Present at the Future

by Ira Flatow

  So it’s important to distinguish between memory loss (of which the major cause is Alzheimer’s disease) and change in memory. Memory is very much a matter of perspective. Where you’re standing, physically and emotionally, influences what you remember and how much. Consider how some memories are seared into your brain forever. For example, most people can tell you exactly where they were and what they were doing when they heard about the attacks on the Twin Towers and the Pentagon of September 11, 2001. In the same way, older people remember exactly what was happening around them when they heard that President Reagan had been shot, or President Kennedy had been assassinated. The emotions that accompanied those pieces of news are also why criminal investigators so often have to struggle with discrepancies among eyewitness accounts. Despite what you may have seen on Law & Order or any number of other television police procedurals, eyewitness accounts frequently vary dramatically—so much so that they are useless in convicting criminals. Eyewitness accounts may be inaccurate 40 to 60 percent of the time. Hard to base a life-and-death decision on percentages like that!

  SENIOR MOMENTS

  Why are all my friends and relatives who are over 40 convinced that they’re losing their memory? It’s actually quite rare to have anything seriously wrong with your memory. But memory does change. What happens as we age is that there is shrinkage inside the brain. The neurons themselves become smaller. What’s affected is speed—how quickly the brain processes information. As the conduits—the neurons—grow smaller, the conductivity of neurons does slow down. Forgetting things as we grow older can be due to all kinds of reasons that have nothing to do with a serious illness such as Alzheimer’s disease. Stress, for example, can be a culprit. So can illness, or remedies for serious illnesses. General anesthesia and chemotherapy can result in temporary memory loss, or “chemo brain.” Heart and artery disease may be factors too if your brain is not getting enough circulation. But there’s no single cause; memory changes are very individual and happen for different reasons in everyone.

  Dr. Aaron P. Nelson, chief of neuropsychology at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School, says that his patients bring him five complaints about their memories:

  Top of the list, what I suffer from: “name-nesia.” You run into someone you know and you can’t think of his or her name.

  The second most common: “room-nesia.” You walk into a room and can’t remember what you’re supposed to be doing there.

  Third on the list is “episodic fleeting thought syndrome,” or losing your train of thought. Suddenly you wonder: What was I trying to say? Where was I?

  Fourth is “parking-nesia,” losing the car in the lot at the shopping mall.

  Fifth is “anavigationalism,” a sudden spell, a moment when you miss the correct exit or the proper turn on the highway.

  Dr. Nelson says he hears about these five types of memory lapses from as many as 90 percent of patients who seek him out. He emphasizes that none of these lapses means that anything significant is wrong with your memory. (I’ve added my own memory loss to the list: “key-nesia,” where you can’t remember where you left the house or car keys. I think it deserves its own category. I even have discovered a quick and easy cure for key-nesia. In your haste to drop the heavy groceries, you don’t even look where you are dropping your car keys. Any place will do. So you never actually see where you left them. But if you watch where you put the keys, eye them carefully, you’ll never lose them. What about that theory, Dr. Nelson?)

  He says new technology can help people like me who have name-nesia. A handheld recording device is a “no-brainer,” he says, to help you remember names. “You really shouldn’t be relying on your brain for that kind of information. It’s not what your brain was designed for. I’m totally reliant on my pocket PC. I consult it several times a day. For example, if I’m going to a social event, I list who’ll be there and something about each person. It works! When I get to the party, that information is in the foreground.”

  THE GOOD AND BAD OF STRESS

  Stress has a yin-and-yang effect on the brain. Too much stress can wreck your memory, says Nelson. “At very high and sustained levels, stress can cause actual physical and physiologic damage to structures in the brain that are important for memory. But at mild or moderate levels, stress actually can help memory function, believe it or not, because it kind of alerts you. It gets you to pay attention to something. It gets you to sort of label an event or an experience as important and worth remembering.”

  You should worry, however, if you can’t remember information that is crucial to who you are, such as the name of your high school, “the name of a grandchild, some specific piece of information about where they worked for twenty years, that kind of a thing.” Or if someone tells you something, and a moment later, you have absolutely no recollection of what’s been said. That kind of memory lapse is more ominous and might spell real memory loss.

  Nelson says that typically, people with more worrisome kinds of memory problems are not the ones who seek help. “It’s usually someone related to them—a spouse, a family member.”

  RX FOR YOUR MEMORY?

  About 50 percent of how your brain ages is genetic. There’s nothing you can do about it. But that leaves 50 percent over which you have some control. The higher your intelligence and the more intellectually inclined you are, the less likely you are to lose core memory. In 2001, an ongoing study of 678 aging nuns found that those who had written more complex sentences in their early twenties were less likely to have succumbed to senility. And in 2003, a study of London cabdrivers—people who have to find their way around for a living—discovered that their hippocampi were larger than normal.

