Dementia Awareness: Recognizing Early Symptoms vs. Metabolic Fog

Tommy Douglas
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What Should I Know About Dementia and Aging?

Is it just aging, or could it be something like dementia? It’s important to spot early signs and check for liver and blood sugar issues, especially in older adults. Many people fear the word "dementia," but as a researcher, I’ve found that this fear often comes from a lack of information. Understanding these issues can greatly impact health and well-being.

A warm, nostalgic painting in the style of Norman Rockwell and Grant Wood. A large, sturdy umbrella labeled ‘Dementia’ arches overhead like a protective canopy. Beneath it, three seniors stand grouped together, each with a hand‑painted label: ‘Alzheimer’s,’ ‘Vascular,’ and ‘Lewy Body.’
Understanding that dementia is a “syndrome” rather than a single disease is the first step toward accurate health literacy


It’s Not Just “One” Disease

One of the most important things to understand—and something I often see missing in mainstream health news—is that Dementia is an umbrella term. It’s a collection of symptoms, not a single diagnosis.

While Alzheimer’s is the most common “rib” under that umbrella, we also have to look at:

  • Vascular Dementia: Often linked to heart health and blood flow.

  • Lewy Body: Which can present with physical symptoms like tremors or balance issues.

  • Frontotemporal: Which often hits “personality” before it hits “memory.”

The “Apathy” Red Flag

In my research, I’ve found that one of the most overlooked early signs isn’t forgetting keys—it’s apathy. When a normally social person stops engaging in hobbies or shows a “loss of initiative,” it’s often dismissed as “just getting older.” In reality, this can be a change in the brain’s networks involved in motivation. If you notice a loved one withdrawing, it’s time to look closer.


Why I’m Optimistic (The Role of “Reversible” Causes)

One of the biggest misconceptions is that a “senior moment” or a period of confusion is a one-way street toward permanent cognitive decline. As a researcher, I look for the data—and the data tells us that many “dementia-like” symptoms are actually metabolic.

A heroic fantasy version of A comparison chart showing symptoms of Hepatic Encephalopathy versus early-stage Alzheimer's.
Metabolic "mimics" like high ammonia can often look like dementia but may be manageable with treatment.

Take my own journey as an example. Managing cirrhosis means I have to stay vigilant about Hepatic Encephalopathy (HE). When my liver isn’t filtering ammonia correctly, it builds up in the blood and crosses into the brain.

The symptoms of high ammonia can be indistinguishable from early dementia:

  • Extreme brain fog

  • Personality shifts or irritability

  • Difficulty with motor skills or “clumsiness”

  • Confusion about time or place

The difference? While Alzheimer’s is currently a progressive disease of the brain tissue, HE is often a manageable metabolic condition. For me, using Lactulose to clear that ammonia helps keep my cognitive “engines” running smoothly.

If I—or my doctor—had simply looked at my age and my symptoms without checking my liver labs, I might have been misdiagnosed years ago. This is why I always advocate for a “Full Rule-Out” approach: checking liver enzymes, kidney function, and B12 levels before ever accepting a diagnosis of “just aging” or “early dementia.”


From the Researcher’s Desk

This Substack will be different from the old blog. I’ll be diving deeper into the “Health Literacy” of these conditions—breaking down the clinical trials and the biomarker testing that is changing how we see Alzheimer’s in real-time.

Do you have a specific question about the difference between “normal aging” and “early signs”? Drop a comment below—I’ll be answering them in next week’s deep dive.


About the Researcher

Tommy T. Douglas is an independent health researcher and patient advocate. A survivor of a major heart attack (2008) who manages Type 2 Diabetes with Metformin and GLP-1 (Ozempic), he specializes in translating complex medical data into actionable health literacy for seniors.

Explore more by topic:

Heart | Metabolism | Brain | Liver

Introducing the Aging Health “Cognitive Clarity” Tracker

One of the most frustrating parts of navigating our senior years is the “fog.” Whether it’s a sudden lapse in memory or a lingering sense of confusion, the first instinct is often fear. We wonder: Is this the start of something permanent?

As an independent researcher, I’ve found that the answer is often found in the data—specifically, our metabolic data.

Confusion isn’t always a brain disease; often, it’s a biological “glitch.” For those of us managing conditions like cirrhosis or diabetes, our cognitive clarity is directly tied to how well we manage toxins like ammonia or fluctuations in blood sugar. If our liver or glucose management is off, the brain is the first to feel it.

I designed this 14-Day Tracker to help you take the guesswork out of your health. By tracking your daily medications (like Lactulose or Metformin) alongside a simple “Clarity Score,” you create a high-definition map of your health. When you take this to your next appointment, you aren’t just reporting a feeling—you are providing your doctor with the clinical evidence needed to make precise adjustments.

Daily Medication & Cognitive Symptom Tracker
124KB ∙ PDF file
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Download

How to get started:

  1. Download and Print: Grab the 2-page PDF below.

  2. Log Daily: It takes less than 60 seconds. Note your meds and rate your mental sharpness on a scale of 1–5.

  3. Spot the Trends: After 14 days, look for patterns. Does your fog lift when your metabolism is stable?

Health literacy is about moving from “patient” to “advocate.” This tool is your first step.

Dementia Warning Signs Checklist Free Download

Dementia Warning Signs Checklist
42.5KB ∙ PDF file
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Download

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Key Health Takeaways

Based on current research and NIA guidelines, here are the vital points to remember:

  • Monitor Regularly: Check your vitals at the same time each morning.
  • Consult Professionals: Always discuss supplement changes with your GP.
  • Stay Informed: Review clinical updates every six months.

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