Improving Memory: Lifestyle Changes

Sharon is a busy mother of four trying to cope with a thriving home-based consulting business while orchestrating her family's move across town. To add to her stress, her mother was just diagnosed with Alzheimer's disease and needs lots of emotional support, and her husband has been having a rough time at his job. Lately, just as Sharon's legendary organizational skills are most needed, she can't seem to remember what she needs to do from one minute to the next. Important phone calls are going unmade, and assignments are falling through the cracks. She's missing appointments and losing her files. As the demands on her time and attention build, her ability to remember only seems to be shrinking. She's even beginning to wonder whether she herself is showing early signs of Alzheimer's disease.

Eventually, Sharon becomes so concerned she consults her doctor, who reassures her that her memory problems in this case are completely normal: She is under enormous personal stress, and that burden is directly affecting her ability to remember.

Without a doubt, one of the most common reasons that healthy people find themselves becoming forgetful is stress. And it's not just major, life-changing stress that affects learning and memory. Most of us never realize how much of a toll the day-to-day irritations, hassles, and annoyances can take. Whether you're a single parent, a young mom, a middle-aged dad involved in business and your son's sports team, or an established professional nearing retirement age, just getting through the day can present you with endless minor frustrations that can mount up exponentially. Whether the alarm doesn't go off...you can't find your best pair of pants...the children are fighting over the last waffle...you forget to refill the gas tank...your secretary calls in sick...the dog throws up on your expensive new rug...all of these seemingly minor problems trigger stress. How many of them there are, and how you react to them, can determine how they will ultimately affect your ability to concentrate and remember.

Oddly enough, short-term, mild-to-moderate stress can actually improve cognitive performance and enhance memory. The body's immediate reaction to a sudden stressor includes the release of hormones and other chemicals, including epinephrine (also known as adrenaline) and norepinephrine, that trigger the body's so-called fight or flight response and, in the short term, make you more alert and focused. To maintain this reaction beyond a few seconds, the body also releases glucocorticoid hormones (such as cortisol). A slightly elevated level of glucocorticoids appears to assist in the laying down of new memories.

Major or prolonged stress that goes untempered, on the other hand, can have a negative impact on memory and concentration. The continued release of and exposure to stress chemicals, with no down time, no chance for the body to return to a "stand down" mode, can take its toll on various systems and organs -- including the brain. Scientists haven't teased out all of the effects (indeed, memory, like so many other brain processes, is one of the least understood functions of the human body), but research suggests that major or ongoing stress and the high levels of glucocorticoids that accompany it have detrimental effects on an area of the brain called the hippocampus. Research suggests that the hippocampus plays an essential (although not yet fully understood) role in the creation of "explicit" memories-that is, memories of facts and events (as opposed to "implicit" memories, which include procedural memories, such as how to drive a car or ride a bike, that we are able to execute without consciously "remembering"). The negative effects of stress on the hippocampus appear to make it more difficult to create long-term memories and harder to access those that have already been formed.

Fortunately, high stress-hormone levels over the short term don't appear to do permanent damage to the brain. As your stress eases or as you employ coping techniques, you should find that your memory improves. On the other hand, there is some evidence to suggest that prolonged exposure to unmitigated stress may damage the hippocampus, making it less able to signal the body to turn off the stress hormones, leading to a vicious cycle of higher and higher stress-hormone levels and further decay of memory and cognition. In time, the hippocampus may actually shrink.

There's another reason why you may not remember so well when you are under a lot of stress, and it has to do with paying attention. In order to record information well enough to form a memory, you have to be able to focus on the subject you want to remember. Anything that interferes with your ability to pay attention, therefore, will impair your memory. When stress is severe or prolonged, it can monopolize your attention to the point that you can't concentrate on anything else. You may become so obsessed with or distracted by the source(s) of your stress that you don't pay attention to what you're doing and what's going on around you. You may function much of the time on a sort of automatic pilot, going through the daily motions but not really focusing on your actions, not paying attention to where you put down your glasses or your car keys, not absorbing what you're reading, etc. (Ever driven home distracted or upset after a stressful day of work and discovered, when you got home, that you had no memory of the drive itself and couldn't even say for sure whether or not you stopped at all the stop signs?) As the sources of your stress monopolize your thoughts, you simply don't record information the way you normally would, and if the information never gets properly stored to begin with, there won't be a memory there to retrieve.

