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OCTOBER 30, 2000 VOL. 156 NO. 17

The Battle to Save Your Memory
Lost your keys or forgot a name—again? These days, people will try anything to sharpen an aging brain. What works—and when should you worry?

The Brain: How memories form
Alzheimer's Disease: When it's not mere forgetfulness

It was the day I froze a household pet that I began to worry about my memory. Technically, it was not a real household pet I froze but a bag of tropical fish, which on the scale of beloved members of any home rank somewhere below the family cat and above an attractive set of coasters. And technically, I didn't completely freeze my fish. Rather, I absentmindedly tossed them into the refrigerator with a bag of other things I had bought and fortunately retrieved them just before my highly sensitive aquarium fish could turn into lightly breaded dinner fish.

Nonetheless, that near-death experience—for the fish, if not for me—woke me up to the fact that my memory might not be all it once was. At the outset, I should say that when it comes to incipient memory loss, I've got good reason to worry. I'm in my mid-40s, the age at which most no-longer-babyish boomers begin to notice that many of the faculties they used to take for granted—eyesight, stamina, the ability to fit into slim-cut khakis—are starting to go. If those things fade, why shouldn't memory? Then there's genetics. While the members of my extended family often live deep into their 90s, by the time they hit their 70s, a lot of their cognitive lights have typically begun to flicker, and memory is the first bulb to blow.

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MEMORY: Recall and the Middle-Aged Mind
Fortysomethings have a hard enough time watching their waistline and hairline go; now it's their memory. Bookstores, health-food shops and websites are awash with products that claim to sharpen the aging brain. Do they work, and should you try them? Plus: test your memory
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With the odds thus stacked against me, I couldn't help being concerned. What does it mean when I'm introduced to three people as I enter a party and find that all their names have flown out of my head before I even reach the bean dip? What does it mean if I walk into a room on an errand of some kind and discover that I can't remember if I came in for a dictionary, a soup spoon or a socket wrench? After a certain age, does everyone's cranial zip disc start to fill up? Or worse, can mundane, mid-life memory glitches actually be warning signs of such later-life dementia as Alzheimer's disease?

"That's the focus of a lot of recent research," says Richard Mayeux, a professor of neurology at Columbia University medical school, "trying to identify biological markers to tell us who's crossing the line into something pathological and who's having simple age-related decline."

Even without hard answers from the labs, 40-somethings—and the people who market to them—have begun taking matters into their own hands. Bookstores bulge with memory-improvement guides. The Web is awash in memory sites, and numerous hospitals and private therapists teach memory courses. There are even over-the-counter memory nostrums available in health-food stores. To find out whether any of these work, I decided to spend a couple of weeks talking to the savants and sampling the cures. Total recall might be too much to ask, but total immersion was the only way to find out.

Before setting out on my memory odyssey, I dialed up a few experts to learn how common memory complaints such as mine are and how serious they could become. On both counts, I came away reassured. While the brain stores memories in a number of areas, it is the frontal lobe that retrieves them and puts them to work. For all its data-crunching power, the frontal lobe is a fragile thing. Everything from fatigue to hormonal changes to simple cellular wear and tear can cause it to falter. "Frontal-lobe processes change in all people as they age," says Scott Small, assistant professor of neurology at Columbia and a research colleague of Mayeux's. "The bell curve shifts uniformly."

In most people, this deterioration is annoying but hardly disabling. You'll lose your glasses but not your marbles. Even in the 65-and-older age group, only 15% of people suffering from mild cognitive impairment will go on to develop Alzheimer's disease. Others, Mayeux explains, may be suffering from undiagnosed problems such as atherosclerosis, ministrokes or thyroid disorders. For still others, alcohol and drugs, legal or illegal, may be part of the problem. Any substances that depress the central nervous system, including anesthetics, throw a similarly wet blanket over the ability to form memories. Blood-pressure medicines and antidepressants may cause problems too, since the receptors they block in doing their job may play a role in memory formation. In general, once the chemicals are cleared out of the system, the problem reverses itself—but not right away. Heavy drinkers may need five full years of sobriety before all their memory breakers are re-engaged. Even then, "they may remain at long-term risk for later-life dementia," says Gayatri Devi, a psychiatrist and memory specialist affiliated with Lenox Hill Hospital in New York City.

