Friday, April 17, 2015

Steve: Good News about Memory Lapses

Spring in State College 2014

This morning, lying in bed waiting for the alarm to go off, I was thinking about a movie I saw awhile ago and couldn’t remember the name of an actor who was in the movie.  This is something that happens from time to time, and it seems to happen more often than in the past.  There are even a couple of actors, Richard Dreyfuss and Julia Roberts (imagine that!), whose names I routinely have trouble retrieving.  Sound familiar?  Is this a sign of the dreaded “A” disease?

All the attention in the media and the research community about Alzheimer’s disease has sensitized us to wonder if each new lapse of memory is a sign of illness.  A new report released this week by the Institute of Medicine on Cognitive Aging reminds us of something that has actually been known for a long time: occasional and mild cognitive problems—what everyone experiences from time to time—is a process related to normal changes associated with aging, but not to disease.  The report also reminds us of something else that is important—there are gains in cognitive abilities with aging.  We gain expertise and maybe grow wise, and many of us learn to manage our emotions and personal relationships better than we did in the past.

Judy and I did some work many years ago where we conducted memory training classes for older people.  We actually did parallel studies: two studies involved training of people who we felt only had problems associated with normal aging, and a third study was specifically for persons who had obvious signs of dementia.  We’ll come back to that group in a later posting, but let’s look at training for healthy older people.  In those studies, classes that involved actual cognitive training were compared to classes that created the expectation that participants were doing something to improve memory, for example, examining current events or focusing on attention and personal effectiveness.  Cognitive training had small positive effects on memory, but all participants reported fewer memory problems after the classes, whether they received actual cognitive training or were in the faux training class.  A lot of what we emphasized in the classes was reassurance—that everyday lapses did not indicate a more serious problem and that people could do something about memory loss, if they wanted.  They wanted the reassurance and in the end were less interested in using strategies to remember names or shopping lists or other things they had occasional problems with.
The Institute of Medicine report suggests practical strategies to help promote “cognitive health.”  These make a lot of sense and include:

·       Stay physically active
·       Manage risk factors for cardiovascular disease, including high blood pressure and diabetes.
·       Review medications regularly.  Avoid the piling up of too many medications that is all too common with older people.
·       Be socially engaged
·       Get adequate sleep and treatment if you have a sleep problem.

Staying cognitively active can be helpful, too.

But perhaps the main message is that the stereotype that forgetting means we are hopelessly slipping into senility is wrong.  Stereotypes have a way of becoming self-fulfilling prophesies.  There is work by the social psychologist Becca Levy that shows that these negative expectations decrease performance, including of memory.  She has even found that calling something a memory test leads to poorer performance than if the test has a different name.

Here is a link to the Institute of Medicine Report.  The full report has not been uploaded yet, but you can find summaries of the committee’s findings and recommendations:

For everything good about the Cognitive Aging report, a New York Times article reported on two studies that purported tell us just how much exercise we should get to extend our lives.  Both studies looked at how much exercise people reported and their risk of death over a 14-year period in one study and an 8 year period in the other study. 
The article states that “the takeaway message seems straightforward.”  But is it?  Exercise is probably good for all of us, but think about it—is the difference in mortality due to how much exercise people engage in?  Or is something else different about people who exercise and people who do not that might cause a difference in mortality?  Think about it.   Send us your suggestions.  Our answer will appear next week.

Here is a link to the article, which also includes links to the two scientific papers.

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