Female and Forgetful: A Six-Step Program to Help Restore Your Memory and Sharpen Your Mind

Important Note

This book is for informational purposes only. It is not intended to take the place of medical advice from a trained medical professional. Readers are advised to consult a physician or other qualified health professional regarding treatment of their health problems or before acting on any of the information or advice in this book.

This book provides selected information about memory loss. Research about this complex subject is ongoing and subject to conflicting interpretations. As a result, there is no guarantee that what we know about this subject won't change with time.

In order to protect the identity of the women whose stories appear in this book, we have changed names and in some cases created composites.

The mail order offer contained in the back of this book is solely the responsibility of the Life Extension Foundation. Warner Books, Inc., its affiliates, and the authors shall have no liability whatsoever in connection with such offer.

What Is Memory?
The Anatomy of Forgetfulness

While scientists debate the subtleties of the categories of memory loss, women march through my office with a litany of complaints. Often the first thing they notice is that they are forgetting names of someone they've just been introduced to in a business or social situation. This is one of the most common and most infuriatingly embarrassing scenarios. Leah, who works for a major university, finds she must constantly cope with looking ridiculous before the student body. "I'm often introduced to students, and I frequently cannot remember their faces or their names," she says. "I find myself in situations where it's clear that I've met a student before and we've talked with each other, but I have absolutely no recollection of the face, let alone the name. It's very embarrassing."

Many women tell me they need to write everything down at work, or they forget it. Anna, who works as an admissions nurse for rehabilitation says, "I get patients who've suffered anything from a stroke to massive trauma. My job involves a lot of detail work and a lot of memory. I was really good at this before. Now I have to write everything down! Insurers ask me ?How far is the patient walking?' and I'll say, ?Wait a minute. I have to look at the PT notes,' even though I just read them a minute ago!"

Just as our bodies lose strength, energy, and flexibility over the years, so may our brains. Dendrites can shrink in size and number, neurons can be damaged and die, and neurotransmitters dwindle and weaken. Some studies show that starting at age forty or fifty, your brain loses about 2 percent of its weight every ten years, much of it in the hippocampus, the memory center of the brain. However, according to PET (positron emission transmission) scans, a type of X-ray image, done by Dr. Stanley Rapoport at the National Institute on Aging, the average brain loses only 10 percent of its mass between ages twenty and seventy. Some experiments do show that this shrinkage (however much it is) translates into failing memory. For example, when people ranging in age from twenty to ninety were tested with a series of numbers and letters, it was found that younger people were able to remember and reverse the series more quickly.

Sometimes the befuddlednes resembles learning disorders or attention deficit disorders. It's particularly devastating for women with high-powered jobs who are used to being sharp and focused, and instead find their mind hopping around like a flea on a kitten. Zelda, a fifty-one-year-old computer programmer, describes it this way: "I used to be able to focus on a task and everything else would fade into the background. Now my brain can't sweep the other things aside." Anna observes, "My son has ADD and sometimes I wonder if I have ADD, too. But of course I didn't just get ADD! Still, the symptoms seem so similar. He is not focused or able to pay attention. He doesn't remember things. Unfortunately, I feel a real kinship with him because I'm the same way!"

New research, however, suggests the picture is not that bleak, and other studies show that age-related cognitive decline does not afflict everyone. For example, when older people are compared with twenty-year-olds, over one-third of the older folks could remember names and events in their lives as well as the young ones.The Seattle Longitudinal Studies (which followed a large group of people over a long period of time) are also encouraging. They show that although perceptual speed and numerical ability reached their peak in persons in their mid-twenties, verbal and reasoning ability held until those people were in their seventies and eighties—provided they remained in good health. People with health problems, such as cardiovascular disease, were eight times more likely to lose brainpower. Another large study of about 6,000 older people published in the Journal of the American Medical Association in 1999 found that 70 percent of the subjects experienced no decline in cognitive abilities during the length of the ten-year study.

