Reviewed by Dr Sarah Gunn
Among the various challenges that having ageing parents brings, dementia stands as a particularly formidable adversary. According to Alzheimer’s Research UK, one in two of us will be affected by dementia in our lifetime – either by caring for someone with the condition, developing it ourselves, or both. The latest figures indicate that 1 in 11 people over the age of 65 have dementia in the UK, and dementia in the under 65s is also being diagnosed more frequently.
Because people are living longer than ever before, and dementia is on the rise, it’s increasingly important to arm ourselves with knowledge and understanding for the potential onset of dementia in our parents and elderly relatives. This is not to foster fear, but rather to empower and equip you with the knowledge and sensitivity to identify subtle shifts in behaviour, memory, and communication that could indicate early dementia. By detecting early signs of dementia, you can seek timely medical intervention, access to appropriate resources, and most importantly, a continued quality of life. Treatment of Alzheimer’s disease and other dementias is also usually more effective when started early in the disease process, so knowing how to spot the signs and get help early is really key.
What is dementia?
Dementia is a complex condition that has somewhere in the region of 200 variations. You don’t need to spend a year studying medical journals to broaden your knowledge, but knowing at least a little about what it is and what the more common dementia conditions are is useful.
In layperson’s terms, dementia is the general word used to describe damage to a person’s brain cells that affects their ability to think, remember, move or act in their usual manner. While there are other conditions which may cause such brain damage, in dementia, it has usually been caused by disease or minor bleeds in the brain. Importantly, it is not a normal part of getting old (although this is a common misconception).
The most commonly diagnosed types of brain diseases that fall under the dementia umbrella term are:
- Alzheimer’s where the brain cells become damaged by excess protein build up
- Vascular dementia which occurs after the brain’s blood supply is reduced – this might be by a stroke or series or strokes, or by long-term narrowing of blood vessels in the brain
- Alcohol-related brain damage caused by long-term excessive alcohol consumption
- Lewy body dementia which is also caused by protein accumulating in the brain
Is there a difference between age-related memory loss and dementia?
Yes, there is a difference between age-related memory loss and dementia. Getting a bit forgetful is normal as we age. Age-related memory loss occurs because of physiological changes that come with getting older, and can be made worse by certain lifestyle factors.
Social isolation can also have an impact. If your elderly parent spends most of their time at home alone, they might not get the brain stimulation they need to stay sharp. Struggling to find the right word when they do converse might just be a symptom of not having spoken to anyone for a few days rather than a symptom of dementia.
We all misplace objects like the TV remote, mobile phone, purse or wallet or front door keys from time to time. If your parent or relative tends to lose things when you visit and has you searching for them, then this might not necessarily be a sign of major problems with their memory It can be a diversion in an otherwise monotonous daily routine. They may also be trying to subtly tell you they’re worried about their memory.
An infrequent misplacing of objects or the occasional search for the right word isn’t something to worry about. However, if it happens often, if your parent forgets the way home, if they repeat themselves constantly, or if they suddenly don’t know how to do something they do every day, then there might be a more serious underlying cause. That cause doesn’t necessarily have to be dementia, but it may mean they have something called ‘mild cognitive impairment’.
What is mild cognitive impairment?
Mild cognitive impairment (MCI), is something you’ve probably never heard of, but is estimated to affect between 5 and 20% of people aged over 65. MCI is a condition in which memory loss and forgetfulness is greater than what is classed as normal for a person’s age. Whether someone has MCI or normal age-related memory loss can be determined by conducting a series of assessments – however, it can be a difficult condition to diagnose and there are no drug treatments available specifically for MCI.
Although a person with MCI is at greater risk of developing dementia, being diagnosed with MCI doesn’t necessarily mean a person will go on to develop dementia. MCI can cause some interference to daily life, but many difficulties can be compensated for using some strategies to help people keep doing the things they enjoy. For example, they might benefit from memory joggers such as a calendar, a daily agenda to remind them of important things, alarms on their phone, or a whiteboard on the fridge with key reminders written where they can see them easily.
What should I be looking out for?
The signs of someone developing dementia can be hard to spot, especially in the early stages. Dementia doesn’t appear overnight, and it takes time for the signs to become apparent. That gradual development means that you’ll more than likely take your parent’s behaviour for granted for quite some time, or maybe not notice that anything has changed at first. People can feel very guilty when that happens, but it’s really easy to miss things that happen gradually in front of you.
