Which mid-late sign of Alzheimer's dementia reflects a decline in ability to organize, plan, or abstract?

The correct choice reflects a significant aspect of cognitive decline observed in individuals with mid to late-stage Alzheimer's dementia. As the disease progresses, a person's executive functioning deteriorates, affecting their ability to organize, plan, or abstract thoughts. This decline manifests as decreased ability for self-care, where individuals struggle with managing daily tasks such as personal hygiene, meal preparation, and medication management, which require a higher level of cognitive processing.

In contrast, other considerations like incontinence can arise from various factors related to the advanced stage of the disease but are not directly indicative of impaired planning and organizational skills. Aphasia primarily pertains to language difficulties, affecting communication rather than organization or planning capabilities. Lastly, while loss of sense of time might occur, it does not directly correlate with the structured, abstract, and organizational skills that self-care tasks require.

Therefore, decreased ability for self-care is the most fitting sign that reflects the decline in the ability to organize, plan, or abstract, demonstrating the cognitive challenges individuals face as Alzheimer's dementia progresses.