Dementia is not just memory loss. It’s cognitive decline.

It affects the brain, and the brain controls everything. Movement. Sensation. Perception. Judgment.

Sure, memory is part of that, but it’s not the whole picture. People can have dementia without obvious memory problems, and we are very bad at recognizing that.

Someone can hold a conversation. They remember your name. They tell you what they had for breakfast. So they seem fine.

But they aren’t fine.

They don’t understand finances anymore. Bills don’t make sense. Numbers don’t add up the way they used to. Tasks that were once automatic—like brushing their teeth or mowing the grass—now take effort or get skipped altogether.

They can still drive safely but they always seem to end up at the wrong place. No one quite trusts them to babysit the grandkids, even though no one can fully explain why.

Maybe they seem apathetic. They don’t really care what the grandkids are up to anymore. Perhaps food doesn’t taste right, so they insist something is wrong with the recipe. Maybe they’re more impatient while waiting in the checkout line at Target or Wal-Mart.

Maybe things that used to be fun are now too much. A parade is loud and crowded and exhausting. A family gathering is just too overwhelming.

If you’re a waiter at a restaurant, you don’t notice anything off. If you’re a relative who visits occasionally, you don’t understand what their spouse is talking about. They seem oriented and normal.

Dementia doesn’t always announce itself in the way that we expect it to.

Sometimes it shows up in ways that don’t reveal themselves over a short conversation or a holiday visit. The people who live with it every day see things that others don’t. And many times we don’t believe them or we think they are overreacting.

This is where we tend to get it wrong.

When someone tells you that they are changing—or that their partner or parent is changing—listen. Don’t discount it. Don’t say you forget things sometimes too. Don’t say everything seems normal to you. Don’t point out that they remember names just fine.

Listen.

We misunderstand dementia because we think cognition means memory alone. And when memory looks intact, we assume everything else must be too.

But cognition is bigger than memory.

And when we miss that, we miss an opportunity to support individuals and families in a critical time.