30: Memory Impairment: Prevention & Improving Functioning

This program will provide

  • A brief overview of how memory works
  • Some strategies for preventing memory impairment and promoting a healthy brain
  • There are no easy answer when its comes to the care of another
  • Our hope is to offer you useful information and guidelines for caring for someone with dementia
  • These guidelines will need to be adjusted to suit your own individual needs
  • Memory involves specialized areas of the brain, such as the hippocampus
  • Memory is subjective
  • People only store information that they are paying attention to
  • Nerve cells (neurons) form connections to establish pathways of information
  • Gray matter contains nerve cells that form the processing centers for the brain’s functions
  • White matter is formed by myelinated nerve fibers (axons)
  • Corpus callosum connects the left and right sides of the brain
  • There is a miniscule space between nerve cell connections called a synapse
  • When a signal in a nerve cell travels from the dendrite to the cell body and onto the end of an axon, chemicals called neurotransmitters are released
  • Neurotransmitters leave the axon and cross the synapse to get picked up by a dendrite of the next neuron
  • When enough neurotransmitters are picked up by the receiving nerve cell, it triggers a signal that travels down this new nerve cell to cause the release of new neurotransmitters
  • This cascade of nerve cell firing and neurotransmitter release is how nerve cells communicate
  • Action potential: signal that travel down the nerve cell
  • A complex pattern of action potentials through networks of nerve cells and pathways is how information is stored and transmitted in the brain
  • In Alzheimer’s disease, the brain produces less neurotransmitters, and nerve cell networks and pathways are damaged and lost
  • Memory is the ability to retain and recall information
  • Encoding: registering the information
  • Storage: creating a permanent record of the encoded information
  • Retrieval: calling back the stored information
  • Information is acquired and passed into short-term memory
  • Short term memory: recall for a period of several seconds to a minute without rehearsal
  • Rehearsal: repeated exposure
  • Memory consolidation: process by which recent or short-term memories are transformed into long-term memories
  • With continued rehearsal, or repeated firings between a network of nerve cells, the connections between them become stronger
  • System for temporarily storing and managing information
  • Where information is processed and manipulated so that learning, reasoning, and understanding can occur
  • Bridge between encoding, storing, and retrieving information
  • Used to bring information in and out of storage to manipulate it
  • Short-term memory is a type of working memory
  • Working memory has limited capacity
  • Memory span: number of items that a person can hold onto and recall
  • Many older people lose working memory capacity
  • Harder for them to refocus when they are interrupted or distracted
  • Comprehension of speech declines with aging
  • The more rapid the speech and more complex the sentences, the more difficult it is for older people to understand what is being
  • Four types ofmemory retrieval
    • Recall:being able to access the information without being provided with any part of the memory
      • Answering fill-in-the-blank questions
    • Recollection: reconstructing a memory using pieces of memories, clues, logical structure, and narrative
      • Answering an essay question
    • Recognition: identifying information as a memory after experiencing it again
      • Answering multiple choice or matching questions
    • Relearning:relearning information that has been previously learned, which often strengthens the memory and makes it easier to remember and retrieve the information in the future
  • People tend to reorder, reconstruct and condense information to fit their own perception
  • Many environmental, physical and mental factors can affect memory
  • The best approach is to minimize the modifiable risk factors for memory impairment
  • Reversible and non-reversible conditions can cause memory loss that is greater than what is expected from normal aging
  • Elderly people have increased vulnerability to memory difficulties
  • Preventing memory loss from reversible causes
  • Diagnose and treat the condition before the memory impairment worsens or becomes permanent
  • Goals of treating memory loss from irreversible causes
  • Slow progression of the disease
  • Preserve function for as long as possible using medications and non-drug approaches
  • Non-drug approaches to managing Alzheimer’s disease include providing an environment that is safe and familiar with clear cues and minimal distractions, and to encourage and support the use of remaining capacities.


What could be causing Robert’s recent memory problems?

