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Signs, symptoms, and diagnosis

Signs and symptoms

Some people think “signs” and “symptoms” are the same, but they are different.

Signs are parts of a disease that can be seen. Symptoms are parts of a disease felt by the patient, but are not always seen.

It’s important to know both signs and symptoms. It might help you figure out if someone you know might have Alzheimer’s disease.

Signs

People living with Alzheimer’s may show several signs of the disease. These signs include trouble with:

Memory

People with Alzheimer’s may have trouble remembering things they just learned. They may also forget dates or events. If they do, they may ask questions over and over again. They might also use notes or other ways to remember.

Examples: forgetting what day it is, what’s happening next week, names of new people, what they just ate
Doing everyday things

It can be hard for people with Alzheimer’s to keep doing things they do every day. They may not be able to work, volunteer, or do hobbies anymore. People with Alzheimer’s might stop caring about how they look. They might not remember or want to bathe. They might also forget how to dress themselves.

Examples: getting confused while driving to a familiar place, trouble doing chores at home or things at work, losing track of a favorite sports team, refusing to shower
Time or place

Dates, times, and places can be hard to remember for people with Alzheimer’s. They may forget where they are or how they got there. They may forget the date or time. People with Alzheimer’s may not be able to retrace their steps. They might often put things where they don’t belong.

Examples: remembering where they are if it’s not a familiar place, not knowing what day or year it is, thinking someone stole something from them because they put it in the wrong place
Planning or solving problems

It may be hard for people with Alzheimer’s to follow plans. They may have trouble concentrating. This makes solving problems harder, especially if it has to do with numbers. It might take longer to do things than it used to.

Examples: trouble paying bills, having a hard time cooking, remembering to attend an event
Eyesight

Problems with eyesight can be a sign of Alzheimer’s. This includes problems with distance and depth. They may also have problems with telling colors apart, especially multiple colors.

Examples: problems with reading, judging distance and depth while driving
Talking

Conversations can be hard for those with Alzheimer’s. People may forget or confuse certain words and their meanings. This makes it hard to follow a conversation. They may also forget what they were talking about while telling a story.

Examples: stopping in the middle of telling a story, forgetting what an object is called
Mood and behavior

People with Alzheimer’s may also get confused, suspicious, depressed, scared, or nervous because of how their mood changes. It gets harder for people with the disease to make good decisions. Other people can take advantage of them.

Examples: giving money to scammers, changing their wills, becoming nervous in an unfamiliar place
Sleeping

Sometimes, people with Alzheimer's have trouble sleeping at night. This can be from depression, restless leg syndrome, or sleep apnea. (Sleep apnea is when breathing stops and starts while sleeping.) They may also nap during the day.

Sundowning is when a person with Alzheimer’s gets very confused, nervous, or frustrated in the late afternoon. This may be because they are tired from the day, their body clock isn’t working right, or the lighting and shadows change the way they see things.

Examples: waking up a lot at night and staying awake, being tired during the day, getting confused or frustrated when the sun sets

Symptoms

Alzheimer’s causes changes in the brain. These changes may start more than 20 years before symptoms appear. Early symptoms of Alzheimer’s disease include trouble remembering recent events, names, or conversations. People with Alzheimer’s may also become depressed. They might stop caring about things like they used to.

As the disease progresses, symptoms can include:

Trouble getting the point across

Trouble getting the point across

Confusion

Not knowing where they are

Not knowing where they are


                                            Poor judgment

Poor judgment

Changes in the way they act

Changes in the way they act

Trouble with speaking, swallowing, and walking

Trouble with speaking, swallowing, and walking

The phrase "signs and symptoms" is common, but the words have different meanings.

Signs refer to any part of a disease that can be seen. Symptoms are experienced by the patient but may not be obvious to others.

It’s important to be aware of both in order to recognize if someone you know might have Alzheimer’s disease.

Signs

Those living with Alzheimer’s may display several signs of the disease, including the following:

Memory

People with Alzheimer’s may have trouble with short-term memory. They may forget dates or events, and as a result they may repeat questions and/or rely more on notes or other memory aids.

Examples: forgetting what day it is, what’s happening next week, names of new people, what they just ate
Completing everyday tasks

It can be difficult for people with Alzheimer’s to continue doing the things they’re used to doing every day. They may not be able to work, and may also stop participating in social projects and hobbies. People with Alzheimer’s may also stop paying attention to how they clean and dress themselves.

Examples: becoming confused with how to drive to a familiar place, trouble completing tasks at work or chores at home, not keeping up with a favorite sports team, refusing to shower
Time or place

Dates, times, and places can be tricky to keep track of for those with Alzheimer’s. They may forget where they are, how they got there, or the date or time. People with Alzheimer’s may not be able to retrace their steps and as a result they might put things where they don’t belong.

Examples: remembering where they are if it’s not familiar, not being able to identify the day or year it is, accusing someone of stealing because they put something in the wrong place
Planning or problem solving

People with Alzheimer’s may have trouble making or following plans or instructions. It may become difficult to follow plans for people with Alzheimer’s. They may have trouble concentrating, so solving problems (especially involving numbers) are difficult for people with Alzheimer's disease. As a result, it may take a longer amount of time to do things than it used to.

Examples: trouble with paying bills, cooking with a recipe, or remembering to attend an event
Vision

Problems with eyesight can be a sign of Alzheimer's, including spatial reasoning. They may also have problems with color contrast and depth perception.

Examples: problems with reading or judging distance and depth while driving
Communication

Conversations can be difficult for those with Alzheimer's disease. They may forget words or confuse what they mean. People with Alzheimer's disease may not be able to follow a conversation, or forget what they were saying while telling a story.

