Severe Alzheimer's Dementia (AD) Symptoms

At this point in the disease, brain plaques (clusters of protein that destroy brain cells) and tangles (dying nerve cells that twist around one another), may appear on imaging tests of the brain. Both are hallmarks of AD. This is the final stage of AD. People at this stage lose control of physical functions and depend on others for care. They sleep more often and are unable to communicate or recognize loved ones.


Other symptoms of severe AD include:

  • Lack of bladder and bowel control

  • Weight loss

  • Seizures

  • Skin infections

  • Groaning, moaning, or grunting

  • Difficulty swallowing

  • Repetitive statements or movement, and occasional muscle twitches

  • Hallucinations, delusions, suspiciousness or paranoia, and irritability

  • Loss of impulse control, such as undressing at inappropriate times or places or using vulgar language

  • Exacerbation of behavioral symptoms, such as restlessness, agitation, anxiety, tearfulness, and wandering — especially in the late afternoon or evening — called “sundowning”

Due to the loss of physical function, people with late-stage AD may deal with complications. Difficulty swallowing can result in inhaling liquids into the lungs, which increases the risk of pneumonia. They may also suffer from malnutrition and dehydration. Limited mobility also increases the risk of bedsores.