What you should know, and what you can do.
by Sherrye Henry
published in Parade magazine on Sunday, March 17, 1996
Even people in their 40s and 50s feel their memory start to slip. "Why can't I remember names?" they sigh. "Where did I put my keys?" With the years, the questions move from annoyance to concern, as in, "Could this be something serious -- like Alzheimer's disease?"
Today, thanks to advanced imaging techniques, animal studies and better psychological studies, researchers are exploring not only the diseases we fear but also how our brains function -- and age -- normally. Furthermore, they say, we can take positive action to keep our minds active and healthy.
What we lose. How normal is everyday, garden-variety forgetting? All those words and names "on the tip of the tongue" are still firmly embedded in brain, researchers say, but they can become increasingly hard to retrieve.
"With age, the memory system is overloaded to begin with," says Dr. Barry Gordon, director of the Cognitive Neurology Division at the Johns Hopkins University School of Medicine in Baltimore. "You have more names to remember than before -- and overload can take its toll on memory. Also, the neural machinery may not be working quite as well -- a little slower, a little noisier than before."
But, he adds, name-blocking also may indicate that you have a rich, healthy network of connections. Because these connections compete with each other, they may inhibit the right word from coming to the surface. That's why relaxing -- turning your attention to something else -- often allows that hidden word to pop out suddenly, or why running through the alphabet jogs your memory.
But it is also true, say experts, that our brains become more physically vulnerable as they age. Younger brains recover faster from damage than older ones. Our brains also slow down as we age, as nerve cells (neurons) weaken and die. Still, Dr. David Drachman, chairman of the Neurology Department at the University of Massachusetts, says: "We start life with far more neurons than we'll ever need. Cells close ranks and take over for one another, rather like an army that loses soldiers but regroups to keep on fighting." Scientists call this comforting concept "brain reserve".
It's some reserve: 100 billion neurons, with a trillion connections in each cubic centimeter, firing 10 million billion times each second -- all comprising an infinitely complex chemical factory that weighs less than 3 pounds. The interaction of these connections and their vital chemicals forms the basis of all our stored memories.
Scientists believe that existing memories stored in the brain are not lost to a significant degree with aging. Instead, the brain structures that enable us to store new memories tend to decline with age. For example, the basal forehead, which manufactures acetylcholine for memory storage, can lose up to half of its cells in normal aging, says Dr. Marilyn Albert, a neuropsychologist at Massachusetts General Hospital in Boston. This loss is responsible for many lost keys and forgotten names.
Promising new approaches. Now that scientists better understand memory loss, they are exploring ways to keep critical chemicals flowing, so that our stored memories can be more readily retrieved. Drugs that have substantially delayed memory loss in animals are now being tested. And preliminary studies indicate that melatonin, the hormone believed to aid sleep, also may promote memory retention. Vitamins C and E may play a role in preventing losses in a healthy brain. Estrogen probably plays an important role too, particularly for women.
What we gain as we age. Aging is not all downhill. Older people have skills and abilities that beat most young people's by a mile, according to Claudia H. Kawas, associate professor of geriatric neurology at Johns Hopkins. That's because aging brains hold larger vocabularies, command a greater understanding of written materials, contain more ability to reason and, overall, display more wisdon -- meaning good judgment based on wide experience.
"Ask a group of 80-year-olds to phone a particular number on a particular day, and the 80-year-olds will perform far better," Kawas expains, "probably because they have developed more effective strategies, like making lists of things to do." Kawas has her own definition of aging: "It's the loss of adaptability," she says. "As long as you can adapt new strategies to accomplish tasks, you are a successful ager."
Alzheimer's and the normal brain. Two-thirds of us probably won't even notice natural memory loss that occurs with age, according to a recent study. And not being able to name all the palyers in a movie or forgetting occasionally where one's car is parked does not for most people signify the start of Alzheimer's disease, where loss of memory and intellectual ability is relentlessly progressive. Marilyn Albert draws the line this way: "It's not when you lose your keys that matters but when you finally find them and can't remember leaving them there."
Dr. Albert is working on finding ways to discriminate between normal aging-related memory loss and Alzheimer's disease, which devastates the memories of some 4 millions Americans -- 10 percent of all people between the ages of 65 and 86. Identifying the disease early, through an MRI (Magnetic Resonance Imaging), for example, will allow us "to intervene when effective treatments are developed," she explains.
And Alzheimer's research is advancing. "The rate of breakthoughs now is so rapid that, before the year 2000, we're likely to see initial drug trials to slow the progress of the disease," says Dr. Dennis J. Selkoe, a professor of neurology and a researcher at the Harvard Medical School.
Keep your brain fit. Brain scientists offer the following suggestions for a healthy brain at any age:
Keep your memory sharp. A 1993 study found that formal schooling was strongly associated with a healthy brain in 1200 highly functioning people aged 70 to 79. But Dr. Richard Mohs -- director of the division of psychology at New York's Mount Sinai School of Medicine and one of the study's investigators -- says the following strategies can help keep your memory sharp, regardless of your schooling and years:
Memory myths. Dr. Barry Gordon, the author of Memory: Remembering and Forgetting in Everyday Life, debunks some popular misconceptions about aging and memory:
Sherrye Henry is former director of Outreach
Programs for the Dana Alliance for Brain Initiatives. The Dana Alliance
has produced "Successful Aging and the Brain", a forum in which all the
experts cited in this story will participate. The program will air on
public television stations in conjunction with Brain Awareness Week,
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