IF SYMPTOMS PERSIST Dr. Jose Pujalte, Jr.

“The advantage of having a bad memory is that  you can enjoy the same good things for the first time several times.” – Friedrich Nietzsche (1844-1900), German philosopher, “A Bad Memory” (1878)

This is an aging person’s nightmare: waking up one day and not knowing who he or she is. And I suppose forgetfulness spikes even more in this quarantine Christmas where friends and relatives will greet virtually. Yes, it doesn’t just happen in the movies. Now we all forget a person’s name or where we put the house keys or where we parked the car in the mall. This is normal. But when does memory loss become a cause of concern? What kind of memory loss points to a bigger danger such as Alzheimer’s disease? Memory Banks. Memory is the function and ability to recall facts and events. Researchers have identified three stages in this skill:

• Encoding (Stage 1) is the first phase where a person takes in the information. For example, someone introduces herself to you: “Hello, I’m Jackie.”
• Consolidation (Stage 2) is the second phase where information is processed and gets stored in specific areas of the brain. Some people automatically associate a new person’s name with certain features or circumstances. For example: “Jackie, the receptionist in the doctor’s clinic with short hair and a wide smile, etc.”
• Retrieval (Stage 3) is the third phase where a person is able to recall the particular information stored. For example, in a follow up visit, you see the receptionist with short hair and a wide smile. She says hello. And immediately, you answer: “Oh hello Jackie, how are you?”

Now this is the problem. If you forget a name, an appointment, a chore, it’s normal. On the other hand, if you are in your 50s or 60s, forgetting can be an early symptom of early Alzheimer’s. Causes of Memory Loss. Still, it helps to know that you’re not necessarily on your way to senile dementia. Since memory can be divided into stages, things can go wrong anywhere along the process. What if you heard Jackie’s name wrong the first time around? Or if, when she was introducing herself, you were filling up clinic data forms? There are many factors in forgetting. But some implicated conditions for memory loss are:

• Stress and anxiety (the downside of cramming for an exam!).
• Medications (for example, drugs that for seizures, insomnia, chronic pain).
• Vitamin B12 deficiency.
• Metabolic diseases – diabetes, thyroid disease, lung, liver or kidney failure.

It is reasonable to expect that as these conditions are treated, the memory loss is reversed. Over and above these reasons, however, is time. The enemy of memory is time. This is the very reason that people enjoy reunions and pine for the “good old days.” As events are further pushed back in time, memory goes into “soft focus” and we seem to want to remember only the good things. Do You Need to See a Doctor? Alarming memory loss that requires a doctor’s investigation includes:

• Forgetting how to drive a car (if you’ve been driving of course) or telling time.
• Forgetting recent events.
• Forgetting having known a particular person (except suspects in plunder, cheating, and other crimes).
• Intermittent confusion and decreasing alertness.
• Forgetfulness being more frequent and severe.

It will help if you visit a neurologist for a thorough check up. Improving Memory. To take charge and not feel that forgetting is inescapable, experts have some suggestions:

• Structure the environment – this is the reason the refrigerator door has magnets! To forget less, write down appointments, use alarms, look at clocks, park in the same place, use the same route to work, and so on. The more predictable, the less forgetting.
• Take naps – fatigue affects remembering.
• Reduce stress – and forget less.
• Focus attention – when first storing information; this is from anything to hearing a name for the first time, listening to facts enumerated by the teacher, or instructions from your doctor. This is essentially keeping the encoding stage of memory as pristine as possible for easy recall.

Memory loss is reversible. It can be delayed. It may not be early Alzheimer’s. But then you must make the effort to sort things out. Start this Christmas – memorize the names of long lost friends and distant relatives! E-mail [email protected]