There’s no denying people do change as they get older, it’s part and parcel of ageing – but the onset of dementia can change them in different ways. And that’s what you need to look out for. Take note if your relative shows signs of any of the following difficulties:
- Constantly repeating questions or saying the same thing over and over again, as if they’ve forgotten they’ve already said it
- Frequently calling everyday objects by the wrong name, in a way that isn’t usual for them
- Seeming generally confused or vague
- Appearing less interested than usual in regular daily activities
- Being wobbly on their feet or having new mobility problems
- Starting to struggle with managing money or understanding their financial affairs
- Being apparently unable to express their emotions or seeming oblivious to someone else’s
- Struggling to hold a conversation
- Developing hearing loss
While the above are the most common signs of dementia, they’re not the only ones, and they can also be associated with lots of other things. Each different type of dementia also has a variety of different symptoms. For example, people developing Lewy bodies may have spells of drowsiness, suffer from hallucinations or fall frequently. And even in the same type of dementia, difficulties can still look very different from person to person.
How do you test for dementia?
Your relative having one bad day or being a bit wobbly on their feet one afternoon isn’t cause for you to rush them to the doctor for an assessment. It’s better to observe their behaviour for two or three weeks and make a note of things that concern you. If over that period of time you note some key symptoms then it’s a wise idea for them to get a professional assessment.
There are also online dementia tests that you can do together with your relative that will help you and they decide if they need to seek further help. But make sure to use a reputable site, as there are lots of not-so-reputable tests online which will not give you good results, but may give you cause to worry. A good place to start is with the questionnaire on the Alzheimer’s Society website. The Alzheimer’s Society online dementia test contains twenty simple multiple-choice questions. Once all of the questions have been answered you can either download the results or have them sent to an email address.
Don’t forget though that even this is not a definitive medical test, just one that may give you a preliminary inkling of whether there is something to be concerned about. It’s not the same as an assessment a doctor would conduct, which would be much more thorough and use specialised tests. So if you suspect that your parent or relative may have dementia, encourage them to make an appointment with their GP and accompany them if they’re happy to have you there.
A dementia assessment conducted by health professionals involves several elements, the most common being:
- A physical examination
- Blood analysis
- A review of existing medical conditions and the medications being used to treat them
- Cognitive tests to measure a person’s “cognition” (thinking skills) such as their memory and concentration
- A hearing test
- A CT or MRI scan of the brain
None of these tests will usually give a conclusive diagnosis of dementia (although there are some specific forms of dementia which can be identified using a blood test – for example, Huntington’s disease). Doctors generally use results from various sources before they reach a decision on whether or not a person has dementia and it takes time for those tests to be completed.
Are there ways to help prevent dementia?
Dementia is thought to be caused by a variety of different factors, and these vary according to the type of dementia someone has. While there is no guaranteed way to prevent dementia the latest evidence according to Alzheimer’s Research shows that up to 40% of dementia cases globally could be prevented or delayed by addressing wide-ranging risk factors in our day-to-day lives. These include hearing loss, high blood pressure, air pollution, smoking and social isolation.
You can learn more about brain health and protecting against dementia by checking out the Think Brain Health Check In.
Lifestyle plays an important part of keeping dementia at bay so the sooner you or your relative start living a healthier, more active life, the better chance of avoiding dementia you, and they, will have. Evidence has shown that the key factors in reducing the risk of developing dementia or slowing down its progress are:
- Being physically active and doing some form of aerobic exercise at least two or three times a week
- Doing activities that will help build muscle strength – gardening or dancing are ideal
- Making sure you’re eating a balanced diet that includes less processed food and more fresh produce. Scientists are currently recommending the MIND diet which is a combination of the Mediterranean diet and the DASH diet which consists of vegetables, fruit and pulses and less meat and sugar products.
- Keeping bad habits like drinking and smoking to a minimum. Better still if you can give them up completely
- Staying mentally stimulated and being sociable
What about ‘brain games’? Although are a lot of ‘brain game’ apps have become available in recent years, be wary of any claims that playing these can stave off dementia or age-related cognitive decline. There is no science to back this up.
It’s never too early to start making positive changes for your brain health. In fact, research suggests that taking steps to look after your brain in your forties and fifties may be particularly important, so take note for yourself not just your parents!
What happens if your parent is diagnosed with dementia?
If your parent is diagnosed with dementia, you’ll need to take things one step at a time and follow the advice of their medical practitioner. Dementia develops differently in each individual, but their doctor will be able to explain what point they are at and the best way to move forward and monitor the disease as it progresses.
