What can be done about memory problems

What you can do

Look for a reason
Could it be stress or depression? Try to work out if you have had an unusual amount of stress recently, or if there is any possibility that you are depressed. For example, has there been any change in your sleep pattern? Sleeping a great deal less or more than in the past, difficulty getting to sleep, or waking early in the morning are all pointers to depression or anxiety. Unless there is an obvious cause that you can deal with for your stress or depression, see your doctor.

Could it be the medications you are taking? Some sedatives, antidepressants and other drugs can affect memory.

Have other people noticed? Ask a close friend or family member whether they have noticed that your memory has deteriorated. As a general rule, if memory loss is due to anxiety or depression, people notice it themselves and worry about it; if it is due to Alzheimer's, other people are much more aware of it than the sufferer.

Keep your mind active. Although it is normal for our memory to be less efficient as we grow older, this can be offset by activities that require thinking and learning. Memory is like a muscle; keep working it so it stays in shape. Research at the University of Southampton in the UK has shown that you can slow mental ageing by deliberately engaging in mentally demanding activities.

Consider taking up a hobby that uses your brain such as reading, evening classes, card games, sudoku, crosswords or discussion groups.
When you are reading a good book or a newspaper article, pause every now and again and imagine you are telling someone about what you have just read.
Even better, join a book group to discuss your reading with other people.
In the evening, try to recall the day's events as vividly as possible.
Keep a journal - write a few lines every evening, describing what you have done during the day.
Pick a topic and think of the opinions opposite to those that you usually hold; for example, if you love pets, think about all the disadvantages of having a pet.

Take exercise. A study of over 71-year-olds in the USA has shown that moderate exercise (for example, walking more than 2 miles a day) helps to keep the brain, as well as the body, in good shape (Journal of the American Medical Association 2004;292:1454–61).

Be sociable. People who have lots of social contact with other people are less likely to develop serious memory problems.

Use common sense to help your memory. There are a number of simple things that you can do to really make a difference.

Pay attention! We best remember things we are most interested in.
Establish a routine for putting frequently used items (keys, pens and spectacles) in the same place each time.
When you are introduced to new people, repeat their names once or twice to commit them to memory.
Write down things that you need to remember. Carry a notebook, use lists, keep an appointment diary or use the diary function on your mobile phone.
It is easy to forget whether or not you have done something if you do it on automatic pilot. Instead, pause and register what you are doing. Make a mental note of information or events you want to hold on to, as soon as possible after the experience, as though you have a notebook in your head. Speaking it aloud may help. A common example is wondering whether you have turned the iron off, so when you finish ironing, pay special attention to your act of turning it off and say aloud 'iron off'.
If you often forget names, go through your address book from time to time, saying the names of your friends and acquaintances out loud. This helps to bring the sounds of their names to the surface of your memory bank. Similarly, before you go to a social gathering, say out loud the names of the people you might meet.

Do not smoke. Do not listen to people who say smoking prevents memory loss. This idea was popular a few years ago, but there is no scientific evidence for it. Nicotine can improve brain function very temporarily, but smoking is likely to damage brain blood vessels and make the problem worse in the long term.

Get enough sleep. When you sleep, your brain processes the information that you have learnt during the day. If you are deprived of sleep, the memories will not stick properly, so students who spend half the night cramming for exams may be wasting their time.

Do not take hormone replacement therapy (HRT) to help your memory. It is untrue that the menopause causes memory loss (British Journal of General Practice 2004;54:434–8, Neurology 2003;61:801–6). If this is happening to you, it is more likely that you are depressed or anxious. HRT does not improve brain function and may even make it worse (Neurology 2007;69:1322–30). Also, taking HRT will not stop you developing dementia (American Journal of Epidemiology 2008;167:692–700).

Do not waste money on fish oil supplements to help your memory. A study comparing fish oil capsules with a dummy version (placebo) in older people found no difference in their memory and reasoning skills (Neurology 2008;71:430–8).