  If you want to stave off memory loss, you don’t have to become a cabbie: Good nutrition and regular exercise are supposed to help, along with “use it or lose it”—the idea that you should stay mentally active. Some psychologists even give out “memory prescriptions,” mental calisthenics or daily exercises—push-ups for the brain—or advise getting involved in the poker craze. (Seventy-one-year-old Doyle Brunson beat 666 opponents to win the 2004 Legends of Poker Tournament.) Others believe that mental activity should become a habit, something you cultivate so that learning new things permeates all your activities. Getting involved in things that engage you, going back to school, trying something new, taking up something creative such as painting or jewelry design, playing games that involve planning and strategy, reading, joining debates and discussion groups—that’s what your brain is for.

  If you stay mentally active, you build up connectivity in the brain that can protect you against a siege of disease. Some nuns in the 2001 study had brain scans that revealed traces of Alzheimer’s disease, but they showed no symptoms. Memory is about connections, associating one stimulus with another. The denser the physical network, the “bushier” your dendritic trees, the more you can afford to lose before you show symptoms.

  “What we’ve learned about memory echoes a lot of what we learned about cardiovascular health, in terms of brain health,” says Nelson. “Everything that we know that’s good for the heart is also good for the brain. So promoting optimal diet, exercise, managing stress—these things will all help ensure brain health as we age.”

  There’s a lot of evidence, says Nelson, that ongoing intellectual activity may help stave off memory decay. “Whatever it is for you, something that engages your interests, something that engages your creativity, whether it’s learning something new, getting involved in a project that puts you in contact with new learning, new people. These are all things that are going to promote that kind of lifelong intellectual engagement, which is important.”

  But what about cases like that of Dame Iris Murdoch? The famous British novelist’s descent into Alzheimer’s disease was the subject of the 2001 Oscar-winning film Iris. A prolific author of highly intellectual novels, Murdoch certainly had been mentally active. (As the movie illustrates, she exercised too: A
ll her life, she loved to swim, even in old age.) Amazingly, a new study has found that daydreaming and woolgathering—something writers and teenagers are very prone to—may overwork and decay your hippocampus, the part of your brain most affected by Alzheimer’s disease. So letting your brain idle—and not be focused on completing a task or reading or carrying on a conversation—could hasten the onset of Alzheimer’s disease! On the plus side, the study may offer a way to diagnose Alzheimer’s disease early, before symptoms become obvious.

  Another possibility in Murdoch’s case is that her mental acuity did give her greater resistance and she successfully held off her illness for years—until it finally overwhelmed her. Recent studies also have found that when people with a high degree of cognitive reserve are finally overcome by this disease, they fail very quickly. Nelson says there’s been some interesting research out of Columbia University since the late 1980s on what’s called “cognitive reserve.” “Here, the notion is that being involved in lifelong learning and keeping intellectually engaged makes a difference. It certainly can push you off the onset of Alzheimer’s disease. We know that people with high levels of cognitive reserve can resist symptoms of Alzheimer’s disease despite an equal or greater amount of brain pathology in the people who have the low levels of cognitive reserve. And this all has to do with both genetic and acquired intellectual interests.”

  As for nutrition, Nelson believes that there is good evidence of the importance of maintaining enough B vitamins in your diet. And if you can’t get the vitamins from food, supplements are a good way to go. “One of the things we look for in patients presenting with memory complaints is what their nutritional status is, what they’re eating, maybe what they’re missing. It’s important.”

  IS IT IN THE GENES?

  I blame my name-nesia on my mother. She has had name recall problems for decades. But what about serious diseases, such as Alzheimer’s disease? If any of your parents or grandparents are afflicted, does that mean you’re going to automatically get it yourself? “Not at all,” says Nelson. “The majority of Alzheimer’s disease is sporadic. It doesn’t have at least an obvious genetic connection, a familial connection. Certainly having a relative with Alzheimer’s disease does increase your risk, but it’s not anything like the type of genetic determination that we see with other illnesses. The genetics of Alzheimer’s disease are extremely complex. We don’t really have it worked out yet, but at this point, having a relative with Alzheimer’s disease does not absolutely seal your destiny as having it yourself.”

  THE COLOR WHEEL

  You may remember the color wheel from art class in grade school. You can find color wheels in art-supply stores, and craftspeople frequently rely on them when they work with colored paper, fabric, or beads. But you probably didn’t know that the color wheel illustrates how the human eye and brain work. Early-twentieth-century German painter and color theorist Johannes Itten, a member of the famous Bauhaus School, invented the color wheel. Itten based his work on the research of Sir Isaac Newton and of physiologist Ewald Hering, who studied color blindness. Itten’s color wheel is a visual tool made up of 12 colors. It starts with the 3 primary colors equidistant from one another: red, yellow, and blue. Mixing 2 primaries creates a secondary color, also equidistant from each other: purple, green, and orange. Mixing a primary color with a nearby secondary color creates a tertiary color. The 6 tertiaries are yellow-orange, red-orange, red-purple, blue-purple, blue-green, and yellow-green.

