The earliest signs of dementia are subtle. Sometimes a change in personality or worsening of previous traits is the first sign. Commonly, mild memory loss (short-term memory), loss of balance, loss of sense of smell (some studies indicate this is among the first signs-but rarely noticed), trouble finding words, forgetting names are common experiences. Frequently, the person may deny the problems, or be unaware of them. In the case of ‘pseudodementia’ associated with severe depression, people often overemphasize their symptoms.
In the middle stage, forgetting appointments, a more severe drop in short-term memory, poor judgment, trouble performing familiar tasks (such as cooking, getting dressed, showering), and getting lost are common signs. Sleep is often disrupted, and there is difficulty learning new information. Any number of psychiatric symptoms can develop including suspiciousness, paranoia, mood swings, hallucinations, impulsive behaviors (e.g. shoplifting), rage episodes and inappropriate sexual behavior.
In the most advanced stages of dementia, the person is unable to take care of their needs, such as dressing, cooking, etc. Walking becomes difficult, and other motor functions, such as swallowing, and eating become a challenge. Long-term memory fails, and recognizing even close relatives may be impossible. Speech may deteriorate, and eventually, the person becomes bed-bound, succumbing to malnutrition, incontinence, falls, seizures, and infections