Ten Steps To An Optimal Memory - Preventing Memory Loss: Improving Memory Understanding Age Related Memory Loss

Content provided by the Faculty of the Harvard Medical School

Ten steps to an optimal memory

Research shows that the following strategies may help preserve your memory.

1. Exercise

Physical fitness and mental fitness go together. People who engage in regular vigorous exercise also tend to stay mentally sharp into their 70s and 80s. There are several ways in which exercise might benefit your memory. First of all, it's good for the lungs, and people who have good lung function are sending a higher volume of oxygen through their blood vessels and into their brains. Second, exercise helps reduce the risk for diabetes, high cholesterol, high blood pressure, and stroke — diseases that can lead to memory loss. There is also some evidence that exercise leads to increased connections between brain cells and enhances neurotransmitter function. And finally, animal research has shown that exercise increases the level of neurotrophins, substances that nourish brain cells and help protect them against damage from stroke and other injuries.

Physical activity keeps both your body and your mind in shape.

Researchers don't know precisely how much exercise is needed for good brain health. The available research suggests that the exercise needn't be extreme, but should be moderately vigorous and regular. The people in the MacArthur study whose mental functions remained strong were active almost daily. A study from Case Western Reserve University School of Medicine concluded that individuals who exercised — by walking or by engaging in physically active hobbies, such as gardening — had a lower risk for Alzheimer's disease. The National Heart, Lung, and Blood Institute of the NIH recommends at least 30 minutes of moderately vigorous exercise most days of the week. So experts recommend that you build physical activity into your daily routine. Here are some examples:

• When possible, walk instead of driving.

• Set aside time each day for exercise — for example, a half-hour walk around the neighborhood. For motivation, ask your spouse or a friend to go with you.

• Use the stairs instead of the elevator.

• Exercise at home, possibly with an exercise video.

• Plant a garden.

• Take an exercise class or join a health club.

• Swim regularly, if you have access to a pool or beach.

• Learn a sport that requires modest physical exertion, such as tennis.

If you haven't been physically active recently, check with your doctor first.

2. Keep learning

In the MacArthur study, the characteristic that correlated most strongly with good mental functioning in old age was a person's level of education. Experts think that advanced education may help keep memory strong by getting people into the habit of being mentally active. Regardless of your level of education, you, too, can be an active, lifelong learner.

Exercising your brain with challenging activities is believed to stimulate communication between brain cells. Some ways of challenging your mind are obvious — for example, doing crossword puzzles, reading, participating in a book discussion group, playing chess, or taking classes. But you don't have to go to great lengths to find mental stimulation. Mental challenges also come from the unexpected occurrences that take you out of your daily routines and make you think. If you're still working, chances are that you get some of these curveballs thrown at you from time to time. But if you aren't working and your time is largely unscheduled, you may need to seek novel experiences. Planning day trips or longer vacations, meeting regularly with friends and acquaintances, going to the theater or to museums, or just making a point of varying your routine can help keep your mind active and engaged.

Learning a new skill can strengthen your memory.

New challenges and learning experiences help your mind thrive. It's a good idea to try to develop new skills or relearn old ones that you may have set aside years ago. Consider challenges such as these:

• Plan a do-it-yourself project that requires some design work, such as building a deck, creating a new tile pattern for your kitchen or bathroom, or designing a new garden layout.

• At work, initiate or volunteer for a project that involves a skill you don't normally use.

• Get on the Internet if you aren't already. You will be challenging your mind by learning computer skills and by gaining access to a wealth of information on almost any conceivable topic. You may even find stimulating communication in the form of chat groups or electronic mailing lists that focus on your interests. And you'll be able to stay connected with friends and relatives via e-mail.

• Try cooking new recipes. Experiment and change the recipes to improve them.

• Figure out new driving routes to work or to other places that you go regularly.

• Join a club to play chess, bridge, or poker.

• Rediscover other challenging games that you can play alone or informally with friends. Scrabble, Boggle, many card games, and even many computer games really make you think.

• Write essays — or even a book — about your life experiences. You may be able to publish your work in your local paper, on a Web site, or elsewhere.

• Take a class in a new or old skill such as playing a musical instrument, music appreciation, or painting.

