Evaluate Your Memory

A good storyteller is a person who has a good memory, and hopes other people haven't.

—irvin s. cobb, american humorist

Woody Allen once said that the brain was his second favorite organ. While the brain may indeed be the number two choice for many of us, it is by far our most important organ, and memory is one of its most critical functions.

In this part of the book, you will learn how to assess your memory and determine whether it is normal or abnormal. You will also learn about the basic processes underlying memory formation and retrieval in the brain, and how aging affects these processes. This information will help you fully understand the reasoning behind the different elements in the Memory Program.

Everyone Forgets

Some of us forget names; others cannot recall places they've been to before. Our ability to associate names, faces, and places in the context of time helps us to reinforce our memories. Lost memories that suddenly resurface indicate that our brains store much more information than we are aware of in everyday life. Sigmund Freud was convinced that the root cause of "forgetting" is an unconscious conflict that creates a mental block when we consciously try to remember.

While this theory may apply to some people, as we grow older there is a different type of memory loss that affects most of us. This memory loss is a direct result of the aging process.

Benign versus Malignant Memory Loss

In the 1960s, V. A. Kral, a Canadian physician, coined the term "benign senescent forgetfulness" to describe the mild memory loss that he observed in older people, which he distinguished from the more malignant memory loss that is an early sign of dementia. Kral's terminology has been replaced by "age-associated memory impairment" (AAMI) and ''age-related cognitive decline" (ARCD). Cognition is a word used to describe a wide range of intellectual functions, including memory. The term "mild cognitive impairment" (MCI) defines a broad group of people who have cognitive deficits and fall between the categories of "normal" and "dementia." Although the original "benign senescent forgetfulness" is rapidly disappearing from the field, it is still useful to recognize that memory loss during aging is often "benign," because it does not worsen markedly over time, especially if sound preventive measures are employed. My patient David Finestone was a case in point: he adopted a systematic program that improved his memory and overall level of functioning.

Forgetting Names

I have always tended to forget the names of people when I am introduced to them for the first time. I am sure that many of the people I met were convinced that I forgot their names because I didn't really care one way or another. In some cases this was true. But even when I do make a conscious effort to remember a name, I often cannot retain it unless it is repeated back to me. Even more embarrassing is when I meet someone who crossed my path some months or years ago and I discover that I am absolutely clueless about that person's name. I wouldn't be surprised if some of you have had similar experiences, though hopefully not as often as I've had.

Before I started studying memory loss, I preferred to forget this personal flaw. However, at the back of my mind was the memory of how my mother used to constantly joke about my late father's inability to remember names. I grew up in Calcutta, India, and my father would regularly call Mr. Chatterjee by the name of Mr. Banerjee while

Mr. Ghosh became Mr. Das. My father gave a few unfortunate souls four or five names on different occasions. In striking contrast, my mother always had a razor sharp recall for names. This facility only doubled her amusement at my father's gaffes, which often led to his laughing at himself. But observing these patterns in my family led me to wonder: is the ability to recall names mainly genetic? If so, I would have a great excuse for my shoddy recall of names, though blaming my father's genes for this deficit does sound like a lame excuse.

Forgetting names is a widespread, almost universal, phenomenon. Some of you may agree with my self-serving explanation that there is a strong genetic component. However, forgetting names is not in itself a clinical syndrome, and few researchers have exerted much time or energy to get to the root of this problem, genetic or otherwise. There has been one remarkable exception: Albert DaMasio, a neurologist who is a giant in his field.

The Tip-of-the-Tongue Phenomenon

In a compelling paper published in the journal Nature, DaMasio and his colleagues showed that the areas of the brain that encode and store memories of proper nouns are distinct from those responsible for other kinds of nouns, even though these regions are physically very close to one another and are near the hippocampus, which forms part of the temporal lobe in the brain. His work has taught us a great deal about how different elements of memory are stored and helps explain the tip-of-the-tongue phenomenon. If memories for different types of words are stored in different groups of nerve cells, these nerve cells need to communicate with one another to produce a composite memory of the entire object or person that is rich in detail. If this communication does not occur, you may recall one element of the memory but not another, and the missing component remains on the tip of the tongue. This process of retrieval is not entirely conscious, because the "missing link" may suddenly resurface when your mind is preoccupied with something else, which somehow gives the nerve cells a better opportunity to communicate.

