Memory loss

Q My husband and I are beginning to show signs of memory loss, which no doubt will get worse with time. We visited a very qualified neurologist, whose special interest and expertise is memory loss and related problems in the aged. She prescribed a medicine, known here in Israel as Memorite. (In the US, it has another name.) It is meant to slow down the process, not eliminate it.


The problem is that my husband suffered awful side-effects, including diarrhoea, nausea, vomiting and eye pain. He went to bed for a few hours to recover. Of course, he refuses to continue with the treatment.


A few background facts. My husband is 85 years old and physically healthy, apart from having emphysema as a result of asthma since childhood. He still plays tennis (doubles) with people much younger than himself. He uses Ventolin when he suffers shortness of breath and before playing tennis. I believe that his voice has been affected by the Ventolin and Flixotide (a steroid) he took until recently.


My husband has no problems doing his professional work. But he forgets names, and has difficulty dealing with new appliances or learning a new trick on his computer. He also has a delayed reaction in understanding when I am talking to him. He has said, on occasion, that he feels confused and is shocked that he seems unable to cope with simple gadgets.


He is very slim and takes a full supplement programme of multivitamins, fish oils, calcium, vitamin C and vitamin E. - ML, Omer, Israel


A Memory loss is very common as we age. After all, our mental faculties start going downhill from as young as 25. From then on, we lose both brain and nerve cells at the rate of about 1 per cent a year. So, by the time we reach 70, it is said that a third of our brain cells will have gone - and, along with them, some of our ability to remember. As we get older, we also run a greater risk of developing ‘cerebral insufficiency diseases’ such as Alzheimer’s, although that does not sound like your problem.


Memorite is a complex Ayurvedic herbal remedy made by Plethico, an Indian pharmaceutical company headquartered in Indore. A Medline search of studies relating to its effectiveness or safety produced no entries. So, it may be that your husband was wise to stop taking this herbal mix, which doesn’t seem to agree with him.


Although your memory loss may be age-related, it is worth eliminating a few other possible reasons for the problem. Memory loss at any age can be due to both diabetes and thyroid disorders, so you need to have these checked out. Diseases of the thyroid gland affect one in 10 elderly people and can have a direct effect on memory function.


Toxins in the environment can also play havoc with brain function. Heavy metals like lead and mercury are obvious candidates, but a more generalised sensitivity to less obviously toxic chemicals (such as carpet odours, paints and gas) can have the same effect (Ann NY Acad Sci, 2001; 933: 48-56).


Toxins in food are another possible cause. Additives such as artificial sweeteners, monosodium glutamate (MSG), preservatives, and artificial colours can accumulate in the body and become toxic, causing brain damage and memory loss. Pesticide residues on food can do the same.


Many prescription and over-the-counter drugs can affect memory function - in particular, sleeping pills, antianxiety drugs, painkillers, antihistamines and antidepressants. Drug interactions may also result in memory problems, too.


Depression is another cause of memory loss - even mild depression will impair brain function. However, this is readily treated with the herb St John’s wort (BMJ, 1996; 313: 253-8).


You could also think about your lifestyle. Stress is well known to be hostile to brain cells. Constant exposure to stress hormones, such as cortisol and adrenaline, cause nerve-cell death and memory loss. Too much alcohol has the same effect.


One solution is to take regular physical exercise, proved in studies to slow mental decline due to ageing (Ann Behav Med, 1997; 19: 152-60).


Good nutrition is vitally important for good cognitive functioning throughout the whole of life, but especially as we get older. Our absorption rate then slows down, making it more difficult for the body to obtain the essential vitamins that it needs.


Certain vitamins in particular have been found to be specific for brain function. The B vitamins have two indispensable functions in the brain: they synthesise neurotransmitters and form myelin, the insulating substance that sheaths the connections between brain neurones, enabling them to transmit messages efficiently.


A deficiency of vitamins B1, folic acid and B12 have all been found to be associated with poor cognitive functioning in the elderly (Biol Psychol, 2001; 56: 47-65). Folic acid may also help protect the brain against degenerative diseases like Alzheimer’s. A recent experiment using laboratory mice showed that a diet containing normal levels of folic acid protected against the formation of the brain plaques that are typically associated with Alzheimer’s (J Neurosci, 2002; 22: 1752-62). Foods high in B vitamins include brewer’s yeast, brown rice, wholemeal bread, green leafy vegetables, and citrus fruits and juices.


An unusual foodstuff recently associated with brain function is the blueberry. In the US, sales of this fruit soared after Tufts University’s Human Nutrition Center reported that it helped to improve short-term memory in rats. Other foods found to do the same were strawberries and spinach. The common thread in these foods is that they are all naturally good sources of antioxidant vitamins (Ann NY Acad Sci, 2002; 959: 128-32).


But not all antioxidants necessarily have the same effects on brain function. A few years ago, nearly 5000 Americans of all ages were tested for memory, and then assessed for antioxidant levels in their blood. The researchers found no correlation between memory and vitamins A, C or selenium, but there was one that stood out. 'After adjustment for age, education and income,' they reported, 'decreasing serum levels of vitamin E . . . were consistently associated with increasing levels of poor memory' (Am J Epidemiol, 1999; 150: 37-44).


Forgetfulness is a worry for people of all ages, so a lot of research has gone into finding so-called ‘smart drugs’ that will improve mental faculties - such as the Memorite preparation that your husband tried with such disastrous results. Because of the inevitable side-effects with pharmaceutical drugs, scientists have looked for nutrients that may act as safer, natural brain-boosters.


Choline, a substance found naturally in many fatty foods, is known to accelerate the synthesis and release of acetylcholine, a neurotransmitter involved in memory storage. Choline supplements given to pregnant women have been shown to boost memory retention later in life for the developing fetus (J Am Coll Nutr, 2000; 19 [5 Suppl]: 528S-31S).


Choline also benefits people at the other end of age spectrum. Older people with dementia-type diseases have been helped by choline alphoscerate supplements (Mech Ageing Dev, 2001; 122: 2041-55).


Foods high in choline include milk, liver, eggs and peanuts. Available in dietary supplements, the recommended daily choline dose is about 500 mg.


Another substance often put forward as a natural brain-booster is lecithin. Related to choline, it is said to have similar effects on brain processes. However, a recent review of all the clinical evidence was disappointing (Cochrane Database Syst Rev, 2000; 4: CD001015).


More hopes have been pinned on a natural extract of lecithin called phosphatidyl serine (PS). But, once again, the results are mixed. While one study in 50-year-olds showed that 300 mg of PS a day for 12 weeks raised cognitive performance to levels typical of a 40-year-old, the most recent clinical trial has shown no benefits whatever (Nutr Neurosci, 2001; 4: 121-34).


More reliance can be placed on the herbal remedy Ginkgo biloba. It’s a remarkable substance which has consistently demonstrated useful effects on mental faculties in both the old and the young - with no appreciable side-effects (Public Health Nutr, 2000; 3: 495-9). A 120-mg dose has been shown to have almost immediate effects on cognitive functioning. It’s even more effective when combined with ginseng (Nutr Neurosci, 2001; 4: 399-412).


Finally, are you really sure you’re becoming forgetful? When older people who believe their memories are failing are actually tested, many turn out to be perfectly normal. Memory loss due to age appears to be more rare than we think (Ann Rev Gerontol Geriatr, 1987; 7: 57-92).