In this stage, more intensive supervision and care become necessary, which can be difficult for many spouses and families. Symptoms may include:

• Increased memory loss and confusion
• Inability to learn new things.
• Difficulty with language and problems with reading, writing, and working with numbers.
• Difficulty organizing thoughts and thinking logically.
• Shortened attention span.
• Problems coping with new situations.
• Difficulty carrying out multistep tasks, such as getting dressed.
• Problems recognizing family and friends.
• Hallucinations, delusions, and paranoia
• Impulsive behavior such as undressing at inappropriate times or places or using vulgar language.
• Inappropriate outbursts of anger
• Restlessness, agitation, anxiety, tearfulness, wandering—especially in the late afternoon or evening.
• Repetitive statements or movement, occasional muscle twitches.

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