Symptoms of Memory Loss

Many other symptoms of memory loss are not as benign as forgetting names and are listed on the following page. If you (or someone close to you) have signs of severe memory loss, or if you've developed functional changes associated with memory loss, you should get your symptoms investigated by a doctor. The most important warning sign is a clear-cut worsening in memory compared to how you were a few months or years ago.

Early, Usually Benign, Signs of Memory Loss

Forgetting names

Forgetting a few items on a shopping list

Misplacing keys, wallets, handbags

Forgetting to turn off the stove once

Losing your way in a giant mall

Not recognizing someone you met a long time ago

Signs of Severe Memory Loss

Getting lost in a familiar place Losing your way when driving a familiar route Forgetting important appointments repeatedly Forgetting to turn off the stove on several occasions Repeating the same questions over and over again Difficulty in understanding words or in speaking fluently Not knowing the date or time

Functional Changes Associated with Severe Memory Loss

Problems at work; coworkers say that your poor memory is causing too many mistakes Making many errors in balancing a checkbook or writing checks Difficulty in naming common objects or finding words

Apathy, irritability, and other personality changes accompanying memory loss Seeing Your Doctor for Memory Loss

Any one of the following categories of professionals can evaluate memory loss:

PRIMARY CARE PHYSICIANS (internists, family practitioners) can identify the medical causes of memory loss (e.g., hormonal abnormality or medication toxicity), but they often miss the early signs of subtle to mild memory loss because most are not very skilled at testing for it. NEUROLOGISTS are physicians trained in the diagnosis and evaluation of neurological disorders such as stroke and multiple sclerosis. They are generally good at identifying early signs of memory loss. However, only some neurologists have developed expertise in diagnosing and treating memory disorders.

PSYCHIATRISTS have a medical degree and specialize in the treatment of mental disorders. They are excellent at identifying causes such as depression underlying memory loss. However, like most neurologists, most psychiatrists are not skilled at diagnosing and treating memory disorders.

NEUROPSYCHOLOGISTS have a Ph.D. and not a medical degree. They are expert at administering tests of cognitive function, including memory, and interpreting the test results as normal or abnormal. They usually work in collaboration with a primary care physician, neurologist, or psychiatrist.

Where to Go for Help

Some doctors still advise their patients not to worry, that memory loss is just part of growing old and can't be helped. Clearly, they have not kept up with the latest developments that show how memory loss can be reversed or at least slowed down.

If you have severe memory loss then you should see a doctor. In our specialty center, neurologists, psychiatrists, and neuropsychologists work closely together, using a team approach. Until the average physician gets better at recognizing the types and causes of memory loss, your best option is to go to one of these specialized academic medical centers that employs a team approach. There are now a large number of these centers serving virtually every major urban, and even semiurban, area in the United States (listed in the appendix). If you do not have ready access to one of these centers, consult a neurologist or psychiatrist, or your primary care physician. Inquire if they have experience in diagnosing and treating memory loss and dementia.

If you have no memory loss, or mild memory loss not due to a specific reversible cause, you probably do not need to consult any physician and can go ahead with learning about and implementing the Memory Program in this book. But to identify exactly where you stand on the spectrum of memory loss, you need to take the following memory tests and see how well you perform on them.

Simple Tests to Check Your Memory

The questionnaire below is a modified version of a published scale (Gilewski et al., 1990) and is followed by two tests of memory. You should complete the questionnaire before attempting the memory tests.

Subjective Memory Questionnaire (Self-Administered)

This test requires five to ten minutes and should be completed by you without any help or interference from anyone else.

Globally, how would you rate your memory? In the row below, circle a number between 1 and 7 that best reflects your overall judgment about your memory.

No problem

Major problem

The next two sets of questions have the same 1-7 scoring scheme for each item: 1=no problem, 2-3=mild problem, 4-5= moderate problem, 6-7=major problem.

General Frequency of Forgetting

In evaluating your own memory, how often do these present a problem for you? Circle a number between 1 and 7 for each item separately.

