How to Recognize Dementia Developing in the Brain? A Neurologist on the First Visible Signal

Written by Henrik Rothen

Feb.12 - 2024 1:55 PM CET

How to Recognize Dementia Developing in the Brain?

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Dementia turns life upside down and changes it forever. When pathological processes start, you begin to feel, speak, and act differently. It's a sign that the brain is starting to disintegrate. Unfortunately, before these destructive changes show symptoms, up to 10 years may pass.

"They are elusive; they cannot be predicted or prevented," admits neurologist Dr. Olga Milczarek according to Med-o-net. So, how can one recognize that dementia is developing in the brain?

"I always remind people about the first visible signal," says the specialist to Medonet. It's often not easy to spot, and it may surprise many. "I often give students the example of a priest who started behaving strangely during a sermon."

In Dementia, Toxic Proteins Build Up in the Brain

In dementia, the brain shrinks and deteriorates—literally falling apart due to damage and eventually the death of cells in various brain areas. Dementia can develop as a result of many diseases (with Alzheimer's being the most common culprit), but they all have one thing in common: the excessive accumulation of toxic proteins in the brain. Eventually, these proteins take up the space of neural cells. "This area becomes granular, spongy, functions increasingly poorly, and eventually deteriorates," says Dr. Olga Milczarek to Medonet.

Unfortunately, there is no sure way to prevent dementia, nor is there a cure for it. Even worse, the destructive changes in the brain start up to 10 years before any symptoms appear.

"They are elusive because they occur at a microscopic level and cannot be predicted," says the specialist. However, early detection of these pathologies and professional intervention can protect the brain from potential degradation. But how to do it? "I always remind about the first visible signal that warns dementia is starting to develop," emphasizes Dr. Milczarek.

How to Recognize That Dementia Has Started in the Brain? The First Sign and Four Alarming Situations

The signal the doctor refers to is changes in our daily routine and habits. If you start having problems performing tasks that were almost automatic due to their familiarity, it means something is wrong. In other words: when we lose repetitiveness, it means the brain is not functioning properly, likely starting to disintegrate.

"Contrary to appearances, it's not easy to catch these changes. Patients often do not notice them themselves. It's also hard for their relatives to spot them at the beginning," notes the expert. Meanwhile, the first symptom indicating that dementia may be developing involves the following situations (often exemplified by cooking scenarios):

  • For years, we've been making scrambled eggs or soft-boiled eggs for breakfast, and suddenly we don't know how to fry or boil them anymore.

  • A mother, who used to be a master at making dumplings, now struggles to shape them.

  • We've been driving the same route to work and one day can't find our way home from work because we've forgotten the route.

  • Someone who has been a math teacher all their life suddenly doesn't know how to teach it anymore.

Dementia Changes a Person

The loss of repetitiveness also affects personality—when dementia changes start, so does a person's character, behavior, and habits. "Of course, it's not that if our father suddenly gets interested in tennis and wants to play, we should suspect him of having dementia," the neurologist clarifies. "Some things can change in our life, and that's normal. However, if a person's previous functioning changes, there is reason for concern," explains Dr. Milczarek, giving an example.

"Suppose our mother was an active, lively person who went to the sauna once a week without fail. Suddenly, all that changes—she neither wants to go out nor knows why she should go to the sauna. For her, this is very strange behavior. And it's precisely such unusual actions for a person, a clear change in strong previous habits, that should draw our attention."

Similarly, if irrational behaviors appear. "I often give students the example of a priest who suddenly started swearing during a sermon (said 'f-word' twice)—this is a true story. It was surprising to everyone that a priest who never swore started behaving strangely. This was not normal, standard behavior—and in such situations, a consultation with a neurologist is necessary."

Dementia Can "Mimic" Other Diseases and Deficiencies

The common denominator of these changes is memory pathways, most often long-term memory, when they deteriorate, we lose previously well-learned skills. They are located in the hippocampi (we have two hippocampi in the brain, one in each temporal lobe—read what else our hippocampi are responsible for).

The neurologist notes that in dementia processes, changes often appear here first. However, this is not a rule. "In reality, destructive changes can appear in different areas of the brain, depending on the type of dementia we are dealing with."

The principle, however, is one: if a person's behavior goes beyond their usual pattern, their learned standards, their "norm"—diagnostics are necessary.

Unfortunately, people rarely notice the changes in themselves—denial is a very strong mechanism here. Usually, it's the environment that finally notices these signals. Practice shows that it's often the family that brings the patient to the doctor, saying he has become "somehow different," while patients often deny this and insist they are as always.

Finally, an important note from the doctor: "The changes in a patient's behavior we are talking about are not 100% proof that dementia changes have started. Brain tumors, for example, can cause dementia-like symptoms (read what symptoms a brain tumor causes and what causes it). Dementia can also "mimic" vitamin deficiencies, including vitamin B12 deficiency (learn how a vitamin B12 deficiency destroys the brain), thyroid diseases, mental disorders, even Lyme disease. The spectrum is huge, but the rule is one: these changes should never be ignored."