• Do puzzles and brainteasers. In addition to the crossword puzzle in your newspaper, you can find math brainteasers and word problems in books and magazines and on the Internet. Try doing some instead of watching TV when you have a free evening. Jigsaw puzzles challenge the mind, too.

3. Don't smoke

As described earlier, smokers perform worse than nonsmokers in studies of memory and cognitive function. No one knows whether smoking directly impairs memory or is merely associated with memory loss because it causes illnesses that contribute to poorer brain function. In addition, smoking increases the risk for stroke and hypertension, two other causes of memory impairment.

Regardless of the exact nature of the link between smoking and memory loss, if you smoke, it pays to quit. Research shows that people who stop smoking have less cognitive decline than people who continue to smoke.

4. Drink alcohol in moderation

While heavy drinking can harm your memory, moderate consumption of alcoholic beverages may actually be beneficial (see "Alcohol use"). Research suggests that moderate drinking reduces the risk of dementia. But excessive consumption of alcohol is toxic to neurons and is the leading risk factor for Korsakoff's syndrome, a disorder that causes sudden and irreversible memory loss. If you have been a heavy drinker, cutting back can prevent further memory loss and will usually lead to some recovery of damaged memory function.

5. Maintain a healthy diet

A healthful diet rich in fruits and vegetables as well as healthy fats from fish, nuts, and whole grains is vital to maintaining brain health. Avoiding saturated fats (in meat and dairy) and trans fats (in commercial products with partially hydrogenated oils) will help keep your arteries clear and cholesterol levels healthy, and that in turn will decrease your chances of cerebrovascular disease, including the small "silent" strokes that can damage brain function. Avoid excess calories to maintain a normal weight; this lowers your risk for illnesses such as diabetes and hypertension, which can impair your memory.

Eating a lot of fruits and vegetables can be especially beneficial because many are good sources of antioxidants, nutrients that may protect against diseases and age-related deterioration throughout the body.

6. Consider taking vitamins

If you eat a healthy diet, chances are that you are already getting most if not all of the vitamins that you need. However, aging can make you vulnerable to vitamin deficiencies due to nutritional restrictions and malabsorption syndromes. Taking a high-quality multivitamin is a good start toward ensuring that you are getting what you need. Individual vitamin supplements can also play a role.

The B vitamins (B₆, B₁₂, and folic acid) are important for neuronal protection as well as facilitating the breakdown of homocysteine, an amino acid in the blood that, at high levels, is a risk factor for heart disease, stroke, and peripheral vascular disease (see "Vitamin B₁₂ deficiency"). Deficiencies of B vitamins tend to become more prevalent with age. Work with your doctor to monitor your homocysteine level, and correct B vitamin deficiencies with supplementation when necessary.

Antioxidant vitamins may protect against memory loss caused by aging and dementia, including Alzheimer's disease. Antioxidants combat free radicals, destructive molecules that damage healthy tissues and accelerate the aging process. The antioxidant vitamins include vitamins C and E and beta carotene.

There is a body of research that lends credence to antioxidant vitamins as a potential preventive measure. A 2002 study published in the Archives of Neurology suggested that vitamin E, but not other antioxidants, may help slow the rate of age-related mental decline. Researchers surveyed 2,889 people with an average age of 74. People who consumed the most vitamin E exhibited 36% less decline in mental function than those who consumed the least. There's also evidence that vitamins C and E taken together might protect against dementia. In a study of 3,385 Japanese American men ages 71–93, those who took supplements of vitamins C and E had an 88% lower incidence of vascular dementia than those who did not use the supplements. The rate of dementia was lowest among men who had taken vitamins C and E the longest, suggesting that long-term use is important for helping to preserve cognitive function over time.

In contrast, a study published in Archives of Neurology in 2003 found no association between antioxidant intake and later development of Alzheimer's disease. This study included 980 people ages 65 and older who did not have dementia when the study began. Researchers asked the participants about their diet and supplement use, then followed the people for four years to see who developed Alzheimer's disease. At the end of the study, the people who consumed the largest amounts of vitamins C and E and beta carotene were no less likely to develop Alzheimer's than the people who consumed the smallest amounts.

