Do you constantly misplace your car keys, forget whether you switched off the iron or walk into a room only to go blank about why you went there? You probably despair that your memory is not what it used to be. And you may be right. As the brain ages, memory can deteriorate in some people. Mild forgetfulness in relation to names, appointment times and names of places or people is commonly reported. As we get older, it’s also harder to retain new memories, even though memories from when we were young often remain vivid.
Beating brain drain
At the University of California, Professor Arthur Shimamura studied a group of university professors in their 60s and 70s who were still intellectually active. He then compared their neuropsychological performance to that of their peers and a group of younger people. In several tests of memory, the academics displayed superior concentration and recall (compared with others of the same age) and their results were equal to those of the younger group. These kinds of findings have led an increasing number of scientists to conclude that when it comes to memory and brain function, you should “use it or lose it”.
Research involving animals shows that those kept in a stimulating environment develop lengthening of the connecting nerve fibres in their brain — in contrast to animals living a humdrum life. Such mounting evidence suggests we can literally think our way to a better memory. Intellectual pursuits such as reading, learning, completing brainteasers or puzzles and memorising music could prove the best insurance policies against a deteriorating memory.
When we acquire a new skill (surfing the net) or retrieve a memory (reminiscing about our 21st birthday), we literally activate a memory lane in the brain. Electrical impulses then whiz like a commuter train across tracks of brain cells, setting off chemical interactions like a series of fireworks as they go. But our brains are not computers. Poor diet, lack of sleep, chronic pain, hormone levels, depression and jet lag can all cause our memory to idle in neutral rather than drive. Over time, these chronic problems can also compromise brain function.
Fuzzy thinking
If you are suffering noticeable changes in your memory or brain function or have noticed this in someone you know, it’s important to discount all possible causes. Some medications, such as sleeping tablets, ulcer medications and anti-depressants, can cause fuzzy thinking or even mimic dementia. In high doses, alcohol also becomes a neurotoxin, which can result in irreversible damage to brain cells.
Any lifestyle factor associated with blockage of blood vessels, such as smoking, high cholesterol, heart disease or high blood pressure, may lead to impeded memory function by reducing bloodflow to the brain. Another common memory zapper is stress. Ever noticed how hard it is to keep your mind operating on all four cylinders when you’re having a heavy-duty day? You sit at the computer but can’t focus; go to the shops but forget what you need to buy; misplace your keys or wallet or both. This mental meltdown is a direct result of adrenal fatigue.
Stress-induced brain drain is caused by the hippocampus, a little seahorse-shaped organ in the brain involved in short-term memory. With too much of the stress hormone cortisol in the brain, dendrites (the little branches that connect brain neurons) start to shrink and the hippocampus can’t get through a clear message to stop pumping out adrenalin. In turn, you begin to release dangerously high levels of adrenaline and cortisol habitually, which continues to perpetuate memory and thinking deficits.
This not only inhibits brain function but over time may lead to depression, which then bumps up your risk of dementia. People who have suffered depression are 2.5 times more likely to develop dementia, according to 2008 research from Erasmus University Medical Centre in the Netherlands. The take-home message? Look after your emotional health.
Dementia or disease?
About 500,000 Australians are affected by dementia. The term describes the symptoms of a large group of illnesses that cause a progressive decline in mental abilities. Memory, intellect, rationality, social skills and normal emotional reactions may all be affected. Family history increases your chances of developing dementia, but only applies in about 2 per cent of cases. Age is the strongest risk factor we all share. Dementia is rare under the age of 60, but over the age of 70 the incidence greatly increases.
Some reversible conditions mimic the symptoms of dementia and should be discounted through medical testing. These include depression, some vitamin and hormone deficiencies, medication clashes (or over-medication), infections, excess calcium and brain tumours. If these are not present, doctors will try to determine the type of dementia:
- Alzheimer’s disease: Affecting 50–70 per cent of all people with dementia, this is usually first indicated by memory loss.
