What to expect During the early stages of Alzheimer’s disease people may start to notice they become forgetful or have difficulty expressing themselves. People may lose their train of thought mid-sentence or need more time to respond to what others are saying. This is because Alzheimer's disease affects communication skills and makes it harder to find the right words and to understand others. It’s important to remember that although people living with early Alzheimer’s disease may have problems communicating they are still very aware of the people around them. Many of us don’t realise we speak loudly when we think we’re not being understood so remember to always talk in a normal voice and try not to argue.