So how do you improve and protect a memory that's being overwhelmed by ongoing stress? You must examine the sources of your stress, come up with plans to avoid or minimize those that you have some control over, learn how to alter your reaction to those that you can't eliminate, and develop some strategies you can use in your daily life to provide your body and mind with healthy breaks from ongoing pressures.

Stress-busting strategies are as varied and individual as we are. But you may be able to find some help developing your own through a class or workshop at your local hospital or community center. The following general suggestions may also help you begin creating a personalized stress-fighting plan:

On the next page, learn about how exercise and fitness can actually improve you memory.

To learn more about the various aspects of memory, see:

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Exercise can help you improve just about every aspect of your health, from boosting your cardiovascular fitness to lowering your risk of certain cancers. And now we know that it can also help improve your memory. Studies have found that people who exercise frequently have a distinctive brain-wave pattern, characterized by steep peaks and valleys, that is associated with alertness. These high-exercise folks are better at blocking out distractions and focusing, which means that they are better at paying attention to material that they want to remember and better at retrieving those memories when needed.

Research has also found that aerobic exercise can help maintain short-term general and verbal memory. This type of memory is especially important when you want to recall names, directions, and telephone numbers or match a name with a face.

The results of research reported in March of 2007 suggest an even more impressive role for exercise: building new cells in a specific region of the brain that is associated with the age-related decline in memory that normally begins sometime around age 30. The region is called the dentate gyrus, and it is part of the hippocampus, which itself is essential to memory. First, studies of mice showed that exercise could spark the growth of new brain cells in the mouse-equivalent of the dentate gyrus. Scientists noted that the growth of the new brain cells was reflected in an increase in cerebral blood supply. In a later study of 11 healthy adult humans who participated in a three-month aerobic-exercise program, a similar increase in the cerebral blood supply was noted, suggesting that exercise had caused the growth of new brain cells in the dentate gyrus of each of the human exercisers. Since the typical, gradual memory decline in humans that begins sometime around the thirtieth birthday appears to be associated with the dentate gyrus, the ability to spark the growth of new brain cells in this region of the hippocampus through exercise may mean that physical activity can help prevent or delay some of the decrease in memory function that naturally occurs as humans age.

Aerobic exercise also helps keep your heart strong and your blood vessels healthy and flexible, which helps ensure that your brain will continue to get plenty of oxygen and nutrients for optimum performance. This is important because, while brain cells make up only two percent of your body weight, they use a quarter of all the sugar and oxygen your body absorbs. Research also suggests that exercise boosts a chemical called brain-derived neurotropic factor (BDNF) that encourages the growth of nerve cells in the brain, makes their connections stronger, and helps shield them from harm.

Scientific research has not yet identified a specific type of exercise regimen or a specific amount of exercise that is most beneficial for memory and brain function. But it's worthwhile to note that the recent studies that showed brain-preserving boosts in BDNF involved older folks who started out walking briskly for 15 minutes and gradually worked up to 45-minute walks three days a week. And studies by the Centers for Disease Control and Prevention indicate that getting 30 minutes or more of moderate exercise on most days can help you capture many of the health benefits of exercise. So for now, a similarly moderate level of activity is probably a good goal to aim for. If you have been relatively inactive of late, however, you should check with your doctor before beginning an exercise plan.

On the next page, learn about how sleep affects memory.

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Research has long indicated that sleep is essential to a well-performing memory. And scientists have long suspected that a lack of sleep is detrimental for reasons beyond the effect it has on a person's alertness and ability to focus during the day. What hasn't been clear is what other role(s) sleep actually plays in memory and during what sleep phase (or phases) essential memory processing occurs. For example, one long-held theory was that dreams are the brain's way of processing the day's memories and impressing traces of them on the brain's neural pathways (storing them, in other words). And research from the 1960s showed that people who don't get enough REM (dream) sleep experience memory problems when they wake up.

More recent research, especially studies using high-tech tools -- such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) -- that allow scientists to "watch" what's happening in the living brain, has begun to reveal much more information about the importance of sleep to memory. Such research suggests that it is during sleep that the brain consolidates the initially fragile memories made during the day, reinforcing them and "uploading" them, so to speak, for long-term storage. Once again our old friend the hippocampus appears to play an essential part in the process, storing the day's memories until they can be consolidated at night. The latest science also indicates that sleep facilitates or improves the brain's ability to remember both declarative information, such as facts and events, and procedural information, such as how to play the scales on a piano keyboard. The hippocampus appears to handle declarative memories, while a different brain region deals with processing procedural information. And it actually appears to be deep, slow-wave, nonRem (NREM) sleep, rather than dream sleep, that is the primary stage for consolidating memories.

