Some Alzheimer’s patients develop fear or suspicion toward people they have known for a long time, even close family members or friends. This happens because Alzheimer’s disease affects the brain’s ability to recognize and interpret familiar faces and emotions. The parts of the brain responsible for memory and emotional processing deteriorate, making it harder for patients to connect the face they see with the person they know. This can cause confusion and anxiety, leading them to feel afraid or mistrustful of those who are actually familiar to them.
Additionally, Alzheimer’s can impair the ability to read emotional cues like facial expressions and tone of voice. A neutral or tired expression from a loved one might be misread as anger or hostility, which can increase fear or paranoia. The patient’s brain struggles to process these social signals correctly, so even gentle or caring behavior might be misunderstood. This emotional confusion can make familiar people seem strange or threatening.
Mood swings and heightened emotional sensitivity are common in Alzheimer’s patients. Small changes in environment or routine, or even simple misunderstandings, can trigger strong reactions like fear or suspicion. The disease also causes difficulty in regulating emotions, so feelings of fear can become intense and persistent without clear reasons.
Because of these changes, Alzheimer’s patients may sometimes react with fear toward people they once trusted deeply. It’s important for caregivers and family members to respond with patience, warmth, and clear, gentle communication. Using calm tones, smiling, and giving simple, one-step directions can help reduce confusion and build a sense of safety. Understanding that these fearful reactions are symptoms of the disease—not personal rejection—can help families cope with these difficult moments.
In essence, the fear some Alzheimer’s patients feel toward familiar people stems from the brain’s impaired ability to recognize faces and emotions, combined with increased emotional sensitivity and confusion caused by the disease.
