Dementia is a condition that affects the brain in many ways, but one of the most noticeable and often distressing changes is how it impacts a person’s ability to remember names. This is something that many families and friends observe as the disease progresses. When someone has dementia, especially Alzheimer’s disease, they may struggle to recall the names of people they know well, even close family members or lifelong friends. This is not just about forgetting a name here and there, but a deeper difficulty in accessing and using information that was once familiar and easy to recall.
The reason this happens lies in how dementia damages the brain. The brain is made up of billions of nerve cells, or neurons, that communicate with each other through complex networks. These networks are responsible for storing and retrieving memories, including the names of people. In dementia, especially Alzheimer’s disease, these networks begin to break down. One of the key areas affected is the hippocampus, which is crucial for forming and retrieving memories, including the ability to recognize faces and recall names [1]. When the hippocampus is damaged, the brain struggles to connect the right name to the right person, even if the person is very familiar.
Recent research has shown that the loss of certain structural supports around brain cells, called perineuronal nets (PNNs), may play a role in this process. These nets are like protective mesh structures that help stabilize the connections between nerve cells. In Alzheimer’s disease, these nets begin to break down, especially in a part of the hippocampus called CA2, which is important for recognizing familiar people and social cues [1]. When these nets break down, the brain’s ability to recognize and remember names is weakened. Studies in mice have shown that when these nets are artificially removed, the animals lose their ability to recognize familiar companions, and when the nets are allowed to regrow, the ability to recognize names and faces returns [1]. This suggests that the breakdown of these structural supports is a key factor in the loss of name recall in dementia.
Another important aspect is the role of enzymes called matrix metalloproteinases (MMPs). These enzymes are more active in the brains of people with Alzheimer’s disease, leading to the excessive breakdown of the perineuronal nets. When researchers treated mice with a drug that blocks these enzymes, the nets were preserved, and the loss of social recognition, including the ability to recall names, was delayed [1]. This finding is significant because it opens up new possibilities for treatments that could help preserve the ability to recall names and other social memories in people with dementia.
In addition to these structural changes, dementia also affects the precision of memory. Memory precision refers to how detailed and accurate a memory is. In the early stages of dementia, even before a person starts to forget names completely, their memories may become less detailed and less accurate. This means that they might remember that they know someone, but the details, such as the person’s name, may be fuzzy or hard to access [2]. This loss of memory precision can be detected years before traditional memory tests would show any problems, making it a valuable tool for early detection of dementia [2].
The loss of name recall in dementia is not just about the hippocampus and perineuronal nets. Other brain regions, such as the prefrontal cortex, are also involved. The prefrontal cortex is responsible for short-term memory and attention, and when it is affected by dementia, it can make it even harder to recall names and other information [2]. This is why people with dementia may have trouble following conversations, remembering recent events, or finding the right words to use in speech [6].
It is also important to note that the loss of name recall in dementia is not the same as normal age-related forgetfulness. While it is common for older adults to occasionally forget a name, in dementia, this forgetfulness is more frequent and more severe. It can also be accompanied by other symptoms, such as difficulty concentrating, misplacing items, and problems with language and communication [6]. These symptoms can be distressing for both the person with dementia and their loved ones, but understanding the underlying causes can help in finding ways to support and care for them.
In summary, dementia affects the ability to recall names by damaging the brain’s networks and structural supports, reducing memory precision, and impacting other brain regions involved in memory and language. Research into these mechanisms is ongoing, and new treatments may one day help to preserve the ability to recall names and other important memories in people with dementia [1, 2, 6].
[1] https://thepathologist.com/issues/2025/articles/november/why-do-alzheimers-patients-forget-their-loved-ones/
[2] https://www.medicaldevice-network.com/comment/study-uncovers-the-first-subtle-sign-of-dementia/
[6] https://www.alzheimersresearchuk.org/news/spotting-early-signs-that-could-be-dementia-when-should-you-worry/
