Alzheimer’s Disease Symptoms: Early Signs & Warning Symptoms

Quick Glance: Common Alzheimer’s Symptoms/ Early Warning Signs

Alzheimer often onsets with early warning signs, which are essential to be evaluated by a doctor. A quick glance at some of the common Alzheimer’s symptoms is given below:

Forgetting recent conversations, appointments or events
Repeating the same questions or statements
Misplacing belongings in unusual places
Becoming confused about time, dates or familiar locations
Struggling to find words or follow conversations
Finding it difficult to plan, solve problems or manage finances
Having trouble completing familiar daily tasks
Developing changes in mood, personality or social behaviour

Alzheimer’s symptoms usually develop over time and become more noticeable as they progress.

Alzheimer’s Symptoms That Should Not Be Ignored

Some critical Alzheimer’s symptoms that should not be ignored are given in the table below:

Symptom	What It May Indicate
Repeatedly forgetting recent conversations or meals	Increasing difficulty forming and storing new memories
Getting lost on familiar roads or inside known places	Problems with orientation and visual-spatial processing
Difficulty managing money, medicines or household tasks	Reduced judgement, planning and decision-making ability
Struggling to find common words or follow conversations	Decline in language and communication skills
Noticeable suspicion, aggression, withdrawal or personality changes	Behavioural and psychological changes associated with dementia
Needing help with dressing, bathing or eating	Increasing loss of independence in daily activities
Difficulty swallowing, frequent choking or unexplained weight loss	Advanced disease with a risk of poor nutrition or food entering the lungs

Why Do Alzheimer’s Symptoms Occur?

Alzheimer’s symptoms develop because brain cells, called neurones, gradually become damaged and lose communication functions. Two proteins are closely associated with this process:

Beta-amyloid, which forms plaques between brain cells
Tau, which forms abnormal tangles inside them

Damage commonly begins in brain regions involved in learning and recent memory, including the hippocampus. It later spreads to areas responsible for language, reasoning, behaviour, movement and recognition. As more neurons stop working, symptoms become more prominent and severe.

Alzheimer’s Symptoms That Require Immediate Medical Attention

The progression of Alzheimer’s disease is usually slow. If an individual suddenly exhibits symptoms, it may not immediately indicate Alzheimer’s or dementia. The symptoms may also be due to conditions like stroke, infection, delirium or another medical emergency.

It is recommended to seek medical attention immediately if one or more of the following symptoms are observed:

Sudden confusion or a rapid worsening of awareness
Sudden weakness or numbness on one side of the body
Facial drooping or suddenly unclear speech
A seizure or loss of consciousness
Severe breathing difficulty or choking
A serious fall or head injury
High fever with new confusion or extreme drowsiness
Persistent vomiting or inability to drink fluids
Severe aggression that places the person or others in immediate danger

Symptoms of Alzheimer’s-Specific Conditions

Some individuals may develop uncommon presentations of Alzheimer’s in which memory loss is not the first noticeable symptom. Such presentations need to be evaluated by a neurologist or another doctor experienced in cognitive disorders.

Some of these Alzheimer’s-specific presentations are given in the table below:

Alzheimer’s Presentation	Common Early Symptoms
Typical Memory-Led Alzheimer’s Disease	Recent memory loss, repeated questions, misplaced items and difficulty learning new information
Posterior Cortical Atrophy	Difficulty reading, judging distances, reaching for objects, recognising objects or navigating surroundings
Logopenic Primary Progressive Aphasia	Frequent pauses, difficulty finding words, slow speech and trouble repeating sentences
Frontal or Behavioural Presentation	Early changes in judgement, planning, motivation, social behaviour or impulse control

Can You Have Alzheimer’s Without Symptoms?

Yes. Biological changes associated with Alzheimer’s disease can begin years before memory or thinking problems become noticeable. This is sometimes called preclinical Alzheimer’s disease.

An individual may later develop mild cognitive impairment or MCI. In MCI, memory or thinking declines more than expected for age, but the person can usually remain independent. Not everyone with MCI develops Alzheimer’s or dementia, so regular medical monitoring is important in such cases.

When Can Alzheimer’s Symptoms Become Life-Threatening?

