What Are the Early Warning Signs of Dementia vs Normal Aging?
Written by Emma Burns
Clinically reviewed by Nicole Murray, Psy.D., C.Psych.
Neuropsychologist and Rehabilitation Psychologist
You forget why you walked into the kitchen. You blank on a coworker's name for a second. You misplace your keys, again. If you're over 50, it's easy to wonder: is this just getting older, or something more?
It's a fair question, and the two can look surprisingly similar on the surface. So let's break down the real differences, and a few things that don't get talked about nearly enough.
The Baseline: Some Forgetfulness Is Just Normal
According to the National Institute on Aging (NIA), it's completely normal for memory to change a bit with age, such as taking longer to learn something new, or occasionally forgetting to pay a bill (National Institute on Aging, 2020). The real question isn't "did I forget something?" It's "is this getting in the way of my life?" Normal aging might cause you to forget a name for a moment. Whereas serious memory problems may make it hard to do everyday things, drive somewhere familiar, use the phone, find your way home etc. (National Institute on Aging, 2020).
What Actually Looks Different
The Alzheimer's Association's well-known 10 warning signs list draws a clear line between normal aging and a memory problem (Alzheimer's Association, 2023). Here are just a few from that list:
Memory loss: Forgetting a name, then remembering it later, is normal. Forgetting recently learned information altogether, or asking the same question repeatedly, isn't.
Planning and problem-solving: An occasional checkbook error is normal. Real trouble following a familiar recipe or keeping track of bills is worth attention.
Confusion about time or place: Briefly forgetting the day of the week, then figuring it out, is normal. Losing track of dates, seasons, or feeling lost somewhere familiar isn't.
Misplacing things: Losing your keys and retracing your steps is normal. Putting things in unusual places and being unable to retrace your steps, sometimes even accusing others of stealing, is a listed warning sign.
You don't need all the warning signs going off to be worth a conversation with a doctor. Even one or two showing up consistently, and getting worse, is enough.
Self-Awareness Isn't All-or-Nothing
Here's something worth knowing: the person experiencing early cognitive decline is often the least reliable source on whether anything's wrong. This isn't stubbornness, it's a real neurological symptom called anosognosia, a reduced awareness of one's own decline. It's common even at early stages and has been linked to faster disease progression (Gallingani et al., 2025). In practice, this means a concerned spouse, adult child, or close friend noticing changes is often at least as clinically meaningful as how the person feels about their own memory.
Dementia Isn't Just Alzheimer's
Most public information about dementia, including the list above, is really describing Alzheimer's disease specifically, the most common cause of dementia. But other forms present very differently, and the mismatch causes real diagnostic delays.
Frontotemporal dementia (FTD), for example, often starts with changes in personality, judgment, or behaviour, not memory. The formal diagnostic criteria for its most common subtype list six defining features, including becoming impulsive or disinhibited, losing empathy, apathy, and compulsive behaviours (Rascovsky et al., 2011). Memory was originally thought to stay relatively intact early on, but a 2025 review of those same criteria found memory and visuospatial problems are actually common in FTD too, and researchers are now recommending "memory stays intact" be dropped as a defining feature altogether, since it isn't as clean-cut as first thought (Piguet et al., 2025). What does seem to hold up is the order things show up in: personality and behaviour changes tend to come first and stand out the most. That's a big part of why FTD gets misdiagnosed so often. If personality or judgment is what's changed, with or without memory issues, that's still worth a closer look, not something to write off just because memory "seems fine."
Before Assuming the Worst: Rule Out What's Treatable
This is arguably the most important, and most hopeful, part of this whole topic. A meaningful share of "possible dementia" presentations turn out to be something else, and often something treatable:
Depression can be associated with cognitive symptoms such as problems with concentration, thinking, and memory. Because mood symptoms and cognitive changes can overlap, depression is one of the conditions clinicians may consider when evaluating new cognitive concerns (Brodaty & Connors, 2020).
Medications, particularly those with anticholinergic effects, or combinations of several drugs in older adults on multiple prescriptions, are among the most common reversible contributors to cognitive symptoms in older adults (Day, 2019).
Urinary tract infections in older adults often skip the usual symptoms and instead show up as sudden confusion or delirium, which can be mistaken for a dementia onset (Day, 2019).
Sleep apnea, thyroid problems, and vitamin B12 deficiency are also well-documented, treatable contributors to cognitive symptoms that can resemble dementia (Day, 2019).
None of this guarantees a reversible cause, but it's exactly why a proper medical workup matters before anyone assumes the worst.
