In Alzheimer’s disease, changes to the brain cause dysfunction that results in progressive dementia and other symptoms. An abnormal protein called beta-amyloid builds up to form plaques between brain cells. Brain damage begins in areas responsible for memory and spreads through the brain, destroying nerve cells, shrinking brain tissue, and worsening symptoms.

The advanced stages of the disease lead to severe physical decline and complications, such as infections or malnutrition, which are eventually fatal.

While there is currently no cure for Alzheimer’s, treatments are available that can help manage many of the symptoms, improving quality of life for individuals and their caregivers.

What Are the Early Signs of Alzheimer’s?

Alzheimer’s begins differently for each person. Mild memory loss is usually the first symptom for those with late-onset Alzheimer’s (Alzheimer’s that is diagnosed after age 65). Those with early-onset Alzheimer’s may notice apraxia (trouble performing a familiar activity). Others notice visual changes, difficulty solving problems, lapses in reasoning or judgment, problems speaking or writing, or changes in mood. Some people experience multiple symptoms at once.

If you recognize symptoms that could be early signs of dementia, let your doctor know.

Types of Alzheimer’s Symptoms

The way Alzheimer’s disease affects individuals can be quite unique, and the symptoms of Alzheimer’s vary for each individual and for each stage of the disease. A person with Alzheimer’s will usually experience mild symptoms early in the disease course. Alzheimer’s is a progressive disease, which means that symptoms worsen gradually over time, new symptoms appear, and disability accumulates.

Cognitive Symptoms

Cognitive symptoms are the hallmark of Alzheimer’s and usually among the first symptoms to appear. Examples of cognitive symptoms include trouble with:

• Remembering
• Focusing or paying attention
• Processing and understanding information
• Recalling words and using them correctly
• Communicating
• Reading and writing
• Calculating numbers and managing finances
• Learning and remembering new information
• Organization and planning
• Decision-making
• Navigating familiar routes
• Recognizing friends, family members, or even one’s own reflection in a mirror

As dementia progresses, people with Alzheimer’s become increasingly confused and less aware of their surroundings.

Psychological Changes

Many people with Alzheimer’s experience mood changes. Psychological issues may include:

• Depression
• Apathy
• Agitation
• Anxiety
• Fearfulness
• Social withdrawal
• Personality changes
• Emotional outbursts
• Loss of inhibitions

Behaviors

As dementia worsens, people with Alzheimer’s often develop problematic behaviors including:

• Acting aggressively
• Wandering
• Refusing to bathe or groom
• Repeatedly asking the same questions
• Accusing others of stealing items
• Placing objects in unusual places
• Repeating behaviors such as hand-wringing
• Showing hypersexual behaviors, such as frequent masturbation or attempts to seduce others

Psychotic Symptoms

In some instances, people with Alzheimer’s may experience psychotic symptoms, which are disturbances in thought and perception. These can include:

• Hallucinations
• Delusions
• Paranoia

Motor Symptoms

For some people, the first symptom of Alzheimer’s may be apraxia. This is difficulty performing a voluntary action they once knew well, such as tying shoes or buttoning a shirt.

In the late stage of Alzheimer’s, severe damage to the brain causes motor (movement) symptoms. At this stage, people begin to need assistance walking or sitting. They may become unable to hold up their head. Some people lose the ability to swallow.

Other Symptoms

Beyond the primary cognitive, psychological, and motor changes, Alzheimer’s disease can manifest in several other ways, impacting various bodily functions.

People with Alzheimer’s may see their sleep patterns change, with frequent daytime sleeping and nighttime restlessness. Sundowning is a noticeable pattern of worsening confusion and agitation that begins around dusk and lasts through the nighttime hours. Sundowning is common in people with Alzheimer’s.

Alzheimer’s can also cause problems with visual processing, especially peripheral vision and perception of motion, depth, contrast, or color.

In advanced Alzheimer’s, many people lose the ability to control their bladder and bowels, leading to incontinence.

People with severe Alzheimer’s have a weakened immune system and are more susceptible to infections, especially pneumonia, skin infections, and urinary tract infections.

Alzheimer’s can also cause seizures. Alzheimer’s and related neurodegenerative conditions are thought to cause 10 percent of new epilepsy cases in people age 65 or over.

At What Age Do Most People First Experience Alzheimer’s Symptoms?

Alzheimer’s is typically diagnosed after age 65, and the likelihood of developing the condition rises with age. However, people as young as their 30s have been diagnosed with Alzheimer’s.

Talk With Others Who Understand

On myALZteam, people share their experiences with Alzheimer’s disease, get advice, and find support from others who understand.

Have you noticed any of these symptoms of Alzheimer’s disease in yourself or a loved one? Share your experience in the comments below.