Remembering an experience and being emotionally affected by it are not the same thing.

Feelings can persist after the event that caused them has been forgotten.

Meaningful interactions matter even when they cannot later be recalled.

This has important implications for how we care for people living with dementia.

Imagine spending an afternoon with someone you dearly love. You sit outside in the sun, share some laughs, listen to yacht rock hits from the ’70s and sing all the lyrics with the kind of shared joy that can only emerge between the two of you. Maybe you share a latte and a piece of caramel cake.

An hour later, they have no explicit memory that you were there.

For families living with Alzheimer’s disease and other causes of significant brain change, experiences like this can be heartbreaking. When someone repeatedly forgets our visits, our conversations, and the things we have done together, it’s natural to wonder: Did it even matter?

As a caregiver turned board-certified neuropsychologist, I think science offers a reassuring answer.

Memory Is Not One Thing

We tend to think about memory as though it were a solitary ability: You either remember something or you don’t. The brain is much more complex than that.

Remembering how to cook a meatloaf, knowing how to ride a skateboard, recognizing your favorite love song, and experiencing the emotional effects of an encounter rely on overlapping but distinguishable brain systems.

Alzheimer’s disease, one of the most common causes of dementia, does not affect every part of the brain equally or at the same time. Early in the disease, there is often significant disruption of medial temporal brain systems, including the hippocampus, that are critical for forming and retaining new declarative memories: the conscious record of what happened, where it happened, and when. But those are not the only ways our brains register experience. Other neural systems contribute to emotion, familiarity, habits, reward, movement, and our responses to other people. These abilities can follow different trajectories as the disease progresses.

This helps explain something families often find puzzling: Someone may genuinely enjoy a visit from her sister but, a........

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