Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Analysis
  • Published:

Emotional enhancement of memory in Alzheimer’s disease dementia: a systematic review

Nature Mental Health volume 3, pages 1078–1087 (2025)Cite this article

Subjects

Abstract

Progressive decline in episodic memory is a hallmark of Alzheimer’s disease (AD). Emotional arousal is known to enhance memory. Enhanced encoding of emotionally arousing stimuli or events may improve memory in patients with AD; however, whether this effect is present in patients with AD remains unclear. Here we conducted a systematic search of the literature to identify relevant literature on emotional enhancement of memory in AD. Inclusion criteria were studies that (1) included individuals with Alzheimer’s disease and (2) assessed emotional memory, particularly episodic memory. Thirty-five studies were included. Twelve out of 35 studies (34.3%) showed clear emotional enhancement of memory for episodic memory among participants with mild AD, while 13 studies (37.1%) found no effect. Ten studies (28.6%) found that emotional enhancement of memory was influenced by stimuli type, valence of emotion, level of encoding or intensity of emotion. Studies including brain imaging showed that amygdala and hippocampus volume are strong predictors of emotional enhancement of memory in AD, regardless of level of cognitive impairment. Evaluating volumes or networks of brain regions known to be involved in emotional memory processing may be a key factor influencing the preservation of enhanced encoding of emotional information. Future studies are needed to confirm whether atrophy of memory-related brain regions diminishes emotional enhancement of memory in AD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Study selection process.

Similar content being viewed by others

Data availability

No primary data are included in this study. Study data were extracted from MEDLINE and PsycInfo and are publicly available through these databases.

References

  1. Scheltens, P. et al. Atrophy of medial temporal lobes on MRI in ‘probable’ Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates. J. Neurol. Neurosurg. Psychiatry 55, 967–972 (1992).

    Article  PubMed  PubMed Central  Google Scholar 

  2. McKhann, G. M. et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 7, 263–269 (2011).

    Article  PubMed  Google Scholar 

  3. Chen, Y., Chen, T. & Hou, R. Locus coeruleus in the pathogenesis of Alzheimer’s disease: a systematic review. Alzheimers Dement. 8, e12257 (2022).

    Google Scholar 

  4. Hämmerer, D. et al. Locus coeruleus integrity in old age is selectively related to memories linked with salient negative events. Proc. Natl Acad. Sci. USA 115, 2228–2233 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  5. McGaugh, J. L. The amygdala modulated the consolidation of memories of of emotionally arousing experiences. Annu. Rev. Neurosci. 27, 1–28 (2004).

    Article  PubMed  Google Scholar 

  6. Poulin, S. P., Dautoff, R., Morris, J. C., Barrett, L. F. & Dickerson, B. C. Amygdala atrophy is prominent in early Alzheimer’s disease and relates to symptom severity. Psychiatry Res. Neuroimaging 194, 7–13 (2011).

    Article  Google Scholar 

  7. Sterpenich, V. et al. The locus ceruleus is involved in the successful retrieval of emotional memories in humans. J. Neurosci.26, 7416–7423 (2006).

    Article  PubMed  PubMed Central  Google Scholar 

  8. LeDoux, J. E. Emotional memory systems in the brain. Behav. Brain Res. 58, 69–79 (1993).

    Article  PubMed  Google Scholar 

  9. Comblain, C., D’Argembeau, A. & Van der Linden, M. Phenomenal characteristics of autobiographical memories for emotional and neutral events in older and younger adults. Exp. Aging Res. 31, 173–189 (2005).

    Article  PubMed  Google Scholar 

  10. Phelps, E. A. Human emotion and memory: interactions of the amygdala and hippocampal complex. Curr. Opin. Neurobiol. 14, 198–202 (2004).

    Article  PubMed  Google Scholar 

  11. Pi, G. et al. Posterior basolateral amygdala to ventral hippocampal CA1 drives approach behaviour to exert an anxiolytic effect. Nat. Commun. 11, 183 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  12. Paz, R., Pelletier, J. G., Bauer, E. P. & Paré, D. Emotional enhancement of memory via amygdala-driven facilitation of rhinal interactions. Nat. Neurosci. 9, 1321–1329 (2006).

