Preventing memory loss
Preventing memory loss
(This article was first printed in the Harvard
Health Publications Special Health Report "Improving
Memory: Understanding and Preventing Age-Related
Memory Loss". For more information or to order,
please go to http://health.harvard.edu/IM.)
No matter what your age, it's not too late to
take steps to prevent memory loss. A good place
to start is with the strategies for improving
your memory described in this report. In addition,
good health habits can reduce the risk for illnesses
that might affect your memory as well as the
likelihood that you'll need medications that
could have damaging side effects. And preliminary
studies have identified vitamins and at least
one medication that may help ward off dementia.
Seven preventive steps
Research shows that the following strategies
may help preserve your memory.
Physical fitness and mental fitness go together.
People who get regular vigorous exercise also
tend to stay mentally sharp in their 70s and
80s. There are several ways in which exercise
might benefit your memory. First of all, it's
good for the lungs, and people whose memories
and mental acuity remain strong in old age characteristically
have good lung function. Second, exercise helps
reduce the risk for diabetes, high cholesterol,
high blood pressure, and stroke - illnesses that
can lead to memory loss. And finally, animal
research has shown that exercise increases the
level of neurotrophins, substances that nourish
brain cells and help protect them against damage
from stroke and other injuries.
Researchers don't know precisely how much exercise
is needed for good mental health. The available
research suggests that the exercise needn't be
extreme, but should be regular. The people in
the MacArthur study whose mental functions remained
strong were active almost daily. A study from
Case Western Reserve University School of Medicine
concluded that individuals who exercised - by
walking or by engaging in physically active hobbies,
such as gardening - had a lower risk for Alzheimer's
disease. So experts recommend that you build
physical activity into your daily routine. Here
are some examples:
- When possible, walk instead of driving or
- Set aside time each day for exercise - for
example, a half-hour walk around the neighborhood.
For motivation, ask your spouse or a friend
to go with you.
- Use the stairs instead of elevators.
- Exercise at home, possibly with an exercise
- Plant a garden.
- Take an exercise class or join a health club.
- Swim regularly, if you have access to a pool
- Learn a sport that requires modest physical
exertion, such as tennis. If you haven't been
physically active recently, check with your
Physical activity keeps both your body
and your mind in shape.
In the MacArthur study, the characteristic that
correlated most strongly with good mental functioning
in old age was a person's level of education.
Experts think that advanced education may help
keep memory strong by getting people into the
habit of being mentally active. Regardless of
your level of education, you, too, can be an
active, lifelong learner. Some people continue
their education with adult education classes
or advanced degrees even in late adulthood. But
efforts don't have to be so ambitious to be beneficial.
Reading regularly, keeping up with current affairs,
learning a new hobby, and playing challenging
games all exercise your mind. (See "Challenge
your mind" for practical ways to keep learning.)
Studies show that smokers don't remember people's
names and faces as well as nonsmokers do. No
one knows whether smoking directly impairs memory
or is merely associated with memory loss because
it causes illnesses that contribute to memory
loss. Smoking is especially common among people
who are depressed, and depression weakens the
memory. In addition, smoking increases the risk
for stroke and hypertension, two other causes
of memory impairment.
Smoking can interfere with memory in other ways,
too. For one thing, it damages the lungs, and
good lung function is one of the characteristics
of people whose memories stay strong in old age.
In addition, smoking constricts the blood vessels
to the brain, depriving it of oxygen and possibly
Maintain a healthy diet
A healthful diet rich in fruits and vegetables
as well as healthy fats from fish, nuts, and
whole grains is vital in maintaining the health
not just of your body but of your brain as well.
Avoiding saturated fats (in meat and dairy) and
trans fats (in commercial products with partially
hydrogenated oils) will help keep your arteries
clear and cholesterol levels healthy, and that
in turn will decrease your chances of stroke,
including the small undetectable ones that can
damage brain function. Avoid excess calories
to maintain a normal weight; this lowers your
risk for illnesses such as diabetes and hypertension,
which can impair your memory.
Eating a lot of fruits and vegetables can be
especially beneficial because many are good sources
of antioxidants, nutrients that may protect against
diseases and age-related deterioration throughout
Nutritious foods such as fruits, vegetables,
and nuts are essential for keepking your
Get a good night's sleep
Sleep is essential for memory consolidation
as well as overall health. Although people vary
widely in their individual sleep needs, research
suggests that six to eight hours of sleep a night
is ideal. Perhaps even more important than the
amount of sleep is the quality of sleep. People
with breathing problems during sleep, such as
obstructive sleep apnea, can sleep for 10 hours
per night but never feel refreshed in the morning.
Of course, for some people, getting a good night's
sleep is easier said than done, especially becaus
e insomnia becomes more common with age. But
certain habits can help. For example, try the
- Establish and maintain a consistent sleep
schedule and routine. Go to bed at the same
time each night and wake up at the same time
each morning. A set sleep routine will "train" you
to fall asleep and wake up more easily.
- Plan to do your most vigorous exercise early
in the day. Exercising in the hours immediately
before bedtime causes physiological changes
that interfere with sleep. Exercising in the
morning, on the other hand, enhances your alertness
when you need it most - at the beginning of
- Avoid coffee and other sources of caffeine
(e.g., chocolate, many soft drinks, some brands
of aspirin, many types of tea) after midmorning,
because caffeine is a stimulant that can keep
you awake for hours afterward.
- Avoid napping during the daytime. Napping
can disrupt your natural sleep cycle and prevent
you from feeling tired enough to fall asleep
- Don't take sleeping pills unless nothing
else works. Like sleep deprivation, sleeping
pills can cause memory loss.
