Your father keeps misplacing his keys, or your mother repeats herself. Should you be worried about dementia? If those seemingly minor issues are new ones, you’re right to be concerned.
“People tend to attribute too much to normal aging and are a little dismissive of cognitive loss,” says Dr. Paul Fishman, a professor of neurology at the University of Maryland School of Medicine and a neurologist at UMD’s Medical Center. “Dementia is very common, and in general it is under-diagnosed, rather than over-diagnosed.”
Roughly 9% of Americans have dementia, which is a blanket term for a loss of intellectual function that is severe enough to interfere with day-to-day life. That interference often takes the form of memory loss or confusion, but it could also manifest as poor hand-eye coordination, problems with tasks like cooking or operating a computer, or mood and behavioral changes ranging from depression to hostility.
“Driving issues, especially struggling to find their way around areas they know, or not judging distance between cars, or making turns inappropriately, are all symptoms,” Fishman says. “Responding to telemarketers when that’s out of character for them or struggling with finances are also worrying things.”
But the number-one red flag a child or caregiver needs to watch out for is change. If someone is acting differently than they used to, that’s good reason for them to see a doctor for an evaluation, Fishman says. That evaluation will include some form of cognitive assessment—either quick or in-depth, depending on the person’s symptoms—and may also entail blood work or other tests to rule out non-Alzheimer’s factors.
In the majority of dementia cases—at least 60%—the loss of cognitive function will be caused by Alzheimer’s disease, says Gary Small, a professor and director of geriatric psychiatry at the University of California, Los Angeles’s Brain Research Institute. “Alzheimer’s is a neurodegenerative process in which abnormal plaques or deposits accumulate in brain regions controlling thinking and memory and other functions,” he says. “As that process progresses, it causes dementia.”
While some drug treatments and lifestyle adjustments may slow the development of Alzheimer’s disease, there is no cure for the condition, Small says.
Still, prompt diagnosis is critical. It’s easier to protect a still-healthy brain than it is to repair a damaged one. “If you can get an accurate Alzheimer’s diagnosis early, we may be able to put off severe effects for years,” he adds.
Even if your parent is relatively young—in her 50s or 60s—don’t ignore memory slips or new symptoms. While rates of dementia really balloon once a person reaches age 80, about 10% of dementia cases are diagnosed by age 65—and for some, the loss of function sets in earlier, Small says.
At the same time, there are also other triggers of cognitive decline that are treatable and in some cases reversible. These include everything from an undiagnosed stroke to a thyroid condition or medication side-effects. This fact—that many cases of dementia are caused by fixable, non-Alzheimer’s sources of impairment—may be a good way to coax a parent into visiting a doctor for an assessment, which can be a tricky conversation for kids and caregivers, Fishman says.
In fact, talking about dementia with a parent is often more difficult than spotting the warning signs. Fishman says another aspect of dementia is impaired insight, so a loved one who’s struggling may not recognize his symptoms or acknowledge that there’s an issue. “When family approach them, they may be either dismissive or angry,” he says. “There can also be some degree of paranoia,” which makes these sorts of conversations rough.
If talking about the issue with your parent isn’t working—or you’re worried they’ll react poorly—Fishman recommends calling your mom or dad’s doctor to let them know about your concerns. “The doctor won’t be able to share results with you,” he says. But at your mom or dad’s next check-up, the doctor can perform an assessment and take appropriate steps.
The most important message: Don’t dismiss memory problems or other symptoms as run-of-the-mill aging. Even for a loved one in her 70s or 80s, “a loss of cognitive ability that interferes with function is not normal,” Small says. If your parent needs help, you can ensure they find it.