  • A. Robert’s Alzheimer’s disease is progressing
  • B. Robert is depressed
  • C. Robert is experiencing normal aging memory lapses

Choice A: Robert’s Alzheimer’s disease is progressing, is possible, but probably not the main reason for his recent memory problems.

Choice B: Robert is depressed, is a good possibility and the best answer.

Choice C: Robert is experiencing normal aging memory lapses, may be a possibility, but it is not the best answer

  • Two basic approaches for optimizing memory
  • Reduce any modifiable risk factors for memory impairment
  • Use strategies for improving memory and overall brain health
  • Major risk factors for memory impairment
  • Family history, older age, female gender, lower educational level, history of severe head trauma, illness, medications, vision or hearing loss, and chronic medical conditions
  • Prevent head injuries
  • Reduce hearing and vision loss
  • Lower risk factors for stroke
  • Avoid medications and psychoactive drugs that cause mental impairment
  • Pursue education
  • Physical exercise
  • Improves blood circulation
  • Promotes a sense of well-being
  • Improves mood
  • Increase attention and concentration
  • Exercise comes in many forms and should be adjusted to the abilities of each individual
  • Offers opportunities for social interactions
  • Healthy diet can help prevent some risk factors
    • High cholesterol levels, high blood pressure, obesity, diabetes, heart disease, and stroke
  • High cholesterol levels, high blood pressure, obesity, diabetes, heart disease, and stroke
  • Whole grains, fruit, vegetables, lean meat and fish, and low fat content can help maintain a healthy brain
  • Diet rich in omega-3 fatty acids or a Mediterranean diet high in olive oil, fish, and plants, can protect against age-related mental decline
  • Anti-oxidants (vitamins C, E, and flavonoids) may be particularly protective to the brain
    • Cocoa, blueberries, strawberries, tomatoes, spinach, broccoli, walnuts, almonds, soybeans, other fruits, vegetables and nuts
    • Vitamin supplements (1000 mg of vitamin C; 400 mg of vitamin E)
  • Vitamins B12, B6 and folic acid help maintain healthy brains
  • Beef, liver, banana, avocado, brewers yeast, spinach, cabbage and shellfish
  • Vitamin supplements
  • Phosphatidylserine, glycerophosphocholin, acetyl-L-carnitine can help optimize brain function
  • Adequate water to prevent dehydration
  • Vitamin E (2000 units daily) may delay functional decline in people with Alzheimer’s disease
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Postmenopausal estrogen
  • Statin drugs for lowering cholesterol
  • High levels of stress hormones impair memory and other brain functions
  • Chronic or excessive stress can contribute to serious medical issues and lead to depression and anxiety disorders
  • Alcohol abuse, drug abuse, and tobacco use cause mental decline
  • Smokers have double the risk of developing Alzheimer’s
  • Higher levels of education reduce risk of memory impairment and Alzheimer’s disease
  • Stay intellectually active
  • Mental stimulation is healthy for the brain
  • Challenge yourself by learning something new
  • Principles for mental exercises
  • Find something that will hold your interest
  • Make sure that you give your full attention
  • Gradually increase the difficulty of the exercises
  • Mindful attention
  • New tasks should be difficult to do at first
  • Principles for mental exercises (cont’d)
  • When tasks are too easy or too routine, the brain becomes lazy
  • For those with dementia, performing tasks involving multiple factors can be a good exercise in manipulating many items in their working memory
  • Allow sufficient time, use memory aids and coach when needed to improve performance
  • Puzzles, games, current events
  • Strategies for mental exercises
  • Repetition or rehearsal is essential for consolidation of the memory
  • Rehearse in an organized way
  • From simple to complex
  • From general to the more particular
  • Chunking related data
  • Elaboration: giving meaning to the information
  • Mental imagery: mental invention or recreation of an experience or event
  • Distinctiveness rule: make the information distinct from the rest
  • Minimize loud or irritating noises, glaring lights, and human or animal traffic in a room
  • Adjust volume of the activity to match the person’s capacities and level of comfort
  • Do not to interrupt or interfere with a memory task
  • Reduce risk factors for memory impairment
  • Manage medical conditions, reducing stroke risk, and preventing head injuries, hearing loss, and vision loss.
  • Avoid psychoactive medications, alcohol abuse, tobacco, and illicit drugs
  • Strategies for maintaining a healthy brain and delaying memory impairment
  • Physical exercise
  • Nutritional meals high in fruits, vegetables, and some nuts
  • Vitamins C, E, B12, and folate
  • High level of education
  • Mental stimulation

