Early Signs of Dementia Checklist: What to Look For

How to Support Brain Health and Decrease the Risk of Dementia

• About Dementia|
• Cognition vs. Memory|
• How Early Can We Spot Dementia|
• Early Signs of Dementia|
• Addressing Cognitive Decline|
• Improving Brain Health|
• Daily Brain Health Checklist|
• Recommended Products|

With nearly 50 million people worldwide living with dementia and cases expected to triple by 2050, especially because of the aging Baby Boomer generation, you may be wondering how to prevent dementia or identify it early [1]. The good news is that there are some early signs you can look out for– and living a brain healthy lifestyle with an anti-inflammatory diet, exercise, and sleep can help to support brain health and cognition, potentially decreasing the risk or onset of early dementia. 

This article will discuss the early signs of dementia and simple tips for living a brain healthy life to help decrease the risk of memory loss. 

What Is Dementia?

Dementia is an umbrella term for anything that causes a continuous decline in memory and thinking skills that severely decrease quality of life and ability to function [1]. 

You are probably most familiar with Alzheimer’s Disease, which causes 70-80% of dementia cases. However, there are many other types of dementia [1]. 

These are the most common forms of dementia:

Alzheimer’s: This causes 70%-80% of all cases of dementia. Memory problems and cognition loss occur when two proteins found in the brain, beta-amyloid proteins and tau proteins, either accumulate or become abnormal, form plaques and deposits in the neurons, and cause them to degenerate [1].

Vascular dementia: This is the second most common form of dementia, found in 5-10% of all cases. It’s caused by decreased blood flow to the brain for any number of reasons. The most common risk factors are high cholesterol, diabetes, hypertension, and smoking [1].

Lewy body dementia: This causes 5-10% of all dementia cases. It’s often called “dementia with Parkinson’s” because people experience the same gait changes and tremors found in Parkinson’s disease [1].

Frontotemporal dementia (FTD): This is the second most common form of dementia in people under 65 years old. It affects the front of the brain and often comes with problems speaking first [1]. 

Creutzfeldt-Jakob disease: This is a fatal and quickly progressing neurodegeneration. It only occurs in one in 1 million people [1].

Wernicke-Korsakoff syndrome: The syndrome occurs in 1-2% of cases and is often related to overconsumption of alcohol [2].

Mixed dementia: This refers to when a person has two or more types of dementia at once [1].

Understanding Symptoms of Dementia: Cognition vs. Memory 

Early signs of Alzheimer’s and other dementias include not only what we think of as typical memory loss (forgetting facts, names, and events) but also cognition (our ability to use all our memories to make complex decisions). So, what’s the difference between cognition and memory, and why does that matter?

A memory is a stored pattern created by the neurons in the brain. Memory involves both manipulating and storing knowledge. In the brain, we constantly receive information (from input like an event, learning a new hobby, reading, or from something we see, smell, or hear). Our brain works with that knowledge and either uses it right away (short-term memory) or stores that information in different ways for later use (long-term memory).

Cognition includes all forms of knowing, from knowing a process, to thinking through a chain of events, problem-solving, abstract thinking (understanding complex topics like empathy or compassion), and making decisions [3]. Cognition is more about how our brain chunks information and allows us to use it for decisions and processing. For example, remembering that a stove is hot and if we touch it, we get burned, helps us decide to put oven mitts on our hands before we take something out of the oven. 

Cognition includes memory, and we need memory in order to have cognitive ability. When we’re talking about memory or brain function, we’re also talking about cognitive ability — how our brain processes and uses stored information (memories). This is why people undergo cognitive testing as part of a dementia diagnosis. In dementia, we need to not only know how memory is working but also how the cognitive process is working.

When Can We Spot Dementia?

Some people report very early signs of dementia decades before diagnosis (around ages 40-60). These include loss of smell in people with Lewy body dementia, progressive trouble remembering names of people and items, consistent loss of daily items such as keys, changes in gait (trouble balancing, dragging feet, lopsided walk), and trouble comprehending learned information from books and reading materials [4, 5].