When considering these somewhat contradictory studies, two things are clear: First, serious problems with memory and cognition are not inevitable. And second, people with healthy bodies also tend to have healthy brains. That's why we all know older people who are still sharp as tacks who would, in fact, put many younger people to shame in the Jeopardy game show of life. It is not "normal" to become senile as we age, any more than it is "normal" to become obese, hunched over, sedentary, arthritic, or depressed. Patients will come to me complaining of memory loss, and when I interview them carefully, I find that there are all sorts of other things that are bothering them—low energy, digestive problems, fitful sleep, mood swings. This tells me that we need to work on their overall health and lifestyle habits. Invariably, when we bring them up to better health, these symptoms improve along with their memory problems.

Although it may be normal to lose some brain cells, it seems that most dwindling brainpower is due to cells losing power and function. The signals are not getting through. In the parlance of E-commerce, the "bricks" are not the problem—it's the "clicks" that need to be serviced. This can result in subtle changes, noticeable to you and you alone. Perhaps you are not as fluidly creative as you used to be—how can you assemble your knowledge in a new way if you have trouble recalling and focusing on what you know? You may have difficulty with memorization, or with learning something new. You may take longer to do complex tasks and become confused and inefficient when multitasking. Your faulty memory, in fact, is only one aspect of overall cognitive decline.

Bonnie, a Unit systems administrator, says, "I've always prided myself on my memory; it's what I've built my career upon. In my field you just don't go to school and then come out and put it into practice. You keep on learning because nothing stays the same. I can't really afford to be less than I was. I need to be more. So, after my hysterectomy I decided to take a couple of classes to prepare myself for an installation of a new system. Because memory loss is subtle in the beginning, it seemed that everything was fine in the classes. I took the amount of notes that I normally take. But once the course was completed, I had no memory of what I did in those classes at all. My books tell me I was there. I must have been there. But I have absolutely no clue as to what those classes consisted of."

Memory is not just remembering the name of the President or what you ate for breakfast. It is remembering your train of thought, where you are, where you are going and why, and what you are doing at any given moment. It is remembering how to put a sentence together, spell a word, balance your checkbook, turn on your computer, and what someone has just said. But many women complain that they are sometimes unable to do these things. They are suddenly rereading things over and over in order to get the meaning, not finding things that are right in front of them, stashing their socks in the freezer, calling their sons by their husband's name, and becoming clumsy, awkward, and, for lack of a better word, "ditzy."

You need memory to hold on to your thoughts and ideas long enough to organize them. But if they slip away like quicksilver before you have the chance to arrange them in a logical sequence, your ability to communicate your thoughts to others breaks down. Zelda says, "I used to be able to store the whole task in my head from start to finish, with one thought progressing to the next. I could count on being able to have a thought and hang on to it while I was thinking the next thought and the next thought, and so on, in branches all over the place. That doesn't happen anymore. Now when I start thinking about a task, I have the original thought, go on to the next thought, and then branch out maybe into a few more, only to find that the original thought is gone. So then I have to go back and start with the original thought, but then I go there and lose it again. I keep going around in circles with my thoughts ...It's very hard to think something through. I can't hold on to the thought long enough to get through a line of reasoning. It's like my memory span has been cut short."

Memory retrieval also slows down as we age, but this doesn't mean the memories aren't still there. We just need to work at it harder. Often, the information we are looking for is the name of someone or something—a place, a book title. As one woman puts it, "The lapse of memory gnaws at me for hours, sometimes days; it's like struggling to open a locked door. And then, when I'm not even trying to remember, the door flings open and the name pops into my head and I feel so relieved." Somehow, all that time our brains are trying to locate the memory.

