Suspect your memory isn’t what it used to be?
You could be right.
“Slow cognitive decline is expected as we get older,” says Joel Salinas, a neurologist at the Massachusetts General Hospital Department of Neurology Henry and Allison McCance Center for Brain Health. What’s not considered a normal or expected part of aging, he says, is dementia — a disease signaled by “more rapid decline in cognitive abilities.”
Many older adults worry about big causes, such as Alzheimer’s, without realizing that “in fact, many cognitive issues signal more general health problems such as thyroid issues, dehydration or lifestyle issues that can be reversed,” Salinas notes.
Low thyroid functioning, he says, can be experienced as ongoing fatigue and slowed thinking. Too much alcohol can impair memory, and dehydration — often simply not drinking enough water throughout the day — causes too little blood flow to the brain.
Getting at the bottom of what’s affecting your ability to reason, remember or articulate your thoughts is important.
To that end, Donna de Levante Raphael, director of the Alzheimer’s Foundation of America National Memory Screening Program, says a memory screening, covered by Medicare, should be part of your annual wellness visit. You might find out that your cognitive issues are caused by one of the below factors — and can often be reversed.
Medications
As we age, we tend to add a variety of medications to our daily intake — along with risks
of adverse health effects from both individual drugs and the overall mix. One of the most common Rx side effects: cognitive impairment.
Tatyana Gurvich, an assistant professor of clinical pharmacy at the University of Southern California School of Pharmacy, says that when older adults mention memory problems, the first thing she does is look at the medications they’re taking. Some over-the-counter medications such as diphenhydramine (Benadryl), which can create confusion, can be purchased under brand names consumers don’t recognize or hidden in combination products like Advil PM. Medications for overactive bladder or incontinence and those for depression or sleep can, in various combinations, also cause cognitive impairment. Combining any with opioids can make an older adult more confused. “Unfortunately, older adults often take a cocktail of medicines — both over-the-counter and prescription — that can cause major changes in cognition,” says Gurvich, who encourages older adults to talk to their doctor or pharmacist about all the drugs they’re taking before making any changes.
Lack of exercise
Numerous studies show that exercise protects memory and thinking skills. One from the University of British Columbia found that regular aerobic exercise such as running or brisk walking boosts the size of the hippocampus, which stimulates the release of chemicals in the brain that affect the health and supply of brain cells. There’s a negative effect, too, for those who aren’t active: “Not walking or doing other aerobic exercise on a regular basis can cause brain shrinkage and lead to an increase of white matter changes or small injuries to the parts of brain cells that connect with other brain cells,” says Mary Ellen Quiceno, a neurologist and researcher in Dallas.
Boost your brain health with Staying Sharp
In good news, the positive effects of exercise on the brain appear to be immediate. A University of Maryland study of brain health in older adults shows that just one session of exercise increases activation in the brain circuits associated with memory. In people diagnosed with mild cognitive impairment as well as in cognitively healthy older adults, verbal fluency and measures of brain function improve after just 12 weeks of exercise, says J. Carson Smith, associate professor of kinesiology at Maryland’s School of Public Health. “Being physically active helps protect the brain from cognitive decline and atrophy. Those who are at increased risk through their genetics and don’t exercise tend to have the most problems,” he says, adding that everyone should walk or do other moderately intensive exercise for 30 minutes at least four days a week.
Sleep issues
“Too much sleep or too little high-quality sleep can cause a problem with memory, reasoning and particularly executive function,” Salinas says. As he explains it, during deeper stages of sleep, the hippocampus, the area of the brain responsible for the formation and retrieval of memories, transfers newly made memories to the prefrontal cortex, a brain area responsible for long-term storage. Without enough shut-eye, this process is disrupted — with sometimes noticeable results.
A University of California Berkeley study found that older people who sleep poorly experience memory loss and brain disorientation. Researchers at Michigan State University’s Sleep and Learning Lab recently found that sleep deprivation doubles your odds of being unable to complete a series of steps without losing your place and triples the number of lapses in attention. “Our findings debunk a common theory suggesting that attention is the only cognitive function affected by sleep deprivation,” says Michelle Stepan, one of the study’s researchers.
Anxiety and depression:
If you’re feeling mentally fuzzy, depression or anxiety could be playing a major role. Depression, which the National Institute on Aging says is common in older adults, who tend to be more isolated, can also mimic the signs of memory loss. “When you’re depressed, the serotonin levels in your brain decrease and this can affect attention, processing speed and memory consolidation, causing a ‘pseudodementia’ of depression,” says neurologist Richard Isaacson, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and New York-Presbyterian Hospital.
Research shows that depression and anxiety can also alter our brain physically. A study from Brigham Young University, for instance, shows that subjects with anxiety and depression showed less brain cell growth in key areas compared with those not dealing with such mood disorders.
Loneliness and Memory Lapses
Loneliness affects up to 40 % of middle-aged and older adults and is closely associated with major depressive disorder (MDD). However, the relationship between loneliness and neural network functioning during executive cognitive processes, such as working memory, in MDD is still unclear. To address this gap, our study recruited 21 medicated MDD patients (mean age = 52.0 ± 5 years) and 24 matched healthy controls (HC) (mean age = 48.7 ± 6 years) who completed an n-back fMRI task.
