Dear Annie: Your column is a regular part of our home, and I truly appreciate the compassion and insight you bring to readers’ questions. I would like to gently offer another perspective, one that may sometimes be overlooked when people write in about the emotional withdrawal of a spouse, parent or longtime friend.

In some cases, what appears to be a change in personality, affection or connection may actually be an early sign of dementia. Especially in longstanding relationships, whether marriage, family or close friendships, people may begin to act in ways that seem confusing, distant or even harmful. But rather than a sudden loss of interest or love, these changes can sometimes be the result of subtle, progressive neurological decline.

I was especially struck by a recent letter from a

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