Forgetting Words — Normal Ageing or an Early Sign of Dementia?

Many caregivers first become concerned about dementia because of changes in speech.

A loved one might pause mid-sentence, struggle to find words, or use the wrong terms entirely. This raises a worrying question:

Is this just ageing — or something more?

The “4 A’s” of dementia

Neuropsychiatrist Dr Richard Restak describes four key warning signs of dementia, known as the 4 A’s:

Amnesia

Difficulty remembering things that were previously familiar.

Agnosia

Trouble recognising or understanding information, objects, or people.

Apraxia

Difficulty organising thoughts or movements in the correct order — for example, struggling with familiar tasks.

Aphasia

Problems understanding or using language, including rambling speech or using incorrect words.

Caregivers often notice aphasia first, because conversation changes are hard to ignore.

What research says about word-finding difficulty

A recent academic paper explored word-finding difficulty (WFD) and its relationship to cognitive impairment.

The key finding wasn’t how long someone paused to find a word — it was how fluent their speech was afterwards.

This suggests caregivers should look for patterns such as:

• Ongoing difficulty continuing a sentence

• Speech becoming disorganised

• Trouble returning to the original point

Does slow speech mean dementia?

No.

The research does not suggest that slow talkers are more likely to develop dementia. The association between speech patterns and dementia still needs more study.

Caregivers should focus less on isolated moments and more on consistent change over time.

What caregivers can do

• Notice patterns, not one-off slips

• Keep a simple record of changes

• Raise concerns gently with a GP

• Trust your instincts — caregivers often notice changes first