2 Overlooked Cognitive Decline Signs Your Doctor Might Not Check

When you think about cognitive decline signs, what comes to mind? Probably memory lapses. Forgetting names. Losing your keys. Maybe trouble finding the right word mid-sentence. Those are real concerns — but they may not be the earliest warnings your brain sends. Emerging research points to two surprisingly simple, observable changes that can appear years before memory troubles start. And here’s the thing: they’re hiding in plain sight.

I’m talking about your sense of smell and your grip strength. Yes, really. A growing body of evidence suggests that a declining sense of smell and weakening handgrip may be among the earliest cognitive decline signs — often detectable long before any conversation about memory loss begins. Let’s explore what the science says, how you can check both at home, and what to do if you notice changes.

The Most Overlooked Cognitive Decline Signs Start with Your Nose

Here’s a surprising fact: your sense of smell is directly connected to brain areas that are among the first affected by Alzheimer’s disease. When something starts going wrong in the brain, the olfactory system is often one of the earliest regions impacted.

Research from the National Institute on Aging tracked 364 adults and found that each point lower on a 16-point odor identification test was associated with a 22% higher chance of developing mild cognitive impairment (MCI). Even more striking: brain scans showed that people with declining smell had higher levels of amyloid-beta and tau proteins — the hallmarks of Alzheimer’s disease — building up in their brains.

Now, you might be thinking: Doesn’t smell just naturally fade with age? That’s a fair question. Some age-related decline in smell is normal, but the pattern matters. If you notice a meaningful change over months or a year — especially if you used to have a sharp nose — it’s worth paying attention to. This is one of those early cognitive decline signs that doesn’t announce itself loudly. It’s subtle. But the research is clear: it matters.

Your Grip Strength: One of the Earliest Cognitive Decline Signs

Now let’s talk about your hands. It might seem strange that how firmly you can grip something says anything about your brain. But the connection is surprisingly strong — and backed by an enormous body of research.

A 2026 systematic review and meta-analysis of 60 studies — involving 380,960 participants across 37 cohorts — found that maintaining handgrip strength over time reduced cognitive decline risk by approximately 19%. Higher baseline grip strength was also protective. This wasn’t a small or flimsy finding. It’s one of the largest analyses ever done on the topic.

But here’s what I find really interesting: the study found that grip strength was positively associated with all cognitive domains — memory, processing speed, executive function, you name it. It’s not that weak grip predicts one specific type of decline. It seems to be a general signal that something may be shifting.

Researchers believe the connection between muscle strength and brain health involves multiple pathways, including blood flow and metabolic health — though the exact mechanisms are still being studied. What’s clear is this: grip strength is one of the most practical, measurable cognitive decline signs available. Your doctor can assess it in under a minute with a simple device called a dynamometer.

Why Two Overlooked Cognitive Decline Signs Work Together

Individually, smell loss and grip weakness are both meaningful cognitive decline signs. But together? They may tell an even more complete story. Research published in Alzheimer’s & Dementia looked at a composite sensorimotor score — combining smell, hearing, vision, balance, gait speed, and grip strength — and found it was strongly associated with MCI risk. People with higher sensorimotor function had roughly 40-50% lower odds of having MCI, and the finding held across two large US study populations.

What this means for you: if you notice that your sense of smell has faded and your grip feels weaker than it used to, that combination may be more informative than either change alone. Think of it like smoke from two different parts of the house — it’s time to look more closely at what’s going on.

How to Detect Cognitive Decline Signs Through Smell

You don’t need a lab test to get a sense of where your smell stands. Here’s a simple approach you can try today:

• The kitchen spice test: Gather 4-5 strong-smelling items from your pantry — cinnamon, coffee grounds, lemon zest, vanilla extract, and peanut butter work well. Close your eyes, hold each one near your nose, and see if you can identify it.
• Keep a smell journal: Test yourself once a month with the same items. Note how many you identify correctly. If you notice a downward trend over 6-12 months, that’s worth mentioning to your doctor.
• Be aware of sudden changes: If smell loss happens suddenly (overnight or over a few days), it’s more likely related to COVID-19, a sinus infection, or allergies than to cognitive decline. Gradual changes over a longer period are the pattern to watch for brain health.

How to Check In on Your Grip Strength

Grip strength is remarkably easy to monitor. Here are three ways to do it:

• The jar test: Can you still open a new jar of pickles or pasta sauce without assistance? If that’s become noticeably harder over the past year or two, it’s a practical signal.
• The grocery bag test: Carrying multiple grocery bags from the car to the kitchen used to be no big deal. If it’s become a struggle — or if your hands feel tired and sore afterward — take note.
• The handshake test: Have you noticed your handshake feeling weaker? Others might comment on it, or you might notice it yourself when opening doors or gripping handrails.

For a more objective measure, you can buy a simple handgrip dynamometer online for about $20-$30. It gives you a numerical reading you can track over time. Research published in GeroScience found that low grip strength predicted lower cognitive performance over four years in cognitively normal adults, so even small changes matter. A meaningful decline over a few years — whatever your starting point — is worth discussing with your doctor.

What to Do About Cognitive Decline Signs

Here’s the empowering part: recognizing these early warning signals isn’t about worrying — it’s about taking action. The SMARRT trial published in JAMA Internal Medicine showed that personalized, multidomain lifestyle interventions led to a 74% greater improvement in cognitive scores compared with the control group over two years. That’s a big deal. It means what you do matters.

Here are the most impactful steps you can take right now to address potential cognitive decline signs:

If you’ve noticed changes in smell or grip strength, start with a conversation. Ask your primary care provider: “I’ve noticed my sense of smell isn’t what it used to be, and my grip feels weaker. Should we do any cognitive screening?” That’s a reasonable, proactive question — and one that more doctors are beginning to take seriously as the research grows.

Frequently Asked Questions

The Bottom Line

Cognitive decline doesn’t always start with forgetting where you put your keys. Sometimes it starts with your nose. Or your hands. These overlooked cognitive decline signs — declining sense of smell and weakening grip strength — are simple to notice, easy to track, and backed by solid science from the National Institute on Aging and large-scale meta-analyses.

The goal here isn’t to worry you. It’s to empower you with information that can help you take action early, when interventions are most effective. If you notice changes, talk to your doctor. Start a strength training routine. Pay attention to your diet. These steps aren’t just good for your body — they’re good for your brain.

Your brain is sending signals all the time. Now you know two more of them — and what to do when you spot them.