Six physical signs of dementia to watch for

Routine activities like walking, eating, and sleeping rely on complex brain functions that often fail before memory does. For millions of American families, noticing these physical shifts can mean getting a diagnosis before the condition becomes advanced.

Approximately 7 million people in the United States currently live with dementia. Projections indicate this figure will double by 2060. Experts estimate that 42 percent of Americans over age 55 will develop the condition during their lifetimes. Early detection allows individuals to make decisions about their care, housing, and finances while they still have the capacity to do so.

Dr. Stephanie Nothelle, a geriatrician and associate professor at Johns Hopkins School of Medicine in Baltimore, explains that the transition from mild cognitive impairment to dementia occurs when impairment interferes with daily function. This might look like getting lost on a familiar driving route or being unable to file taxes after doing so for decades.

Dementia is an umbrella term for several conditions, including Alzheimer’s disease, vascular dementia, and Parkinson’s. Dr. Jori Fleisher, an associate professor of neurological sciences at Rush University in Chicago, notes that Lewy body dementia is the second most common form. The specific physical symptoms depend on the underlying diagnosis.

Walking and balance issues are among the earliest physical signs. Nothelle states that walking requires the brain to process inputs from the feet and eyes simultaneously. Trouble balancing or frequent falls can indicate cognitive decline, though these issues can also stem from arthritis or clumsiness. In Lewy body dementia, patients may exhibit posture changes, shuffling feet, or a slower gait.

Changes in taste and smell are another indicator. Fleisher points out that a person might not notice a change in these senses, but a family member might. A loved one might report that a patient did not smell food burning on the stove. While these changes can result from sinus issues or infections, unexplained shifts can be linked to Lewy body dementia.

Swallowing difficulties pose a serious health risk. Nothelle explains that when food or fluid enters the windpipe instead of the esophagus, it can carry bacteria from the mouth into the lungs. This condition, known as aspiration pneumonia, is common in the later stages of dementia. Bladder control issues also emerge as nerves responsible for continence degenerate. New constipation in older adults can be an early sign of Parkinson’s and related conditions.

Sleep disturbances often go unnoticed by the patient but are visible to those sharing the home. Fleisher advises looking for a condition called REM behavior disorder, where individuals punch, shout, or talk in their sleep. This symptom can precede a diagnosis of Parkinson’s or Lewy body dementia by years.

Doctors can now use blood and spinal fluid tests to check for biomarkers that identify the specific type of dementia. Fleisher notes that research is ongoing to find new pharmaceutical treatments. Nothelle adds that while treatments are not a cure, they help manage the disease. Both experts emphasize that starting interventions early improves outcomes.

Reducing the risk of dementia involves maintaining a healthy lifestyle. Fleisher recommends following the MIND diet, which focuses on brain-healthy foods. Regular exercise, social interaction, and managing chronic conditions like diabetes, high blood pressure, and sleep apnea are also key. Nothelle says that early knowledge empowers patients to have a say in their future.