Occasional forgetfulness, wrong turns, or moments of confusion are a natural part of life. However, as individuals age, these instances can become increasingly unsettling, potentially signaling more significant underlying brain health concerns. Dementia, a condition currently affecting over 6 million Americans, is projected to see its cases double by 2060. This stark projection underscores the critical importance of understanding when to take a symptom seriously and the profound value of proactive engagement with brain health. Early identification and intervention for cognitive changes can make a substantial difference, especially given that up to 45 percent of dementia risk is modifiable, according to research published in The Lancet. As neurologist Dr. Georgina Aldridge of University of Iowa Health Care emphasizes, "Anyone with a brain should be looking out for their brain health, from kids to elders."

While forgetfulness, particularly in older age, is the most commonly associated symptom of declining brain health, it is far from the only indication that something could be amiss. Dr. Aldridge categorizes many common symptoms into five main areas: short-term memory, language, visual-spatial awareness, executive function (encompassing thinking, planning, and problem-solving), and behavioral changes. It is crucial to recognize that everyone is different, and an individual may experience any combination of these symptoms depending on their specific condition and stage of life.

Leading experts in neurology, including Dr. Georgina Aldridge, Dr. Armen Moughamian (Medical Director of the Ray Dolby Brain Health Center at Sutter’s California Pacific Medical Center), and Dr. Shae Datta (Neurologist at NYU Langone), highlight specific symptoms that they would not ignore:

1. Forgetfulness and Short-Term Memory Problems: This involves issues with the brain's ability to hold limited information for short periods, ranging from seconds to hours. While memory issues in middle-aged adults can stem from various causes unrelated to dementia—such as undiagnosed sleep apnea which disrupts memory formation, or a deficiency in essential vitamins like B12—it is imperative to monitor progressive changes in adults over 65. The risk of neurodegenerative brain diseases like Alzheimer’s rises significantly with age, notes Dr. Moughamian. Forgetting recent conversations or events can be an early warning sign of mild cognitive impairment that may progress to dementia or Alzheimer’s disease. Families might initially attribute this to inattention, but consistent and frequent episodes warrant a conversation with a doctor.

2. Irregular Sleep Patterns or Poor Sleep Quality: Practicing good sleep hygiene is paramount for overall health, including brain health, with studies linking lack of sleep in middle age to an increased dementia risk. Dr. Shae Datta explains that sleep is a critical period when the brain clears waste products and consolidates memories. Consequently, declining sleep quality can negatively affect cognitive performance and long-term brain health. Persistent daytime sleepiness and excessive napping, particularly observed in women in their 80s, could serve as an early marker of dementia, as indicated by a 2025 study in the journal Neurology. While individual sleep needs vary, the Centers for Disease Control and Prevention (CDC) recommends most adults aim for seven to nine hours of sleep per night.

3. Mood, Personality, or Behavior Changes: Alterations in mood, personality, and behavior are significant indicators of dementia or Alzheimer's disease. These changes can manifest broadly, including unwarranted suspicion or feeling threatened by others, unusual sexual behavior, physical aggression, or exhibiting social faux pas like talking excessively to strangers, as noted by the National Institute on Aging and Dr. Aldridge. Dr. Moughamian highlights that new-onset anxiety, depression, or irritability in individuals in their 60s can be an early and often overlooked sign of Alzheimer’s, frequently appearing before any memory problems and signaling deeper changes in the brain. Personality shifts may also suggest frontotemporal dementia (FTD), a common type of dementia affecting younger and middle-aged adults, typically between 40 and 65, though it can occur outside this age range and affects men and women equally.

4. Struggling with Language or Trouble Finding the Right Words: While occasionally having a word "on the tip of your tongue" is common, new or worsening difficulties with language that extend beyond occasional slip-ups can signal potential brain problems. Experts, including Dr. Datta and Dr. Moughamian, describe this as struggling to understand complex sentences, dropping connecting words, difficulty naming familiar objects, or frequently encountering "walls" in conversation. These persistent language issues may point to early Alzheimer’s disease or another neurological condition.

5. Difficulty with Everyday Household Skills and Tasks: Executive function, which encompasses the brain’s ability to manage daily tasks such as planning, problem-solving, and decision-making, is often affected in individuals with dementia and Alzheimer’s. Dr. Moughamian advises that if someone consistently struggles with activities they previously managed with ease—like cooking, managing medications, or paying bills—it could be a concerning sign. He emphasizes that people typically do not simply stop doing these things without an underlying reason, and such changes are often associated with dementia.

6. Changes in Visual-Spatial Awareness: Impaired visual-spatial awareness, which is the brain's capacity to understand and interpret visual information and the relationships between objects in space, can be an early symptom of emerging brain health issues. This might present as difficulty with depth perception (e.g., signing too high on a check) or struggling to find objects amidst clutter, which could be an early sign of Alzheimer’s or specific types of dementia, according to Dr. Aldridge. Furthermore, visual hallucinations—seeing or hearing things that are not present—can be a specific indicator of Lewy Body Dementia (LBD). LBD is a complex disorder characterized by abnormal deposits of a protein called alpha-synuclein (known as "Lewy bodies") in the brain, which affect brain chemicals and lead to changes in thinking and behavior. If hallucinations are severe, medication may be prescribed. Any experience of hallucinations warrants immediate medical attention.

Should you or a loved one experience any of these symptoms, consulting a doctor, particularly a neurologist, is strongly advised. While some cognitive changes are a natural part of aging, a proactive approach can help differentiate between mild cognitive impairment and more serious conditions, enabling better navigation of future health decisions and potentially mitigating progression.