Techniques for improving memory in older people
June 18, 2015 12:04 PM Subscribe
I'm looking for ways an older relative can improve his memory, which has become very poor, probably because of anxiety and post-chemotherapy issues.
I have a family member in his 70s whose short-term memory / recall has become terrible in the last 2 years. During that time he has had depression, anxiety, cancer, surgery and chemotherapy. He now has a reasonable prognosis regarding the cancer.
Because of the severity of his memory issues, forgetting things he had just heard or done, losing his way in familiar places, we were fairly sure that he had some ageing-related brain issue. His psychiatrist was also concerned that the forgetfulness was beyond what might be caused by anxiety. He has now had a brain scan, however, and is completely clear of signs of dementia or other conditions related to ageing that could be causing memory problems.
We would like to make some suggestions to him about ways in which he could remember better and feel less anxious about forgetting. I do realise that there may be some difficulty in saying both "try this to remember better" and "don't feel anxious about not remembering". Alternatively, maybe there are things we can do to help him better remember what we tell him, ways of phrasing things maybe.
He already has many notebooks, both paper and electronic, and makes notes of what we talk about and what he is scheduled to do. This doesn't appear to help. He is fit, takes exercise, eats fairly healthily, has interests, is not seeing friends particularly often at the moment but lives with a partner and is not isolated. We see him about once a week and talk by telephone every two or three days.
He is on anti-depressants, which have just been changed to a different type as they didn't seem to be having much effect. I think he is also on something specifically for anxiety. He has had talk therapy, CBT and sessions on mindfulness. He is sceptical about all these things and if we were to suggest something like mindfulness to help with memory we would need to be able to point to decent research evidence. I'm only finding studies with fairly small numbers of participants, which I don't think would convince him. He would not be open to vitamins or other dietary supplements.
He has not explicitly asked for family help with this but he has talked to us about his frustration and concern about his memory. I think we are fairly good at listening to his feelings about this (half the family are social workers, FWIW) but would like to be able to make some suggestions.
Sorry about the length of this. Although the good brain scan result is excellent news it has left us a bit thrown as we thought we were on a different path.
I have a family member in his 70s whose short-term memory / recall has become terrible in the last 2 years. During that time he has had depression, anxiety, cancer, surgery and chemotherapy. He now has a reasonable prognosis regarding the cancer.
Because of the severity of his memory issues, forgetting things he had just heard or done, losing his way in familiar places, we were fairly sure that he had some ageing-related brain issue. His psychiatrist was also concerned that the forgetfulness was beyond what might be caused by anxiety. He has now had a brain scan, however, and is completely clear of signs of dementia or other conditions related to ageing that could be causing memory problems.
We would like to make some suggestions to him about ways in which he could remember better and feel less anxious about forgetting. I do realise that there may be some difficulty in saying both "try this to remember better" and "don't feel anxious about not remembering". Alternatively, maybe there are things we can do to help him better remember what we tell him, ways of phrasing things maybe.
He already has many notebooks, both paper and electronic, and makes notes of what we talk about and what he is scheduled to do. This doesn't appear to help. He is fit, takes exercise, eats fairly healthily, has interests, is not seeing friends particularly often at the moment but lives with a partner and is not isolated. We see him about once a week and talk by telephone every two or three days.
He is on anti-depressants, which have just been changed to a different type as they didn't seem to be having much effect. I think he is also on something specifically for anxiety. He has had talk therapy, CBT and sessions on mindfulness. He is sceptical about all these things and if we were to suggest something like mindfulness to help with memory we would need to be able to point to decent research evidence. I'm only finding studies with fairly small numbers of participants, which I don't think would convince him. He would not be open to vitamins or other dietary supplements.
He has not explicitly asked for family help with this but he has talked to us about his frustration and concern about his memory. I think we are fairly good at listening to his feelings about this (half the family are social workers, FWIW) but would like to be able to make some suggestions.
Sorry about the length of this. Although the good brain scan result is excellent news it has left us a bit thrown as we thought we were on a different path.
Play Scrabble, either with other people or online (like on the iPad app), or do other sorts of puzzles and things. This is assuming he has any interest in that sort of thing. Crosswords, GAMES magazine, that sort of stuff.
posted by freecellwizard at 12:39 PM on June 18, 2015 [1 favorite]
posted by freecellwizard at 12:39 PM on June 18, 2015 [1 favorite]
It's not clear what type of brain scan your relative had, but you really cannot exclude dementia by brain imaging. You can exclude certain causes of dementia (strokes, normal pressure hydrocephalus, etc.) There are also some promising functional and molecular imaging techniques that aren't really well validated yet. But most types of dementia, including Alzheimer disease, are clinical diagnoses, meaning they're made on the basis of reported symptoms, sometimes with the help of neuropsychological testing, and the exclusion of other diseases. If your relative has not seen a neurologist or geriatrician with expertise in memory disorders, that might be helpful, and neuropsych testing can be useful in demonstrating exactly which areas of function are impaired and which are still doing well, which can help guide coping strategies. There are some medications available for memory loss like Namenda and Aricept--they're not tremendously effective, but they do slow the progress of memory loss a bit.
