Signs of Dementia vs. Normal Aging: 7 Warning Signs

At first, it can be hard to tell whether the changes you notice in an aging parent or loved one's behavior result from dementia or normal aging. However, after nearly 30 years working in the homes of seniors and supporting family caregivers as a home care professional, Nurse Melissa Neylan notes there is a difference between mild cognitive impairment symptoms associated with aging and the early signs of dementia. Most importantly, memory loss associated with normal aging manifests as slow retrieval of memories or facts, rather than as consistent memory disruptions that negatively impact independent daily functioning.

For example, someone with age-related memory loss may forget a name or pause in a sentence while trying to find the right word, but that information eventually comes to mind. If the memory loss is dementia related, they probably won't be able to retrieve the name or word they're searching for. In more advanced cases, they don't recognize the person, lose track of their thoughts mid-sentence and can't retrieve them, or may not remember how to get home from their neighborhood grocery store or bank.

The following signs of dementia can help shed light on your concerns about mild cognitive impairment symptoms or on when your parent should see a doctor for memory loss.

What Normal Age-Related Memory Changes Actually Look Like

Again, we want to reiterate that normal, age-related memory changes slow the brain's ability to retrieve certain information. Still, they do not seriously impede daily functioning, physical safety, or the ability to take care of yourself.

The following age-related memory changes are physiological and not the result of disease. They include things like:

• Inability to recall a name when they run into someone or while introducing one familiar person to another.
• Forgetting the name of a street they lived on in their 30s.
• Slower word retrieval (it's right there on the "tip of the tongue").
• Taking a bit longer to follow directions on a new route.
• Not remembering specifics on a recipe they used to make "by heart," but without losing the ability to follow the printed version.
• Not being able to finish crossword puzzles as quickly as they used to.
• Misplacing their keys (and then finding them again soon thereafter).

While these forgetful moments may be irritating, especially if the name or word isn't recalled within a few minutes, they in no way affect daily life or personal safety.

Warning Signs of Dementia That Go Beyond Normal Aging

If dementia is the root cause of your parent's memory loss, you'll notice more serious warning signs. These seven early signs of dementia warrant your attention and concern. They are typically a sign that a loved one's memory loss is beyond that associated with normal age-related cognitive decline.

1. Forgetting close family names and not recalling them. Drawing a blank on someone's name and then remembering it soon after is normal with age. However, forgetting the names of close family members without recall soon after is a red flag.
2. Getting lost on familiar routes. Despite our best intentions, it's natural for the mind to wander while driving, which can lead to a missed exit or turn. However, getting lost on a familiar route and not being able to get back home is not normal.
3. Repeating the same question within one conversation. Sometimes, people repeat a question in the same conversation because they weren't really paying attention the first time. If this is happening more frequently, rather than just once in a while, it could be a sign of more significant memory issues.
4. Poor judgment that is new and persistent. Normal memory loss can cause someone to take longer to make a decision or to troubleshoot, but their decisions or actions will still be sound. With dementia, executive function becomes less accessible, and this can lead to poor judgment or decisions that don't make sense. New and persistent poor judgment may show up in giving away or donating larger sums of money, neglecting hygiene, or not cooking as many meals because it's harder to follow recipes or cooking instructions.
5. Disorientation about time/season. If your parent occasionally loses track of what day or the exact date, that's not necessarily alarming. A retirement schedule, or lack thereof, can have that effect. That said, if you notice increased confusion about the day or date, or disorientation about the season, they may be experiencing dementia-related side effects.
6. Personality changes. Age-related memory loss does not cause a personality change. Chronic pain might have an effect to some degree, as can frustration around mobility loss or age-related declines in hearing or eyesight. However, uncharacteristic irritability, becoming highly suspicious or even paranoid, or increasing withdrawal from social connections or favorite activities are worth checking in about.
7. Difficulty performing routine tasks. The more dementia changes the brain, the more challenging it is to perform our complete routine tasks. Some of these we've mentioned above, like not being able to follow a recipe. However, someone with dementia will demonstrate a progressive inability to perform routine daily tasks, which can include remembering to feed pets or water plants, cleaning the house or doing laundry, getting the mail or paying bills, keeping up with regular appointments, and forgetting to take medication, among others.

The Middle Ground: Mild Cognitive Impairment

Clinicians use the term mild cognitive impairment (MCI) to describe memory changes that are "greater than normal" but do not yet affect daily living in a disabling way. As a child of someone with MCI, odds are you (and your parent) are aware that "something seems a little off," which is a concern, but there haven't been any serious, safety-threatening events indicating a significant change is necessary.

Some people with MCI may simply experience age-related memory loss that is exacerbated by diet/lifestyle, grief, medication side effects, or other factors. These individuals can still function independently in daily life. Despite the memory gaps or occasional lapses, some of which may be more disturbing than others, individuals with MCI are still safe to stay at home. However, this is the time to begin discussing longer-term options and care plans.

For others, MCI is the visible sign of Alzheimer's or another dementia-related condition. Instead of remaining consistent, the memory lapses increase in duration and severity. As MCI progresses, your parent will need to make changes in their daily life to support their safety, security, and well-being.

