What were the first signs of dementia you noticed in elderly parents?

[romatucci]

I wonder what you spotted first as the sign of parent's dementia. My DM is 85 lives independently and manages ok. I visited her this summer (she lives abroad) and I noticed although she is still tidy, she doesn't clean (hoover dust) anymore so I did that for her but she had a freak out and a melt down about it. She would clean her windows eventhough she has a person to do it (just the windows), she doesnt want a cleaner. I visit her once a year because a) we have a specific relationship b) I can not afford to fly more often. I talk to her on the phone every 2/3 days. Last 3 years significantly changed and it is same old with an elderly so I do not really have a Mum to talk about life or ask for help. She was alwasy a difficult mother so I moved out at 21. For those last 3 years I started observing occassional slips in memory, or using wrong words to describe something, can not pronounce words that are not difficult. The strangest thing was 3 years we got a new washing machine and she was not able to memories a 3 steps simple sequence. It was horrendous to watch, she was agressive, defensive etc and just could not either understand it (so it makes sense and you remember it) or memorise it. The words twisting became a continuous thing but today i got astounded by the fact she could not remember my surname. I told her to go by the letters of alphabet in order but she did not want to do that, then I suggested maybe she should check it as this is one of the first major sign of dementia and she went off with 'oh yes I was waiting for you to say it of course yes I have it and I need to be locked away' - she just does not want to admit anything, she has always been very vain and starts to become a bit deluded. Last year I noticed a substantial amount of money in cash she withdrew from her account but never told me what for. Denied it. I wonder should I start worrying? What other signs I should look out for?

That sounds like fairly well advanced cognitive decline with multiple classic dementia signs. But if she won't see a doctor or accept help there's not much you can do about it.

Three relatives but not my parents - a number of years ago now so I can't remember exact timings but early symptoms in all three were asking the same questions repeatedly e.g. 'do you want a cup of tea', 'have you been on holiday.yet?' They could still have conversations at this stage but short term memory problems meant that the conversations would often be circular. Another slightly later common symptom was losing items and accusing others (usually a family member ) of stealing them. And being angry about it - none of them had been angry/accusing people previously. Another early-ish symptom in 2 of them was losing understanding of time - in one this meant turning up hours late but with zero awareness that they were late, in another it was phone calls at 3am asking what the time was/whether it was day time etc.

Visiting my parents, also abroad, to find that every cup had a chip in it. My DM was so fastidious we used to joke that smokers had to swallow their ash and the Sunday papers were in the bin by teatime.

I thought my mum was starting with dementia, turns out she just needed hearing aids. I would rule out other possibilities first.

Lack of interest in precisely absorbing hobbies/interests
What looked like a depression but didn’t respond to treatment
stopped contacting friends/family
unable to do online banking
did support unwell relative
very anxious
anger outbursts

Lack of interest in other people
Failing to give ‘normal’’ responses to news
getting lost coming back from the bathroom in restaurants, cafes, museums etc
asking the same question over and over again

My mum forgot my birthday, and when I mentioned it she didn't apologise or really seem to care. She was previously fastidious about cards for the family, even distant relatives. She just stopped giving a fuck. The house also got dirty too and she didn't care, in fact she got angry if I cleaned the loo or ran a hoover round. The previous her would have been mortified. And yes, terrible anxiety. Those were the first signs a couple of years before it all went properly tits up.

Repeated questions and forgetting words, extreme anxiety and catastrophising, social withdrawal, apathy. Increasing self absorption. Gradually losing the ability to do things in the house (cooking etc). The thing with dementia is that it's (often) such an insidious decline. Day by day, the changes are tiny - but now, when I look back to how she was four or five years ago, the change in that time is seismic.

@hoomhom I'm seeing the same with my dad. He's 81 , definitely slowing down mentally and physically. I've asked him to go to the doctor's and get checked out. His response.... I went 3 years ago.
According to him its just age related memory loss.
🤷🤷

It's difficult to say really as people present very differently. Both my parents had alzeheimers (at the same time) but were completely different. The early signs for me was :- general forgetfulness. Nothing to major, just wondering where the remote was etc.. It then became more obvious in things like their appearance. My dad would wear a few layers and mum would wear clothing that she would never dream of wearing!! All I would say, is please take her to the GP as early detection can slow down the process (medication). Our doctor was absolutely brilliant. I know it's not easy getting them there, but I booked an appointment then emailed the GP beforehand about my concerns. Maybe you could try that. Good luck

I think it depends of which bit of the brain gets the protein tangles, or whatever they are, in it first. For dad direction finding seemed to be one of the first things. If anything happened on a familiar route, like closure of a small section of a local road (he was born and lived almost all his life here) he would be completely thrown off.

With mum it was stopping bothering with "stuff". She used to insist on a big family gathering and refusing any help (which would have been gladly given by anyone who endured mum's cooking!) New Years Day but it but suddenly it was too much effort. She used to shop online for birthday and Christmas gifts but shifted to random tat from the Aldi central aisle because "they've made the internet too difficult now".
Then it became she was unable to make a decision having previously been very decisive she'd mull minor decisions for months. Obvious forgetfulness only came later.

The brain, or memory, being unable to hold onto new information sounds very typical. That was the first sign I noticed in my mother. We (my children and I) had a cat and a dog for years, my mum knew their names, of course. Then we got two new kittens, and every time she visited, my mum kept asking 'and what are those cats called?' She just could not retain the names of the new animals. She also became less decisive. My father (very un-domestic and a man of his time) had to take over suggesting things for dinner and even buying stuff for it. And increasingly 'faffy', checking and rechecking the contents of her handbag. And asking the same questions over and over. It is very common and understandable for a dementia victim to be in denial and say 'it's just old age', so your mum sounds very typical.

