Communication During Different Stages of Alzheimer's

Whether you have Alzheimer's or you're caring for someone with the disease, you may have noticed that communication with loved ones and friends has become more difficult. How does Alzheimer's affect communication as the disease progresses?

People with Alzheimer’s lose particular communication abilities during the early, middle, and late stages of the disease. Here's what to expect and what kinds of communication challenges can occur during each stage of Alzheimer's:

Older woman talking to caretakers
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Early Stage Alzheimer's

  • Increased concentration may be required to follow conversations
  • Trouble staying on topic
  • More time may be required to formulate verbal responses to questions
  • Increased frustration
  • Difficulty finding the right word, at times
  • May lose a train of thought more often than before symptoms began

Middle Stage Alzheimer's

  • Difficulty understanding long conversations
  • Difficulty understanding reading material
  • Decreased ability to interpret facial expressions
  • Trouble explaining abstract concepts
  • Decreased vocal expression and ability to raise or lower voice
  • Difficulty finishing sentences
  • Apathy, including reduced interest in communication
  • May speak in vague and rambling sentences

Late Stage Alzheimer's

  • Inability to understand the meaning of most words
  • Problems realizing when being addressed
  • Diminished use of proper grammar
  • In some cases, the person may become totally mute

If you're a caregiver, try to remember that although your loved one may appear uninterested in communicating, it could be that the disease has simply made him or her incapable of showing a desire to communicate. That is why it's crucial to always strive for meaningful communication with your loved one at every stage of the disease.

-Edited by Esther Heerema, MSW

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.
  • Mace, N. L., & Rabins, P. V. (2006). The 36-hour day: A family guide to caring for people with Alzheimer disease, other dementias, and memory loss in later life (4th ed.). Baltimore, MD: Johns Hopkins University Press.
  • Ostuni, E., & Santo Pietro, M. J. (1986). Getting through: Communicating when someone you care for has Alzheimer’s disease. Princeton Junction, NJ: The Speech Bin.

By Carrie Hill, PhD
 Carrie L. Hill, PhD has over 10 years of experience working for agencies in the health, human service, and senior sectors, including The Alzheimer's Association in St. George, Utah.