Dementia & Memory Loss: When Should You Worry

When is memory loss a red flag for Dementia? When is it an age-related memory problem?

When Geeta V's grandmother started getting confused about her medicines, food timings or whether she had brushed in the morning, Geeta chalked it down to advanced age. By the time she had taken her grandmother to the doctor and, after some tests, received a diagnosis of Dementia, her grandmother's behaviour had become uncontrollable without assistance. But is memory loss always a sign of Dementia? We asked Dr Soumya Hegde, Consultant Geriatric Psychiatrist from Bangalore, to shed some light on this. Here's what she had to say:

Dementia may not always present with memory loss; unfortunately, it may often be misinterpreted as a sign of ageing.

•Nearly 90 per cent of patients in India do not receive a diagnosis until a crisis or behaviour becomes impossible to manage at home. 

•The person may realise that something is not quite right with their behaviour but are afraid to share their concerns for fear of hospital investigations, bothering their family or because they are afraid that the doctor may confirm their fears.

•In several cases, the first sign may be disorientation in a familiar place or confusion. E g., Mr A steps down from the train while travelling from Mumbai to Pune to get a bottle of water. Once done, he boards the train going back to Mumbai instead of his train to Pune. 

•Some of these instances of confusion and memory loss may happen even years before the actual memory loss starts becoming obvious to those around the person.

• Personality change is another sign – excessive spending, a very elated mood, or overfamiliarity may happen for some people. In some cases, an outgoing person may start withdrawing from conversations and become extremely reticent. 

•When we talk about memory loss, it is important to differentiate it from normal age-related memory loss. In Dementia, we are referring to short-term memory. Long-term memories are intact for longer, and people can vividly recall their childhood and early adult years. What they forget would be their breakfast that morning or a conversation with their daughter the previous day.

• Another differentiating feature is the person's inability to retrace their steps. For example, Mrs A enters the home and walks straight to the kitchen to put something in the freezer and leaves her keys in there. She may find them later and recall how they got there. But a person with Dementia may not be able to do so. Inability to retrace steps or having no recollection of the event at all is of concern and should be evaluated

•You need to watch out for difficulty in remembering and performing familiar tasks such as operating the television remote or a washing machine, which they have for years.

• Language difficulty, especially the inability to find words is another sign.

When should you get concerned enough to seek help?

These instances must be consistent for at least six months for a diagnosis of Dementia. Family members are often unaware of these changes or tend to club them under "age." However, it's important to stay aware and seek help and support if you find an older loved one with any of these symptoms.