David PerlmutterPresident,, Perlmutter Health Center · Board-Certified Neurologist | Functional Medicine Pioneer | #1 New York Times Best-Selling Author | International Speaker | Host of The Empowering Neurologist Podcast

Why Alzheimer’s Affects Memory This Way

24 Apr 2026 · 1 min

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In this brief explanatory segment, Dr. David Perlmutter addresses why Alzheimer’s disease preferentially damages certain brain regions and why short‑term memory deteriorates earlier than long‑term memory. He proposes that the most energy‑intensive neural circuits are the first to succumb to the disease’s metabolic stress, leading to selective regional degeneration. He then explains that short‑term memory relies on rapid encoding and retrieval processes that are especially vulnerable to this degeneration, whereas long‑term memories—consolidated earlier in life—are more resilient, allowing patients to recall distant past events while forgetting recent activities.

Chapters

Why is it that some parts of the brain are much more susceptible to degeneration in Alzheimer's than other parts of the brain? It's a question we've been pondering for an awful long time, and I think it gets down to the energetics. I think those areas of the brain that are very highly energy-dependent seem to be those that degenerate first. But, you know, when it gets to memory, it seems that short-term memory is certainly affected much more than long-term memory. It's really quite common that we see individuals being able to remember, for example, memories from when they were in their teenage years and yet not remember what they did earlier that day. And I think that has to do with both the encoding of that information into short-term memory versus long-term, as well as the ability to retrieve that memory. And it really has to do with how susceptible those mechanisms are to the whole degenerative process.