Natural Solution for Alzheimer

Unraveling Alzheimers Disease

Unraveling Alzheimers Disease

I leave absolutely nothing out! Everything that I learned about Alzheimer’s I share with you. This is the most comprehensive report on Alzheimer’s you will ever read. No stone is left unturned in this comprehensive report.

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The Great Brain Secret

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Normal Aging or Dementia A Questionnaire

How do you know when memory loss is an early symptom of Alzheimer's disease or another type of dementia There's no question that severe, progressive memory loss is a hallmark of dementia, but recent research suggests that forgetfulness alone is not a perfect predictor of Alzheimer's disease. In an article published in the Archives of Neurology in 2000, researchers at Harvard Medical School found that responses to eight standard clinical questions predicted with a high degree of accuracy whether people with memory impairment would remain stable, decline, or improve. The eight questions were derived from three categories judgment and problem solving, home and hobbies, and personal care as follows

If Youve Developed Mild Memory Loss

If you are in your forties to fifties, you are likely to have an identifiable, reversible cause of memory loss. If you are in your sixties to eighties, memory loss due to either the aging process or dementia is much more common. If there is a relatively rapid onset (weeks to months) of symptoms, a potentially reversible cause of memory loss is more likely. A fluctuating course of symptoms, with periods of clear memory and cognition intervening between episodes of confusion or memory loss, is more likely to be due to an identifiable, reversible cause. A gradual dwindling in memory over many years, even decades, is characteristic of memory loss due to the aging process. A steady decline with mild symptoms progressing to severe symptoms of memory loss within a few years suggests Alzheimer's disease.

If Youve Developed Mild Memory Loss What Does It Mean

If you are in your forties to fifties, you are likely to have an identifiable, reversible cause of memory loss. If you are in your sixties to eighties, memory loss due to either the aging process or dementia is much more common. If there is a relatively rapid onset (weeks to months) of symptoms, a potentially reversible cause of memory loss is likely. A fluctuating course of symptoms, with periods of clear memory and cognition intervening between episodes of confusion or memory loss, is more likely to be due to an identifiable, reversible cause. A gradual dwindling in memory over many years, even decades, is typical of memory loss due to the aging process. A steady decline, with mild symptoms progressing to severe symptoms of memory loss within a few years, suggests Alzheimer's disease. Early benign signs of memory loss due to the aging process include forgetting names, forgetting a few items on a shopping list, misplacing keys, or not recognizing someone you met a long time ago....

Does Everyone Eventually Get Alzheimers Disease

Several years ago, Denis Evans's research group at Harvard conducted a survey in East Boston and found that literally half the people above the age of eighty met diagnostic criteria for Alzheimer's disease. Their results suggested that Alzheimer's disease, not memory loss due to aging, was the normal clinical course for people as they grew older. However, other investigators have since reported much lower rates of Alzheimer's disease in octogenarians. As I discussed in an earlier chapter, if performance on cognitive tests is corrected for age and education, then few people meet criteria for dementia, or Alzheimer's disease more specifically. But if absolute cutoff scores on cognitive tests are used to make the diagnosis without accounting for the impact of age or education, then a large proportion of elderly people will meet the diagnostic criteria for dementia, primarily Alzheimer's disease.

Identifying Reversible Causes of Memory Loss Is Critical

The importance of making sure that there is no potentially reversible cause of memory loss cannot be overemphasized. Just imagine taking a memory enhancer like ginkgo biloba or vitamin E when in fact the root cause is medication toxicity or alcohol abuse or depression or hormonal abnormalities. Not only will the memory-enhancing medication have no positive effect, but the fact that things do not improve will also mislead you into thinking that the memory loss must be the first sign of Alzheimer's disease. This can be disastrous, both emotionally and practically. Therefore, if you suffer from mild to moderate memory loss, do not automatically assume that you have age-related memory loss. Rather, you should examine your habits and daily routine to see if there might be an identifiable, potentially reversible, cause. In the next few chapters you will learn about these specific causes of memory loss and the optimal therapeutic strategies to reverse them. I will focus on common disorders...

If Youre Highly Educated Subtle Memory Loss Is a Red Flag

This example shows that the impact of education (and culture) on cognitive test performance is almost as large as the effect of age itself. Education increases brain reserve capacity and thus decreases the likelihood of memory loss and intellectual decline. My colleague Dr. Yaakov Stern published a paper in the Journal of the American Medical Association demonstrating that highly educated people can mask memory loss by talking around the problem'' in the early stages of Alzheimer's disease. Presumably, their association cortex around the hippocampus is better developed, giving them a cognitive reserve that can be brought into play when the brain's frontline attempt at recall fails. So if you're highly educated, even subtle memory loss may be more serious than it seems, because it says that your strong cognitive reserve is breaking down.

Inflammation in the Alzheimers Brain

Within the brain, the immune system interacts closely with nerve cells in several regions and is triggered in a variety of ways. The complement pathway (a sequence of enzymes proteins) plays an important role in the immune response, and an overactive complement response can damage different areas of the brain. In patients with Alzheimer's disease, complement activation can trigger the formation of amyloid protein that collects in clumps to make up the pathologic amyloid plaques. Researchers are now studying anti-inflammatory agents that can block or inactivate complement in the treatment of not only Alzheimer's disease, but also mild to moderate memory loss during the aging process.

Treatment for Moderate to Severe Alzheimers Disease

Memantine, either alone or in combination with one of the cholinesterase inhibitors, is used for patients with moderate to severe Alzheimer's disease. Research shows that memantine helps slow the progression of memory loss and other cognitive symptoms for a period of time. A study published in the Journal of the American Medical Association in 2004 compared a group of Alzheimer's disease patients taking donepezil plus memantine with another group, taking donepezil plus a placebo. People taking both medications for six months exhibited a significantly slower pace of decline in cognitive functions. A similar finding was reported with respect to activities of daily living, which refer to bathing, dressing, and other aspects of personal care. Although patients in both groups declined over the six-month study, the decline was steeper in the donepezil plus placebo group. Our clinical experience with memantine is similar to what we see with the cholinesterase inhibitors. Specifically,...

Memory Myth My Mother Had Alzheimers So Im Bound to Get It

Having a first- or second-degree relative (sibling, parent, aunt, uncle, grandparent) with Alzheimer's disease does not mean that you're destined to get it. Only the rarest form of Alzheimer's disease, the early-onset familial type, is unequivocally genetically transmitted. But even if your mother or another close relative had early-onset Alzheimer's disease, unless you carry one of the genetic mutations that cause it, your risk is no higher than that of someone without a family history of the disease.

Aluminum and Alzheimers Disease

You might have heard that exposure to aluminum can cause Alzheimer's disease. Scientists have been studying this issue for many years, ever since finding that aluminum accumulates in the abnormal brain tissue of people with Alzheimer's disease. The evidence has been difficult to sort out, and many studies have offered contradictory findings. You can be exposed to aluminum in drinking water, in foods cooked in aluminum pots and pans, and possibly in foods and beverages packaged in aluminum. Some antiperspirants contain aluminum, which can be absorbed through the skin. But such environmental exposures tend to be extremely small. Although scientists continue to study the Alzheimer's-aluminum connection, most experts discount aluminum as a significant risk factor for the disease.

Medications for Mild to Moderate Alzheimers Disease

All of the cholinesterase inhibitors are equally effective in temporarily stabilizing memory and other functions of people in the early to middle stage of Alzheimer's disease, although people's response is highly individual. People who aren't helped by one of the drugs might respond to one of the others. After using one of the cholinesterase inhibitors for several weeks, about half of patients are somewhat more alert and better able to care for themselves and engage in activities. The drugs may have other benefits, according to a 2003 report in the Journal of the American Medical Association. This review of twenty-nine studies found that cholinesterase inhibitors might also ease some of the psychiatric symptoms of Alzheimer's disease, such as depression, anxiety, hallucinations, and delusions.

Alternative Remedies for Memory Loss

If medications for Alzheimer's disease can improve memory and related cognitive function in people with the disorder, can they confer the same benefits to people with normal memory The answer is, maybe. A 2001 study compared the performance of a small cohort of commercial airline pilots who took donepezil for one month with those who took a placebo. The pilots who took the Alzheimer's disease drug performed better on difficult flight-simulation tasks. The researchers interpreted the results to mean that donepezil might have improved the pilots' procedural memory their retention and execution of complex skills. ple with Alzheimer's disease, although not for people with normal age-related memory loss.