    Article  PubMed  Google Scholar 

  13. Lemon, N., Aydin-Abidin, S., Funke, K. & Manahan-Vaughan, D. Locus coeruleus activation facilitates memory encoding and induces hippocampal LTD that depends on β-adrenergic receptor activation. Cereb. Cortex 19, 2827–2837 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jacobs, H. I. L. et al. Dynamic behavior of the locus coeruleus during arousal-related memory processing in a multi-modal 7T fMRI paradigm. eLife 9, e52059 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  15. Clewett, D. V., Huang, R., Velasco, R., Lee, T.-H. & Mather, M. Locus coeruleus activity strengthens prioritized memories under arousal. J. Neurosci. 38, 1558–1574 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tully, K. & Bolshakov, V. Y. Emotional enhancement of memory: how norepinephrine enables synaptic plasticity. Mol. Brain 3, 15 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  17. Atucha, E. et al. Noradrenergic activation of the basolateral amygdala maintains hippocampus-dependent accuracy of remote memory. Proc. Natl Acad. Sci. USA 114, 9176–9181 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  18. Phelps, E. A. & LeDoux, J. E. Contributions of the amygdala to emotion processing: from animal models to human behavior. Neuron 48, 175–187 (2005).

    Article  PubMed  Google Scholar 

  19. Ateş, F. E. et al. Frontal activity during a verbal emotional working memory task in patients with Alzheimer’s disease: a functional near-infrared spectroscopy study. Psychiatry Res. Neuroimaging 261, 29–34 (2017).

    Article  PubMed  Google Scholar 

  20. Sara, S. J. Locus coeruleus in time with the making of memories. Curr. Opin. Neurobiol. 35, 87–94 (2015).

    Article  PubMed  Google Scholar 

  21. Dutt, S., Li, Y., Mather, M., Nation, D. A. & Alzheimer’s Disease Neuroimaging Initiative. Brainstem volumetric integrity in preclinical and prodromal Alzheimer’s disease. J. Alzheimers Dis. 77, 1579–1594 (2020).

  22. Mather, M. & Harley, C. W. The locus coeruleus: essential for maintaining cognitive function and the aging brain. Trends Cogn. Sci. 20, 214–226 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chen, M.-S., Chen, W.-R., Ho, H.-H. & Lin, S.-C. Effect of stimuli type on affective memory of patients with different severities of cognitive impairment. Aging Ment. Health 27, 1226–1232 (2023).

    Article  PubMed  Google Scholar 

  24. Gao, Z. et al. Sex-dependent changes in emotional memory associated with cerebral blood flow alterations during Alzheimer’s disease progression. Neuroradiology 65, 751–763 (2023).

    Article  PubMed  Google Scholar 

  25. Li, X. et al. Impaired white matter connections of the limbic system networks associated with impaired emotional memory in Alzheimer’s disease. Front. Aging Neurosci. 8, 250 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nieuwenhuis-Mark, R. E., Schalk, K. & de Graaf, N. Free recall and learning of emotional word lists in very elderly people with and without dementia. Am. J. Alzheimers Dis. Other Dement. 24, 155–162 (2009).

    Article  Google Scholar 

  27. Tombaugh, T. N. & McIntyre, N. J. The Mini‐Mental State Examination: a comprehensive review. J. Am. Geriatr. Soc. 40, 922–935 (1992).

    Article  PubMed  Google Scholar 

  28. Schultz, R. R., de Castro, C. C. & Bertolucci, P. H. F. Memory with emotional content, brain amygdala and Alzheimer’s disease. Acta Neurol. Scand. 120, 101–110 (2009).

    Article  PubMed  Google Scholar 

  29. Guzmán-Vélez, E., Feinstein, J. S. & Tranel, D. Feelings without memory in Alzheimer disease. Cogn. Behav. Neurol. 27, 117–129 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  30. Guzmán‐Vélez, E., Warren, D. E., Feinstein, J. S., Bruss, J. & Tranel, D. Dissociable contributions of amygdala and hippocampus to emotion and memory in patients with alzheimer’s disease. Hippocampus 26, 727–738 (2016).