My co-author calls this the "three o'clock in the morning Glenn Close phenomenon." She and her friend Fanny were talking about the movies and their favorite actresses. Neither one could remember the name of an actress who was in The Big Chill. They went through the list of her other movies, confirmed that she had had a child late in life, described the myriad of hairstyles she had sported in films, and could see her face and her expressions as clear as day. But they absolutely could not think of her name. In the middle of the night the name came to Nancy. She waited until morning to call Fanny and spoke only two words into her answering machine: "Glenn Close." Somehow, all that time, her brain was at work trying to locate the memory.

And then there is what women call "brain fog," and its cousin "brain fatigue." This state of mind seems to be a kind of temporary loss of short-term memory, and is sometimes also related to an inability to focus and pay attention. It feels like being drugged—similar to being stoned, confused, disoriented, and dissociated without the accompanying pleasurable high. Deborah describes it as "trying to think underwater" and says it's "like someone had turned my thinking down to lowest speed." Diane says her head feels "empty, depleted" and that she feels "easily overwhelmed." Michelle says that her "head feels cloudy" and that she is "easily distracted and needs to concentrate really hard to focus and be accurate"; she usually has brain fog and dizziness together. Some women say they simply "can't think" or "can't think straight."

Female and Forgetful

To my knowledge, there are no studies that compare the ways in which the loss of cognitive function varies between men and women. But as I stated in the introduction, there are indications that women experience memory loss differently than men. Their brains differ anatomically, and this alone suggests profound possibilities of uniqueness. Other factors such as stress, nutrition, and hormonal influences also set women's forgetfulness apart from men's.

As they age, men and women lose tissue in distinct parts of the brain, and thus may experience dissimilar types of memory loss. Studies also suggest that men and women use their brains differently. For example, females generally have thicker, more developed left cerebral hemispheres, while males usually have thicker, more developed right hemispheres. What might these discrepancies mean? For one thing, they may explain why females often learn to speak at a younger age and remain better at language skills throughout life, and why males excel at spatial skills, such as map reading and navigation. In addition, the bridge between the brain's two hemispheres appears to be thicker and larger in women. This suggests that the two halves of the female brain generally communicate better with each other, and that men's brains are more specialized.

The structure of women's brains may explain why women are more intuitive, since they may be more naturally adept at coordinating logic with emotion. Men may be more naturally able to compartmentalize information and thinking; perhaps this ability to isolate problems enables them to solve certain problems better. This in turn may also explain why males tend to excel in math, mechanics, and engineering. On the other hand, males are more prone to dyslexia and hyperactivity because these conditions are made worse by a weak communications bridge between the hemispheres. Men also have a harder time recovering from stroke and other brain injuries because they are less able to let the uninjured half take over these lost functions. However, women tend to suffer from dementia more than men do; possibly because women have fewer brain cells to begin with, so when cells die it has a greater impact.

There are other differences that we've all noticed in real life, and that have been confirmed by scientific testing. It's long been recognized that men tend to have a better sense of direction and can decipher maps better—tasks that require spatial reasoning. Anatomically speaking, this also makes sense. Men, on average, have 13 percent more neurons in the outer layer of the brain, but women have a similar percentage of cells that are responsible for communication between nerve cells. The researchers conclude that, in men, the extra cells may contribute to greater spatial reasoning, or that men may have more of a certain type of brain cell devoted to this type of thinking. Men's brains may have more cells, but women's brains have better wiring.

Hope:Your Plastic Brain

Fortunately, your brain has an amazing capacity to continue to change and grow throughout your whole life—this ability is called plasticity. Until recently, scientists thought that humans did not grow new brain cells. They thought that only fetuses could grow brain cells and the rest of us were stuck with the brain cells with which we were born. But the world of neuroscience was pleasantly shocked when researchers at Princeton University discovered in 1998 that monkeys could grow new memory cells. While we do not yet have any accepted way of stimulating the growth of new brain cells in humans, this exciting news suggests that what has been lost can be replaced, at least in part. For now, we can protect and support the cells that exist so they perform to their full potential and do not die off.

