Subtle changes occur, but the problem is sometimes hard to pinpoint. More often, family members recognize these changes rather than the patients themselves. Common changes may include:

• Forgetfulness and attempts to hide frequent forgetting
• Misplacing things
• Getting lost while driving
• Loss of interest in hobbies
• Difficulty concentrating
• Inability to recall words
• Decrease in sentence complexity
• Problems with mathematical calculations
• Getting lost in familiar surroundings
• Difficulty with tasks that require fine motor ability, such as putting a key in the keyhole or buttoning a shirt
• Difficulty in dealing with daily life tasks, such as managing finances, tending to household tasks, maintaining personal hygiene
• Repeating questions and stories
• Nonsensical wordy speech
• Naming difficulties
• Depressed mood

Impairments in memory and mental functioning become more obvious. Long-term memory may still be intact, but short-term memory fails. Other changes include:

• Difficulty sleeping
• Becoming less sociable and less aware of the feelings of others
• Needing help in making decisions
• Needing assistance with bathing, grooming, dressing
• Forgetting one’s own past history of personal events
• Personality changes, such as sudden mood shifts, anger, worry, or fearfulness

Abilities decline dramatically. Changes include:

• Inability to use language
• Becoming easily disoriented
• Incontinence
• Walking with a shuffle
• Frequent falls
• Showing minimal emotional response
• Immobility and pain
• Weight loss and inability to swallow
• Agitation, paranoia, hallucinations, delusions, and mood changes
• Difficulty sleeping