    Article  PubMed  Google Scholar 

  31. Baran, Z., Cangöz, B. & Ozel-Kizil, E. T. The impact of aging and Alzheimer’s disease on emotional enhancement of memory. Eur. Neurol. 72, 30–37 (2014).

    Article  PubMed  Google Scholar 

  32. Blessing, A., Keil, A., Linden, D. E. J., Heim, S. & Ray, W. J. Acquisition of affective dispositions in dementia patients. Neuropsychologia 44, 2366–2373 (2006).

    Article  PubMed  Google Scholar 

  33. Kazui, H., Mori, E., Hashimoto, M. & Hirono, N. Enhancement of declarative memory by emotional arousal and visual memory function in Alzheimer’s disease. J. Neuropsychiatry Clin. Neurosci. 15, 221–226 (2003).

    Article  PubMed  Google Scholar 

  34. Fleming, K., Kim, S. H., Doo, M., Maguire, G. & Potkin, S. G. Memory for emotional stimuli in patients with Alzheimer’s disease. Am. J. Alzheimers Dis. Other Dement. 18, 340–342 (2003).

    Article  Google Scholar 

  35. Hamann, S. B., Monarch, E. S. & Goldstein, F. C. Memory enhancement for emotional stimuli is impaired in early Alzheimer’s disease. Neuropsychology 14, 82–92 (2000).

    Article  PubMed  Google Scholar 

  36. Sava, A.-A., Krolak-Salmon, P., Delphin-Combe, F., Cloarec, M. & Chainay, H. Memory for faces with emotional expressions in Alzheimer’s disease and healthy older participants: positivity effect is not only due to familiarity. Aging Neuropsychol. Cogn. 24, 1–28 (2017).

    Article  Google Scholar 

  37. Sava, A.-A. et al. Emotional memory enhancement in respect of positive visual stimuli in Alzheimer’s disease emerges after rich and deep encoding. Cortex 65, 89–101 (2015).

    Article  PubMed  Google Scholar 

  38. Perrin, M. et al. Influence of emotional content and context on memory in mild Alzheimer’s disease. J. Alzheimer’s Dis. 29, 817–826 (2012).

    Article  Google Scholar 

  39. Philippi, N. et al. Impaired emotional autobiographical memory associated with right amygdalar–hippocampal atrophy in Alzheimer’s disease patients. Front. Aging Neurosci. 7, 21 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  40. Sundstrøm, M. Modeling recall memory for emotional objects in Alzheimer’s disease. Aging Neuropsychol. Cogn. 18, 396–413 (2011).

    Article  Google Scholar 

  41. Nashiro, K. & Mather, M. Effects of emotional arousal on memory binding in normal aging and Alzheimer’s disease. Am. J. Psychol. 124, 301–312 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  42. Boller, F. et al. Processing emotional information in Alzheimer’s disease: effects on memory performance and neurophysiological correlates. Dement. Geriatr. Cogn. Disord. 14, 104–112 (2002).

    Article  PubMed  Google Scholar 

  43. Landré, L. et al. Effects of emotionally-rated material on visual memory in Alzheimer’s disease in relation to medial temporal atrophy. J. Alzheimers Dis. 36, 535–544 (2013).

    Article  PubMed  Google Scholar 

  44. Mistridis, P. et al. Distinct neural systems underlying reduced emotional enhancement for positive and negative stimuli in early Alzheimer’s disease. Front. Hum. Neurosci. 7, 939 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  45. Kumfor, F., Irish, M., Hodges, J. R. & Piguet, O. The orbitofrontal cortex is involved in emotional enhancement of memory: evidence from the dementias. Brain 136, 2992–3003 (2013).

    Article  PubMed  Google Scholar 

  46. Kumfor, F., Irish, M., Hodges, J. R. & Piguet, O. Frontal and temporal lobe contributions to emotional enhancement of memory in behavioral-variant frontotemporal dementia and Alzheimer’s disease. Front. Behav. Neurosci. 8, 225 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  47. Parra, M. A. et al. Medial temporal lobe function during emotional memory in early Alzheimer’s disease, mild cognitive impairment and healthy ageing: an fMRI study. BMC Psychiatry 13, 76 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  48. Ally, B. A. Using pictures and words to understand recognition memory deterioration in amnestic mild cognitive impairment and Alzheimer’s disease: a review. Curr. Neurol. Neurosci. Rep. 12, 687–694 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  49. Nelson, D. L., Reed, V. S. & Walling, J. R. Pictorial superiority effect. J. Exp. Psychol. Hum. Learn. 2, 523–528 (1976).

