Beyond Memory Lapses: Six Physical Signs of Dementia to Watch For
Getting older often brings occasional memory lapses, like forgetting where you left your sunglasses or struggling to recall a name. These cognitive changes are typically normal and not a cause for alarm. However, there is a distinct difference between age-related forgetfulness and dementia, a serious condition affecting approximately 7 million Americans, with projections suggesting this number could double by 2060.
According to Dr. Stephanie Nothelle, a geriatrician and associate professor at Johns Hopkins School of Medicine in Baltimore, the transition from mild cognitive impairment to dementia occurs when cognitive issues begin to impair daily function. "For me, that’s one of the key parts of defining when someone has transitioned to dementia," she explained. This might manifest as an inability to drive a car, getting lost on familiar routes, or failing to manage tasks like taxes after years of competence. When cognitive changes disrupt normal daily activities, it serves as a significant red flag.
Dementia is an umbrella term encompassing various forms of cognitive impairment, including Alzheimer's disease (the most common type), vascular dementia, and Parkinson's disease. While cognitive decline is a central feature, dementia can also present with physical symptoms that are often overlooked. Here are six physical signs experts say may indicate dementia.
1. Trouble Walking and Balancing
Dr. Nothelle notes that while many physical manifestations appear later in dementia, difficulties with walking and balance can emerge earlier and worsen over time. "The ability to maintain your balance and walk smoothly actually requires a lot of brain power because you have to process a lot of different inputs," she said. This involves processing sensations from the feet, visual cues from the environment, and reacting quickly. Consequently, frequent stumbling, balance issues, or falls can be signs of dementia, though they may also stem from conditions like arthritis or general clumsiness.
2. Posture Changes and Feet Shuffling
Lewy body dementia, the second-most-common form of dementia, includes types like Parkinson's disease. Dr. Jori Fleisher, an associate professor of neurological sciences at Rush University in Chicago, explains that in these cases, individuals may exhibit posture changes, feet shuffling, or a slower gait. While it's easy to attribute such issues to aging or arthritis, "if we’re seeing a pattern of that, we want to pay attention to it," she emphasized.
3. Changes in Sense of Taste and Smell
Unexplained alterations in taste or smell, beyond known causes like COVID-19 or sinus problems, can be linked to dementia, particularly Lewy body dementia. Dr. Fleisher points out that loved ones might notice this first, such as when someone fails to detect burning food. This symptom warrants a medical evaluation to rule out or confirm underlying issues.
4. Problems Swallowing
Dementia can lead to dysphagia, or trouble swallowing, where food or drink accidentally enters the windpipe. Dr. Nothelle warns that this can introduce harmful bacteria from the mouth into the lungs, potentially causing aspiration pneumonia, a common complication in later stages of dementia. "That’s why pneumonia is relatively common in the later part of dementia," she noted.
5. Bladder Control Issues
Incontinence may develop as dementia progresses due to nerve degeneration affecting bladder control. Similarly, new-onset constipation can be a sign, often preceding other symptoms in conditions like Parkinson's disease by years, according to Dr. Fleisher.
6. Sleep Changes
Sleep disturbances, such as REM behavior disorder where individuals move, shout, or talk in their sleep, can be early indicators of Parkinson's or Lewy body dementia. Dr. Fleisher advises that if a loved one exhibits these behaviors, it's important to inform their healthcare team, as this may occur years before other symptoms appear.
The Importance of Early Diagnosis and Risk Reduction
Early detection of dementia is crucial for effective management and future planning. Dr. Fleisher highlights that we are in an era of innovation for dementia treatments, with ongoing research into pharmaceutical options. Doctors can now use biomarkers from blood or spinal fluid to diagnose specific types of dementia and tailor treatments accordingly. "Finding out early on can be really helpful for a lot of different reasons, including planning and just having a say in your future," said Dr. Nothelle. Early diagnosis allows individuals to make informed decisions about care, living arrangements, and finances.
While treatments are not a cure, they can aid in disease management. To reduce dementia risk or slow progression, experts recommend adopting a healthy lifestyle. This includes following a nutritious diet like the MIND diet, engaging in regular exercise, maintaining social connections, and managing chronic conditions such as diabetes, hypertension, and sleep apnea. With experts predicting that 42% of Americans over 55 may develop dementia in their lifetime, proactive measures and awareness of physical symptoms are essential steps toward better health outcomes.
