Real Dementia Warning Signs That Families Miss — Dr. Anand Karnam, Hyderabad

Dementia affects over 5.3 million people in India — and the number is rising steeply as the population ages. Despite this, the average time between first symptoms and a formal diagnosis in India is still over 3 years. Families dismiss the early changes as "old age," or the patient hides their difficulties, or a busy GP reassures them that "some forgetfulness is normal."

Dr. Anand Karnam, Neurologist at Sri Anand CNC, shares the real patterns from his clinical practice — the warning signs that separate concerning cognitive decline from normal ageing.

Normal Ageing vs Dementia — The Critical Distinction

It is completely normal to occasionally:

• Take longer to recall a name, then remember it a few minutes later
• Forget why you walked into a room, then remember when you go back
• Need more time to learn new technology
• Slow down in processing speed

These are normal age-related changes. What is NOT normal:

• Forgetting recent conversations and events entirely — not with a delay, but completely
• Asking the same question repeatedly in the same conversation
• Getting lost in familiar places — a locality they have lived in for 20 years
• Not recognising family members they have known all their life
• Being unable to manage finances, medications, or cooking they previously handled independently

Ten Warning Signs of Dementia

1. Memory loss that disrupts daily life: Forgetting recently learned information, important dates, asking the same question over and over
2. Difficulty with planning and problem solving: Cannot follow a recipe they have made for 30 years; makes errors in bills or calculations
3. Difficulty completing familiar tasks: Getting confused driving to a familiar place; forgetting the rules of a game they play regularly
4. Confusion with time or place: Losing track of dates, seasons; forgetting where they are or how they got there
5. Trouble with visual images and spatial relationships: Difficulty reading, judging distance, determining colours — which can also manifest as driving problems
6. New problems with words: Stopping mid-sentence and not knowing how to continue; repeating themselves; struggling to find the right word or using wrong words
7. Misplacing things and losing the ability to retrace steps: Putting things in unusual places (mobile in the refrigerator); accusing others of stealing
8. Decreased or poor judgment: Giving large amounts of money to fraudsters; ignoring personal hygiene; making poor financial decisions
9. Withdrawal from social activities: Giving up hobbies, sports, social engagements; becoming passive — watching TV for hours
10. Changes in mood and personality: Increased anxiety, suspicion, depression; becoming easily upset; confusion, fearfulness

Types of Dementia — Not Just Alzheimer's

Alzheimer's Disease (60–70%): Gradual memory loss first, progressing to other domains. Amyloid plaques and tau tangles destroy neurons progressively.

Vascular Dementia (second most common): Caused by stroke or chronic small vessel disease from hypertension, diabetes. May progress in a stepwise fashion — sudden worsening after each mini-stroke.

Lewy Body Dementia: Fluctuating cognition, visual hallucinations, Parkinson-like movements. Often misdiagnosed as Alzheimer's or psychiatric illness.

Frontotemporal Dementia: Personality change and language difficulty first — memory relatively preserved initially. Affects younger people (50s–60s). Often mistaken for depression or psychiatric disorder for years.

Reversible Causes of Memory Loss

Before diagnosing irreversible dementia, Dr. Anand Karnam always screens for and treats reversible causes of cognitive decline:

• Hypothyroidism — very common in India, very treatable
• Vitamin B12 deficiency — especially in vegetarians and those on metformin
• Depression ("pseudodementia") — responds to antidepressant treatment
• Normal pressure hydrocephalus — treatable with a surgical shunt
• Subdural haematoma — blood collection on brain after head injury
• Medication side effects — benzodiazepines, anticholinergics, polypharmacy

What to Do If You Are Worried

Bring your family member for neurological assessment at Sri Anand CNC. The assessment includes cognitive testing (MoCA or MMSE), neurological examination, blood tests (thyroid, B12, glucose, kidney function), and MRI brain review. Early diagnosis matters — not because all dementia is reversible, but because some is, and because early management slows progression, reduces caregiver crisis, and enables the patient to plan while they still can.

Sri Anand CNC, Chanda Nagar, Hyderabad. Call +91 90633 66983.