10 early signs of dementia that appear years before the onset of the disease

Dementia doesn’t appear overnight. Its roots can stretch back a decade or more, silently altering the brain. Many people dismiss subtle changes in memory, mood, or daily functioning as normal aging.

However, a landmark study found that lower cognitive test scores predict the development of Alzheimer’s disease 13 to 17 years before diagnosis. Recognizing early signs can be life-changing, offering opportunities for early intervention, lifestyle adjustments, and proactive planning.Dementia is a general term for a group of brain disorders that cause a gradual decline in memory, thinking, reasoning, and the ability to perform everyday activities.

It is not a single disease; Alzheimer’s disease is the most common type, followed by vascular dementia, Lewy body dementia, and frontotemporal dementia.

10 early signs of dementia

1. Subtle short term memory and recall difficultiesThis sign may include forgetting what one just did, repeatedly asking the same question, forgetting a recent appointment, but still managing daily life.A study at University College London found that individuals destined to develop early‑onset Alzheimer’s had normal memory at 30‑minute recall, but worse performance when asked to recall after 7 days.

2. Decline in problem‐solving abilityTrouble managing complex tasks, for example something that requires a multi-step function, difficulty switching between tasks, or multi‐tasking.Cambridge University study found that people who developed Alzheimer’s later scored worse on problem‑solving tasks, reaction time, number recall and prospective memory years in advance.3. Changes in mobility, balance or fallsSubtle motor changes such as slower walking speed, more frequent tripping or falling, balance problems, or reduced locomotor agility are some of the early signs. Same study from Cambridge University found those who later developed Alzheimer’s were more likely to have had a fall in the 12 months before baseline assessment. NIH study found increased incidence of motor dysfunction/injuries were noticed 5 to 10 years ahead of dementia diagnosis. 4. Physical and psychological changesSubtle changes like unintended weight loss, shrinking waist circumference, decline in BMI, changes in metabolic markers are some of the early signs of dementia. A longitudinal study found that weight loss began at least 10 years before dementia diagnosis, accelerating 2‑4 years before onset. 5. Changes in mood or emotional regulationAnxiety, depression, lack of interest or apathy, irritability or social withdrawal are subtle signs that shouldn’t be ignored. Large population data show diagnoses of depression, anxiety or mood disorders 5‑10 years before Alzheimer’s diagnosis. It is important to note that depression and anxiety are common in the general population and do not necessarily lead to dementia.

6. Hearing loss or sensory decline Onset of hearing problems, untreated vision impairment, and resulting reduction in cognitive stimulation are found to be the very early signs of dementia.The World Health Organization lists hearing loss and untreated vision impairment among modifiable risk factors for dementia.7. Difficulties with navigationGetting lost in a familiar neighborhood, difficulty with maps or directions, mis‐placing objects, or confusion about spatial layout, if experienced persistently, then one should consult with a doctor. According to Fisher Center For Alzheimer’s Research Foundation, early physical brain changes show spatial/navigation region damage decades before symptoms.

8. Trouble naming familiar objects or in communicationLanguage networks are affected early. Trouble naming familiar objects or people, searching for words, repeating phrases, using more vague language, or difficulty following or joining conversations. A review of early Alzheimer’s symptoms noted that in about half the cases the earliest sign was not memory, but psychiatric or neurologic change. 9. Sleep disturbances or changes in circadian rhythmThis sign may include new onset of disrupted sleep, restless legs, sleep apnea, increased daytime naps or tiredness despite adequate sleep.The Mayo Clinic lists “sleep conditions” (e.g., sleep apnoea) among modifiable risk factors for dementia.10. Unexplained sensory changesThis refers to new onset smell loss, reduced sense of smell or taste, minor tremor or changes in gait, slight vision changes, slower reaction times, or other subtle neurological signs.A large claims‑based study found sensory disorders and motor dysfunction had increased odds for dementia 5 to 10 years before diagnosis.

What to do if you notice these signs