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Changes in Thinking (Cognition)

Changes to Everyday Functioning

The changes happening in a person with HD’s brain will impair their ability to manage work and family life. Below are common examples, what they look like, and how to treat them. 


Impulsivity is acting without thinking. Disinhibition is not feeling embarrassed or ashamed. When these symptoms appear, some people lose their temper, drink too much, steal, have inappropriate sexual relations. This symptom can have very negative results for the person with HD and everyone around them. 

These symptoms can be successfully treated with medications prescribed by a psychiatrist. Good strategies for the household to use when the person HD gets upset include staying calm, listening to understand how the person feels, not allowing the hurtful or embarrassing comments to upset you because this probably wasn’t their intention.   

Apathy and Lacking Initiation 

Apathy describes a situation where someone is no longer interested in things they used to really care about. Apathy usually gets worse as the disease progresses. Sometimes apathy and depression come together, but they are not the same. 

Lack of initiation is a common symptom of HD. If a person doesn’t start an activity or conversation, it can be because of the deterioration of parts of their brain.   

Calling a person “lazy” won’t help the situation. Try to gently nudge a person to get started, but don’t force the issue. It may help to break a task down into simpler steps. 


Having trouble organizing can impact getting projects done at work and home. This symptom of HD will get worse as the disease progresses.  

Because organizing relies on a variety of thinking skills, losing the ability makes daily living activities harder. Eventually, problem-solving, logical thinking and reasoning skills will decrease and a person’s intellectual, social skills and personality will suffer. 

To make it easier for a person to stay organized, present information with limited details. Focus on providing the most important pieces. Keep the same schedule every day and write down the routine on a calendar. 

Sense of Time 

Suddenly running late? One of the early symptoms of HD is losing the ability to estimate time. A person’s internal clock becomes less accurate as the disease progresses. Not leaving enough time to get something done is another symptom of HD.

  • Allow extra time for completing activities. HD effects how accurately a person judges time. 
  • Avoid creating time pressure and deadlines if possible. 
  • Show forgiveness if someone is late. Their internal clock isn’t working well. 
  • Use calendars and reminders on phone/tablet/computer to help keep track schedules. 
  • Make timelines and offer reminders by text or calls. 

Sense of Smell

People with HD can smell different scents, but their ability to correctly identify smells starts to go in the earliest phases.  As a result, they can have poor hygiene when they don’t realize that they have a bad odor. It can also present a safety hazard if a gas leak isn’t noticed.  

  • Encourage or remind a loved one to bathe. They may not be aware that they don’t smell fresh.  
  • Establish a bathing schedule or routine to keep up good hygiene. 
  • Put a reminder sign on the stove to turn it off after using. A person with HD may not recognize the smell of gas.