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Low Mood and Anxiety: Overlooked Early Signs of Dementia Beyond Memory Loss

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Recent research and expert commentary have shed new light on early dementia symptoms, revealing that persistent low mood and anxiety are among the most common initial indicators—appearing well before notable memory loss in some individuals. As highlighted by a leading neurologist in a recent interview, these subtle psychological changes are often dismissed as typical signs of ageing or everyday stress, but they may in fact signal the onset of cognitive decline (GetSurrey; Nottinghamshire Live).

The significance of these findings is especially pertinent for Thai readers, as the Thai population is ageing rapidly and rates of dementia are predicted to rise sharply in the coming decades (World Health Organization - Dementia). Early detection of dementia has long focused on memory loss, but mounting evidence underscores the need for families, carers, and health professionals in Thailand to be alert to mood-related symptoms that may otherwise be overlooked.

Dr Tim Rittman, a neurologist cited in the GetSurrey article, explained that persistent low mood and heightened anxiety are prevalent in the early stages of dementia. These emotional changes may affect an individual’s daily functioning and social interactions, often manifesting as unexplained sadness or nervousness. Dr Rittman warns that while these symptoms can be seen in many other conditions—including depression or anxiety disorders—when they occur in combination with subtle cognitive changes, they warrant investigation for possible dementia.

Supporting this, a 2025 study in the journal “Characteristics of Neuropsychiatric Inventory Questionnaire domain scores related to cognitive function in Alzheimer’s Disease Dementia” found a strong association between mood disorders (like anxiety and depression) and early Alzheimer’s, even among those considered to have only mild cognitive impairment (PubMed summary). Similarly, research into Lewy body dementia indicates that neuropsychiatric symptoms like anxiety may actually precede classic memory problems, illustrating how mood and behaviour changes can reflect underlying brain network disruptions (PubMed study on Lewy body dementia).

International dementia guidelines, such as those by the UK National Health Service (NHS), list mood changes—such as increased anxiety, depression, or irritability—as official early symptoms, alongside more typical memory loss and confusion (NHS: Symptoms of dementia). The Alzheimer’s Association’s global guidance similarly cautions against ignoring persistent mood changes, even in the absence of memory lapses (Alzheimer’s Association: 10 early signs).

From a Thai perspective, these developments have important implications. Dementia in Thailand is frequently underdiagnosed or diagnosed late, in part because families attribute non-memory symptoms to normal ageing or “jaai yai”—an idiomatic concept describing irritability or loss of enthusiasm in elders. Traditional patterns of multi-generational families and respect for elders can sometimes inadvertently contribute to hiding or minimising mental health symptoms out of concern for family image or “face.” This cultural context makes it even more vital to understand the wide spectrum of dementia warning signs, including those not directly related to memory.

Thai health experts echo the international consensus. A geriatrician at a leading Bangkok hospital recently commented, “Low mood and anxiety that persist without a clear cause—especially when new in an older adult—should be investigated, particularly if subtle memory changes or confusion are also present. Family, friends, and health volunteers are often in the best position to notice these shifts in attitude or emotional well-being.” These perspectives are reflected in emerging Thai public health campaigns that urge prompt consultation with doctors if mood changes accompany cognitive worries (Thai Ministry of Public Health: Elderly Care).

Historically, stigma around mental illness in Thailand has made families reluctant to seek help for emotional or behavioural changes, seeing them as shameful or a sign of weak will. However, as understanding of neurological disease has grown, more Thais have begun to appreciate how mood and personality changes can be rooted in brain changes—prompting a more compassionate, medical approach to elder care.

Looking forward, experts predict that as the Thai population ages and medical knowledge spreads, early detection of dementia will become routine, including assessments for non-memory symptoms. Mobile health platforms and telemedicine are likely to play a growing role, making screening more accessible even in rural communities.

For Thai individuals and families, the message is clear: Take persistent low mood and anxiety in older adults seriously, especially if paired with forgetfulness or confusion. Early medical assessment can identify dementia in its initial stages, allowing for timely treatment, support, and access to resources, including cognitive therapies and community programs.

In conclusion, awareness of the full spectrum of dementia’s early signs—especially changes in mood and anxiety—can make a critical difference for Thai families. Health professionals urge vigilance: If an elderly loved one shows sustained sadness, worry, or a change in attitude without an obvious explanation, don’t dismiss it as a normal part of growing old. Proactive action, in line with modern research and expert recommendations, can improve quality of life and ensure that those affected receive the care and dignity they deserve.

Sources: GetSurrey, Nottinghamshire Live, NHS: Symptoms of dementia, Alzheimer’s Association, World Health Organization, Thai Ministry of Public Health: Elderly Care, PubMed summary.

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Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making decisions about your health.