Neurologists often encounter patients who attribute early signs of dementia to other causes. Dr. Adel Aziz, a neurologist at JFK University Medical Center, notes that many cognitive changes—like slower processing and diminished comprehension—are frequently brushed off as part of aging instead of being recognized as potential dementia indicators.
While memory loss is commonly associated with dementia, it’s not the only symptom to be aware of. Dr. Tara Carlisle, a behavioral neurologist at UCHealth, emphasizes that understanding these less-known signs can facilitate earlier diagnosis and recognition by healthcare providers. Although there’s no cure for dementia, early intervention can sometimes slow cognitive decline. Neurologists shed light on a particular silent sign often overlooked—apathy.
The No. 1 Overlooked Sign of Dementia, Neurologists Warn
Neurologists want to highlight that apathy may be a subtle symptom of dementia. Dr. Aziz emphasizes that apathy, or the absence of goal-directed thought and action, can be one of the first signs in some dementia types, especially frontotemporal dementia. It often goes unnoticed because it doesn’t present as overt distress.
People may misinterpret their apathy as simply a preference for solitude or tiredness. Dr. Aziz suggests that those who used to actively socialize might just stop engaging altogether, leading loved ones to feel hurt, mistakenly believing that the individual has become indifferent or depressed. Dr. Katherine D. Amodeo from New York Medical College points out this complexity.
The Link Between Apathy and Dementia
Neurologists suggest several reasons for apathy in individuals with dementia. Dr. Amodeo explains that chemical changes and cell loss in brain areas related to motivation can reduce a person’s inclination to engage in previously enjoyed activities. Situational factors can also play a role, according to Dr. Daniel Lesley from Remo Health, who notes that if everything feels overwhelmingly difficult, it might seem like it’s “not worth the effort.” Individuals may then feel useless or burdensome.
Apathy is linked to various types of dementia, particularly receiving more attention in frontotemporal dementia, which is usually diagnosed in younger individuals. A 2020 study even indicated that apathy could foreshadow frontotemporal dementia by years. Dr. Amodeo mentions that this connection is likely due to personality or mood changes being among the first signs in affected individuals.
Research also suggests that apathy may correlate with a rapid decline in function. Dr. Lesley explains it can diminish one’s ability to adapt to cognitive changes and disrupt activities that support cognitive health, like socializing, exercising, and ensuring proper nutrition.
Common Signs of Apathy
Dr. Lesley clarifies that apathy isn’t a condition but rather describes a lack of feeling or interest. The common signs include:
- Loss of interest in activities once enjoyed
- Decreased motivation to perform even essential tasks, like paying bills or eating
- Reduced goal-directed efforts
- Neglecting self-care activities
However, understanding that apathy can stem from many sources is critical. It doesn’t always indicate dementia. Dr. Amodeo warns that while a person may seem apathetic, it doesn’t mean dementia is a certainty. Apathy can also appear in other conditions, such as depression. It’s vital to be cautious about drawing conclusions based solely on this symptom.
Dr. Amodeo highlights additional symptoms that might suggest a link to dementia, including:
- Progressive changes in memory, language, attention, and focus
- Hallucinations or delusions
- Changes in sleep patterns
- Variability in confusion and alertness
- Mood or personality shifts
What To Do if You’re Concerned
Experts recommend speaking with a primary care physician if there are concerns about cognitive decline. If necessary, the physician can order further testing.
While there’s currently no cure for dementia, Dr. Carlisle states that several medications can help manage symptoms and lifestyle changes might slow down cognitive deterioration. Suggested changes include:
- Engaging in regular moderate exercise
- Following a Mediterranean diet
- Participating in social and cognitively stimulating activities
- Ensuring adequate quality sleep
- Treating vision and hearing problems
A diagnosis can be emotionally challenging for individuals and may exacerbate apathy. Regardless of the cause, supporting mental well-being is essential. Dr. Amodeo advises reaching out to healthcare providers, who might refer individuals to mental health professionals for additional support.
