Sudden noises often provoke fear in people with late-stage Alzheimer’s because their brains process sensory information differently and their ability to interpret and respond to the environment is impaired. In Alzheimer’s, the brain undergoes changes that affect memory, cognition, and emotional regulation. This means that unexpected loud sounds can be confusing and startling, triggering a fear response because the person may not understand what caused the noise or whether it signals danger.
As Alzheimer’s progresses, individuals have more difficulty filtering out irrelevant stimuli and managing their emotions. Sudden noises can overwhelm their senses, leading to heightened anxiety or agitation. Their impaired cognitive function makes it hard to contextualize the noise, so what might be a minor disturbance to others feels threatening to them. This is why common triggers like fireworks, doorbells, or alarms can cause distress.
Additionally, people with late-stage Alzheimer’s often experience sundowning, a phenomenon where confusion and agitation worsen in the late afternoon or evening. During these times, sensitivity to noise and other stimuli can increase, making sudden sounds even more likely to provoke fear.
Because communication abilities decline, those with Alzheimer’s may not be able to express their fear or understand reassurance, which can intensify their reaction. Caregivers can help by minimizing sudden loud noises, maintaining a calm environment, and using gentle, familiar cues to comfort and redirect attention when distress occurs. Creating a predictable routine and reducing sensory overload can also reduce fear responses linked to unexpected sounds.