It is important to remember that all brains are different and some people are just more forgetful than others. A new and progressive change in memory function or forgetfulness may indicate very early stages of dementia or another brain health issue. A change in cognitive function or ability to complete daily tasks (such as those listed below) should be checked by a neurologist.

Early Signs of Dementia Checklist

A person struggling with memory may not notice these early changes or may chalk them up to typical forgetfulness. However, family members often notice them. These changes in one’s ability to function in daily life are important indicators of brain health:

• Trouble sequencing: This is one of the earliest signs of dementia, and it can be hard to spot. Sequencing is our ability to follow the steps to complete a task, such as buttoning a shirt, balancing a checkbook, cooking, driving, feeding the dog, or remembering your partner asked you to get meat from the fridge and then cook it. It is hard to spot because at first, sequencing is not lost but slowed. So, the noticeable symptom often looks like frustration or anger [6, 7].
• Trouble finding words: We all forget words sometimes, but if you have consistent trouble finding the right words in a conversation, that may indicate a problem with cognitive function [1].
• Personality changes: These can include rapid mood swings, becoming more easily irritated and overwhelmed during social activities, angry when completing common tasks such as cooking or using email, or less concerned about safety or cleanliness [1]. 
• Impairment of decision-making: Needing a longer time to make decisions or having poor judgment. Examples can include spending large sums of money or even an inability to choose an item off of a menu [1].
• Disorientation: This means being disoriented when going from one familiar place to another, such as being confused as to why you are walking from the family room to the kitchen during a holiday, or being unable to find your way while driving to a favorite restaurant [1].
• Impaired spatial awareness: Spatial awareness is the ability to discern the distance between two objects. People with poor spatial relationships struggle to know how far apart things are, so they may drive over curbs, miss the table when placing a cup down, or struggle to find buttons on a shirt [8].

What if I Have Early Signs of Dementia?

If you are having serious dementia-like symptoms, the path to improving your brain health lies in addressing some of the root causes of cognitive decline. 

Always check with your health professional if you experience a change in your ability to complete everyday tasks to rule out any possibility of stroke, traumatic brain injury, or other acute injury to the brain. If you are not struggling with any of those issues, some of the most common problems that lead to cognitive decline are related to the brain/gut axis or even the brain liver axis. 

The Gut-Brain Connection

The health of our gut directly influences the health of our brain. Here are a few examples:

• Neurotransmitters that affect mood, such as dopamine, serotonin, and norepinephrine, are made in the gut and travel to the brain along the vagus nerve [9, 10].
• An imbalanced gut microbiome can lead to leaky gut and inflammation, which can lead to improper communication between the gut and brain [11, 12].
• There is also a gut-brain-liver connection. A type of cognitive impairment that occurs in liver disease is called hepatic encephalopathy (HE). In HE, the liver does not do an adequate job of filtering toxins from the blood, and those toxins can travel to the brain. HE has been linked to small intestinal bacterial overgrowth (SIBO) which is an imbalance of gut bacteria [13, 14, 15, 16, 17].

Tips for Improving Brain Health 

The best place to start with improving your gut and brain health is with diet and probiotics. Let’s take a look.

Diet and Dementia

You can start by eating an anti-inflammatory diet. This can help heal any damaged gut lining, balance the gut microbiome, and remove any microbes (bacteria or fungi) that may be causing a gut microbiome imbalance. As a result, it can improve memory, mood, and cognition [18, 19, 20, 21].

Managing your metabolic health and weight is critical for preventing Alzheimer’s disease and other dementias.   

A lower amount of processed and sugary foods can help even out blood sugar levels. Alzheimer’s has been nicknamed “type 3 diabetes” because Alzheimer’s disease can develop when brain cells become insulin resistant and can no longer use glucose properly [22].

I recommend starting with a Paleo diet, which removes inflammatory foods such as gluten, dairy, and legumes.