Also neglecting to change linen or washing or general lack of hygeine

People are sometimes too quick to assume dementia. There’s a difference between natural age-related cognitive decline and dementia.

With one of my parents, they are slower to think, generally anxious about life, forget names and dates, take a day to finish a crossword that used to take them half an hour, clean less as just don’t see the dust or mess - natural age-related cognitive decline.

With my other parent, who has dementia, as an example, I am taking them out for the day and agree to pick them up. They call first thing in the morning to ask what time I am picking them up, I say 9.30am. Five minutes later, they call asking what time I am picking them up and I answer again. Another 10 minutes later, they call asking what time I am picking them up! Repeat. No memory at all of already phoning me a few minutes earlier, repeatedly. But can talk at length about their childhood in detail.

Yes what is the obsession with childhood? It's all my mother talks about. It's like the rest of her life didn't happen.

Looking back, there were signs that maybe should have begun to ring alarm bells. Things like being unable to plan or organise anything or do any admin, turning up very early for things, taking the wrong day's medication, phone/computer were always 'playing up', talking about 'when everything gets back to normal', and repeated phrases like 'it's a strange time, isn't it...', claiming she'd been terribly busy when I knew she hadn't. Oh - and forgetting to pay her car tax for 2 years. These were all in the year or so before being diagnosed earlier this year. Things have progressed fairly rapidly and she now has no concept of time, doesn't know here she lives etc.
It's easy to see now, looking back, but at the time they didn't necessarily feel connected - although I know now that they were. She'd been a little chaotic and passive for some time, so initially they just felt like those characteristics becoming more pronounced.

It is never a good idea to suggest to someone they have dementia. Someone who has dementia is very unlikely to acknowledge it. They no longer have the cognitive capacity to realise it.

From what you describe it does sound like she has dementia. Not being able to use a new washing machine is sign of sequencing problems, which is common with dementia. My mother could not remember the simple sequencing to heat up a ready meal. Forgetting names, and withdrawing money and forgetting about it is another.

When these things happen it is best not to disagree or ‘put her right’. She won’t believe you and it will upset her.

She will start to lose her ability to live independently, and will need increasing amounts of help. Are there any other relatives who live near her? Do you have LPA?

Just changes in attitude and behaviour at first.

Dads sense of humour changed (he always used to be sharp and get the joke / sense the sarcasm).

He also used to love cars and when I got a new car would normally be all over it, asking what buttons did / can we go for a drive etc. Then one day I had a new car and he was totally uninterested and disengaged.

Not being able to work out what he was looking at on a screen - visual processing

A different person - ‘senior moments’ like standing with her front door wide open in winter and wondering why it was cold in the house but still not joining the dots when we pointed out the door was wide open and it was nearly freezing outside.

Those are the clear memories. More recent memories are foggy or disappeared.

With MIL the stand-out incident for me was when we were visiting from abroad, and all of us plus SIL and her family were invited for lunch at PIL. So 6 adults and 3 children. It became apparent that she’d only bought one standard pizza to feed us all. Usually she’d turn out a full three-course meal or at the very least home made soup with filled rolls and salad, then dessert. She looked so confused, and was very quiet about it. SIL made lots of cheese on toast instead. Unf FIL was just oblivious so it was quite a while before any action was taken.

She had Parkinson’s so was much less mobile and started freezing in doorways, looking very confused.

Both of these incidents were about a year or two pre-Covid so about eight years ago.

The first (with visual processing symptoms) is still living pretty independently but needing more support with things like medications and is more ‘difficult’ in personality. Also more general cognitive decline - he was very intelligent so had to fall a long way for it to start interfering with life.

The lady with ‘senior moments’ is now advanced dementia, still recognises family (just) but living in the moment with no short term memory.

Occasional word-finding difficulties - often referred to as an "age-related recall problem" or circumstantial speech - are a normal part of getting older. Whereas a profound loss of comprehension and repetitive mimicking represent genuine signs of cognitive decline. In the context of advanced cognitive decline or conditions like Alzheimer's and frontotemporal dementia, the brain struggles to process the meaning of incoming language. Instead of generating a thoughtful response, the person automatically echoes back the words they just heard, much like a tape recorder, because it is the only way their brain can attempt to participate in the interaction.

Not my parents, but a neighbour I'd known a bit for years - a well-educated professional woman. We were on the management committee for our block of flats and she alleged in a meeting that the accountant at the managing agent's firm must have been stealing from us because of his race. The agent's representative at the meeting reprimanded her but she didn't seem to care, and looked quite pleased at herself for "solving" the issue (there was no missing money).

Then we noticed little acts of vandalism around the building, including a brick in the stairs from the street up to our front door which was loose, then fixed, but then someone repeatedly dug into the drying mortar and loosened it again. It was a pointless thing to do but it happened several times, and another neighbour said he thought he knew who was doing it and I said I also thought I knew, but neither of us would actually say her name. Then she started ripping up junk mail addressed to her flat and scattering the pieces around the foyer instead of just putting it in the bin or the recycling. We could see it was her because she didn't rip through the address properly.

Eventually I heard she'd been diagnosed with dementia, but that was maybe five to seven years after the comment at the meeting.