Signs of Dementia


November 18, 2016

Often when we think of a dementia patient we have a specific idea of who that may be. Generally, we picture a grandparent or great-grandparent, someone who is at least 65 years old and who has retired. In our minds, this person is able to sit back and relax and reminisce about their younger days: childhood memories, the birth of children, or a fruitful career. But while they may be able to remember certain memories, we picture this patient unable to remember anything about what happened yesterday. We imagine them elderly and stuck in the past.

Unfortunately, this is not a true representation of what dementia is.   

According to the Alzheimer’s Association, this is an “artificial cut-off point.” While we think dementia can’t happen to those who are younger, the truth is dementia can begin to show itself in patients as young as their 30s and 40s. And, these signs and symptoms are exactly the same as we see in patients age 65 and older.

Problem – Solving Difficulties

Memory loss is the number one symptom of dementia. Typically a close family member will recognize the signs and an accurate diagnosis can happen even as young as in your 30s. Problem-solving issues and complex tasks become more of a struggle, as well as finding the right words to explain a thought can become overwhelming. Things that were once simple, such as planning a meal or taking out the trash, can cause someone with early signs of dementia to sit for a long time to think about how to complete the task.

Also, those who are struggling with dementia will show signs of confusion or disorientation. For example, they may be driving a familiar route to or from the store and become confused as to where they are and how to get home. While many of us have experienced walking into a room and forgetting what we went in that room to do, someone with dementia might not know where they are once they walk into the room.


Personality changes are also a sign of someone who is struggling with dementia. They may become anxious, agitated and depressed very easily and sometimes even suffer from paranoia.  Some patients may behave in an inappropriate way that is completely out of character with the person they have always been. Others describe hallucinations that are very real to them.

Caregivers of dementia understand the struggle with complex tasks that confuse the patient, but delusions can also become a very intimidating problem to handle. When the confusion is combined with delusions, the situation can go from difficult to out of control.


Patients with dementia see the world in a completely different way than those who do not have dementia. Dementia patients can hear something that is not there, or they may believe something that is not true. In the early stages they can typically understand that something is a delusion, but later they have an increased amount of stress and agitation when they try to determine what is real and what is not.

Hallucinations and delusions are not the same. A hallucination is a complete sensory experience and involves what they see, hear and feel, but none of it is real. Delusions are false impressions of something that is actually happening, but not the way the patient understands it.

Reassure, Respond and Refocus

It is important to remember the “Three R’s” when caring for someone who is experiencing a delusion and is fearful or anxious. Do not try to logically explain the situation but rather reassure, respond and refocus the patient to calm them. Empathize and reassure the patient that they are safe and help them to feel understood and calm. Say things such as, “You seem upset about the noise at the door. It was the dog, and you are safe.” Then try to refocus them with a new activity to distract from the stress they are feeling.

As dementia progresses, delusions will likely occur. Remember to always show respect to the patient and try not to diminish their self-esteem. While it is difficult sometimes to be patient, do not forget to reassure, respond and refocus when caring for someone with dementia. Regular communication with a medical provider will help to ensure patient safety.

Again, accurate diagnosis is important, especially with someone in their 30s and 40s. Often healthcare professionals attribute signs of dementia to stress. Regular communication with a medical provider will help to ensure patient safety if symptoms do not improve. Additional cognitive or neurological tests may be necessary to effectively diagnose and treat dementia patients no matter the age.

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