You were introduced to the guy at a party, you turned away for a second to grab a drink, and now you can`t recall his name.
You find yourself drawing a blank at familiar phone numbers-even your own. You look at your watch and realize seconds later you have no idea what time it is. You run into an old friend on the street and, to your utter dismay, you can`t even remember his name.
It`s folk wisdom with more than a little basis in fact: Past the age of 30 or so, just about everybody`s memory starts to slip. Your grandparents and even your parents probably accepted it as an expected, if annoying, part of getting older, just like wrinkles and graying hair.
But these days, as the phenomenon of middle-aged forgetfulness begins to strike the success-oriented baby-boom generation, the reaction has been predictable:
”Panic, panic, panic, panic, panic!” recounts Joseph Mendels, the psychiatrist who runs the Memory Institute, part of the Philadelphia Medical Institute in Center City Philadelphia, an independent organization primarily involved in testing new drugs for conditions including bulimia, depression and memory loss.
Sales of memory-training manuals and cassette tapes are booming. Just about every adult-education program now offers a memory course. At the Memory Institute (the only Philadelphia facility offering a combination of testing and experimental drugs), stressed-out professionals who can`t recall business conversations minutes after having them have been calling up or showing up in a state of high anxiety.
Their worst fear isn`t that forgetfulness will get them in bad with the boss. It`s that it could be the signal of something far more ominous-the onset of Alzheimer`s disease, the debilitating neurological disorder that affects about 5 percent of Americans over 65 and is marked by progressive loss of memory.
”There`s almost an epidemic of concern about Alzheimer`s,” said Mendels, 51, who started the drug-testing organization in 1981. ”With all the publicity about it, and with an aging population . . . In fact, of course, Alzheimer`s rarely if ever strikes anyone under the age of 50. Even under 60, it`s uncommon. But that doesn`t stop people from worrying.
”And since we know very little about how Alzheimer`s starts, we don`t know for certain that a mild memory problem at 50 might not develop into Alzheimer`s 10 or 20 years later. We can tell people they don`t have it, but we can`t tell them with certainty that they might not develop it.”
Many people who turn up at such places as the Memory Institute or the Memory Assessment Clinic in Bethesda, Md., demand more than simple reassurance that they don`t have the terrible disease, for which there is no known cure or effective treatment. It takes testing in a clinical setting-comparing their scores in a battery of computerized tests against the scores of other people of the same age-to convince them that they do not have Alzheimer`s.
And even those who are not worried about Alzheimer`s often decide it`s a sensible precaution to take the tests, so they can detect any future deterioration in memory.
”More and more people are demanding an annual memory checkup, the same way they get checked for cancer or heart disease,” said Mendels. ”We`ll be starting to offer them in March, and we already have a waiting list of more than 200 people. And 10 or 15 years from now, as these people start hitting their 50s and 60s, we`re going to be seeing real panic.”
Mendels said the basic memory checkup, which will be stored in a computer and used as a baseline for future comparison, probably would cost about $200. Officials at the institute are investigating whether some of the cost may be covered by health insurance.
Who is most likely to conclude the worst when the normal memory lapses of middle-age surface? Hard-driven professionals: people who, in the words of Martin Samuels, an associate professor of neurology at Harvard Medical School, ”have grown to their point in life by worshiping their brain.”
Memory ”has simply become more and more important for more and more people,” said Mendels. ”The amount of information bombarding us all constantly is simply overwhelming . . . you can`t remember it all. Nobody can remember it all. So it`s understandable that people who think their memories are deteriorating are getting upset.”
In fact, researchers say that the vast majority of people over age 30 who have begun to worry about their ”bad memories” probably have a perfectly normal condition called age-associated memory impairment, also referred to as benign forgetfulness. Or they may not have a memory problem at all.
The brain, according to Samuels, is ”an electrical piece of machinery,” and people simply start losing circuits as they age. That explains why short- term memory tasks, such as remembering three unrelated words for a half-hour, usually are harder for older people.
