Warning signs of dementia can be challenging to discern. After all, who hasn’t misplaced their keys from time to time or forgotten someone’s name? But those minor lapses in memory differ from dementia. Bigger lapses, such as forgetting how to manage finances and medication, are more concerning. It is important to recognize these warning signs in a loved one early so they can make the lifestyle changes that will allow them to maintain their quality of life.

“When presented with early warning signs, it’s more important than ever to make brain exercises — like problem solving, focused attention, and information-processing tasks — part of your daily routine,” explains Emily Eckhardt, MA, CCC-SLP, CDP, a member of EmpowerMe Wellness’ Clinical Education and Enrichment team. “It is also never too early to begin creating external aids, like written or recorded reminders, for important information to help manage your own or a loved one’s care.”

What Are Dementia and Alzheimer’s Disease, and How Do They Differ?

Dementia describes a group of symptoms that affect memory, thinking, and social abilities severely enough to interfere with daily life. Dementia is not a single disease, but an umbrella term that encompasses various medical conditions caused by abnormal brain changes. These changes are attributed to a decline in cognitive abilities, behavior, emotional status, and functional abilities.

Alzheimer’s disease is the most common type of dementia. Although not all causes of Alzheimer’s are known, experts know that a small percentage are related to mutations of three genes, which can be passed down from parent to child. While several different genes are probably involved in Alzheimer’s disease, one important gene that increases risk is apolipoprotein E4 (APOE). Patients with Alzheimer’s disease have plaques and tangles in their brains. Plaques are clumps of a protein called beta-amyloid, and tangles are fibrous tangles made up of tau protein. It is thought that these clumps damage healthy neurons and the fibers connecting them, causing cognitive changes.

Stages of Cognitive Change Observed in Dementia

Knowing the different stages of cognitive change can be helpful when trying to best understand how to support a loved one. Our Clinical Education and Enrichment Department’s own Emily Eckhardt offers some insight into how to best support in the five different stages:


Mild Cognitive Impairment

A person with mild cognitive impairment will typically be able to follow directions and recall most of their important routine information to function day to day. They may deny any help at this stage; occasional cognitive assistance through reminders and support of more complex new tasks can be offered.


Early-stage Cognitive Decline

A person with early-stage cognitive decline will benefit from more structure in their day-to-day life. They can typically attend to a task for at least 20 minutes with one or two verbal or visual cues. No matter the task, try not to rush them, as they may need additional time to perform an activity.


Mid-stage Cognitive Decline

A person with mid-stage cognitive decline will benefit from someone else choosing the activity or setting up the task. They can typically attend to an activity for 5-20 minutes and will require consistent cues to continue. Again, do not rush to complete the activity and, at this level, do not correct errors. They will require and can follow cues or instructions. They will require direct supervision and may need to have an activity demonstrated by someone else before understanding how to perform. It is helpful to simplify the number of steps and provide verbal, visual, and hands-on cues. They may not clearly understand or hold onto a specific topic being discussed, but can be brought back to socializing with use of old photos or personal belongings.


Late-stage Cognitive Decline

A person with late-stage cognitive decline will benefit from someone else providing constant one-on-one cueing with sensory stimulation around a single theme using familiar items. They may walk away from an activity and will need to be redirected. The person will need more time to complete a task and will work much slower than usual. They may enjoy music, singing familiar songs, and keeping rhythm by dancing and playing instruments using hand-over-hand assistance. Conversations may consist of short, simple 1-to-2-word phrases.


End-stage Cognitive Decline

A person with end-stage cognitive decline may likely be provided with additional assistance from palliative care and will benefit from brief one-on-one visits with high sensory input, including music, touch, and strong sensations incorporated like taste or smell. This person can still feel, express love, and experience relationships.

Remember, a dementia diagnosis does not mean your loved ones can no longer live their lives to the fullest. A safe and nurturing environment is key to a happy and healthy life.

EmpowerMe Wellness offers specialized therapy programs that treat cognitive and memory difficulties resulting from neurological conditions. To learn more, reach out to EmpowerMe.