Early-onset dementia affects more than 200,000 people in the US, and the warning signs can look different from one person to the next.
The Alzheimer’s Association estimates that about 7.2 million Americans aged 65 and over are living with Alzheimer’s.
With 74 percent of cases occurring in people aged 75 and older, that still leaves an estimated 110 in every 100,000 adults aged 30 to 64 living with early-onset dementia.
While dementia is most often associated with memory and thinking, it can also have physical effects as the condition progresses.
According to the Mayo Clinic, possible symptoms include memory loss, difficulties communicating or finding the right words, problems with visual and spatial awareness, issues with reasoning and problem-solving, trouble completing complex tasks, challenges with planning and organization, poor coordination or movement control, confusion, disorientation, and more.
Researchers also suggest that certain personality and behavior shifts may appear years before the more widely recognized symptoms.
Professor Gill Livingston at University College London (UCL) has highlighted six midlife changes that may be worth paying attention to.
One potential signal is a noticeable drop in self-confidence. If you—or someone close to you—starts to doubt themselves much more than before, it may be worth taking seriously.
In research cited in relation to these traits, low self-confidence stood out as the strongest predictor, even compared with low mood or sleep difficulties.
It was linked with a 50 percent higher likelihood of later developing dementia, including when compared against people with established risk factors or genetic predispositions.
Geir Selbaek, professor and research director at the Norwegian National Centre for Ageing and Health, told The Telegraph:
“I think low self-confidence creates loneliness. And we’ve published a study showing that persistent loneliness increases the risk of dementia.”
Another possible red flag is struggling more than usual with everyday setbacks in your 40s or 50s—situations you previously handled without much difficulty.
Livingston suggested this could reflect changes in the brain, including shrinkage seen in some forms of dementia.
Livingston explained:
“For small children, stresses are much more likely to lead to them breaking down, shouting and crying, because they have a smaller brain,”
“We know that decades before they’re diagnosed with Alzheimer’s disease, people’s brains can begin to shrink. Things they’ve previously been able to cope with, they’re unable to manage like before. It’s both the stress and that they’re on their way to developing dementia.”
Reduced emotional connection can also be a concern.
‘not feeling warmth and affection for others’
People who reported that feeling in midlife were found to have a higher associated risk in the analysis.
In fact, they were 44 percent more likely to develop dementia than those who didn’t report similar changes.
Impulsiveness isn’t automatically a problem—but a sudden, out-of-character shift in behavior may be worth noting.
In an interview with The Telegraph, Prof Livingston said:
“I remember one woman who’d always been what I’d describe as a very conventional person, and then she suddenly seemed to change,”
“She went out more, she was less interested in her husband and wanted to go out without him. They had always done things together, but she suddenly seemed to feel he was not adventurous enough for her.”
Livingston also linked this kind of change to the breakdown of cells in the brain’s frontal regions.
Livingston explained:
“One of the things that enables us to control our impulsivity is the frontal region of the brain,”
“As we mature and become adults, that becomes much more developed. It doesn’t necessarily change what we want to do, but it makes us less likely to do it suddenly.”
High levels of nervousness or persistent anxiety were also mentioned as a potential risk-linked trait.
Selbaek suggested long-term stress could play a role.
He said:
“I think that is one of the mediating factors. Increased levels of stress lead to higher levels of inflammation in the body, and both are devastating for brain health.”
Another reported trait may sound minor at first: frequently feeling that tasks aren’t being completed properly.
But in some cases, the issue might not be other people’s performance—rather, it could reflect that you’re finding it harder to carry out tasks to the level you previously could.
The report also linked concentration problems in midlife with a greater likelihood of developing dementia later, noting the connection to cognitive function.
‘difficulties concentrating’
If you recognize any of these changes in yourself or someone else, speaking with a healthcare professional is the best way to get tailored guidance and, if needed, early support.