When most people think of dementia, memory loss is usually the first symptom that comes to mind. However, experts warn that changes in sleep, personality, behavior, and everyday abilities can sometimes appear before someone begins noticeably forgetting things.
Recognizing these early warning signs is important because identifying potential cognitive changes sooner can help people seek medical evaluation and access appropriate support. While occasional forgetfulness and changes in daily habits are common with aging, persistent or unusual changes should not automatically be dismissed as a normal part of getting older.
According to neurosurgeon Dr. Betsy Grunch, some lesser-known symptoms may offer important clues that something is affecting brain health. Here are five early signs of dementia to watch for, including symptoms that can develop before significant memory problems become apparent.
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1. 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.
2. 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 Someone who was once social and outgoing may become withdrawn, lose interest in activities they once enjoyed, or stop spending time with friends and family.
"They may become more withdrawn and not go out with their friends as much," she explains.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.
3. 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.
4. Difficulty Finding Words or Following Conversations
Struggling to communicate can sometimes be an early sign of cognitive decline, even before significant memory loss becomes noticeable.
Someone experiencing early dementia may have trouble finding the right words, frequently pause in the middle of sentences, repeat themselves, or struggle to follow conversations.
They may also have difficulty understanding complicated instructions or keeping up when several people are talking. According to experts, these communication difficulties can occur when changes in the brain begin affecting language processing and other cognitive abilities.
Although occasionally forgetting a word is normal, consistently struggling to express thoughts or follow discussions may warrant a conversation with a healthcare professional.
5. Poor Judgment and Unusual Decision-Making
Changes in judgment and decision-making can also emerge before obvious memory problems.
A person experiencing early cognitive decline may begin making unusual financial decisions, falling for scams, neglecting personal hygiene, or struggling to evaluate everyday risks. They might also have difficulty planning, organizing, or weighing the consequences of their actions.
These changes can be particularly concerning when they represent a noticeable departure from someone's usual behavior.
Because judgment relies on several cognitive functions, including reasoning and problem-solving, persistent difficulties in these areas may be worth discussing with a doctor.
