Forgetful or something more? What to listen for on your parent's phone calls.

Normal forgetfulness is losing a detail and recovering it later; early dementia is losing the whole event, repeating the same question within a call, or struggling with something your parent has done for decades. On the phone, the pattern is across several calls rather than just one, and a pattern persisting over more than a few weeks is the point to book a memory assessment instead of waiting to see what happens.

Misplacing keys vs. forgetting what keys are for

Your mother forgetting the neighbour’s name and remembering it an hour later is getting old. Your mother forgetting that the neighbour has been a friend for thirty years is another conversation. The Alzheimer’s Association draws the line in its “10 Early Signs” guidance: occasionally forgetting a name or appointment and remembering it is typical, but forgetting something newly learned, asking the same questions repeatedly or losing track of dates and seasons is not.

The difference matters in India more than most people assume. The LASI-DAD study published in Alzheimer’s & Dementia in 2023 estimated that 7.4% of Indians above 60 lived with dementia, and most families in that figure waited for years before anyone looked into it.

Six Early Signs of Memory Loss You Can Hear on a Phone Call

Distance gives you something the family in the next room doesn’t have: a clean before-and-after. You hear your parent in weekly slices, so changes are easier to catch than they are for someone seeing them daily.

• Same story or question once in one call, again in the next call

• Losing the thread mid-sentence and not recovering it, where they used to circle back

• Hunting for ordinary words, or substituting odd ones (“the thing you cook rice in”)

• Muddled time: unsure of the day, the month, or have already had lunch at 4 p.m.

• New trouble with the phone: hitting the wrong button, not knowing how to answer a video call they managed last year, ringing you three times in an hour with the same query

• A shift in personality: new suspicion about the maid or the neighbour, flat disinterest in things they loved, irritability that doesn’t fit them

Any of these could be from a poor night’s sleep. Several together, repeating, is what you are listening for.

How to listen without turning the call into a quiz

A parent who feels tested will get defensive or get good at covering. Skip “Do you remember what I told you on Sunday?” and ask open questions you can later verify: what they cooked, who visited, what the doctor said about her knee. Details that do not match what a neighbour, caregiver or sibling says are more informative than any direct question. Don’t correct small errors on the call. Correcting a repeated story teaches a parent to say little, and you lose the best data source.

One bad call means nothing; five similar ones mean something

Keep a log. After each call, write the date and one line on anything that stood out, including “nothing” when that is the truth. A notes app is fine. After six weeks you will either have a pattern or a reason to stop worrying, and a doctor will take a dated list of observed examples far more seriously than “she’s been a bit forgetful lately.”

The log also protects you from your own anxiety. The memory of a bad call grows with distance; the written record keeps it the size it was.

Rule out the fixable causes first

Several treatable conditions imitate dementia: vitamin B12 deficiency (common in long-term vegetarians and in people on metformin), an underactive thyroid, depression, untreated hearing loss, poor sleep, and medicines that cloud thinking, including some sedatives and older antihistamines. A basic blood panel and a hearing test clear up a surprising share of “memory problems.” If you are not sure what your parent is actually swallowing each day, sort that out first; our earlier post on what actually helps with medication when you can’t be there covers that.

Sudden confusion is a separate matter. If a parent who was clear last week is disoriented, drowsy or talking nonsense over hours or a couple of days, that is delirium, and a urinary tract or chest infection is a frequent trigger in older adults. It needs a doctor the same day, not a memory clinic booking next month.

Getting a parent to agree to the appointment

Don’t say “dementia” or “memory test.” Say the annual check-up, and ask for it to include eyes, ears, blood sugar and B12 along with a short thinking screen. Ask the family doctor to raise it, because many parents will accept from a doctor what they would refuse from a child. If they resist outright, hearing and vision checks are an easier first step.

What a memory assessment involves

Expect a 10 to 30 minute cognitive screen, usually the Montreal Cognitive Assessment (MoCA) or, in India, often the Hindi Mental State Examination (HMSE) or a local-language version, plus blood tests and sometimes an MRI. Start with a family physician or geriatrician. Referral to a neurologist or a memory clinic follows if the screen is abnormal; large teaching hospitals such as NIMHANS in Bengaluru and AIIMS in Delhi run them.

The next call is the first entry

Start the log on your next call. Date, one line. Whatever it shows in six weeks, you will be deciding from evidence instead of from a feeling at 2 a.m.