Whether to take vitamins for the specific purpose of preventing or slowing Alzheimer's disease or improving normal memory is controversial; this is particularly so in the case of vitamin E. At doses above 400 IU, vitamin E has been linked with a marginally increased rate of death. Also, if you have a rare vitamin K deficiency that affects blood coagulation or if you take anticoagulant medicine, you should check with your doctor before taking antioxidant vitamins. Vitamins C and E can complicate these conditions by promoting anticoagulant action. Patients with any other form of bleeding disorder should also consult their physician before taking these supplements.

7. Get a good night's sleep

Sleep is essential for memory consolidation as well as overall health. Although people vary widely in their individual sleep needs, research suggests that six to eight hours of sleep a night is ideal. Perhaps even more important than the amount of sleep is the quality of sleep. People with breathing problems during sleep, such as obstructive sleep apnea, can sleep for 10 hours per night but still feel unrested in the morning. Of course, for some people, getting a good night's sleep is easier said than done, particularly because insomnia becomes more common with age. But certain habits can help. For example, try the following:

• Establish and maintain a consistent sleep schedule and routine. Go to bed at the same time each night and wake up at the same time each morning. A set sleep routine will "train" you to fall asleep and wake up more easily.

• Plan to do your most vigorous exercise early in the day. Exercising in the hours immediately before bedtime causes physiological changes that interfere with sleep. Exercising in the morning, on the other hand, enhances your alertness when you need it most — at the beginning of the day.

• Avoid coffee and other sources of caffeine (e.g., chocolate, many soft drinks, some brands of aspirin, many types of tea) after midmorning, because caffeine is a stimulant that can keep you awake for hours afterward.

• Avoid napping during the daytime. Napping can disrupt your natural sleep cycle and prevent you from feeling tired enough to fall asleep at night.

• Don't take sleeping pills unless nothing else works. If you do take a prescription sleep medicine, work with your doctor on using it effectively but only on a short-term basis, because sleeping medications can be habit-forming. In addition, like sleep deprivation, sleeping pills can cause memory loss.

• Some people find that drinking warm milk before bedtime helps them feel sleepy. Milk contains tryptophan, a chemical that may help you relax.

• Don't try to sleep if you're not tired; otherwise you'll set yourself up for tossing and turning. If you're still awake after about 20 minutes in bed, get up and read awhile to help yourself relax.

• If you experience persistent sleep problems, consult your physician so that you can identify the specific problem and get treatment if needed.

8. Be social

Social support — that is, close ties with others — can improve the cognitive performance of older people, according to the MacArthur study on aging and other research. Social support can come from relationships with friends, relatives, or caregivers.

A Canadian study published in 2003 identified a lack of relationships with friends and family as a risk factor for cognitive decline. The study, which followed people over age 65 for four years, found that the probability of maintaining good cognitive function was highest among people who socialized often and had strong social ties, and the probability of losing cognitive function was highest among people who had the least social contact.

There are several ways that social engagement can benefit memory. It often goes hand in hand with intellectually stimulating activities, which in turn support good memory function. Social relationships can also help support you during stressful times, reducing the damaging effects that stress can have on the brain.

9. Manage stress

When you're under a lot of stress, it's hard to concentrate. And not concentrating sufficiently is one of the main causes of poor learning and memory. Being under sustained stress for many weeks can impair your memory by altering brain chemistry and damaging the hippocampus. You can't control all the stressful events in your life, but you can control your reactions to those events to some degree.

There's no one-size-fits-all strategy for reducing stress. You have to find the strategies that work for you. For some people, taking a brisk walk or getting other kinds of regular exercise helps. Listening to music, meditating, talking to a friend, or engaging in a relaxing activity, such as gardening or knitting, can also help you cope with stressful situations. If you can't lower your stress level on your own, you might benefit from counseling.

10. Protect your brain

Head trauma is a major cause of memory impairment and a risk factor for future development of dementia. You can prevent head trauma by using the appropriate gear during high-speed activities and contact sports.

Wear seat belts when riding in motor vehicles. Car accidents are by far the most common cause of brain injury, and wearing seat belts greatly reduces the injury risk. Wear a helmet when bicycling, riding on a motorcycle, in-line skating, and skiing. Wear a mouth guard to lower the risk of a concussion by deflecting the force of a blow to the chin during contact sports such as football, ice hockey, soccer, basketball, rugby, and martial arts.

Last updated:	January 23, 2007