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September 29, 2014

Memory loss in aging: What is normal?

The Canadian Charger

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"Where did I leave my glasses?" That question is the provocative title of a book by Martha Weinman Lear, a writer who specializes in social- and health-related subjects.

Published in 2008 by Wellness Control, this account of normal memory loss in aging and its implications is altogether charming, while at the same time informative. 

It conveys scientific information in a totally painless fashion.  She has gathered her facts largely through personal interviews with experts in the U.S., Canada, and Great Britain. 

While she wanders far from the facts of normal memory loss to implications for future surgical and pharmacological possibilities and other matters, we will focus primarily on the facts of normal memory loss today.

To begin, why as we age do we forget where we left our glasses and the names of people we know? 

“It’s on the tip of my tongue.”  Quite basically, we forget—or are slow to remember—for the same reason that we lose strength as we grow older.  The mind, like the body, slows down.  Our ability to perform heavy labor at 60 or 70 is not the same as it was at 20. 

In the case of memory, loss begins in our 20’s as the frontal lobe of the brain, important in retrieving information such as people’s names, begins to shrink.  Beginning in our 30’s, the brain starts to shrink at a rate of half a percent a year, most markedly in the frontal lobe.  It is retrieval, rather than storage, of memory, that is affected in aging.

People’s names are particularly susceptible to being forgotten because they usually lack a referent.  A name is essentially a meaningless word, unlike the name of a thing, a chair or an animal for example.  People’s names are stored in one section of the brain but are retrieved from the frontal lobe.

Memory is not a unitary thing.  She speaks of phonetic memory and semantic memory.  In the former, we remember how something sounds, and in the latter we remember facts and meanings—what a tree and a dog are, how to use a fork and chop sticks, where the capital of Canada is.  However, a person’s name may become so strongly imbedded that it becomes semantic, a spouse for example.

There are several techniques for remembering someone’s name or other things. 

One is to repeat the name over and over, over a period of time--not just all at once.  Another is to link a person’s name in your mind with someone or thing. 

Mary may remind you of the Virgin Mary or the Mary in the rhyme about Mary, Mary, quite contrary.  Making lists is a substitute for having to keep everything in your head.

Then there are some general health promotion factors that affect memory as well—good diet (for example, the Mediterranean diet), avoiding excessive stress, getting enough sleep, and exercise, physical and mental.  Aerobics are recommended, especially if weight lifting is added.  Stretching does not seem to do as much.

Normal memory loss is marked by forgetting names, having difficulty multi-tasking, and difficulty in processing new information. 

In order to get around the difficulty multi-tasking, one can separate the tasks out rather than trying to do them all at once.  That makes it easier to concentrate. 

Concentration can also be enhanced by using certain substances: caffeine, nicotine, and amphetamines.  However, as is well known, there are problems especially with the last two –cancer and addiction.  Caffeine in moderation is not so harmful, but remember moderation.

  1. Memory may be distorted or even manufactured, giving us false memory syndrome.

All this is about normal memory loss. 

When does loss become abnormal?  When are we dealing with dementia?  Gaps in semantic memory are an indication.  You forget how to tie your shoes, or you lose our way while walking in a familiar neighborhood.  Forgetting names is not such a big deal unless they are the names of your spouse or children, names so familiar that they are embedded in semantic memory.

There are, as mentioned, ways to enhance mental functioning to some extent.  Part of the answer is genetic.  Choose the right parents.  More practically, engage the mind.  Use it or lose it.  Crossword puzzles and Sudoku may help, but it appears that they may not ward off dementia.  Learning a new language, on the other hand, may even serve to prevent or slow down dementia.

A long-term study conducted by the U.S. National Institute of Aging, with nuns from the School Sisters of Notre Dane, begun in 1990, looked at their mental and physical functioning with ongoing assessments while alive and brain autopsies after death. 

A perhaps surprising finding was that there were cases where the brain showed marked signs of Alzheimer’s disease, in spite of the fact that mental functioning of the person recently before death was more robust than one would expect from someone with Alzheimer’s which had advanced to the degree seen. 

Education and ongoing intellectual activity appear to make a difference.

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