Examples: stopping during the middle of a story they were telling or not being able to associate a word with an object
Mood and behavior

Alzheimer's causes confusion, so people may not be able to make smart decisions. They may be tricked more easily because of poor judgment anymore. People with Alzheimer’s may also experience suspicion, depression, fear, and anxiety because of mood changes.

Examples: giving money to scammers, changing their wills, becoming anxious in an unfamiliar place
Sleeping

People with Alzheimer's disease may have trouble sleeping. This may be caused by depression, restless leg syndrome, or sleep apnea (changes in breathing while sleeping). People with Alzheimer's may nap during the day.

Sundowning is a term used for confusion, frustration, or anxiety that may happen when the sun sets. It could happen because a person is tired from the day, their body clock isn't working right, or the lighting casts shadows that change the way things look.

Examples: waking up a lot at night and staying awake, being tired during the day, getting confused or frustrated when the sun sets

Symptoms

Alzheimer’s can cause changes in the brain that may start more than 20 years before symptoms appear. Early symptoms of Alzheimer’s disease include trouble recalling recent events, names, or conversations, as well as depression and indifference.

As the disease progresses, symptoms can include:

Trouble getting one’s point across

Trouble getting one’s point across

Confusion

Confusion

Inability to figure out where they are

Inability to figure out where they are

Poor judgment

Poor judgment

Changes in behavior

Changes in behavior

Trouble with speaking, swallowing, and walking

Trouble with speaking, swallowing, and walking

The terms "signs" and "symptoms" often seem synonymous, but the words have different meanings.

Signs refer to any component of a disease that can be observed, whereas symptoms are experienced by the patient but may not be apparent to others.

It’s important to be observant of both to recognize if someone you know might have Alzheimer’s disease.

Signs

People living with Alzheimer’s may exhibit numerous signs of the disease, including difficulty with:

Memory and recall

People with Alzheimer’s may have trouble committing key events and experiences to short-term memory. They may also be unable to recall important dates or events, and as a result they may ask repetitive questions and/or rely more on notes or other memory aids.

Examples: forgetting the date, events planned for next week, names of new acquaintances, what they just ate for dinner
Completing activities of daily living

It can be challenging for people with Alzheimer’s to complete ordinary tasks, whether they’re at home, at work, or somewhere else. They might stop participating in work, social projects, or hobbies. People with Alzheimer’s may not be aware of how to groom and dress themselves, and may refuse to shower.

Examples: becoming confused when driving to a usual or familiar place, trouble completing tasks at work or chores at home, not staying up-to-date with a favorite sports team, refusing to shower
Time or place

Keeping track of dates, times, and places can be challenging for those with Alzheimer’s. They may forget where they are, how they got there, or the date or time. People with Alzheimer’s may be unable to retrace their steps and they may place items where they don’t belong.

Examples: forgetting where they are in unfamiliar places, inability to identify the day or year, accusing someone of stealing because they put something in the wrong place
Planning or problem solving

It may become especially burdensome for people with Alzheimer’s to follow plans. They may have trouble concentrating, so problem-solving skills (especially involving math) are also difficult to maintain. As a result, it may take longer to do things than it used to.

Examples: trouble with paying bills, following a recipe, or remembering to attend an event
Vision and spatial relationships

Problems with vision can be a sign of Alzheimer’s. This includes spatial reasoning and trouble with image contrast and/or color.

Examples: difficulty reading, or judging distance and depth while driving
Communication

Conversations can become problematic for those with Alzheimer’s. They may struggle with vocabulary, become discouraged, or call things by the wrong name. They may stop in the middle of a conversation and become confused or repeat themselves.

Examples: becoming frustrated when recounting a story or not being able to associate a word with an object
Judgment, mood, and behavior

People may experience changes in judgment or decision-making because Alzheimer’s causes confusion. Poor judgment may cause them to be easily misled or tricked. People with Alzheimer’s may also experience confusion, suspicion, depression, fear, and/or anxiety because of mood changes.

Examples: donating money to scammers, changing their wills or other legal documents, becoming anxious in an unfamiliar place
Sleeping

People with Alzheimer's may experience sleeping issues. They may be due to depression, restless leg syndrome, sleep apnea, or daytime napping.

Sundowning is a term used for confusion, frustration, or anxiety that happens simultaneously with the sunset. It could happen because a person is exhausted from the day, their body clock isn't working right, or the lighting casts shadows that change the way things look.

Examples: waking up a lot at night and staying awake, being tired during the day, getting confused or frustrated when the sun sets

Symptoms

Alzheimer’s can cause structural changes in the brain, such as amyloid plaques and tangles of tau protein, that can begin more than 20 years before the onset of symptoms. Early symptoms of Alzheimer’s disease include cognitive impairment and mood or behavior changes, such as trouble remembering recent events, names, or conversations as well as depression and apathy.

As the disease progresses, symptoms can include:

Difficulty conversing

Difficulty conversing

Confusion

Confusion

Disorientation

Disorientation

Poor judgment

Poor judgment

Altered behavior

Altered behavior

Impaired speaking, swallowing, and walking

Impaired speaking, swallowing, and walking

NEXT: Diagnosis

References: 1. Alzheimer’s Facts and Figures 2021. 2. Signs & symptoms. Nature.com. https://www.nature.com/subjects/signs-and-symptoms. Accessed September 22, 2021. 3. Treatments for sleep changes. Alzheimer's Association. https://www.alz.org/alzheimers-dementia/treatments/for-sleep-changes. Accessed September 22, 2021.