However, many middle-aged people who complain about bad memories really have far more efficient recall than they realize, according to Mendels. They simply don`t realize what is considered ”normal” for someone of their age and education. Only about 10 to 15 percent of people 60 and over (excluding those with Alzheimer`s) have a memory loss that`s ”clearly worse than average for their age,” he said.
Though researchers do not understand exactly how the memory operates, they do know that an area of the brain called the hippocampus seems to function as a ”switchboard,” directing bits of information to areas of the brain where related information is stored.
Thus, Mendels pointed out, there is a difference between ”memory”-
registering a bit of new information in the brain-and ”remembering”-
retrieving that bit of information at will.
”Often, when people say they have a bad memory, they don`t really mean they have a bad memory at all,” he said. ”The stuff is there, filed in the brain. But it`s the filing system that`s at fault. The more you can improve the index to your filing system, the better your memory will function.”
Though most people experience at least a little more difficulty with short-term memory as they age, there are some ways to fight the impairment.
Perhaps the most basic is to ”improve the way you learn,” said Mendels, in other words, to improve the chances that the information makes it into your brain in the first place.
Take the guy at the party whose name you forgot immediately upon hearing it. Probably, according to Mendels, you were not really concentrating; you may have been looking over his shoulder at someone else you recognized, wondering where the bar was, worried that you were dressed inappropriately. You didn`t really forget the name; you never actually heard it.
It`s also important, according to Mendels, to be aware that the emotional climate can affect how much information makes it into the brain and how easy it is to recall later.
”New information that is accompanied by some strong emotion is more likely to be remembered,” he said. ”It`s the bland things we don`t remember. So if you want to remember something, be emotional about it, not passive. Get excited. Talk to somebody else about it.”
There`s one emotion you want to avoid, however: anxiety. ”Anxiety can interfere with remembering,” said Mendels. ”It`s been shown that if you teach people certain tricks to improve their memory, you`ll get improvement, but if you teach them these tricks plus relaxation therapy, you`ll get much more improvement.”
Then there`s the effect of alcohol on memory, not just the blackouts or lost weekends associated with a true alcoholic binge.
”What`s interesting is that even one or two drinks can take the edge off your ability to remember,” Mendels said. ”Memory is a complex chemical-electrical process that takes place in the brain. Alcohol is a chemical. It gets into the brain, and it interferes with the system.”
Even such a simple tactic as writing down information you fear you`ll forget can be important in helping memory, Mendels said. (Some `80s professionals have gone a step further, programming computers at work to beep to remind them of appointments and the like.)
Other behavioral strategies-such as mnemonic devices (making up a word from the initials of several words you wish to remember) or visualization
(meeting a man named Nickels and imagining his face as a slot machine with nickels pouring out of his mouth)-can be learned and prove helpful to some people.
It`s also important for those having trouble remembering to make certain the impairment is not being caused by a psychiatric problem, such as anxiety or depression, or the medication prescribed for such a condition. Many drugs prescribed for depression and anxiety are known to cause severe memory loss in some people.
There may come a day when all we will have to do to improve our memories is to pop a pill.
About a half-dozen drugs that seem to improve memory in animals are being evaluated in Europe and in the United States under supervision by the Food and Drug Administration to see whether they might also benefit humans, said Mendels. Though the effort has barely begun, he said there have been some promising initial results.
A typical example is Kathleen Hackett, a 53-year-old revenue investigator for the City of Philadelphia who showed up at the institute in September, hoping to be part of the seven-month research project.
”The thing that really bothered me was when I realized I wasn`t able to memorize music anymore. When I was young, I could do that. My kids were always joking about Alzheimer`s, and though I didn`t think I had that, it still bothered me.”
Hackett, found to have age-associated memory impairment, became a participant in the program. The improvement, with twice-daily doses of one of the experimental memory drugs, has been ”unbelievable,” she said.
”I`m memorizing my second piece of music,” she said proudly. ”It`s a rare occasion when I forget anything anymore.It`s so incredible to have my memory back. ”
