When most people think about dementia, memory loss is usually the first symptom that comes to mind. However, according to neurosurgeon Dr. Betsy Grunch, some of the earliest warning signs can show up long before someone begins forgetting names, appointments, or important events.
In a recent video, Dr. Grunch explained that subtle changes in behavior, sleep patterns, and everyday activities may be among the first clues that something is happening in the brain. While experiencing one of these symptoms doesn’t necessarily mean a person has dementia, experts say it’s important to pay attention to persistent changes and discuss concerns with a healthcare provider.
Here are four early symptoms neurologists say could be linked to dementia.
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1. Financial Problems
Difficulty managing money may be one of the earliest signs of cognitive decline. According to Dr. Grunch, people with dementia can begin experiencing financial challenges years before noticeable memory issues appear.
Tasks like paying bills on time, balancing a budget, tracking expenses, or making sound financial decisions require multiple cognitive skills working together. As these abilities begin to decline, mistakes can become more frequent.
"People with dementia can demonstrate trouble with money or declining credit scores years before memory loss," Dr. Grunch explains.
If a loved one suddenly struggles with finances despite previously managing them well, it may be worth taking a closer look.
2. Significant Sleep Changes
Sleep patterns naturally change with age, but dramatic shifts could be a red flag.
Dr. Grunch notes that some people with early dementia begin waking up extremely early, such as 3 a.m., or experience excessive daytime sleepiness despite getting enough rest. These changes may occur because some of the brain regions responsible for regulating sleep are among the first areas affected by Alzheimer's disease.
"Sleep disorders are common as we get older, but dramatic changes in someone's sleep habits can be a sign of dementia," she says.
Researchers have increasingly found connections between sleep quality and brain health, making unusual sleep disturbances something that shouldn't be ignored.
3. Personality Changes
One of the most overlooked warning signs of dementia has nothing to do with memory at all.
According to Dr. Grunch, noticeable personality changes can occur early in the disease process. Someone who was once social and outgoing may become withdrawn, lose interest in activities they once enjoyed, or stop spending time with friends and family.
"They may become more withdrawn and not go out with their friends as much," she explains.
As cognitive decline progresses, individuals may also become more disorganized, struggle to complete household tasks, or have difficulty keeping up with responsibilities at work. Because these changes can happen gradually, loved ones are often the first to notice them.
4. Driving Difficulties
Driving is one of the most complex daily activities we perform, requiring memory, attention, reaction time, judgment, and visual processing. Because so many parts of the brain are involved, changes in driving habits can sometimes signal cognitive decline.
Dr. Grunch says warning signs may include frequent fender benders, unexplained scratches on the car, taking turns too aggressively, or braking and accelerating erratically.
Some people may also begin avoiding driving at night or feel uncomfortable driving with passengers. "Driving is actually a really complex behavior," she notes. "Changes in one's cognition can be demonstrated in difficulty with driving."
While conversations about driving safety can be challenging, experts emphasize that addressing concerns early can help prevent accidents and keep everyone safer.
The Bottom Line
Dementia doesn't always begin with obvious memory problems. According to Dr. Betsy Grunch, early warning signs can include financial difficulties, major sleep disruptions, personality changes, and declining driving skills. While these symptoms don't automatically indicate dementia, they can signal changes in brain health that deserve attention. If you notice any of these persistent changes in yourself or a loved one, speaking with a healthcare professional may help identify the cause and determine the best next steps.
