As Alzheimer's progresses, it moves into the cerebral cortex, damaging areas in the temporal, frontal, and parietal lobes responsible for language, reasoning, perception, and judgment. An AD sufferer may find it more and more difficult to express herself and to understand what others are saying.
This is the stage in which many people with AD begin to behave in what seems to be bizarre or inappropriate ways. Increasingly confused by the world around her, her judgment diminished, a person with AD may be prone to emotional outbursts. She may be restless and agitated, particularly late in the day. Individuals with mid-stage AD may experience these symptoms:
Increased memory loss. Forgetfulness begins to interfere with daily activity. She has some problems recognizing friends and family and may not recall her own address and phone number. She forgets key events in her own life. Because memories are so important to the human sense of self, she begins to lose self-awareness.
Difficulty performing basic tasks like making tea or coffee. She may be overwhelmed by household chores.
Confusion. Increasingly disconnected from the world around her, she forgets current events in the world at large and her own life. She may think a show on TV is real, and confuse a plot with her own life.
Shortened attention span. She has difficulty reading, writing, and doing basic math.
Communication problems. She has trouble following conversations, and in gathering and expressing thoughts.
Visual-spatial disorientation. Many people with AD lose their sense of geography, spatial relations, and where their bodies are in relation to the physical world. She may be uncoordinated and awkward. She may have trouble setting a table or getting in and out of a car.
Loss of impulse control. She may curse, swear, and forget her table manners. She might refuse to dress appropriately either for an occasion or the weather and may undress spontaneously or even masturbate in public. She may behave amorously toward someone other than her spouse or mistake a stranger for her husband.
Anxiety and fearfulness.
Restlessness, pacing, and repetitive movements such as hand wringing and tissue shredding.
Hallucinations. A hallucination is a mistaken sensory perception of objects or events that seem real to a person but are not actually happening. The most common hallucinations are visual (seeing something that isn't there) and auditory (hearing something that isn't there), but taste, smell, and touch may also be involved.
Delusions, depression, and agitation. A delusion is a false or peculiar conviction a person firmly believes despite overwhelming evidence to the contrary. Common delusions among dementia patients involve suspicion — that people are hiding things or stealing from them — or that a spouse is having an affair.
Disrupted sleep cycle. She may take naps during the day and be active from late afternoon through the night.