Be cautious about spending money on brain-improving computer programs. Computer software companies have realized that there is a lot of money to be made from so-called mind-games and brain-training products that claim to improve brain function and/or prevent memory loss. Memory experts are cautious about whether these programs really help. There is even a worry that these programs take up brain capacity that is needed for day-to-day tasks (British Medical Journal 2008;336:246–8).

Consider a ginkgo biloba supplement. Extracts of the leaves of the gingko tree (also known as the maidenhair tree or fossil tree) have been used for hundreds of years in Chinese medicine. Over the past few years, gingko supplements have become very popular with people who think their memory is poor, but the scientific evidence to support this is scant. Many of the so-called scientific studies have been flawed for several reasons, so their results cannot be trusted.

For a good scientific study, you need a large number of people. Half of them need to be given the gingko supplement, and the other half a dummy tablet that looks and tastes exactly the same. Then you compare the results in the two groups to see if the supplement is having a real effect. One difficulty is that ginkgo has a very pronounced taste and smell, so most researchers have been unable to make a similar dummy tablet.
Some of the best studies of gingko have been in patients with Alzheimer's disease. But even if it does help in Alzheimer's, it would not necessarily improve memory in people who do not have Alzheimer's disease.
Herbal remedies are very big business. So, like standard pharmaceuticals, there are vested interests promoting them.

A study has examined all the published evidence about gingko and memory. It concluded that gingko appears to be safe to use with no excess side effects compared with placebo (dummy tablets). Many of the early trials used unsatisfactory methods and were small. The evidence that ginkgo has real benefit for people with dementia or cognitive impairment is inconsistent and unconvincing (Cochrane Database of Systematic Reviews 2007:CD003120).

Side effects (allergic reactions, gastrointestinal symptoms, headache) are rare. It would probably be unwise to take it if you are on blood-thinning medication.

Contradictory studies on gingko and memory

For

Several studies have concluded that gingko does have some effect, but many were flawed. In one of the better studies, people with Alzheimer's disease or similar dementia diseases were given 120 mg gingko each day for a year, or a dummy tablet. Those given the gingko did not deteriorate as quickly as those on the dummy tablet (Archives of Neurology 1998;55:1409–15, Journal of the American Medical Association 1997;278:1327–32).

Against

In a Dutch trial of elderly patients with memory impairment given either gingko or a dummy tablet for 24 weeks, there was no difference between the two groups in a large number of memory tests. This was a good trial, because the researchers used a very convincing dummy tablet with the same taste and smell as real gingko (Journal of the American Geriatrics Society 2000;48:1183–94)
In a UK 6-month study (i.e. longer than many other studies) of older people with memory impairment, ginkgo did not improve mental function or quality of life. (International Journal of Geriatric Psychiatry 2008;23:1222–30)
A big American study has concluded that gingko does not have any effect in preventing dementia. 1500 people aged 75 years or over took gingko or a dummy tablet for 6 years. The same number of people taking the gingko developed dementia as those taking the dummy (Journal of the American Medical Association 2008;300:2253–62).

What your doctor can do

Depression can creep up so gradually that you may not be aware that you are suffering from it, so your doctor will first assess whether or not you are depressed. If so, antidepressant medication would be the most appropriate treatment and would restore your memory. The improvement might not be immediate, as antidepressant drugs can take several months to have an effect. Your doctor could also help you to identify stresses or problems that may be affecting your memory, and could advise on coping strategies.

If you or your doctor cannot work out the reason for your memory problem, he or she could refer you to a special clinic. There are National Health Service memory clinics throughout the UK. These clinics assess whether or not you have a memory impairment and what the cause might be. They also teach strategies to improve your ability to acquire new information and to memorize it.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Wednesday, October 5th 2011

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Comments on this article

Posted by Anonymous on 05/01/2010 at 12:45, Australia

i have found that over the last year my mind feels so slow and i am very forgetful and have a short attention span. From reading this article i am able to relate this to stress that i have been under. Now i know where to start - so thanks!