7 surprising signs of dementia

Do you find you have more cavities lately, or have you even lost a few teeth? That could mean you’re at risk for dementia. A 2021 analysis of more than 34,000 older adults published in the Journal of the American Medical Directors Association found that those with more missing teeth had a 28 percent higher risk of dementia. They also had a 48 percent greater risk of cognitive impairment.

Chewing issues may be another indicator, according to a 2012 Swedish study published in the Journal of the American Geriatrics Society. Researchers examined 577 people over the age of 77 and found those who had trouble chewing hard food were at greater risk of cognitive impairment. 

Neglecting your teeth can lead to inflammation of the gums. Though it is not proven, there is some research that points to possible connection between the two, says neurologist G. Peter Gliebus, MD. Tooth loss may also be a sign of how well you take care of yourself (or how well you’re able to take care of yourself).

Walking slower can be an early predictor of dementia. “That’s one of the signs of brain degeneration,” says Dr. Gliebus. And it’s not just walking slower—changes in stride length and variability can also predict cognitive decline.

Sometimes a walking test for someone with early Alzheimer’s or mild cognitive impairment will seem normal, until the person is asked to do something else while walking, like counting backwards or naming as many animals as they can. If their gait slows drastically, it could be a red flag.

Changes in the circadian rhythm—the body’s internal clock—can be a sign of impending dementia. “Sleep centers can be affected by brain degeneration,” says Gliebus. “That could mean hypersomnia (sleeping a lot), insomnia, fragmented sleep, or starting to sleep during the day.”

For example, in one study published in Neurology in 2017, scientists discovered that over the course of 13 years, those who moved from under nine hours of sleep to over nine hours had more than double the risk of dementia.

When dementia begins to affect the areas of the brain that control language, communication can become difficult. If it progresses to the point you lose the ability to speak or understand speech, it is called aphasia. 

Speech issues often begin subtly, by stumbling over a word here and there. People may use the wrong words, have trouble finding the right words, mispronounce things, speak slowly or haltingly, or talk around a word—“that place where they bring you the food” instead of “restaurant." It’s important to note that some problems with word retrieval are a normal part of aging but be on the lookout for other symptoms.

Some forms of dementia affect the parts of the brain that govern judgment, self-control, violence, and sexual behavior. Dementia can also cause frustration and anger in daily life, when you’re no longer able to do the things you used to. A 2019 American Journal of Geriatric Psychiatry analysis of 17 studies found that people with Alzheimer’s disease were five times more likely to show aggressive behaviors than people without dementia. They were also much more likely to act aggressively than people with only mild cognitive impairment.

Occasionally, as judgment becomes more compromised, law troubles could occur. Crimes sometimes committed by people with dementia include theft, trespassing, and public urination.

Up to 25 percent of people with dementia display inappropriate sexual behavior, because the areas of the brain influencing self-control start to degenerate. While this sexual disinhibition is typically reserved for patients with late-stage Alzheimer’s disease, it can occur early on in patients with another type of dementia called frontotemporal dementia. “There is no standard behavioral change,” says Gliebus. “It depends on the disease and the parts of the brain that are affected.”

Inappropriate sexual behavior can include harassing language, public masturbation, stripping, groping, and other forms of sexual assault.

Can you no longer tell the difference between two very different odors, like gasoline and lemons? That could be an early sign of Alzheimer’s, according to a June 2017 study in Neurology.

Using scratch-and-sniff tests, researchers measured the sense of smell of 300 healthy people, average age 63, at risk for Alzheimer’s due to their family history. They found that participants who had the most trouble distinguishing scents had both lower cognitive test scores and more chemicals associated with Alzheimer’s in their spinal fluid.

Loss of smell is also an early symptom of Parkinson’s disease.