Symptoms of Alzheimer's Disease

Memory loss and confusion are the two key symptoms of Alzheimer's disease. While anyone can have an episode of being unable to remember a name or where you put your keys, there is a significant difference between being absent-minded or preoccupied and having a true progressive memory problem such as Alzheimer's disease.

Here are four signs that could indicate a more serious problem:

• You lose your keys. When they're found, you have no recollection of how they might have gotten there.
• You always were a fantastic cook, but lately even making coffee seems more difficult. You wonder who has been messing around with your coffeemaker.
• You're great at covering for yourself. For example, when someone asks you a question to which you don't know the answer, you turn the question around by saying with a chuckle, "I'm not sure. What do you think?"
• You've had a hard time recently balancing your checkbook, even though that's always been your job.

If these symptoms paint a picture of you or someone you love, seek an evaluation from a physician, geriatrician, or psychologist.

The Alzheimer's Association has identified 10 warning signs of Alzheimer's disease:

1. Memory changes
2. Withdrawal from usual activities
3. Disorientation to time and place
4. Visual-spatial difficulties
5. Decrease in written or verbal communication ability
6. Challenges in problem-solving and planning
7. Personality and mood changes
8. Misplacing items frequently
9. Decline in judgment
10. Difficulty performing familiar tasks

While Alzheimer's disease has been described as having seven stages, the symptoms of Alzheimer's can also be collapsed into three broad stages: early, middle, and late. Remember that symptoms can overlap and may vary in each person with Alzheimer's.

Early (Mild) Stage Symptoms:

• Difficulty with tasks such as balancing a checkbook or making dinner
• Difficulty learning new tasks
• Slower reaction time when driving or making decisions
• Occasional difficulty finding words
• Short-term memory impairment
• Increased irritability, anxiety, or depression
• Often an awareness of these changes

In early-stage Alzheimer's, individuals may still function quite well overall. Although they may be aware of the increasing difficulty with certain tasks, they are also often quite skilled at hiding this from others by deflecting questions, changing the topic, or relying on their family or loved ones to make decisions or answer questions. Some persons also begin to withdraw, perhaps due to their uncertainty over their ability to cope with decisions or social interaction. Notice that in this stage, long-term memory typically remains intact.

Middle (Moderate) Stage Symptoms:

• Significant personality changes, such as being argumentative, impulsive, angry
• Resistive to, or combative with, physical care, even (sometimes especially) when provided by a loved one
• Short-term and long-term memory loss
• Increased difficulty in communicating with others
• A "love-hate" relationship with their caregivers; for example, extremely dependent on but also very unkind toward a spouse or adult child
• Potential for wandering away from home
• Very poor judgment and decisions
• Often the physical abilities still remain intact here, such as their ability to walk around
• Sometimes incontinence becomes a concern

Moderate, or mid-stage, Alzheimer's is often the most difficult stage. While some individuals remain "pleasantly confused" throughout the entire disease, many display inappropriate behaviors and emotions. They may be quite restless and become paranoid or have hallucinations or refuse to let you help them with a bath or getting dressed. They may get up several times in the night, and rummage through the same drawers repeatedly. This middle stage of Alzheimer's can be very taxing for the primary caregiver, and this is often when in-home help is hired or the person is placed in a facility, such as an assisted living or a nursing home.

Late (Severe) Stage Symptoms:

• Decreased ability to interact with others
• Ability to recognize people diminishes
• Physical decline, such as inability to walk or talk
• Difficulty with eating, even with assistance
• Apparent withdrawal from surroundings
• Incontinence

In this final stage of Alzheimer's, people often are quite immobile and spend much of their time in bed or a wheelchair. They are no longer able to respond much to others, although you may occasionally receive a smile or hear some attempts at language. The behavior challenges of mid-stage Alzheimer's are replaced with what looks like complete withdrawal; however, these individuals can still benefit from gentle conversation, holding their hand or giving them a hug, visual stimulation such as colors and pictures, and especially hearing music. Individuals with late-stage Alzheimer's become more prone to illnesses as their body loses strength. Often, infections like pneumonia eventually cause their death.

While Alzheimer's disease most often presents symptoms after age 65, early-onset Alzheimer's disease is seen in about 5% of cases. Early onset dementia often affects people as young as those in their 40s and 50s. While the symptoms are similar, they may be seen in difficulty in performing on the job. You might confuse directions, get more angry or irritable, or forget to perform important tasks. Because the onset is gradual, the symptoms might be dismissed as due to stress or depression. However, early detection of cognitive impairment can help determine the cause and trigger earlier treatment.

Familial Alzheimer's disease often has early onset. This type is linked to specific genes and affects at least two generations. It occurs in less than 3% of all cases of Alzheimer's disease.

Complications of Alzheimer's disease include an increased risk of falling and a higher risk of hip fractures from falls. Remaining as active as possible, for as long as possible, may help delay some of the physical changes in apraxia that develop in Alzheimer's. Bladder and bowel problems may also develop as the person doesn't recognize urges, has limited mobility, or is confused as to where the bathroom is. There can also be difficulty in eating, drinking, and swallowing, leading to aspiration pneumonia, choking, malnutrition, and dehydration.

If you see yourself or your loved one described in these symptoms, contact your physician to arrange for an evaluation. Diagnosing Alzheimer's disease involves several tests to rule out other conditions and is an important first step in treatment and management of the disease.

Not all problems with cognition (the ability to think and remember) are due to Alzheimer's disease. This is one of many reasons why it's important to see your physician if you're experiencing these symptoms.

Sometimes memory loss can be caused by reversible conditions that can be treated. For example, inadequate amounts of vitamin B12 in your body has been shown to cause symptoms that are similar to early-stage Alzheimer's. True Alzheimer's disease is not reversible, although multiple non-drug approaches and medications can be helpful in treating its symptoms. So, even if you're feeling anxious about going to the physician, it is very important to rule out these other conditions that could be effectively treated and partially or even completely reversed.

Alzheimer's disease is the most common cause, or type, of dementia, but there are several other conditions that also cause symptoms of dementia. This can include vascular dementia (related to a stroke or tiny, unnoticed blockages of blood flow in your brain), Lewy body dementia (a condition that consists of Parkinson-like effects in the body and impaired cognition), frontotemporal dementia (sometimes called "Pick's disease") and Huntington's disease (a genetic condition that often affects younger persons with involuntary movements and cognitive problems).

A Word From Verywell

Affecting more than 5 million people in the United States alone, Alzheimer's disease is far from uncommon. However, because Alzheimer's disease affects the mind and many other conditions affect the body, there can be a greater fear and stigma about the disease. Unfortunately, this can cause people to hide and ignore symptoms, delay treatment, or simply isolate themselves. Rather than sharing a diagnosis via multiple phone calls, social media posts, and an online journal, Alzheimer's disease is too often a whispered word in the corner of a room.

Hold on to the knowledge that there is no blame or shame in an Alzheimer's diagnosis. Instead, by seeking support (whether in an official group or simply by sharing your story with others), you can gain strength, knowledge, and hope while living with Alzheimer's disease.

Read more about the prevention of Alzheimer's disease.