How Poor Judgment Can Be a Sign of Early Dementia

Poor judgment is one of the hallmarks of Alzheimer’s disease. In fact, while a typical symptom of early stages of Alzheimer’s is short-term memory loss, poor judgment can sometimes precede memory loss.

Poor judgment refers to the inability to make appropriate decisions. If your relative has Alzheimer's or another type of dementia, they might be unable to evaluate the different factors that should be considered when making a decision. Looking ahead to the possible outcome of behavior or choice may also be a challenge, as is considering abstract ideas vs. concrete ideas.

Poor judgment in Alzheimer's is not just one questionable decision, but rather a pattern of clearly inappropriate decisions or actions. Here are a few examples of poor judgment in Alzheimer’s disease and other kinds of dementia.

Older couple driving in car
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Safety/Danger Recognition

Your loved one recently fell and broke their hip. They had surgery and fortunately came through that well. However, they are not able to accurately assess their safety limits. At times, they clearly seem to have forgotten the restrictions regarding weight bearing. However, even when reminded, they still express an uncharacteristic desire to disregard this important medical advice. They may keep trying to get up and walk. Even the fact that it hurts doesn’t stop them from trying to get up out of the chair.

Another scenario that demonstrates an inability to recognize danger is one in which your loved one wanders away from the house and tries to walk across a very busy street during rush hour. They are not able to assess the traffic to determine that it's too busy to cross the street at this time.

Finances

Even though you’ve told your father he can’t give away money anymore, he continues to fall for get-rich-quick scams and phony prize offers. You’ve tried explaining that he needs his money to pay for the groceries and the home health aide who comes to help him shower. You've even put a note in his checkbook reminding him of this. Regardless, he continues to write checks and give away money that he needs, or even money that he doesn't have.

Social Interaction

Perhaps your husband has always been an outgoing, friendly man. Now, however, he doesn't seem to know when to stop. Yesterday, you took him out to lunch and he was so flirty with the waitress that everyone was uncomfortable. The waitress ended up trading tables with another server because she wasn't sure how to react to him.

Personal Grooming and Hygiene

Your sister, who was diagnosed with Alzheimer's a year ago, doesn't spend any time on her appearance anymore. She always had her hair nicely styled, and now she rarely seems to wash or comb it. When you remind her that it's a special occasion, it doesn't seem to make a difference. You also notice that she could benefit from a bath or shower more frequently.

Dressing

Even if it’s the middle of a cold, snowy winter day, your wife with Alzheimer’s might try to go outside dressed in shorts and a t-shirt. When you suggest a change of clothes, she appears irritated and continues to try to wander out the door.

Driving

This is an area that can be difficult to address. However, if you’re uncomfortable riding with your loved one as he drives, that’s a pretty clear sign that he shouldn’t be driving anymore. Perhaps he can’t judge the distance from his car to the next one anymore, or he’s not able to discern how fast he should be driving on the expressway.

Driving requires the use of multiple aspects of our brains, and as the symptoms of Alzheimer's progress, these abilities continue to decrease. (If driving is questionable for your loved one, you can request a driving evaluation specialist to assess his safety and ability.)

A Word From ​Verywell

While it can be worrisome and even frustrating to see these signs of poor judgment in your loved one, it may be helpful as you cope to consider that there may be a reason for these behaviors that are beyond their control. An evaluation by a physician can help rule out reversible causes of memory loss, and treatment can begin if it appears that dementia is the cause of these judgment problems.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Capucho PHFV, Brucki SMD. Judgment in mild cognitive impairment and Alzheimer's disease. Dement Neuropsychol. 2011;5(4):297-302. doi:10.1590/S1980-57642011DN05040007

  2. Alzheimer's Association. Home safety.

  3. National Institute on Aging. Managing money problems in Alzheimer's disease.

  4. Daily Caring. 9 Ways to handle Alzheimer's and sexually inappropriate behavior.

  5. National Institute on Aging. Bathing, dressing, and grooming: Alzheimer's caregiving tips.

  6. National Institute on Aging. Driving safety and Alzheimer's disease.

By Esther Heerema, MSW
Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia.