Brain & Nervous System Alzheimer's Symptoms Alzheimer's Guide Alzheimer's Guide Symptoms Causes Diagnosis Treatment Coping Prevention Signs and Symptoms of Alzheimer's Disease By Esther Heerema, MSW facebook twitter linkedin Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia. Learn about our editorial process Esther Heerema, MSW Medically reviewed by Medically reviewed by Shaheen Lakhan, MD, PhD on December 02, 2019 linkedin Shaheen Lakhan, MD, PhD, is an award-winning, board-certified physician-scientist and clinical development specialist. Learn about our Medical Review Board Shaheen Lakhan, MD, PhD on December 02, 2019 Print Table of Contents View All Frequent Symptoms By Stage Complications/Sub-Groups When to See a Doctor Next in Alzheimer's Guide Understanding the Causes and Risk Factors 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 they put their keys, there is a significant difference between being absent-minded or preoccupied and having a true progressive memory problem such as Alzheimer's disease. For example, these instances could be symptoms of Alzheimer's disease or another concerning cognitive issue: 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. Frequent Symptoms The Alzheimer's Association has identified 10 warning signs of Alzheimer's disease: Memory changesWithdrawal from usual activitiesDisorientation to time and placeVisual-spatial difficultiesDecrease in written or verbal communication abilityChallenges in problem-solving and planningPersonality and mood changesMisplacing items frequentlyDecline in judgmentDifficulty performing familiar tasks The Four As Alzheimer's disease has also been described using four words that begin with A:Amnesia: Memory lossAphasia: Impaired communicationApraxia: Physical functioning (motor skills)Agnosia: Difficulty understanding information from the senses, such as vision or smell Understanding the 4 As of Alzheimer's By Stage While Alzheimer's disease has been described as having seven stages, the symptoms of Alzheimer's can 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 dinnerDifficulty learning new tasksSlower reaction time when driving or making decisionsOccasional difficulty finding wordsShort-term memory impairmentIncreased irritability, anxiety, or depressionOften 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. In early-stage Alzheimer's, long-term memory typically remains intact. Eary Signs of Alzheimer's Disease Middle (Moderate)-Stage Symptoms Significant personality changes, such as being argumentative, impulsive, angryResistant to, or combative with, physical care, even (sometimes especially) when provided by a loved oneShort-term and long-term memory lossIncreased difficulty in communicating with othersA "love-hate" relationship with their caregivers; for example, extreme dependence on a spouse or adult child who they also are very unkind toPotential for wandering away from homeVery poor judgment and decisionsPossible incontinence Often, one's physical abilities—such as their ability to walk around—still remain intact in this stage. 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, 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. Symptoms in the Middle Stages of Alzheimer's Disease Late (Severe)-Stage Symptoms Decreased ability to interact with othersDiminished ability to recognize peoplePhysical decline, such as inability to walk or talkDifficulty with eating, even with assistanceApparent withdrawal from surroundingsIncontinence 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. Verywell / JR Bee 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, 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 the body loses strength. Often, infections like pneumonia eventually cause their death. Complications/Sub-Group Indications 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. The symptoms are similar and are most apparent when someone is performing a job or task. Because the onset is gradual, the symptoms might be dismissed as being due to stress or depression. However, early detection of cognitive impairment can help determine the cause and lead to 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 motor functioning that develop in Alzheimer's. As Alzheimer's can cause someone to engage in unsafe behaviors such as wandering, losing concentration when driving, and leaving a stove burner on, it's also important to be aware of other injuries that may result. 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. When to See a Doctor 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. Know, though, that not all problems with cognition (the ability to think and remember) are due to Alzheimer's disease or other forms of dementia. This is one of many reasons why it's important to see your physician if you're experiencing these symptoms. 13 Kinds of Dementia 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. Hold on to the knowledge that there is no blame or shame in an Alzheimer's diagnosis. Instead, by seeking support, you can gain strength, knowledge, and hope while living with Alzheimer's disease. Was this page helpful? Thanks for your feedback! When it comes to Alzheimer's, the MIND diet has shown promise in reducing risk and promoting brain health. Sign up for our Alzheimer’s and Dementia Newsletter and get your free recipe guide today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Alzheimer’s Association. 10 Early Signs and Symptoms of Alzheimer's. Melnick VL, Dubler NN. Alzheimer’s Dementia, Dilemmas in Clinical Research. Springer Science & Business Media; 2012. Li XL, Hu N, Tan MS, Yu JT, Tan L. Behavioral and psychological symptoms in Alzheimer's disease. Biomed Res Int. 2014;2014:927804. doi:10.1155/2014/927804 Dassa A, Amir D. The role of singing familiar songs in encouraging conversation among people with middle to late stage Alzheimer's disease. J Music Ther. 2014;51(2):131-53. doi:10.1093/jmt/thu007 Brunnström HR, Englund EM. Cause of death in patients with dementia disorders. Eur J Neurol. 2009;16(4):488-92. doi:10.1111/j.1468-1331.2008.02503.x Vieira RT, Caixeta L, Machado S, et al. Epidemiology of early-onset dementia: a review of the literature. Clin Pract Epidemiol Ment Health. 2013;9:88-95. doi:10.2174/1745017901309010088 Bird TD, Adan MP, Ardinger HH, et al. Early-Onset Familial Alzheimer Disease. Seattle, WA: University of Washington; 1999. Lamotte G, Shah RC, Lazarov O, Corcos DM. Exercise Training for Persons with Alzheimer's Disease and Caregivers: A Review of Dyadic Exercise Interventions. J Mot Behav. 2017;49(4):365-377. doi:10.1080/00222895.2016.1241739 Additional Reading Alzheimer's Association. Stages of Alzheimer's. U.S. National Institutes on Health. National Institute on Aging. About Alzheimer's Disease: Symptoms.