Why a Quick Office Visit Doesn't Always Catch It
A regular checkup often includes a brief cognitive screen, a 10-minute test like the MoCA or MMSE. These tools are useful, but they have real limits. For instance, these screening measures cannot detect early cognitive decline or cover all the cognitive domains that could potentially be impaired.
Cognitive reserve is a concept used to help explain why people can differ in how they tolerate age- or disease-related brain changes. Factors such as education, occupational experiences, and cognitively stimulating activities have been studied in relation to cognitive reserve (Stern, 2002). A normal score on a brief screening measure does not necessarily resolve every cognitive concern; when symptoms, functional changes, or history remain concerning, a more comprehensive assessment may be appropriate.
What to Actually Do
If any of this sounds familiar, the next step isn't to self-diagnose off a blog post, it's a proper evaluation. Two things are worth holding at once here: some of what looks like early dementia turns out to be something else, treatable, and worth ruling out first. At the same time, a normal score on a quick screening test doesn't fully rule out early changes either, especially for someone who's spent a lifetime being mentally sharp.
If it does turn out to be dementia, an early, accurate diagnosis still matters, it means more time to plan, more support options, and treatments that tend to work best when started early. Either way, getting an actual answer beats living with uncertainty.
If you are noticing memory changes in yourself, or someone you love, and are not sure if it's normal aging or something more, Durham Region Centre for Cognitive Health (DRCCH) offers comprehensive cognitive health assessments to help families better understand changes in memory, thinking, and aging. Early evaluation means more time to plan and more options for support.
References
Alzheimer's Association. (2023). 10 early signs and symptoms of Alzheimer's & dementia. https://www.alz.org/alzheimers-dementia/10_signs
Brodaty, H., & Connors, M. H. (2020). Pseudodementia, pseudo-pseudodementia, and pseudodepression. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 12(1), Article e12027. https://doi.org/10.1002/dad2.12027
Day, G. S. (2019). Reversible dementias. Continuum: Lifelong Learning in Neurology, 25(1), 234–253. https://doi.org/10.1212/CON.0000000000000688
Gallingani, C., Tondelli, M., Vannini, P., & Zamboni, G. (2025). The association between anosognosia and neuropsychiatric symptoms in neurodegenerative dementias: A narrative review. Frontiers in Neurology, 16, Article 1649627. https://doi.org/10.3389/fneur.2025.1649627
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., & Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
National Institute on Aging. (2020, October 21). Memory, forgetfulness, and aging: What's normal and what's not? U.S. Department of Health and Human Services. https://www.nia.nih.gov/health/memory-loss-forgetfulness-and-aging/memory-forgetfulness-and-aging-whats-normal-and-whats-not
Piguet, O., Clarke, A. J., Foxe, D., Tse, N. Y., Teng, H., Burrell, J. R., Cheung, S. C., Carrick, J., Devenney, E., Halliday, G. M., Kwok, J. B., Dobson-Stone, C., Cordato, N. J., Hwang, Y. T., Hodges, J. R., & Ahmed, R. M. (2025). Fourteen years later: Reviewing the diagnostic criteria for behavioral-variant frontotemporal dementia. Alzheimer's & Dementia, 21(8), Article e70604. https://doi.org/10.1002/alz.70604
Rascovsky, K., Hodges, J. R., Knopman, D., Mendez, M. F., Kramer, J. H., Neuhaus, J., Van Swieten, J. C., Seelaar, H., Dopper, E. G. P., Onyike, C. U., Hillis, A. E., Josephs, K. A., Boeve, B. F., Kertesz, A., Seeley, W. W., Rankin, K. P., Johnson, J. K., Gorno-Tempini, M. L., Rosen, H., . . . Miller, B. L. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134(9), 2456–2477. https://doi.org/10.1093/brain/awr179
Pozzi, F. E., Licciardo, D., Musarra, M., Jonghi-Lavarini, L., Crivellaro, C., Basso, G., Appollonio, I., & Ferrarese, C. (2022). Depressive pseudodementia with reversible AD-like brain hypometabolism: A case report and a review of the literature. Journal of Personalized Medicine, 12(10), Article 1665. https://doi.org/10.3390/jpm12101665
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448–460. https://doi.org/10.1017/S1355617702813248
UCSF Health. (n.d.). Frontotemporal dementia. University of California, San Francisco. Retrieved September 2026, from https://www.ucsfhealth.org/care/conditions/frontotemporal-dementia
