Are “Tip-of-the-Tongue” Moments Normal or a Cause for Concern?

Q. Not long ago, I used to have a great command of the English language, but now I keep forgetting simple words during a conversation. I’ll be having a conversation, then stop because a word is on the tip of my tongue. Sometimes I’ll find it after an awkward pause. Other times I stammer through a few synonyms until the person offers the word for me. This is just so frustrating, and frankly it has me worried about my memory.

I can’t see any reason why I would forget certain words. They typically aren’t difficult words, either. If I’m tired or nervous, I can forget basic words like “sandwich” or “umbrella.” Once, when I was with my husband at a nice restaurant, I couldn’t remember the word, “pepper,” so I had to ask him to pass “the spicy salt!”

Should I be worried about this? My family does have a history of Alzheimer’s, but I’m only 47. Perhaps forgetting words here and there is just part of the aging process? Thanks so much in advance for clarifying!

A. Most of us have experienced “tip-of-the-tongue” moments where we are mid-conversation and forget the word we wanted to say. This is typically normal and becomes more prominent with age. It can often worsen when people feel anxious, excited, depressed, or even sleep deprived. Sometimes, it can, in fact, be a symptom of a neurodegenerative disease, such as Alzheimer’s or another form of dementia. The question weighing on everyone’s mind who experiences it: when is word-finding difficulty caused by a neurodegenerative disease, and when is it normal?

“Tip-of-the-Tongue” Moments Happen to Everyone

Tip-of-the-tongue moments are so common, they even have a scientific name lethologicabut are typically referred to as simply a tip-of-the-tongue (ToT) phenomenon by language scientists. Researchers say these types of memory recall glitches occur for nearly everyone, young and old, and in any language. In fact, surveys suggest that nine out of 10 people experience them.  

Older Adults Have More Tip-of-the-Tongue Moments than Others

You may have noticed that these moments occur more as you get older. Several studies have found that younger adults had trouble recalling a word or item about once a week. For older adults, it was closer to once a day!

“Not being able to recall a word or name is certainly annoying. But usually, that’s all it is,” says geriatrician Taimur Habib, MD. “For most people, it’s not a sign of something worse.”

Here are some normal signs of an aging brain:

Occasional difficulty finding words.
Forgetting the names of acquaintances.

You’re worried about your memory, but your loved ones are not.

Don’t despair if any of these things are happening to you. These memory recall issues are normal for an aging brain. The brain is a complicated organ, and with age, certain parts shrink. Some areas may show a decrease in blood flow, and neural connections can wear down. Inflammatory response to illness or injury can be more pronounced. This can take a toll on memory. For most people, these age-related changes show up in frustrating but generally harmless ways. You may forget the name of a former colleague, misplace your car keys or phone every now and then, or take longer to learn something new. Most of the time, that’s nothing to worry about.

Research Proves that Tip-of-the-Tongue Lapses Are Typically Not Linked to Dementia

Tip-of-the-tongue lapses do not indicate an increased risk of dementia, research from the University of Virginia has found. Researchers asked more than 700 participants, ages 18 to 99, to give the names of famous places, common nouns, or famous people, based on brief descriptions or pictures. The volunteers indicated which answers they knew, which they did not, and which gave them a tip-of-the-tongue experience.

Several descriptions were particularly likely to induce such a moment like “what is the name of the building where one can view images of celestial bodies on the inner surface of a dome?” and “what is the name of the large waterfall in Zambia that is one of the Seven Wonders of the World?”

Overall, older participants experienced more of these frustrating moments. But there was no association between the frequency of tip-of-the-tongue occurrences and their performance on the types of memory tests often used in the detection of dementia.

According to Dr. Timothy Salthouse, Professor of Psychology at the University of Virginia, “(e)ven though increased age is associated with lower levels of episodic memory and with more frequent tip of the tongue experiences, the two phenomena seem to be largely independent of one another.”

When It’s Time to Talk to a Doctor

It’s normal to forget things once in a while as we age, but serious memory problems make it hard to do everyday things. In general, when memory issues start to interfere with your daily life, it’s time to see your doctor. The following are indicators that it’s time to see a professional about memory lapses:

Forgetting the names of family members.
Memory issues affect your ability to complete normal tasks.
You’re asking the same questions over and over again.

Your loved ones are worried about your memory, but you haven’t noticed any problems.

Your doctor can help you get to the bottom of what’s going on — or reassure you that you’re simply experiencing the normal effects of aging.

Could Aphasia Be the Reason for Forgetting Words?

At least 180,000 Americans are diagnosed with aphasia every year, and it’s estimated that some 2 million Americans have it; it’s more prevalent than Parkinson’s disease, cerebral palsy, multiple sclerosis, muscular dystrophy, and Lou Gehrig’s disease combined. Actor Bruce Willis and former congresswoman Gabrielle Giffords are perhaps the most famous people to have publicly acknowledged their aphasia. The damage from aphasia is variable and involves different deficits unique to each person. For Bruce Willis, his aphasia later turned into a diagnosis of Lewy Body Dementia. Read more about him and aphasia in my recent article here. Read about his later diagnosis of Lewy Body Dementia here.

If You Are Concerned About Dementia. . .

Dementia is not a normal part of aging. It includes the loss of cognitive functioning — thinking, remembering, learning, and reasoning — to the extent that it interferes with a person’s quality of life and activities. Memory loss is not the only sign of dementia. People with dementia may also have problems with executive functioning including decision-making, language skills, visual perception, or paying attention. Some people have personality changes.

If you or a loved one have been diagnosed with dementia, it is prudent to start your planning as soon as possible. If you have not done Incapacity Planning, Long-Term Care Planning, or Estate Planning (or had your Planning documents reviewed in the past three to five years), now is a good time to plan and get prepared!

Plan in Advance if You Have a Loved One with Dementia  

At the Farr Law Firm, we are dedicated to easing the financial and emotional burden on those suffering from all forms of dementia and their loved ones. We help protect your family’s assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. If you have a loved one who has been diagnosed with Alzheimer’s or another form of dementia, please call us to make an appointment:  

Northern Virginia Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797  

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.