People with Alzheimer’s disease sometimes talk to people who aren’t actually there because of changes happening in their brain. Alzheimer’s affects memory and how the brain processes reality, which can cause confusion and hallucinations. When someone with Alzheimer’s talks to an imaginary person, it might be because their brain is trying to make sense of things it can no longer clearly remember or understand.
As the disease progresses, parts of the brain that control memory and perception start to break down. This can lead to a mix-up between what is real and what is imagined. For example, if a person feels lonely or scared, they might create conversations with someone who isn’t physically present as a way to comfort themselves or feel less isolated.
Sometimes these “people” are memories from the past—like old friends or family members—that seem very real in the moment. The person may not realize these figures aren’t actually there because their ability to distinguish between past memories and current reality has weakened.
Another reason could be related to hallucinations caused by sensory changes in the brain. Just like some people with vision loss experience visual hallucinations when their brains try to fill in missing information, those with Alzheimer’s may experience auditory or visual hallucinations that lead them to hear voices or see people who aren’t present.
This behavior isn’t meant as deception; rather, it reflects how deeply Alzheimer’s affects cognition and perception. Talking aloud—even if no one else is there—can also help patients express feelings they cannot otherwise communicate due to language difficulties caused by dementia.
In essence, when Alzheimer’s patients talk to unseen people, it’s often a natural response of a damaged brain trying desperately for connection and understanding amid confusion and fading memories.
