Early-stage signs and symptoms of dementia

What happens in the early stage of dementia?

Dementia affects everyone differently and the first signs of dementia are often relatively mild and not always easy to notice.

Many people at the early stage of dementia stay largely independent and only need a bit of assistance with daily living. It is important to focus on what the person can do and not to take over and do things for them. Instead, try doing things with them, for example helping the person develop a routine, reminder lists and prompts, and use technology.

For more information for people living with dementia, see the 'Keeping active and involved' page.

The early stage of dementia is when many people choose to make plans for the future, while they still have the ability (‘mental capacity’) to do so. This includes making a Lasting power of attorney (LPA), and advance decisions and advance statements to ensure their wishes and preferences are made clear.

What are the early-stage symptoms of dementia?

As a very rough guide, the early stage of dementia lasts on average about two years.

In the early stage of dementia, the following common symptoms start to affect the person’s daily life:

Memory problems

Difficulties with memory are the most well-known first signs of dementia. For example, a person may not recall recent events or may keep losing items (such as keys and glasses) around the house. Memory loss is often the first and main symptom in early Alzheimer’s disease. It is also seen, although less often, in early vascular dementia and dementia with Lewy bodies (DLB). Memory loss is not common in early frontotemporal dementia (FTD).

Difficulties in thinking things through and planning

A person may get confused more easily and find it harder to plan, make complex decisions (for example, about finances) or solve problems.

Language and communication

A person may struggle to find the right word in a conversation, or they might not follow what is being said. Speech can also be affected when someone with vascular dementia has had a stroke. Specific types of FTD cause particular early problems with language.

Poor orientation

A person may no longer recognise where they are and so get lost, even in a place that is familiar to them.

Visual-perceptual difficulties

This can cause problems judging distances, for example when using stairs. They are more common in early-stage Alzheimer’s disease and DLB than in vascular dementia or FTD. Visual-perceptual difficulties are different from the visual hallucinations (often of animals or people) that are a feature of early-stage DLB.

Changes in mood or emotion

The person may be more anxious, frightened or sad, and so at risk of depression. It is also common to become more irritable – perhaps in frustration at lost abilities – or easily upset. A person can often be more withdrawn, lack self-confidence and lose interest in hobbies or people.

Changes in behaviour are not common first signs of dementia, other than in FTD. A person with behavioural variant FTD may lose their inhibitions and behave in socially inappropriate ways. They may also act impulsively and lose empathy for others.

Significant physical changes at this stage tend to be limited to DLB, where problems with movement are similar to Parkinson’s disease. If someone with vascular or mixed dementia has a stroke, this can lead to weak limbs on one side.