As people age, it’s typical to see some changes in behavior or personality. After all, no one stays the same forever. But sometimes, unexplainable personality changes can be associated with dementia or cognitive decline. Some behavioral changes are more common than others and may occur during different stages of dementia.
Common dementia personality changes
Some of the earliest personality changes may become noticeable even before a dementia diagnosis. Early signs may include the following:
Apathy or withdrawal
Your loved one may care less about favorite activities or avoid social interactions. This change alone may not indicate dementia, as this can also be a sign of depression.
Difficulty concentrating or following the steps of a task
This may begin as something subtle — your loved one may appear to be daydreaming, do familiar tasks out of order, or struggle with planning and organizational skills.
Increased anxiety or agitation
Someone with dementia may be more easily worried than they used to be, especially if they’re unable to orient themselves in a familiar routine or environment.
These could be predictable, such as with sundown syndrome, which refers to increased agitation and confusion later in the day. However, in some cases, mood changes in people with dementia may appear more randomly.
Middle and late-stage dementia personality changes
Other personality changes may occur in the middle or later stages of dementia. These changes include the following:
Your loved one’s words and actions may come across as uncaring toward others.
Paranoid or delusional behavior
Your loved one may become suspicious of those around them or believe that others are taking things from them.
Losing inhibitions or exhibiting inappropriate sexual behavior
These behavioral changes can be shocking, but the person with dementia doesn’t usually intend to be offensive or inappropriate. Examples might include making rude comments or touching themselves inappropriately in public.
Remember that each person experiences dementia differently. The type of dementia a senior has can also make a difference in the personality changes you see.
Why people with dementia experience personality changes
Dementia symptoms appear due to changes in the brain. Different aspects of a loved one’s personality or behavior may change depending on which areas of the brain are affected. Certain personality changes are associated with different dementia types, according to the Weill Institute for Neurosciences.
For example, Alzheimer’s disease is most likely to result in apathy, anxiety, depression, repetitive behavior, and irritability. Someone with Lewy body dementia may experience more hallucinations and delusions. Seniors with frontotemporal dementia may be more likely to experience eating disorders and a lack of inhibitions because this dementia affects areas of the brain responsible for judgment, communication, and personality.
Coping with personality changes associated with dementia
If your loved one has been diagnosed with dementia, you’ll likely experience a wave of emotions. Cindy Laverty, caregiver advocate and former caregiver, recommends allowing yourself to feel whatever emotions that arise. Giving yourself permission to experience and process anticipatory grief will help you go on to continue caregiving with more purpose and clarity.
“Feel the sadness, anger, unfairness, and frustration,” Laverty urges. “Allow yourself time to grieve. Try to fully embrace the fact that you can do nothing to bring your loved one’s memory or personality back.”
Although your relationship with your loved one will undoubtedly change as their dementia progresses, the love you share is still there.
Dr. Kenneth M. Sakauye, a geriatric psychiatrist with the Memphis Veterans Affairs Medical Center in Tennessee, advises, “You may just have to dig a little deeper to find that love.”
No relationship stays the same forever. The personality changes that come with dementia may highlight those changes, though, and make them more obvious.
On the toughest days, try to remember how your loved one was prior to their diagnosis. If there was once a close, affectionate bond between you, it hasn’t disappeared. Reflecting on the past can be an emotional experience, but reframing the way you reminisce can be helpful.
Strive to focus on the enjoyable moments you had together and how fortunate you were to be able to share them. Things are increasingly complicated now and will likely never be the same moving forward, but there will be other touching moments ahead for both of you — if you keep an open heart and mind.
Chronic conditions like dementia put families and their relationships through the wringer. No matter how difficult things get, you must remember that the forgetfulness, difficult personality changes, and troubling new behaviors are a result of the disease.
Are my loved one’s personality changes a sign of dementia?
Personality changes may be an early dementia symptom, but they don’t always indicate that a senior has dementia. Try speaking with your loved one about your concerns. You may discover other factors that could be affecting their mental and cognitive health. Depression, for instance, can have symptoms that mimic dementia. Other illnesses, such as stroke or heart disease, the death of a loved one, and sleep disturbances are common risk factors for depression in seniors, according to the National Institute on Aging (NIA).
As a caregiver, it’s important to keep track of any new or unusual behaviors you observe. This will make it easier to help your loved one understand why you’re concerned and address these changes with their doctor.
Find caregiver support
If your loved one has been diagnosed with dementia, you may be struggling. Even if you’ve done all that you can to prepare for the changes that come with a dementia diagnosis, actually experiencing them can be physically and mentally trying. Remember that you don’t have to go through this alone. Consider seeking counseling from a mental health professional or joining a caregiver support group or online resource, such as AgingCare’s Caregiver Forum.
If your loved one has recently received a dementia diagnosis, remember that you don’t need to do everything yourself. While caring for your loved one will become more challenging over time, it’s just as important to schedule time for yourself to avoid caregiver burnout. To take care of your own needs, you might consider respite care. An in-home caregiver can spend time with your loved one for a few hours a week or more to give you additional support.
Loss of inhibitions and dementia (https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptons/losing-inhibitions)
Personality Changes in Dementia (https://www.alz.org/media/cacentral/dementia-care-30-personality-changes-in-dementia.pdf)
11 Early Signs of Dementia (https://www.healthline.com/health/dementia/early-warning-signs)
Managing Personality and Behavior Changes in Alzheimer’s (https://www.nia.nih.gov/health/managing-personality-and-behavior-changes-alzheimers)
Depression and Older Adults (https://www.nia.nih.gov/health/depression-and-older-adults)
Frontotemporal dementia (https://www.mayoclinic.org/diseases-conditions/frontotemporal-dementia/symptoms-causes/syc-20354737)