No problem

Major problem

Remembering

Names

Faces

Appointments

Where you put things, like keys

To perform household chores

Major problem

4

5

6

7

4

5

6

7

4

5

6

7

4

5

6

7

4

5

6

7

Page 17

Directions to places

1

2

3

4

5

6 7

Phone numbers just checked

1

2

3

4

5

6 7

Phone numbers

1

2

3

4

5

67

frequently used

Things people tell you

1

2

3

4

5

67

To keep up correspondence

1

2

3

4

5

67

Personal dates (e.g., birthdays)

1

2

3

4

5

67

Words

1

2

3

4

5

67

What to buy in the store

1

2

3

4

5

67

How to take a test

1

2

3

4

5

67

Other Memory Problems

Starting a task, then forgetting it

1

2

3

4

5

67

Losing the thread of thought in conversation

1

2

3

4

5

67

Losing the thread of thought in public speaking

1

2

3

4

5

67

Not knowing if you've already told someone something

1

2

3

4

5

67

Use of Mnemonics

How often do you use these techniques to remind yourself about things?

nartiy

i^uiisiaiiuy

Keep an appointment book

1

2

3

4

5

6

7

Write yourself reminder notes

1

2

3

4

5

6

7

Make lists of things to do

1

2

3

4

5

6

7

Make grocery lists

1

2

3

4

5

6

7

Plan your daily schedule in advance

Use mental repetition

Associate items with other things

1234567

Keep things you will need in a prominent place so as to notice them

1234567

Interpret Your Score

Now that you've completed this questionnaire, it's time to check the results. The first section, General Frequency of Forgetting, covers a number of areas that people commonly worry about with their memory. You can add up the total score and then divide by the number of items (eighteen in the first section) to get an average score on the 1 to 7 scale. If your average score is in the 1 to 2 range, your memory as measured by this scale is very good. If your average score is in the 5 to 7 range, then clearly these memory problems are interfering with your daily life.

If you have trouble remembering words or things that people tell you, you have poor verbal memory—information coded as words in the brain is not retained and retrieved well. In most people, verbal memory depends on proper functioning of the left half of the brain. If you scored 2 to 5 (or higher) for trouble remembering where you put your keys or losing your way when going to a place you've been before, your visuospatial or three-dimensional (3-D) memory is not up to the mark. In most people, this type of "nonverbal" memory depends on proper functioning of the right half of the brain.

The second part of the questionnaire evaluates the use of mnemonics and related techniques. Using mnemonics to compensate for a memory deficit may indicate a problem, but if you consciously use mnemonics to improve a basically sound memory, then scoring high on this part of the questionnaire doesn't mean very much. So the mnemonics section is harder to interpret than the first section.

There are other problems with all self-administered questionnaires of this type. Some worrywarts with an excellent memory will give themselves terrible scores, while others who blithely report no memory complaints on this questionnaire may score poorly on objective tests. So the self-administered memory questionnaire requires follow-up with objective memory tests in order to get a true picture.

Objective Memory Tests

Before you take these tests, you must recognize the difference between lack of attention and true memory loss. Poor attention leads to difficulty in registering the material presented in the test (or in real life), and if a fact isn't recorded in the brain it obviously cannot be recalled. This is quite different from true memory loss, where the material is registered and then recorded as a memory that resides in a group of nerve cells, but later the memory cannot be retrieved. So if you feel you cannot pay attention or concentrate because you are distracted, or have too many stresses in your life or worries on your mind, or suffer from depression, these tests can mislead you into believing that you have severe memory loss or dementia, when in fact the problem lies elsewhere. Therefore, you must free yourself of all distractions and interference when you take these tests.

The tests described here require a second person to administer them. Hints and prompts are not allowed during these tests, which is why it is sometimes better to ask someone other than a family member or close friend to be the tester. Ideally, the tests should be administered by trained neuropsychologists or other professionals, but they are simple enough for a nonprofessional to administer, as long as he or she carefully follows the required rules for administering the tests.

The tester should now take over and read the following sections, then administer the tests to you, one by one. Only after you've completed these tests are you allowed to read the remainder of this chapter. If you do not follow these instructions strictly, the tests are completely invalid. Therefore, if you're going to take these two tests, ask the tester to carefully read the following section and understand what he/she needs to do before giving you the test. Stop reading here and hand this book over to the tester, who will need a pencil.

Mini Mental State Examination

Tester: carefully read and understand the next two paragraphs, then give the test exactly as instructed in these two paragraphs.

The tester recites three unrelated objects (nouns)—for example, bus, door, rose (another option: apple, table, penny)—and the subject is required to repeat them back correctly.

Accuracy, not order, is what counts. The tester should circle the number of words correctly repeated by the subject at the first attempt.

