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Female and Forgetful
By Elisa Lottor and Nancy P. Bruning
Warner BooksCopyright © 2002 Elisa Lottor and Lynn Sonberg
All right reserved.
Chapter OneImportant Note
This book is for informational purposes only. It is not intended to take the place of medical advice from a trained medical professional. Readers are advised to consult a physician or other qualified health professional regarding treatment of their health problems or before acting on any of the information or advice in this book.
This book provides selected information about memory loss. Research about this complex subject is ongoing and subject to conflicting interpretations. As a result, there is no guarantee that what we know about this subject won't change with time.
In order to protect the identity of the women whose stories appear in this book, we have changed names and in some cases created composites.
The mail order offer contained in the back of this book is solely the responsibility of the Life Extension Foundation. Warner Books, Inc., its affiliates, and the authors shall have no liability whatsoever in connection with such offer.
What Is Memory? The Anatomy of Forgetfulness
While scientists debate the subtleties of the categories of memory loss, women march through my office with a litany of complaints. Often the first thing they notice is that they are forgetting names of someone they've just been introduced to in a business or social situation. This is one of the most common and most infuriatingly embarrassing scenarios. Leah, who works for a major university, finds she must constantly cope with looking ridiculous before the student body. "I'm often introduced to students, and I frequently cannot remember their faces or their names," she says. "I find myself in situations where it's clear that I've met a student before and we've talked with each other, but I have absolutely no recollection of the face, let alone the name. It's very embarrassing."
Many women tell me they need to write everything down at work, or they forget it. Anna, who works as an admissions nurse for rehabilitation says, "I get patients who've suffered anything from a stroke to massive trauma. My job involves a lot of detail work and a lot of memory. I was really good at this before. Now I have to write everything down! Insurers ask me? How far is the patient walking?' and I'll say, ?Wait a minute. I have to look at the PT notes,' even though I just read them a minute ago!"
Just as our bodies lose strength, energy, and flexibility over the years, so may our brains. Dendrites can shrink in size and number, neurons can be damaged and die, and neurotransmitters dwindle and weaken. Some studies show that starting at age forty or fifty, your brain loses about 2 percent of its weight every ten years, much of it in the hippocampus, the memory center of the brain. However, according to PET (positron emission transmission) scans, a type of X-ray image, done by Dr. Stanley Rapoport at the National Institute on Aging, the average brain loses only 10 percent of its mass between ages twenty and seventy. Some experiments do show that this shrinkage (however much it is) translates into failing memory. For example, when people ranging in age from twenty to ninety were tested with a series of numbers and letters, it was found that younger people were able to remember and reverse the series more quickly.
Sometimes the befuddlednes resembles learning disorders or attention deficit disorders. It's particularly devastating for women with high-powered jobs who are used to being sharp and focused, and instead find their mind hopping around like a flea on a kitten. Zelda, a fifty-one-year-old computer programmer, describes it this way: "I used to be able to focus on a task and everything else would fade into the background. Now my brain can't sweep the other things aside." Anna observes, "My son has ADD and sometimes I wonder if I have ADD, too. But of course I didn't just get ADD! Still, the symptoms seem so similar. He is not focused or able to pay attention. He doesn't remember things. Unfortunately, I feel a real kinship with him because I'm the same way!"
New research, however, suggests the picture is not that bleak, and other studies show that age-related cognitive decline does not afflict everyone. For example, when older people are compared with twenty-year-olds, over one-third of the older folks could remember names and events in their lives as well as the young ones. The Seattle Longitudinal Studies (which followed a large group of people over a long period of time) are also encouraging. They show that although perceptual speed and numerical ability reached their peak in persons in their mid-twenties, verbal and reasoning ability held until those people were in their seventies and eighties-provided they remained in good health. People with health problems, such as cardiovascular disease, were eight times more likely to lose brainpower. Another large study of about 6,000 older people published in the Journal of the American Medical Association in 1999 found that 70 percent of the subjects experienced no decline in cognitive abilities during the length of the ten-year study.
When considering these somewhat contradictory studies, two things are clear: First, serious problems with memory and cognition are not inevitable. And second, people with healthy bodies also tend to have healthy brains. That's why we all know older people who are still sharp as tacks who would, in fact, put many younger people to shame in the Jeopardy game show of life. It is not "normal" to become senile as we age, any more than it is "normal" to become obese, hunched over, sedentary, arthritic, or depressed. Patients will come to me complaining of memory loss, and when I interview them carefully, I find that there are all sorts of other things that are bothering them-low energy, digestive problems, fitful sleep, mood swings. This tells me that we need to work on their overall health and lifestyle habits. Invariably, when we bring them up to better health, these symptoms improve along with their memory problems.
Although it may be normal to lose some brain cells, it seems that most dwindling brainpower is due to cells losing power and function. The signals are not getting through. In the parlance of E-commerce, the "bricks" are not the problem-it's the "clicks" that need to be serviced. This can result in subtle changes, noticeable to you and you alone. Perhaps you are not as fluidly creative as you used to be-how can you assemble your knowledge in a new way if you have trouble recalling and focusing on what you know? You may have difficulty with memorization, or with learning something new. You may take longer to do complex tasks and become confused and inefficient when multitasking. Your faulty memory, in fact, is only one aspect of overall cognitive decline.
Bonnie, a Unit systems administrator, says, "I've always prided myself on my memory; it's what I've built my career upon. In my field you just don't go to school and then come out and put it into practice. You keep on learning because nothing stays the same. I can't really afford to be less than I was. I need to be more. So, after my hysterectomy I decided to take a couple of classes to prepare myself for an installation of a new system. Because memory loss is subtle in the beginning, it seemed that everything was fine in the classes. I took the amount of notes that I normally take. But once the course was completed, I had no memory of what I did in those classes at all. My books tell me I was there. I must have been there. But I have absolutely no clue as to what those classes consisted of."
