Studies are showing that subtle symptoms of dementia may be starting at least a dozen years before any clinical diagnosis of even mild impairment can be made. Subtle symptoms can include, for example: a person’s gait begins to slow down dramatically. Other research has shown that, compared with healthy controls, patients suffering from mild cognitive impairment have a higher blink rate and lower heart rate variability. Circadian rhythm disruptions also seem to occur in the very early stages of cognitive decline. But alone, by themselves, these small changes are unreliable markers of neurodegenerative disease. Several companies are doing studies with smart phones to see if data could be collected that could help with earlier detection. Time will tell. Prevention is the name of the game, however. The healthier a person’s lifestyle and the regular inclusion of challenging mental exercise on a daily basis, the better.