Another type of plasticity is called redundant circuitry, or multiple mapping. We know about this thanks to increasingly sophisticated imaging technology, which has rendered the brain less mysterious than when it was hidden behind an impenetrable skull. Using a PET (positron emission transmission) scan, we are now able to see a representation of the brain in action in a living, breathing, thinking, remembering person. We can actually see which parts of the brain are active during certain processes, including memory, and we now know that each memory is stored in several areas throughout the brain. This means that each area could serve as the springboard to remembering aspects of a memory. This is nature's way of making it difficult for you to lose a memory completely, because this memory is stored in many widely separated storage areas. Plasticity allows the brain to re-route pathways through a different neuron, should a particular cell die.

We also know that dendrites (your brain's receiving stations) can grow and extend throughout your life. The creation of new dendrites that connect with other brain cells makes for richer and more complex memory path-ways. The more connections, the better your brain works. These extra branches may help to compensate for the loss of individual cells. Think of the network of neurons in your brain as a grid of city streets. A city grid has many intersections, options, and detours, so if one path is blocked, there is always an alternate route. This means that once a connection is broken, it is not broken permanently—another can replace it. That's how people with strokes or head trauma can recover from brain damage—their cells grow new dendrites, enabling them to relearn how to talk and walk. It is also what makes it possible for people in their fifties, sixties, seventies, and beyond to learn to play piano, do the tango, speak Italian, and surf the Web.

The Inner Workings of the Female Mind

Until you began having problems with your memory, you probably didn't give your brain a second thought. If you think the Internet or a computer is incredible, consider that your brain is even more vast and complex. Your brain is the most complicated entity in the entire known universe! Think about it—your brain is the very organ that makes you aware that you are having trouble thinking. Together with the rest of your nervous system, the brain forms an elaborate network over which communications, thoughts, and feelings flow faster than the brain itself can fathom.

Imagine a tree with long roots, a sturdy trunk, and limbs that reach out into ever-smaller branches. Now imagine a veritable forest of 100 billion trees with branches that communicate with one another, sending and receiving uncountable numbers of messages every minute of every day. This gigantic forest is your brain, and the trees are your brain cells, which are the seat of your memory, your mind, and—some would say—your essence and your consciousness.

So, what happens when our brain cells fail, when communications between them misfire? Why do you misplace your keys, have trouble adapting to a new computer program at work, or forget your train of thought mid-sentence? Is a dimming memory an inevitable part of getting older? What kind of memory does aging affect most and which is the first kind to go? And, most importantly, how can becoming more knowledgeable about your brain help you to better understand why diet, nutritional supplements, herbs, exercise, and stress management are such potent tools for protecting and repairing your mind?

To tackle these questions about the causes of and treatments for memory failure, we first need a basic understanding of the various components of our brains and brain cells (see the box on page 14).

What Is Memory?

Every moment we live, our memories are working. Memory can be thought of as both a process and a result of a process. It is the act of registering, storing, and recalling information, and it is the thing being stored and recalled. Memory is what allows you to perceive, store, and access information you need to survive and enjoy life. Memory is the cornerstone of the learning process, which is what allows us to gain new knowledge, to grow in awareness, to acquire wisdom. Memory, the retention of that knowledge, influences how you feel, make decisions, and express yourself. Memory is our rock; it grounds us in the world and gives us a position in relation to the past, places us in the present, and tells us that there is a future. And memory is what allows you to understand this sentence by remembering the words long enough to give the sentence meaning.

But how does your brain form and store so many memories? And how does it retrieve them when you want it to? To answer these questions, we need to think microscopically for a moment. Your brain is composed of specialized cells called nerve cells, or neurons. (See the box on page 18.) Scientists estimate that the average person has approximately 100 billion nerve cells—that's half of all the nerve cells in your body. Neurons differ from other cells because they alone can receive electrochemical impulses and currents and transmit them to other neurons. Each neuron in your brain links up with up to 10,000 other neurons, forming complex neuron pathways of communication. Our memories and other thought processes depend on the ebb and flow of these electrochemical currents, much like our bodies depend on the flow of blood.