Number of words repeated correctly (first attempt only)

Then the tester asks the subject to mentally subtract 7 serially from 100 (93, 86, 79, etc), and stop after five answers. After this test of calculation, which is meant to distract the subject from focusing on memorizing the three words, the tester tells the subject "Repeat back the three words that I told you earlier. '' Again, absolutely no hints or prompts or extra conversation are permitted. Responses should be exact to get a positive score, and words that are similar in meaning (dime instead of penny) or spelling (tablet instead of table) should be given a score of 0. The tester should score only the subject's first attempt, based on how many of the original three words were accurately recalled.

Number of words recalled correctly (first attempt only)

End of Test

Tester: skip the next two paragraphs and proceed to List-Learning Test.

This is clearly a test of verbal memory. Recalling all three words accurately at the first attempt indicates that there are no major problems with your memory, while recalling 2 out of 3 words suggests that your memory may be a little shaky. Recalling only 1 word, or even worse, 0 out of 3 words, is not a good sign and should trigger clinical consultation. These recommendations flow partly from the results of a study that I published with my colleagues in 1997. In that study, seventy-five outpatients, who ranged in age from their forties to eighties, with minimal to mild cognitive impairment were followed for an average of two and a half years. People who recalled 0 or 1 out of 3 objects on this test were at high risk of developing dementia during follow-up, a score of 2 out of 3 was associated with low to moderate risk of developing dementia, and virtually no one who correctly scored 3 out of 3 met diagnostic criteria for dementia at the final follow-up visit. Other studies have also shown that this simple test is quite useful in distinguishing between people with mild versus severe memory disorders. The complete version of the Mini Mental State examination has a dozen items that covers a range of cognitive functions, with a maximum score of 30 (Folstein et al., 1975; see bibliography).

The next memory task is a little more difficult and is particularly useful in distinguishing normal memory from subtle memory loss.

Tester: read and understand this section (until "end of All tests ") before actually giving the test.

List-Learning Test (brief version of standard tests)

The tester needs a pencil and paper, and access to a watch or clock.

The tester gives the subject the following instruction: "I am going to read you a list of words. Listen carefully because when I'm through I want you to tell me all the words I read to you. The order in which you repeat the words does not matter. Are you ready? "

The tester then reads the following list of words in a normal conversational voice at a steady pace, clearly pronouncing all the words.

cry

step

load

plate

pound

shirt

hip

blank

queen

fold

gift

teach

Immediately after reading this list, the tester says, "Now tell me every word in the list that you remember. " As the subject recites the words, the tester checks them off against the list above. The tester scores the number of words correctly recalled. Near misses (for example, jacket instead of shirt or toad instead of load) are scored 0, and all other errors also get a 0. There is no minus scoring for wrong words (no penalty).

Number of words correctly recalled:_

Then the subject is distracted (e.g., with conversation or by doing chores or other tasks) for the next fifteen minutes. Then the tester asks how many words the subject remembers from the original list of words. Using the same rules (near misses and wrong answers each get 0) as with the initial presentation, the number of words correctly recalled is noted.

A key factor in this test is that the subject should not be given a warning that the list of words will need to be recalled fifteen minutes after the initial presentation.

End of All Tests

The subject is now allowed to resume reading this book.

You, the reader, should now go back and start reading again from the point where you stopped and handed the book over to the tester.

On the list of words test, the maximum score is 12. If you scored in the 8 to 12 range at the initial presentation (immediate recall) and recalled 6 to 12 words correctly fifteen minutes later (delayed recall), you have an excellent memory. Among people with average memory, those in their forties will usually recall 5 to 8 words after the fifteen-minute delay, while people in their sixties to seventies will usually get 4 to 6 words right on delayed recall. The delayed recall score is more important than the immediate recall score. Some people with a good memory don't pay enough attention to the initial list presentation but later are able to remember the majority of the words that they recited initially.

Interpreting Your Test Results

These memory tests are not foolproof and do not adequately substitute for neuropsychological testing, but they do provide a useful guide to categorize memory loss.

1. NO MEMORY LOSS. If you remembered 3 out of 3 objects on the MMS memory subtest and scored 5 or more on delayed recall on the 12-word list-learning task, you don't have memory loss. Nonetheless, as you grow older, there is a good chance that your memory will decline, even if it is sound right now. Therefore, I recommend that you read on and learn more about taking proactive action against future memory loss.