Drugs for Vascular Dementia or Mixed Dementia

Treatment of these types of dementia is two-pronged. First, we aim to prevent further injury to the brain by controlling vascular problems the root cause of vascular dementia and one of the causes of mixed dementia. This means managing hypertension, high cholesterol, and diabetes with a healthier diet, more exercise, and, if necessary, medications. Second, we treat symptoms of vascular dementia with the same medications that are approved for Alzheimer's disease. Clinical trials have found that galantamine, donepezil, and memantine bring about temporary improvements in memory and related cognitive domains, as well as in daily functioning in patients with vascular dementia.

The Aging Process Worsens Reversible Causes of Memory Loss

Some people with chronic depression or low-level medication toxicity develop mild memory loss for the first time in their sixties and seventies. Many of these people chug along for years with minimal memory loss induced by a specific, reversible cause, like depression or medication toxicity, because it is too subtle to affect daily functioning. Then the process of age-related memory loss, which has been progressing slowly but steadily in the meantime, catches up and adds an extra wallop that leads to clear-cut memory loss. In other words, the two types of memory loss may each be very mild, but when added together they cross the threshold above which most people recognize the presence of memory loss. Clearly, it can be risky to assume that subtle memory loss is always due to the normal aging process. As Jack Kaufman's story illustrates, medication toxicity is a common, often unrecognized cause of generalized cognitive decline, including memory loss. Medication toxicity is only one of...

Step 1 Identify Reversible Causes of Memory Loss

I have started with reversible causes of memory loss for a very important reason. If you fall within the category of people with mild memory loss, identifying and treating these reversible causes, where a cure is often possible, should be your first step. A large minority of people with mild memory loss suffer from reversible causes, and it is absolutely essential to fix these causes first. The following table outlines the most common reversible causes of memory loss, and describes typical symptoms and the main treatment approaches for the specific disorder. To avoid clutter, less common causes like drug abuse and infections are not listed in the table. The symptoms of many of these reversible causes are not restricted to memory loss but also include general cognitive and intellectual decline. If you suffer from mild memory loss and think you may be suffering from a potentially reversible cause Reversible Causes and Age-Related Memory Loss The Domino Effect Returning to an earlier...

How Depression Causes Memory Loss

Joan complained about memory loss even though her symptoms were caused by depression. In other words, memory loss masked her clinical depression, for which treatment was successful. Therefore, if you have begun to experience memory loss and you also feel down or blue (or lack all feelings) most of the time, depression may be the source of your memory problems. Depression itself may be related to stresses and traumatic events in your life, but sometimes depressive illness can strike for no apparent reason. This type of depression is likely to be due to abnormal chemical neurotransmission in the brain, which can be treated successfully with medications, as Joan Marciano discovered.

Tackling Drug Induced Memory Loss Isnt Easy

With these various drugs of addiction, high doses often lead to amnesia, which is a technical term for memory loss. Being unable to recall, or only partially recall, the horrible subjective experiences when the drug's toxicity was at its peak makes it even more difficult for the addict to recognize the need to quit. Also, many addicts welcome drug-induced memory loss as a way to escape from life's problems, and this reinforces their desire to continue their drug use. But those who are able to kick the habit in time alcohol and other addicting drugs alike can regain all their intellectual abilities, including memory.

Diabetes Can Cause Memory Loss

Diabetes, which is caused by deficiency of the hormone insulin produced by the pancreas in the abdomen, leads to damage to very small blood vessels in different parts of the body, including the brain. Mini-ministrokes are the result, producing cognitive deficits that include memory loss. nourishment. Hippocampal nerve cells have high metabolic needs and are very vulnerable to hypoglycemia death of nerve cells with memory loss can result. Fortunately, most diabetic patients who maintain good control over their blood glucose levels do not experience this type of brain damage.

Male Forty to Fiftynine Years Old Mild Memory Loss

Identifying a reversible cause of memory loss should be your top priority carefully go through the list in this chapter and read the earlier relevant chapters to see if you have a condition worsening your memory. If you think there might be such a cause, or you're not sure, consult your doctor.

Biblography On Memory Loss

L., Grady, C. L., Pietrini, P., Brady, D. R., Mentis, M. J., Schapiro, M. B. Association of premorbid intellectual function with cerebral metabolism in Alzheimer's disease implications for the cognitive reserve hypothesis. American Journal of Psychiatry 154 165-172, 1997. Alexopoulos, G. S., Meyers, B. S., Young, R. C., Mattis, S., Kakuma, T. The course of geriatric depression with reversible dementia a controlled study. American Journal of Psychiatry 150 1693-1699, 1993. Amaducci, L., and the Smid group. Phosphatidylserine in the treatment of Alzheimer's disease results of multicenter study. Psychopharmacology Bulletin 24 130-134, 1988. Amaducci, L. A., Fratiglioni, L., Rocca, W. A., et al. Risk factors for clinically diagnosed Alzheimer's disease a case-control study of Italian population. Neurology 36 922-931, 1986. Backman, L., Small, B. J. Influences of cognitive support on episodic remembering tracing the process of loss from normal aging to...

Alzheimers Disease Memory Disorders Centers

These centers are funded by the National Institute of Aging (part of the NIH)and focus on research and clinical services for patients with Alzheimer's disease (www.alzheimers.org), but in recent years they have expanded their efforts to patients with mild to moderate memory loss. If you suffer from mild to moderate memory loss, and wish to seek expert physician consultation, it is worth going to a center that is in your geographic region. The clinicians and researchers in these centers (the name and telephone number of the director of each center, as of mid-2000, are listed below) are the leading experts in the field of memory disorders. Director, UC Davis Alzheimer's Disease Emory Alzheimer's Disease Center Marsel Mesulam, M.D. Director, Alzheimer's Center Northwestern University Medical School 320 East Superior Street, Searle 11-450 Chicago, IL 60611 Tel 312-908-9339 Denis E. Evans, M.D. Rush-Presbyterian Alzheimer's Disease Center Bernardino Ghetti, M.D. Indiana Alzheimer's Disease...

Early Diagnostic Tests for Alzheimers Disease

Neuropsychological testing typically reveals that loss of recent memory is the only deficit in the disease's earliest clinical stages, which progresses over time to widespread memory loss, great difficulty in naming objects, poor fluency in reciting verbal material, and defects in constructional (drawing a cube, for example) and visuospatial abilities (finding the way to the neighborhood store). However, age and education strongly influence test scores, and these patterns of deficits can occur in conditions other than Alzheimer's disease. (Mary O'Brien, the steady alcohol user, was wrongly diagnosed with Alzheimer's disease based on neuropsychological testing.) The great strength of neuropsychological testing is its ability to pick up subtle, very early memory deficits. It sounds a bit strange difficulty in identifying smells occurs early in the course of Alzheimer's disease. But there is a sound physiologic explanation neurofibrillary tangles, a neuropathologic hallmark of...

Memory Loss Following Heart Surgery

We think that hypertension impairs memory by damaging tiny blood vessels that terminate in the brain's white matter, the bundles of axons that transmit messages throughout the brain and central nervous system. Lesions, or abnormalities, in white matter occur to some degree in virtually everyone older than age sixty and contribute to age-related memory loss. But people with hypertension have more extensive white matter damage than same-age peers with normal blood pressure. Research suggests that hypertension that is inadequately treated might also predispose you to dementia. There's an additive effect brain imaging studies suggest that increased blood pressure can cause small strokes, which can then cause dementia. Hypertension also increases the risk for heart disease, which can cause memory loss. One common treatment for heart disease, coronary artery bypass surgery, can itself lead to memory impairment. (See the sidebar Memory Loss Following Heart Surgery.) Evidence also suggests...

When Did Ronald Reagans Alzheimers Begin

During a deposition in 1990, President Ronald Reagan could not recall the name of the chairman of the Joint Chiefs of Staff. We now know that he went on to develop Alzheimer's disease. Did he already have the disease at that time, or perhaps even earlier While we will never know the answer definitively, his experience illustrates how Alzheimer's disease often starts. In Reagan's case it began with forgetting names, a common symptom of age-related memory loss. This is classic for Alzheimer's disease in its very early phases, it is nearly impossible to distinguish it from memory loss solely due to the aging process, but over time, other symptoms develop. (Recall the case of Frieda Kohlberg, the seventy-four-year-old Holocaust survivor with a genius-level IQ whose only neuropsychological abnormality was a subtle deficit in recent memory this was the first sign of Alzheimer's disease.) But with all the new technology now at our disposal, isnt there a better, more accurate way to make an...

