Symptoms of familial Alzheimer's disease
Last Reviewed: Feb 22, 2026Before symptoms start
People with familial Alzheimer's disease (FAD) experience changes in the brain many years before they begin to show symptoms. In some cases, these changes can be detected through laboratory tests, neuropsychological tasks, and specific brain imaging techniques. This stage prior to the onset of symptoms is known as the preclinical phase.
Researchers are currently working to understand how these preclinical brain changes are related to the appearance of symptoms.
Common symptoms of Alzheimer’s disease
Like sporadic Alzheimer’s disease, FAD starts with changes in how a person thinks or acts. Common symptoms include:
Memory Problems: Forgetting recently learned information, important dates, or events; asking repetitive questions or having repetitive conversations.
Difficulty Solving Problems: Trouble handling tasks like paying bills or following recipes.
Confusion: Losing track of time, dates, or even seasons.
Difficulty with Words: Struggling to find the right words in conversations or while writing.
Misplacing Items: Losing or hiding belongings and being unable to retrace steps to find them.
Decreased Judgment: Making poor decisions, like giving away money irresponsibly.
Social Withdrawal or Apathy: Losing interest in hobbies, social activities, or interacting with friends and family—activities that were previously enjoyed.
Mood Changes: Becoming angry more easily than before, feeling anxious, or experiencing sudden mood swings.
Motor Changes: Difficulty with the ability to write, stiffness in the legs when walking, or other difficulties performing coordinated movements.
Since symptoms of FAD often start between age 30 and 50, doctors may not always suspect Alzheimer’s disease. Alzheimer's disease can be confused at the onset of symptoms with depression, because some of these symptoms (e.g., memory problems, impaired judgment, and social withdrawal) can occur in both conditions.
Learn more about how Alzheimer’s is diagnosed.
Symptoms unique to familial Alzheimer's disease
There are certain symptoms which arise more often in FAD than in sporadic Alzheimer’s disease. These symptoms include:
Spastic Paraparesis: Muscle stiffness and mild weakness in the legs.
Seizures: Sudden, uncontrolled electrical activity in the brain causing physical convulsions.
Myoclonus: Quick, involuntary muscle twitches.
Parkinsonism: Movement abnormalities such as tremors, slow movement, and muscle stiffness.
Intracerebral Hemorrhages: Bleeding within the brain.
Language Impairment: More pronounced difficulties with speech and understanding language.
Hallucinations: Seeing or hearing things that aren't really there.
Hypertonia: Increased muscle tension and reduced flexibility
Late stage symptoms
As the disease progresses, symptoms become severe and profoundly affect daily life. Late-stage FAD can be challenging for families and caregivers, as individuals become fully dependent for all aspects of care. Adequate medical and social support is essential for managing these late-stage symptoms.
Physical Decline: Inability to walk, difficulty swallowing causing increased susceptibility to infections like pneumonia
Cognitive Symptoms: Inability to recognize close family members, loss of communication skills, high levels of confusion and disorientation.
Behavior Changes: More frequent agitation and aggression, lack of cooperation, and hallucinations, illusions, or delusions, such as believing things are being stolen from them or that their home is not their home.
Daily Life Impact: Total dependence on others for basic personal grooming, hygiene, feeding, and bladder and bowel control.
Neurological Signs: More frequent seizures, muscle stiffness or twitching.
Taking care of someone with FAD
Caring for a person with FAD begins with small steps, such as making sure their bills are up to date and helping them with personal shopping. The person may become disoriented in familiar places, so home modifications and locators may be needed to prevent unplanned outings and reduce the risk of getting lost. Gradually, caregiving becomes more demanding, as they begin to need help with everyday activities such as bathing, dressing, walking, and eating.
If you are caring for a person with FAD, it can be very helpful to connect with other caregivers who understand the challenges and can share their experiences.
Learn more in our guide for caregivers.