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Is your memory problem a normal part of aging, or a form of dementia?

April 11, 2018 By B.C. Manion

Those attending Dr. Andrew E. Budson’s talks at the Plantation Palms Golf Club in Land O’ Lakes last week had two key takeaways.

Dr. Andrew Budson (Courtesy of The Roche Associates)

First, if you’re having problems with your memory, go to a doctor who specializes in memory issues. In some cases, the problem may be the result of something that’s completely reversible, and even when it’s not, the sooner treatment begins, the better, said Budson, co-author of the book “Seven Steps to Managing Your Memory.”

The second takeaway was this: If you’re looking for something that’s very likely to help your memory, exercise is the key.

“People often ask me, ‘Dr. Budson, is there a magic pill out there to help improve my memory?’ My answer is, ‘Yes, there is. It’s called exercise.’”

Budson gave two talks on April 6 as part of a program presented by Keystone Place at Terra Bella, a new retirement community that will be opening in Land O’ Lakes, which will offer independent living, assisted living and memory care accommodations.

To get things rolling, Budson asked the audience during the 12:30 p.m. talk to consider whether these common memory issues were a result of normal aging, or something else:

  • You walk into a room to get something and you forget why.
  • You’re having trouble remembering the name of a friend of yours from church, even though you’ve met her a half-a-dozen times.
  • You’re having trouble remembering some of the details of your life, such as your wedding.
  • When you are driving and not paying attention, you take one or more wrong turns, and you end up somewhere you did not intend to be.
  • You spend too much time looking for your keys, glasses, wallet or purse.
  • Your family said you’ve asked that question before.

One of the key things to watch for is a change in behavior, Budson said.

“If you are someone who every morning as you’re getting ready to leave the house you spend 5, 10 or 15 minutes hunting around for keys, glasses, wallet, purse, and now you’re getting a little bit older and you’re still spending 5, 10, 15 minutes hunting around the house for these things, well, that’s probably normal for you.

“But if you are someone who is always very organized, never spend any time hunting around for these things — and now you’re spending 5, 10, 15, maybe 20 minutes, maybe an hour, maybe you never find that wallet, you have to replace the credit cards or you have to replace the cellphone because you couldn’t find it, you know, that would be concerning,” Budson said.

He gave another example.

“Anyone can forget that they’ve already told their best friend that story and start to tell it again, or cannot remember the answer to a question and ask it again. Sure, that can happen once or twice, no big deal.

“But, for somebody that’s telling the same story, again and again and again … every time you meet this individual they tell it, maybe even twice during the same visit, that sounds like rapid forgetting. Rapid forgetting is never normal,” he said.

To help explain how memory works, the doctor used the analogy of a filing system.

“The file clerk is our frontal lobes. It is our frontal lobes’ file clerk’s job to take the information in from the outside world and to put it inside the file cabinet.

“So, when we want to retrieve a memory, you can picture the frontal lobe file clerk pulling open the file drawer, leafing through the files until he finds the memory that he’s looking for,” he said.

As we get older, our file clerk doesn’t hear quite as well as he used to, so information may need to be repeated a couple of times in order for it to be stored in the file cabinet.

It also can take longer to retrieve a memory, and we may need a hint or cue about what a memory was about, he added.

But, the main thing is, if a memory goes into the cabinet — it can be retrieved.

Using the same filing system analogy, he then focused on the file cabinet itself.

“The file cabinet is another part of the brain. It’s actually our hippocampus. The hippocampus is the part of the brain that stores new memories. It’s located in the temporal lobes.

“The problem with diseases like Alzheimer’s is that it damages the hippocampus, and ultimately, in fact, destroys the hippocampus.

“Imagine if you pull open the drawer of the file cabinet and you look down inside, and you find out there’s a big hole in the bottom of the file drawer.

“You can have the most efficient file clerk in the world, taking information in from the outside world, putting it into the file cabinet. If there’s a big hole there, the memories are going to disappear, never to be retrieved again,” he said.

Diet and exercise can strengthen memory
The doctor also explained the distinction between the terms dementia, Alzheimer’s and mild cognitive impairment.

Dementia is a general term that means that someone’s thinking and memory have declined to the point that it interferes with day-to-day function, he said.

It can be caused by things that are easily treatable and actually completely reversible, but also can be caused by serious diseases, including Alzheimer’s.

Mild cognitive impairment means that a person has a confirmed memory loss, but that the individual’s day-to-day function is normal, Budson said.

Over time, about half of the people with mild cognitive impairment go on to develop Alzheimer’s or another form of dementia, but the other half don’t, he said.

Once a memory problem has been determined, the next step is treatment, Budson said. There are standard medications that have been approved by the U.S. Food and Drug Administration, he said. Plus, there’s more research underway now than there ever has been during the 110-year history of Alzheimer’s.

Early treatment is crucial, he said.

“They (medications) can turn the clock back by six to 12 months,” he said. “I am much more likely to be able to turn the clock back all of the way to 12 months, all the way to make their memory like it was a year ago, if they come to see me early.”

Research also shows that lifestyle changes can help, he said.

“The Mediterranean diet, and a few variations of it, is really the only diet that study after study after study has been proven to be healthy for the brain and good for the memory,” he said. That diet includes fish, olive oil, avocados, fruits and vegetables, nuts and beans, and whole grains.

Exercise also is good for you, but before increasing your activity, be sure to check with your doctor, he said.

The recommended amount of exercise is at least 30 minutes of aerobic exercise five days a week, plus two hours a week of things that help with strength and balance, and flexibility.

Besides reducing the risk for stroke and improving your mood, exercise can help you sleep better — which is critically important for the memory, he said.

“Remember we talked about how the new memories are stored in the hippocampus, in our new memory file cabinet? Well, it turns out there’s another memory file cabinet that is storing the older memories. It is during sleep that the memories go from the short-term, temporary store (file) to the long-term permanent store (file),” he said.

Besides exercise and diet, other ways to strengthen the memory including social engagement and learning new things, Budson said.

There is no evidence, however, that doing brain-training games and crossword puzzles will improve the memory, he said.

“What the studies show is that if you spend time doing crossword puzzles, or Suduko or computerized brain training programs, you get better at crossword puzzles, Suduko and computerized brain training programs. It simply does not translate to overall brain function,” he said.

Know the 10 signs

  • Memory loss that disrupts daily life
  • Challenges in planning or solving problems
  • Difficulty completing familiar tasks at home, at work, or at leisure
  • Confusion with time or place
  • Trouble with understanding visual images or spatial relationships
  • New problems with words in speaking or writing
  • Misplacing things and losing the ability to retrace steps
  • Decreased or poor judgment
  • Withdrawal from work or social activities
  • Changes in mood or personality

For more details on this list and for more information about Alzheimer’s, visit ALZ.org.

Published April 11, 2018

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