Alzheimer’s disease: Signs and Symptoms

What is Alzheimer’s disease?

Alzheimer’s disease is a serious brain disorder. It is the most common form of dementia among older people. The disorder affects thinking and memory skills as well as the ability to complete daily activities and to care for yourself. An estimated 13 million people in the United States are expected to have the disease by 2050.

Alzheimer’s disease begins slowly and gets worse over time. Some research suggests it can begin 20 years before symptoms appear. However, catching it early can help manage symptoms.

Alzheimer’s disease is not a normal part of aging. Initial symptoms affect thought, memory, and language. Knowing what to look for and how it differs from normal aging can help you decide when to talk to your family doctor.

Early stages of Alzheimer’s disease

The earliest stage of Alzheimer’s disease may be subtle. For example, you may forget certain words (which is normal in aging). However, there are 10 primary symptoms that are very specific.

Every person is different and may have more or less than these 10 symptoms. Talk to your doctor if you notice 1 or more in yourself or a loved one.

• Memory loss that affects daily life: This includes forgetting important dates, things you just learned, or asking the same question over and over. You may find yourself relying more on reminder notes, technology, or other family members to remember things.
• Changes in the ability to follow a plan or solve a problem: This may include having trouble focusing on a problem. It could also mean trouble following a plan, such as a recipe. Keeping track of regularly scheduled tasks, such as paying monthly bills becomes a challenge.
• Changes in the ability to complete familiar tasks: AD can make it hard to do the things that you used to do all the time. For example, it might be hard to do chores at home, run errands, or finish a routine task at work.
• Confusion about time or place: This includes losing track of how much time has passed, the date or the day of the week, or forgetting where you are and how you got there. Oftentimes, this includes thinking it is many years previous than it really is and not recognizing friends and family.
• Problems with vision or understanding visual information: Examples include trouble with reading comprehension, identifying colors, judging distances, or getting confused about what you see.
• Problems with words: This may include forgetting words in the middle of a conversation, repeating parts of a conversation, or calling things by the wrong names.
• Misplacing things: This could mean putting things in unusual places, losing things often, being unable to retrace your steps to find a lost object, and even accusing others of stealing.
• Poor judgment: Examples include paying less attention to appearance or cleanliness. It could also mean using poor judgment with money, such as giving large amounts of money to solicitors.
• Withdrawal from activities: This could include withdrawing from work and social activities or family gatherings. It may also mean discontinuing a hobby, sport, or favorite activity.
• Changes in mood and personality: You may become unusually confused, suspicious, upset, depressed, fearful, or anxious. This may happen when you are in new or unfamiliar places.

If you notice any of these signs, don’t wait. Speak to your family doctor. They will be able to tell you whether it’s a part of normal aging or something more.

Middle stages of Alzheimer’s disease

Many of the same symptoms that are present in the early stages of Alzheimer’s disease are present in the mid-stage but grow worse. For example:

• Your memory causes you to forget names of family members.
• You get lost when you are on your own.
• You cannot make an everyday plan or decision.
• Basic math, reading, and writing become increasingly difficult.
• You are unable to care for your daily hygiene, dressing, eating, or medicines.
• Behavior changes increase, including:
  • Not knowing where you are.
  • Wandering away from your environment.
  • Repeating words, stories, or actions.
  • Experiencing serious sleep pattern changes.
  • Growing more agitated, suspicious, depressed or anxious.
  • Experiencing paranoia about close family, friends, or caregivers.
  • Losing control and acting inappropriately or impulsively.
  • Seeing or hearing things that are not there.

Late stages of Alzheimer’s disease

All the above symptoms continue to worsen. Some of the more serious examples of advanced Alzheimer’s disease include:

• Inability to speak
• Difficulty swallowing
• Uncontrolled urinary and bowel movements (incontinence)
• Difficulty sitting, standing, or walking
• Malnutrition (not eating), leading to unintended weight loss
• Increased injuries and illness from falls and infections like pneumonia
• Increased hallucinations and delusions (things that aren’t real)
• Increased mood swings and aggression toward others
• Unable to stay safe because you are frequently getting lost

Share your symptoms with your family doctor

Tell your doctor everything. For example, you may say, “I’ve noticed changes in my memory and thinking. I’m concerned this might be an early sign of Alzheimer’s disease.” Be as specific as possible to give your physician a clear understanding of your concerns. Also, report any physical changes that concern you, including unintended weight loss, frequent infections, fractures or injuries, incontinence, etc.

Resources

Us Against Alzheimer’s Brain Guide

AAFP Cognitive Care Guide

Alzheimer’s Association