Certainly, additional study is needed to confirm these latest suspicions and to help fill in the many blanks in science's understanding of the link between sleep and memory. But scientists generally agree that one important way to help your memory work at full power is to get quality sleep on a regular basis. The amount of sleep needed for performing well mentally (as well as for maintaining physical health) seems to vary among individuals but typically falls in the range of seven to nine hours each night. You may need to do some experimenting to determine the amount that seems to give you that edge. Then you need to give sleep time the importance in your schedule that other essential bodily functions require.

If you make the time for adequate sleep but have difficulty falling asleep or staying asleep for as long as you need to, there are a variety of steps you can take. To improve your mental performance -- including memory performance -- you're probably better off not using sleep-inducing medications or alcohol in an effort to get sleep, since they can leave you feeling groggy and unable to focus the next morning.

So here are some drugfree tips to help you get the shut-eye your brain needs:

On the next page, learn about diet and its effect on memory.

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Evidence continues to build that many of the same poor lifestyle choices that lead to major health problems, such as heart disease, diabetes, obesity, and cancer, are similarly detrimental to the brain. Our dietary decisions are no exception. The quality of the diet appears to affect brain health and function, including memory.

So what makes for good brain food? Despite the claims on various snacks, beverages, and other food products, there is no miracle brain food that can boost your thinking and memory skills (just as there is no single food or food ingredient that can ensure heart health or protection from cancer). The best diet for your brain is, basically, the kind that's also healthy for the rest of your body -- a well-balanced diet, filled with whole grains, a wide variety of colorful fresh fruits and vegetables, and moderate amounts of protein, that supplies just enough calories to fuel your daily activities. That diet should also include some fat, but not just any kind of fat: A diet that is healthy for cell membranes, including the cells in the brain, appears to be one that includes monounsaturated fats and polyunsaturated fats that are high in omega-3 fatty acids rather than saturated fats.

Some research indicates that diets that are rich in olive oil, which is made up primarily of monounsaturated fat, may help prevent age-related memory loss in healthy older people. Italian researchers found that senior citizens who consume diets that are high in monounsaturated fats are less likely to experience age-related thinking and memory decline. The more of this type of fat the subjects consumed, the better they were protected against age-related cognitive decline. Fortunately, monounsaturated fat is also the preferred type of fat to include in your diet to protect the health of your heart and blood vessels, which can help ensure a steady supply of oxygen and nutrients to hard-working brain cells.

In addition, polyunsaturated fats that are high in omega-3 fatty acids appear to be beneficial to your health, including the health of the brain, in a variety of ways. Research suggests that these fatty acids, found primarily in cold-water fish (anchovies, herring, mackeral, salmon, sardines, tuna, and whitefish, for example) may lower the risk of heart disease, high blood pressure, and stroke. That's good news for people who want to protect their memory, as well, since the brain relies on a smooth, uninterrupted flow of blood to function well. Some evidence also suggests that these fatty acids may counter the effects of free radicals that can damage cells throughout the body. And recent animal studies showed that adding fish oil to the diet of rats increased the level of BDNF in their brains, so the oils may help protect brain cells from damage and may even promote brain cell growth.

Of course, that doesn't mean you should pack your diet with fat, even the monounsaturated or polyunsaturated kind, because fat is a calorie-dense nutrient. Consuming a lot of extra calories without increasing your physical activity level can lead to obesity, which in turn increases your risk of heart and blood-vessel disease. So talk to your doctor or a registered dietitian about the appropriate amount of fat to include in your diet.

A brain-healthy, memory-wise diet should also provide sufficient amounts of the vitamins and minerals the body needs for health. Of course, loading up on any particular vitamin or mineral will not turn you into a memory machine, but there is some evidence that taking in less than optimum levels of certain vitamins can keep your mind and memory from performing at their best. That's one of the reasons it's so important to consume a wide variety of fresh fruits and vegetables (they also contain myriad phytochemicals and other substances that can help protect the body from damage, disease, and some of the effects of aging). And, if you find yourself struggling to consistently achieve such variety in your diet, you may want to consider taking a multi-vitamin-mineral supplement that supplies the recommended allowances (but not mega amounts, because more is not necessarily better and can actually be detrimental) of these nutrients.

