Alzheimer’s disease is the leading cause of dementia worldwide, affecting 10% of people over 65. People with Alzheimer’s experience memory loss, behavioral changes, and progressive cognitive decline. The disease process takes a long time, with symptoms only becoming noticeable after decades. There are several early warning signs of Alzheimer’s, however. By noticing these changes early, patients can work with their loved ones and care teams to make plans and lifestyle changes to support their care as the disease progresses.

A portrait of an older woman in front of a dark background, looking off into the distance.

 What are early Alzheimer’s disease warning signs?

The symptoms of middle- and late-stage Alzheimer’s disease are very noticeable. In contrast, the signs of preclinical and early-stage Alzheimer’s are subtle. These manifest primarily as mild cognitive impairment (MCI) and psychological changes.

Note that many of these symptoms occur during normal aging. If you notice too many of these symptoms, however, you should consider contacting your doctor about getting screened.

Mild cognitive impairment and early Alzheimer’s warning signs

MCI is when a person’s mental ability begins to decline but is not severe enough to be dementia. But, MCI can get in the way of day-to-day activities and responsibilities.

Memory loss is a crucial symptom of MCI and early-stage Alzheimer’s disease. People with MCI often forget newly learned information. This symptom can make it difficult to follow through on plans. For example, a person might ask the same question repeatedly because they forgot the answer, and it may have slipped their mind that they had already asked it once. Likewise, they may struggle to remember names or the week’s day. MCI also makes it easy to misplace objects, which can be particularly frustrating.

People with MCI and early-stage Alzheimer’s also face issues with thinking and planning. For example, they may struggle with complex tasks, especially new ones. Even familiar tasks can be a problem, resulting in missed appointments and late paying bills.

Psychological and neurological Alzheimer’s early warning signs

In addition to cognitive changes, many people with early Alzheimer’s disease experience psychological symptoms. Research has found that anxiety and depression later in life are potential warning signs of Alzheimer’s disease. Take special note if the symptoms appear when no significant life changes occur.

People with early Alzheimer’s sometimes develop behavioral changes. They may become more frustrated than usual at minor events. Some people begin to act more impulsively or erratically than they did earlier in life. In other cases, the person’s emotions may be more intense than usual. Or, they may have uncharacteristic lapses in judgment.

Finally, vision problems are sometimes an early indicator of Alzheimer’s disease. Eyesight changes include decreased peripheral vision and sensitivity to visual contrast. People with early or preclinical Alzheimer’s often have difficulties with pupil dilation.

It is difficult to identify many of these changes in oneself. As a result, loved ones are usually the first to notice these changes. If you have a loved one with a family history of Alzheimer’s, be aware of these warning signs.

How can I get tested for early-stage Alzheimer’s disease?

If you or a loved one are experiencing these symptoms, you may want to get screened for Alzheimer’s. Cognitive assessments can help determine if a person is developing Alzheimer’s disease or has cognitive decline. The Mini-Mental Status Exam (MMSE) is the most common type of assessment, followed by the Montreal Cognitive Assessment (MoCA).

In these tests, clinicians ask patients a series of questions. The clinician may ask about the day of the week or current events and have the patient repeat a series of words. The questions measure a person’s language skills, problem-solving ability, attention, processing, and knowledge. The doctor then scores and interprets the test results. If the score falls in a specific range, the patient likely has cognitive deficits.

Doctors can usually identify cognitive impairment with one or more cognitive assessments. If not, patients may take a complete neuropsychological exam. These exams are much longer and more involved than cognitive assessments. Some versions can take an entire day, and they give clinicians more information to make a diagnosis.

How can someone prepare for a cognitive assessment?

While a cognitive exam is not something one “studies” for, patients and their loved ones can plan. Family members should write down details of their loved one’s symptoms. Doing this will help the doctor build a personal history for the patient. The patient can take notes about the issues they struggle with. Doing so is especially important, as they may not remember every detail at the visit.

One of the most important things loved ones can do is support the person undergoing the assessment. The process of testing can be stressful, and getting the news you may have Alzheimer’s is emotionally challenging. While such a diagnosis is always severe, catching it early sets patients up for the best care and quality of life.