2. SUBTLE TO MILD MEMORY LOSS. If you recalled 2 out of 3 objects on the MMS, or if you had a delayed recall score of 3 to 4 on the list-learning task, you probably have subtle to mild memory loss. Note that scoring well on one (but not both) of the two tests still suggests subtle memory loss.

3. SEVERE MEMORY LOSS. If you remembered none or only 1 out of 3 objects on the MMS subtest, or had a delayed recall score of only 2 or less out of 12 words, you absolutely must go see your doctor, and the Memory Program is not for you. These recommendations also apply to anyone else who takes these tests, for example, one of your parents.

Other Tests of Memory

The Selective Reminding Test is a complex list-learning test that starts in a simple way: the tester recites a list of twelve unrelated words and then asks the subject to recite all twelve words together. Then comes the tricky part: the tester prompts the subject with only those words that the subject missed on the first repetition, following which the subject is again required to repeat all twelve words, that is, recite the words that were missed the first time as well as those that were "kept in memory" from the first to the second trial. This sequence continues until the subject either gets all twelve words correct in successive repetitions or a total of twelve trials is completed. In the delayed recall part, the subject is challenged fifteen minutes after the last trial to recall the entire list of twelve words. The large number of trials requires complex scoring procedures and neuropsychological expertise. The Visual Reproduction subtest of the Wechsler Memory Scale is a different type of test because it evaluates the ability to remember shapes (recalling visual images).

Each test taps into a slightly different aspect of memory. A neuropsychologist typically administers a whole range of tests and looks for consistent patterns of deficits. If the subject performs well in all except one test, it may be due to a lapse in concentration. On the other hand, if someone scores consistently below normal on several memory tests, further investigation is necessary.

Factors That Affect Your Memory Test Performance

Three well-recognized factors can influence performance on memory tests: age, education, and gender.

Since it is "normal'' for memory test scores to worsen as people grow older, the standard test scores are adjusted downward to get the "norms" for that age group. Therefore, a "normal" ninety-year-old person may actually score worse on the standardized memory tests than a fifty-year-old person with moderate memory loss.

These age-adjusted test scores are used to help distinguish a clinical disorder from normal test performance within a particular age group. The flip side, of course, is the risk of dismissing worsening memory as "normal" for a person's age and doing nothing about it.

Education

People who are highly educated score much better on neuropsychological tests than people with low levels of education. You may recall that when my patient Frieda Kohlberg, who had a genius-level IQ developed only very subtle memory deficits and otherwise tested at or above the normal range for someone her age, it was actually the first sign of Alzheimer's disease. But compared to other tests of intelligence and cognitive ability, memory is less affected by the subject's educational background.

Gender

You may be wondering about the third leg of the triad: age, education, and gender. In fact, there are subtle differences: women score slightly better on tests of verbal memory, and men score slightly better on tests of nonverbal memory (unusual shapes and diagrams that cannot be "coded" verbally for recall) and mathematical ability. However, these differences are very small and may result more from bias during the educational process than from a true genetic influence.

If You Get Neuropsychological Testing

If you get neuropsychological testing, you should find out from the neuropsychologist if the actual raw scores were used to make the interpretation or if they were adjusted for age and other factors. If you do well with or without age and education adjustments, your mental faculties are in excellent condition. If you need such adjustments to raise you into the normal range for people at your age and education level, then you probably have subtle age-related memory loss. If you score poorly, whether age and education adjustments are made, your mem ory loss is severe enough that you should go see a physician (if you haven't already).

Action Steps to Evaluate Your Memory

Subjectively, is your memory worsening over time based on your own perception? Do others say that your memory is worsening?

Use the lists in this chapter to check if you have symptoms of mild or severe memory loss, and if you have functional impairment due to memory loss.

Identify your strengths and weaknesses, separating them into the verbal and nonverbal (spatial, 3-D) memory categories, based on the Subjective Memory Questionnaire. Have someone give you the memory tests in this chapter. Classify yourself according to the post-test instructions into one of three categories: no memory loss, subtle to mild memory loss, severe memory loss.

If your memory has worsened considerably over time, or if you have symptoms of severe memory loss, or if you scored very poorly on the memory tests, you should consult a neurologist or psychiatrist, preferably with the input of a neuropsychologist. If you have access, go to the memory disorders clinic at your local major academic medical center. If your memory has not worsened considerably over time and you do not have severe symptoms and you scored well on the memory tests, or if you have only minimal to mild deficits on the memory tests, medical consultation is not essential. In essence, if you have no memory loss or mild memory loss, you should read further to understand and implement the Memory Program in your daily life.