- Try drinking warm milk before bedtime. Some
people find that it helps them feel sleepy.
Milk contains tryptophan, a chemical that may
help you relax.
- Don't try to sleep if you're not tired; otherwise
you'll set yourself up for tossing and turning.
If you're still awake after about 20 minutes
in bed, get up and read awhile to help yourself
- If you experience persistent sleep problems,
consult your physician so that you can find
out what's wrong and get treatment if needed.
Consider taking vitamins
For several years, experts have thought that
antioxidant vitamins, such as vitamins C and
E and beta carotene, might benefit memory by
neutralizing free radicals, destructive molecules
that damage healthy tissue in the body. Free
radical damage has been found in the brains of
patients with Alzheimer's disease, prompting
researchers to speculate that it may contribute
to the memory impairment and other symptoms of
the disease. The findings have been mixed, but
research suggests that some antioxidants might
convey some benefits in the treatment of age-related
memory loss and some forms of dementia, although
not against Alzheimer's disease.
A large study suggested that vitamin E, but
not the other antioxidants, may help slow the
rate of age-related mental decline. This study,
which was published in Archives of Neurology in
2002, looked at 2,889 people ages 65 and older
who did not have dementia or other cognitive
illness. Researchers asked the study participants
what they ate and which vitamin and mineral supplements
they took, then tracked their mental function
over about three years. Mental function was assessed
with the Modified Mini-Mental State Examination
and other standard tests. Participants who consumed
the most vitamin E had 36% less mental decline
than did people who consumed the least.
In contrast, a study published in Archives of
Neurology in 2003 found no association between
antioxidant intake and later development of Alzheimer's
disease. This study included 980 people ages
65 and older who did not have dementia when the
study began. Researchers asked the participants
about their diet and supplement use, then followed
the people for four years to see who developed
Alzheimer's. At the end of the study, the people
who consumed the largest amounts of vitamins
C and E and beta carotene were no less likely
to develop Alzheimer's than the people who consumed
the smallest amounts.
However, an earlier study found that vitamins
C and E might protect against some forms of dementia
- vascular dementia, which is related to stroke,
as well as so-called mixed/other dementia, which
includes dementia caused by Parkinson's disease.
In this study, which included 3,385 Japanese
American men ages 71-93, those who reported taking
vitamin C and E supplements had an 88% lower
incidence of vascular dementia compared with
those who didn't take the supplements. Like the
more recent study, this one found no relationship
between these vitamins and the incidence of Alzheimer's.
This study also found that the rate of dementia
was lowest among men who had taken vitamins C
and E the longest, which suggests that long-term
use is important for helping to preserve mental
function in old age. Vitamins C and E are generally
safe and nontoxic. However, if you have a rare
vitamin K deficiency that affects blood coagulation
or if you take anticoagulant medicine, you should
check with your doctor before taking these vitamins.
Vitamins C and E can complicate these conditions
by promoting anticoagulant action. Patients with
any other form of bleeding disorder should also
consult their physician before taking these supplements.
Cultivate social support
Social support - that is, close ties with others
- can improve the mental performance of older
people, according to the MacArthur study on aging
and other research. Social support can come from
friends, relatives, or caregivers, but to be
truly supportive, relationships must make people
feel good about themselves.
Not all relationships are beneficial. The MacArthur
researchers described a study in a nursing home
in which residents were asked to do a simple
jigsaw puzzle. During a practice session, one
group was given verbal encouragement by one of
the experimenters as they practiced doing the
jigsaw puzzle. The second group was told how
to do the jigsaw puzzle. The third group got
no social support or how-to advice. Later, when
they took a test in which they did a puzzle on
their own, those in the group given encouragement
did better than they had during the practice
session. The people who had been told what to
do had more trouble during the test than they'd
had in the practice session. And those who had
received neither encouragement nor advice did
neither better nor worse.
The results of this study suggest that social
support can improve a person's performance on
particular mental tasks, but only if the support
promotes the person's self-confidence. Being
too quick to show a person what to do can lower
that person's self-confidence and motivation
to figure things out. In other words, it can
instill a sense of helplessness. The lesson for
older people is to seek out the company of people
who will encourage them to keep on trying. The
lesson for children and caregivers is to resist
the impulse to jump in and do things for older
people that they are capable of doing for themselves.
Troubleshooting memory problems:
Common memory lapses and strategies
to overcome them
to remember better
you meet someone for the first time,
use his or her name in coversation.
about whether you like the name.
of people you know well who have the
the name with an image, if one comes
to mind. For example, link the name Sandy
with the image of a beach.
the person's name down in your memory
notebook, personal organizer, or adress
Where you put things
put things you use regularly, such keys
and eyeglasses, in the same place.
other objects, repeat aloud where you
you put an object down, make a point
of looking at the place where you put
you still don't think you'll remember,
write down in your memory notebook or
personal organizer where you put the
What people tell you
someone to repeat what he or she just
the person to speak slowly; that way,
you'll be able to concentrate better.
to yourself what the person said and
think about its meaning.
the information is lengthy or complicated
(such as advice from your doctor), use
a small cassette recorder or take notes
while the person is talking.
them down in an appointment book, in
a calendar that you look at daily, or
in your personal organizer.
Things you must do
them down in your personal organizer
yourself a note and leave it in a place
where you'll see it (for instance, on
the kitchen table or by the front door).
a friend or relative to remind you.
an object associated with the task you
must do out in a prominent place at home.
For example, if you want to order tickets
to a play, leave a newspaper ad for the
play near your telephone.
you must do something at a particular
time (such as take medicine), set an
Adapted with permission from Winifred
Sachs, Ed.D., Center for Cognitive Remediation
and Treatment, Beth Isreal Deaconess