    Article  PubMed  Google Scholar 

  50. Carstensen, L. L., Fung, H. H. & Charles, S. T. Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motiv. Emot. 27, 103–123 (2003).

    Article  Google Scholar 

  51. Spaniol, J., Voss, A. & Grady, C. L. Aging and emotional memory: cognitive mechanisms underlying the positivity effect. Psychol. Aging 23, 859–872 (2008).

    Article  PubMed  Google Scholar 

  52. Mather, M. & Carstensen, L. L. Aging and motivated cognition: the positivity effect in attention and memory. Trends Cogn. Sci. 9, 496–502 (2005).

    Article  PubMed  Google Scholar 

  53. Baudouin, J.-Y., Gilibert, D., Sansone, S. & Tiberghien, G. When the smile is a cue to familiarity. Memory 8, 285–292 (2000).

    Article  PubMed  Google Scholar 

  54. Mather, M. The emotion paradox in the aging body and brain. Ann. NY Acad. Sci. 1536, 13–41 (2024).

    Article  PubMed  Google Scholar 

  55. Bennett, D. A. et al. Neuropathology of older persons without cognitive impairment from two community-based studies. Neurology 66, 1837–1844 (2006).

    Article  PubMed  Google Scholar 

  56. Schneider, J. A., Arvanitakis, Z., Leurgans, S. E. & Bennett, D. A. The neuropathology of probable Alzheimer disease and mild cognitive impairment. Ann. Neurol. 66, 200–208 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  57. Heilman, K. M. & Nadeau, S. E. Emotional and neuropsychiatric disorders associated with Alzheimer’s disease. Neurotherapeutics 19, 99–116 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  58. Botto, R., Callai, N., Cermelli, A., Causarano, L. & Rainero, I. Anxiety and depression in Alzheimer’s disease: a systematic review of pathogenetic mechanisms and relation to cognitive decline. Neurol. Sci. 43, 4107–4124 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  59. Mori, E. et al. Amygdalar volume and emotional memory in Alzheimer’s disease. Am. J. Psychiatry 156, 216–222 (1999).

    Article  PubMed  Google Scholar 

  60. Nelson, P. T. et al. The amygdala as a locus of pathologic misfolding in neurodegenerative diseases. J. Neuropathol. Exp. Neurol. 77, 2–20 (2018).

    Article  PubMed  Google Scholar 

  61. Mattsson, N. et al. Emerging β-amyloid pathology and accelerated cortical atrophy. JAMA Neurol. 71, 725 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  62. Devanand, D. P., Lee, S., Huey, E. D. & Goldberg, T. E. Associations between neuropsychiatric symptoms and neuropathological diagnoses of Alzheimer disease and related dementias. JAMA Psychiatry 79, 359 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  63. Robinson, J. L. et al. Pathological combinations in neurodegenerative disease are heterogeneous and disease-associated. Brain 146, 2557–2569 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  64. Matej, R., Tesar, A. & Rusina, R. Alzheimer’s disease and other neurodegenerative dementias in comorbidity: a clinical and neuropathological overview. Clin. Biochem. 73, 26–31 (2019).

    Article  PubMed  Google Scholar 

  65. Beach, T. G. & Malek-Ahmadi, M. Alzheimer’s disease neuropathological comorbidities are common in the younger-old. J. Alzheimers Dis. 79, 389–400 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  66. Husain, M. Transdiagnostic neurology: neuropsychiatric symptoms in neurodegenerative diseases. Brain 140, 1535–1536 (2017).

    Article  PubMed  Google Scholar 

  67. Jack, C. R. et al. Introduction to the recommendations from the National Institute on Aging‐Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 7, 257–262 (2011).

