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Early Signs and Symptoms of Dementia and Alzheimer's Disease

There are many early signs of Alzheimer's disease, with the most common being listed below. Every individual may experience one or more of the signs, which can often be dismissed as signs of ageing.

Memory loss that disrupts daily life. This may include not being able to recall recent events or information. This can also result in repeated questions and discussion about the same topic. Not being able to remember what the person ate or did the day before.
Forgetting names of common-day objects and close family members.
Troubles in planning, for instance not being able to organize relatively simple tasks, or being unable to organize a shopping list.
Difficulty in completing daily tasks. This may include not being able to remember how to play a familiar game, forgetting how to make a cup of tea, being unable to drive to a familiar location. Taking longer than normal to complete simple tasks.
Confusion with time or place. Not knowing what day of the week it is, what time of the day it is, not remembering how the person got to a particular location.
Troubles in understanding visual relationships. Visual problems are common, not recognizing familiar people or places, troubles with distinguishing contrasts.
Problems with language. Not being able to find a particular word to describe things, or not being able to identify a particular object by name.
Misplacing or displacing objects. Putting objects in unusual places, being convinced that objects have been moved or stolen.
Decreased or poor judgment, including lack of personal insight. People with AD may have poor judgment when it comes to social behaviour, or in dealing with money. They may not recognize social norms and may do or say inappropriate things.
Withdrawal from friends, hobbies, social interactions or sports. They may avoid events or conditions that expose their condition.
Changes in mood and personality are quite common. The AD person may be confused, anxious, irritable or lose interest in normal activities.
Depression.
Loss of sense of smell.
Loss of continence in bladder or bowel.
Troubles keeping track of expenses and failing to pay bills.
Decline in personal hygiene
Forgetting how to play familiar games
Difficulty sleeping

Early Physical Signs of Dementia and Alzheimer's Disease

Apart from the mental signs of dementia outlined above, there are also early physical signs of dementia. Some of these may be apparent up to 7 years before clinically diagnosed onset of dementia.

Changes in gait, including reduced stride length, reduced velocity and increased stride time. These were predictive up to 7 years before the development of clinical dementia (1,2,3, 4). Gait speed alone was predictive of survival time (5)
Changes in balance, including mild swaying on standing.
Frequent falls.
Inability to balance on one leg
Fatigue
Unsure step and shuffling gait
Loss of muscle tone/strength.
Peripheral neuropathy, including tingling in hands or feet, numbness in hands and feet, dropping things, insensitivity to cold, lack of feeling of touch, inability to do up buttons.
Urinary and fecal incontinence are much more prevalent in those with dementia (6,7).
Insomnia is associated with an increased risk of dementia (8).
Weight loss.
Slower activity in the Timed Up and Go Test (ie how often a person can stand from a sitting position in a limited amount of time)
Lower performance in the Berg Balance Scale (BBS) (9)

Assessment of Dementia

An Internationally agreed set of criteria for diagnosing dementia has now been established, and a simple test is often used that can be found at the following link: http://dementia.ie/images/uploads/site-images/MoCA-Test-English_7_1.pdf . It should be noted, however, that by the time that a person "fails" this test their condition is very well advanced. It is the intention of this site to help people who may develop dementia, with earlier modes of detection, in the hope that they can delay, prevent or even reverse the development of AD.

A Berg balance test has been found to be useful in comparing the status of individuals with dementia and Alzheimer's disease (8).The test combines assessment of balance during standing, turning, walking, reaching for objects, and also time to stand from sitting. This sort of assessment may be particularly useful for early assessment of dementia, particularly for persons associated with the affected person

References on Dementia

Bahureksa etal, 2016 The impact of mild cognitive impairment on gait and balance: A systematic review and Meta-analysis of studies.... PMIT: 27172932
Dumurgier etal, 2016 Gait speed and decline in gait speed as predictors of incident dementia. PMIT: 27302701
Cohen etal, 2016 Cognition and gait in older people. PMIT: 27240713
Tian etal, 2017 The relative temporal sequence of decline in mobility and cognition among initially unimpaired older adults PMC5860013
Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA 2011;305:50–58
Orme etal, 2015 Managing urinary incontinence in patients with dementia. Pharmacological treatment option and considerations. PMIT: 26169438
de Codt etal, 2015 Management of demented patients with urinary incontinence: A case study. PMIT: 26147911
Almondes etal, 2016 Insomnia and risk of dementia in older adults: Systematic review and meta-analysis PMIT: 27017287
Muir-Hunter etal, 2016 Defining Rehabilitation Success in Older Adults PMIT 2699925
Berg Balance Scale www.aahf.info/pdf/Berg_Balcance_Scale.pdf