For behavioral performance, we observed no significant moderating effect of MDD or loneliness on the task condition effect. However, loneliness was positively associated, and MDD was negatively associated, with the functional connectivity between the inferior parietal cortex and the rostral dorsomedial prefrontal cortex (DMPFC) during task performance. Furthermore, an interactive effect of loneliness and MDD was observed on the functional connectivity between the supplementary motor area and the caudal DMPFC during the n-back task, with loneliness showing a positive relationship in the HC group but a negative relationship in the MDD group with the connectivity.
Our results indicated that loneliness may be associated with altered neural regulatory functioning on self-referential processing and action control, which may further depend on the individual’s depressive state. These findings can form the theoretical basis for devising intervention programmed and aimed at improving the mental wellness of the healthy and depressed lonely individuals.
Does Chronic Pain Affect Memory?
By Ann Marie Gaudon, PNN Columnist
One Is the Loneliest Number — Pain News Network
Pain is a complex experience.
Does it affect our memory?
It not only affects us biologically, but we also experience it cognitively and emotionally. You bet it does.
Chronic pain patients often complain of memory problems and there are numerous studies which confirm these challenges are indeed a reality. Twenty-four studies evaluating working memory (WM) and/or long-term memory (LTM) in chronic pain groups and control groups were reviewed last year by French researchers. WM was defined as the processing and manipulation of information within a short period of time (a few seconds), while LTM involved the “storage” of knowledge and memories over a long period of time.
Concentration and memory deficits on a daily basis were the most frequently reported cognitive difficulties. Memory complaints included forgetfulness and problems performing everyday tasks and conversations. Emotional distress common to pain patients, such as depression, anxiety and rumination (the inability to divert attention away from pain), was also found to play an important role in memory difficulties.
One study compared two groups of pain patients who had minor or major memory complaints. Between the two, no significant differences were found with regard to age, gender, education level, marital status, medication use, long-term pain or pain intensity. However, patients in the major memory complaint group suffered from emotional distress to a significantly greater degree. They also reported a lack of family support and discontent with their social and sexual lives.
These were noted as additional daily sources of suffering for this group. Adding to potential negative effects on memory were comorbidities which many pain syndromes share. Conditions such as depression, anxiety, sleep disturbances, and chronic fatigue could alone or combined affect memory. A major concern expressed was the need to disentangle pain-related cognitive effects from those resulting from these comorbidities.
Medications and Memory.
The review really became interesting when it came to medication, because researchers found contradictory results. One European study reported that opioids exerted a negative effect on working memory — finding a clear association between higher levels of analgesics and perceived memory dysfunction in chronic back pain patients. Some studies confirmed that medication can have a negative effect on memory, but others showed improvements in memory following analgesic treatment.
That suggests that effective pain relief may also reverse pain-induced memory impairment. The researchers concluded it was unclear whether analgesic medications are beneficial or detrimental, because both scenarios were reported. Age was also identified as an important factor in the relationship between chronic pain and memory, but not in the way you may think. Surprisingly, it was shown that an increase in age did not additionally affect memory performance.
One study reported that gender and age significantly affected memory decline in those suffering from chronic migraine headaches. Cognitive decline in migraineurs was greater among younger individuals, and females showed greater decline during headache intervals than males. It was acknowledged that gender as a factor in pain-related experience is poorly investigated.
Like all reviews, this one has its limitations. There was a “large heterogeneity” of tests within the 24 studies. This diversity of tests did not allow for a suggestion of which memory processes were altered by chronic pain itself. The study populations were also heterogeneous regarding pain etiologies and an assessment of the intensity of pain was not performed.
Can We Forget About Chronic Pain? — Pain News Network
Studies which included a mix of chronic pain disorders did not provide data on whether specific memory impairments were more frequently observed in specific disorders. The authors suggest there is a need for comparative studies across pain-related disorders in order to determine whether impairments are pain-related or a consequence of other pathophysiological features.
These numerous studies confirmed the memory decline that is often reported by chronic pain patients. Even if these effects are mild, the impact on quality of life could be substantial as they may indeed worsen suffering including depression, anxiety, and limitations on activity. Researchers suggested that examining memory function should be part of the clinical assessment of chronic pain patients. The spectrum of cognitive difficulties must become acknowledged and understood in order to find ways to overcome them.
Ann Marie Gaudon is a registered social worker and psychotherapist in the Waterloo region of Ontario, Canada with a specialty in chronic pain management. Suffering pain herself for more than 30 years, Ann Marie knows how chronic pain can shrink lives physically, psychologically, and socially, and has dedicated her career to those afflicted, misunderstood, and unnecessarily hurt because of it. A mental health therapist specializing in managing chronic pain, she counsels adults of all ages, in all conditions, and with many different diagnoses.
She also volunteers on behalf of the vulnerable and the voiceless. That work has become a moral imperative for her, now that people with pain—increasingly scapegoated as “problem users” and blamed for overdoses—have become political pawns and are suffering devastating consequences. For more information about Ann Marie’s counseling services, visit her website.
The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.