What If Memory Loss Persists after Depression Improves

In some people with both depression and memory loss, the memory deficit may not improve even after the depression is successfully treated. In such a situation, the memory loss that accompanies depression may be the first sign of Alzheimer's disease. We showed this in a community study of elderly subjects, where the presence of depression conferred a threefold increased risk of developing Alzheimer's disease during a follow-up period of up to five years. George Alexopoulos's research group at Cornell reported similar results in hospitalized patients who had both depression and cognitive deficits. These results seem to run counter to the notion that memory loss is part of the depressive illness itself. The age distribution of the patients in Alexopoulos's and my studies provides a partial solution to this riddle. Our studies were conducted in people who were all more than sixty-five years old, with an average age in the seventy-five-to-eighty-year range. The findings probably do not...

Frontotemporal Dementia

Frontal or frontotemporal dementia is a less common subtype. Earlier, all such cases were thought to have Pick's bodies, a specific type of microscopic abnormality, but many cases of frontotemporal dementia do not show this lesion. The clinical features overlap with those of Alzheimer's disease, but ''frontal lobe disinhibition signs are more prominent overeating, sleeping excessively, hypersexuality, motor agitation, and impulsive and unpredictable behavior. Following damage to the temporal and frontal lobes, impulsive behaviors are unleashed from lower parts of the brain, as in the case of Phineas Gage, the railroad foreman whose frontal lobes were crushed by a tamping iron over a hundred years ago. For example, I remember a patient of mine with frontal lobe dementia who gained eighty pounds in one year and lost a hundred pounds in the next. These changes happened without any conscious effort on her part to either diet or put on weight. It was as if the appetite center in the...

FDA Does Not Approve Medications to Prevent Age Related Memory Loss

The FDA does not recognize age-related memory loss to be an illness and is hence unwilling to approve any medication to prevent or treat this condition. This attitude has worked against research development efforts for both pharmaceutical agents and alternative remedies, because no company will invest tens of millions of dollars in clinical research on a compound or natural substance if at the end of this effort there is no hope of regulatory approval. This situation has led to most studies of new medications being conducted in patients with Alzheimer's, an FDA-recognized disease, rather than in people with mild memory loss.

Vitamin E for Memory Loss

In the Introduction, I described the story of David Finestone, a forty-nine-year-old man whose memory loss for names was probably caused by a small stroke. His treatment regimen consisted of cutting down on saturated fats, eating more fresh fruits and vegetables, taking an aspirin a day for its anticoagulant effects to prevent further strokes, and ingesting a capsule of 800 IUs of vitamin E daily. At that time, the antioxidant and antiaging properties of vitamin E were well known, but there were no data to indicate that it could directly prevent memory loss. However, recent studies have produced positive results, and vitamin E is now a frontline strategy to prevent memory loss due to the aging process.

Take Vitamin E to Prevent Memory Loss

Since vitamin E-rich foods can only go so far, you should take 400 to 800 IUs of vitamin E daily as a promemory (and antiaging, more broadly) dose, with 1,200 units for those among you who are more adventurous. Higher doses of vitamin E can cause headache, raise blood pressure, and increase the risk of bleeding in people taking anticoagulant medications like warfarin (Coumadin). There were few side effects in the study involving more than three hundred Alzheimer's patients who each took 2,000 IUs of vitamin E daily, but note that patients at high risk like those on Coumadin were excluded from study participation. Research-wise, large-scale, systematic studies with vitamin E have moved beyond Alzheimer's disease to people with mild memory loss, but these will take a few more years to complete.

Choosing Antioxidants to Prevent Memory Loss

The brain needs the same nutrients and vitamins as the rest of the body it just needs a lot more of them. There is evidence supporting the use of antioxidants like vitamin E, and to a lesser extent vitamins A and C. One or more of these essential vitamins is a must in any program to prevent memory loss. One note of caution these antioxidants are true long-term prevention agents and not quick-fix therapies. You will not see any immediate effects on your memory, and may not observe any change for several months. However, over a period of several years, there is a good chance that your memory will have declined less than that of your aging peers who have not chosen the antioxidant path. In any case, given that these are naturally occurring vitamins and related substances with hardly any side effects, and most are easy to obtain and not very expensive, what is the harm in taking them on a regular basis I am perfectly happy with my own regimen of lots of orange and grapefruit juice, which...

Donepezil Aricept for Mild Memory Loss

There are more and more people like Diane Pozniak who are taking donepezil (Aricept) for memory loss. Some, like Diane, have very mild symptoms that fall beneath most clinicians' scanning radar, while others have more clear-cut symptoms that can be called mild to moderate memory loss without dementia. After all, if donepezil is successful in improving memory in a condition like Alzheimer's that is horrendously difficult to treat, why shouldn't it work as well, or even better, for milder forms of memory loss As Diane's story demonstrates, there is a place for donepezil in such a situation. In fact, recent studies suggest that it has a broad array of actions in improving memory patients with multiple sclerosis show improved memory on donepezil compared to placebo, and patients taking antidepressants and similar medications (some with known anticholinergic effects) report a subjective improvement in memory on donepezil. (There was no objective memory testing or placebo control in that...

Donepezil Aricept to Treat Alzheimers Disease

In the double-blind study that provided the basis for obtaining FDA approval, outpatients with mild to moderate Alzheimer's disease were randomized to receive 10 mg donepezil daily (157 patients), 5 mg donepezil daily (154 patients), and placebo (162 patients). Both the 5 mg and 10 mg donepezil groups showed an average 3 to 8 percent advantage over placebo on cognitive performance and global clinical improvement. The peak effect occurred after six weeks on medication, and by six months the effect had begun to wear off. Nonetheless, throughout this period, patients on donepezil retained an advantage over patients who continued on placebo. In other words, the progress of Alzheimer's disease was not dramatically changed, but being on donepezil meant that the patient's worsening was delayed, unlike people on placebo, who deteriorated steadily over time. From the original series of donepezil study participants, 133 Alzheimer's patients were followed for an average of two years. Donepezil...

Hydergine The First FDAApproved Antidementia Medication

Hydergine is derived from ergot alkaloids (present in rye fungus) that are also used in antimigraine medications. The drug company Sandoz (now part of Novartis) began to study hydergine after it learned that ergot alkaloids were used by nontraditional practitioners to lower a pregnant mother's blood pressure during childbirth. Sandoz's goal was to use hydergine to lower blood pressure and the risk of stroke this didn't pan out, but they did manage to get it approved as a treatment for dementia. From the 1980s into the early 1990s, I saw a large number of patients suffering from dementia who took hydergine. General practitioners or internists usually prescribed it to these patients. On occasion, I myself prescribed hydergine to patients with dementia when, out of desperation, family members insisted that I prescribe something, anything, even if there wasn't any solid evidence supporting the medication's use. At that time, hydergine was the only medication approved in the United States...

Estrogen in Long Term Prevention of Memory Loss

Clinical anecdotes and observations about the power of estrogen have been supported by the results from systematic studies, especially of elderly women living at home. In a report from the Baltimore Longitudinal Study on Normal Aging, 472 menopausal and postmenopausal women were followed for sixteen years. Women on estrogen-replacement therapy were 50 percent less likely to develop dementia. Other studies of women living in the community have also shown that estrogen provides a protective effect against dementia. Most of these studies suggest a twofold to fourfold protective effect, meaning that if you are sixty years old and your risk of getting dementia in the next ten years is 12 percent, this risk will drop to 3 to 6 percent if you are taking estrogen. No one is suggesting that estrogen will cure Alzheimer's, but rather that the procognition properties of estrogen will delay the onset of the disease by several years. The results of several studies indicate that the longer you take...

Social Isolation Leads to Stress and Memory Loss

Is common following the profound trauma of bereavement. What is less well known is that memory loss occurs during the grieving process. In my own experience, I had poor concentration with memory lapses for several weeks after my father's death. I lost track of what people told me at work and in my personal life, and I was functioning below par for quite a while. It was as if my brain was a sieve, with information not being registered properly for later recall because my mind was preoccupied with thoughts and emotions and scenes that involved my father and the rest of my family.

