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About Memory Loss
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Occasionally, you may forget where you left your keys, or why you walked into a room. In many cases, this type of common forgetfulness is merely due to preoccupation, fatigue or stress. But if it continues, it's important to know that other diseases or conditions may be responsible for more serious memory loss-and some can be treated.
WHAT IS MEMORY LOSS?
"Memory is made up of many circuits in the brain, and dozens of causes can destroy these sensitive connections," says Susan Colligan, Ph.D., head of neuropsychology at John Muir Rehabilitation Services. "Memory loss can be due to a functional or emotional problem, or it may be a neuroanatomical issue." Some causes that can wreak havoc with memory include traumatic brain injury (even if mild), stroke, depression, thyroid problems, hormonal imbalances, vascular conditions, high blood pressure or drug or alcohol use. Other causes include malnutrition and side effects from medications.
"Overall," she says, "if memory seems to be a problem, it's important to take it seriously and check with your physician. It could be secondary to something else that is reversible."
Dr. Colligan stresses, "Don't forget to tell your physician what prescription medications you take, plus over-the-counter substances. These could have major interaction effects, including memory problems."
WHAT ABOUT REMEDIES SUCH AS GINKGO?
Many products are touted to help sharpen mental abilities or work against memory loss. Some research suggests that non-steroidal anti-inflammatory drugs (NSAIDS), such as those used for arthritis, may have a protective effect against dementias. "Other substances, such as vitamin E or ginkgo biloba, might have some modest beneficial effect," according to Raymond Stephens, M.D., a neurologist at John Muir Medical Center, Walnut Creek Campus and John Muir Medical Center, Concord Campus. But experts warn that thousands of supplements on the market are not controlled or inspected, and their purity is unknown.
HOW DO YOU KNOW IF IT'S A DEMENTIA?
There are many types of dementias, with Alzheimer's being the most common. When memory loss is combined with a general loss of other intellectual abilities, such as judgement and abstract thinking, and these worsen over time, a brain disorder such as Alzheimer's must be considered.
Frequently, people who have the disease are not aware of it. Family members or friends may notice a change in their loved one's functioning and behavior, and bring them in for an evaluation.
"Dementia is still primarily a clinical diagnosis, and there is no blood test or scan result that confirms the diagnosis," according to Dr. Stephens. Basic memory tests can be done during a physician appointment, or more in-depth assessments, such as a neuro-psychological evaluation, may be performed. Brain scans and blood tests can be used to rule out other causes of memory loss.
Unfortunately, Alzheimer's is a very serious, long-term disease that gradually robs an individual of reason, independence, and physical ability.
According to researchers, dementias are increasing in incidence as the population ages. Approximately 15 percent of people who live to age 65 will develop a dementia; by 85, the proportion increases to about 35 percent. By the 90s, 50-60 percent are affected. Currently, about four million Americans have Alzheimer's.
WHAT HAPPENS TO THE BRAIN WITH A DEMENTIA?
In Alzheimer's specifically, research shows a loss of nerve cells in memory centers. This is thought to be due to a decreased supply of a vital chemical messenger, acetylcholine, which normally carries signals between cells. Plaques, or deposits between nerve cells, and tangled bundles of nerve fibers eventually kill nerve cells in brains affected by Alzheimer's. The plaques and neurofibrillary tangles are seen in autopsies of these brains.
WHAT CAN BE DONE FOR ALZHEIMER'S?
There is currently a variety of drugs on the market that can help slow the progression of the disease process, such as donepezil (Aricept®), rivastigmine (Excelon®) and galantamine (Reminyl®). But these drugs may not work in all patients, and do not reverse the progressive brain damage characteristic of Alzheimer's.
"These medications are not a cure and not a home run, but they can set back the clock," says Dr. Stephens.
"Still, in the past ten years, huge strides in understanding the biochemistry and pathophysiology of Alzheimer's have been made," he adds.
FUTURE TREATMENTS
"We are gaining a much better understanding of genetic and molecular mechanisms that give rise to the disease process," says Dr. Stephens. "Later, specific interventions may be possible: blocking enzymes that give rise to toxic proteins, identifying genetic causes (there are families with a genetic pattern for Alzheimer's), and even developing Alzheimer's or dementia vaccines."
"There is a lot of hope," confirms Dr. Colligan. "There are many more studies being done now than ever before, and new interventions may be available within the next few years."