While all those conditions can spell big trouble, the fact remains that the majority of folks probably suffer from none of them. In most cases, it's possible to hang on to the memory you've got well beyond middle age—and perhaps even improve it a bit. "Having a good memory is often just a matter of practicing memory wellness," says clinical psychologist Cynthia Green, author of the book Total Memory Workout.

In the hope of upping my memory amperage, I decided I would first try the memory books. It turned out there were a load of them. An Amazon search using the key word "memory" yielded a whopping 6,439 hits, and while plenty of them were wide of the mark—Dean Koontz's potboiler False Memory was not what I was looking for—hundreds were on the money. I decided to sample eight of them, including Kevin Trudeau's Mega Memory, Harry Lorayne's Page-a-Minute Memory Book and Carol Turkington's 12 Steps to a Better Memory. Much of what I read was, at first blush, utterly forgettable.

If there's one thing the memory mavens want to teach you, it's how to remember names, and the best way to do it is visually. When you first meet someone, look for a defining facial feature and then link it to the person's name—the more absurdly, the better. If you meet a Mr. Kannen who has prominent ears, suggests Lorayne, picture a cannon shooting off the ears. If you meet a Mr. Hamper with a wide mouth, picture filling the mouth with laundry. It's hard to say whether these peyote-button images will do much for your memory, but it's clear that Lorayne needs to work on his people skills.

Other ways to remember the names of people you meet include asking them how to spell their name (problematic with, say, Bob) or commenting on the name ("Meat Loaf? Do you know the Loaves of Kennebunkport?"). Also helpful is using the name several times. Trudeau suggests trying, "Are you from the area, Bill? What type of work do you do, Bill? Do you have any children, Bill?" Trudeau and others recommend going easy on this one, though, lest you next find yourself saying, "Why are you running away, Bill? Please don't call security, Bill."

My skepticism aside, such devices did seem to work. At the first dinner party I attended after reading the memory books, I made it a point to notice that the Ginny I was introduced to had ginger-colored hair and the Terry I met seemed like an emotional—or teary—sort. For the first time in a long while, I learned names once and didn't have to go groping for them the rest of the evening.

Websites are a helpful way to pump up your memory. Even a simple Internet search turns up hundreds of memory sites, some useful, some awful. One of the best turned out to be, an easy-to-navigate site that takes its memory training seriously. Mindtools teaches many of the techniques offered in the books, ranking each in terms of difficulty. One of the more popular methods I practiced at the site was the phonetic-peg system, designed to make it easier to remember numbers.

The first step in mastering this technique is memorizing a list that assigns consonant sounds to each of the numbers, 0 through 9. The t, d and th sounds are 1, n is 2, m is 3, r is 4, and so on. Once you learn the list, you can easily remember a string of digits like a license-plate number by switching the numbers with letters and turning the letters into words. At first the system struck me as only slightly less complex than KGB cryptography. Then I realized that nuisance numbers like the eminently forgettable combination to my gym locker—12, 31, 43, if you must know—are a lot less forgettable when I think of them as thin mad ram.

If I was truly going to juice up my recall, however, Web surfing and book reading wouldn't cut it. What I needed was hands-on help, and that meant a memory class—something more universities and community groups have begun to offer. The course I chose meets at Mt. Sinai Hospital in New York City and is led by clinical psychologist Margaret Sewell.

Sewell's class is small—just eight women, all boomer age or older—and was clearly designed with the forgetful in mind. Though the group meets six times over six weeks, the participants all wear name tags at all the sessions. Members who forget to attend a class are free to come back in the next six-week cycle—especially helpful for absentminded folks like me who may still be trying to make up missed dental appointments originally scheduled in 1986.

The students in Sewell's class learn the memory basics—keeping date books and to-do lists, developing first-letter mnemonics. A shopping list that includes lettuce, tomatoes and dishwashing liquid, for example, may be abbreviated ltd, or lots to do. I found the esprit de corps of the class a lot more motivating than hunching over a website by myself. As with all memory aids, however, the key to Sewell's program is rehearsing the tools until they become routine. "There's a difference between having a bad memory," she says, "and having bad memory habits."

