Many, if not most of us have worries at some time that we are developing cognitive problems. Perhaps it is an increase in those ‘senior moments’. Maybe we find that we just cannot grasp how to work a new piece of household equipment. Possibly our family and friends are suggesting that we may have a problem and ought to see a doctor. The popular press is not helpful in the way it describes the first symptoms of dementia.
It is common to see statements such as ‘dementia begins by forgetting small things such as where we have put our keys’. But forgetting where you have put your keys is not in itself an indication of early dementia.
Look at these symptoms:
- Short term memory loss
- Impaired judgment
- Difficulties with abstract thinking
- Faulty reasoning
- Inappropriate behaviour
- Loss of communication skills
- Disorientation to time and place
- Gait, motor, and balance problems
- Neglect of personal care and safety
- Hallucinations, abnormal beliefs, anxiety, agitation
These are all signs and symptoms of dementia. However not everyone with dementia will have all these symptoms and some problems may develop later than others.
Unfortunately not everyone in the early stages of dementia is able to understand or realise that they have a problem with cognition. Dementia by its very nature can prevent the clear thinking and analysis of symptoms which might help you to realise. You may think that your memory is fine. Everyone forgets the odd appointment don’t they? It is part of getting old. You have not forgotten where you put your wallet. Obviously someone must have moved/stolen it.
If you are not sure whether you have a problem or if someone close to you is suggesting that you do have a problem then you might instead like to look at these questions and answer them honestly:
- Does it seem that the person closest to you (wife/husband/child) is less patient than they used to be?
- Do people accuse you of forgetting appointments? (even if you are sure you did not make the appointment)
- Do you sometimes find that things you use have disappeared from their usual place?
- Do you ever find yourself somewhere without remembering how you got there?
- Do complete strangers say hello and suggest you were ignoring them?
- u feel that you cannot be bothered to do anything?
- Do you lose track of the time quite often?
No one wants to think that they are suffering from a serious disease. Doctors’ surgeries are full of patients who did not attend early in their illness because they hoped that by ignoring the symptoms they would go away. For this reason if your family or friends are saying they are worried about your memory you should take their concerns seriously. It might help to remember that other conditions can cause memory loss and confusion. You may not have dementia. However if you do have the early stages of dementia it is better to have the diagnosis as soon as possible so that you can get all the support you can.
Your first step should be to make an appointment to see your GP. If a family member has said that they are worried about you it is a good idea to take them along with you when you go to the GP. Your relative will be able to explain to the doctor why they are worried about you.
Your doctor is likely to do some physical tests such as blood tests. This is because there are some illnesses not connected with dementia which can affect your cognition and your memory. Most of these illnesses are treatable so you should welcome the chance to see if a specific illness is the cause of your cognitive problems. It is quite likely that the doctor may administer a short ‘mental test’. This is simply to check whether the problems you and/or your relative are referring to are ‘normal’ for your age and state of health. You should not be worried about the test and you should not think of it in terms of passing or failing.
After these tests, if the doctor thinks that you have a cognitive problem which needs further investigation he is likely to refer you to a Psychiatrist who specialises in mental health in older people. Occasionally the GP may refer you to a geriatric consultant instead. If you have private medical insurance and wish to use that you will probably be referred to a Consultant Neurologist. The Consultant is likely to give you a longer mental health test and will spend some time talking to you and discussing any problems which you are having with memory. He or she is also likely to want to have a private discussion with your relative be it wife/husband /son or daughter – whoever has most to say about your present problems. This can be quite difficult as it may seem as though people are ‘talking behind your back’ but you should bear in mind that no one wishes to hurt you. It is easier for a relative to speak about things which they have noticed when you are not present to be hurt or upset or even surprised by what may be said.
After the first appointment the Consultant may refer you for further tests or they may order a brain scan. Finally you will meet the consultant again and hopefully receive a diagnosis. If the diagnosis is not clear to you then you should ask any questions you need to at this stage. Some doctors are reluctant to give a clear diagnosis. A diagnosis of dementia depends upon signs of a progressive cognitive decline. Sometimes it may be necessary for the consultant to see you again after a few months to assess if this is happening in your case. It can be difficult to ‘wait and see’ but the consultant is trying to do their best to give you an accurate diagnosis. In the meantime there is nothing to prevent you doing things to help yourself.*
How to help yourself if you think you have dementia is explained in my book Essential Guide to Avoiding Dementia: Understanding the Risks Published by Hammersmith Health Books, priced £14.99 in print, £10.99 ebook www.hammersmithbooks.co.uk
About the author
Mary Jordan works for a national dementia charity and is an Associate Director of ELM (End of Life Management Ltd). She has had considerable experience of caring for elderly relatives and friends and worked in the NHS for 9 years. Earlier publications include books on Caring and on GP Practice Management, in addition to articles in nursing and social care journals and magazines.Last modified: June 10, 2021