However, as you note, other factors like anxiety and "chemo brain" can certainly make memory problems worse. It sounds like your relative is doing lots of good things (taking care of his general health, seeing a psychiatrist, exercising, etc.). There are no supplements/vitamins that have been demonstrated to be helpful for the memory.
Your relative might benefit more from switching focus from improving his memory to finding better ways to cope with a poor memory. Having more than one notebook is a mistake, for example, because how is he supposed to remember which notebook he wrote something down in? He should just have one, and write everything in it. Having calendars that are large and prominently displayed can be helpful.
Hopefully your relative's memory will improve a bit now that his physical health has stabilized, but in the meantime he's probably going to get the most benefit by putting some thought into systems that will help him function.
posted by The Elusive Architeuthis at 12:51 PM on June 18, 2015 [6 favorites]
However, as you note, other factors like anxiety and "chemo brain" can certainly make memory problems worse. It sounds like your relative is doing lots of good things (taking care of his general health, seeing a psychiatrist, exercising, etc.). There are no supplements/vitamins that have been demonstrated to be helpful for the memory.
Your relative might benefit more from switching focus from improving his memory to finding better ways to cope with a poor memory. Having more than one notebook is a mistake, for example, because how is he supposed to remember which notebook he wrote something down in? He should just have one, and write everything in it. Having calendars that are large and prominently displayed can be helpful.
Hopefully your relative's memory will improve a bit now that his physical health has stabilized, but in the meantime he's probably going to get the most benefit by putting some thought into systems that will help him function.
posted by The Elusive Architeuthis at 12:51 PM on June 18, 2015 [6 favorites]
post-chemotherapy issues.
I have several relatives who have had cancer and I have a serious medical condition myself and was once on like 8 or 9 prescription drugs. I would put him on nutritional supplements. Being subjected to strong drug regimens can cause deficiencies.
If possible, get a list of drugs he takes/has taken and search online for which vitamin deficiencies they specifically are known to cause. I was on Ibuprofen therapy for my condition for about 6 years. After I stopped needing Ibuprofen daily, my need for B vitamin supplements dropped dramatically. Ibuprofen is known to cause deficiency of a specific B vitamin. B vitamins are important to brain function. My memory issues are getting less serious. When I was really sick, I would deny having done something that I did 5 minutes ago ("I haven't been to the bathroom. What are you talking about?"). So I have first hand experience with this.
Best of luck.
posted by Michele in California at 1:29 PM on June 18, 2015
I have several relatives who have had cancer and I have a serious medical condition myself and was once on like 8 or 9 prescription drugs. I would put him on nutritional supplements. Being subjected to strong drug regimens can cause deficiencies.
If possible, get a list of drugs he takes/has taken and search online for which vitamin deficiencies they specifically are known to cause. I was on Ibuprofen therapy for my condition for about 6 years. After I stopped needing Ibuprofen daily, my need for B vitamin supplements dropped dramatically. Ibuprofen is known to cause deficiency of a specific B vitamin. B vitamins are important to brain function. My memory issues are getting less serious. When I was really sick, I would deny having done something that I did 5 minutes ago ("I haven't been to the bathroom. What are you talking about?"). So I have first hand experience with this.
Best of luck.
posted by Michele in California at 1:29 PM on June 18, 2015
Have him take a good quality fish oil supplement such as Nordic Naturals. Seconding Michele in CA that vitamins, specifically B vitamins, might be an issue as well - give him a high-quality supplement with folate and B12 such as Garden of Life.
Sleep is another issue - many older people sleep poorly, and drugs such as Ambien and Xanax (z-drugs and benzos) make memory issues and alertness much worse. Is your relative getting at least 7 hours of sleep a night? Has he had a sleep test to rule out things like sleep apnea (which reeks havoc on the brain - take it from one who's been there!), restless leg syndrome, or other sleep-robbers?
Good nutrition and good sleep should help.
posted by Rosie M. Banks at 1:38 PM on June 18, 2015 [1 favorite]
Sleep is another issue - many older people sleep poorly, and drugs such as Ambien and Xanax (z-drugs and benzos) make memory issues and alertness much worse. Is your relative getting at least 7 hours of sleep a night? Has he had a sleep test to rule out things like sleep apnea (which reeks havoc on the brain - take it from one who's been there!), restless leg syndrome, or other sleep-robbers?
Good nutrition and good sleep should help.
posted by Rosie M. Banks at 1:38 PM on June 18, 2015 [1 favorite]
If fish oil is a no go for some reason, flaxseed oil is a good alternative source of Omega 3 oil. I can't do fish oil. My go to for Omega 3 is snacking on walnuts. For different reasons, coconut oil is another brain-friendly oil.
