How memory works -- and why it can fail us

<p>''Where are the keys? I declare, if it weren't screwed on tight, I'd forget where I put my own head!"</p><p>How often have you felt this way? The older we get, the more often we forget things we used to remember easily. We make more lists and wonder if our inability to remember details means we will need full-time custodial care in a year or two.</p><p>Understanding the basics of how memory works can both reassure us certain changes are normal and help us recognize when something more dire may be afoot.</p><p>Our brain stores information in different areas, depending on the different types of memory. We have short-term memory that lets us remember the name of someone we just met moments ago; we have recent memory that allows us to tell a friend what movie we saw last week; and we have remote memory that we use when we reminisce about our childhood.</p><p>As a natural process of aging, sometime in our 20s we begin to lose brain cells a few at a time. With time, our bodies start to make fewer of the chemicals our brain cells need in order to work smoothly. And the older we are, the more we notice these changes.</p><p>Short-term and remote memories are not significantly affected by age. With normal aging, it's the recent memory that suffers the most and this is why we occasionally find it difficult to remember a conversation we had last week. Getting older has an impact on attention processes, on recall time, and on our ability to get new information into storage. Sometimes it is hard to pull a word out of our memory. While this is one of the most common and frustrating glitches of an aging brain, it is not serious.</p><p>A memory problem is serious if it affects your daily life. If you begin to have repeated difficulty remembering how to do something you have done many times before, have trouble finding your way to a place you've been to often, or are unable to do things that require following steps, like making a recipe, see your doctor.</p><p>When people notice their memory is changing, their first fearful response is to think they may be developing early Alzheimer's. Alzheimer's is a form of dementia, a disease that causes severe problems with memory, thinking, personality and behavior. It is a progressive and rightfully dreaded disease. Normal forgetfulness makes us forget where we left the keys; dementia makes us forget what the keys are for.</p><p>There are many causes for serious memory loss and dementia; Alzheimer's is only one. Depression and stress can cause severe memory impairment. The side effects of some drugs, strokes, head injuries, infections, thyroid disease, vitamin B12 deficiency and alcoholism have all been implicated in dementia.</p><p>If you or someone in your family is concerned about significant memory loss, first consider the normal changes of an aging brain. If the loss seems to be affecting daily activities, ask your doctor for an evaluation. A simple and brief test of memory can be done in your doctor's office, and blood tests can be done to check for other causes. If indicated, your doctor may order some brain imaging studies.</p><p>Most adults have the memory challenges that come with wisdom and experience (aka age). Memory is like a muscle -- it needs to be exercised to stay strong, and using your brain helps to keep it sharp.</p><p>Avoid abusing alcohol or drugs. Relax, and trust yourself more -- people who feel that they have control over their lives can actually improve their brain chemistry. Pay attention and minimize distractions; make lists and carry a calendar. Finally, challenge yourself. Learning new skills and keeping mentally active can strengthen brain connections and form new ones.</p><p>The fear of losing our mind can be powerful and stressful. Knowing that brain changes are to be expected can relieve some fear, and doing what we can to slow those changes can ease the frustration.</p><p>Now if I could just remember where I left my keys ...</p><p>Longtime Sonoma County family physician Dr. Stacey Kerr, a graduate of UC Davis Medical School, is certified in her specialty by the American Board of Family Medicine. Her columns are not intended as a substitute for hands-on medical advice or treatment. Consult your health care provider before adhering to any recommendations in this column. E-mail her at drkerr@the-doctors-inn.com.</p>