Processing Faces in Alzheimer’s Disease Patients: How a Familiar Face Becomes Unfamiliar

  • Elizabeth Gregory University of Vcitoria
Keywords: Alzheimer's, Dementia, Face recognition, Theory of Mind


Alzheimer’s disease, a progressive neurodegenerative disorder, is the most pervasive form of dementia worldwide. Impairment in face processing is a common trait of the disorder, causing a deficit not only in the processing of emotional expressions, but also causes a deficit in face recognition. Research into the neural causes of impaired face recognition in Alzheimer’s disease patients has found several factors at play: Abnormal temporal lobe activation in response to familiar faces, a breakdown in holistic processing of faces due to changes in frontal lobe activation, and atrophy of areas of the brain implicated in theory of mind. These neural changes are evident long prior to any differences in behavior. Due to the progressive nature of Alzheimer’s disease, patients will display increasing levels of impairment in face recognition over time. At the final stages of the disorder, patients lose all ability to recognize familiar faces, and most strikingly, lose the ability to self-recognize. Further research on face recognition in Alzheimer’s disease may improve our knowledge both in neurotypical face recognition, as well as aid in discovering novel ways of helping patients cope with their symptoms.

Author Biography

Elizabeth Gregory, University of Vcitoria
Department of psychology, 3rd year undergraduate combined major in biology and psychology in the faculty of science


Bediou, B., Ryff, I., Mercier, B., Milliery, M., Henaff, M., D’Amato, T., Bonnefy, M., Vighetto, A., and Krolak-Salmon, P. (2009). Impaired social cognition in mild Alzheimer’s disease. Journal of Geriatric Psychiatry and Neurology, 22(2), 130-140. DOI:


Biringer, F., and Anderson, J. R. (1992). Self-recognition in Alzheimer’s disease: a mirror and video study. J Gerontol., 47(6), 385-388.

Cheng, P.J., and Pai, M. C. (2010). Dissociation between recognition of familiar scenes and of faces in patients with very mild Alzheimer disease: An event-related potential study.

Neurophysiology, 121(9), 1519-1525. DOI: 10.1016/j.clinph.2010.03.033

Dohnel, K., Schuwerk, T., Meinhardt, J., Sodian, B., Hajak, G., and Sommer, M. (2012). Functional activity in the right temporo-parietal junction and of the medial prefrontal cortex associated with true and false belief reasoning. Neuroimage, 60(3), 1652-1661.

DOI: 10.1016/j.neuroimage.2012.01.073

Donix, M., Jurjanz, L., Meyer, S., Amanatidis, E. C., Baumler, D., Huebner, T., Poettrich, K., Smolka, M. N., and Holthoff, V. A. (2012). Functional imaging during recognition of personally familiar faces and places in Alzheimer’s disease. Archives of Clinical

Neuropsychology, 28(1), 72-80. DOI: 10.1093/arclin/acs093

Golberg, I. I., Harel, M., and Malach, R. (2006). When the brain loses its self: Prefrontal inactivation during sensorimotor processing. Neuron, 50(2), 329-339. DOI: 10.1016/j.neuron.2006.03.015

Hawley, K. S., and Cherry, K. E. (2004). Space-retrieval effects on name-face recognition in older adults with probable Alzheimer’s disease. Behavior Modification, 28(2), 276-296.

DOI: 10.1177/0145445503259283

Hodges, J. R., Salmon, D. P., and Butters, N. (1993). Recognition and naming of famous faces in Alzheimer’s disease: A cognitive analysis. Neuropsychologia, 31(8), 775-788. DOI:


Irani, F., Platek, S. M., Panyavin, I. S., Calkins, M. E., Kohler, C., Siegel, S. J., Schachter, M., Gur, R. E., and Gur, R. C. (2006). Self-face recognition and theory of mind in patients with schizophrenia and first-degree relatives. Schizophrenia Research, 88(1), 151-160.

DOI: 10.1016/j.schres.2006.07.016

Kawagoe, T., Matsushita, M., Hashimoto, M., Ikeda, M., and Sekiyama, K. (2017). Face-specific memory deficits and changes in eye scanning patterns among patients with amnestic mild

cognitive impairment. Scientific Reports, 7, 14344. DOI: 10.1038/s41598-017-14585-5

Kurth, S., Moyse, E., Bahri, M. A., Salmon, E., and Bastin, C. (2015). Recognition of personally familiar faces and functional connectivity in Alzheimer’s disease. Cortex, 67, 59-73.

DOI: 10.1016/j.cortex.2015.03.013

Lavallee, M. M., Gandini, D., Rouleau, I., Vallet, G. T., Joannette, M., Kergoat, M., Busigny, T., Rossion, B., and Joubert, S. (2016). A qualitative impairment in face perception in Alzheimer’s disease: Evidence from a reduced face inversion effect. Journal of

Alzheimer’s Disease, 51(4), 1225-1236. DOI: 10.3233/JAD-151027

Moreau, N., Rausy, S., Viallet, F., and Champagne-Lavau, M. (2016). Theory of mind in Alzheimer disease: Evidence of authentic impairment during social interaction. Neuropsychology, 30(3): 312-321. DOI: 10.1037/neu0000220

Norton, D. J., Baena, A., Pulsifier, B., Lopera, F., and Quiroz, Y. T. (2016). Face-name recognition memory in preclinical autosomal-dominant Alzheimer’s disease: An fMRI study. Alzheimer’s & Dementia, 12(7), P525. DOI: 10.1016/j.jalz.2016.06.1029

Pant, R., Mukhopadhyay, S., and Lakshmayya, B. (2014). Review on Alzheimer’s disease: A neurodegenerative disorder. International Journal of Pharmaceutical Research and

Biomedical Analysis, 3(2): 1-19.

Ramon, M., Vizioli, L., Liu-Shang, J., and Rossion, B. (2015). Neural microgenesis of personally familiar face recognition. PNAS, 112(35), E4835-E4844. DOI: 10.1073/pnas.1414929112

Reisberg, B., Ferris, S. H., de Leon, M. J., Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry, 139(9), 1136-1139. DOI:


Richier, J. J., Cheung, O. S., and Gauthier, I. (2011). Holistic processing predicts face recognition. Psychological Science, 22(4), 464-471. DOI: 10.1177/0956797611401753

Rossion, B., Schiltz, C., & Crommelinck, M. (2003). The functionally defined right occipital and fusiform “face areas” discriminate novel from visually familiar faces. NeuroImage, 19(3), 877-883. DOI: 10.1016/S1053-8119(03)00105-8

Taubert, J., Apthorp, D., Aagten-Murphy, D., and Alais, D. (2011). The role of holistic processing in face perception: Evidence from the face inversion effect. Vision Research, 51(11), 1273-1278. DOI: 10.1016/j.visres.2011.04.002

Visser, P. J., Verhey, F. R. J., Hofman, P. A. M., Scheltens, P., and Jolles, J. (2002) Medial temporal lobe atrophy predicts Alzheimer’s disease in patients with minor cognitive impairment. Journal of Neurology, Neurosurgery & Psychiatry, 72, 491-497. DOI:


Werheid, K. and Clare, L. (2007). Are faces special in Alzheimer’s disease? Cognitive conceptualisation, neural correlates, and diagnostic relevance of impaired memory for faces and names. Academic Pediatrics, 43(7), 898-906. DOI: 10.1016/S0010-


Wong, S. L., Gilmour, H., and Ramage-Morin, P. L. (2016). Alzheimer’s disease and other dementias in Canada, Statistics Canada Health Reports, 27(5).