My cats woke me up this morning, both fearing that I had forgotten to feed them. In fact, I had not forgotten. But forgetting and remembering are things that weigh on my mind a lot these days.
Just What is Memory?
Unfortunately, there is no one clear answer to this question. Memory is a lot of different things. It is remembering. It is recalling. It is rehearsal. It is repetition. It is recognition. And those are just the “r’s”! It is episodic. It is semantic. It is sensory. It is storytelling. It is emotional. It is archetypal.
I was reading that Dame Judi Dench is having difficulty memorizing lines for her roles. She has been famous not just for her acting, but for her ability to memorize swaths of script. But what is happening here is not due to memory problems, but caused by a disease that is resulting in blindness. Dame Judi has a self-described “photographic memory”, and without the ability to read, she can’t memorize. (Note to self: What kind of memory did people have before photography was invented?)
The Challenge of Understanding Memory: The Seen and The Unseen
Memory, unlike a beating heart, isn’t something that can be seen. Yet we all know it exists. (Kinda like gravity!) So, when we talk about “losing our memory” or “forgetting”, it is difficult to pinpoint exactly what is happening. Yet the thought of losing our memory causes untold anxiety in so many of us.
Ever since I had covid, I have had a sluggish brain. Before covid I would occasionally experience what neurologists call “tip-of-the-tongue” episodes. I would know what I wanted to say, but just couldn’t find the right word. Usually, in fairly short order, the word would pop up and I would just go on. But now the gaps are more like chasms and I am worried that something else is happening.
And the experience now regularly includes proper nouns. I can describe a person in detail; his or her history, what s/he was wearing, where s/he lived, but for the life of me, I can’t produce his or her name! Fortunately, while this is embarrassing in social situations, I no longer am self-diagnosing my need for memory care, since huge numbers of my friends also report similar word-hunting expeditions.
Diagnosing Memory Problems
The challenge of diagnosing memory problems is that there are so many things that cause blips in memory functioning. For example, memory can be impacted by dehydration, lack of sleep, too high/too low blood sugar, and infection.
Or it can be injury or disease like a concussion, stroke, tumor, a brain bleed, or plaques and tangles. Or, more typically, it can be alcohol, weed, or interactions between multiple medications and OTC remedies.
Should I Be Worried?
Of course you should be worried! But what should you be worrying about?
Worry about climate change, where you are going to live as you grow older, who will win Best Picture at the Oscars. Worry about the lousy educational system and elected officials. Worry about things that will actually be impacted because you are worrying about them.
But worrying about your memory? Seriously, it won’t help. What is useful, though, is to get a baseline measure of just how well your brain is working. And getting this done is pretty straightforward. You can get a memory screening during your annual wellness visit with your primary care provider.
What We Can Measure: Executive Functioning
While I can’t measure your “memory”, I can measure just how well you perform certain tasks that in turn will give me a glimpse into how your brain is working. This includes your ability to learn new things and recall them. This is known as short-term memory. And I don’t need any special machines to do this – just a pencil and paper, and a good test administrator.
Here are the key measures of brain functioning that can be measured in this testing:
- your ability to recognize and name things,
- your ability to understand consequences and make good decisions based on that understanding,
- your ability to recall things just learned as well as things you have known for years,
- your ability to pay attention and, if you are distracted, come back to where you left off, and, finally,
- just how aware you are of the present moment.
Why Are These Things Important?
Let’s face it, some days we are functioning on all cylinders and other days we are not. If these aspects of your brain are working well, you are most likely going to be able to get things done, stay out of trouble, and keep your life on an even keel. Understanding which indicators are signals that something needs attention is essential if we are to enjoy a good quality of life.
Check Engine Light Is On!
If your “check engine” light goes on, you take the car to your mechanic. Maybe you hear a knock or a ping, or if you “feel” something is off. These are indicators that the car needs a tune-up.
Indicators that parts of your brain may need a tune-up or may need attention are monitored when doing a cognitive evaluation. If issues are identified, it does not mean an automatic life sentence to a memory care facility. Where problems are noted and confirmed, there are things that can be done to preserve your quality of life.
We Are Not Good Judges of Our Own Abilities
Sadly, we are not very good at estimating our own abilities. Lots of reasons for this, but mostly, it comes down to the fact that we just aren’t objective. For many, pride and stubbornness are worse conditions than cognitive impairment. For others, fear of being diagnosed with memory problems actually results in avoiding doing something. It can delay receiving support and treatment that might make a difference!
