VOLUME 17 • N UMBER 6 February 2010

Preserving and improving memory as we age

Proven approaches include healthful habits and some do-it-yourself strategies. IN THIS ISSUE

I
f you’re over 50, you’ve probably noticed
some changes in your ability to remem-
ber things. Maybe you’ve gone into the
kitchen and can’t remember why, or can’t
recall a familiar name during a conversation.
You may even miss an appointment because it
slipped your mind. Memory lapses can occur
at any age, but we tend to get more upset by
them as we get older because we fear they’re
a sign of dementia, or loss of intellectual
function. Mostly, we fear Alzheimer’s disease.
The fact is, when significant memory loss
occurs among older people, it is not due to
aging but to organic disorders, brain injury,
or neurological illness.
Studies have shown that you can help pre-
vent cognitive decline and reduce the risk
of dementia by maintaining good general
health habits: staying physically active, getting
enough sleep, not smoking, having good social
connections, limiting alcohol to one drink a
day, and eating a balanced diet low in saturat-
ed and trans fats. (Recent studies have shown
a lower risk of mental decline among people
who follow a Mediterranean diet, which is rich
in fruits, vegetables, whole grains, and healthy
fats.) For women with certain health condi-
tions, memory problems are less likely to de-
Anatomy of memory
Deep within the brain, a structure
known as the hippocampus plays Cerebral cortex
a crucial role in acquiring and
consolidating (establishing) new
memories. The nearby amygdala is
the part of the brain that reacts to
emotionally powerful information,
helping the brain to retain infor-
mation that has emotional impact.
Once a memory is consolidated,
it is stored mainly in areas of the
cerebral cortex, the large, domed
outer layer of the brain.
velop if they seek and follow medical advice
(see “Care for your health,” page 2).
Most of the fleeting memory problems
that we experience with age reflect normal
changes in the structure and function of the
brain. These changes can slow certain cogni-
tive processes, making it a bit harder to learn
new things quickly or screen out distractions
that can interfere with memory and learning.
Granted, these changes can be frustrating
and may seem far from benign when we
need to learn new skills or juggle myriad re-
sponsibilities. The good news: thanks to de-
cades of research, there are various strategies
we can use to protect and sharpen our minds.
Here are several you might try.
✔Keep learning
A higher level of education is associated with
better mental functioning in old age. Experts
think that advanced education may help keep
memory strong by getting a person into the
habit of being mentally active. Challenging
your brain with mental exercise is believed
to activate processes that help maintain indi-
vidual brain cells and stimulate communica-
tion among them. Many people have jobs that
keep them mentally active, but pursuing a
hobby or learning a new skill
can function the same way.
Read; join a book group; play
chess or bridge; write your life
Hippocampus story; do crossword or jigsaw
puzzles; take a class; pursue
music or art; design a new
Amygdala
garden layout. At work, pro-
pose or volunteer for a project
that involves a skill you don’t
usually use. Building and pre-
serving brain connections is
an ongoing process, so make
lifelong learning a priority.
Screening
mammography 4
A doctor talks about the
debate over updated guidelines
recommending that breast
cancer screening start at
age 50, not 40.
Essential tremor 6
Shaky hands can make daily
life difficult. Medications and
coping strategies can help.
In the journals 7
Researchers find yet another
heart benefit from dark
chocolate.
By the way, doctor 8
What can I do about
vulvodynia?
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 Memory continued
✔Use all your senses even though the smells were no longer pres-
The more senses you use in learning some- ent and the subjects hadn’t tried to remem-
thing, the more of your brain will be involved ber them. So challenge all your senses as you
editorial board in retaining the memory. In one study, adults venture into the unfamiliar. For example, try
Board members are associated with Harvard Medical School were shown a series of emotionally neutral to guess the ingredients as you smell and
and affiliated institutions. They review all published articles.
Editor in Chief Celeste Robb-Nicholson, M.D.
images, each presented along with a smell. taste a new restaurant dish. Give sculpting or
Cardiology
Dermatology
Paula Johnson, M.D., M.P.H.
Suzanne Olbricht, M.D.
They were not asked to remember what they ceramics a try, noticing the feel and smell of
Endocrinology Anne Klibanski, M.D. saw. Later, they were shown a set of images, the materials you’re using.
JoAnn Manson, M.D., Dr.P.H.
Karen K. Miller, M.D. this time without odors, and asked to indi-
Epidemiology
Gastroenterology
I-Min Lee, M.D., Sc.D.
Stephen E. Goldfinger, M.D. cate which they’d seen before. They had ex- ✔Believe in yourself


