Five surprising dementia red flags that aren’t memory loss

Perhaps it crosses your mind when you lose your car keys, (for the fourth time today). Or when you call your son my the dog’s name. Again. Memory loss is the best-known symptom of dementia, after all, and one in three people born in the UK today will develop it at some stage in their lifetime.

Yet a growing body of research suggests that the very first warning signs (those that signal the earliest brain changes) are not always related to forgetfulness. In fact, on the surface, they might appear to have very little to do with your mind.

In isolation, of course, each of these red flags may well prove nothing at all to worry about. But if they persist, appear in combination or trouble you, it’s always better to get your doctor’s opinion. Accessing the right support early, and putting the right interventions in place, can make all the difference.

5 early signs of dementia

Becoming less sociable

While dementia’s link with learning and memory problems is well recognised, its impact on your social and emotional life is much less so. Yet, your sociability and mood can be important early signs, says Dr Barbara Sahakian, Cambridge University neuroscientist and author of forthcoming book Brain Boost: Healthy Habits For A Happier Life.

“Watch out for early signs of older family and friends becoming detached socially and not engaging in conversation when on holiday or at other social events – this may herald the onset of dementia,” she says.

Why? Because ageing brains undergo changes to both the chemical serotonin (associated with mood) and dopamine (associated with motivation). “So, early signs of dementia may include increases in depressive symptoms or the lack of motivation or interest in participating in activities that a person used to find enjoyable,” says Dr Sahakian.

In fact, it works both ways. While dementia leaves you more likely to become socially isolated, isolation can also contribute to your dementia risk. Studies suggest that depression raises your risk of dementia twofold, so getting out and seeing friends really will help lower your risk.

Suffering from nightmares

In 2022, researchers at the University of Birmingham found that you might develop a persistent problem with nightmares several years, or even decades, before the well-known memory and thinking problems of dementia set in.

“We’ve demonstrated for the first time that distressing dreams or nightmares can be linked to dementia risk and cognitive decline among healthy adults in the general population,” said study lead Dr Abidemi Otaiku.

His research showed that middle-aged people (35-64) who experience bad dreams on a weekly basis were four times more likely to experience cognitive decline over the following decade, while older people were twice as likely to be diagnosed with dementia. Interestingly, the association was much stronger for men. Older men experiencing nightmares on a weekly basis were five times more likely to develop dementia than those reporting no bad dreams, while for women, however, the increase in risk was only 41%.

“We believe bad dreams could be a useful way to identify individuals at high risk of developing dementia, and put in place strategies to slow down the onset of disease.”

The good news is that recurring nightmares are treatable. In fact, a common medical treatment for them has already been shown to decrease the build-up of abnormal proteins linked to Alzheimer’s disease. “Nightmares can be treated,” says Dr Otaiku, “and it logically makes sense that treating nightmares would help to reduce Alzheimer’s risk – although no study has definitely proved this yet.”

Losing your sense of smell

“An olfactory test is a possible early test for dementia,” says Dr James Goodwin, director of Science and Research Impact at the Brain Health Network, former Chief Scientist at Age UK and author of Supercharge your Brain. In 2017, American researchers discovered a surprising link between dementia and smell. Cognitively healthy 57- to 85-year-olds who have difficulty detecting odours were, they found, more likely to develop dementia five years later. Further investigation showed that a declining sense of smell was associated with a reduced volume of grey matter in the areas of the brain associated with memory.

“This study provides another clue to how a rapid decline in the sense of smell is a really good indicator of what’s going to end up structurally occurring in specific regions of the brain,” said senior author Jayant M. Pinto. While sense of smell alone shouldn’t worry you, it could, he suggests, form part of a picture. “If we could identify people in their 40s, 50s and 60s who are at higher risk early on, we could potentially have enough information to enroll them into clinical trials and develop better medications,” said Rachel Pacyna, another researcher in the study.

Slightly slower driving

In 2021, a study from the University of Washington found that, for some people, very subtle changes to the way they control a car could be indicators of the early stages of Alzheimer’s disease.

Study participants aged 65 and over had GPS trackers attached to their cars for a year. Medical tests had already shown some of them to have preclinical or very early stages of Alzheimer’s. When the GPS data was analysed, these participants were found to drive more slowly. They were also less likely to travel at night, logged fewer miles overall and visited a smaller circle of destinations. “The findings suggest that GPS driving may serve as an effective and accurate digital biomarker for identifying preclinical Alzheimer’s disease among older adults,” said the study’s authors.

Worsening vision

Last year, a study by Loughborough University found that changes to your vision can predict dementia 12 years before it might be diagnosed.

More than 8,500 healthy people were enrolled in the long-running research project. At the start, each one took a simple visual sensitivity test, in which they had to press a button as soon as they saw a triangle forming in a field of moving dots. Over the years, it emerged that those who would go on to develop dementia were also much slower to spot this triangle than others.

Why might vision tests flag dementia before memory tests? The researchers suggested that the toxic amyloid plaques, or protein clumps, associated with Alzheimer’s disease may first affect areas of the brain associated with vision, with parts of the brain associated with memory only becoming damaged as the disease further progresses.

Research is mixed, but the link between vision and dementia may work both ways, the researchers pointed out. Some studies have found that eye movement can improve memory. People who watch more TV and read more have been shown to have better memory and less dementia risk than those who do not. So exercising your eyes is definitely not a bad idea.

And if in doubt? Do see your GP, if only to settle your nerves. In fact, that act itself could have dementia protective properties, says Dr Goodwin, as long as you can see the same doctor repeatedly, building a relationship over time. “Seeing the same GP at your doctors’ will reduce your risk of dementia substantially,” he explains.