The symptoms of moderate Alzheimer's disease are in large part an increase in the severity of the symptoms of the first stage. Professional and social functioning continue to deteriorate because of increasing problems with memory, logic, speech, and initiative. The frustration resulting from these diminishing capacities will likely exacerbate the behavioral symptoms often associated with Alzheimer's disease.
Sleep disorders, including disruptions in the sleep/wake cycle and sundowning begin to become a problem as a person progresses through the middle stage of the disease. Light therapy and aromatherapy can be useful tools to treat sleep disorders.
Inappropriate judgment becomes a bigger concern and can become a real safety issue. Hygiene might be neglected, and incontinence should be watched for. There will likely be a loss in initiative - the affected person will not think to start anything or to do anything. The caregiver's role must become more proactive at this point, helping the care-receiver start and continue with an activity.