Read an Excerpt
CHAPTER 1
A BREAKTHROUGH APPROACH TO MEMORY ISSUES, AGING, AND ALZHEIMER'S
Memory is all we are. ... Take a man's memories and you take all of him. Chip away a memory at a time and you destroy him as surely as if you hammered nail after nail through his skull.
MARK LAWRENCE, KING OF THORNS
Memory is the fabric of our souls. It enables us to integrate and make sense of the experiences of our bodies, minds, and spirits. It makes us who we are and allows us to keep our loved ones close, even when they are far away. Memory houses our joys, our hurts, and all of life's lessons. It reminds us who is trustworthy and who isn't, who has helped us and whom we need to help. Memory enables us to recall the important events in our lives and keeps us centered and growing. And because it contributes to our values and outlook, it also provides us with a sense of purpose that gives our lives meaning.
Our memories are such a part of us that we often take them for granted. Yet when our memory is damaged, the costs can be high. A diminished memory can rob us of our ability to make good decisions (because we forget important life lessons) and disconnect us from those we love. Memory problems limit our success at work, steal our independence, and ultimately make us vulnerable to anyone who might take advantage of us.
When someone's mental abilities, including memory, deteriorate enough to affect daily life, we say that person has dementia. Worldwide, a new person is diagnosed with dementia every seven seconds. Of the approximately 318 million Americans living today, 45 million — about 15 percent — will get Alzheimer's disease (AD) at some point in their lives. Tens of millions more will experience other forms of dementia, and 75 percent of older adults will suffer from memory problems. Plus, more than 200 medication trials have failed to reverse Alzheimer's disease and other forms of dementia. Given the complexity of the illness and how early it begins altering the brain, we are likely never going to have a medicine that cures it.
Yet new research suggests that a "memory rescue" program, like the one presented in this book, can dramatically improve memory and can prevent and sometimes even reverse some forms of dementia. Given how most doctors approach this issue, however, you cannot count on traditional medicine to rescue your memory.
THE OLD APPROACH TO MEMORY COMPLAINTS
Here is a common scenario: You are having difficulty remembering conversations, forgetting where you put your reading glasses, or briefly getting lost driving in familiar areas. So you see your primary care physician or local neurologist, who asks you a few questions, gives you some short tests, orders an MRI (magnetic resonance imaging), and tells you, "Everyone has memory problems as they age. You're normal." It's also common for family members and friends to downplay forgetfulness.
A week or so later, you meet again with your doctor, who says that the report on your MRI came back as "mild, age-appropriate brain atrophy." He or she tells you that you have mild cognitive impairment (MCI). You're reassured that it's common and that you'll likely retain your personality and longterm memory until later in the illness. You're encouraged to get your affairs in order, given a prescription for Aricept (donepezil, a common memory medication that has short-term benefits but loses its effects after 18 months), and told to schedule a follow-up appointment in six months. Typically, there is no discussion about eliminating risk factors through exercise, diet, supplementation, or memory training exercises.
That's literally the extent of the workup in 80 to 90 percent of the memory-related cases that come to us at Amen Clinics from the traditional medical system.
It's completely ineffective, heartbreaking ... and unconscionable given what we know now.
Until recently, health-care professionals assessing the presence of memory problems in patients classified their cognitive functioning as: (1) normal with no symptoms; (2) mild impairment observed by patients or their families; or (3) Alzheimer's disease, in which dementia was becoming significant and getting worse.
The National Institute on Aging announced a significant change in 2011. Based on new brain imaging data, they added a new "preclinical" level. As a result, the current staging guidelines are
1. normal
2. preclinical: no obvious symptoms, but negative changes can be seen on biomarkers such as brain scans
3. mild cognitive impairment
4. Alzheimer's disease
Can you see the problem here? Long before symptoms develop, your brain may already be beginning to deteriorate, years or even decades before you realize it! A UCLA study found that 95 percent of people with Alzheimer's are not diagnosed until they are in the moderate to severe stages of the disorder. Yet the brain of a person diagnosed with Alzheimer's disease at age 59 likely started to show signs of deterioration by the time that person turned 30.
No matter your age, memory symptoms should be taken seriously. Developing brain fog or feeling as if your memory is slipping when you are in your forties, fifties, sixties, seventies, or even eighties is common, but it's not normal. It is a sign of impending doom. Ten years after you notice a problem (called subjective cognitive decline), there is an estimated 70 to 100 percent chance of your getting worse and slipping into dementia.
But while it is true that memory issues are common with age, they are not inevitable. In the presymptomatic stage, when memory problems are minor, help is likely to be most effective. If you're struggling with your memory, even if it seems inconsequential, now is the time to get serious about your brain's health.
