Bill had another fight with his wife yesterday. It seems they never used to disagree, but lately, he feels she's constantly nagging.
“Yesterday, my wife did it again! We've had a perfect marriage until lately, and I don't know what is happening with her. She keeps telling me I'm wrong when I know I'm right. She says I shouldn't go for a drive at three in the morning. I can't sleep; why can't I go for a drive if I want?" She got mad when I bought an expensive new lawnmower because the old one worked just fine. I told her I wanted a backup if the other one broke.
Then she keeps reminding me I’m repeating what I’m saying. Isn’t this just part of getting older? She is aggravating me so much that I've begun hollering at her, and she sometimes starts to cry, making me feel awful.
Worse yet, she keeps badgering me to take a shower or shave; she says I stink. I already took one, and she swears I haven't."
She wants me to get a check-up with a doctor, but there is nothing wrong with me!”
The initial symptoms of dementia can be even more inconspicuous than in this story. Executive function changes commonly begin even before memory loss is noticeable, and usually, the person experiencing it is unaware of it. Their ability to plan and organize declines, and they may have trouble keeping finances straight. Attention to detail and time management are affected, and they start making bad decisions.
The person’s personality also changes and becomes prone to emotional outbursts. It's usually the family who begins to notice first, as to most people, they seem perfectly normal.
Early Alzheimer's symptoms usually include loss of smell and an inability to tell when food is off. Many doctors consider this a potential indicator of the disease. The person’s hygiene becomes lax, often not shaving or showering for days. Sleep patterns change, and they have less control over their emotions. This part of early dementia progression, along with slight memory loss, is often overlooked and explained away as part of getting older.
Depending on the cause of dementia, the person has usually had it for several years by the time of diagnosis. It takes a dementia specialist to identify the earlier executive function deterioration, and that depends mainly on what the family has observed. Often, the person experiencing it is in denial and has very reasonable rationalizations for their behaviors; thus, their family doctor may not detect a problem and will brush off memory loss as part of aging.
Some of those aware of their changes often feel something is not right, but they are still functioning and ignore it. After all, nobody wants to think they might be getting dementia.
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