6 Red Flags to Watch for in a Person with Dementia

True dementia is a progressive condition, and with progression comes gradual changes. However, when changes happen suddenly or feel out of the ordinary, they shouldn't be brushed off as simply "a part of the dementia". These shifts could be signs of an underlying medical issue, and in many cases, they’re treatable if caught early. Recognizing red flags can make all the difference in preventing complications and getting the right care in time. In this blog post, we will briefly discuss 6 red flags to watch for. If you notice any of these changes, please contact your partner's doctor right away.

‍

6 Red Flags:

1. Sudden Incontinence
If a person with dementia suddenly begins having accidents after previously managing toileting well or being able to stay dry in between assistance, this could indicate more than just disease progression. Urinary tract infections (UTIs), side effects from medication, dehydration, or constipation are all common triggers for new or worsening incontinence.

‍

2. Sudden Confusion or Disorientation to Time and Place
While some level of disorientation is expected with many types of dementia, a sharp and sudden decline—such as thinking it’s a completely different year, not recognizing their own home, or familiar people—can be a red flag. This may signal delirium, an infection like a UTI, a medication reaction, or even a more serious condition like a TIA or stroke.

‍

3. Sudden Sluggishness or Agitation
A dramatic drop in energy or a increase in restlessness and irritability are both potential red flags. Sluggishness could result from depression, overmedication, or infection, while sudden agitation might point to discomfort, pain, overstimulation, or some other unmet need.

‍

4. Sudden Decreased Attention
A noticeable change in the ability to focus, engage, or follow along in conversation could also be a red flag. While attention span may gradually decline in dementia, an abrupt shift may indicate delirium or another medical concern that needs evaluation.

‍

5. New Aggressiveness
A person who is typically known to  be calm and cooperative may suddenly become verbally or physically aggressive. This isn't just a behavioral issue. This is not "just the dementia"—it can be a sign of physical pain, an emotional response to confusion or overstimulation, or an adverse effect of medication. It’s especially important not to dismiss aggression as just “acting out” or just a part of the condition—it’s often a form of communication.

‍

6. Change in Motor Abilities
Sudden changes in movement, such as increased difficulty getting out of bed or walking, changes in gait such as shuffling, problems with balance, or inability to stand up without help, may point to something more than dementia. It could signal an an infection, a stroke, a recent fall, or even something like a reaction to new medications. Any noticeable shift in how they move or get around should be taken seriously. Most sudden changes in motor abilities are not due to dementia alone.  

‍

Being able to recognize when something is off—especially when it happens suddenly—can help you advocate effectively for your partner with dementia and address their needs. These changes aren’t always just “part of the disease.” Many are treatable and, if caught early, may prevent a more serious outcome like hospitalization, injury, complications, or death.

‍

If you notice any of these red flags, please document what you’re seeing and speak with your partner's doctor right away. Sharing when the change started, how quickly it came on, and what else is going on can help providers narrow down the cause and determine next steps. Your observations and ability to communicate those observations matter—and they can make a meaningful difference in care.

‍