There is no cure for dementia at the present time, but there are medications that can be prescribed to help decrease the amount of accumulated proteins in brain cells. Your parent’s doctor may recommend taking those to help their cognitive functioning, but it will depend on the type of dementia they have and what stage they are at. They may also be prescribed antipsychotic medication if they’re having hallucinations, antidepressants to help with mood changes, anti-anxiety medication if they are stressed, or medication to help them sleep better.
Dementia is still not fully understood, but there are ongoing clinical trials that are researching:
- Ways to prevent dementia
- Better ways to diagnose dementia
- Ways to improve quality of life with dementia
- The effects of new drug treatments and non-drug treatments
All of the clinical trials rely on volunteers to be able to continue with the research. If you’d like to help dementia science advance through volunteering, you and your relative can find out more on the Alzheimer’s Society clinical trial webpage, and sign up to Join Dementia Research.
If your relative is still in the early stages of dementia and their symptoms are mild, their doctor or health team may recommend cognitive stimulation therapy (CST). CST was developed at University College London for people with a mild-moderate dementia diagnosis, and evidence shows that people taking part in CST report increased quality of life and typically improve on tests of memory and other abilities. CST is usually conducted as a group therapy session in which those present are encouraged to participate in mentally stimulating activities, but it can be done one on one at home with the help of these official manuals. As well as CST organised by local authorities, AgeUK are in the process of setting up and running CST sessions throughout the country so you might like to check if they have one in your local area.
How to cope with a parent with dementia
Once you’ve come to terms with your parent’s dementia diagnosis (and that can take time), it’s perfectly understandable to find yourself worrying about how you’re going to cope as the disease progresses. The one way you can’t cope is alone. You will need support.
One way people are increasingly finding community and support is through social media, with Instagram influencers like @dementiadarling (Carrie Aalberts), @belightcare (Adria Thompson) and @dementia_careblazers (Dr. Natali Edmonds) offering tips and encouragement for families and carers coping with dementia. However, when turning to the internet or social media for advice, always check that the account creator is backed by an authentic organisation or has professional qualifications.
Other good sources of support can be found at:
- The Alzheimer’s Society who will give you personalised support over the phone
- Dementia UK who offer one to one support from their team of Admiral nurses
- AgeUK who have a free advice line you can call for support from 8am to 7pm any day of the week all year round
There may also be special dementia support groups in your area. You can find out about those at the doctor’s surgery or from the local council office.
The more you know about dementia the better. By becoming aware of its early signs and symptoms, we can play a crucial role in intervening early and providing the support and care our ageing parents and relatives need for a better quality of life with this disease. And being well-informed about how to keep it at bay means you and your parents can start to make lifestyle changes that could delay its potential onset.
- Is there an online test to determine if someone has dementia?
No, no online test can tell you if a person has dementia. However, there is an online test on the Alzheimer’s Society webpage. It doesn’t determine whether a person has dementia, but will indicate if you need to investigate further and get a professional opinion.
- How reliable are online dementia tests?
Online dementia tests are simple questionnaires, and don’t replace a medical diagnosis. They can’t determine whether a person has dementia or not, but will indicate if dementia is a possibility. You would then need to get a professional assessment.
- What is the 12 question dementia test?
This is a test, the SAGE test, that may be conducted by a medical practitioner to check for cognitive function during diagnostic procedures for dementia.
- Can dementia be prevented or slowed down?
It is thought that the onset of dementia and the progression of its symptoms may be delayed by being physically active, mentally stimulated, socially connected and by following a well-balanced diet. However, the degree to which this can make a difference is uncertain. We do know though that these things are good for general health and wellbeing, so they are worth doing.
- Are there any new breakthroughs or treatments for dementia?
Research into dementia is continuous and new findings are made regularly. New medication is being developed, as are non-drug related therapies. You could consider signing up to the mailing list for organisations like the Alzheimer’s Society, which will keep you up to date on new developments.
Disclaimer: The information provided in this article is intended for general informational purposes only and should not be considered as professional medical advice or a substitute for consultation with a qualified healthcare provider. While we strive to present accurate and up-to-date information, the field of dementia is complex and rapidly evolving.
Individual experiences with dementia can vary, and the signs mentioned in this article may not apply to everyone. If you suspect that an ageing parent or elderly relative is exhibiting signs of dementia, it is important to seek guidance from a healthcare professional who can provide personalised assessment and recommendations.
Furthermore, this article is not an exhaustive resource on dementia, and readers are encouraged to consult reputable medical sources and organisations for comprehensive information. We do not endorse any specific treatments, therapies, or interventions mentioned in this article. Always consult with a healthcare provider before making any decisions about the health and well-being of your loved ones.