It happens to all of us at one time or another. We’re in a conversation when and suddenly can’t remember the name of someone very familiar to us. We might even be able to visualize their face or remember the first letter of their name. It doesn’t even have to be a person’s name – it can be an object. There’s a name for this: The Tip of The Tongue Phenomenon, or TOT. I kid you not. The French term this Presque vu, for “almost seen.”

Reference to TOT appeared in non-academic literature as early as 1885 when Chekhov mentioned it in a short story. Harvard psychologists Roger Brown and David McNeill reported the first empirical investigation of the tip-of-the-tongue state in 1998. They recounted, "[t]he signs of it were unmistakable" and "he [a research participant] would appear to be in mild torment, something like on the brink of a sneeze, and if he found the word his relief was considerable." They reported that TOT is a fairly universal phenomenon occurring about once a week but will increase in frequency with age. While experiencing TOT we are often able to access the first letter of the intended word as well as remember related words.

Okay, but what causes it to happen?

Although it is safe to say no one knows for certain, the literature includes hypotheses that include both the psycholinguistic and memory oriented. Psycholinguists can get wrapped around the axel debating non-testable hypotheses, so I’ll not go into those. Suffice it to say from what I’ve been able to read about TOT, it appears to be like a temporary mild form of aphasia. We know the word but can’t pull it from memory. It’s frustrating and, often, the more we try, the more elusive the word is. And it’s usually after we stop trying the word pops back to the surface like a submerged balloon.

What we do know for sure is TOT happens at all age groups and becomes more frequent with age. This again suggests a memory problem because studies suggests that older adults remember less information about the intended word and thus have more difficulty resolving the TOT experience when it happens. It is a harbinger of dementia? Probably not. But like everything else, the symptom must be taken within the context of the broader neuropsychological examination.