Either way, its not as if folks around us aren’t already aware that something is going on. And it’s not as if we aren’t aware that something is going on. We just don’t want to face up to what it means!
Boomers Are Cursed and Blessed
Boomers are an interesting generation. Those born at the beginning of the Boomer years had to face the fear of polio. And now, as the last of our generation is transiting this end-stage of life, we are confronted by Alzheimer’s.
During the interim, a cure was found for polio, vaccines were discovered that eradicated measles, mumps, and chicken pox. We landed a man on the moon, invented the internet, and created the most memorable music since Mozart and Beethoven. We have a right to expect that a cure will be found for memory loss.
But so far, that has eluded us.
Preserving Your Cognitive Functioning
What can you do to preserve your cognitive functioning? First, make sure you are born into a family with really good genetics! Next, make sure you eat nutritious, balanced meals, get plenty of sleep, minimize your stress, and exercise regularly. Finally, stay curious about life. Connect with others and give your mind something to do that is new and challenging.
No, Seriously, What Should I Do?
Seriously – all those things are the best advice we have right now.
No Magic Bullet or Pill
For whatever reason, we have yet to find a cure for memory loss. In the interim, we are left with finding ways to care for people we love who may not recognize us, who can no longer remember how to dress themselves, and who need constant supervision because they are not making good decisions.
And, if I am the person who is searching for that word or has forgotten where I put my keys, I may need reassurance and support around what could be an uncertain future. One sure way to address that uncertainty is to get a baseline evaluation of your memory. Then you can turn your “Check Engine” light off.
4 responses to “Forgetting to Remember & Remembering to Forget”
This is a very creative article on a subject that matters to boomers. One area you didn’t touch on is the desire in our culture to find a medication for “memory” or “problem behaviors”. As a physician who focused on the care of medically complex seniors, the medical system has an ageist culture that favors chemically restraining seniors with these problems, which we wouldn’t do with our kids, and is potentially very harmful. We need to look at these problems as likely an unmet need that the person with cognitive impairment isn’t able to articulate. However, if we go there, we can reduce the triggers in their lives and provide support that matters to them and do so without the potential major burdens of marginally effective drugs.
Thank you for your insightful additions. More thoughts on “chemical restraint” to come in a future blog!
Mary: What profound, sweet, poignant and hilarious post (as usual!).
In reply, I offer two thoughts plus a poem (one of mine)! First, I am very lucky that—back in the 1990s—artist-poet me found myself becoming a computer geek as well (remember DOS?). Why? Because, as a terminally “visual extrovert,” I discovered using (ever updated) computers as a visual sounding/board (a Prosthetic Left Brain) — to balance my quite lopsided brain! And thus, the ongoing aggravation of my PC, the internet etc. turned into a positive thing (ongoing brain stimuli)!
Secondly, I am VERY lucky now, to be living with someone else, he brilliant, ornery, funny, deep and equally “process-oriented” — such that we are both neurally stimulated to the max. (I believe that living alone IS a real detriment to good mind/brain aging; a problem for which I can offer no “solution!”).
SO: Regarding our eldering memories? A poem I wrote back in 2016 may help us all! (Dedicated to my mother, who was scary sharp “to the end” in her 90s.):
After a splendid four-bar start
enroute to spouting something smart
the symphony of words I’d planned
goes quiet, just to vex this verbal ham.
It’s there I know, I maddeningly feel
dancing its own Virginia Reel
round and round it goes
when it stops, nobody knows!
My mind is sound, my memory sharp
no worries there and no fears carp,
but at this age I’ve finally found
my thoughts have changed from straight to round:
When not entirely gotten out
they take their time to come about,
like finest yachts they tack and yaw
before they show up through my jaw.
For memory nowadays, you see
isn’t what it used to be
it’s different – while still working well –
it’s just become a carousel!
great topic mary-when this became an irritant to me, had the initial tests done, then went further for brain scans-and lo and behold-an anomie has been the culprit of forgotten names-yet the abilities of vocabulary in description of the lost names more than suffices. and you are correct-the name does eventually surface, yet not quick enough. just a minor irritant that is overcome daily