- Vascular dementia: The second most common dementia, this is associated with circulation problems, causing multiple strokes or infarcts, in the brain.
- Parkinson’s disease: Late in the course of this disease, dementia may occur.
- Dementia with Lewy bodies: Tiny spherical structures called Lewy bodies, found in the nerve cells of the brain, have been detected in many people with dementia. They are thought to contribute to the death of brain cells.
- Fronto-temporal dementia: Picks disease, for example, initially presents with personality, behavioural and psychiatric changes rather than memory problems. This type of dementia often runs in families and symptoms usually appear between the ages of 40 and 65.
- Huntington’s disease: This inherited degenerative disease can cause personality changes, memory disturbance, slurred speech, impaired judgement and psychiatric problems.
- Alcohol-related dementia: The parts of the brain most vulnerable are those used for memory, planning, organising, judgement and social skills.
- Other conditions: A range of other health conditions can cause cognitive decline; some are preventable through diet, safe sex practices and lifestyle changes, such as reducing intake of refined carbohydrates.
- According to the Mayo Clinic in the US, health conditions such as an underactive thyroid can affect memory, while hypoglycaemia can lead to behavioural changes and confusion.
- Pernicious anaemia, which results in deficiency of vitamin B12, can lead to cognitive changes, while a severe deficiency in niacin (vitamin B3) may cause pellagra, a condition that also compromises brain function.
- Creutzfeldt-Jacob Disease, the human equivalent of mad cow disease, can result in personality changes and memory loss.
- HIV/AIDS can cause cognitive impairment and dementia in the late stages of the disease.
- Brain infections such as meningitis and encephalitis can also cause symptoms of dementia.
- Sexually transmitted infections, such as syphilis, often lead to cognitive decline.
Memory malfunction
Dementia can cause a variety of memory glitches. The person affected may find that sometimes they can’t remember how to cook a meal or dress themselves or may suffer more chronic symptoms, such as the inability to recall their own name, the names of their children or which day of the week it is. Until the later stages of dementia, the tasks we’ve performed repeatedly and habitually, such as brushing our teeth, tend to be preserved. However, as the condition progresses, the person loses more of their ability to look after themselves, along with the insight to understand or even acknowledge their illness.
In addition, they may experience anxiety, depression and delusions. Over time, people with dementia lose the ability to express (and possibly to feel) a full range of emotions. Dementia is not a curable condition and if it does reach the end stages it is fatal. Most forms of dementia migrate to other areas of the brain as the disease progresses. In the final stages, when the patient is unable to move, they are at risk of life-threatening complications such as pneumonia or blood clots. In some cases, the dementia may shut down essential bodily functions, such as the ability to swallow or breathe.
Diagnosis of dementia takes into consideration symptoms and memory tests (for example, remembering three words and repeating them several minutes later). Brain scans involving CT or MRI technology may also be used. Vascular dementia will show up as previous strokes or long-term changes consistent with a problem such as high blood pressure. In Alzheimer’s disease, shrinkage in the hippocampus and temporal lobes occurs, while in other forms of dementia, areas of the front or the back of the brain may have shrunk.
Alzheimer’s is the most common form of dementia. Memory loss is usually the first, most noticeable symptom, sometimes accompanied by personality change, apathy or irritability. There may also be impairment of other functions, such as use of language, the ability to organise objects in space and reasoning skills. Alzheimer’s results in abnormal accumulations of two types of protein in the brain: “tau”, which builds up in the centre of brain cells forming tangles; and “beta-amyloid”, which forms plaques on the outside of brain cells. There is no cure for the destructive disease.
Medications for dementia act in two ways: as a stimulant, improving the transmission processes of the brain that govern thinking and memory; and by blocking the formation of proteins known to be involved in certain forms of dementia, for example, with Alzheimer’s disease. These drugs buy time, but they don’t slow the illness, and studies show that in most patients, drug treatments lose efficacy after 6–18 months.
