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Health Assessment

Is It Normal Ageing or Something More?

Your mum forgot where she put her keys. She told you the same story twice in one phone call. She couldn't remember the name of that restaurant. Is this just getting older — or is it the beginning of dementia?

Almost 400,000 Australians live with dementia, with 1,800 new diagnoses every week. But not all memory changes are dementia. This guide helps you understand the difference, know when to see a GP, and learn how daily monitoring can detect subtle changes over time.

Normal Ageing vs Early Dementia

The key difference is not what they forget, but how it affects their life.

SituationNormal AgeingPossible Cognitive Decline
Forgetting namesForgets a name momentarily, remembers laterDoesn't recognise familiar people at all
Losing thingsMisplaces keys, retraces steps to find themPuts things in strange places (keys in fridge), can't retrace steps
Repeating storiesTells the same story to different peopleTells the same story to the same person within minutes
Managing moneyOccasionally forgets a billCan't understand bank statements, gives money to strangers
CookingSometimes burns food or over-saltsForgets they were cooking, leaves stove on repeatedly
NavigationTakes a wrong turn on unfamiliar routesGets lost driving to familiar places (shops, church, GP)
Word findingTip-of-the-tongue momentsUses wrong words or can't follow a conversation
JudgementMakes a bad decision occasionallyConsistent poor judgement (inappropriate clothing, unsafe behaviour)
Mood changesOccasional irritability or sadnessPersonality changes — previously calm person becomes angry or suspicious
Daily routinesNeeds a list for new tasksCan't follow familiar routines (making tea, getting dressed in order)

15-Point Family Assessment Checklist

Score each item: 0 = not present, 1 = sometimes, 2 = frequently. A total score of 10+ warrants a GP visit. This is not a diagnostic tool — it helps you prepare for a medical conversation.

1

Asks the same question or tells the same story repeatedly within one conversation

2

Forgets recent events (yesterday's visit, last night's dinner) but remembers the distant past clearly

3

Difficulty following the plot of a TV show or book

4

Gets confused about dates, seasons, or time of day

5

Trouble managing medications independently (skipping, doubling, wrong times)

6

Difficulty with familiar technology (remote control, phone, microwave)

7

Problems handling money — paying bills, making change, understanding statements

8

Personality changes — becoming suspicious, anxious, or unusually passive

9

Poor judgement in social situations or with personal safety

10

Declining personal hygiene (not showering, wearing same clothes for days)

11

Getting lost in familiar places or losing track of where they are

12

Difficulty planning or organising (cooking a meal with multiple steps)

13

Using the wrong word or struggling to follow conversations

14

Withdrawing from hobbies or social activities they used to enjoy

15

Changes in sleep patterns — sleeping much more or up at unusual hours

Scoring Guide

0–5

Likely normal ageing. Monitor but don't worry.

6–14

Worth discussing with GP. May be Mild Cognitive Impairment (MCI).

15–30

See GP urgently. Multiple areas of concern need assessment.

Reversible Causes That Mimic Dementia

Before assuming the worst, know that many conditions cause dementia-like symptoms and are treatable:

Depression

Often called "pseudodementia" — causes memory problems, confusion, and withdrawal that completely resolve with treatment.

Urinary Tract Infection (UTI)

In the elderly, UTIs frequently present as sudden confusion rather than urinary symptoms. Antibiotics resolve it within days.

Medication Side Effects

Anticholinergics, benzodiazepines, opioids, and some blood pressure medications cause cognitive impairment. Adjusting medications can restore function.

Vitamin B12 Deficiency

Common in over-65s (up to 20%). Causes memory loss, confusion, and balance problems. Blood test diagnosis, injection treatment.

Thyroid Disorders

Hypothyroidism causes cognitive slowing, fatigue, and memory problems. Simple blood test and medication treatment.

Dehydration

Chronic dehydration causes confusion, dizziness, and poor concentration. Common in elderly who don't feel thirsty.

Sleep Apnoea

Untreated sleep apnoea causes daytime cognitive impairment. CPAP treatment can significantly improve cognition.

Social Isolation

Prolonged isolation causes cognitive disuse — skills deteriorate without practice. Social engagement can reverse early decline.

What to Expect at the GP

Book a long appointment (double slot). Consider attending without your parent first to share your observations privately.

1

Cognitive Screening

Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA). Takes 10–15 minutes. Tests memory, orientation, language, and executive function.

2

Blood Tests

Full blood count, thyroid function, vitamin B12, folate, glucose, kidney and liver function. Rules out reversible causes.

3

Medication Review

GP reviews all medications for cognitive side effects. May pause or swap medications and retest after 4–6 weeks.

4

Referral (if needed)

Geriatrician, neurologist, or memory clinic for formal assessment. Brain imaging (MRI or CT) may be ordered. Wait times vary by state.

5

Diagnosis & Planning

If Mild Cognitive Impairment (MCI) diagnosed: lifestyle modifications (exercise, social engagement, cognitive stimulation) can slow progression. If dementia: early planning for legal, financial, and care decisions.

How Daily Calls Track Cognitive Changes

A single GP visit is a snapshot. Daily conversations are a trend line. Here's what regular calls can detect:

Repetition Patterns

If your parent tells the same story on 3 consecutive calls — and doesn't remember the previous conversation — that's a meaningful data point for their GP.

Orientation Changes

Confusion about day of week, time of day, or recent events. "I thought it was Tuesday" on a Friday is significant if it happens regularly.

Language Changes

Increasing word-finding difficulty, shorter sentences, or inability to follow the flow of conversation. Gradual changes are harder to spot in weekly visits.

Mood Tracking

Daily calls detect mood shifts — increased anxiety, paranoia ("someone was in the house"), or sudden apathy. These can signal progression or treatable conditions like depression.

Support Services

OrganisationPhoneServices
Dementia Australia1800 100 500Information, counselling, support groups, education
National Dementia Helpline1800 100 50024/7 phone support and referrals
My Aged Care1800 200 422Assessment and access to government-funded services
Carer Gateway1800 422 737Support for family carers including respite
Cognitive Dementia & Memory Service (CDAMS)Via GP referralSpecialist assessment clinics in all states
Alzheimer's Australia Researchalzheimers.com.auClinical trial registrations and research updates

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