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He’s able to care for himself, but this issue is frightening to me. Is this start of decline?

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This is more than mild cognitive decline. It doesn’t just happen overnight.

Definitely start educating yourself. You’ll need to be prepared for the next things that happen. You’ll need to manage a lot of issues from here on in, The legal things should be first priority.

So sorry this is happening.
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One of the earlier signs my mom displayed of her dementia was when she'd introduce me as her mother. The first time she did that, I turned around to look at her, expecting to see her laughing. She wasn't. She was dead serious!

I suggest you read this 33 page booklet about dementia and what to expect with an elder who's been diagnosed with it. Lots of Do's and Don't tips for dealing with dementia sufferers are suggested in the booklet.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 

https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.

The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:

https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

Educate yourself about what lies ahead as dementia progresses. Knowledge is power.

Best of luck
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Sounds like this is more than just "mild cognitive" issues. I would try and get him in to see his neurologist for a more definitive diagnosis.
And in the meantime start educating yourself about the disease of dementia so you won't be so frightened when changes and declines happen, as both are inevitable.
The book The 36 Hour Day is a good place to start along with books and videos by a dementia expert Teepa Snow.
And find a local caregiver support group where you can share with others what you're feeling and going through.
Also make sure that you have all your legal paperwork in order like POA's(both medical and durable)because if he gets too far into his dementia he will no longer be able legally to designate someone for those.
You're going to be ok, just do your homework and start getting your ducks in a row.
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It broke my heart when my mom began to call for her mother and confuse me with her, and this was very early in her spiral into dementia. My mom did get over that phase and recovered somewhat for a time, but it was definitely a sign of things to come.
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I would start by taking him to the doctor for a cogntive and memory test. You don't have to tell him this is the reason for the appointment -- a "therapeutic fib" is morally and ethically ok in order to keep your loved one calm and cooperative. An accurate diagnsosis is important. Also ask them to test him for a UTI, which can cause sudden and rapid changes in behavior, cognition, memory, etc. There are other health problems that can create dementia-like symptoms as well, many of them treatable.

Next, make sure all his legal ducks are in a row: he has an assigned medical and financial PoA (and please, not you (or only you) -- it needs to be someone at least a generation younger than him). He should have a Advanced Healthcare Directive, too.

Finally, you will need to educate yourself on dementia (if this is the diagnosis). In this forum, under Care Topics find D for dementia and read. Also, Teepa Snow has very excellent videos on YouTube that I found very helpful. There are also books, and probably podcasts as well.

You are in good company on this forum -- many, many have been in your shoes and can give you support and advice. May you receive wisdom, clarity and peace in your heart on this journey.
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