Prevention and protection
Research indicates that the physical damage that causes dementia starts decades before symptoms appear, so the lifestyle choices you make now can help keep your brain healthy later in life. In view of this, Alzheimer’s Australia has released Mind Your Mind, the first-ever campaign actively encouraging Aussies to look after their brain health. Strategies include:
- Exercising at least three times a week to encourage blood flow to the brain
- Eating a diet high in fish, olive oil, nuts and antioxidant-rich foods such as blueberries and broccoli
- Keeping neural pathways limber through activities such as crosswords, painting and reading
- Kicking bad habits such as smoking
Clearly, a holistic lifestyle can help prevent the inflammation and arterial blockage that contributes to dementia. So there’s no time like the present to start looking after your grey matter. In particular, ensure you address the following.
- Weight gain: Belly fat is bad for your brain. Research involving 6500 men and women in California found that those carrying belly fat in their 40s are substantially more likely to suffer dementia in their 70s. Surprisingly, people who are overweight or obese have a risk equal to the risk of those who carry abdominal fat but are otherwise of normal weight. Fat cells produce harmful chemicals, which may lead to inflammation throughout the blood vessels of the entire body, including your brain.
- Hypertension: Reducing high blood pressure helps to lower the incidence of dementia by about 13 per cent. This is possibly because hypertension causes restricted blood flow, which starves the brain of oxygen.
- Diabetes: Developing type 2 diabetes before the age of 65 more than doubles the risk of ending up with dementia later in life, according to Swedish research of twins. To avoid high blood glucose and insulin resistance problems, which lead to diabetes, exercise regularly and follow a diet high in low-GI (glycaemic index) foods, as these don’t elevate blood sugar levels.
- Omega-3 intake: Regularly tucking into salmon or sashimi may reduce your risk of developing Alzheimer’s disease by around 60 per cent, according to research at St Luke’s Medical Centre in Chicago. The higher your intake of the omgea-3 DHA (docosahexaenoic acid), the better the protection. People who consumed omega-3s from a range of sources, including fish, nuts and vegetable oils, enjoyed a 70 per cent lower risk of dementia. To boost your levels beyond fish, snack on pumpkin seeds and walnuts, add a little flaxseed oil to salad dressings and bake with salba, a South American gluten-free grain that is high in omega-3s and antioxidants.
- Exercise: Staying active in any way — even via a leisurely stroll — can help reduce the likelihood of developing dementia, according to an increasing body of evidence. It also helps to prevent further brain shrinkage in people with mild Alzheimer’s disease. As well as improving blood flow to the brain, exercise may decrease the stress hormones that can compromise brain function and tissue over time, while promoting greater elasticity in the synapses of the brain. Aerobic exercise such as walking, cycling, swimming or jogging is particularly beneficial for boosting circulation.
- Homocysteine: If levels of this amino acid are elevated in your blood, your chance of developing dementia increases. Eating more leafy greens or taking a folate supplement can help reduce homocysteine levels.
- Vitamin D deficiency: Sunshine helps your brain produce serotonin and melatonin, which improve mood and sleep. In addition, research involving the Universities of Cambridge and Michigan has now linked low vitamin D levels to dementia and cognitive impairment. Aim for 10 minutes’ exposure to sun — choose early the morning or late afternoon to avoid sunburn.
- Alcohol and cigarettes: Alcohol interferes with short-term memory and can damage little branches in the brain called “dendrites”, which pass on messages between brain cells. Meanwhile, smoking limits oxygen and blood flow to the brain and studies show it significantly ramps up the risk of dementia.
- Head injury: A blow or other injury to the head that has resulted in loss of consciousness may put you at slightly higher risk of developing dementia later in life, possibly because it kickstarts a process of inflammation. Make sure you protect your head when cycling, renovating or doing other activities such as playing sport, and always wear your seatbelt when travelling in a car.
