I’m Forgetting Names — Is That Normal?
We’ve all been there — you can’t remember someone’s name, even though they just told you. You can’t remember where you ate dinner for your anniversary (wait, what year did we just celebrate?). Your keys magically disappear around 7:50 a.m. every morning.
Is this normal? Is something wrong with my brain?
I have many patients ask me these questions. They’re worried about their memory and have a difficult time understanding where the line is drawn between normal memory lapses and actual cognitive decline. They want to know how to accurately test and track their memory over time.
I’d like to take the time to review memory and explain the difference between a memory lapse and memory loss. At the end, I’ll also highlight a way to test and track subtle memory changes associated with increased Alzheimer’s disease risk over time using a clinically validated testing platform that can be used at home.
Memory Lapses That Are Less Concerning for Alzheimer’s Disease
I hear concerns all the time about memory lapses and whether they’re warning signs of future cognitive decline. Here are some of the most common examples, along with my thoughts.
1. Forgetting Names
Names are arbitrary labels that provide little additional context about a person. To keep our memories sharp throughout our lives and allow quick retrieval of relevant details, our brains prioritize retaining information that has context or meaning.
The name “John” tells you very little about who John is. But if we associate details with his name — John’s son is friends with our son, John is a musician, or John likes cycling — we’re much more likely to remember it. This is why we can recognize faces, remember the setting in which we met someone, and recall important details about that person before their name finally comes to us.
2. Misplacing Objects
It can be anything, but we’ve all misplaced something and struggled to find it. Most of the time, misplacing items is less about memory storage and more about distraction.
When we set our keys down, our brains have to encode that information so we can retrieve it later. If you’re setting your keys down while thinking about 12 other things, talking on the phone, and carrying groceries, your brain simply may not have the bandwidth to remember where you put them. You can’t easily recall information that wasn’t strongly encoded in the first place.
If you’re constantly misplacing something, a simple solution is to verbally state what you’re doing: “I’m setting my keys down on the bedside table.” Saying it out loud can help your brain retain that information for later.
3. Delayed Recall
How many of us can’t remember the name of something, only to have it pop into our minds at 3 a.m. the next night? This is a common example of delayed retrieval: you eventually remember a detail, but it takes some time.
I’ve come across a very good analogy for what’s going on here.
Imagine that your brain is a library that grows over time as you learn new things and have new experiences. Although our library grows with age, we still have only one librarian. In a larger library, the librarian may take longer to find a specific book, but eventually, they find it!
The key feature that separates delayed retrieval from more concerning memory loss is that the information eventually comes back.
Memory Lapses That Are More Concerning
Although far less common than the examples above, some memory lapses can be more concerning for an underlying pathological process in the brain. They tend to be subtle but involve recurring gaps in memory that are often initially recognized by family members or close friends rather than by the person experiencing them.
There’s a spectrum of memory loss, from subtle changes, such as reduced precision when recalling details, to more obvious difficulties, such as losing track of time. The key feature here is the word recurring. We may experience some of the following memory lapses from time to time. What separates a normal lapse from a potentially concerning pattern is the frequency of these experiences, particularly when others begin to notice them.
Because I work in prevention and early intervention, I want to focus on the more subtle, early warning signs of memory changes.
1. Loss of Memory Precision
An increasingly studied feature of memory loss, reduced memory precision has been identified as a potential warning sign of early cognitive impairment.
With reduced memory precision, you may remember that a recent event happened, but your ability to recall the details becomes fuzzy, especially when distinguishing between similar, recurring events.
A common example is losing your car in a parking lot. You remember that you parked your car, but you have no idea where. Or you confuse where you parked yesterday with where you parked today.
2. Memory Binding Deficits
A close cousin of memory precision is memory binding. This type of memory difficulty involves the ability to properly link two or more details together. The pieces of information may be there, but the brain has difficulty connecting them appropriately.
You remember a conversation but attribute it to the wrong person, or you remember an appointment but repeatedly associate it with the wrong day.
3. Loss of Recall Despite Cueing
This refers to a reduced or complete inability to recall specific information, even after receiving a cue or hint.
With normal retrieval difficulty, a clue often unlocks the memory. Someone says, “We met at the park last week,” and suddenly everything clicks.
More concerning is when increasingly specific cues still fail to bring the memory back. This differs from delayed recall because the person is unable to retrieve the information, even with help.
To take our library analogy further, the problem isn’t that the librarian is slow; it’s that the book may have been misplaced or is missing, and the librarian simply cannot find it.
4. Subjective Memory Concerns
Lastly, if you or a loved one has concerns about memory, I take that very seriously.
Subjective memory concerns aren’t always caused by neurodegenerative disease. Sleep loss, stress, depression, medications, menopause, and many other factors can affect memory. However, a person’s sense that “my brain doesn’t work the way it used to” deserves attention.
As clinicians, we must listen carefully to the concerns our patients share. An old medical saying fits well here: “If you listen to the patient, they will tell you the diagnosis.”
How Do I Assess Memory Loss?
We have different ways of assessing memory loss, from forms you can complete at the doctor’s office to more rigorous, hours-long cognitive assessments.
Two of the most common tools in my practice are the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). These are useful, validated screening tools, particularly when cognitive impairment has become more established.
But in a preventative practice, I’m often trying to identify something much subtler: Has this person’s cognitive performance begun to change before they meet the threshold for mild cognitive impairment?
Brief screening tests can also be influenced by education, language, and baseline ability. A highly educated or high-functioning person may experience meaningful cognitive decline relative to their own baseline while still scoring within the “normal” range.
Authentic Health in Asheville, NC, has partnered with PREMAZ, a cognitive testing platform focused specifically on memory precision — one of the subtle aspects of memory that may begin to change early in the course of cognitive decline.
The assessment can be completed at home and gives us another way to evaluate memory function before more obvious impairment appears. We can also use this data to track cognitive performance over time, making it a helpful tool for monitoring changes longitudinally.
Although it isn’t a diagnostic tool for Alzheimer’s disease, it provides another piece of information to help us track brain health alongside other clinical measures.
Memory Loss Is Normal — Until It Isn’t
Not every memory lapse represents memory loss, so I hope this article helps ease your concerns about the common memory lapses that have nothing to do with dementia.
Forgetting a name, searching for your keys, or having a word finally come to you hours later can all be normal features of a busy, aging brain.
What concerns me more is a recurring change in the quality of memory itself: losing precision, confusing details, being unable to retrieve information even with help, or noticing a clear decline from your previous baseline.
Our brains are incredibly complex and are under enormous pressure to retain and recall information all the time. But when our memory starts to change in ways that affect our daily lives, it’s important to consult a clinician who can assess those changes and help support your brain health.
If you’re concerned about changes in your memory, Authentic Health in Asheville, North Carolina, can help you explore appropriate next steps for evaluating and supporting your cognitive health.