A memory begins with a stimulus—something you perceive with your five senses. Your sense organs pick up a message and send it along a pathway of nerves to your brain. Once it has been received by a neuron's dendrite, the message enters the cell body. An electrical charge pushes the message through the cell body and the cell's axon. Then the message is transmitted by the axon to the dendrite of a neighboring neuron. This process gets repeated from neuron to neuron until the message reaches its destination, each neuron sending the message to another neuron via axon, neurotransmitter (brain chemical), and dendrite.

But each neuron can retain only a tiny fragment of a memory. So, the entire memory is stored in a network of memory traces, or long chains of nerves that snake through the brain. Each bit of memory is laid down or created when your senses pick up a signal from your environment—a sound, color or shape, a texture, taste, or odor—that is carried along a chain of neurons by chemical and electrical forces. We don't know exactly how this occurs, but the most recent theory is that in the process, the RNA (ribonucleic acid) or genetic material in the neuron gets changed and holds the codes for that memory. Memory is the billions of neurons communicating with each other through these electrical and chemical signals. Neurons, with their thread-like projections, form a dense adaptable network in your brain. The more stimulation in your environment, and the more memories you store, the larger, richer, and more complex the dendrite branches.

Needless to say, the ability of your neurons to communicate across the synapse, or the tiny space between the axon and dendrite, determines the speed and clarity of the messages being sent. Like a faulty or overloaded connection between a plug and an electrical outlet, a compromised synapse can dim your thinking bulb or short out your memory circuits. This might seem a precarious and fragile way to transmit messages. Why not just connect the nerve cells like a web or a net so the messages can pass through directly without depending on a chemical molecule to bridge the gap? The advantage to this setup is that it allows for a tremendous amount of versatility and flexibility. Without the gaps and neurotransmitter bridges, your brain would not have the potential to adapt to the new information you continually take in from your constantly changing environment. Your brain was designed to be flexible, and to create and store different types of memories for different lengths of time.

Types of Memory

Have you ever noticed, even before you began having memory problems, that certain memories penetrated deep into your mind and stayed there? But other experiences and information just "went in one ear and out the other"? What is the difference between recalling the name of someone you have just been introduced to, remembering the various components of a project at work, and knowing how to tie your shoe? Obviously, there are different types of memories. The two basic types of memory are short-term memory and long-term memory. Memory is part of cognition, a general term that refers to the ability to know, which includes all types of perceiving, recognizing, thinking, learning, reasoning, problem solving, imagining, mental clarity, and the ability to concentrate and focus.

Short-Term Memory

You may not realize it, but there are a couple of types of short-term memory. The most transient type of short-term memory is sometimes referred to as "immediate memory" or "working memory." As the name implies, working memory is the memory you are working with at the moment. It lasts only a few seconds or less and consists of the newest, moment-to-moment information you need to keep in mind for the task or situation at hand. You discard this memory so quickly it may not even seem like a memory. For example, you use this type of memory when you are driving through an intersection and need to juggle several pieces of information to make snap decisions, such as your position and speed, the position and speed of other cars, and the presence of pedestrians. Another example is when you hear "I-17" at a Bingo game and remember it long enough to cover that number on your Bingo card. People naturally vary in what they retain for immediate use. Often when you have trouble with this type of memory, it is a matter of lack of concentration and focus. Working memory is of a fluid, flash-in-the-pan quality that melts into nothingness for good reason. If every single one of your experiences became a permanent inhabitant, your brain circuits would eventually become overcrowded with information you really don't need.

The other type of short-term memory, on the other hand, lasts several minutes, hours, and days, and comes in to play when working memory wouldn't last long enough. It is still temporary, but makes a deeper impression because it is more important in the larger scheme of things. You use short-term memory, for example, when you remember that there is road construction this week in order to make sure to take a different route to work. The name of someone you are introduced to at a party is also parked temporarily in short-term memory, because you will only need it for the party's duration.

