Dementia and Normal Ageing, Spotting the Difference

With dementia, someone is likely to show a noticeable decline in the ability to communicate, to learn skills, to remember things and to solve problems, what is known as ‘executive function’. These changes tend to occur very slowly over time. If you think someone may have dementia there are ten key things to look out for which are detailed further, to read on click here.

* Short-term memory loss
* Impaired judgment
* Difficulties with abstract thinking
* Faulty reasoning
* Inappropriate behaviour
* Loss of communication skills
* Disorientation in time and place
* Gait, motor and balance problems
* Neglect of personal care and safety
* Hallucinations, abnormal beliefs, anxiety, agitation

The fact is that, as we grow older, many of us suffer from some of the above symptoms. It is very difficult for someone without medical knowledge to know whether these are a sign of ‘normal’ ageing or are evidence of developing dementia. It can be very frightening to forget your telephone number or a recent event and then to worry that you are developing dementia.

Dementia is not part of normal ageing. Older people may have memory lapses but the memory problems associated with dementia are specific to the illness.

Losing your thread

It is possible to compare some of the symptoms and to see how these differ in normal ageing and in dementia. For example, any elderly (or not so elderly) person may complain about memory loss, but on questioning they would be able to provide examples of this, such as ‘I completely forgot where I put my keys yesterday’. However, someone with dementia may not even realise that they have memory problems, may indeed vigorously deny this and may accuse others of making things up when they are given examples of how they have forgotten something.

Most people have occasions when they have to search for a word or substitute a word temporarily. Someone with dementia frequently has to pause to find the right word and may often lose their way in a sentence, perhaps trailing off or diverting to some other subject or drifting into irrelevance.

Getting lost in familiar places

As we get older some of us may find we have to pause to recall directions clearly or may have to repeat directions to remember them, but we do not get lost in familiar places or forget the route home from the local shops, for example. People with dementia may often get lost in familiar places. Many carers say one of the first things they noticed was that the person with dementia forgot a simple route, such as the way back from the toilet in a restaurant (this is a very good example of short-term memory loss).

Forgetting what just happened

Older people generally can remember recent personal events, especially major events, but people with dementia may forget what happened yesterday even if it was something as important as a grandchild’s christening. They may, however, easily recall events in the distant past with great clarity.

Losing interest

People with dementia may lose interest in social activities or hobbies and pastimes. They may forget to wash or be unable to put on a simple article of clothing.

Older people generally retain their social skills and normal routines, such as washing and dressing, even if it takes them longer to carry out these actions than when they were younger. They also usually continue to enjoy social occasions and their normal interests.

What else might it be?

These signs and symptoms are indicative of dementia, but we have to be wary of making assumptions. For example, some forms of depression cause people to lose interest in their appearance and to cease bothering to wash or change their clothes. There are also a number of conditions that may ‘mimic’ dementia or cause a temporary dementia-like state. One example is low blood sugar, which can cause susceptible people to become confused and agitated. A urinary infection can also cause symptoms similar to dementia in older people. These symptoms normally come on fairly suddenly, without the history of a slow decline that we usually see with developing dementia.

Adapted from: The Essential Carer’s Guide to Dementia by Mary Jordan (Hammersmith Health Books)

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