Mixed Dementia

Mixed dementia refers to a syndrome with underlying pathological features of both Alzheimer's disease and vascular dementia. The diagnosis is often made in someone with symptoms of dementia who has a personal history of vascular risk factors and a family history of Alzheimer's disease. The link between vascular dementia and Alzheimer's disease may be more than just a coincidence research suggests that vascular problems play a role in the development of Alzheimer's. A study published in the Archives of Neurology in 2003 found that adults who'd had strokes were at higher risk of developing Alzheimer's disease than people without a history of stroke. This finding added weight to an earlier, well-known National Institute ,131 on Aging-funded study involving 678 nuns that uncovered an association between strokes and Alzheimer's disease. The women who had had strokes plus plaque and tangle pathology were more likely to be diagnosed with Alzheimer's disease than women who had plaque and...

Vascular Dementia

The second leading cause of dementia, vascular dementia is the result of one or more strokes that interrupt blood flow to the brain. The lack of perfusion damages neurons by starving them of 130 oxygen. In contrast to Alzheimer's disease, which commences , figure 7.2 Risk of Alzheimer's Disease by Age gradually, vascular dementia often starts suddenly right after a stroke and then progresses in a stepwise fashion, with further declines in function resulting from subsequent small strokes or cumulative cerebrovascular compromise. You can reduce the risk of vascular dementia by taking steps to control the conditions that can lead to stroke hypertension, heart disease, diabetes, and obesity as well as by not smoking. There are medications available, such as aspirin and warfarin, that can improve cerebral blood flow and possibly help prevent further memory deterioration following a stroke.

Dementia

Dementia is a progressive deterioration of memory and other cognitive functions. Although extremely rare in people younger than sixty years old, dementia becomes increasingly more common with age. The incidence is about 10 percent at age sixty-five and doubles every ten years thereafter. The leading cause of dementia is Alzheimer's disease other causes include cerebrovascular disease, Lewy-body disease, Parkinson's disease, alcoholism, HIV, and rare degenerative brain disorders, such as Pick's disease, progressive supranuclear palsy, Creutzfeldt-Jakob disease, and Hunt-ington's disease. In addition to advancing age, factors that increase the risk of developing dementia are a family history of Alzheimer's disease, possession of the e4 ApoE allele (a genetic variant that increases the risk of Alzheimer's disease), traumatic brain injury, and exposure to toxic substances. Some new research suggests a causal role for certain types of viral infections, including herpes simplex virus type 1...

Alzheimers Disease

Alzheimer's disease is the leading cause of dementia, accounting for between 50 and 70 percent of all cases. The outward signs of classical Alzheimer's disease are all too familiar the insidious onset of memory dysfunction that relentlessly worsens over time and comes to eclipse all aspects of cognitive function. Less frequently, the initial symptoms may be in another neuropsychological realm, such as word finding, higher-order visual processing, spatial construction, or executive function. Patients with Alzheimer's disease also exhibit changes in personality and a decline in self-care. Inside the brain, the neuropathological features of Alzheimer's disease are a significant loss of neurons and the accumulation of amyloid plaques and neurofibrillary tangles. In the early stages, pathological features are concentrated in the hippocampus and other regions of the brain that are important for memory consolidation. Long-term memory is often spared in people with mild to moderate...

Other Dementias

Vascular Dementia After Alzheimer's disease, the second most common form of dementia is vascular dementia, which is a direct result of multiple strokes destroying large portions of brain tissue (discussed in chapter 12). Lewy Body Dementia Diffuse Lewy body disease is a diagnosis that has gained in popularity in the 1990s. Lewy bodies are microscopic structures present in the brains of patients with Parkinson's disease. At least one-third of Alzheimer's patients also have clinical features of Parkinson's disease tremor, slow movements, rigidity of muscles, and difficulty in walking. Some of these patients have Lewy bodies in addition to the typical Alzheimer's autopsy findings of neurofibrillary tangles and amyloid plaques. A British group headed by Ian McKeith has led the charge in calling for a separate diagnostic category called diffuse Lewy body disease, which has the clinical features of dementia, Parkinsonian signs, fluctuating memory loss and confusion, hallucinations, and...

Put Together Your Memory Program

You need to adopt a comprehensive memory program rather than hope for a quick fix against age-related memory loss. 2. No single approach will be sufficient to prevent memory loss due to aging, or to block or reverse age-related memory loss after it has set in. An integrated approach that includes sound general health measures (diet, exercise, memory training), identifying and reversing specific causes of memory loss for those who have such causes, and limited use of medications (vitamins, alternative therapies, and pharmaceuticals) will give you the maximum benefit. 3. The program requires consistency and long-term commitment, because given the nature of age-related memory loss, you may not see any results for many months or even years after you begin the program. 4. You don't need to follow every single suggestion or piece of advice rather, you should tailor the program to your own needs. For example, while everyone should develop sound dietary and exercise habits, not everyone needs...

Vitamins Diet Plus Supplements for a Promemory Effect

The beauty of vitamins is that they are completely natural substances essential for daily bodily functioning, and hence there is little danger in taking extra amounts, with a few exceptions. A diet rich in fruits and vegetables provides sufficient vitamins and minerals to prevent nutritional deficiencies, but a proactive intervention for memory loss requires supplementation well above the recommended FDA daily requirements. In other words, a healthy diet with proper nutrition is excellent for maintaining general health, but specific supplements are needed to obtain a promemory effect. The free radical theory of aging and memory loss lies behind the use of vitamin C and vitamin E, as well as vitamin A or beta-carotene. Vitamins A, D, E, and K are fat-soluble vitamins, whereas the B complex vitamins and vitamin C are water soluble. The fat-soluble vitamins are broken down mainly in the liver, which has a limited capacity to handle these compounds. Therefore, if taken in large amounts,...

Foods Rich in Antioxidants

May diminish the risk of heart attack and stroke (not yet fully proven) and thereby decrease the likelihood of memory loss. The nutritional supplement dose of vitamin A is 10,000 to 50,000 units daily, or 10,000 to 25,000 units daily when taken together with 15 mg of beta-carotene. Carrots are an excellent source of beta-carotene, which is closely related to vitamin A. While vitamin A doses up to 100,000 units daily are generally safe, megadoses of vitamin A can lead to liver toxicity. Vitamin A has antioxidant potency that is comparable to vitamin E, and hopefully it will be studied further in people with memory loss. Until then, vitamin A will remain a second-level intervention in the Memory Program. Linus Pauling, who won two Nobel Prizes, began to be considered a quack after he advocated taking huge doses of vitamin C to fight the common cold and to tackle a host of other diseases. More recently, his original arguments have been vindicated as the free radical toxicity theory has...

Trace Metals in Your Diet

Selenium is a trace element that has antioxidant properties and is claimed to be an antimemory-loss agent, but it has not been tested rigorously in people who have memory loss. There are other elements magnesium and zinc in particular that are necessary for normal brain function in small quantities, or traces. Until more solid evidence is forthcoming, and given the potential toxicity of these metallic elements and compounds, I don't recommend taking supplements of any trace metals. The amounts of these various substances present naturally in foods (and most multivitamin tablets) easily reach the FDA minimum daily requirement guidelines, so nutritional deficiency states are extremely rare.

Cholinesterase Inhibitors

Cholinesterase inhibitors represent the only class of medications that are FDA-approved to treat dementia, specifically Alzheimer's disease. After tacrine came donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl). Although these medications were developed to treat patients with Alzheimer's disease, the pharmaceutical industry has become aware that the market for mild memory loss is much larger. Aricept has been shown to improve cognition in patients with multiple sclerosis, and is now being tested in people with mild to moderate memory loss. The other newer cholinergic agents may have similar properties. The underlying rationale is that cholinergic nerve cells decay in all of us during the aging process, and cholinesterase inhibitors can reverse this deficit and thereby improve cognitive performance.

How Education Affects Memory Rosas Story

Rosa Gonzalez, a sixty-four-year-old woman from the Dominican Republic, was brought by her daughter into our Memory Disorders Center for evaluation of her declining memory. Rosa Gonzalez had forgotten to turn off the stove on one occasion and had begun to forget the names of distant relatives. Otherwise, she was functioning quite well at home, managing her daily chores without any difficulties. The neurological, psychiatric, and brain imaging workup revealed no significant abnormalities, but her neuropsychological test results threw us into a quandary. She scored in the range that would merit a diagnosis of dementia. However, her subpar scores were most prominent in naming, language, and general knowledge. She couldn't name any of the past five American presidents. From a set of ten pictures of objects, she couldn't name five a camel, dominoes, a pretzel, a tennis racquet, and an igloo. On the Selective Reminding Test, which requires repeated learning and recall of a list of common...