B Vitamins

Nutritionists have known for some time that severe deficiencies of the B vitamins can lead to memory problems. And some initial research suggests that increasing intake of certain B vitamins can help enhance memory abilities. There is some evidence, for example, that niacin (B3) may be a memory enhancer; in one study, subjects improved their memory between 10 percent and 40 percent simply by taking 140 mg of niacin a day.

B12 is also important for memory and other cognitive functions. Unfortunately, with age, some people lose the ability to absorb enough B12. Some 20 percent of people over age 60 can't absorb enough B12; that percentage jumps to 40 percent by age 80. For this reason, older individuals might want to choose cereals that are fortified with B12 or consult a doctor about taking a B12 supplement. Low blood levels of vitamin B12 may also occur in those vegetarians who don't eat eggs, fish, or dairy products and therefore don't get sufficient vitamin B12. Some diseases (such as Crohn's disease), as well as surgical removal of the intestine, can also result in poor B12 absorption. In a small number of cases, chronic B12 deficiency requires injections of the vitamin on a monthly basis.

Scientists at the University of North Carolina discovered that if pregnant rats don't get enough of the B vitamin choline, the learning and memory centers in the brains of their developing offspring may be permanently affected. Whether the same holds true in pregnant women who get too little choline is not yet known. (If you are pregnant or trying to become pregnant, be sure to discuss vitamin and mineral supplementation before conception or as early in your pregnancy as possible. But don't take any over-the-counter or prescription supplement or drug without clearing it with your doctor first.)

The B vitamin folic acid has been closely linked to dementia in the elderly. And among healthy people, low levels of folic acid have been linked to lower scores on memory tests. This vitamin is found in a wide variety of foods, especially liver and raw vegetables, legumes, nuts, avocados, cereals, and spinach and other leafy greens. Normally, a well-balanced diet provides enough folic acid, but low-dose supplements (200 to 500 micrograms) seem safe. Taking higher doses of folic acid requires medical supervision.

Vitamins C & E

Vitamins C & E

Getting enough of vitamins C and E may also help perk up a flagging memory and keep it sharp. Vitamins C and E are antioxidants and as such may help to ease some of the stress put on brain cells by free radicals, which are released during normal chemical reactions in the body. Research clearly shows that free radicals damage the brain during normal aging as well as in Alzheimer's disease. Therefore, it has been speculated that antioxidants, which neutralize damaging free radicals, might also be able to improve memory, even in those without dementia. Because these vitamins are relatively safe and are essential to proper functioning of a wide variety of processes in the body, ensuring adequate intake of them-and even getting more than the recommended daily allowance-is not likely to be harmful. But it's still best to consult your doctor before taking higher-than-recommended doses.

Magnesium

Magnesium, sometimes described as an "antistress" mineral, has many essential metabolic functions in the body, and it may be important in learning and memory. Magnesium is also vital for the production and transfer of nerve impulses, in muscle contraction and relaxation, in protein synthesis, and in many biochemical reactions. Several studies have noted that low levels of magnesium are one of the most common dietary deficiencies in the world, especially among older people. There is some speculation that magnesium deficiency may be linked to the development of Alzheimer's disease, as well.

The current Recommended Daily Allowance (RDA) for magnesium is about 350 mg for men and 300 mg for women, increasing to about 450 mg during pregnancy and lactation. The minimum is also expressed as about 6 mg per 2.2 pounds of body weight. Many authorities feel that the RDA should be doubled, to about 600 to 700 mg daily. An average diet usually supplies about 120 mg of magnesium per 1,000 calories (or an estimated daily intake of about 250 mg). This does not produce adequate tissue levels of magnesium for most people.

Therefore, you may want to increase your dietary intake of magnesium to ensure that you are getting adequate levels for optimum functioning. Dietary sources of magnesium include green leafy vegetables, nuts, whole grains, soybeans, milk, and seafood.

On the next page, learn about the effects of alcohol and tobacco on memory.

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The detrimental health effects that can occur from drinking and smoking, caused by alcohol and tobacco, are now well known. But beyond producing ailments such as cirrhosis of the liver and lung cancer, overindulgence in these common substances can permanently damage your ability to remember everyday life.

Alcohol

You may feel like the life of the party after a few drinks, but you may be surprised to learn that having a few beers or glasses of wine several times a week can begin to interfere with your ability to remember.