When Should You See a Doctor About Memory Concerns?

There can be all kinds of non-dementia causes of mild cognitive impairment in an aging parent, spanning the gamut from nutrient depletion, thyroid issues, or medications to grief, heightened stress or depression. Even so, to be on the safe side, it's never a bad idea to discuss these changes with a general practitioner so they can begin to investigate the cause.

Some more serious red flags or signs that it is time to see a doctor about memory loss are:

Others notice the memory lapses. Usually, the person experiencing memory loss notices first, but becomes adept at covering up the gaps or signs. Eventually, they can't hide it. At this point, their memory loss becomes evident to others, including you, close friends/family, and neighbors.

There's a dangerous "near miss" incident. The risk of harm to themselves or others becomes a very valid concern when senior parents show signs of dementia. Typically, these first "near-miss" incidents include things like forgetting to turn off the stovetop or the oven. They might get lost on their way home from a familiar place or forget which house is theirs while they're out for a walk.

Significant memory lapses happen more frequently. It's one thing if a parent has a "senior moment" every once in a very great while. It is worth your concern if those memory lapses occur multiple times a week rather than every few months.

Personality changes accompany memory loss. Any personality changes that accompany memory loss can be a sign of dementia rather than normal aging. Most of the time, these changes are considered negative, like irritability, moodiness (that may be exacerbated at sunset or in the evening), violence, or the unusual use of vulgar language, social withdrawal, heightened anxiety, or depression.

If these or other memory concerns cause you to worry, speak to your parent about scheduling an appointment with their GP to assess what's going on. There's no need to assume the worst. This is a wellness visit and a request for more information, not a verdict.

Often, the cause of seemingly significant memory loss is as simple as an undiagnosed urinary tract infection or a negative drug interaction. However, if a dementia-related condition is the source, an earlier diagnosis is essential to creating collaborative care plans and to bringing meaning, joy, and safety to everyday life.

What Families in Alameda County Can Do Next

We understand a dementia diagnosis can feel like an emotional landmine. However, the steps you take next can go a long way towards slowing the disease's progression and improving the quality of everyday life for your parent and family.

HomeAide Home Care was founded by Melissa Neylan, LVN, after more than 25 years of a successful nursing career. She was committed to bridging the gap between the clinical world of dementia diagnosis and care plans and an individual's ability to age independently in place at home, surrounded by the people and things they love best.

We are partners in Medicare's GUIDE Program, which provides respite care for family caregivers. Our experienced, compassionate staff works closely with clients and their families to understand the diagnosis, develop current and long-term care plans, and ensure their home or living spaces are accessible, safe, and secure.

Our team has decades of experience providing exceptional dementia care for our clients in Hayward, Fremont, Castro Valley, and San Leandro.

Frequently Asked Questions

Is it normal to forget things more often as you get older? Yes, it is completely normal to experience mild memory loss as we age. However, this type of memory loss has more to do with the brain taking longer to recall things than with complete memory lapses. So, while you may not remember a former colleague's name when you first run into them at the grocery store, odds are it will make its way to the surface by the time you leave the store or are on your way home. Atypical memory loss might look like not recognizing close friends or family members at all, or being unable to recall certain words or recent experiences even hours or days later.

My parent keeps getting lost on routes they've driven for years. Is that dementia? There is no way to answer that question without a formal memory assessment by a qualified professional. Your parent may be getting lost because of negative reactions to their medication or an undiagnosed UTI, which can cause dementia-like symptoms. However, their safety is a primary concern, so we recommend scheduling an appointment with their physician.

What is the Medicare GUIDE Program, and does HomeAide offer it? Yes, HomeAide Home Care is proud to participate in Medicare's new care model, the Medicare GUIDE Program. This nationwide model coordinates dementia care support for those with dementia and their caregivers. It provides evidence-based services including care navigation, 24/7 access to a support line, caregiver training and education, respite services up to $2,500 annually, and connections to community resources.

Should I worry if my parent keeps repeating the same stories? Occasionally repeating stories is normal. However, the frequency and duration of these repeated stories may paint a different picture. If they repeat stories here and there over an extended period of time, that's not such a warning bell. On the other hand, if they ask the same question or repeat the same story repeatedly in the same conversation or visit, or if their frequently repeated questions or stories are accompanied by any of the other signs of dementia we listed above, you are right to be concerned.

Can stress or depression cause memory problems that look like dementia? Yes, absolutely. Stress, depression, grief, or anxiety can cause memory lapses that replicate dementia but are actually just a sign that your parent needs additional emotional support. Memory assessments should be administered by vetted, compassionate professionals who take a comprehensive inventory of your parent's lifestyle and recent history, all of which play a role in the dementia screening process.

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This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a physician regarding memory concerns.

Author: Bobby Young, HomeAide Home Care, Inc. (HCO License #014700021). HomeAide is a nurse-owned home care agency founded in 1998 by Melissa Neylan, LVN, with 25+ years of nursing experience.