  The color wheel helps demonstrate the phenomenon of “successive contrast,” which happens when the brain creates an afterimage of a color when you look at it for an extended period of time. Green, for example, is the afterimage of red. (In Florida, you hear about the “flash of green” that supposedly you can see immediately after the sun sets in a blaze of red.) On Itten’s color wheel, that afterimage is always the color’s complement.

  Try using the color wheel to come up with a split-complementary color scheme of your own choosing. Pick a key color. Then go directly across the color wheel to find its complement. Instead of the complement, use the two colors next to it. Itten recognized that the brain finds color equilibrium and recognizes harmonies. But of course, everyone sees color somewhat differently. Itten thought that his color wheel would help “liberate” painters and designers from “indecision and vacillating perception.”

  CHAPTER THREE

  OLIVER SACKS: MUSIC MAKES THE MEMORY

  Every disease is a musical problem.

  —NOVALIS

  You remember Oliver Sacks. Robin Williams portrayed him in the 1990 film Awakenings. He brings back to life a room full of hospitalized comatose patients suffering from Parkinson’s disease by giving them a drug called L-dopa. Neurologist and famed author Oliver Sacks has spent a good deal of his life translating medical mysteries into common language, bringing science and medicine into the public arena in a way like no other storyteller. Through his musings and writings about his patients and his own life, Dr. Sacks has brought us greater understanding of neurological maladies, including autism, prodigies, vision loss, coma, and migraines and how they affect people in their daily lives.

  As clinical professor of neurology at Albert Einstein College of Medicine and adjunct professor of psychiatry assigned to neurology at New York University School of Medicine, Sacks continues to discover and explore fascinating and mysterious workings of the brain. His latest project: music and memory, how music offers a unique way to look at the human brain, how the power of music transcends otherwise devastating memory loss to make life more bearable for people who are afflicted with memory loss.

  First, some perspective. Sacks’s interest in music and memory goes back decades, to 1966, to the patients portrayed in Awakenings. He discovered that before L-dopa was available as a treatment, his nurses reported that some of his patients would respond to music. “And then I rapidly saw this myself, that sometimes these people who could not take a step could dance. Some of these people who couldn’t utter a syllable could sing. And that while they sang and while they danced, they were able to move freely. It was almost as if their Parkinsonism and their other neurological problems were bypassed. But the moment the music stopped, they stopped too.”

  Intrigued, Sacks called for a second opinion.

  “I took the poet W. H. Auden along to the hospital to see this, and he quoted something of the German poet Novalis, who said, ‘Every disease is a musical problem; every cure is a musical solution.’ And certainly, one had the feeling that this was the case, although only for the few seconds or minutes that music lasted, with these patients.

  “And then I was very struck. At some of the hospitals where I work, we have a lot of people with Alzheimer’s disease and dementia.” Sacks was struck by “how often how some of these people, although they’d lost the powers of thought and language, might recognize music, might sing along, might suddenly become lucid when they were exposed to music.” It changed his views about the brain. “I think music perception, because it has such a widespread basis, is very robust, and even patients with widespread brain damage are usually able to respond to music.”

  A few years later, in the 1970s, Sacks saw a strange case of amnesia that made him think again about the power of music. “I saw a patient, one I call ‘Jimmy,’ who had lost so much memory he couldn’t remember people or events, but he had a good memory for music.”

  Jimmy would be the first person Sacks met who could remember music quite well but only remember things he’d seen for just a few seconds. But Jimmy would not be the last case or the most extreme case like this. That would be Clive. Clive Waring.

  Clive was an eminent musician and musicologist in England, an expert on Renaissance music, who in 1984 had devastating encephalitis due to herpes—shingles. This had the effect of destroying much of his memory; in particular, it destroyed what’s sometimes called event memory, or episodic memory, so that he couldn’t remember what had happened five seconds before.

  The illnes
s also deleted all the memories Clive had of the two or three decades before his encephalitis. At best, those days were but hazy apparitions. “He probably seemed to have no reliable memories since childhood. He didn’t recognize the room in which he was. And so it came as a great surprise, given this utter devastation, when it turned out that his memory for music and his ability to sing, to play the organ or piano, to conduct an orchestra or choir, was brilliant and quite unimpaired.”

  Even with devastating brain damage, Clive could sit down at the piano and play a whole piece of music from beginning to end. He could stand before musicians and conduct an entire orchestra “and beautifully, turning to all the different sections of the orchestra and, obviously, knowing the piece in great detail. When he conducts an orchestra or a choir, when he sings, he seems absolutely normal. You wouldn’t think that anything was the matter. But five or ten seconds after he’s finished, he’ll have no recollection of it. And sometimes if you ask him, ‘Do you know such-and-such a piece?’ or ‘Do you know this particular Bach prelude and fugue?’ he’ll say no. But if you start him on one note, then he’s got it. So he’s not entirely conscious of what he has.”

  Clive will also forget faces. A few seconds after he meets you, he will not remember having met you.

  “You might not realize this at first from the charming way in which he greets people. He improvises his greetings, but he doesn’t genuinely recognize anybody except his wife. The two of them were married a little bit before his encephalitis, and they’re still very much in love.