Early symptoms of dementia may include mood and personality changes, but can racist comments mask the onset of devastating disease?
Anything is possible, say experts in the wake of an exclusive Barbara Walters interview with Shelly Sterling, the estranged wife of embattled Clippers owner Donald Sterling, who said Sunday, "I -- in my opinion, I think he -- it's the onset of dementia."
"The most universal sign of early dementia is not memory loss, but personality change," said Dr. Igor Galynker, associate chairman of research at Mt. Sinai Beth Israel in New York City, who has written several papers on dementia. "Two basic characteristics not related to memory are apathy and indifference or callousness. People become withdrawn and disinterested in other people to the point of being rude."
While family members may think, "My mother was really like that all along," Galynker said the changes like insensitivity and inappropriateness have "little to do with their personality before."
"Some of the nicest people become callous and tactless," he said. "The nastiest people, too."
The 80-year NBA co-owner has been at the center of scandal since an audiotape obtained by TMZ revealed him telling his personal assistant, V. Stiviano, not to encourage her relationship with African-Americans, including Magic Johnson, and to keep them away from the Los Angeles Clippers games.
Sterling's wife is currently estranged from the Clippers owner. She is also currently involved in a lawsuit against Stiviano.
In her interview with Walters, Shelly Sterling said her husband of 60 years told her: "I don't remember saying that. I don't remember ever saying those things.”
"I said, 'Well, this is the tape.' And he says, 'Hmm. I don't remember it,'" she added. "That's when I thought he had dementia."
Donald Sterling has been accused of racism in the past. He settled a lawsuit brought by the Justice Department in 2009 for housing discrimination, and in 2011 won a lawsuit brought by former Clippers general manager Elgin Baylor over harassment and discrimination claims.
ABC News contacted Donald Sterling for comment on his wife's interview, but he declined. He has, however, maintained he is not a racist, telling CNN's Anderson Cooper that he made a "terrible, terrible mistake."
"The reason it's hard for me, very hard for me, is that I'm wrong. I caused the problem. I don't know how to correct it," he told CNN.
More than 5 million Americans suffer from dementia, the umbrella term for several diseases, including Alzheimer’s. The majority are over the age of 65, but an estimated 200,000 are younger, according to the Alzheimer's Association.
The disease usually progresses over four to eight years, according to Beth Kallmyer, vice president of constituent services for the Alzheimer’s Association.
"Typically, what you see first is some level of depression or social withdrawal because the person’s brain isn’t working right,” said Kallmyer. “Many social situations become challenging. They can get anxious, especially if they have not been diagnosed and worry about what is happening.”
Some become frustrated with loss of memory and others develop suspicious behavior or “shorter fuse,” she said.
Rather than having a single symptom, most with early dementia have a “two or three,” that affect daily living, according to Kallmyer. Families are also not always the first to see changes.
“Sometimes they see [early dementia] first,” she said. “But there are also high levels of denial around this disease, especially for spouses who, as they age, do things for each other to compensate.”
As for Donald Sterling, his wife told Barbara Walters that she had never heard her husband make derogatory comments toward black or Hispanic people before she heard the now infamous tape.
"It sounds as if there are suspicions that this person has changed and that he has not been like that - that there's something new there in the last several years," said psychiatrist Galynker. "If so, he needs to be evaluated."
"The earliest manifestations alert you to the need for an exam," he said. One of the simplest tests is asking a patient to draw the hands on a clock, according to Galynker. "It takes 15 seconds."
According to the Alzheimer's Association, the major early warning signs of dementia are: Memory loss that disrupts daily life
Challenges in planning or solving problems
Difficulty completing familiar tasks at home, work or leisure
Confusion with time or place
Trouble understanding visual image and spatial relationships
New Problems with words in speaking or writing
Misplacing things and losing the ability to retrace steps
Decreased or poor judgment
Withdrawal from work or social activities
Changes in mood and personality