A rare binge will probably not cause permanent memory problems, but habitually abusing alcohol can cause real damage. In fact, short-term memory loss is one of the hallmarks of alcoholism. Alcohol destroys brain tissue and interferes with the process of absorbing information so that it never enters long-term memory. Prolonged alcohol abuse causes permanent damage to the memory system. Short-term memory loss is often the first indicator of alcohol-related neurological damage. This type of memory loss means a person has difficulty remembering new information, so the learning process takes longer. It also reduces a person's higher-level thinking (the ability to think in abstract terms). Excessive drinking changes the underlying brain chemistry that controls ability and skills. People who habitually drink too much may also experience blackouts -- periods of amnesia that occur when the amount of alcohol consumed prevents the formation of memories in the brain. If untreated, chronic alcoholics may develop a confused state of thinking that can lead to severe amnesia and disorientation.

So if a better memory is your goal, you would do well to examine your alcohol consumption patterns. And if you regularly have more than one (if you're a woman) or two (if you're a man) drinks a day or occasionally consume several drinks in a sitting, you may want to cut back to protect your thinking cap. If you experience difficulty moderating your drinking on your own, look into local programs for problem drinkers (such as Alcoholics Anonymous) or contact a mental health professional who specializes in treating substance abuse problems.

Smoking

While smoking a cigarette may make you feel momentarily energized, smoking can actually lower the amount of oxygen that reaches your brain, thereby affecting your memory. In fact, studies have found that smokers score lower on memory tests than nonsmokers, and smokers who average more than a pack a day appear to have an especially hard time recalling names and faces. Some research suggests that smoking can slow your memory performance about as much as having a couple of drinks. Smoking a pack a day exposes you to 1,000 micrograms of toluene (among other things), which is highly toxic and can cause confusion and memory loss.

On the next page, learn about dietary supplements and how they can affect memory.

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Wouldn't it be great if you could just pop a pill to improve your memory? Well, if you listen to or read the advertisements for a seemingly endless string of supplements and supplement-fortified beverages and foods, you'd think there really was such a magic bullet. But so far, there really isn't any strong research supporting the use of any supplement to improve memory or overall brain function. There have been some intriguing findings, as we'll discuss here, but the evidence is suggestive, at best. The following are some of the supplements you're likely to hear the most about in terms of enhancing memory power.

Ginkgo Biloba

The leaves of this tree have been "prescribed" as a memory aid by traditional healers in China for the past 4,000 years. And in Germany today, it's said to be the third most commonly prescribed drug for the treatment of dementia. In the United States, ginkgo has been touted not only as a treatment for Alzheimer's but as a memory enhancer even for people without signs of dementia.

Studies have documented the safety and efficacy of ginkgo in treating patients with mild to moderate Alzheimer's disease, although most experts in the United States agree that the benefits are mild at best and that more research is needed. Few side effects are associated with the use of ginkgo. They include headache, nausea, gastrointestinal upset, diarrhea, dizziness, and allergic reactions. There is also some evidence to suggest that ginkgo can increase the risk of bleeding, so people who take anticoagulants (blood thinners) or have bleed disorders may be better off avoiding ginkgo. At any rate, ginkgo should be considered for use in treating the memory loss associated with Alzheimer's disease only after consultation with a physician and only under medical supervision.

In terms of boosting memory ability in healthy people, there is even less scientific research to support such use. Indeed, a study of more than 200 healthy adults over age 60, sponsored by the National Institute on Aging, found that taking ginkgo for six weeks did not improve memory. There is still considerable interest in the use of ginkgo for memory enhancement, and perhaps future studies will find some benefit from longer periods of supplementation. But at this point, the evidence is not strong enough to recommend the use of ginkgo for memory improvement in healthy adults.

Coenzyme Q10

Coenzyme Q10 (or ubiquinone) is an antioxidant that occurs naturally in the body and is needed for normal cell reactions to occur. Some preliminary research suggests that Coenzyme Q10 may slow down, but not cure, dementia in people with Alzheimer's disease, but additional research is needed before any recommendation can be made for its use in treating this condition. (Little is known about what dosage of coenzyme Q10 is considered safe, and there could be harmful effects in overdose.)

There is currently no good research to support its use for improving memory in healthy people.

