Signs and Symptoms of Alzheimer's Disease
Medically reviewed by Nicholas R. Metrus, MD
People with Alzheimer's disease (AD) may experience issues with memory, have trouble finding the words they want to say, and make small lapses in judgment. People typically then progress to moderate and then severe or late-stage AD symptoms.
AD is a neurological disorder significantly affecting cognitive functions, including memory, reasoning, and language. More than six million people over the age of 65 in the United States have AD. Read on to learn more about signs and symptoms.
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Related: Signs and Symptoms of a Concussion
Assessing Symptoms
The hallmark symptoms of AD include disruptions in cognitive functions. The major categories of symptoms used to make an AD diagnosis include:
Behavioral and psychological: These symptoms are typically more noticeable in people with moderate and severe AD. You may feel irritable, disinterested, and socially disengaged. You might show aggression and wander away from home.
Executive functions, judgment, and problem-solving: Executive functions include setting goals, planning, and completing activities. Issues may arise with shifting from one task to another, regulating your response to different situations, and needing to complete small tasks towards a larger objective. You may not know you have these problems until someone close to you notices.
Language: You are more likely to experience issues with speech and writing later in the disease, such as difficulty finding the words you're trying to say.
Memory: You may start forgetting recent events or getting lost in familiar places in the early stages of AD. You might eventually have trouble finding words, learning new concepts, and performing daily tasks.
Visual-spatial: Some people with AD have visual problems, including difficulties reading, determining distance, and identifying color or contrast.
People can also experience the following types of symptoms:
Difficulty performing motor tasks they know well, like getting dressed
Issues with detecting smells
Motor symptoms like reflex issues and incontinence, which is a loss of bladder control
Seizures
Sleep problems, such as restless sleep
Early Warning Signs
It's normal to experience memory changes as you grow older. Consider speaking to a healthcare provider to get a full evaluation if you or people around you notice these issues more frequently:
Confusion about where or when things happen: You may have a hard time distinguishing how long ago something happened or where it happened.
Difficulty completing familiar tasks: You might briefly forget how to do things you do all the time, such as cooking, picking an outfit, or using a phone.
Difficulty planning or problem-solving: You may forget to pay your bills or struggle to plan and complete a multi-step activity.
Memory loss that interferes with daily life: You can forget important events, frequently repeat yourself, or constantly require reminders to stay on track.
Misplacing things: This includes misplacing things in odd places and not remembering how or why.
Mood and personality changes: You may get upset or fearful more easily and feel suspicious of others.
New language issues: This includes having difficulty with finding the right words to say or making more writing mistakes.
Visual-spatial problems: You might have trouble estimating distance, drop objects, or stumble often.
Worsening judgment: You may have a hard time managing money, noticing scams, or taking care of yourself.
Worsening social life: This includes not wanting to participate in your usual social activities or being unable to follow things you enjoy, such as sports or the news.
Mild (Early-Stage) Symptoms
People often get a diagnosis at the early stage of AD. Mild symptoms mainly affect cognition, behavior, and personality. People experience these symptoms often or enough to interfere with normal life.
Cognition
Memory loss can affect a variety of things, appearing in some of the following ways:
Forgetting or having trouble finding words, making it more difficult to keep a conversation
Getting lost in familiar places
Losing things often
Losing track of dates and times of the year
Repeating questions
Other cognitive issues can include trouble with:
Completing daily tasks like paying bills, shopping, or bathing
Judgment and decision-making
Planning
Problem-solving
Behavior
People with mild AD may start exhibiting the following behaviors:
Bathing less or wearing the same clothes every day
Engaging in out-of-character sexual activity
Hitting or slapping others
Pacing a lot
Wandering away from home
Withdrawing from social activity, sometimes because of loss of interest or difficulty following activities and conversations
Personality
People may experience the following for the first time or more than usual:
Anger or aggression
Apathy, or loss of interest in things they used to enjoy
Hallucinations and paranoia (being suspicious or mistrusting others without a cause)
Sadness
Moderate Symptoms
Areas of the brain that control language, reasoning, thought, and processing of the senses are further affected with moderate AD. People with moderate AD require more help and supervision. New concerns can also come up as symptoms of the early stage, like memory loss and confusion, worsen.
People may experience cognitive, behavioral, and psychological changes, including issues with:
Dealing with new situations
Detecting and identifying sights and smells
Completing usual tasks
Participating in social activities
Paying attention
Reading, writing, and using numbers
Recognizing people
Regulating emotions, which can lead to inappropriate outbursts
Regulating impulses, which can lead to using vulgar language or undressing when it's not appropriate
Thinking logically
People may also experience the following physical issues:
Muscle twitches
Repetitive movement
Sleep changes, like sleeping more throughout the day and being restless at night
Severe (Late-Stage) Symptoms
The late stage of AD sets in when the disease causes changes to the brain, and the brain tissue physically shrinks. People with severe AD are typically unable to communicate and take care of themselves. They experience far more physical concerns. They rely on their caregivers completely and stay in bed all or most of the time.
People with late-stage AD are often unable to or have difficulties doing the following:
Communicating
Remaining aware of their surroundings or recent experiences
Not being able to swallow properly can cause food or liquid to get into the lungs instead of air, leading to aspiration pneumonia. Aspiration pneumonia is the most common cause of death for people with AD.
The following physical issues can also occur:
Dental, tooth, and foot problems
Increased sleeping
Weight loss along with little interest in eating
When To Contact a Healthcare Provider
Make sure to speak to a healthcare provider if you have memory or other cognitive issues that interfere with your daily life. The people around you may notice changes in your mood, personality, and ability to complete tasks earlier than you do. Consider talking to a healthcare provider as well if they tell you something is different.
You can start by seeing a healthcare provider, who may refer you to a:
Geriatric psychiatrist: A specialist in emotional problem evaluations
Geriatrician: A specialist in aging and care for older adults
Neurologist: A specialist in conditions affecting the brain and spinal cord
Neuropsychologist: A specialist in memory and thinking testing
Seeing a healthcare provider as soon as you or others notice changes leads to earlier and more effective AD treatment. You may also discover that you have another, more treatable, or even curable condition. Vitamin D deficiency or side effects from medication, for example, can cause similar symptoms.
Related: The 4 Stages of Migraine Symptoms
A Quick Review
AD first affects your cognition (e.g., memory), personality, and behavior. The disease progresses to difficulties completing basic tasks and eventually an inability to communicate and take care of yourself.
Do not hesitate to speak to a healthcare provider if you or the people around you notice changes in your thinking, personality, or mood. They may rule out other issues or put you on an early path to AD treatment.
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