Does the paranoia ever subside or does it keep getting worse with Alzheimer's dementia?

My husband had paranoia in the very earliest stage of his Lewy Body Dementia but not in the 9 years since that.

I doubt that there is a "standard" way paranoia presents itself. It varies by individual.

I'm sure every person's situation is different, but with my mother (who was a paranoid, suspicious person pre-dementia) it has changed over the years. She is now moderate-to-severe dementia and it is definitely less pronounced and less emotionally fueled. We also recently moved her (for the 3rd time in 4 months) and it is definitely much better in the memory-care residence she is now in. It is the most appropriate setting for her and I think that in part is why she is doing better. (And now I hope I have not jinxed everything by putting that in black and white! Ha!)