Dementia Symptoms

By Dr Ananya Mandal, MD

People with dementia suffer from several symptoms that indicate decline of mental faculties over time. Areas of the brain affected by dementia include those used for language, memory, perception, emotional behavior and personality and cognitive skills including abstract thinking, calculations or judgment.

Initial symptoms

The first symptom is usually forgetfulness. Forgetfulness is normal to a certain extent. The stage between normal forgetfulness due to aging and frank dementia is called Mild cognitive impairment (MCI).

People with MCI are at risk of future dementia but not everyone with MCI develops dementia. They may have mild problems with thinking and memory that do not interfere with everyday activities and the individuals are usually aware of their forgetfulness.

In dementia, individuals commonly forget recent events or conversations.

Other initial symptoms include:

  • Difficulty in multi-tasking. Most individuals face difficulty in focuses or concentrating that makes doing more than one task at a time difficult.
  • Difficulty in solving problems, making judgements or making decisions.
  • Individuals may take longer to perform more difficult mental activities.
  • During the early stages patients with dementia have difficulty in performing tasks that require some thought, but that used to come easily, such as balancing a check book or playing known card games. At early stages due to forgetfulness individuals may get lost even on familiar routes, have trouble finding the name of familiar objects and misplace items.
  • Early dementia also is characterized by loss of interest in things the individuals enjoyed previously and flattening of mood and apathy. There are personality changes such as loss of social skills, which can lead to inappropriate behaviors in company.

Symptoms of progressive dementia

With progressive dementia, symptoms become more obvious and interfere with daily living activities. Patients may complain of changes in sleep patterns with insomnia being common, difficulty in choosing appropriate clothing, cooking meals and driving, forget their own life history and awareness of self and details of current happening.

Some individuals with progressive dementia may develop delusions, hallucination and turn to arguments and violent behavior. They may suffer from depression and agitation as well.

Individuals have difficulty reading or writing and difficulty in judging danger (for example reckless driving or crossing the roads), use mis-pronounced or wrongly used words, develop confusion and withdraw from social contact.

Symptoms of severe dementia

People with severe dementia cannot perform basic activities of daily living, such as eating, dressing, maintain hygiene etc. They cannot recognise friends and family members or understand language. This may be accompanied by incontinence and swallowing difficulties.

Symptoms of vascular dementia

The symptoms of vascular dementia can develop suddenly and quickly worsen. They may also develop and progress gradually. Individuals have:

  • increasing difficulties with tasks and activities that require attention or thought
  • loss of memory
  • reduced attention span
  • changes in personality and flattening of mood
  • periods of mental confusion
  • depression
  • muscle weakness or paralysis on one side of the body mimicking a stroke
  • urinary incontinence
  • visual hallucinations
  • unsteady gait

Symptoms of dementia with Lewy bodies

The symptoms of dementia with Lewy bodies also develop slowly over many years. Some of the symptoms include:

  • memory loss
  • low attention span
  • mental confusion periods
  • delusions and hallucinations
  • slow movement and muscle rigidity and stiffness
  • shaking or arms and legs
  • difficulty in maintaining balance while walking
  • loss of facial expression
  • insomnia
  • lack of judgement and planning abilities

Symptoms of fronto-temporal dementia

Since the frontal and temporal lobes of the brain are affected, emotional responses and behavior are affected in this type of dementia. These individuals become less sensitive to other people’s emotions. This can make them seem cold and unfeeling. There may be uninhibited and unacceptable behavior in public.

Other symptoms include

  • agitation 
  • aggressing, distracted behaviour
  • lack of interest
  • personality changes
  • compulsive behaviors etc.

Some people with fronto-temporal dementia also have problems with language.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Dec 17, 2012

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