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Clinical Manifestations.

Darren M Lipnicki1, Meritxell Valentí2, Elizabeth Valeriano-Lorenzo3

  • 1Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney, Sydney, NSW, Australia.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
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Summary

Not remembering dreams may signal early Alzheimer's disease. Lower dream recall in older adults is linked to higher p-tau levels, APOE ε4 carriage, and faster cognitive decline.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Alzheimer's Disease Research

Background:

  • Dreaming is linked to the default mode network (DMN).
  • Alzheimer's disease pathology, including beta-amyloid plaques and tau tangles, affects the DMN early.
  • APOE ε4 carriage is also associated with early DMN dysfunction.

Purpose of the Study:

  • To investigate the association between dream recall in cognitively normal older adults and biomarkers of neurodegeneration (p-tau, APOE ε4).
  • To determine if dream recall predicts future cognitive decline.

Main Methods:

  • 1049 cognitively unimpaired older adults from the Spanish Vallecas Project.
  • Dream recall assessed via self-report; high blood p-tau217 and APOE ε4 carriage defined.
  • Cognition tracked using the Preclinical Alzheimer Cognitive Composite (PACCm) over 10 years.

Main Results:

  • 31% of participants reported no dream recall.
  • Higher p-tau217 and APOE ε4 carriage were linked to lower dream recall likelihood.
  • Non-recallers showed faster PACCm decline over 10 years compared to recallers.

Conclusions:

  • Dream recall is associated with Alzheimer's biomarkers and future cognitive decline in healthy older adults.
  • Not remembering dreams may serve as an early indicator of neurodegeneration in the DMN.
  • This finding supports earlier observations linking reduced dream recall to incident dementia.