DALLAS — It could be as simple as constantly misplacing keys, or forgetting to pay a bill, or repeating questions over and over.

As people age, their memory and cognition tends to take a small hit. But about one in 10 older Americans experience dementia, characterized by cognitive and memory issues that are connected to a disease process, as opposed to normal aging.

Doctors and aging experts say early intervention is key. When dementia is diagnosed early on, there are more treatment and management options.

Dr. Sudha Seshadri — the founding director of the Alzheimer’s and neurodegenerative diseases institute at UT Health San Antonio — said patients and their families sometimes want to avoid an appointment about memory and cognition issues.

But in other areas of medicine, the idea of early intervention is already ingrained in the public mind.

“We understand this so well for cancer,” Seshadri said. “Why do you need to go and detect a cancer early? Because then it’s curable. And if you just ignore it and it has metastasized or it’s spread, then it’s much less curable.”

Here are some things you can keep an eye out for when you think that you, or a loved one, might be experiencing dementia.

What is dementia?

Outside of the medical field, people may use the term “dementia” interchangeably with other terms, including “Alzheimer’s.” But the words describe different things.

Seshadri said dementia is an umbrella term that includes any “detectable difference” in a person’s cognition, coupled with some impact on a person’s ability to function. That means, essentially, that dementia is any perceptible loss in a person’s cognition.

Dementia can be caused by a number of things, including Alzheimer’s disease.

Seshadri said she does not consider dementia to be a “normal” part of aging — even though it is common in older people.

“Just because something is frequent, doesn’t mean it’s normal,” she said. “Dementia is not an inevitable consequence of growing older.”

Courtney Ranger, program director for the Greater Dallas chapter of the Alzheimer’s Association, said signs of dementia can be noticed by patients themselves or by their loved ones.

But the warning signs are not a diagnosis.

“These warning signs are really a sign for you to go and speak to that general practitioner or speak to another health care provider about what you might be experiencing,” she said.

What are the common early signs?

Dementia can exhibit differently in different people, but there are a few signs that are most common.

Seshadri and Dr. Brendan Kelley, a neurologist who focuses on memory and cognition at UT Southwestern Medical Center, mentioned many of the same signs, including:

•Repeating questions

•Retelling the same stories multiple times

•Spending a long time looking for personal items, or leaving personal items in odd places, such as keys in the oven or the fridge

•Difficulty keeping track of appointments, medications and/or bills

•Poor decision-making

Kelley noted everyone displays some of these behaviors some of the time. Occasional forgetfulness or repetition is not a sign of dementia.

“It would be a mistake to make a mountain out of a molehill,” Kelley said.

“All of us may have occasional memory lapses, but where there starts to be a pattern — or where there’s a change, a real deviation from the previous pattern — those could be things a family might notice that would warrant seeking medical attention."

That change from a previous pattern is key, Seshadri said. For instance, it’d be completely normal for a non-scientist to have trouble remembering the different parts of the brain from their high school or college science classes.

But for Seshadri, a neurologist, it would be a serious concern.

“If I start having trouble remembering what’s the cerebellum and what’s the cerebrum, that’s abnormal,” she said.

While some people don’t pay much attention to their clothes and outfits, it could be a warning sign if a previously well-dressed person becomes unkempt, according to Kimberly Knight, the director of the caregiver support program at The Senior Source.

“I love fashion,” Knight said. “So if you catch me and all of a sudden I’m very disheveled in my appearance ... that’s me operating below my baseline and so that’s something we would take a closer look at.”

Ranger, at the Alzheimer’s Association, also said some people become suspicious or paranoid, assuming misplaced items have been stolen, for instance.

Seshadri noted early dementia can manifest in physical symptoms, too, such as issues with balance, appetite loss and excessive sleeping.

What should you do if you see warning signs?

If you notice any signs of dementia in yourself or in a loved one, experts said, your first step should be seeing your primary care physician.

“One of the things I would say is, ‘If you are worried, talk to your doctor,’” Seshadri said.

In some cases, the person showing cognitive changes could have a different underlying issue, such as a urinary tract infection, which can cause older adults to appear tired and confused.

Some primary care doctors have a lot of experience with aging and dementia, but patients can also ask about seeing a geriatrician, neurologist or psychiatrist.

If a patient is exhibiting signs of dementia, early diagnosis could mean access to treatment or enrollment in clinical trials. Typically, those are not an option for people whose dementia has progressed past the early stages.

And, importantly, early diagnosis means the patient can make their own decisions about how they’d like to be cared for and treated down the line.

“Early detection can allow the person who’s been diagnosed to have a voice in what happens next,” Ranger said. “They can participate in making plans. They can live life on their own terms.”

Starting the conversation

It’s common for family members to feel nervous about bringing up the changes they’ve noticed. But avoiding the conversation isn’t necessarily protecting the loved one, Seshadri said.

“We all suffer inside. If you think that the loved one doesn’t actually know they have some memory problem, that may not be true,” she said. “They may be trying to hide it from you, and you’re trying to hide it from them.”

Kelley recommended approaching the situation with a collaborative mindset, instead of a confrontational one.

The best outcome is likely to come from “approaching these issues in a way that aligns you next to and working together with the person who might be experiencing these difficulties,” Kelley said.

The Alzheimer’s Association has more information on dementia — including on common warning signs and ways to approach an initial conversation — and also operates a 24/7 helpline at 1-800-272-3900. The Senior Source in Dallas also provides resources to aging people and their loved ones.