Huperzine A

Huperzine A is an extract from a club moss (Huperzia serrata) that has been used for centuries in Chinese folk medicine as a memory enhancer. It appears to be able to interfere with the enzyme acetylcholinesterase that breaks down acetylcholine, which is involved in memory and learning. This means more acetylcholine becomes available to stimulate brain cells. Alzheimer's disease is a condition where there's a relative shortage of acetylcholine.

Huperzine A may hold some promise as a potential treatment for Alzheimer's disease, but more studies are required to determine its long-term safety and side-effect profile as well as the extent of any positive effects. Likewise, research has yet to prove that this extract has any ability to improve memory in people who do not have dementia. Until experts know more about this herbal extract, its use is not recommended.

Phosphatidylserine (PS)

This fat-soluble substance is an essential component of cell membranes. It is found in highest concentrations in brain cells, where it may help preserve or improve some aspects of mental functioning in the elderly, according to some reports. Studies have shown mild benefits from supplementation in patients with mild Alzheimer's disease, who showed improvement on standardized tests of mental functioning.

It has also been suggested that adults age 50 and older, especially those with age-related memory loss, may not synthesize enough PS and may benefit from supplemental PS. Taken orally, PS is rapidly absorbed and readily crosses the blood-brain barrier to reach the brain.

At this time, however, there is not enough evidence of its usefulness or long-term safety to recommend its use.

Pregnenolone

This natural hormone closely related to cortisone is made in many organs and tissues that produce steroid hormones, including the adrenal glands, liver, skin, and gonads (testicles and ovaries). Until 1981, scientists thought that steroids found in the brain came from elsewhere in the body, but in fact the brain has the capacity to use cholesterol to make pregnenolone and other steroids.

A 1992 study conducted with laboratory mice concluded that giving pregnenolone to aging animals could significantly improve memory function. Certain drugs prescribed for cancer and mental disorders frequently block the synthesis of cholesterol, thereby causing a deficiency of pregnenolone. Basically, however, there is no evidence to suggest that this hormone is helpful in improving memory function in healthy people.

Vinpocetine

It has been suggested that this substance, a derivative of the periwinkle extract vincamine, may benefit memory by boosting blood flow to the brain and enhancing the brain's use of glucose and oxygen. Vinpocetine was introduced into clinical practice in Europe more than two decades ago for the treatment of cerebrovascular disorders and associated symptoms. Experiments with vinpocetine suggest that it can dilate blood vessels, make red blood cells more pliable, and interfere with clumping of platelets; it may also have antioxidant properties. In one British study, statistically significant cognitive improvements were found. Vinpocetine appears to be helpful in memory disorders caused by poor blood flow to the brain, but it has not been approved for use in the treatment of Alzheimer's disease, nor is there sufficient evidence to support its use in healthy people.

On the next page, learn about how head injuries can affect memory.

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If you want to make sure that your memory stays as strong as possible, always wear a helmet during biking, skiing, and similar sports, and avoid contact sports. It pays to protect your skull from injury, since more and more research has linked head injuries to later problems with memory and to Alzheimer's disease.

Even a mild bump on the head can damage the brain, which typically moves within the skull and crashes against the opposite side of the bony cranium. The problems may be caused by direct physical damage to the brain, as well as a brief lack of oxygen and subsequent swelling. Even a very mild head injury can cause swirling movements throughout the brain, tearing nerve fibers and causing widespread blood vessel damage. Bleeding in the brain may cause even more damage that can lead to memory problems. The temporal lobes of the brain are especially sensitive to this kind of injury, leading to a puzzling interplay of memory, thinking, and behavioral symptoms that may be hard to diagnose. Scientists suspect that up to 60 percent of those who suffer mild brain injury still have memory problems up to three months after the injury.

After a head injury, you may notice you feel a bit confused and disoriented and have trouble storing and retrieving new information or recent memories. For some reason, the physical and emotional shock of the injury interrupts the transfer of information that was in the short-term memory just before the accident; that's why some people can remember events from several days before and after an accident but not what happened immediately preceding, following, or during the accident.

Until recently, doctors didn't have the tools to reveal the subtle structural changes that can occur after a mild head injury and that can lead to subsequent memory problems, although many patients with these kinds of injuries report headaches, memory loss, and confusion that persist for months. In the past, a typical computed tomography (CT) scan did not reveal any brain damage. But more sophisticated magnetic resonance imaging (MRI) scans can pinpoint contusions (bruises) and diffuse brain cell injury that underlie the memory symptoms. Unfortunately, few people who experience a mild head injury are hospitalized overnight or given any instructions explaining possible memory, thinking, and emotional symptoms that may persist.