Some Alzheimer’s symptoms can become life-threatening if left untreated and require immediate medical attention. These include:

Emergency Complication	What Can Happen
Aspiration Pneumonia	Swallowing problems may allow food, liquid or saliva to enter the lungs and cause infection.
Severe Dehydration	A person may forget to drink, lose the ability to communicate thirst or have difficulty swallowing fluids.
Malnutrition	Problems recognising food, using utensils or swallowing may lead to serious weight loss and weakness.
Severe Infection or Delirium	Pneumonia, urinary infection or another illness may cause sudden confusion, reduced awareness or rapid physical decline.
Falls and Head Injuries	Poor judgement, impaired balance and difficulty judging distances can increase the risk of serious injury.
Prolonged Immobility	Limited movement may contribute to pressure injuries, infections, blood clots and loss of physical strength.

How are Alzheimer’s Symptoms Diagnosed?

Alzheimer’s cannot usually be diagnosed with a single test. Doctors often conduct multiple cognitive tests along with examining symptoms and medical history to rule out other possibilities and reach a confirmed diagnosis.

An overview of these tests and their purpose to diagnose Alzheimer’s is given below:

Diagnostic Test or Assessment	Purpose
Medical and Symptom History	Reviews when the symptoms began, how they have progressed and how they affect daily life.
Family or Caregiver Interview	Provides information about memory, behaviour and functioning that the person may not recognise or remember.
Physical and Neurological Examination	Checks movement, strength, reflexes, sensation, balance and signs of other neurological conditions.
Cognitive Assessment	Tests memory, attention, language, orientation, planning and problem-solving.
MMSE or Addenbrooke’s Cognitive Examination	Provides a structured assessment of different areas of cognitive functioning.
Daily-Activity Assessment	Examines the ability to manage money, medicines, cooking, travel, dressing and personal care.
Blood and Urine Tests	Help identify anaemia, thyroid disease, vitamin B12 deficiency, infection, electrolyte imbalance or liver and kidney problems.
MRI or CT Scan of the Brain	Looks for stroke, tumours, bleeding, hydrocephalus, brain shrinkage or another structural cause.
Detailed Neuropsychological Testing	Assesses individual thinking abilities when the diagnosis or pattern of impairment remains uncertain.

FAQs

Q1. What is usually the first symptom of Alzheimer’s disease?

Ans: Persistent difficulty in remembering recent events, conversations, or newly acquired information is usually considered a common early symptom of Alzheimer's. However, in some uncommon cases, changes may first affect language, behaviour or visual processing.
Q2. How is Alzheimer’s memory loss different from normal ageing?

Ans: Normal ageing may involve temporarily forgetting a name or appointment and remembering it later. Alzheimer’s-related memory loss is persistent, becomes more frequent and gradually interferes with everyday activities.
Q3. Can Alzheimer’s disease develop before the age of 65?

Ans: Yes. Alzheimer’s disease that begins before 65 is called young-onset or early-onset Alzheimer’s disease. Any progressive memory, language, visual or behavioural change in a younger adult should be medically evaluated.
Q4. Can someone have Alzheimer’s disease without knowing it?

Ans: Yes. Some people have limited awareness of their difficulties, while others remain symptom-free during the preclinical stage of Alzheimer’s. Family members may notice repeated questions, missed payments or changes in behaviour before the person does.
Q5. When should someone see a doctor about memory problems?

Ans: It is recommended to visit a neurologist or cognitive specialist when memory or thinking changes persist, worsen or interfere with work, finances, medicines, communication, travel or personal care. A doctor can also check for treatable causes of cognitive symptoms and check for Alzheimer’s.
Q6. Are Alzheimer’s symptoms different in men and women?

Ans: There is no reliable male-specific or female-specific symptom pattern of Alzheimer's disease. Age, disease stage, general health, education, language and the affected brain regions may influence how symptoms appear.
Q7. Can hallucinations occur in Alzheimer’s disease?

Ans: Yes. Hallucinations can occur in later stages of Alzheimer’s. Early, well-formed visual hallucinations may suggest another type of dementia and should be assessed by a doctor.
Q8. Which Alzheimer’s symptoms indicate an emergency?

Ans: Some Alzheimer's symptoms that require immediate medical attention include sudden confusion, one-sided weakness, facial drooping, loss of consciousness, seizures, severe breathing difficulty or choking.

References
- https://www.who.int/news-room/fact-sheets/detail/dementia
- https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447
- https://indianpsychiatricsociety.org/wp-content/uploads/2022/05/Shaji_2018_Clinical_Practice_Guidelines_for.pdf
- https://memory.ucsf.edu/dementia/posterior-cortical-atrophy