It’s on our minds – how can we stay sharp and ward off memory loss, even Alzheimer’s?
Never before have people been so aware of their memories. Nervous about aging and especially about Alzheimer’s, we’ve started to wonder what kind of memory is normal at any stage of life. Even those of us with perfectly satisfactory memories want to improve them. A huge industry has grown up around people’s fears and hopes in this department. The good news is that we understand much better than we used to how memory operates within the brain and how we can strengthen it throughout outlives. The bad news is that the so-called quick cures are pretty much useless. There’s nothing out there that can give you a superhuman memory or even prevent you from forgetting where you put your keys.
What constitutes a normal memory it turns out, is extremely variable. Part of it is genetic. I was perpetually astonished, when I worked in politics, to see people who routinely met thousands of constituents and remembered the names and lives of every one. Bill Clinton would run into a woman he hadn’t seen in ten years and ask her how her son was doing and whether he was still so interested in airplanes. You are born with that or you’re not. At the opposite extreme is a friend who recently failed to recognize a woman he dated for a year in college. Imaging techniques are making it possible to see what’s going on in the brains of people as they recall things, but we haven’t yet figured out why some people remember so much better than others. Pharmaceutical companies are working assiduously, so far without tangible results, to find agents that will enhance memory It’s known that stimulants used to treat attention deficit disorder boost short-term memory, but their effect on longer-term memory is less clear, and the side effects (addiction, nervousness, interrupted sleep) indicate that this may not be the best way forward. Some medications being developed for Alzheimer’s may have potential as general memory enhancers, but these are not yet approved. The drugs currently in use for Alzheimer’s only slow the progress of the disease; they don’t improve memory per se, or cause the growth of new synapses.
In the meantime, a bull market in natural remedies thrives. Maui Tacos, a restaurant in New York City, offers a Memory Petro shake, which the menu describes as “an unforgettable blend of pineapple, strawberry kiwi sorbet, ginkgo biloba, and Smoothie Island Energy.” Senior Moment, available in liquid-filled capsules, promises that its brain-specific nutrients (derived from pork) will help maintain memory at a low dose or improve it at a higher dose (you pick). The Memory Solution, by Julian Whitaker, MD, proposes that one can boost memory by taking B-complex vitamins, choline, folic acid, vitamin E, vitamin C, vitamin A, betacarotene, and coenzyme Q10. Whitaker is also the coauthor of Shed 10 Years in 10 Weeks – and if you think that’s feasible, then by all means, pursue these suggestions as well.
The best-known natural remedy for memory is ginkgo biloba, which has domestic sales of more than $100 million a year. Although some studies have suggested a benefit, The Journal of the American Medical Association published a large study last August indicating that the herb has absolutely no positive effect on memory in healthy people. Further, ginkgo has been reported to cause excessive bruising and bleeding, as well as dangerously low blood pressure, heartburn, nausea, headaches, and dizziness – even blood clots surrounding the brain.
Courses and books offering memory improvement strategies also abound, and though some may help slightly many only waste your time and money. Mega Memory System’s “breakthrough techniques were developed while working with blind and mentally handicapped students [whose] recall ability increased from 15 percent to 90 percent in just five days,” according to the infomercial. These techniques, it promised, would help anyone to achieve a photographic memory The Federal Trade Commission declared that Mega Memory System would do no such thing, and demanded its developer, Kevin Trudeau, stop making false claims about his products. But Trudeau is still freely selling his Mega Memory CDs and tapes online, boasting “in just two or three days you’ll be performing prodigious feats of memory.”
So far, the most effective way to heighten memory appears to be through learned techniques that have been developed and tested over years of practical and clinical experience. Samuel Johnson said, “The true art of memory is the art of attention,” and this does appear to be the case. Being conscious about attention is extremely important; you have to listen to what is said to you, say it back (aloud or to yourself), repeat it as often as possible in the minutes or hours after learning it (if you meet a woman at a function, you should say her name every time you speak to her: “Hi, Sally”; “What do you think of that, Sally?”; “Sally you do seem to have a lovely wit”), and focus on remembering it. Often the things you forget are the things you never embedded in memory in the first place. The lapse is not of memory but of initial concentration.
