For most people, memory slowly deteriorates with age. You learn new things less easily than before, you forget something, you think less quickly... That's normal.
So it is not because your father asks the same question twice or three times, has forgotten the name of his grandchild, cannot find his glasses or is occasionally a bit confused, that he is on his way to becoming demented. In addition, as you get older, you may have to deal with physical ailments that can occasionally confuse you. Or you can be emotionally impressed by a death, a move... That's all normal.
Dementia is not a normal ageing phenomenon
With dementia, memory deteriorates much faster and worse than is normal for your age because a brain disease causes your brain to deteriorate. The language also deteriorates, familiar actions are lost, familiar objects are no longer recognized and so on.
Dementia is a collective term for a number of brain disorders that involve psychological, physical, mental and social deterioration. It is estimated that 6 percent of over-65s and 30 percent of over-80s suffer from dementia. There are different causes of dementia, but they all have roughly the same characteristics and symptoms.
The main cause of dementia is Alzheimer's disease. More than 60 percent of people with dementia suffer from this condition.
The symptoms of this condition are – especially in the initial phase – not always clearly recognizable. The first signs of dementia are usually subtle behavioral changes. Little by little, mental functioning deteriorates. In the course of the condition, changes in behavior and character occur. The further the disease progresses, the more severe the symptoms become.
The Alzheimer's Association has compiled a list of 10 warning signs that may indicate that someone is suffering from Alzheimer's disease. In other causes of dementia, other symptoms may come to the fore at the onset.
Ten warning signs
- Memory loss
Someone with (early) Alzheimer's often forgets recent things and events. For example, he forgets what he has eaten, who has just been there, where he has put things... But also names and telephone numbers, dates (such as birthdays of children or grandchildren)... Repeating the same things or repeating the same questions over and over again can also be a signal.
In a first phase of dementia, it can happen that the person uses camouflage techniques to hide this as much as possible from the environment, and fills gaps in his memory with events that he imagines. For example, he can tell that he went to the cinema yesterday, when this was not the case at all. It is remarkable that in many cases the long-term memory remains good for a long time. Only in the next phase will that long-term memory be lost.
With ordinary age memory loss, one sometimes forgets names or appointments, but usually one remembers them later.
- Problems planning and organizing
People with dementia gradually have difficulty planning, organizing and making decisions. As a result, they can no longer perform complex actions. For example, performing a prescription, operating a new electrical device, managing medication, running errands or following up on monthly bills. Or they do not understand (anymore) what certain figures stand for. They can also think and act less flexibly, which means that they sometimes strongly stick to certain habits or do not adjust after an error.
- Problems performing easy tasks ('apraxia')
Performing ordinary actions is becoming increasingly difficult because sometimes one loses the overview and no longer knows what one is doing, what has already been done and how it should be tackled further. For example, arranging money matters, operating household appliances, practicing hobbies... It also becomes more difficult to carry out things in the right order. Such as making coffee, preparing a meal, washing or shaving, brushing teeth, dressing and undressing, closing buttons, playing cards...
- Confusion (disorientation) in time and/or space
A person suffering from Alzheimer's disease may be mistaken in time and place. Disorientation in space can manifest itself in different ways, for example by forgetting the place of residence, getting lost in places that are normally well known, no longer knowing where one is...
Disorientation in time can manifest itself in forgetting dates or appointments, not knowing what day or month it is, whether it is day or night... This disorientation in time often leads to nocturnal unrest.
In a later phase of dementia, the person can no longer recognize people from his immediate environment. With an ordinary old-age forgetfulness one can sometimes doubt the day of the week, but fairly quickly one remembers that again.
- Problems recognizing objects, sounds and smells (agnosia)
Over time, the person with Alzheimer's may have trouble recognizing objects, faces, sounds, smells... He may see, hear, smell and feel well, but does not recognize what he perceives. For example, he may smell burnt air but not recognize the meaning of that smell. Or, for example, he can hear the ringing phone, but not recognize the signal as a request for communication. It is also possible that he recognizes the signal, but does not recognize the phone as a device. And he can also estimate distances less well.
- Language problems ('aphasia')
Another symptom is forgetting simple words. The person with dementia can no longer name what he sees or hears. Even basic words such as 'bread', 'bed' or 'eat' can be forgotten. Also, words in the wrong context or unusual words can be used (e.g., "clock" for "hour," or "drink" for "water"). The person may stop talking in the middle of a conversation and forget how to proceed. Or he repeats what he said before. Following a conversation also becomes more difficult.
With age-related forgetfulness, one can sometimes have difficulty finding the right word immediately, but sooner or later one will come up with it.
- Putting things in the wrong place
A person with Alzheimer's can put things in the wrong place and lose things and not find out where they left them. For example, putting a toothbrush in the fridge or a book in the oven. Everyone can sometimes put something wrong, but usually they manage to return to their steps and still find the object.
- Poor assessment of situations
The poor assessment of situations can happen in different ways. For example, an Alzheimer's patient may put on a warm coat when it is scorching hot or leave the house in his shirt sleeves in full winter. Or he can buy things he doesn't need, judge offers badly and suddenly spend a lot of money...
That can also manifest itself in inappropriate behavior, such as undressing in company, starting to swear, giving sexual comments, being afraid of the television, because he perceives the images for real. Usually, this reduced judgment also means that the person with dementia does not see that he is ill.
- Loss of initiative and/or social isolation (apathy)
Someone with Alzheimer's can isolate themselves and, for example, stop with favorite hobbies, avoid social activities, no longer want to do the things of everyday life ... But, for example, watching television all day.
- Behavioural and personality changes
Someone with dementia may start to show different behavior. He may become confused, suspicious, depressed, anxious, or very irritable. For example, he may think that things are being stolen. Also errant behavior, shouting, agitated or aggressive behavior ... may occur.
Without a clear reason, his mood may change. For example, the person with dementia can suddenly start crying and be very happy half an hour later. The character also changes. He can sometimes do things he would never have done otherwise. For example, in people who are previously closed and introverted, it can happen that they suddenly show an openness and disinhibition.
- The earlier the better
When you or a family member exhibit one or more of these behaviors, there is certainly no reason to panic. Nevertheless, it is wise to make an appointment with your doctor. There is little point in waiting for the symptoms to get worse. Your doctor can perform a number of tests and examinations to determine whether it is indeed dementia, or normal memory loss or, for example, depression. The sooner Alzheimer's is treated, the better. Although healing is impossible, a treatment that slows down the disease is possible.