Long-Term Memory

Long-term memory is the type that can stay with us throughout life. This is information that you have decided is important enough to keep—information that you will need to recall and use often in the foreseeable future. This is the type of memory you draw upon to remember that we drive on the right side of the road in this country, and that in your city you can or can't make a right turn on a red light. Other examples are the names of your friends and relatives, locations of important places and things, plus information you learned in school or on the job. The name of someone you meet at a party may become a long-term memory if you decide to make that person an ongoing part of your life. Although it is called "long-term," this type of memory is not permanent. And although it tends to stay intact in most people, much of what we learn can grow dim and vague unless we actively use it.

Some experts make a further distinction between recent long-term memory and "remote" or "vital" memory. The latter are core memories that are so deeply etched into your being that they are a part of you—information such as what a cookie is, how to put on a shoe, the words to a childhood prayer or lullaby that you pass on to your own children, and the name of your country, your mother, or your first dog. They give continuity to your life and help form your unique personality.

To remember is human. Bill Thies, Ph.D., vice president of medical and scientific affairs for the Alzheimer's Association says, "We expect people to integrate memory with behavior—that's probably the single most striking ability of the human organism. It's what separates us from other animals. Our behavior is frequently driven by our memory and we've gotten to the point now where we not only use our own memories, but we use other people's memories. We write books, we collect them in a library, we have a kind of internal Internet that allows us to go get other people's memories and information. This is an indication of how much we depend on past experience to manage our current behavior."

Turning Short-Term into Long-Term

Short-term memories get placed in limbo or a holding pattern, hovering there until we tell them to get lost or until we decide to pass them to another place in the brain for more permanent storage as a long-term memory. Short-term memory is sometimes likened to the temporary impression you make when typing a document into a computer. It remains long enough for you to print it out, but disappears unless you elect to "save" it, in which case it is stored, much like long-term memory. Short-term memories are recorded in your neural circuit, but result in relatively minor, shallow changes in the cells. Some researchers believe that short-term memory is processed in a single system or location in the brain. Long-term memories are more solidly imprinted and result in deeper, more significant changes in the cells, and are also stored in many places in the brain; they are rich in associations, providing many pathways for retrieval.

One way to etch a short-term memory more permanently in your brain is through sheer willpower, determination, and work, by studying and repeating it over and over to yourself. Another mechanism involves attaching strong emotions to the memory. When emotions are involved, another part of the brain, called the limbic system, comes in. This is the part of your brain that governs emotions and decides what's important and what is not. Located deep inside your cerebrum, this cluster of structures is linked with emotions and feelings. If an emotion is attached to a memory, the memory is more powerful. Your emotion causes norepinephrine to be released, which fixes the memory strongly in your brain, so you are likely to remember it and be able to recall it more vividly for a longer period of time. Therefore the limbic system has a tremendous amount of influence on your ability to remember and recall things. A key part of the limbic system is the hippocampus, the brain's primary memory control center. If you are having problems with short-term memory, your hippocampus is involved; this part of the brain seems most vulnerable to damage by excess stress hormones in anyone, male or female, regardless of age.

Our memories, our thoughts, are not just a part of ourselves—they seem to be ourselves. These are the most intimate, powerful, and creative inner processes we experience. They are powerful in spite of their wispy, transient, intangible, elusive, invisible nature. Like digestion, circulation, breathing, and reproduction, our memories and thoughts have a physical basis. And thus we can protect and restore memory and thinking with physical means—food, nutrients, herbs. By furnishing the brain with the right materials and environment, my program not only helps prevent brain cell death, but also helps to forge new connections between cells. So, although our brains, like our bodies, were not designed to last forever, the mental changes we undergo need not be dramatic—if we stay healthy and supply the brain with the protection and raw materials it needs. As you'll see, you can get back your brain, your memory, your thoughts ...yourself.

Copyright 2002 by Elisa Lottor and Lynn Sonberg

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