Symptoms of Alzheimer's disease progress slowly over the years. These symptoms can be confused with other illnesses and may initially be due to old age.
The rate at which symptoms progress varies from person to person. Alzheimer's disease’s symptoms are divided according to the disease’s three main stages:
- Early symptoms:
In the early stages, the main symptom of Alzheimer's disease is memory lapses. This can be manifested in:
- forget about recent conversations or events
- misplace items
- forget the names of places and objects
- have trouble thinking of the right word
- ask questions repetitively
- show poor judgement or find it harder to make decisions
- become less flexible and more hesitant to try new things
There are often signs of mood changes, such as increasing anxiety or agitation, or periods of confusion.
- Middle-stage symptoms:
As Alzheimer's disease progresses, memory problems worsen. People in this state may have increased difficulty remembering the names of people they know and recognizing family and friends.
Other symptoms may also appear like:
- increasing confusion and disorientation – for example, getting lost, or wandering and not knowing what time of day it is
- obsessive, repetitive, or impulsive behavior
- delusions (believing things that are untrue) or feeling paranoid and suspicious about carers or family members
- problems with speech or language (aphasia)
- disturbed sleep
- changes in mood, such as frequent mood swings, depression and feeling increasingly anxious, frustrated, or agitated
- difficulty performing spatial tasks, such as judging distances
- seeing or hearing things that other people do not (hallucinations)
- Some people also have some symptoms of vascular dementia.
At this stage, patients with Alzheimer's disease usually need support in their daily lives (like in eating, washing, changing clothes, using the toilet, etc.)
- Later symptoms:
In the later stages of Alzheimer's disease, the symptoms become increasingly severe and can be distressing to the person, their caregivers, friends, and family. Hallucinations and delusions can come and go as the illness progresses but can worsen as the illness progresses. Alzheimer's patients at this stage sometimes can be violent, demanding, and distrustful of those around them.
Other symptoms that can appear as the disease progresses include:
- difficulty eating and swallowing (dysphagia)
- difficulty changing position or moving around without assistance
- weight loss – sometimes severe
- unintentional passing of urine (urinary incontinence) or stools (bowel incontinence)
- gradual loss of speech
- significant problems with short- and long-term memory