Changes in behavior and personality in the Alzheimer's patient can be one of the most distressing aspects of the disease for friends, family and care givers.

A patient can suddenly start exhibiting the exact opposite behavior and personality as they have shown throughout their lives.

In addition, previously hidden or controlled personality traits such as spiteful behavior, a tendency to anxiety, nervousness or aggression (both verbal and physical) can surface mainly in the later stages.

While many Alzheimer sufferers can remain unchanged apart from the memory loss and orientation problems, others can have varying mood swings which can fluctuate from being ecstatically happy to very sad.

Personal hygiene can become a major issue with Alzheimer disease sufferers and their care givers, as washing and bathing is often forgotten or becomes very infrequent.

This may be especially surprising and upsetting when combined with a personality change where a patient who previously was very fastidious with their hygiene becomes very lax.

This can be very distressing for their friends and relatives, as clothing can be stained with urine or faeces leading to body odors.

Lewd public behavior such as undressing in public and flashing or fondling of genitals can also become a difficult problem for care givers to deal with if it is not carefully monitored.

The biggest challenge that these problems pose to care givers, friends and relatives is to remember that it is the disease that is causing this behavior and the most important thing is to maintain the patient's dignity at all times.

Dignity is a very precious commodity to own when suffering from Alzheimer's disease, as this is often all they have left.