The onset of Alzheimer's disease (AD) is usually subtle. Progression can be gradual or rapid unless treated. Most people do not recognize that AD is present until it is well established. Treatment may provide small improvements, but more commonly, treatment stabilizes remaining abilities, at least for a time.

AD patients develop difficulty learning and remembering new information (recent memory). Long-term memory is usually preserved early in the course of Alzheimer's disease, so people remember their distant past well. Sufferers experience increasing difficulty with complex tasks, are less able to think and reason well, and have noticeable problems with language and behavior.

In Alzheimer's disease:

• Recent or short-term memory is more impaired than distant or long-term memory.
• Planning, judgment and insight become impaired, but the individual is often unaware of these problems.
• Difficulty finding words progresses to problems forming sentences, and eventually speech may not make sense.
• Disorientation for date and time of day may occur.
• The person may get lost, especially in a place not visited often.
• Decreased interest in previously important and pleasurable activities progresses to apathy.
• Depression occurs in about one-half of patients and about one-quarter become delusional with firmly fixed but false beliefs.
• Agitation may occur later as the disease progresses and often necessitates nursing home or other facility care if not successfully managed with behavioral strategies or medications. Later still, other abnormalities of brain function such as problems walking or seizures may occur.

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