    Article  PubMed  Google Scholar 

  68. Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2022); https://doi.org/10.1176/appi.books.9780890425787

  69. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research vol. 2 (World Health Organization, 1993).

  70. Baumeister, R. & Vohs, K. Encyclopedia of Social Psychology (SAGE Publications, 2007); https://doi.org/10.4135/9781412956253

  71. Abrisqueta-Gomez, J., Bueno, O. F. A., Oliveira, M. G. M. & Bertolucci, P. H. F. Recognition memory for emotional pictures in Alzheimer’s patients. Acta Neurol. Scand. 105, 51–54 (2002).

    Article  PubMed  Google Scholar 

  72. Budson, A. E. et al. False recognition of emotional word lists in aging and Alzheimer disease. Cogn. Behav. Neurol. 19, 71–78 (2006).

    Article  PubMed  Google Scholar 

  73. Chainay, H. et al. Impaired emotional memory enhancement on recognition of pictorial stimuli in Alzheimer’s disease: no influence of the nature of encoding. Cortex 50, 32–44 (2014).

    Article  PubMed  Google Scholar 

  74. Kalenzaga, S., Piolino, P. & Clarys, D. The emotional memory effect in Alzheimer’s disease: Emotional words enhance recollective experience similarly in patients and control participants. Cogn. Emot. 29, 342–350 (2015).

    Article  PubMed  Google Scholar 

  75. Kazui, H. et al. Impact of emotion on memory: Controlled study of the influence of emotionally charged material on declarative memory in Alzheimer’s disease. Br. J. Psych. 177, 343–347 (2000).

    Article  Google Scholar 

  76. Kensinger, E. A., Anderson, A., Growdon, J. H. & Corkin, S. Effects of Alzheimer disease on memory for verbal emotional information. Neuropsychologia 42, 791–800 (2004).

    Article  PubMed  Google Scholar 

  77. Kensinger, E. A., Brierley, B., Medford, N., Growdon, J. H. & Corkin, S. Effects of normal aging and Alzheimer’s disease on emotional memory. Emotion 2, 118 (2002).

    Article  PubMed  Google Scholar 

  78. Maria, G. G. & Juan, G. G. Negative bias in the perception and memory of emotional information in Alzheimer disease. J. Geriatr. Psychiatry Neurol. 30, 131–139 (2017).

    Article  PubMed  Google Scholar 

  79. Moayeri, S. E., Cahill, L., Jin, Y. & Potkin, S. G. Relative sparing of emotionally influenced memory in Alzheimer’s disease. NeuroReport 11, 653–655 (2000).

    Article  PubMed  Google Scholar 

  80. Satler, C. et al. Emotional arousal enhances declarative memory in patients with Alzheimer’s disease. Acta Neurol. Scand. 116, 355–360 (2007).

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by National Institutes of Health grants (grant nos. R01AG064228, R01AG060049, R01AG082073 and P01AG052350, to D.A.N.) and the American Heart Association (grant no. 23PRE1014192, to A.K.).

Author information

Authors and Affiliations

  1. Department of Psychological Science, University of California, Irvine, Irvine, CA, USA

    Arunima Kapoor

  2. Davis School of Gerontology, Department of Psychology, University of Southern California, Los Angeles, CA, USA

    Mara Mather & Daniel A. Nation

  3. Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Daniel A. Nation

Authors
  1. Arunima Kapoor
    View author publications

    Search author on:PubMed Google Scholar

  2. Mara Mather
    View author publications

    Search author on:PubMed Google Scholar

  3. Daniel A. Nation
    View author publications

    Search author on:PubMed Google Scholar

Contributions

A.K.: formal analysis, data curation, writing – original draft. D.A.N.: writing – review and editing, supervision. M.M.: writing – review and editing.

Corresponding authors

Correspondence to Arunima Kapoor or Daniel A. Nation.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature Mental Health thanks Samuel Warren and the other, anonymous reviewer(s) for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kapoor, A., Mather, M. & Nation, D.A. Emotional enhancement of memory in Alzheimer’s disease dementia: a systematic review. Nat. Mental Health 3, 1078–1087 (2025). https://doi.org/10.1038/s44220-025-00470-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s44220-025-00470-y

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing