21 September 2026 (Navroze Bureau) : Not every memory lapse in an older person indicates dementia. However, persistent or worsening changes in memory, behaviour, movement or everyday independence should not automatically be dismissed as normal ageing, a neurosurgeon has cautioned.
Dr Tejesh Shavi, Consultant, Neurosurgery at Manipal Hospitals Hebbal, says families should pay attention when changes become frequent, progressively worsen or begin interfering with a person’s normal routine.
1. Repeated Forgetfulness That Affects Daily Life
Occasionally forgetting where keys or glasses were kept can happen with normal ageing. Taking longer to recall a familiar name can also be relatively common.
More concerning changes include repeatedly asking the same question, forgetting familiar routes, failing to recognise people or struggling with tasks that were previously routine.
A person who has managed household finances for years, for example, may suddenly struggle to pay bills or keep track of regular expenses. Forgetting whether medicines have been taken can also create safety concerns.
2. Changes in Walking or Frequent Falls
Neurological problems do not always begin with memory loss.
New difficulty walking, unsteadiness or repeated falls, particularly when accompanied by changes in memory or thinking, can warrant medical evaluation.
Dr Shavi also highlights changes involving speech, movement and bladder control as symptoms that may provide additional clues about an underlying neurological condition.
3. New Headaches, Seizures or Weakness
Families should also pay attention to new or unusual headaches, seizures, unexplained weakness or difficulty speaking.
These symptoms can have many different causes, and they do not automatically indicate a serious brain disorder. However, sudden neurological symptoms require prompt medical assessment. The US National Institute of Neurological Disorders and Stroke, for example, advises emergency evaluation for sudden weakness, confusion, speech problems, trouble walking or a severe unexplained headache because these can be signs of stroke.
4. Sudden Personality or Behaviour Changes
A noticeable change in someone’s usual personality can also be important.
Unusual agitation, apathy, paranoia, confusion or significant changes in behaviour may require evaluation, particularly when they are new or progressively worsening.
Medical conditions other than dementia can sometimes produce such changes. Brain tumours, for example, can cause memory problems, confusion, personality changes, seizures and balance or speech difficulties, although these symptoms have many other possible causes.
5. Loss of Independence in Everyday Tasks
One of the clearest warning signs is when a person begins losing the ability to manage everyday activities independently.
Difficulty handling money, taking medicines correctly, navigating familiar places or completing previously familiar household tasks may indicate that cognitive changes are becoming significant.
The important factor is a noticeable change from the person’s previous level of functioning rather than an occasional lapse.
Memory Loss Does Not Always Mean Dementia
An important point for families is that cognitive changes can have several causes.
According to Dr Shavi, memory problems may sometimes be linked to vitamin deficiencies, metabolic problems, medication side effects or untreated sleep disorders. Certain neurological conditions can also produce symptoms resembling dementia.
For example, normal pressure hydrocephalus can involve thinking difficulties alongside walking and urinary problems, while a chronic subdural haematoma can develop weeks after a minor head injury and cause confusion or behavioural changes.
Why Early Medical Evaluation Matters
Families sometimes delay seeking medical help because they fear a dementia diagnosis. But an assessment can help doctors identify the underlying cause and determine whether a treatable condition is involved.
Even when a neurodegenerative condition such as Alzheimer’s disease is eventually diagnosed, early recognition can help families understand the condition, consider available treatment options, make safety changes and plan future care.
Don’t Simply Blame Ageing
The key message for families is to watch for new, persistent and worsening changes.
An older person occasionally forgetting a name or misplacing an object is different from repeatedly forgetting familiar information or losing the ability to perform routine tasks.
When the person’s usual behaviour or abilities change significantly, professional medical advice can help determine whether further evaluation is needed.
When Symptoms Need Urgent Attention
Some neurological symptoms should not wait for a routine appointment.
Sudden facial weakness, weakness or numbness on one side, difficulty speaking, sudden confusion, trouble walking, vision problems or a sudden severe headache can indicate stroke and require emergency medical attention.