Here’s what the research says about anti-inflammatory diets and cognitive decline:

• Low inflammatory diets have been shown to improve cognitive decline in people with dementia. The Mediterranean diet (a lower inflammatory diet rich in whole foods, fresh fruit and vegetables, oily fish like sardines, and healthy fats like olive oil) and ketogenic diets (foods similar to the Mediterranean diet but also and very low carbohydrate) are the most studied low-inflammatory diets [23, 24, 25]. We find that many of our patients have success with a Paleo diet, which is a less studied but well balanced anti-inflammatory diet.
• An anti-inflammatory diet can help to resolve metabolic syndrome, which may contribute to early signs of dementia [26].

Research suggests that other dietary interventions can also be helpful for Alzheimer’s patients:

• A 2020 systematic review evaluated the effect of ketogenic interventions (extreme carbohydrate restriction) on patients with Alzheimer’s disease or mild cognitive impairment [24]. Ketogenic interventions were generally effective in improving general cognition, episodic memory (memory of past experiences), and secondary memory (long-term storage and recall of information). 
• Another systematic review published in 2020 looked at dietary interventions for Alzheimer’s patients more broadly. The researchers concluded that the effects of most dietary interventions are inconclusive and better research is needed [27]. However, omega-3 fatty acids, probiotics, ginseng, inositol, and specialized nutritional formulas appeared to have positive effects on cognition in Alzheimer’s disease. 

It is important to note that more research needs to be done on how diet affects cognitive function, as studies are inconsistent and some studies don’t show a large improvement with diet changes [25, 27].

Probiotic Support

Probiotics support your gut and help to improve the gut-brain axis by balancing the gut microbiome. Improving the gut microbiome has shown to be beneficial for people with cognitive decline and even Alzheimer’s disease:

• Two clinical trials have demonstrated that supplementing with probiotics for 12 weeks can improve cognition in patients with Alzheimer’s [28, 29].
• Probiotics have been shown to improve brain function in hepatic encephalopathy [17, 30, 31].
• Probiotics may improve cognitive function, especially word finding [28, 29, 32, 33, 34, 35].
• Multiple clinical trials have shown that probiotics change the makeup of the gut microbiome and improve cognitive function and mood [34, 36]. They may even help improve long-term memory [37].

Here is a simple chart to show you how you can add probiotics into your life:

Every probiotic falls into one of three categories: lactobacillus & bifidobacterium species blend, saccharomyces boulardii, and soil-based probiotics. In order to have a balanced probiotic plan, follow our three-for-balance probiotic protocol and choose one probiotic from each category.

In addition to addressing the gut-brain axis, two other important components can help support good cognition and brain health: sleep and exercise. 

Optimize Exercise and Sleep

Exercise is beneficial to the brain because it:

• Supports the neural connections between movement of the body and the brain, improving gait. Gait change is an early sign of dementia and indicator of progression of disease [5]. 
• Supports blood flow to the brain, which can be particularly helpful in vascular dementia [38, 39].
• Decreases leaky gut and supports the brain-gut axis [40, 41].
• Can improve cognition and executive functioning in people with dementia [42, 43].
• Increases BDNF (brain-derived neurotrophic factor), which is important in supporting neuroplasticity and, thus, memory and learning [44].
• Allows us to learn new things through sports, which supports brain function and cognition [45, 46].
• Improves sleep, which is essential for brain health and memory, as we discuss below [47, 48].

Sleep is essential for the brain. Inadequate sleep can contribute to brain fog, difficulty focusing, difficulty learning, dementia (by leading to elevated amyloid plaque in the brain,) and poor memory [49, 50].

Tips for better sleep:

• Sleep consistency and routine: Try to go to bed and wake up at the same time each day, even on weekends. Get ready for bed in the same way each day. 
• Block blue light: Turn off electronics and wear blue light blocking glasses two hours before bed to help start melatonin production [51].
• Block all light in your room: Use blackout curtains, covering lights from chargers and/or wearing a good sleep mask.
• Regulate temperature: Most people sleep best in a room that is around 60 degrees Fahrenheit. 

Your Daily Brain Health Checklist

Now that you know some of the early signs of dementia, let’s review the basics of good brain health you can practice every day:

• Anti-inflammatory and gut healing diet
• Consistent exercise
• Sleep well

If you are unsure about the state of your cognition or memory and want personalized help, please reach out to our clinic. 

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