Once you’ve absorbed information by paying attention, it helps to associate. If you can connect your new memory to older memories, you hold on to information better. There are various methods that seem to work. For example, it’s easier to remember narrative than lists of information, so the idea is to make up a story that uses everything you want to remember: “The evil queen stole the apple from the Princess of Tides” might remind you to buy apples before going to the beach with your mother-in-law.
Another system, called chunking, is based on the fact that it is hard for the mind to absorb more than five to nine new pieces of information at once. I have a terrible memory for phone numbers but have remembered one friend’s – 646-3752 – since she told me that it consists of a six, then three pairs of numbers that connote ten (4+6, 3+7, and 5×2). You can remember a long number by associating each digit with a consonant and then using vowels to turn the sequence into words. Or you can remember a series of words by making a new word from the first letters of all the words you need to remember. In a toast at a friend’s wedding this summer, I praised the bride’s scholarship, charm, refinement, and diligence, which I remembered by thinking “scrod.” It would be nice to say that you could just do such exercises for a month and acquire the skills to remember everything, but in fact all these operations take daily practice and maintenance. If you don’t have the will or the patience for these elaborate devices, remember that there’s one fully reliable and universally acknowledged memory booster: Write things down.
Forgetting As We Grow Older
Alzheimer’s disease appears to involve an accumulation of strings and clumps of protein – tangles and plaques – in the brain, which eventually consume it. Tangles and plaques can begin to develop ten to 20 years before any obvious symptoms. The point at which they start to have an effect is undetermined, however, and maybe different from person to person. Some people can, develop a whole brain full of them and never show symptoms of Alzheimer’s disease. This seems to be partly a function of fundamental genetics and partly a function of how well developed one’s mind is, how sharp, agile, active, social, and well nourished.
We have not worked out, so far, the relationship between Alzheimer’s and ordinary age-related forgetfulness. The mechanism causing severe symptoms is often not clear until autopsy. Meanwhile, scientists have been hypothesizing for years about whether the healthy brain retains elasticity as it ages or slowly dies and depletes itself. There does now seem to be substance to the idea that the brain can grow new cells and make new adaptations in later life. Persistent neurogenesis, long thought to be only a fantasy, has been documented by Fred Gage, PhD, a world-renowned scientist who currently works at the Salk Institute in San Diego. What we don’t know is how this neural growth affects memory function – if it does at all.
Use It or Lose It
Graham McDougall, Ph.D., associate professor at the University of Texas at Austin School of Nursing, who has recently received a $2.4 million grant from the National Institute on Aging to study memory improvement, is working on what he calls the Senior WISE project. He proposes that using four techniques together can increase memory. The first is strategy training, in which you do what seems like common sense: writing lists, putting things out so that you’ll remember them in the morning, and, perhaps most important, coming up with mnemonic devices of various kinds: for example, connecting what you want to remember with something you already know (the name Adam Smith might be mentally affixed with “Granny Smith,” “Adam and Eve,” or “Smith and Wesson”) or visualizing the new information with a full-blown image, smell, taste, or touch in your mind. The second technique is a kind of confidence training, aimed particularly at older people who have bad perceptions of their own memories. Here you learn how to eliminat e negative beliefs about your memory that may adversely affect it. The training involves learning both what the strengths of your memory really are, which we tend to underestimate, and how much the average person can expect from his or her memory, which we tend to overestimate. The third strategy is simple health promotion: understanding how depression, sleep irregularities, and medications may adversely influence memory The fourth is a program of stress-reduction and relaxation exercises, such as deep breathing and tense-and-release techniques, because anxiety can block memory recall and efficacy.