Written by:
Catherine M. Harris, PhD, RNCS.
Mindy J. Kim-Miller, MD, PhD

Edited by:
Sasha Asdourian

www.LightBridgeHealthcare.com

28: Memory Impairment: Risk Factors

Select the best answers from the list of choices following each question.

Click here to open Certificate of Completion

  • Angevaren M, Aufdemkampe G, Verhaar HJ, Aleman A, Vanhees L. (2008). Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 16(3):CD005381.
  • Ashbrook PW, McDermott MJ, Kline JS, Hayden SR, & Land JW, (1986). Emotion and memory: Depressed mood states and memory for schematically organized events. Unpublished manuscript. University of New Mexico, Albuquerque, NM.
  • Brand-Miller, J; Volwever, TMS; Colaguiri, S; Foster-Powell, K. The glucose revolution. New York: Marlow; 1999.
  • Brown, A.S. (1991). A review of the tip-of-the-tongue experience. Psychological Bulletin, 109(2), 204-223.
  • Del Ser, T; Hachinski, V; Merskey, H; Munoz, DG. An autopsy-verified study of the effect of education on degenerative dementia. Brain.1999;122:2309–2319.
  • Ellis HC, McFarland AD, Christian KM & Thompson RF (2003). Neural substrates of eyeblink conditioning: Acquisition and retention. Cold Spring Harbor Laboratory Press.
  • Columbia University Medical Center (2007, March 20). New Reason To Hit The Gym: Fighting Memory Loss. ScienceDaily. Retrieved January 15, 2009, from http://www.sciencedaily.com /releases/2007/03/070320073516.htm.
  • Ellis H C & Ashbrook PW. (1987). Resource allocation model of the effects of depressed mood states on memory. In K Fiedler & J Forgas (Eds.) Affect, Cognition and Social Behavior. Hogrefe: Toronto.
  • Eriksson, J; Lindstrom, J; Tuomilehto, J. Potential for the prevention of type 2 diabetes. Br Med Bull. 2001;60:183–199.
  • Folstein, M; Folstein, S; McHugh, P. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–198.
  • Friedland, RP; Fritsch, T; Smyth, KA; Koss, E; Lerner, AJ; Chen, CH, et al. Patients with Alzheimer’s disease have reduced activities in midlife compared with healthy control-group members. Proc Natl Acad Sci USA. 2001;98:3440–3445.
  • Gage, FH. Neurogenesis in the adult brain. J Neurosci. 2002;22:612–613.
  • Higbee, KL, (1977). Your memory: How it works and how to improve it. Prentice-Hall, Inc. Inglewood Cliffs, New Jersey.
  • Joseph, JA; Nadeau, D; Underwood, A. The color code: a revolutionary eating plan for optimum health. New York: Hyperion; 2002.
  • Kandel ER, Schwartz JH, & Jessell TM, (1995). Essentials of neural science and behavior. Appleton and Lange. Stamford, Conn.
  • Kidd PM. (2008). Alzheimer’s disease, amnesic mild cognitive impairment, and age-associated memory impairment: current understanding and progress toward integrative prevention. Altern Med Rev. 13(2):85-115.
  • Kramer, AF; Hahn, S; McAuley, E; Cohen, NJ; Banich, MT; Harrison, C, et al. Exercise, aging and cognition: healthy body, healthy mind? In:Fisk AD, Rogers W. , editors. Human factors interventions for the health care of older adults. Hillsdale, NJ: Erlbaum; 2001.
  • Lautenschlager NT, Cox KL, Flicker L, Foster JK, et al. (2008). Effect of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer Disease. JAMA. 300(9):1027-37.
  • Luria AR (1073). The working brain. Basic Books. New York.