Second Level Medications Doses Actions Side Effects

The main reason that vitamins A and C did not make it to the first level is that they have not been rigorously tested against memory loss. Nevertheless, their powerful antioxidant properties, which in animal Aspirin's anticoagulant effects help protect against ministrokes, a common cause of memory loss during the aging process. If you have any risk factors for stroke, such as high cholesterol, smoking, or a positive family history of stroke, an aspirin daily (or even a baby aspirin daily) is a good idea. Its anti-inflammatory properties may also be useful in delaying the onset of Alzheimer's disease, and memory loss more generally. Use aspirin with caution if you're prone to stomach upset or irritation (or ulcer), and avoid it if you have bleeding tendencies or are taking anticoagulants. Ginkgo biloba joins phosphatidylserine as an alternative medication that makes the list. EGb 761 is the best-studied form of ginkgo biloba, and can be taken in doses of 120 mg daily. While there is...

Types of Antiinflammatory Agents

Anti-inflammatory medications are of two types steroidal and nonsteroidal. It may seem odd that steroids, which in high concentrations can damage the hippocampus, can be therapeutic for patients with dementia. However, the fact that inflammation does occur in the brains of these patients suggests that steroids, which have extremely powerful anti-inflammatory properties, may indeed be effective treatments. Drs. Paul Aisen and Ken Davis at the Mount Sinai Medical Center in New York certainly think so, and they recently completed a placebo-controlled clinical trial using prednisone, a synthetic steroid, in Alzheimer's disease. However, the trial results were negative prednisone showed no advantage over placebo in these patients. In rheumatoid arthritis, the kind that causes swelling and deformity of the fingers and toes, as well as the hands and feet, the body's immune system mistakenly identifies joint tissue parts as alien and attacks them with a vengeance. Since many people who suffer...

Which Medications Should You Take

If you wish to take a memory enhancer, what medication should you choose from this list Obviously, you cannot take the whole lot for several reasons the high cost and large number of capsules required, the increased risk of toxicity, and the lack of solid evidence that combinations are better than single agents. Adding selegiline to vitamin E, for example, does not improve matters for patients with Alzheimer's disease, even though individually each agent has a small effect. Critically, combining too many medications can be dangerous because the risk of toxic interactions will skyrocket. The solution is to follow the medication guidelines in the following tables, based on whether you have a normal memory or have mild memory loss.

Combination Therapies Need to Be Tested

From a theoretical perspective, tackling different pathways that lead to memory loss may be more beneficial than dealing with only one pathway, but a few studies that attempted combination therapies met with poor results. The Alzheimer's study using vitamin E plus selegiline showed no advantage for the combination over either medication taken alone. Earlier, Ken Davis's group at Mount Sinai Medical Center in New York tried a medication cocktail to simultaneously correct the cholinergic and adrenergic (norepinephrine) deficits in Alzheimer's disease, but the combination did not work well in a clinical trial. But another incidental finding suggests that the search for an optimal combination therapy should not be abandoned. In the tacrine study of patients with Alzheimer's disease, the medication's effect was strongest in women taking estrogen, indicating that the combination was better than tacrine alone. In an entirely different field, AIDS treatment underwent a revolution after...

Case of Subtle Brain Toxicity Jacks Story

I was a little surprised to see someone like Jack in our Memory Disorders Center. The episodes that he described could have happened to anyone, and most people wouldn't have rushed to seek help from a specialist. When I probed further, the source of his anxiety became clearer. His father had died of stroke, his mother from complications of Alzheimer's disease, and both conditions were present in the extended family on both sides. Jack's fears now made a little more sense. Neuropsychological testing produced a profile of no memory loss with mild deficits in attention and in the ability to change between sets, which means that the rules of the test are changed in midstream and the subject is forced to readjust quickly and answer correctly according to the new rules. These deficits in executive function can be caused by a disease of the frontal lobe, that huge part of the brain sitting directly behind the forehead that is vital for intelligence and decision making, as well as storage of...

Other Anticoagulant Medications to Prevent Stroke

Stroke in its various forms is more common than Alzheimer's disease, and contributes to memory loss in a large number of people. While you may think that your memory loss is caused by the aging process, you may actually have been having ministrokes in the brain, and accurate diagnosis with prevention and treatment can stop this type of memory loss in its tracks.

How Estrogen Works in the Brain

May reduce destructive amyloid formation that occurs to a small extent during normal aging and to a precipitous degree in Alzheimer's disease. 3. May diminish the inflammatory response in the brain. Abnormal immune reactions are believed to underlie many brain disorders and may contribute to age-related memory loss.

Ive Always Had a Few Drinks at Night Marys Story

Deficits in recent memory associated with generalized brain atrophy on MRI scan. These results strongly suggested Alzheimer's disease. But as I usually do before I drop this diagnostic bombshell, I spent a little extra time double-checking all aspects of the patient's history. I recalled that at her first visit, she had responded to the question about alcohol use by stating that she drank a little every day. After I received her alarming test results, I decided to probe further into this issue. Mary then revealed that she had four shots of whiskey every evening, a long-standing habit. Her husband confirmed her report. He also mentioned that she had begun to make up stories to fill the gaps in her recent memory, a tendency that is called confabulation. Mary said that she had played with her grandchildren the previous weekend when in fact she hadn't seen them for a month. Confabulation is common in both Alzheimer's disease and Korsakoffs syndrome, which is the diagnostic term for a...

When Depression Strikes at Memory Joans Story

I realized that quick action was needed and immediately arranged for a number of tests to help clarify the situation. The medical diagnostic workup was within normal limits. On neuropsychological testing, she scored slightly below normal for her age on several measures of attention, concentration, and memory. Her test performance was confusing to the neuropsychologist, who could not decide between the diagnosis of depression and the early stages of Alzheimer's disease. I was more confident about the clinical presentation. I made a diagnosis of major depression and asked Joan if she would agree to participate in one of my studies. The study involved twelve weeks of treatment with the antidepressant medication sertraline (Zoloft) to evaluate its effects on both depression and cognitive deficits in people who had both these problems. Joan was quite willing to do the research evaluation and interview procedures in the study, but she was reluctant to take medication, as many patients are....

Therapeutic Guidelines for Antiinflammatory Medications

For anti-inflammatory agents, a few broad guidelines are in order. Although steroids like prednisone have the strongest anti-inflammatory properties, these are fairly toxic compounds that are quite tricky to use. In addition, the negative results in the recent Alzheimer's study have convinced me to exclude steroids from the Memory Program. Among the NSAIDs, the antioxidant and anticoagulant properties of aspirin give it a slight edge over the other available compounds. If you have risk factors for stroke or heart attack for example, a strong family history or a high cholesterol blood level an aspirin a day is a good idea. It may also protect against memory loss, given its antistroke and anti-inflammatory properties. Other NSAIDs like ibuprofen (Motrin) or indomethacin (Indocin) also irritate the stomach lining, though to a lesser extent than aspirin (enteric-coated or buffered aspirin helps but does not always solve the problem). The other NSAIDs do not share aspirin's anticoagulant...

The Kentucky Nuns Controversy

In a study of nuns residing in a convent, David Snowdon and his colleagues from the University of Lexington in Kentucky examined the autobiographical essays that all the candidate nuns were required to write when they joined the convent. The young nuns who had low idea density (number of ideas per every ten words) were significantly more likely to be diagnosed with Alzheimer's disease (diag Does this mean that the template for developing Alzheimer's disease in old age is already set when we are young We know that there is a strong genetic component to this disease, but for some reason it does not show up clinically until we are much older. Could it be that the educational process, and the additional mental challenges that galvanize us in many of our occupations, can stave off the illness for years, maybe even an extra decade If that were true, it would represent one of the most intriguing interactions between genetics and environment. But if you step back and think about this issue a...

