Last year, I lost my grandmother — the person I loved most in this world. She had lived with dementia for seven years.

By the end, she knew I had become a mother of two. But she no longer knew that the woman standing in front of her was her eldest granddaughter, the one she used to dote on more than anyone. My first child, at least, got to be held in her arms — got to be known, however briefly, as mine. My second child, she only ever saw through a screen. She passed away without ever meeting him in person.

What broke my heart the most wasn’t the things she forgot. It was the things that didn’t change. When I sat in front of her and talked to her, the way she looked at me — that gaze was still the same one that used to call my name so tenderly. Even now, writing this, my eyes well up.

She would listen to everything I said, all the way to the end, with that same warm expression, as if any second now she’d say my name. And then, when I finished, she’d simply ask me for candy.

She seemed to understand. She seemed, somehow, to recognize me. And yet she didn’t. Even now, thinking back on it, it still hurts more than I can say.

Dementia is such a cruel disease. For years, a person can be surrounded by their family’s love and care every single day, and still not know any of it is happening. It quietly erases eighty, ninety years of a life — every memory, one by one. That’s what makes it so frightening.

These days, I’ve noticed my mother-in-law telling me the same stories more and more often. I don’t think it’s dementia — it feels more like the ordinary forgetfulness that comes with age. But having gone through what I went through with my grandmother, I find myself paying closer attention than I probably would have before, quietly watching for the difference.

Today, I wanted to write a little about dementia — partly for myself, and partly for anyone out there wondering the same thing I once did: is this just old age, or is it something more?

The Core Difference: “Forgetting” vs. “The Memory Never Existed at All”

Looking back, I understand now what I was watching happen to my grandmother. The most useful way to think about the difference between normal aging and early dementia is this:

Normal aging is like a memory that’s still there, just harder to retrieve. Give a gentle hint, and the person usually says, “Oh, right!” and remembers.

Early dementia is different. Often the memory was never properly stored in the first place, or it has been erased entirely. Even with a hint, the person doesn’t remember — and sometimes insists the event never happened at all.

A Side-by-Side Comparison

Situation	Normal Aging	Early Sign of Dementia
Misplacing items	Occasionally can’t find keys or glasses	Puts things in strange places (a remote in the fridge) and may accuse others of stealing them
Forgetting words or names	A name is “on the tip of the tongue” but comes back later	Forgets common, everyday words, or substitutes odd words in their place
Missing appointments	Occasionally forgets, but remembers once reminded	Forgets the appointment — or even the entire conversation — completely
Getting lost	Occasionally disoriented in unfamiliar places	Gets lost even on routes they’ve walked a thousand times
Judgment	Occasional minor mistakes (miscalculating change, etc.)	Repeated, serious lapses in judgment around money or hygiene
Conversation	Words come slowly, but conversation flows naturally	Asks the same question, or repeats the same story, minutes apart
Mood and personality	Personality largely stays the same	Becomes suspicious, withdrawn, or noticeably different in character, for no clear reason
Daily tasks	Handles familiar tasks without much trouble	Struggles with things they’ve always known how to do — cooking, using appliances

Five Red Flags of Early Dementia Worth Watching Closely

If several of the following appear together, and worsen over time, it’s worth seeing a doctor.

1. Repeating the same question — asking something five minutes after already asking it, with no memory of the answer they were just given
2. Struggling with everyday tasks — fumbling with a remote control or washing machine they’ve used for years
3. Losing track of time and place — regularly unsure what day it is, or what year
4. Impaired judgment — buying strange things in bulk, or becoming unusually vulnerable to scams
5. Withdrawal or personality change — someone who was once outgoing suddenly avoiding gatherings (often because, on some level, they sense something is wrong and try to hide it)

On the other hand, if a person can catch themselves and laugh it off — “oh, I totally forgot!” — that’s usually closer to normal aging. In early dementia, the person often doesn’t recognize the problem at all, or becomes defensive when it’s pointed out.

Looking back, this is part of what made my grandmother’s dementia so disorienting to witness. In her eyes, in her warmth toward me, there was so much that looked unchanged. It’s easy to mistake that warmth for recognition. It so rarely is.

Sometimes It Isn’t Dementia at All

Memory loss that looks like dementia can sometimes come from something else entirely — and often, something treatable.

• Depression — late-life depression can cause fatigue and poor concentration that closely resembles dementia (sometimes called “pseudodementia”)
• Hypothyroidism — a common medical cause of cognitive decline
• Sleep deprivation or sleep apnea
• Medication side effects — especially with multiple medications interacting
• Vitamin B12 deficiency
• Dehydration or urinary tract infections — which can cause sudden confusion, especially in older adults

Because so many of these causes are treatable, it’s worth getting checked rather than trying to decide “dementia or not” on your own.

What Helps When You Go See a Doctor

If you do take a parent or grandparent in for an evaluation, it helps to come prepared. When asked “how have you been?” many older adults will simply say “I’m fine” — even when their family has noticed real changes.

• Keep notes on specific incidents from the past two or three months — what happened, and when
• Track the pace of change — has it worsened sharply over a few months, or been gradual over years?
• Come along to the appointment, if possible, so you can describe what you’ve observed directly
• Ask about cognitive screening tests (like the MMSE or MoCA) for a more objective assessment

A Final Thought

I know how hard it can be to even bring up the idea of seeing a doctor. There’s pride involved, and sometimes a quiet hope that if you don’t look too closely, maybe it isn’t really happening. I understand that hesitation more than I wish I did.

But catching things early means treatable causes can actually be treated — and even when it is dementia, care and support can start sooner, which matters more than I ever understood before I watched it happen myself.

I still think about my grandmother’s eyes. How they never stopped looking at me like they knew exactly who I was. I’ll never really know how much she understood, in those last conversations. But I know I was loved by her for my entire life, long before dementia took anything from either of us — and that part, at least, no illness could erase.

Only a doctor can give a real diagnosis. But I hope this gives you a starting point — something to hold onto the next time you find yourself wondering, quietly, whether what you’re seeing is just age, or something more.

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This article is for general informational purposes and is not a substitute for medical diagnosis. If you’re concerned about specific symptoms, please consult a neurologist or psychiatrist.