- Education: Engaging in further study and working in an intellectually stimulating career appear to be protective against dementia, possibly because educated people have richer neural networks in the brain or because they keep stimulating their brain with new learnings.
- Friends and family: Research from the Karolinska Institute in Sweden, which tracked people from their 50s to their 70s, has found that living with a partner can be protective against Alzheimer’s disease. This may simply be due to the increased social and intellectual stimulation that being in a relationship brings, particularly as we age. For similar reasons, research shows a reduced risk of dementia in people who are socially active. So take the time to catch up with friends for coffee, dinner, a picnic or party and keep in touch via phone, text and email. While you’re chatting, sipping on wine (not too much) and staying connected you will also help keep your mind and memory sharp for years to come.
For more information go to www.alzheimers.org.au or contact the National Dementia Helpline on 1800 100 500.
Brain gym
People who engage in a wider range of activities in adulthood are better protected against developing Alzheimer’s disease, according to research. Anything that challenges your brain to problem solve or learn is particularly beneficial, so make sure you do the following.
- Juggle it: Juggling balls for a mere one minute every day can significantly improve brain function by increasing the amount of grey matter in the areas of the brain that process visual motion and information.
- Puzzle over it: Make a habit of doing crosswords, playing chess or checkers and completing Sudoku puzzles or jigsaws. Mentally stimulating activities strengthen brain cells and the connections between them — in particular, they help lengthen the connective fibres in the brain.
- Play an instrument: Always wanted to learn the piano or guitar? Don’t delay. Studies show that people who play a musical instrument have less incidence of dementia — again, because the stimulation of the brain in reading musical notes, maintaining tempo and altering the tone of a piece obviously exercises important neural pathways, keeping them healthier.
- Learn a new skill: Discovering how to do something new, such as surfing, flower arranging, cooking Vietnamese food or learning a language (never too late), sets off chemical interactions that build new memory lanes in our brains. So sign up for a course.
- Go dancing:The Einstein Aging study published in the New England Journal of Medicine looked at a range of physical activities and their effects on the brain and found that, in particular, dancing helped prevent dementia. This is most likely due to the cerebral activity involved in remembering steps and engaging your feet to the beat.
- Create something: Research shows that activities such as knitting, painting and creative writing benefit brain capacity, reducing dementia risks.
- Soak up some culture: Attending concerts, plays and art galleries are all enjoyable activities that boost brain function. In addition, make sure you read regularly — join a book club to help give you motivation.
- Breathe better:The better your lung function, the better your brain is oxygenated throughout life and the more clearly you are able to think and remember, according to research. So maintain good posture and inhale through your nose, ensuring you breathe from your abdomen.
Think Clearly
Having trouble keeping your mind on task?
- Grab a drink of water. When we’re dehydrated we often have trouble thinking, concentrating and remembering.
- Listen to Baroque music, such as Vivaldi’s Four Seasons. This will stimulate your alpha beta brainwaves — thought to assist memory and learning.
- Stock your shopping trolley with Brazil nuts, avocado, cheese, carrots, oranges, lentils and peas. These foods are high in vitamin B6, which ensures the production of the chemical gamma aminobutyric acid (GABA). It might sound like an alien blob from the next X-Files movie, but in fact it helps cells in different parts of the brain communicate.
- Put on the kettle. A cup of tea or coffee will not only give you a lift, but Finnish research suggests that drinking caffeine in mid-life can help protect against developing dementia later in life, though it is not clear why.
- Create “memory” spots for objects such as your handbag, keys, bills and notes from school so you always know where to find them.
- Keep bedcovers to a minimum at night — overheating while you sleep can cause fatigue and low mood the next day.
- Burn some essential oil. Pleasant and invigorating scents can help improve mood and concentration. Try basil, cinnamon, geranium, peppermint or rosemary.