Typical Sequence of Symptoms

This sequence occurs because the brain reacts to the ministroke by pouring out edema fluid that compresses the area surrounding the dying brain tissue. As the edema subsides, the nerve cells that were compressed and paralyzed by the edema fluid regain their function, but those cells that already died in the center of the ministroke (infarct) cannot recover. Hence, there is only partial clinical recovery after each ministroke. If these little strokes occur repeatedly over several years, they can lead to full-blown dementia with severe memory loss. The history of repeated, staggered decline with incomplete

Other Potential Promemory Agents

Many other medications have been proposed as treatments for mild memory loss, or as part of an antiaging regimen. These agents include DHEA, hormones and related peptides, and metallic elements. Although several of these substances are intriguing, the knowledge base is currently insufficient to include them in the Memory Program. Nonetheless, knowing the basic facts will give you a better understanding of the stories that you are likely to hear in the media about one or more of these agents as potential cures for memory loss. Clinically, some patients with lupus who take DHEA have reported improved mood and less generalized pain. DHEA has also been administered to people with a variety of age-related maladies, including memory loss. A major limitation is that most studies to date have involved only a handful of subjects. German investigators recently reported that a single 300 mg dose of DHEA did not affect memory test performance in young adults. In another negative study, Kristine...

Depression and Memory

Depression is a common reversible cause of memory loss. Depressed people are often slow in their thought processes, and some find it difficult to retrieve memories. Depression causes a deficit in attention, and hence new information is not registered properly, so attempts at recall often fail because the external stimulus meeting someone for the first time, for example isn't recorded as a permanent memory in the brain. These two symptoms slowing down of thought processes and poor attention underlie memory loss in depression.

Why Other Medications Did Not Make the

The cholinergic compounds lecithin and Alcar just missed the cut because the data are much weaker than for Aricept (or Exelon or Reminyl). DHEA (discussed in the next chapter) is not on my list, not only because its efficacy against memory loss has not been established, but also because it is more toxic than the medications that are on the list. The data on hydergine and the nootropics do not suggest sufficient action against memory loss. The COX-II inhibitors did not make it to the list either, mainly because they have just been released and we have no information on their use against memory loss. Ongoing and future clinical studies may demonstrate significant antimemory-loss properties for the COX-II inhibitors, in which case Celebrex or Vioxx might well vault to the top of the list.

Final Memory Program Tips

A combination of general health measures like proper diet and regular exercise, memory training, and appropriate medications (particularly if you have mild memory loss medications are less critical if you currently have a normal memory), provides a comprehensive strategy to prevent memory loss due to the aging process. 2. If you have mild memory loss, you should first look for a reversible cause. 4. This field is evolving rapidly, so you need to keep up with the latest developments, which are certain to be given considerable play in the media. These new developments may make it necessary for you to change your strategy over time for example, you may need to switch to COX-II inhibitors in the future if they are shown to be effective in treating mild memory loss.

Stop the Addicting Drug and See If Memory Improves

If you, or someone close to you, are not sure if alcohol or another substance is causing subtle memory loss, there is a simple way to find out stop taking the drug for two to three months and see if your memory improves. If it does, you have your answer, and staying off alcohol or the drug that you are using is the solution for your memory loss. But if you are unable to stop for even a few weeks, this proves that you are addicted and need to take specific steps, such as joining Alcoholics Anonymous or Narcotics Anonymous or another addiction program, to help you get over your addiction.

Common Medication Culprits

Steroids, benzodiazepines, and medications with anticholinergic properties are among the commonly used medications that can cause memory loss. Steroids like hydrocortisone and prednisone are used to treat severe asthma and autoimmune diseases like rheumatoid arthritis and systemic lupus erythematosus (SLE or lupus). Many skin creams and ointments also contain steroids, but these are not absorbed in sufficient quantities to affect the brain. Steroids work by suppressing the body's natural immune response against bacteria, viruses, and toxins, and this helps in diseases where there is a wayward, self-destructive immune response. Steroids have a number of side effects, including stomach ulceration and weakening of bone structure (osteoporosis). In high doses, steroids can affect the brain, causing memory loss, confusion, and even psychosis. But subtle effects particularly low-grade depression, anxiety, and memory loss are far more common. Benzodiazepines comprise another class of...

Male Forty to Fiftynine Years Old Currently Normal Memory

Memory exercises and training this is the right time to begin using all the methods to improve learning and recall that you can use, before memory loss begins to occur. Identifying reversible causes of memory loss should not be an issue if you have a normal memory, but it is worth checking the list to see if you have a reversible condition that can be corrected.

Step 3 Supplement with Medications Vitamins Alternative Pharmaceutical

Medications to prevent future memory loss, or to treat mild forms of memory loss, should be used to supplement, and not replace, general health measures like proper diet and exercise. You may wish to try the alternative medications in the list, or you may prefer to Be Realistic Long-Term Therapy Is Needed to Protect against Memory Loss You must not forget that a truly effective preventive strategy will take many months to years to exert its full effects, and being impatient about the fact that medications are not giving you a rapid response will be self-defeating. Bear in mind the reality that for age-related memory loss without a specific reversible cause, there is no miracle cure. Blocking further decline, and hopefully experiencing a moderate degree of improvement in memory, should be your goal.

Diagnosis and Treatment

Memory loss, depression, lethargy Physical and mental slowness, weight gain, constipation, cold intolerance Poor concentration, memory loss Generalized weakness, fatigue Abnormal gait, unsteadiness on feet Stomach, gastrointestinal complaints chug along for years with minimal memory loss induced by a specific, reversible cause like depression or medication toxicity, because it is too subtle to affect daily functioning. Then the process of age-related memory loss, which has been progressing slowly but steadily in the meantime, catches up and adds an extra wallop that leads to clear-cut memory loss. In other words, the two types of memory loss may each be very mild, but when added together, memory loss becomes obvious.

Hormones and Nutrition Staying Well Tuned

Unfortunately, many people who develop memory loss assume that it must be due to the aging process and do not consider the possibility that reversible causes like hormonal and nutritional abnormalities may be the culprits. The good news about hormonal and nutritional abnormalities is that if they are recognized early, they usually improve and can often be completely reversed with the right treatment. For hormonal abnormalities, early recognition is the key and physician consultation is required. To prevent nutritional causes of memory loss, in addition to eating a diet low in saturated fats and rich in fruits and vegetables, taking a daily multivitamin tablet that meets the FDA requirements for the major vitamins (B1 to B12, A, C, D, E) is the best strategy. For a promemory effect, higher dose supplements of the antioxidant vitamins A, C, or E are necessary.

Female Forty to Fiftynine Years Old Currently Normal Memory

Follow the physical exercise regimen (chapter 5 and this chapter), but go easy on running and lifting weights. Equality of the sexes does not extend to bone structure you need to protect your knees, ankles, and hips more than men of your age. Perform moderate, regular exercise three to six times per week use any mixture of aerobic and anaerobic exercise that suits your interests. Memory exercises and training this is the right time to begin using all the methods to improve learning and recall that you can use, before memory loss begins to occur. Identifying reversible causes of memory loss should not be an issue if you have a normal memory, but it is worth checking the list to see if you have a reversible condition that can be corrected.

Hormone and Peptide Therapy

If thyroid deficiency causes memory loss, can giving thyroid hormone to people without this hormone deficiency boost memory The answer is no the body's internal regulatory system maintains a fine balance in the levels of thyroid and most other hormones, quickly getting rid of the excess hormone that is ingested. An additional factor weighing against these hormones is that they cause a variety of side effects (differs markedly among different hormones) when given in high doses, thus reducing their potential utility as a long-term preventive strategy against age-related memory loss.

How about a Male Estrogen

How about a male estrogen to prevent not only memory loss but also heart attacks and strokes that are more common in men than in women There is work afoot to try to develop compounds that retain many of the properties of estrogen without producing its feminizing effects such as changes in breast size and other physical features. The antiosteoporosis medication raloxifene (Evista), which some have informally labeled as estrogen-light, has fewer feminizing properties than regular estrogen, but it is still not suitable for use by men. A recent study in women showed that Evista was much less likely to lead to breast cancer than estrogen, and this compound may be worth testing in women with mild memory loss. The irony about estrogen is that it is a steroid, as is the male hormone, testosterone. Corticosteroids are thought to damage hippocampal cells, but sex hormone steroids may actually protect the same cells. Testosterone therapy in men has not been studied as much as estrogen in women...

Bright Future Awaits

While the final product will be extremely beautiful, you are likely to meet a few thorns along the way. In this book, I have reviewed our current knowledge base and laid out a comprehensive program to help you prevent memory loss due to the aging process, or to identify and treat mild memory loss if it has already set in. But all this is based on current knowledge, which is clearly limited in many ways. Given the various research directions that the field is taking, what does the future hold If things pan out the way that some experts hope, every Kodak moment will literally be inside your head in a perfect image, and cameras will become obsolete. But I do not entirely subscribe to this view, because the fact is that human memory is finite. We all have to wipe out old, useless memories to make way for the new, important ones. We do this daily, as our hippocampi and frontal lobes deliberately forget what we ate for lunch yesterday, two days ago, a week ago, and so forth. Therefore, at...

