Sarah Biren

Sarah Biren

January 16, 2025

This Common Sign of Dementia Is Often Ignored—Don’t Miss It

Memory loss is a commonly-known sign of Alzheimer’s disease, but it is not always the first symptom. Alzheimer’s, one cause of dementia, is a brain disease caused by damaged neurons, thereby impacting the ability to think, talk, and walk. The beginning stages tend to involve damage to the area of the brain responsible for memory, language, and logic. Unfortunately, Alzheimer’s is degenerative, meaning it worsens over time. Sometimes the early warning signs of dementia are easy to overlook, but a recent study discovered a new symptom to look out for. 

People at risk of Alzheimer’s disease

Mature students working in library
Source: Shutterstock

The study involved 100 middle aged adults who were cognitively healthy but at elevated risk of Alzheimer’s. These risk factors included family history, genetics, head injuries, medical conditions like high blood pressure, and lifestyle factors like a lack of regular exercise, says the U.S. Alzheimer’s Association. The researchers estimated the participants — who ranged from 43 and 66 years of age — were about 25 years from when they may expect the onset of the disease.

Testing spatial navigation skills

Man walking with VR glasses on mountain
Source: Shutterstock

The purpose of the study was to assess spatial navigation skills. So the study authors assigned the participants a series of walking tests while wearing virtual reality (VR) goggles. The first task involved the participants navigating a path using numbered cones to direct them. They then repeated this test with three different changes: One was a route identical to the first; the second involved all of the ground textures being replaced by smooth textures; and the third was a path without any cones to give directions.

Difficulties with spatial navigation

Elderly man taking a walk
Source: Shutterstock

Although the subjects had a high risk of Alzheimer’s from different factors, they struggled with spatial navigation in similar ways. However, they scored well on cognitive tests and didn’t show any other symptoms of dementia.

Spatial navigation is one of the earliest cognitive domains to be affected by Alzheimer’s disease,” says Vaisakh Puthusseryppady, PhD, of the spatial neuroscience lab at the University of California in Irvine to Everyday Health. (He wasn’t involved in the study.) “The reason for this is that Alzheimer’s pathology usually first appears in regions of the brain that function to help us navigate.”

An early sign of dementia

Older man sitting in camper van using gps navigation map system digital device. Smiling mature active traveler driving car vehicle looking at screen touching sensor gadget dashboard, close up view.
Source: Shutterstock

The study, published in the journal Alzheimer’s and Dementia, suggests spatial navigation tests may help detect this disease earlier on. However, further research needs to determine the best way to analyze patients, especially since people may not realize they have poor spatial navigation. “In real life people may not notice the change, since they will subconsciously adopt a different strategy to compensate, such as using landmarks for navigation, or relying on aids like Google Maps,” says senior study author, Dennis Chan, MD, PhD, a professor and neurologist at the institute of cognitive neuroscience at University College London. 

Familiar and unfamiliar settings

age, vision and old people concept - close up of senior woman face and eye
Source: Shutterstock

Additionally, VR headsets may not accurately reflect the navigation skills people use in day-to-day life. Especially considering that people can navigate familiar locations like their homes and neighborhoods by rote.

“Virtual reality is likely to be well correlated with real life spatial navigation when it comes to unfamiliar places,” says Sandra Bond Chapman, PhD, a professor and the chief director of the Center for BrainHealth at the University of Texas at Dallas. She wasn’t involved in the new study. She notes that familiar places take up a different part of the brain compared to the region that navigates unfamiliar settings.

“Such habits are routinized in other subcortical regions of the brain which may be less vulnerable to the disease,” says Chapman. “Therefore, a person may be able to continue to function in familiar routes despite the disease being present, even with involvement of the parietal lobes.”

How to stay sharp

Vacation Tour Offer. Back View Of Senior Couple Hugging And Carrying Backpack Walking On Lisbon Street, Enjoying Sightseeing Outdoors. Travel And Tourism In Europe Concept
Source: Shutterstock

Fortunately, there are ways to maintain spatial navigation skills. One way involves using observation to familiarize oneself with new surroundings instead of depending on GPSs. 

“One will not remember details or have the ability to navigate if they are not attending to the relevant information in the first place,” says Scott Hayes, PhD, an associate professor of psychology at the Ohio State University, in Columbus, who wasn’t involved in the new study.

Preventing Alzheimer’s disease

. Hiking, adventure and exploring with a group of senior friends having fun, exercising and enjoying the outdoors. Walking, discovery and journey with old people sightseeing in the forest or woods.
Source: Shutterstock

Overall, people can protect their brain health and slow signs of dementia through healthy lifestyle habits. “Optimizing both physical and mental health can have beneficial effects for potentially slowing Alzheimer’s related brain and cognitive decline,” Hayes says.

Therefore, the CDC recommends staying physically active, preventing/managing diabetes, managing blood pressure, preventing/correcting hearing loss, quitting smoking, and limiting alcohol consumption.

Other early signs of dementia

Close up caring nurse holding smiling mature patient hand at meeting in hospital, doctor caregiver wearing uniform comforting and supporting senior man, good news about treatment, empathy and care
Source: Shutterstock

Bear in mind, poor spatial navigation skills is only one potential sign of dementia. According to Cleveland Clinic, there are multiple, and can vary depending on each case. They can involve:

  • Issues with short term memory loss
  • Mood or behavioral changes
  • Apathy toward people and activities they used to care about
  • Increased confusion and challenges with problem-solving tasks
  • Changes in routine causing fear, disorientation, or irritability 
  • Difficulty with decision-making
  • Sudden behavior that is reckless or lacking in judgement
  • Difficulty completing familiar or unfamiliar tasks
  • Feeling like they have “slowed down” and “are less coordinated”
  • Problems with keeping up with conversations

Read More: Common Injury in Seniors Found to Elevate Dementia Risk