar areas
  • Trouble managing money (signs of a possible problem: shut off notices from the utility company. Also very susceptible to scams and con artists)
Which of these challenges is the most pressing?

* Signs and stages adapted from a publication of the Alzheimer’s Association – Greater Illinois Chapter.

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Common issues, tips and concerns

In the early stages, you may not even know there is a problem. Your family member may just seem a little less “with it.” People are very adept at compensating. And if your relative is married, a spouse may naturally take up the slack. But if you suspect something is not right, get a full medical assessment just to be sure.

  • Early diagnosis is important. Medications are available that can slow the progression of the symptoms. And it may be that your loved one’s confusion is caused by something such as depression, which can be cured. The sooner your family member gets tested, the sooner treatment can begin.
  • Deciding who to tell and when. Many people feel ashamed of a diagnosis of dementia. And some people or situations may become uncomfortable once a diagnosis is disclosed. This is a very personal decision.
  • Concern about driving. Driving requires thinking and good spatial skills. Dementia impairs both of these. The person with dementia is not likely to even recognize they have a problem. Everyone will eventually need to retire from driving. Knowing exactly when to stop is complicated. Read our article about driving safely and talk with the doctor.
  • Depression is big. Depression can cause many of the same symptoms as dementia. And, a person with memory problems can get very frustrated and feel very blue. Especially after a formal diagnosis, it is not uncommon for the patient to become depressed. The good news is that depression can be treated. Staying on top of the depression can at least lessen the number of factors contributing to your relative’s confusion or distress.
  • Join a support group. People in the early stages of dementia have special problems and needs. So do their family members. Gathering with others can provide a tremendous amount of comfort for you both. You are also likely to learn valuable tips for handling common situations.
  • Important legal and financial decisions. This is the time to make decisions about financial and medical matters. Now, when your loved one is still able to assess options, he or she should complete an advance directive. Your relative should also arrange for a will or living trust. He or she should assign a person to handle finances when managing money becomes too difficult. See our article about proxy decision makers in Your Changing Role.
Which of these tips appeal most?
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