Communication of all kinds becomes difficult as written and spoken language ability dwindles. Withdrawal from family members begins and the person may become agitated, displaying belligerence and a denial of the illness. In the last stages of the disease, people with Alzheimer's become bedridden, unable to recognize themselves or their closest family members. They may make small, purposeless movements and communicate only by screaming out occasionally. Essentially, the brain forgets how to live.
Death often results from pneumonia and from complications of immobility.
So diagnosis of Alzheimer's rests largely on the judgment of physicians experienced in dealing with dementing illnesses. But that judgment has become quite sophisticated. Since there are so few treatments for Alzheimer's disease, many of the available therapies attempt to improve the quality of patients' lives, keep them safe, and make caring for them easier. The primary care doctor will closely watch the progress of the person with Alzheimer's to check for medical complications, adjust medications to reach the lowest effective dosage, and assess any changes in drugs used. The doctor may do mental status tests routinely to chart the course of the illness.