  • Matser, JT; Kessels, AG; Lezak, MD; Jordan, BD; Troost, J. Neuropsychological impairment in amateur soccer players. JAMA. 1999;282:971–973.
  • Mattson, MP. Existing data suggest that Alzheimer’s disease is preventable. Ann N Y Acad Sci. 2000;924:153–159.
  • Mayeux, R. Gene-environment interaction in late-onset Alzheimer disease: the role of apolipoprotein-epsilon4. Alzheimer Dis Assoc Disord.1998;12(suppl 3):S10–S15.
  • Merchant, C; Tang, MX; Albert, S; Manly, J; Stern, Y; Mayeux, R. The influence of smoking on the risk of Alzheimer’s disease. Neurology.1999;52:1408–1412.
  • Morris, MC; Beckett, LA; Scherr, PA; Herbert, LE; Bennett, DA; Field, TS, et al. Vitamin E and vitamin C supplement use and risk of incident Alzheimer disease. Alzheim Dis Assoc Disord. 1998;12:121–126.
  • Newcomer, JW; Selke, G; Melson, AK; Hershey, T; Craft, S; Richards, K, et al. Decreased memory performance in healthy humans induced by stress-level cortisol treatment. Arch Gen Psychiatry. 1999;56:527–533.
  • Patel AK, Rogers JT, Huang X. (2008). Flavanols, mild cognitive impairment, and Alzheimer’s dementia. Int J Clin Exp Med. 1(2):181-91. Epub 2008 Apr 15.
  • Relkin, NR; Tanzi, R; Breitner, J; Farrer, L; Gandy, S; Haines, J, et al. Apolipoprotein E genotyping in Alzheimer’s disease: position statement of the National Institute on Aging/Alzheimer’s Association Working Group. Lancet. 1996;347:1091–1095.
  • Ruitenberg, A; van Swieten, JC; Witteman, JC; Mehta, KM; van Duijn, CM; Hofman, A, et al. Alcohol consumption and risk of dementia: the Rotterdam study. Lancet. 2002;359:281–286.
  • Sapolsky, RM. Glucocorticoids, stress, and their adverse neurological effects: relevance to aging. Exp Gerontol. 1999;34:721–732.
  • Schacter, D.L. (2001). The seven sins of memory: How the mind forgets and remembers. New York: Houghton Mifflin.
  • Shatenstein B, Kergoat MJ, Reid I, Chicoine ME. (2008). Dietary intervention in older adults with early-stage Alzheimer dementia: early lessons learned. J Nutr Health Aging. 12(7):461-9.
  • Silverman, DHS; Small, GW; Chang, CY; Lu, CV; Kung de Aburto, MA; Chen, W, et al. Positron emission tomography in evaluation of dementia: regional brain metabolism and long-term clinical outcome. JAMA. 2001;286:2120–2127.
  • Small GW. The memory bible: an innovative strategy for keeping the brain young. London: Penguin; 2002.
  • Small GW. What we need to know about age related memory loss. BMJ. 2002 June 22; 324(7352): 1502–1505.
  • Small, GW; Rabins, PV; Barry, PP; Buckholtz, NS; DeKosky, ST; Ferris, SH, et al. Diagnosis and treatment of Alzheimer disease and related disorders: consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer’s Association, and the American Geriatrics Society. JAMA. 1997;278:1363–1371.
  • Solfrizzi, V; Panza, F; Torres, F; Mastroianni, F; Del Parigi, A; Venezia, A, et al. High monounsaturated fatty acids intake protects against agerelated cognitive decline. Neurology. 1999;52:1563–1569.
  • Van Praag, H; Kempermann, G; Gage, FH. Neural consequences of environmental enrichment. Nat Rev Neurosci. 2000;1:191–198.
  • Woodruff-Pak DS & Thompson RF. (1985). Classical conditioning of the eyelid response in rabbits as a model system for the study of brain mechanisms of learning and memory in aging. Experimental Aging Research 11(2) p109-119.
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