Memory is not just remembering the name of the President or what you ate for breakfast. It is remembering your train of thought, where you are, where you are going and why, and what you are doing at any given moment. It is remembering how to put a sentence together, spell a word, balance your checkbook, turn on your computer, and what someone has just said. But many women complain that they are sometimes unable to do these things. They are suddenly rereading things over and over in order to get the meaning, not finding things that are right in front of them, stashing their socks in the freezer, calling their sons by their husband's name, and becoming clumsy, awkward, and, for lack of a better word, "ditzy."
You need memory to hold on to your thoughts and ideas long enough to organize them. But if they slip away like quicksilver before you have the chance to arrange them in a logical sequence, your ability to communicate your thoughts to others breaks down. Zelda says, "I used to be able to store the whole task in my head from start to finish, with one thought progressing to the next. I could count on being able to have a thought and hang on to it while I was thinking the next thought and the next thought, and so on, in branches all over the place. That doesn't happen anymore. Now when I start thinking about a task, I have the original thought, go on to the next thought, and then branch out maybe into a few more, only to find that the original thought is gone. So then I have to go back and start with the original thought, but then I go there and lose it again. I keep going around in circles with my thoughts ... It's very hard to think something through. I can't hold on to the thought long enough to get through a line of reasoning. It's like my memory span has been cut short."
Memory retrieval also slows down as we age, but this doesn't mean the memories aren't still there. We just need to work at it harder. Often, the information we are looking for is the name of someone or something-a place, a book title. As one woman puts it, "The lapse of memory gnaws at me for hours, sometimes days; it's like struggling to open a locked door. And then, when I'm not even trying to remember, the door flings open and the name pops into my head and I feel so relieved." Somehow, all that time our brains are trying to locate the memory.
My co-author calls this the "three o'clock in the morning Glenn Close phenomenon." She and her friend Fanny were talking about the movies and their favorite actresses. Neither one could remember the name of an actress who was in The Big Chill. They went through the list of her other movies, confirmed that she had had a child late in life, described the myriad of hairstyles she had sported in films, and could see her face and her expressions as clear as day. But they absolutely could not think of her name. In the middle of the night the name came to Nancy. She waited until morning to call Fanny and spoke only two words into her answering machine: "Glenn Close." Somehow, all that time, her brain was at work trying to locate the memory.
And then there is what women call "brain fog," and its cousin "brain fatigue." This state of mind seems to be a kind of temporary loss of short-term memory, and is sometimes also related to an inability to focus and pay attention. It feels like being drugged-similar to being stoned, confused, disoriented, and dissociated without the accompanying pleasurable high. Deborah describes it as "trying to think underwater" and says it's "like someone had turned my thinking down to lowest speed." Diane says her head feels "empty, depleted" and that she feels "easily overwhelmed." Michelle says that her "head feels cloudy" and that she is "easily distracted and needs to concentrate really hard to focus and be accurate"; she usually has brain fog and dizziness together. Some women say they simply "can't think" or "can't think straight."
Female and Forgetful
To my knowledge, there are no studies that compare the ways in which the loss of cognitive function varies between men and women. But as I stated in the introduction, there are indications that women experience memory loss differently than men. Their brains differ anatomically, and this alone suggests profound possibilities of uniqueness. Other factors such as stress, nutrition, and hormonal influences also set women's forgetfulness apart from men's.
As they age, men and women lose tissue in distinct parts of the brain, and thus may experience dissimilar types of memory loss. Studies also suggest that men and women use their brains differently. For example, females generally have thicker, more developed left cerebral hemispheres, while males usually have thicker, more developed right hemispheres. What might these discrepancies mean? For one thing, they may explain why females often learn to speak at a younger age and remain better at language skills throughout life, and why males excel at spatial skills, such as map reading and navigation. In addition, the bridge between the brain's two hemispheres appears to be thicker and larger in women. This suggests that the two halves of the female brain generally communicate better with each other, and that men's brains are more specialized.
The structure of women's brains may explain why women are more intuitive, since they may be more naturally adept at coordinating logic with emotion. Men may be more naturally able to compartmentalize information and thinking; perhaps this ability to isolate problems enables them to solve certain problems better. This in turn may also explain why males tend to excel in math, mechanics, and engineering. On the other hand, males are more prone to dyslexia and hyperactivity because these conditions are made worse by a weak communications bridge between the hemispheres. Men also have a harder time recovering from stroke and other brain injuries because they are less able to let the uninjured half take over these lost functions. However, women tend to suffer from dementia more than men do; possibly because women have fewer brain cells to begin with, so when cells die it has a greater impact.
There are other differences that we've all noticed in real life, and that have been confirmed by scientific testing. It's long been recognized that men tend to have a better sense of direction and can decipher maps better-tasks that require spatial reasoning. Anatomically speaking, this also makes sense. Men, on average, have 13 percent more neurons in the outer layer of the brain, but women have a similar percentage of cells that are responsible for communication between nerve cells. The researchers conclude that, in men, the extra cells may contribute to greater spatial reasoning, or that men may have more of a certain type of brain cell devoted to this type of thinking. Men's brains may have more cells, but women's brains have better wiring.
Hope: Your Plastic Brain
Fortunately, your brain has an amazing capacity to continue to change and grow throughout your whole life-this ability is called plasticity. Until recently, scientists thought that humans did not grow new brain cells.
Excerpted from Female and Forgetful by Elisa Lottor and Nancy P. Bruning Copyright © 2002 by Elisa Lottor and Lynn Sonberg. Excerpted by permission.
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