But it's that practice, practice, practice part that most people would just as soon forget. In a quick-fix culture, what I was looking for was some kind of memory pill, a once-a-day dose that would do my mind sharpening for me. To hear some people tell it, those potions may already be out there.

The big bat in the memory-pill lineup is ginkgo biloba, the dried leaf of the maidenhair tree, thought to improve circulation and, in theory, memory. While ginkgo is still considered an alternative medication, it has caused such a stir and gained such a following that even so button-down a company as Bayer, better known for aspirin, has begun marketing the stuff.

The principle behind ginkgo is straightforward enough: fortify the aging brain with a bit more blood, and most of its faltering functions—memory included—ought to come back online. But what works in principle often doesn't stand up to pharmacological scrutiny, and ginkgo is giving scientists pause. The few clinical studies that have been conducted on ginkgo involved only patients with Alzheimer's disease. While these people did experience flickers of improved memory, that's no indication that ordinary middle-agers with ordinary memory woes will benefit similarly. "We don't really know whether it works for mild memory loss," says Devi.

Vitamin E is another common memory nostrum, popular because it is an antioxidant, able to gather up and neutralize cell-damaging chemicals known as free radicals, a highly reactive form of oxygen that is a normal byproduct of metabolism. Like ginkgo, vitamin E has been tested mostly on Alzheimer's patients and has been shown to slow down the advance of the disease as much as seven months—not much for a condition that takes years to do its brain-ravaging work, but progress nonetheless. "There is a lot of evidence that there's oxidative damage in the brain both in the course of normal aging and in Alzheimer's disease," says Neil Buckholtz, chief of the dementias-and-aging branch of the National Institute on Aging. "The idea is to lessen or prevent this damage."

Again, however, what works for Alzheimer's patients may not work for other people. Buckholtz explains that it takes very high doses of vitamin E before the chemistry of the brain changes even a little, and for healthy middle-agers, such a small neurochemical difference may make no difference in memory.

Other purported memory potions include such nonsteroidal anti-inflammatories (NSAIDS) as Advil and Motrin, which in one study appeared to reduce the risk of Alzheimer's disease as much as 50% over a 15-year period. Lecithin, vitamin B12 and folic acid also generate buzz in the memory biz, but again there is little or no in-the-lab science to back up the claimed benefits. "There just aren't any good data that we know of," says Buckholtz.

Not only may memory potions not help, there is a real chance they could hurt. Ginkgo and vitamin E both act as blood thinners. Taking either one could increase the risk of internal bleeding; taking them together makes the danger even greater. NSAIDS can contribute to internal bleeding and anemia, aggravate ulcers and damage the kidneys.

Forewarned, I nonetheless decided to sample a couple of the memory nostrums, starting with ginkgo. The package warned that in addition to any other potential problems, ginkgo can cause "mild gastrointestinal discomfort." After just one pill, I discovered that the package was—how best to put this?—not kidding. It's hard to say if my memory improved in the little time I was on ginkgo, but I can say I had no trouble at all remembering to eat a bland diet for several days afterward. Vitamin E had similarly little impact on my memory. Those antioxidants may be able to sponge up free radicals, but in my case either the sponge was not absorbing much or my brain was already pretty much free-radical free.

For me, the answer to memory woes was not in the medicine chest, but that didn't mean I was a hopeless case. My recall had improved only incrementally after two weeks in the memory-enhancement trenches—but the fact is, it had improved. I may not be able to read a magazine and instantly memorize it, but I now remember to buy it when I get to the store. I may not be able to memorize hundreds of names and faces, but at least I won't meet an Alex at a party and find myself calling him Alan or Alvin or Evelyn. If I am any indication, improving memory requires little more than a bit of concentration and practice. Fortysomething might be too late for a whole new cerebral hard drive, but it's nice to know I'm never too old for a simple upgrade.

With reporting by Unmesh Kher/New York

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