Signs and Symptoms of Alzheimer's Disease

Senior lady looks out of the window
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We all have those times when we think, "What was his name? I know I met him before…Was it Jim? Tim?" Or, "I know I have it somewhere. If I can just remember where I put it!"

If you're like me, these moments happen frequently in the busy pace of life. However, 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 warning 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.

Symptoms of Early, Middle and Late Stage Alzheimer's Disease

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:

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 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 are 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.

Diagnosis and Treatment

If you see yourself or your loved one described in these symptoms, contact a physician, psychologist or neurologist 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.


Alzheimer's Association; Stages of Alzheimer's. Accessed July 8, 2011.

US National Institutes on Health. National Institute on Aging. Accessed July 10, 2011.

US National Institutes on Health. National Institute on Again. Accessed July 10, 2011.

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