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Dementia has stages Early stage Dementia affects everyone differently and early symptoms are often relatively mild and not always easy to notice. Many people at this stage stay largely independent and only need a bit of assistance with daily living. It is important to focus on what the person can do and not to take over and do things for them.

Instead, try doing things with them, for example helping the person develop a routine, reminder lists and prompts, and use technology. For more information see factsheet 526, Supporting a person with memory loss and booklet 1506, Keeping active and involved (for people living with dementia). The early stage of dementia is when many people choose to make plans for the future, while they still have the ability (‘mental capacity’) to do so. For more information see factsheets 472, Lasting power of attorney and 463, Advance decisions and advance statements.

Symptoms of early-stage dementia As a very rough guide, the early stage of dementia lasts on average about two years. This stage is when the following common symptoms start to affect the person’s daily life: nThe most well-known early symptoms are memory problems. For example, a person may not recall recent events or may keep losing items (such as keys and glasses) around the house. Memory loss is often the first and main symptom in early Alzheimer’s disease. It is also seen, although less often, in early vascular dementia and DLB. Memory loss is not common in early FTD.

Difficulties in thinking things through and planning are also common at this stage. A person may get confused more easily and find it harder to plan, make complex decisions (for example, about finances) or solve problems.9 The progression and stages of dementia nLanguage and communication are often affected early on. A person may struggle to find the right word in a conversation, or they might not follow what is being said. Speech can also be affected when someone with vascular dementia has had a stroke.

Specific types of FTD cause particular early problems with language – see factsheets 500, Communicating and 404, What is frontotemporal dementia (FTD)? for more information. nPoor orientation is another feature of early stage dementia. A person may no longer recognise where they are and so get lost, even in a place that is familiar to them. nPeople may also struggle with visual-perceptual difficulties. This can cause problems judging distances, for example when using stairs. They are more common in early-stage Alzheimer’s disease and DLB than in vascular dementia or FTD.

Visual-perceptual difficulties are different from the visual hallucinations (often of animals or people) that are a feature of early-stage DLB. nChanges in mood or emotion are common at this stage. The person may be more anxious, frightened or sad, and so at risk of depression. It is also common to become more irritable – perhaps in frustration at lost abilities – or easily upset. A person can often be more withdrawn, lack self-confidence and lose interest in hobbies or people. For more information see factsheet 444,

Supporting a person with dementia who has depression, anxiety or apathy. Changes in behaviour are not common in early-stage dementia, other than in FTD. A person with behavioural variant FTD may lose their inhibitions and behave in socially inappropriate ways. They may also act impulsively and lose empathy for others. Significant physical changes at this stage tend to be limited to DLB, where problems with movement are similar to Parkinson’s disease. If someone with vascular or mixed dementia has a stroke, this can lead to weak limbs on one side.