Symptoms

Memory loss is usually the first sign of Alzheimer's disease. Having some short-term memory loss in your 60s and 70s is common, but this doesn't mean it's Alzheimer's disease.

Compare these examples of normal memory problems and the types of memory problems that may be caused by Alzheimer's disease.

Alzheimer's disease also causes changes in thinking, behavior, and personality. Close family members and friends may first notice these symptoms, although the person may also realize that something is wrong.

Following are some of the symptoms of the different stages of Alzheimer's disease. They vary as the disease progresses. Talk to your doctor if a friend or family member has any of the signs.

Mild Alzheimer's disease

Usually, a person with mild Alzheimer's disease:

• Avoids new and unfamiliar situations.
• Has delayed reactions and slowed learning ability.
• Begins speaking more slowly than in the past.
• Starts having trouble handling money and paying bills.
• Starts using poor judgment and making inappropriate decisions.
• May have mood swings and become depressed, irritable, or restless.

These symptoms often are more obvious when the person is in a new and unfamiliar place or situation.

Some people have memory loss called mild cognitive impairment. People with this condition are at risk for developing Alzheimer's disease or another type of dementia. But not all people with mild cognitive impairment progress to dementia.

Moderate Alzheimer's disease

With moderate Alzheimer's disease, a person typically:

• Has problems recognizing close friends and family.
• Becomes restless and wanders, especially in late afternoon and at night. This is called sundowning.
• Has problems reading, writing, and dealing with numbers.
• Has trouble dressing.
• Cannot work simple appliances such as a TV remote or a microwave.

Severe Alzheimer's disease

With severe Alzheimer's disease, a person usually:

• Can no longer remember how to bathe, eat, dress, or go to the bathroom independently. The person may become bedridden or confined to a wheelchair because he or she has forgotten how to move.
• No longer knows when to chew and swallow.
• Has trouble with balance or walking and may fall frequently.
• Becomes more confused in the evening (sundowning) and has trouble sleeping.
• Cannot communicate using words.
• Loses bowel or bladder control (incontinence).

Early in the disease, Alzheimer's usually doesn't affect a person's fine motor skills (such as the ability to button or unbutton clothes or use utensils) or sense of touch. A person who develops motor symptoms (such as weakness or shaking hands) or sensory symptoms (such as numbness) probably has a condition other than Alzheimer's disease. Conditions such as Parkinson's disease, for instance, may cause motor symptoms along with dementia.

Other conditions with symptoms similar to those of Alzheimer's disease may include:

• Dementia caused by small strokes (multi-infarct dementia).
• Thyroid problems, such as hyperthyroidism or hypothyroidism.
• Depression.
• Other problems such as kidney and liver disease and some infections such as HIV (human immunodeficiency virus).