You must remember this


Six Things to keep in mind about memory loss.

If you’re a member of the “Where did I put my keys?” club, you’re not alone.

 “Nobody really escapes the age-related changes that occur with the mind,” says UC Davis’ Michael McCloud, M.D., a geriatrician and healthy-aging expert. While memory loss isn’t the only kind of cognitive decline that happens as we age—processing speed and attentional abilities, for example, also are affected—it’s a big part of the story, and probably the one that scares people most.

What’s normal and what’s not? If we play with puzzles and eat bushels of blueberries, can we fight the fickle finger of fate? With one in eight Americans ages 65 and older diagnosed with Alzheimer’s disease, according to 2011 figures from the Alzheimer’s Association, a lot of us are confronting these questions. 

Here are six things to keep in mind.

1. Sometimes, it’s normal. Older than 60? Get used to it: Age-related cognitive changes in our seventh decade of life are normal, says McCloud. It may even start in our 50s. “Having trouble retrieving words and names, finding things are not at the tip of our tongue—that’s absolutely universal,” he says. The “normalcy” question is one of the most common, says McCloud, who in addition to practicing medicine is the founder of UC Davis’ überpopular Mini Medical School devoted to the second half of life, where he teaches classes such as Memory and Aging. “People want to know: Is it normal aging, is it Alzheimer’s or dementia, or something in between?” The fear of Alzheimer’s is a biggie among his patients, too, says neurologist John Schafer, M.D., of the Mercy Neurological Institute. “People ask, ‘If I’m having trouble remembering people’s names, will I develop Alzheimer’s?’” But science still isn’t good at answering that question, says Schafer. “Right now, we don’t have a good way of determining who will go on to develop full-blown dementia and who is not,” he says. “It’s a problem.”

2. Worsening symptoms are a red flag. OK, here’s the deal: Occasional memory lapses—such as  forgetting why you went into a room (or where you left those darned keys)—are no cause for alarm. But if it happens more and more or the decline is steep, call your doctor. “It’s when symptoms are worsening that someone should be concerned,” says Shawn Kile, M.D., a Sutter Neuroscience Institute neurologist. “If it’s progressive, I’d get it checked out.” Short-term memory problems are the most concerning kind, Kile says. “If you notice your spouse is repeating the same question within minutes, that’s troublesome,” he says, by way of example. “In Alzheimer’s, short-term is the first aspect of memory to be lost.” In most cases, adds McCloud, people who fear they have Alzheimer’s don’t; more commonly, they are found to have MCI, mild cognitive impairment, which affects one in four individuals older than 65. McCloud calls MCI the “border zone”—a place where simple interventions can sometimes help. “If patients have MCI, we don’t want it to progress to dementia, and we do frequently recommend mental stimulators, like crossword puzzles or learning a new language.” Which brings us to No. 3.

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3. A healthy lifestyle helps. Even though dementia has its own mind, so to speak, there are plenty of things you can do to help stave it off. At the top of the list: exercise, both mental and physical. According to data from a large-scale Framingham Study released in 2010, moderate to heavy exercise can reduce a person’s risk of dementia by about 40 percent. And, as we’ve all been hearing forever, crossword puzzles and other “mental stimulators” can help maintain a healthy mind. But keep the focus on learning new things instead of repeating the old, says McCloud. “If you’re good at one thing, whether it’s playing bridge or crossword puzzles, just doing a lot of that one thing is not going to help a lot,” he says. “The idea is to learn or do something new, whether it’s a language, an instrument or becoming active in clubs.” Learning new things opens up new neural paths in the brain, explains Schafer—a concept known as cognitive reserve. “The more things you learn, the more you put your brain to work, the longer it’s going to last,” he says. “The better your brain works, the more you can lose before you become demented.” Other things that have been shown to battle memory loss and improve brain function: blueberries, turmeric, Omega-3 fatty acids, and vitamins B12 and D. And don’t forget the two s’s: sleep and socializing. A sleep-deprived brain can’t function well, and socializing gives the brain a big boost, says Kile. “Of all the cognitive activities,” he says, “it’s the best.” How so? It exercises all of the different hemispheres of the brain, from your language cortex to your memory centers.  

