Are you experiencing memory loss or dementia?

Published September 2024 | 5 min read  
Expert contributors Associate Professor Michael Woodward, director of dementia research, Austin Health; Lee-Fay Low, professor in ageing and health, University of Sydney   
Words by Karen Burge

As we age, it's natural to become more forgetful, but here are some signs to watch out for when that happens and what to do about it. 

We all have moments of forgetfulness – misplaced keys or items left off the shopping list. But when do a few slips of the mind become cause for concern?

Memory loss is often one of the first noticeable signs of dementia, which is a condition affecting some 421,000 Aussies. That figure is tipped to double by 2058, according to the Australian Institute of Health and Welfare (AIHW).

While many think of dementia as being a disease, it’s actually a broad term that describes a group of diseases that cause gradual loss of brain function, impacting mood, memory, thinking and behaviour.

Dementia is most common in the over-65 age group in Australia; however, it isn’t a normal part of ageing. When diagnosed in people under 65, it’s known as younger onset dementia, and there are almost 29,000 people living with this condition in Australia. There’s also a rare form, called childhood dementia, which affects one in 2,900 babies globally.

Dementia in adults and children is a progressive condition, which means symptoms will vary and worsen over time, and can progress over months, years or even decades. If you have concerns about your brain health, or that of a loved one, here’s what you need to know.

Understanding dementia

According to the World Health Organisation, dementia is “an umbrella term for several diseases affecting memory, other cognitive abilities and behaviour". Essentially, a diagnosis of dementia occurs when there's damage to the brain, including abnormal build-ups of toxic proteins.

Our cognitive abilities can be placed into one of three categories: normal; mild cognitive impairment; and dementia, says Associate Professor Michael Woodward, director of dementia research at Melbourne’s Austin Health.

“If you've got significant memory problems, you may have mild cognitive impairment,” he says. “If these go on and start affecting your day-to-day function, you've moved into the stage of dementia.”

In normal ageing, our general knowledge and crystallised intelligence (the ability to use skills and knowledge) are mostly unaffected, but our fluid intelligence (the ability to think on the fly and solve new problems) suffers, according to the Queensland Brain Institute.

However, the memory issues associated with dementia can include a loss of historical information. So, rather than forgetting where your keys are, it may be forgetting what they’re for.

Types and causes of dementia

There are various types and causes of dementia. The most common are listed below.

• Alzheimer’s disease – resulting from a build-up of proteins which damage neurons in the brain, people suffering from this disease can't communicate with other people as well as they once did. Later on, as the disease progresses and the symptoms become more severe (memory loss and disorientation), the neurons die and brain volume shrinks. A diagnosis of dementia usually follows. In Australia, Alzheimer’s disease is the most common form of dementia, accounting for nearly seven in 10 cases of dementia and affecting one in 10 Australians over 65.
• Vascular dementia – a form of dementia caused by reduced blood flow to the brain, often as a result of a series of strokes. Symptoms include problems with memory, thinking and trouble following instructions.
• Lewy body dementias – a term covering both dementia with Lewy bodies and Parkinson’s disease dementia. Robin Williams was diagnosed with this condition. Symptoms include trouble focusing, reasoning and problem-solving. When the disease starts with motor deficits in physical movements (as opposed to cognitive impairment) and then progresses, it’s usually diagnosed as Parkinson’s disease dementia.
• Younger onset dementia – when a person under the age of 65 is diagnosed with any form of dementia, it’s known as younger onset dementia.
• Frontotemporal dementia – a progressive brain disease, this form of dementia affects the parts of the brain that control personality traits, behaviours and speech. This is the form of dementia with which Hollywood actor Bruce Willis was diagnosed.

Why does dementia develop?

While ageing is the most obvious leading factor of dementia, there are over 100 diseases that can develop into dementia as well.

“Often, particularly in older people, multiple causes will be found for a dementia diagnosis,” says Prof Woodward, who is also an honorary medical adviser to Dementia Australia.

Almost all of the known genes linked to dementia are risk-factor genes, which means if you have that gene in your DNA, you may be more at risk. However, in the case of Alzheimer’s, for example, these genes don’t mean you will develop Alzheimer’s – they just change your risk slightly.