A 10-year landmark study on aging funded by the MacArthur Foundation has found that the more educated people are, the less likely they’ll be to experience memory decline or Alzheimer’s as they age. The theory now is that those with higher education levels continue to pose challenges to themselves and that these efforts contribute to a form of brain exercise. An educated brain may have formed more neural connections throughout life and can therefore better sustain some decay. The big question about memory maintenance is whether exercising your brain is, like exercising your body a key to health. Some claim that this idea comes from a puritanical insistence that everything can be achieved by work and that people with poor memory are lazy. Others say the popularity of the idea is comforting to people who like to imagine they have control over functions that in fact they cannot control. In any event, this kind of brain exercise needs to be done throughout life, not just when memory is failing. “I do believe that stimulating environments improve brain functions and grow neurons,” McDougall says. “Do we have enough evidence in humans yet to confirm it? No.”
Still, it’s clear that using your memory doesn’t deplete it, so one can make a Pascalian decision to practice as much as possible (though one should also note that many brilliant, fully engaged people do develop Alzheimer’s; these are statistics, not absolute rules). The point here is that real improvement seems to come with cognitive challenge, so you’ll probably do more for your memory by reading and considering great literature, doing crossword puzzles, or learning to scuba dive, which all involve processing a large amount of new and complex information, than you would by working on so-called brain exercises, or “neurobics,” promoted in trendy memory courses and books. Even if these general efforts don’t improve your overall memory capacity, constant retrieval of specific information is usually effective: Try to recall important things once a week and the likelihood is that you’ll remember them longer and more clearly than if you allow the memories to lie dormant for extended periods of time.
Although we still have a lot to learn about how you can augment your memory, it’s very clear what we can do to destroy it. Poor sleep and stress are two of the most common sources of memory loss. Research suggests that less than six hours of sleep per night will impair memory for most people; eight hours seems to promote optimum function. Severe chronic stress causes increases in the hormone cortisol, which damages the part of the brain essential to laying down new memories. A lack of physical exercise is also bad for memory formation. Aerobic exercise seems to raise levels of nerve growth factor, which plays a key role in maintaining brain elasticity.
Alcoholism is next in line. People who drink heavily (men can get away with more than women can in this matter) will have problems with short-term memory Eventually, their long-term memory goes as well, creating blanks where once there was recollection. One mechanism by which this occurs is the leaching of vitamin B1. While the idea that megadoses of B1 can help memory is not substantiated, there is no question that depletion of B1 can have catastrophic effects on memory; deficiency of B12 can also be a culprit. The effect of having a glass or so of wine every night is still debated; two recent studies have indicated that regular light drinking may lower the risk of Alzheimer’s.
Smoking, which limits blood flow to the brain, has an adverse effect on memory – as it does on just about everything else. There is also good evidence now that memory decay may be caused by severe head injuries such as concussion (which also seems to bring on premature Alzheimer’s). Lead and aluminum exposure and the herpes virus are other possible risk factors. Untreated diabetes, high blood pressure, poor kidney function, meningitis, and Lyme disease lower memory function. And many scientists believe that sustained untreated depression will also damage memory, both because it distracts the mind and limits attention and because it appears to cause cell death in key areas of the brain. The longer the depression remains untreated, the worse the memory loss will be. Finally, several medications – including, ironically, some used to treat depression – are known to cause memory loss, among them Elavil, Ativan, Valium, Kionopin, Dalmane, Ambien, Demerol, Tagamet, insulin, and the eyedrops used for glaucoma.
Even if one avoids all the pitfalls of memory loss and lives a healthy, intellectually challenging life, at some point the mind will begin to falter. The most common complaints among older people – indeed among people across the board – are forgetting the names of friends or where you’ve put your glasses, and finding you can’t recall a PIN number or a phone number. But what of deeper memory loss? Does one increasingly forget one’s feelings, the nature of one’s first love, the scenes that make up a remembered childhood? One doesn’t forget how to ride a bicycle, because such muscle memory has permanence. One does forget facts and information unless they are rehearsed. Between that which we naturally remember and that which we naturally forget lie our emotions, which we half remember, which haze but are never quite lost, which are always present in our current personality. This is the domain of greatest mystery. Mental practice can help you to improve cognitive function, but those profound memories that give us the f eeling of substance in our lives are much less likely to respond to self-improvement techniques; they are simply who we are. We give them weight when our own actions are consistent with them, and we hold on to them by being constant and true to ourselves, by having a coherence in our lives that makes the past fully relevant to the present.