A BREAKTHROUGH CONCEPT: MEMORY RESCUE
Our decades-long experience at Amen Clinics of looking at the brain, together with the latest scientific research, has convinced me that the traditional approach to memory problems is misguided and leads to unnecessary disease and disability.
Just as many tributaries feed a river that is about to flood and destroy a community, we've discovered that there are many different causes of memory loss. It is no longer accurate to talk about mild cognitive impairment or AD as single entities with single causes, just as at Amen Clinics we no longer talk about a single type of depression, addiction, attention deficit hyperactivity disorder, or obesity. The ability to identify and address each of the potential causes of memory problems has enabled us to develop a plan to prevent or even reverse these devastating issues. Steve's story illustrates how effective our approach can be.
Steve: staring down Alzheimer's
Steve, a 60-year-old father and CEO, lost both his father and grandfather to AD. Steve was named after his grandfather, and they were very close. Steve found it heart-wrenching to watch him deteriorate to the point that his grandfather no longer recognized him. But watching it happen to his father was even worse. He worried about his dad every day for a decade. His father got lost, acted irrationally, and spent money in ways that jeopardized his life savings and family. In addition, Steve's mother always seemed sad and stressed.
Steve was terrified he'd get AD too. When his own memory began slipping, he went to see his family physician. His doctor did a cursory physical examination, ordered some blood work and a brain MRI, and saw him for follow-up a few weeks later. Steve's physician told him that his blood work was "mostly" within normal limits but didn't elaborate; his MRI was "normal for age with mild atrophy." He also told Steve it was "normal" for most people to struggle with memory problems as they aged. His doctor, who was Steve's age, said that he was having more senior moments too. Plus, he said, if Steve had early AD, there was nothing he could do for it, so why worry? The last thing the doctor said was "Make sure you have your affairs in order and let me see you in six months."
Deeply unsettled by the appointment, Steve came to see us at Amen Clinics. We have heard stories like Steve's over and over, and our approach is dramatically different. We know that the best way to prevent and even reverse significant memory problems is to identify them as early as possible and work to eliminate or treat all the risk factors that may be contributing to them. The mnemonic I developed to help us remember the risk factors is BRIGHT MINDS.
B – Blood Flow
When I reviewed Steve's records, I noticed that he had several important risk factors. He was prehypertensive (blood flow) and 60 years old (retirement/aging). His blood tests showed he had markers of inflammation. He also had a family history of severe memory problems (genetics) and was under chronic stress from watching his father's health decline and taking care of his mother (mental health). He was not eating organic or paying attention to the products he put on his body (toxins). His vitamin D (immunity/infections) and testosterone levels (neurohormone deficiency) were low, his fasting blood sugar and HbA1c levels were high, and he was overweight (diabesity). He had not been sleeping well for three years (sleep). Steve's risk factors and our recommended interventions (both of which will be explained in more detail in chapters 5 through 15) are summarized in the box below.
Steve's Memory Rescue risks and plan
As part of Steve's evaluation, I ordered much more extensive blood work and a SPECT (single photon emission computed tomography) scan, which measures blood flow and activity in the brain. SPECT is different from a CT (computed tomography) or MRI, which are anatomy scans that look at brain structure. SPECT looks at function. Functional problems almost always precede structural problems. SPECT tells us three things about the brain: Is there good blood flow? Too little activity? Or too much?
Steve's SPECT scan showed very low blood flow, the number one predictive sign of future trouble and Alzheimer's disease.
Steve became serious about his self-care (he became a brain warrior), and within nine months of being on the Memory Rescue: BRIGHT MINDS program, Steve felt sharper, his memory was better, and he was hopeful that he could do something about his risk of Alzheimer's. A year later his scan showed remarkable improvement. Armed with this information, he taught his children about brain health.
THE MEMORY RESCUE PROMISE
Memory Rescue will teach you the most common reasons for memory loss and help you identify the specific factors affecting your brain health. It will then provide you with a step-by-step approach to get your memory back, strengthen it, and keep it healthy for a lifetime.
You will learn:
How to assess your brain on a regular basis to pick up issues early
How to test for each of the risk factors
Strategies to decrease or eliminate avoidable risks through exercises, nutritional supplementation, and diet
How to follow the Memory Rescue Diet (one of the most powerful weapons for memory sustainability)
Memory training and workouts to keep your brain sharp
Innovative strategies to enhance brain function
Before we dive into those details, join me on a fascinating and important journey into your brain, the place where memories are truly made.
(Continues…)
Excerpted from "Memory Rescue"
by .
Copyright © 2017 Daniel G. Amen, MD.
Excerpted by permission of Tyndale House Publishers.
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