Furthermore, just like toddlers need a high cholesterol diet to support brain development, his memory issues may benefit from cholesterol. At times, I have eaten bacon and eggs and real butter because the cholesterol helps with my neurological issues. (Obviously, if he is high cholesterol, this may be contra-indicated.)
posted by Michele in California at 4:45 PM on June 18, 2015
Furthermore, just like toddlers need a high cholesterol diet to support brain development, his memory issues may benefit from cholesterol. At times, I have eaten bacon and eggs and real butter because the cholesterol helps with my neurological issues. (Obviously, if he is high cholesterol, this may be contra-indicated.)
posted by Michele in California at 4:45 PM on June 18, 2015
If he will read text messages you can schedule automatic texts (or he can). My old phone had it built in but my new one doesn't so I had to download an app. The one I use was free and is called SMS Scheduler. I set it to remind me a couple of hours before an appointment, the night before the street sweepers come through, so I and 6 of my neighbors can move our cars and avoid a $50 ticket, and 3 times a day, every day, to remind a friend to take her pills. Things can be scheduled up to a year in advance. It works well for me.
There are also ICE apps that you can download with emergency contacts, prescription names and dosages etc. The one I use is called ICE card and shows up as a big, red dot with ICE on my phone. ICE stands for in case of emergency. That app was also free.
posted by BoscosMom at 5:23 PM on June 18, 2015 [1 favorite]
There are also ICE apps that you can download with emergency contacts, prescription names and dosages etc. The one I use is called ICE card and shows up as a big, red dot with ICE on my phone. ICE stands for in case of emergency. That app was also free.
posted by BoscosMom at 5:23 PM on June 18, 2015 [1 favorite]
An occupational therapist is a professional who helps people with tasks of every day living. You want one who works with seniors and is familiar with all of the tools and activities that can help him regain function and/or compensate for the deficits.
posted by metahawk at 8:34 PM on June 18, 2015 [1 favorite]
posted by metahawk at 8:34 PM on June 18, 2015 [1 favorite]
I would recommend Your Memory: How It Works And How To Improve It by Kenneth Higby. You might give it to your relative to read, or you might read it yourself and teach him some of the techniques in it, or you might do both.
It won't be a magic fix for memory problem, but it will teach a number of memory techniques that might be helpful. These are pretty much the same techniques that any book on memory will teach, but I think Higby's approach might be particularly helpful. First, he includes some discussion that is specifically aimed at elderly people who wish to improve their memory. Second, because he is an academic, he does a good job of keeping his claims grounded in valid research, which I gather is important to your relative.
Ironically, a lot of the techniques only work if you remember to use them. For example, you can remember somebody's name better if you create a vivid mental picture that links their name to their face -- but if you don't remember to create that visual picture as soon as you're introduced, you're out of luck.
As a result, your relative might find that he understands the techniques Higby recommends but is unable to apply them in his daily life. If that is the case, he might consider using the techniques for some sort of deliberate memory project, which he can undertake in the calm and quiet of his own home. For example, he might try using them to remember the names of the Presidents in order, or some other data set that is meaningful to him. That will give him practice in the techniques -- and even if he can't apply the techniques to his daily life, it will at least reassure him that he is capable of remembering things in the right circumstances, which might help with the anxiety.
posted by yankeefog at 3:55 AM on June 19, 2015
It won't be a magic fix for memory problem, but it will teach a number of memory techniques that might be helpful. These are pretty much the same techniques that any book on memory will teach, but I think Higby's approach might be particularly helpful. First, he includes some discussion that is specifically aimed at elderly people who wish to improve their memory. Second, because he is an academic, he does a good job of keeping his claims grounded in valid research, which I gather is important to your relative.
Ironically, a lot of the techniques only work if you remember to use them. For example, you can remember somebody's name better if you create a vivid mental picture that links their name to their face -- but if you don't remember to create that visual picture as soon as you're introduced, you're out of luck.
As a result, your relative might find that he understands the techniques Higby recommends but is unable to apply them in his daily life. If that is the case, he might consider using the techniques for some sort of deliberate memory project, which he can undertake in the calm and quiet of his own home. For example, he might try using them to remember the names of the Presidents in order, or some other data set that is meaningful to him. That will give him practice in the techniques -- and even if he can't apply the techniques to his daily life, it will at least reassure him that he is capable of remembering things in the right circumstances, which might help with the anxiety.
posted by yankeefog at 3:55 AM on June 19, 2015
Mod note: This is a followup from the asker.
Thanks to all for the replies. A second scan has confirmed that this is in fact dementia, but the ideas are still helpful.posted by cortex (staff) at 8:15 AM on July 31, 2015
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posted by PuppetMcSockerson at 12:12 PM on June 18, 2015