I was talking with a friend of mine recently who I have known for close to 25 years.  Our conversation flowed and we enjoyed uninterrupted memories until we tried to recall the names of several people.  We both stopped in our tracks.  We could describe the most exacting details about a given encounter, but were stuck trying to name the person – “Whatshizname!  You know – he wore plaid shirts and couldn’t park his car or make coffee …” Sound familiar?

This is called “tip-of-the-tongue” phenomena.

Many of my patients ask me, somewhat anxiously, whether or not this is a sign of Alzheimer’s.  I can happily say that, in and of itself, it is NOT!  While it has been studied, observed, and written about, we really don’t know why we are unable to recall a specific name.  It happens across the lifespan, and seems to happen more frequently as we age.


From our earliest babbling and repeating of sounds that appear to have no meaning at all, our brains are piecing together these elements and forming special connections between the thing and the word associated with it.  By repeating over and over, our brains systematically attach the thing to the word strengthening that connection.  One way to think of this wagon wheel tracks.

As we learn more and more words, parts of speech, and meanings, our brain develops connections and webs for recalling that respond to unconscious cues in nanoseconds.  This process of acquiring the name of the thing and then recalling the name of the thing are the building blocks of language.  It seems effortless, until we cannot remember the name of that thing!

There are a couple of theories about what happens with tip-of-the-tongue phenomena.  One suggests that in an attempt to retrieve the word, something happens that blocks the pathway.  Another theory suggests that we collect evidence and infer the name of the thing, but that evidence isn’t sufficient to actually recall the word.  Either way, we end up searching and trying to create prompts that will help us remember.

For example, many of us try using the alphabet to remember someone’s name.  When this doesn’t work, we give up and think we have a brain tumor or Alzheimer’s.  (Not really.)


What is going on here is how our memory retrieval systems change as we age.  There are any number of things that can interfere with recalling something.  It may be as simple as being tired, being dehydrated, or being anxious.  It may be due to worry, or trying to do too many things at once, or even side effects from caffeine, medications, or alcohol.

Memory, as we now understand it, actually consists of two parts – mapping the acquisition of the thing and using that map to recall the thing.  This is very different from what I first learned.  In the old days, we talked about our memory like it was a filing system.  We would categorize, sort, and then “file it away”.  In recalling something, all we needed to do was go to the right file and pull out the memory.

Turns out that was more reflective of how the scientists collected their information back then, not how the brain actually works.  What we hypothesize now is that our brain uses multiple webs and pathways to collect and distribute information and codes these in unique ways.  When we “recall” a memory, we are actually “re-membering”, or putting the code back together again, to recreate the experience in the moment.  (For more information on how scientists are studying this, check out this website.)

We use something called ‘metamemory’ to do this – remembering to remember.  Connections and associations that are used to re-member have varying strengths within our brain webs and pathways.  For example, you may be familiar with the concept of muscle memory.  Our physical body remembers how to do a thing that has been done multiple times.  Brushing your teeth is an example of this.


These kinds of memories are known as procedural memory (how something is done).  They are generally thought to have strong connections and well-developed networks within the brain.  Other kinds of memory are called semantic (meaning) and episodic (events).  These kinds of memory shape the ‘who’ and the ‘what’ of re-membering.

We acquire a memory by paying attention to something and then deciding whether it is important enough to recall it later.  We are apparently hard-wired to pay attention to faces more than names, so it is more likely we can recall what someone looks like than remember their name.

Tip-of-the-tongue phenomena happens when the naming portion of the memory doesn’t work.  You see the person’s face, you can recall the last time you saw them, what they were wearing, what you ate, the time and the temperature, but you can’t recall their name.

When should you be concerned about tip of the tongue phenomena?   Generally, this isn’t something to be worried about.  In some instances, when it is found along with other changes that have to do with learning new information or forgetting how to do things like brush your teeth, you may want to have your memory screened.  But in and of itself, you can relax.

In future blogs, I’ll talk about how cognitive functioning is measured and share insights into what we know and what we don’t know about keeping our brain healthy and working at its best.  In the meantime, relax, and give yourself a break – that name will come to you in a little bit.

Thanks for reading!