Is it dementia? Signs, normal aging and getting a diagnosis

Fatima Warsame is forty-four, a community health worker in Ottawa, whose family came from Somalia when she was a girl. Her mother, Hodan, is seventy-two, a former teacher who runs the women's tea after Friday prayers. Last week Hodan got lost walking home from the mosque. On her own street. She laughed it off. Fatima didn't.

So here's the question. How do you tell the forgetting that comes with age from the changes that need a doctor, and what are the first steps to find out?

Start with the World Health Organization: dementia is more common after sixty-five, but it is not an inevitable part of ageing. The Alzheimer Society lists ten warning signs and pairs each with normal aging. Forgetting a name now and then is normal; forgetting recent events so often it affects daily life is a sign. Struggling for a word is normal; substituting odd words is a sign.

Forgetting what day it is happens to everyone; getting lost on your own street is a sign of disorientation. Misplacing your keys is normal; the remote in the fridge is a sign. An occasional bad decision is normal; not recognizing a medical problem is a sign. Changes in mood or personality, and losing the drive to start things, count too. The society's list is guidance, not a test.

How common is it? Government figures count nearly half a million Canadians sixty-five and older with a dementia diagnosis in twenty twenty-two. The real number is higher, because many people are never diagnosed. The Alzheimer Society's model puts it at about six hundred thousand in twenty twenty, heading toward a million by twenty thirty. And by an older count the society quotes, most people caring for someone with dementia at home are adult children.

The first step is the family doctor or nurse practitioner. Bring your written examples, with dates. The doctor can examine your parent, order tests, and refer on if needed. If it is dementia, ask the doctor to send a First Link referral to the Alzheimer Society, which connects families to education and support. You can also call your local Alzheimer Society directly and ask how to get connected.

Now, their side. Hodan laughed it off, and it's fair to guess she knows more than she's saying. People hide slips out of fear: of the word itself, of losing a licence, a home, or the respect of the women at Friday tea. So don't start with the word. Ask about her day. Ask what's been harder lately. And promise her that finding out doesn't mean deciding anything about her life.

Let's change one fact. Hodan is fifty-eight, not seventy-two. Getting lost on her own street is still a sign, and still worth the appointment. Dementia before sixty-five is uncommon, about three percent of people with dementia by the government's count, but it exists. The same first step applies: the doctor, with examples and dates.

The mistake families make is saying it's just old age. It's a kind thought, and sometimes it's even right. But it can delay finding out, and finding out opens doors: planning while your parent can still sign, support from the Alzheimer Society, and answers where there are answers. Getting lost on your own street isn't old age. It's a reason to ask.

Here's the rule, in one breath. Normal aging forgets the name; dementia forgets the street. Write it down, and see the doctor.

This week, write down what you've noticed, each with a date and what happened, no labels. Then book the appointment, and ask your parent if they'd like you to come along.

Next time, living with dementia: talking so it goes better, responsive behaviours, and staying safe.