Planning Pen and Paper Are Better Than Your Head

Don't feel shy about using pen and paper Notebooks (paper pen or computerized) and lists are excellent memory aids. And if you suffer from moderate memory loss, you need to take this a step further keep detailed lists and schedules, and paste important information in prominent places around the house.

Genetic Factors Influence Treatment Response

In all branches of medicine, there is a general rule that genetic factors play an important role in predicting treatment response. If one family member responds to a treatment, the other family member will likely respond to the same treatment. I am convinced that estrogen could have accomplished for Cynthia what it had achieved for Myra, and that its effects on both mild depression and memory loss would have been far greater than the standard antidepressant and antimemory-loss medications that she received. My guess is that her primary problem was estrogen deficiency (blood estrogen levels are

Antiaging Properties of Zinc

Zinc's utility against memory loss remains to be tested clinically. In an elegant series of laboratory experiments in animals, Dennis Choi, chairman of the department of neurology at Washington University in St. Louis, showed that zinc in low concentrations protects against some types of hippocampal neuronal injury, but that at higher concentrations it kills nerve cells. So zinc therapy may be a double-edged sword at low doses it is good, at high doses it is bad. This twist has led to a reversal in therapeutic strategies for memory loss zinc therapy is now being replaced by substances that actually decrease zinc's availability in the brain. Zinc is present in concentrations that are sometimes too low to detect, but new technology has opened up opportunities that should eventually tell us a great deal about the

The Stress Memory Connection

During periods of great stress we tend to make more mistakes than usual and don't remember things well, such as where we put our keys or tracking our appointment schedules. However, high stress levels do not always lead to memory loss. For example, most occupants of the White House have reveled in the challenge and have not broken down under the stress of all the responsibilities that are thrust upon them. Their stress is offset by the gratification that comes from the power, importance, and control in the presidential role. Also, these people have a great capacity to withstand and overcome stress, which is why they became successful politicians in the first place. At the opposite end of the spectrum, an employee performing boring, repetitive tasks a postal worker is a prime exam

First Level Medications Doses Actions Side Effects

Vitamin E's broad antioxidant and antiaging properties vaulted it to the top, particularly as a long-term preventive measure against future memory loss. Vitamin E should be taken as a single daily capsule of 400 to 800 IUs, but you can go up to 1,200 IUs (a maximum of 2,000 IUs if you're very adventurous). There is a very small risk of bleeding if you also take anticoagulants like Coumadin for the same reason, be cautious about combining vitamin E with aspirin or ginkgo biloba. Fortunately, in the very rare instances of bleeding caused by taking vitamin E, it is likely to begin gradually, so there will be time to reverse the problem by just stopping vitamin E.

Methods to Improve Learning and Recall

Obviously, the most effective diet and exercise (physical and mental) program is just that a diet and exercise program, not just one or the other. From a health standpoint, this combination needs to be executed on a steady, continuous basis. Fits and starts are not very helpful in preventing memory loss. Stick to a sensible diet without drastic changes and exercise regularly, preferably a few times each week. Memory training to maintain mental sharpness is also important. Once you convert these changes into regular habits you will be on automatic pilot, and the regimen will not seem so difficult to maintain.

Environmental Chemical Damage to Your Brain Cells

In children, nerve cells are still reproducing and growing, and heavy metals like lead wreak havoc on DNA and the process of cell reproduction. In adults, the nerve cells have already been fully formed, so the potential for brain damage and memory loss is much lower, though it still exists. In our Memory Disorders Center, we have seen a handful of middle-aged patients with possible heavy metal or organic solvent (benzene, toluene) toxicity, usually from a work-related source. In such cases, the facts can become a little murky if workmen's compensation claims are involved. poisoning are those that need oxygen the most the basal ganglia that control motor movements and hippocampal nerve cells. Naturally, motor movement abnormalities and memory loss are common complications. If the person survives, the death of nerve cells leads to motor and cognitive deficits that neither improve nor deteriorate over time.

How Stress Affects Memory in the Brain

Animal studies show that chronic stress can lead to increased formation of free radicals. As previously discussed, these free radicals, including bad oxygen, can inflict damage on vulnerable cells in the hippocampus and other brain regions. The outcome, not surprisingly, is memory loss. There is a third, indirect, way in which stress can induce memory loss. Stress stimulates the sympathetic nerves that supply the heart and affect blood pressure. As a result, chronic stress increases the likelihood of heart disease and high blood pressure. High blood pressure and heart disease can, in turn, lead to the development of strokes, including ministrokes, in the brain that can affect memory.

Techniques to Improve Your Memory

There are many books devoted to memory improvement by using a variety of tricks and techniques. I will not discuss techniques used by high school and college students to cram for exams, and instead will focus only on those methods that can help prevent age-related memory loss in people above the age of forty. you will always remember, even if you have mild memory loss. Or the small elderly woman yelling, Where's the beef '' in the hamburger ad. Three factors help imprint these memories in your brain

Other Novel Strategies

The elusive prion, discovered by Nobel laureate Stanley Prusiner, must not be forgotten. These microscopic prions play a role not only in neurological disorders, but possibly in memory loss due to the aging process itself. I suspect that we will hear a lot more about the role of prions in memory loss.

The Essential Promemory Diet

A saturated fat-rich diet is the worst dietary culprit. It can lead to memory loss because high cholesterol levels and plaques begin to block the brain's arteries. Eventually, blood clots can lead to ministrokes and cognitive deficits, depending on which specific part of the brain has been damaged. If hippocampal or frontal cortex nerve cells, or the pathways connecting these regions, are destroyed, memory loss is the result. High levels of saturated fats also generate toxic free radicals, which can damage brain cells even further. Lowering saturated fats boosts the antioxidant potency of your diet, which is beneficial for memory and the aging process more broadly. A diet rich in fresh fruits and vegetables will prevent vitamin deficiencies, promote memory, and reduce the risks of cancer, heart attacks, and stroke.

Genetic Strategies There Is No Memory Gene

A large part of the human genome, or genetic map, focuses on controlling protein synthesis within the brain. As of now, we do not know which genes are responsible for triggering the process of neuronal degeneration and death in the hippocampus and frontal lobes, or for that matter any other part of the brain. It is likely that we all possess both ''good memory genes and bad memory genes, and once we discover them we will be able to directly tackle the problem of age-related memory loss that affects most of us as we grow older.

Your Future Memory Program

The long-standing defeatism about preventing and treating memory loss has now given way to a feeling of growing excitement that we will soon have the keys to the memory kingdom. But we have just scratched the surface, and new knowledge will eventually render obsolete our current repertoire of preventive and treatment strategies, including some of the components in the Memory Program. Several potential therapies for age-related memory loss are still in the development stage. These include a new crop of cholinesterase inhibitors, treatment with combinations of cognitive enhancers, stimulation of neuronal growth, blocking the formation of toxic compounds in the brain, and genetic strategies. Most of these attempts are likely to fail, but the few gems that emerge will revolutionize the field of memory loss research and potentially could completely reverse the memory loss that occurs during the aging process.

Current Research Priorities

Making an early diagnosis and finding a treatment with robust effects are among the current research priorities in this field. If you already suffer from mild memory loss that continues to worsen even after you adopt the memory-enhancing strategies described in this book, I recommend physician consultation to make sure that you are not suffering from early dementia, whether it be Alzheimer's or a less common type.

Small Catch The Practice Effect

As discussed in the Preface, in evaluating treatments for memory loss, a unique factor absolutely mandates a placebo-controlled trial. This is called the practice effect. better, even on those tests that seemed hard to do the first time. This is the practice effect, which means that repeated testing results in superior performance because the brain automatically (even without conscious learning) begins to figure out how best to do the test. In people with little to no memory loss, the practice effect can last for many months after only a single testing session. Therefore, if neuropsychological test performance is compared before and after medication (or other) treatment for memory loss, there will often be some improvement due to the practice effect. If, however, active medication is compared to placebo, subtracting the change on placebo from the change on active medication gives us the real medication effect, thus accounting for the practice effect, which is assumed to be equal in...

