5 Early Speech-Related Signs of Alzheimer’s

Language is a powerful window into how our brains are working. Subtle changes in the way we speak and use words can often be one of the earliest indicators of Alzheimer’s disease.

While occasional forgetfulness is normal, consistent difficulties with speech or language can signal that something more serious may be going on. Here are five early signs to look out for:

1. Pauses, hesitations, and vagueness

One of the most recognisable signs is struggling to recall specific words. This can lead to frequent or lengthy pauses mid-sentence. When the word doesn’t come, a person may speak vaguely instead — using phrases like “that thing” or “you know what I mean” rather than naming the item directly.

2. Using the wrong words

In the early stages of Alzheimer’s, people may substitute one word for another. Sometimes it’s a related word — for example, saying “cat” when they meant “dog.” Other times, they use a broader category, like saying “animal” instead of “cat.” These substitutions can be subtle at first, but grow more frequent over time.

3. Talking about a task instead of doing it

Completing everyday tasks can feel overwhelming. Instead of getting started, someone may begin to verbalise their doubts, saying things like, “I don’t think I can do this” or “I’m not sure what comes next.” This hesitation can sometimes replace the action itself.

4. Reduced word variety

Another early sign is a noticeable narrowing of vocabulary. Rather than using a wide range of words, people begin relying heavily on common ones. This leads to repetition — the same adjectives, nouns, or verbs — while less familiar or more complex words fall away.

5. Difficulty finding words in categories

When asked to name examples from a group — like foods, colours, or body parts — a person with Alzheimer’s may struggle. This difficulty is sometimes used as part of cognitive testing, and it reflects the challenges the brain has in retrieving stored information.

Why these signs matter

Spotting these changes early matters. While no single sign confirms Alzheimer’s, patterns of language difficulty can be an early warning signal worth exploring with a GP or specialist. Early recognition gives families more time to plan, access support, and consider treatments that may help.