4. It could be a zillion things. Listen up: Memory problems are not all age-related. On the short list of possible causes: depression, diabetes, brain tumor, silent stroke, thyroid disease, anemia. From No. 3 above, you also can deduce things such as vitamin B12 deficiency (long known to muck up the memory banks) and sleep disorders. And here’s a really big one: medication madness. “Many of the medicines older adults are on significantly affect memory and brain skills,” McCloud says. That’s why he suggests seeing a primary doc or geriatrician for evaluation first, before you run to the neurologist. “When people say, ‘Oh gosh, I’m having too many senior moments,’ I stress the importance of seeing your primary care physician or geriatrician, because we really do look at the broad picture,” says McCloud. “You need someone who can step back and take off the blinders.” If need be, have your primary doc refer you to a neurologist. 

5. Science is working on it. There’s good news and bad news. First, the bad: Even though it’s 2012, science still hasn’t come up with a way to successfully treat dementia. Though several drugs on the market are purported to improve cognitive performance and slow the disease’s progression, they don’t quite cut it, according to Mercy’s Schafer. “The effects of these drugs are very modest, to say the very least,” he says. “In my experience, most patients don’t notice a significant difference.”  But there is hope. Preliminary studies have been especially promising for IVIG, an intravenously administered blood product that has been shown to help clear the beta-amyloid plaques associated with Alzheimer’s disease. These plaques build between the neurons of the brain, disrupting normal function, explains Kile. He would know: It’s among the things Kile and his team are studying at Sutter’s Memory Clinic, where a clinical trial is currently under way to study IVIG’s effect on patients with mild cognitive impairment. It’s too soon to guess the outcome of the study, which is in its early stages, Kile says. But he is hopeful. “It’s not far-fetched to predict good results, because in studies with Alzheimer’s patients, it (IVIG) has been shown to improve cognition and maintain brain volume,” he says. “It’s an exciting trial.” But, as he points out, it’s just one of many studies under way for the prevention or treatment of AD or MCI, lending hope to the idea that effective therapies may arrive sooner rather than later.

6. Look on the bright side. Let’s be real: No one welcomes memory loss or any of aging’s not-so-sweet side effects. But McCloud offers a positive spin. “Along with the intellectual decline that happens with aging, there are other things that improve: our vocabulary, our wisdom, our sense of humor,” he says. “When you look at what we lose, maybe it’s a fair trade-off when you look at the positive thingswe gain.” 

We’ll try to commit that to memory.




Gloria Kiley: Boldly Enrolling in a Clinical Trial at 70
Gloria Kiley’s mother died of Alzheimer’s disease. But no one knew she had it when she was alive. “She was never diagnosed until she passed away,” says Gloria, 70. A brain study, post-mortem, revealed her mother’s cause of death. So when Gloria “began forgetting where I put my keys” about six years ago, her family was concerned. They grew even more concerned, says her daughter Dawn Kiley, when her memory issues began to accelerate. “About three years ago, we started recognizing that it was getting progressively worse,” recalls Dawn. “She was forgetting things more frequently, like when to pick up my daughter from high school. She would forget until the last second, or we would have to remind her.”

Sometimes they would have conversations “and the next day it would be as if we didn’t have those conversations,” says Dawn. After seeing her general practitioner, Gloria was referred to Sutter neurologist Shawn Kile, M.D., for evaluation. When she found out he was conducting a clinical trial in which patients were being tested with a promising new anti-Alzheimer’s medication, she eagerly signed up.

She was not afraid. “It was really neat,” Gloria says. “I went every two weeks for maybe six or eight times and got an infusion.” Medicine usually doesn’t affect her much, says Gloria, and neither did this. “I didn’t have any kind of a reaction,” she says, “and I wasn’t expecting one.” Daughter Dawn is very proud. “A lot of people are in denial about facing these types of things head-on,” she says. “I’m so very proud of the fact that she’s proactive and is not afraid. Instead, she’s always asking, ‘What can we do about this?’” The study, under way at Sutter’s Memory Clinic, is exploring the efficacy of intravenous immunoglobulin, or IVIG, in patients ages 50 to 85 with mild cognitive impairment. Gloria, who had been diagnosed as in the very early stages of possible dementia, was a perfect candidate.

Having watched her mother’s demise, Gloria likes the idea that she’s contributing in some small way to scientific progress. “If it works out to be good, we would be able to use that drug,” she says. “I just figure the more we learn, the better everybody’s going to be.”