Dont Take Any Medications Roberts Story

Robert Molson, a fifty-six-year-old man living in Greenwich Village, came to see me, stating that his memory had begun to decline, he was forgetting names more easily, and he was misplacing things more often. He was afraid he was getting Alzheimer's disease. He worked as a paralegal and hadn't yet run into problems at work, but he did point out that nothing short of a disastrous performance on his part would even be noticed in the New York City court system. He also had financial problems that were a source of constant worry. He had no risk factors for dementia, and no neurological or psychiatric signs or symptoms on examination. I asked him if he was taking any medications. Unfazed, I systematically went through a checklist of all possible medicines that people take for memory loss. On neuropsychological testing, he performed very well. I reviewed the results with him, and he was relieved to learn that he did not have Alzheimer's disease. Since his main fear was resolved, he decided...

Taking Medications to Improve Memory What to Ask Your Doctor

Most studies of treatments for mild memory loss have evaluated people over a few months or at most a year or two. If there is a slight improvement in memory functioning, will this effect be maintained ten, twenty years down the road Also, will continuous long-term usage result in medication side effects that we did not see in the short-term Although we don't yet have the answers from long-term therapeutic trials, the research evidence from short-term to intermediate-term studies with a variety of medications is now sufficient to help build a sound program to prevent memory loss due to the aging process.

BR16A Travails of a Promemory Ayurvedic Preparation

Chittaranjan Andrade, has studied an Ayurvedic preparation that now goes by its modern name, BR-16A. In controlled animal experiments, he showed that BR-16A improved learning and reversed short-term memory deficits in mice. But when he approached the four manufacturers of BR-16A in India, none of them were willing to fund further basic research to find out which of the twenty or more ingredients in the substance was responsible for improving memory. They also refused to fund controlled clinical studies in patients, because if one of the companies invested a large amount of money in research on BR-16A, any positive results obtained would translate into free profits for the other three manufacturers that had not invested in the research effort. As Chittaranjan discovered to his chagrin, it is virtually impossible to get financial support to conduct large-scale, systematic studies of Ayurvedic and other traditional medications. His basic science research...

The Major Alternative Systems of Medicine

Unani is a system of medicine developed centuries ago in Arabia and Persia, which later mingled with local influences in the Indian subcontinent. Its popularity has dwindled over time. Chinese medicines include a variety of plants and their extracts to treat both symptoms and diseases. Many of them are meant to promote health and block some of the effects of aging even in the absence of disease, and some of them have recently risen to prominence in the fight against age-related memory loss. Most of these older medical systems focused on the maladies of youth and middle age, because few people lived to a ripe old age in those times. Hence they had few medicines for age-related memory loss. The one exception Chinese medicine, from which several remedies arose to treat the diseases of aging, including memory loss.

Promemory Actions of Ginkgo

Leaf extracts improve the ability of mice to remember newly learned behavior. In animal studies, enhances recovery from injury to the frontal lobes. In animal studies, acts against the memory deficits associated with aging. In a few clinical studies, slows memory decline in dementia. In healthy young adults, speeds up reaction time in stimulus-response tests, improving alertness. Anticoagulant properties may protect against stroke (and hence indirectly against memory loss). Antioxidant effects may protect directly against memory loss. Recently, a physician friend of mine told me that he now takes ginkgo regularly because he has a strong family history of Alzheimer's disease. And he definitely isn't the only card-carrying member of the American Medical Association who takes this substance. So even though the jury is still out, the evidence in favor of ginkgo is piling up to such an extent that former skeptics have begun to turn the corner. If you are worried about losing your memory,...

Ginsengs Actions in the Brain

Ginseng seems to boost cholinergic neurotransmission in the brain. Given the link between loss of cholinergic nerve cells and memory loss, this may explain its memory-enhancing effects. Ginseng contains a class of compounds called saponins, also known as glycosides, which may affect the function of neurotransmitters in ways that are not fully understood. In experiments involving people ranging from telegraph operators to students, ginseng reduces the time required to perform some neuropsychological tasks. This activating property may, in turn, lead to improved registration of new memories. Given the limited knowledge base on ginseng in people with mild memory loss, I am currently not recommending it as part of your promemory program. The preparations listed above are not known to have any major side effects, so I am not campaigning against their use either.

Selegilines Promemory Actions

This dual antioxidant action likely underlies selegiline's action in delaying functional decline in Alzheimer's disease. Obviously, taking selegiline will not double your life span as it can in mice, but its broad antiaging effects are a plus. Overall, the weight of the evidence suggests that it may be useful in preventing age-related memory loss. Taking Selegiline to Prevent Memory Loss My colleague Dr. Mary Sano headed a national consortium that compared four treatment conditions vitamin E, selegiline (also called Deprenyl), vitamin E plus selegiline, and placebo to treat three hundred outpatients with early to midstage Alzheimer's disease. They found that both vitamin E 2,000 IUs daily (a high dose) and selegiline helped delay functional deterioration or nursing home placement by six months to a year. The results were published in the New England Journal of Medicine in 1997. Vitamin E alone, selegiline alone, and the combination of vitamin E and selegiline each delayed

Vitamin C The Essential Acid

Older people who stop eating vitamin C-rich citrus fruits and vegetables may develop memory loss and mild confusion. Despite Linus Pauling's exhortation to swallow huge amounts of vitamin C to treat the common cold and other illnesses, clinical research in people with memory loss has been sparse. But given that it has antioxidant properties comparable to vitamin E, a promemory effect is more than likely. Vitamin C is found in most fruits and a few vegetables. I suggest a daily glass or two of orange or grapefruit juice, but if you want to be more aggressive you can add 1 to 5 grams of vitamin C tablets daily. Other than a possible increase in stomach acidity, you should not have any side effects. This is because as soon as the water-soluble vitamin C reaches high blood levels, the kidneys expel the excess into the urine. Effective therapy requires staying one step ahead of this mechanism, which means that unless you take high doses continuously, vitamin C therapy won't do you much...

Prescribing Off Label Is Common

Donepezil (Aricept) is approved by the FDA for Alzheimer's disease, and not for the treatment of mild memory loss. So what on earth was I doing prescribing this medication to Diane Pozniak, who had very mild memory loss by any definition, someone who clearly did not have any signs of dementia or Alzheimer's disease The answer to this seemingly loaded question is quite straightforward. Although the FDA labels the use of a medication only for a specific disease or diseases, all licensed physicians are free to prescribe approved medications for other conditions if they wish to do so. Obviously, if something goes wrong and a lawsuit ensues, the physician will have a tough time

Science in Evolution The Cholinergic Story

In 1976, Peter Davies, who was examining autopsied brains of patients with Alzheimer's disease, reported the death of nerve cells that normally produced the neurotransmitter acetylcholine. Around the same time, David Drachman showed that administering scopolamine, which is an antagonist of acetylcholine, to normal people could produce memory impairment and other cognitive deficits that mimicked Alzheimer's disease. These discoveries began the race to develop an effective medication that could reverse the acetylcholine deficit seen in patients with Alzheimer's disease. Nerve cells that release the neurotransmitter acetylcholine form the cholinergic system in the brain, which is divided into two parts muscarinic (main focus of attention in memory) and nicotinic. The muscarinic projections are outlined in Figure 3, which represents a midline slice through the whole brain. Specific masses of nerve cells, or nuclei, in the deep part of the brain form the center of the muscarinic...

Role of Acetylcholine in Cognition

This loss of cholinergic nerve cells causes a delay in the brain's ability to process information quickly and accurately, which is why aging leads to slower reactions as well as to mild memory loss. In Alzheimer's disease, the nucleus basalis is nearly wiped out within a few years after clinical onset of the illness, causing severe memory loss.

Different Ways to Boost Acetylcholine

Cholinesterase inhibitors are compounds that inhibit the action of this enzyme, acetylcholinesterase. Treatment with cholinesterase inhibitors indirectly raises the level of acetylcholine by preventing its breakdown, thereby leading to improved attention, mental arousal, learning, and memory. In fact, cholinesterase inhibitors have now reached the forefront of treatment in Alzheimer's disease, and memory loss more broadly.

Properties of Acetyllcarnitine Alcar

Promising results emerged in small numbers of patients with Alzheimer's disease, but larger placebo-controlled trials met with failure. Other small-scale studies have shown an advantage for acetyl-l-carnitine over placebo in people with mild memory loss, but there are also several negative reports. Like other compounds in its class, there are no long-term studies to determine if it can prevent age-related memory loss.

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