This is also true of the E4 gene that Aussie actor Chris Hemsworth recently discovered he has, which is a risk for, but not a cause of, Alzheimer’s, says Prof Woodward.

Early signs of dementia

If you’re not sure what to look for when it comes to the early signs of dementia, Prof Woodward says persistent and repeated forgetfulness should trigger investigation.

“This includes repeatedly misplacing items, repeating yourself, repeatedly forgetting names and repeatedly forgetting recent arrangements, conversations or past events,” he says.

This could also include getting lost when driving or losing your car, having difficulty following the plot of a show, or re-watching a show without realising you’ve seen it before.

“It's a matter of severity, rather than just the odd occasion,” he says.

What are the symptoms of dementia and how is it diagnosed?

Along with memory loss, dementia symptoms include:

• changes in planning and problem-solving skills
• trouble doing everyday tasks
• changes in mood and personality
• a lack of interest in things and activities you used to enjoy
• poor judgement and lack of insight
• problems with speaking and writing
• confusion about time and place.

Doctors will use a range of tests to diagnose dementia and rule out other potential causes.

These include:

• a personal history
• physical examination
• neurological examination, including sensory and movement tests
• pathology tests, including bloods and urine
• neuropsychological tests to examine abilities and problem areas
• cognitive testing to check thinking functions
• psychiatric testing
• X-rays and scans.

There's no cure for dementia but Lee-Fay Low, a professor in ageing and health at the University of Sydney, says an early diagnosis is essential to connect patients with treatment, rehabilitation, therapy and support. Dementia Australia has a range of resources to help with this.

“Timely diagnosis, regardless of age or disease progression, allows for the person and their family to adjust, plan ahead and make lifestyle changes now that can slow the progression of dementia and significantly improve their quality of life,” she says.

Caring for someone with dementia

People with dementia will require ongoing support, including healthcare, transport, mobility assistance, help with chores, meal preparation, communication and self-care. Something that Sydney-based Keri Kitay knows all too well.

When Keri’s mother, Terry, began showing signs of withdrawal and forgetfulness, Keri and her family were concerned. She’d already pulled back from social circles and wasn’t participating in family chats around the dinner table, which was unusual for her.

“My mum was a very happy, kind, outgoing and sociable person, then all of a sudden, she became withdrawn and reserved,” says Keri. “It was uncharacteristic and just didn't feel like my mum. It felt like she’d gone into a slump of depression.”

Then other things started to happen, says Keri. Simple tasks that she'd been doing for her whole life, or for many years, became impossible and quite complex.

After an assessment, much to the family’s surprise, Terry was diagnosed with early onset Alzheimer’s at the age of just 54.

Keri remembers the big learning curve her family experienced as her mother’s disease progressed. “It was such a challenging time. There was just so much that I and my family had to learn and navigate,” she says. “There is this constant need to look after that person and their wellbeing, and they can’t be left alone.”

As Keri watched her mother’s decline, she felt the urge to write things down and has turned that experience into a book, The Long Goodbye: Lessons on humanity from the grips of Alzheimer's, which she hopes will help others.

How to prevent dementia

While there's no known way to prevent dementia, maintaining brain health is important, particularly from your 40s onwards, says Prof Woodward. Especially if you have a family history of Alzheimer’s or have been diagnosed with mild cognitive impairment.

“Focus on physical exercise, eating a Mediterranean diet, keeping socially active and keeping mentally active,” she says. “Those four activities can reduce your risk of progression and reduce your risk of moving into the dementia stage substantially.”

Prof Woodward advises reaching out early if you’re having memory issues to help prepare for what may come as well as connecting with important areas of support, like Dementia Australia, the National Dementia Helpline (call 1800 100 500). You can also talk to your GP, and this will often be the first step in receiving a diagnosis for dementia. HCF members can also speak to a GP online through our partnership with GP2U. All HCF members with health cover can access a standard GP consultation (up to 10 minutes) for a fee of $50.

“We plan many things in our life – our children, our families and how we train for our career,” he says. “We should also plan for how cognitive changes are going to affect us and the adjustments that we need to make.”

Need to talk to someone?

If you’d like to talk to someone about your memory loss, or you’d like to try a free HCF HealthyMinds Check-in for eligible members^*, PSYCH2U psychologists^{^} and digital support services give you faster, easier access to mental health support. Take control of your mental wellbeing today.