Genetics
Gynecology
Susan P. Pauker, M.D.
Martha K. Richardson, M.D. cellent recall for all odor-paired pictures, and Myths about aging can contribute to a

Internal Medicine
Isaac Schiff, M.D.
Karen Carlson, M.D.
especially for those associated with pleasant failing memory. Middle-aged and older


Nancy Rigotti, M.D.
Beverly Woo, M.D.
smells. Brain imaging indicated that the learners do worse on memory tasks when
Neurology Anne B. Young, M.D., Ph.D. piriform cortex, the main odor-processing they’re exposed to negative stereotypes
Nutrition Bruce Bistrian, M.D., Ph.D.
Helen K. Delichatsios, M.D., S.M. region of the brain, became active when peo- about aging and memory, and better when
Oncology Judy E. Garber, M.D., M.P.H.
Psychiatry Ellen Blumenthal, M.D. ple saw objects originally paired with odors, the messages are positive about memory
Malkah T. Notman, M.D.
Margaret S. Ross, M.D.
Radiology Barbara Weissman, M.D.
Surgery Barbara Smith, M.D., Ph.D.
Care for your health
E d i t o r i a l s ta f f
Editor Carolyn R. Schatz You won’t have much luck with memory-improvement strategies if a health condition is sapping
Managing Editor Nancy A. Ferrari
Copy Editor James C. Sellman your learning ability. Many medical problems that become more common with age can impair
Contributing Editors
Art Director
Christine Junge, Kristie Reilly
Heather Derocher
cognitive skills if they go unrecognized or untreated. Here are some ways to protect yourself:
Production Editor Melissa Rico
Illustrator Joanne Haderer Müller Treat diabetes. Surges in blood sugar hamper memory by reducing blood supply to the brain.
Customer service In Harvard’s Nurses’ Health Study, women ages 70 to 81 performed worse on cognitive tests
Phone: 877-649-9457 (toll-free) and showed more deterioration over a two-year period if they had type 2 diabetes. The de-
E-mail: HarvardWL@StrategicFulfillment.com
Online: www.health.harvard.edu/ cline was mitigated somewhat among those taking medication to control their glucose. Exer-
customer_ service cise is another way to improve blood sugar levels.
Mail: Harvard Women’s Health Watch
P.O. Box 9308
Big Sandy, TX 75755-9308
Control blood pressure. Some memory lapses result from reduced blood flow to the brain
Subscriptions $32 per year (U.S.) caused by high blood pressure. In a study of 20,000 women and men over age 45 published
Bulk subscriptions last year in the journal Neurology, researchers found that the rate of memory problems in-
StayWell Consumer Health Publishing
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memory in women.
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Editorial correspondence during sleep.
E-mail: carolyn _schatz@hms.harvard.edu
Letters: Harvard Women’s Health Watch Address depression. Cognitive problems can be a symptom of depression. Older women who


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Permissions cline more rapidly with time. Among adults diagnosed with mild cognitive impairment, those
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Published by Harvard Health Publications, Check your thyroid. An underactive thyroid (hypothyroidism) can adversely affect learning,
a division of Harvard Medical School
Editor in Chief Anthony L. Komaroff, M.D.
memory, and attention—even among women whose thyroid levels aren’t low enough to cause
Publishing Director Edward Coburn other symptoms. Proper treatment brings thyroid hormone levels back to normal, with a corre-
© 2010 Harvard University  (ISSN 1070-910X) sponding improvement in cognitive performance. People who go untreated are twice as likely to
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Keep an eye on cholesterol. High cholesterol appears to increase the risk for mild cognitive im-
The goal of the Harvard Women’s Health Watch is to interpret pairment and Alzheimer’s disease many years down the road. Experts don’t fully understand why,
medical information for the general reader in a timely and
accurate fashion. Its contents are not intended to provide and they don’t know whether the problem is too much “bad” LDL cholesterol or too little “good”
personal medical advice, which should be obtained directly
from a physician. We regret that we cannot respond to inqui-
HDL cholesterol. A long-term study published in 2008 (involving 3,673 British adults whose
ries regarding personal health matters. cholesterol and memory were measured at ages 55 and 61) found a link between low HDL levels
PUBLICATIONS MAIL AGREEMENT NO. 40906010 and memory decline. It’s too soon to know whether raising HDL levels might ward off dementia,
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2| Harvard Women’s Health Watch | February 2010 www.health.harvard.edu

