# Can Dementia Make People Forget How To Use A Key
Dementia is a condition that affects the brain in many different ways. One of the most troubling aspects of dementia is how it can change a person’s ability to do everyday tasks that they have done for decades without thinking. The question of whether dementia can make someone forget how to use a key is an important one, and the answer involves understanding how the disease affects different parts of the brain and different types of memory.
The short answer is yes, dementia can eventually make people forget how to use a key, but this typically happens in the later stages of the disease. To understand why, we need to look at what happens in the brain when dementia develops and how different types of memory work.
## How Memory Works in the Brain
The human brain stores different types of information in different ways. There is memory for facts and events, memory for how to do things, and memory for people and social connections. When we learn how to use a key, we are creating what is called procedural memory or motor memory. This is the type of memory that helps us remember how to ride a bike, tie our shoes, or use a key without having to think about each step.
Procedural memory is different from other types of memory because it is stored in different parts of the brain. While facts and events are stored mainly in the hippocampus and related structures, procedural memory involves the cerebellum and other motor areas of the brain. This is why someone with dementia might forget what they had for breakfast but still remember how to walk or use familiar objects, at least in the early stages of the disease.
## Early Signs of Dementia and Memory Loss
Research from the University of Cambridge has shown that memory problems in dementia start much earlier than most people realize. The study found that subtle memory decline can begin as early as the late 30s and 40s, decades before traditional cognitive screening tools show any problems [1]. However, these early changes are very subtle and involve what researchers call memory precision, which means that memories become less detailed and less accurate even when people can still remember the basic facts.
In the early stages of dementia, people typically experience problems with recent memory first. They might forget conversations they just had, repeat the same question multiple times, or misplace items like car keys in unusual places [2]. They might struggle to remember the names of objects around the house or have difficulty concentrating on daily tasks [2]. At this stage, they would still know how to use a key because procedural memory is usually preserved longer than other types of memory.
## The Progression of Dementia and Functional Abilities
As dementia progresses, it affects more and more of the brain. The disease involves the buildup of abnormal proteins called amyloid plaques and tau tangles that interfere with normal brain function [4]. These proteins damage and kill brain cells, and the damage spreads to different areas of the brain over time.
In the middle stages of dementia, people begin to have more significant problems with thinking and planning. They might start missing appointments, struggling with money and managing finances, or showing confusion about what day it is [2]. They might have problems with forward planning and following instructions, like shopping and cooking [2]. At this stage, some people might begin to have difficulty with more complex tasks that require multiple steps or planning.
However, using a key is still a relatively simple motor task, and many people with moderate dementia can still perform it, especially if they have used the same key in the same lock for many years. The brain has practiced this action thousands of times, and procedural memory can be quite resistant to the effects of dementia, at least compared to other types of memory.
## When Procedural Memory Begins to Fail
It is in the later stages of dementia that procedural memory begins to break down more noticeably. By this point, the disease has caused significant damage to many parts of the brain, including areas that control movement and coordination. People in the later stages of dementia might have difficulty with coordination, increased unsteadiness, or limb stiffness [2]. They might have problems with their gait or the way they walk [2].
When these motor and coordination problems develop, using a key becomes more difficult. A person might not be able to hold the key steady, insert it into the lock properly, or turn it with the right amount of force. They might forget the sequence of steps involved, or they might not understand what the key is for anymore. At this stage, they would likely need help from a caregiver to open doors.
## The Role of Different Brain Systems
Different types of memory and different abilities are controlled by different parts of the brain. Research has shown that short-term memory precision is related to the prefrontal cortex, while long-term memory precision is related to the hippocampus [1]. The hippocampus is the area most commonly associated with Alzheimer’s disease, which is the most common cause of dementia [1].
Motor skills and procedural memory, on the other hand, are controlled by the cerebellum and other motor areas of the brain. These areas are often affected later in the course of dementia than the hippocampus and prefrontal cortex. This is why people with early to moderate dementia often retain the ability to perform familiar motor tasks even when their memory for facts and events is severely impaired.
However, as dementia progresses and spreads to more areas of the brain, eventually even these motor skills can be affected. The person might forget not just how to use a key, but also how to perform other familiar tasks like eating with utensils, brushing their teeth, or getting dressed.
## Social Memory and Recognition
Another important aspect of dementia that can affect how people interact with objects is the loss of social memory. Recent research has found that Alzheimer’s patients can forget loved ones because of the breakdown of protective neuronal nets that safeguard social memory [3]. These structures, called perineuronal nets, are mesh-like coatings around neurons that maintain proper communication and support social memory formation [5].
When these nets break down, people with Alzheimer’s disease can lose the ability to recognize family members and friends, even though they might still retain other types of memory [3]. In mouse studies, researchers found that animals with faulty nets lost their ability to remember other mice, their social memory, even as they could still form new memories of objects in their environment [3].
This loss of social memory and recognition could indirectly affect how someone uses a key. For example, if a person no longer recognizes their home or their family members, they might not understand why they need to use a key to open a door. They might not remember that the door leads to their home or that they live there. This confusion about place and identity can make the task of using a key seem meaningless or confusing, even if the motor ability to turn the key is still intact.
## When to Seek Help
