Knowledge and Research

Dementia is an umbrella term for conditions where brain disease leads to an impairment of cognitive (= mental) functions to such an extent that it affects daily functioning.

Therefore, when we talk about dementia, we are not referring to one specific disease. Dementia encompasses a heterogeneous group of conditions with different causes, symptoms, and disease progressions.

Cognitive functions include memory, language, attention, planning, problem-solving, and spatial orientation. In dementia, one or more of these functions are affected so significantly that the person finds it more difficult to manage daily activities independently.

Dementia often develops gradually over years, but both the initial symptoms and the rate at which the disease progresses can vary considerably. [1, 3]

Early Symptoms and Signs of Dementia

Many associate dementia with memory problems, and often it is indeed memory that is affected first, especially in Alzheimer’s disease, which is the most common cause of dementia.

However, the early symptoms of dementia are not the same for everyone. For some, it is language, for others, it is the ability to plan and maintain an overview that is first affected. In certain less common dementia diseases, changes in behaviour or personality can be among the first signs.

The symptoms depend, among other things, on which cognitive functions are affected and which disease is causing the changes. [1, 3, 4]

Memory Problems as an Early Sign of Dementia

In Alzheimer’s disease, problems with episodic memory are often the first prominent symptom. Episodic memory enables us to recall personal experiences and events, such as what we did earlier in the day or what was said during a conversation.

Early memory problems can manifest as the person repeating the same questions, forgetting recent conversations or appointments, or having difficulty remembering new information.

It is characteristic that the difficulties primarily involve learning and recalling new information, while older memories may initially be better preserved. [1,3]

However, ordinary forgetfulness is not the same as dementia. What can be a sign of dementia is particularly a clear and persistent change from the person’s previous memory function, which gradually affects daily life. [1, 2]

Language Difficulties Can Be Early Symptoms of Dementia

For some people, the first symptoms of a dementia disease may manifest as language difficulties.

This can include word-finding difficulties, where the person knows what they want to say but struggles to find the right words. This can lead to more frequent pauses in conversations, slower speech, or the need to describe an object instead of naming it.

Others experience problems with word comprehension. The person may still speak relatively fluently but begins to have difficulty understanding the meaning of certain words, especially less common ones. It can also become more difficult to name objects or understand what individual words mean.

For some, it becomes harder to formulate sentences. Speech may become slower and more strained, and grammatical errors or difficulties pronouncing words correctly may occur. [1,4]

Problems with Planning and Overview

The first symptoms of dementia can also manifest as problems with planning and overview.

For example, the person may find it difficult to organise tasks that they previously managed without problems. It can become harder to manage finances, make decisions, or change plans if something unexpected happens.

These difficulties can be due to an impairment of the brain’s executive functions. Executive functions are a collective term for the cognitive processes that enable us to plan, prioritise, and organise our actions, retain and process information, and adapt to new situations.

In everyday life, this can manifest, for example, as the person losing track while cooking, finding it difficult to handle multiple tasks simultaneously, or struggling to complete an activity in the correct sequence.

Tasks that were previously performed almost automatically may begin to require significantly more time and concentration.

In some dementia diseases, executive functions can be affected early in the disease course, even if memory remains relatively well-preserved. This is seen, among others, in vascular cognitive impairment, frontotemporal dementia, and certain atypical forms of Alzheimer’s disease. [2, 4, 5]

Changes in Behaviour and Personality

In some of the less common dementia diseases, the first symptoms can be changes in behaviour or personality.

This is particularly seen in the behavioural variant of frontotemporal dementia, where the person may, for example, become more impulsive, make inappropriate comments, or show less understanding of others’ feelings.

Others become more passive, lose initiative, or interest in activities they previously enjoyed. Changes in eating habits or an increased tendency for repetitive and fixed actions may also occur.

The crucial factor is that there is a clear change from the person’s previous behaviour and personality. In frontotemporal dementia, memory can be relatively preserved initially, even if behaviour has already changed significantly. [5]

Sadness, Low Mood, and Worry

Some may experience sadness, low mood, or worry at the beginning of a dementia disease because they themselves notice that their cognitive functions are no longer as they used to be.

They may find that tasks they previously managed without problems have become more difficult. This can create frustration, uncertainty, and worry about the future. Some try to hide their difficulties or withdraw from activities and social situations where they feel insecure.

However, depressive symptoms can also be part of the disease picture and do not necessarily have to be solely a psychological reaction to experienced cognitive changes. At the same time, depression itself can lead to problems with memory, concentration, and initiative.

Therefore, sadness and low mood are not specific signs of dementia, and the connection between depression and cognitive impairment can be complex. [1, 6]

When Should One Be Aware of the Symptoms?

The individual symptoms do not in themselves mean dementia. Memory problems, difficulty concentrating, and problems with overview can also be caused by stress, depression, sleep problems, medication, or other illnesses, among other things.

It is particularly relevant to be aware if there is a new and persistent change in the person’s cognitive functions that gradually becomes more pronounced or begins to affect daily life.

The initial symptoms can vary, but common to dementia diseases is that disease processes in the brain lead to an impairment of cognitive functions, which eventually affects the person’s daily functioning.

In case of persistent or increasing symptoms, it is relevant to contact your GP to clarify the cause.

References:
1. Atri A, Dickerson BC, Clevenger C, et al. (2025). The Alzheimer’s Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer’s Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for primary care.

2. Swartz RH et al. (2025).Canadian Stroke Best Practice Recommendations: Vascular cognitive impairment, 7th edition practice guidelines update, 2024.

3. Alzheimer’s Association (2024). 2024 Alzheimer’s disease facts and figures.

4. Jones D, Pelak V, Rogalski E (2024). Atypical Presentations of Alzheimer Disease.

5. Piguet O, Clarke AJ, Foxe D, et al. (2025). Fourteen years later: Reviewing the diagnostic criteria for behavioral-variant frontotemporal dementia.

6. Shinagawa S, Nagata T. (2026). Toward Precision Neuropsychiatry of Dementia: Neuropsychiatric Symptoms as Multidimensional Clinical Phenotypes.