preservation into old age. People who believe that they are What about a memory course?
not in control of their memory function are less likely to If taking a memory-improvement course appeals to you,
work at maintaining or improving their memory skills and choose one that’s run by health professionals or experts in
therefore are more likely to experience cognitive decline. psychology or cognitive rehabilitation. And make sure it focus-
If you believe you can improve and you translate that be- es on practical ways to manage everyday challenges. Stay
lief into practice, you have a better chance of keeping your away from courses that center on computer or concentration
mind sharp. games, which generally won’t help you with real-life problems.
The results you get from a memory course will depend
✔Economize your brain use largely on the effort you put into it. Research suggests that
If you don’t need to use mental energy remembering where people who do well in these courses are distinguished less by
you laid your keys or the time of your granddaughter’s their age or health than by their strong motivation to practice.
birthday party, you’ll be better able to concentrate on learn-
ing and remembering new and important things. Take ad- re-study the essentials after increasingly longer periods of
vantage of calendars and planners, maps, shopping lists, file time—once an hour, then every few hours, then every day.
folders, and address books to keep routine information ac- Spacing out periods of study is particularly valuable when
cessible. Designate a place at home for your glasses, purse, you are trying to master complicated information, such as
keys, and other items you use often. Remove clutter from the details of a new work assignment. Research shows that
your office or home to minimize distractions, so you can spaced rehearsal improves recall not only in healthy people
focus on new information that you want to remember. but also in those with certain physically based cognitive
problems, such as those associated with multiple sclerosis.
✔Repeat what you want to know
When you want to remember something you’ve just heard, ✔Make a mnemonic
read, or thought about, repeat it out loud or write it down. This is a creative way to remember lists. Mne­monic devices
That way, you reinforce the memory or connection. For ex- can take the form of acronyms (such as RICE to remember
ample, if you’ve just been told someone’s name, use it when first-aid advice for injured limbs: Rest, Ice, Compression, and
you speak with him or her: “So, John, where did you meet Ca- Elevation) or sentences (such as the classic “Every good boy
mille?” If you place one of your belongings somewhere other does fine” to remember the musical notes E, G, B, D, and F
than its usual spot, tell yourself out loud what you’ve done. on the lines of the treble clef). For older learners, a particu-
And don’t hesitate to ask for information to be repeated. larly helpful approach is a story mnemonic—a brief narra-
tive in which each item cues you to remember the next one.
✔Space it out For example, the sentence “The dog knocked over my glass
Repetition is most potent as a learning tool when it’s prop- of milk so I have to wash the floor” could remind you that
erly timed. It’s best not to repeat something many times in a your dog has a vet appointment, you should pick up your
short period, as if you were cramming for an exam. Instead, new glasses, and you need to buy milk and floor cleaner.

Common stumbling blocks to memory

In the book The Seven Sins of Memory: How the Mind Forgets and
Remembers (Mariner Books, 2002), Harvard psych­ology professor
and researcher Daniel Schacter identifies several common memo-
ry flaws that healthy people of all ages can experience. Some may
become more pronounced with age, including the following:
Transience. You are most likely to forget information soon after
you learn it, and there is a tendency to further forget facts and
events over time. But memory has a use-it-or-lose-it quality:
if you call up and use a memory often, you are less likely to
forget it. Transience might seem like an indication of memory
weakness, but brain scientists regard it as beneficial because it
clears the brain of unused memories and makes way for newer,
more important ones.
Absentmindedness. This kind of forgetting occurs when you
aren’t paying close enough attention in the first place. You forget
where you just left your coffee cup because you didn’t focus on
where you put it in the first place. You were thinking of something
else, and your brain didn’t encode the information securely.
Absentmindedness is also forgetting to do something at a pre-
scribed time, like taking your medicine or keeping an appoint-
ment. One way to avoid this problem is to identify things that
can serve as reminders. For example, if you need to take certain
medications at breakfast, make a habit of putting them next to
your coffee cup at the table.
Blocking. Someone asks you a question and the answer is
right on the tip of your tongue—you know that you know it, but
you just can’t think of it. This is the most familiar example of
blocking, the temporary inability to retrieve a memory. Block-
ing doesn’t occur because you weren’t paying attention or be-
cause the memory has faded from your brain. In many cases,
it’s blocked by another, similar memory. For example, you call
your older son by your younger son’s name or vice versa. Mem-
ory blocks become more common with age and account for
much of the trouble older people have in remembering names.
The good news is that about half of the blocked memories can
be retrieved within a minute.

www.health.harvard.edu February 2010 | Harvard Women’s Health Watch |3

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