This study examined the quality of emotional responsivity in mid-to late-stage dementia patients. Eighty-two nursing home patients with a DSM-III-R diagnosis of primary degenerative dementia of the Alzheimer type served as subjects. Patients were staged using the Global Deterioration Scale. The level and type of patient affectivity were assessed by family reports, aide reports, and direct observation and coding of patient facial expressions during a family visit. All three measures indicated that patients with Alzheimer's disease expressed a range of affective signals. Some showed an intact and functional emotion system even during the last stage of the disease; one third of end-stage dementia patients expressed sadness at the departure of their relatives as coded by an objective facial affect coding system.