Another quarter of patients have evidence of psychosis marked by delusions and hallucinations. Although usually occurring shortly after the onset of movement disorder, the dementia syndrome of HD may precede chorea by several years. Early cognitive impairments include word-finding difficulty as well as recent and remote amnesia. Fluent aphasia, agnosia, and apraxia, typical of Alzheimer's disease, are usually absent. As the disease progresses, frontal lobe deficits become prominent including impaired judgment, concentration, planning, and sequencing abilities.
Dysarthric speech is common.
As the disease progresses the movements become more pronounced and affect the entire body including the trunk. The gait is characterized by writhing and lurching movements. Involuntary movements become slower and blend together in an athetotic appearance. Dystonic postures occur. Dysphagia is common, and may lead to frequent aspirations.