More serious than a one-time mild head injury are the concussions related to sports injuries, experts believe. More than half of retired football players experienced concussions during their playing days, and as a group these players are more likely to have memory problems. In fact, many neurologists believe that concussions and repeated blows to the head do lasting damage to the brain and the memory processes. For example, the "punch drunk" syndrome of speech and movement impairments is quite typical of retired boxers who sustained repeated blows to the head during their careers.

On the next page, learn about how various medications can impact memory.

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Jim was starting to worry about the problems he was having with his memory. At 64, he seemed far too young to be experiencing dementia, but he was starting to forget to turn off the stove or unplug the coffeepot. When he complained to his family doctor, he was told to come in for an exam and to bring any medications he was taking with him. Jim needed a shopping bag to gather up all of the supplements, vitamins, drugs, and herbs he took each day -- several of which he learned were interacting with each other and almost certainly causing his memory problems.

Your local pharmacy's shelves are lined with purported "miracle" drugs, but a surprising number of them can turn your sharp memory into mush. In fact, about five percent of all memory problems are related to medication interactions. It's a serious problem, especially among older Americans, who are more likely to be taking several medications and supplements at once.

Many of the drugs typically taken by people over 50 can cause subtle thinking problems by themselves, but when several are taken at once, significant Alzheimer's-like problems can appear. These problems may include memory loss, absentmindedness, confusion, disorientation, and emotional outbursts. Alcohol abuse will worsen drug-related memory problems.

Opiate painkillers and drugs that act on the brain are the most common drugs that cause memory problems. Other often-used drugs that may cause or aggravate memory problems include anticholinergic medications, which are used to treat movement disorders, allergic reactions, or stomach problems, and drugs used to treat cardiovascular problems such as high blood pressure. And the Food and Drug Administration recently required makers of the popular new sleep medications to warn patients about the possibility of rare side effects including sleep-driving and sleep-eating -- in which patients who have taken one of these medications unknowingly get up and drive or eat while they are asleep but have no memory of having done so when they wake up -- after multiple reports of such effects hit the news. Even if you suspect that your memory problems may be linked to prescribed medication, however, do not discontinue use of the medication without first discussing it with your doctor.

Anticholinergic Drugs (scopolamine, atropine, glycopyrrolate)

These drugs block acetylcholine and are used to treat movement disorders (such as Parkinson's disease), irritable bowel syndrome, asthma, certain types of urinary incontinence, and other problems. Scopolamine in particular is a strong memory blocker.

Anti-epilepsy Drugs (phenytoin/Dilantin)

Drugs that are used to treat brain problems such as epilepsy are considered to be harmful to memory, as are derivatives of atropine, which typically induce amnesia. In particular, large doses of Dilantin can interfere with memory, reaction time, and thinking.

Opiates (heroin, morphine, codeine)

Natural opiates come from the opium poppy Papaver somniferum. Narcotics are made from opium and are used legally as prescription painkillers. Many of the opiates are quite capable of interfering with both short- and long-term memory and learning. Experts think these drugs interfere with memory by affecting brain chemicals including acetylcholine and norepinephrine.

Psychoactive Drugs

While many psychoactive medications interfere with memory, different drug classes within this broad category may cause different types of memory problem. In fact, the type and extent of memory loss may vary even among the drugs within the same class. For example, one type of antidepressant that interferes with certain brain chemicals may improve memory, compared to another group of antidepressants (such as the tricyclics) that interferes with memory. Some of the psychoactive drugs that cause memory problems include:

ChemotherapyMild memory loss may be a potential side effect of chemotherapy. How significant a problem it is, which drugs cause it, how long it lasts, and what you can do to combat it are questions scientists are trying to answer. One Canadian study found that half of all women taking or finished with chemotherapy showed mild problems with cognition and memory. The women taking chemotherapy during the study had more significant memory problems than those who had already finished chemotherapy.

Other Chemicals and DrugsMany other drugs can cause memory problems, including:

To learn more about the various aspects of memory, see:

ABOUT THE AUTHOR:

Richard C. Mohs, Ph.D., has been vice chairman of the Department of Psychiatry at the Mount Sinai School of Medicine and associate chief of staff for research at the Bronx Veterans Affairs Medical Center. The author or co-author of more than 300 scientific papers, Dr. Mohs has conducted numerous research studies on aging, Alzheimer's disease, and cognitive function.