Which of the following is the most common early presenting sign in Alzheimer's disease?

• A. Change in personality
• B. Loss of memory
• C. Depressed mood
• D. Multiple physical complaints

Answer: (B)

Memory loss, especially difficulty remembering recent events or learning new information, is the earliest and most characteristic sign of Alzheimer's disease. This early impairment reflects involvement of the hippocampus and medial temporal lobes, which are essential for encoding and retrieving new memories. As the disease progresses, other cognitive domains—language, attention, and visuospatial skills—become affected and daily functioning declines. Changes in personality or depressed mood can occur as the disease evolves or may be due to other conditions, but they are not the initial hallmark of Alzheimer’s. Multiple physical complaints are not typical early features of a neurodegenerative process. So memory loss best captures the initial deficit that drives the early presentation.