Imaging Your Brain to Diagnose Memory Loss

While neuropsychological testing is critical to define the extent of memory loss, brain imaging is often more helpful in identifying the type of brain abnormality that may be causing the memory loss. Brain imaging techniques broadly fall into two categories: structural (CT and MRI) and functional (SPECT and positron-emission tomography, or PET).

Features of Scan CT or CAT MRI

SPECT

What the scan evaluates Time spent in scanner Diagnostic use

Resolution (smallest identifiable brain region)

Radiation exposure

Claustrophobia (machine closely surrounds head)

Intravenous injection

Availability

Cost

(approximate)

Structure Structure of brain of brain

20-30 minutes 25-40 minutes

Blood flow 30-45 minutes

Stroke, tumor, Stroke, tumor, Possibly early abscess

4-5 mm (one-fifth of an inch) Moderate

Glucose consumption 45-60 minutes

Possibly early Alzheimer's abscess; possibly Alzheimer's early

Alzheimer's

2-3 mm (one-tenth 7-10 mm (one-third 6-8 mm (one-fourth of an inch) of an inch) of an inch)

None

Uncommon Common

Moderate

Uncommon

Moderate

Sometimes

Widespread Widespread $200-500 $400-1,100

Common $400-800

Yes Rare

Structural brain imaging techniques are used to evaluate the structure, or anatomy, of the brain. Computerized axial tomography (CAT or CT) was the first such technique. Strangely enough, it was invented in the 1970s by researchers at EMI, a British music recording company that couldn't capitalize on it, although they did get the Nobel Prize for their invention. CT scanners take a large number of X rays in different planes and use computer technology to "reconstruct" the internal brain structure, which then becomes crystal clear to the viewer.

MRI works on a different principle. A strong magnetic field is applied around the head, and the distance traveled by individual protons (subatomic particles) in response to the magnetic field is measured in various parts of the brain. The MRI's computers use this information to produce clear, fine-grained images of internal brain structures. Unlike CT, MRI involves no radiation exposure. In any case, the risk of damage from radiation is low for the brain because it has few dividing or reproducing cells, making DNA damage unlikely.

Claustrophobia can develop in the MRI machine, which makes a loud banging noise. "Open" MRI is a method recently developed for people who have claustrophobia, but because it is open (the head is only partially enclosed) the magnetic field used is weaker and the sensitivity of the technique is much lower than that of a regular MRI.

Both SPECT and PET involve the intravenous injection of a radioactive tracer that is taken up by the brain. A combination of high-resolution cameras and sophisticated computers produces a 3-D image of radioactive tracer counts, representing blood flow or glucose metabolism (consumption), throughout the brain. SPECT or PET can reveal subtle deficits in blood flow or glucose consumption that have not led to changes in brain structure—the subject may still have a normal MRI. The first patient described in the introduction, David Finestone, had a subtle blood flow deficit on SPECT in the presence of a normal MRI, and this information proved very useful in his clinical management.

Brain Imaging to Diagnose Early Alzheimer's Disease

Recent studies show that a reduction in size of the hippocampus (which can be detected by using MRI) and a reduction in temporal and parietal lobe blood flow (SPECT) and glucose metabolism (PET) are often early diagnostic features of Alzheimer's disease. However, using MRI to assess the hippocampus requires sophisticated, labor-intensive research techniques (visual inspection isn't good enough). Also, these abnormalities detected by MRI and SPECT/PET can occur as part of normal aging and in other neurologic disorders. Although none of these techniques are diagnostic by themselves, they can help when the clinical picture is unclear.

Functional MRI is a new technique that involves looking at changes in hemoglobin oxygen saturation (indicates brain tissue oxygen use), usually while the subject is performing a test of attention or memory. Functional MRI is in its infancy but may well become the wave of the future. A major problem is that its results are worthless if people cannot keep their heads completely still while they lie in the scanner.

The decision about which brain imaging technique to use remains in the hands of your physician. Nonetheless, if you have memory loss, knowing the basics outlined here will make you a more informed consumer about the role of these brain imaging procedures in diagnosing the cause of your memory loss.

CHAPTER 2

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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