Do YOU have a memory like a goldfish?

Do you worry that your memory isn’t what it used to be? Forget what you went upstairs for or frequently fail to put a name to a face?

A string of moments such as this can make many fear the worst — that it’s the beginning of the slow decline into the horror of dementia.

A survey last year by Saga found that most of us dread incurable brain diseases such as dementia more than cancer or a heart attack.

Do you have a memory like a goldfish? A string of moments such as this can make many fear the worst — that it’s the beginning of the slow decline into the horror of dementia

It’s this fear that drives many to seek help. Figures show dementia clinics, the majority of which rely on GP referrals, have recently been ‘bombarded’ by middle-aged people who fear they have the condition because they sometimes struggle to find their house keys.

There was a four-fold rise in patients being seen at specialist centres between 2010 and 2013.

However, clinics say the vast majority of cases are patients who are simply absent-minded, perhaps due to stress at work. So when should you worry about your own memory lapses or those of a loved one?

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IT’S IMPORTANT TO FORGET SOME DETAILS

‘There’s a great deal of hysteria these days over memory ability,’ says Barry Gordon, a professor of neurology and cognitive science at Johns Hopkins University in the U.S. and a world-renowned expert on memory.

‘We seem to have unrealistically high expectations for our memory. 

‘Most of us don’t complain about waning strength or appetite, but the first time we forget the name of an acquaintance, we assume we may have Alzheimer’s disease.

Most of us don’t complain about waning strength or appetite, but the first time we forget the name of an acquaintance, we assume we may have Alzheimer’s disease

‘We never give ourselves credit for what we do remember, instead we fixate on what we forget!’

Most cases of absent-mindedness are normal — ‘it may just be a matter of simplifying your life so that you reduce the ‘information overload’ in your brain’, says Professor Gordon, who is also author of Memory: Remembering and Forgetting in Everyday Life.

‘If you have a busy life, you have more opportunities to forget — and more opportunities to blame your memory.’

FORGOTTEN YOUR KEYS? DON’T PANIC

Reassuringly, some aspects of memory actually improve with age, says Sube Banerjee, professor of dementia at Brighton and Sussex Medical School.

So-called intelligent memory (a term coined by Professor Gordon and his team) — which covers such things as knowing how to ride a bike, vocabulary and social awaremess, or knowing how to behave with people — does not weaken with age.

It may even get stronger in some respects in later years.

Misplacing your keys once a week isn’t concerning — doing it every day is, experts have said

What’s crucial, says Professor Gordon, a neuroscientist and editor-in-chief of the journal Cognitive and Behavioural Neurology, is to realise forgetting things now and again is normal — especially as we get older, as we have more to remember, and as the connections in our brains slow down.

The truth is that only a small portion of people develop significant memory problems due to brain disease.

Misplacing your keys once a week isn’t concerning — doing it every day is, says Professor Banerjee. 

‘And forgetting where you’ve parked your car in a car park isn’t worrying [car park floors can look identical] — but it’s concerning if you don’t know which car park you used.’

WORRYING MEANS IT ISN’T DEMENTIA

In general, the more severe your worries about issues with your memory, the less likely you actually have a serious problem, says Professor Gordon.

‘The typical Alzheimer’s patient generally does not worry about his memory — their friends and family do.’ 

Famage to the brain frequently affects areas that impair your knowledge of your own abilities

This is because damage to the brain frequently affects areas that impair your knowledge of your own abilities.

You can test the state of your memory with the unique checklist on the facing page created by Professor Gordon.

It is designed to highlight and help explain some of the warning signs of memory problems — and when you may need to see a doctor.

You MUST complete the checklist with someone who knows you well (for example, your spouse, a good friend or close relative), because how they rate your memory is crucial.

‘Provided you know him/her reasonably well, and have a chance to see them in everyday life, their rating is a fairly reliable guide to how good — or bad — it actually is,’ says Professor Gordon.

‘In general, I give far more weight to the impressions of memory loss from a spouse or close friend than from the person being rated.’

In general, the more severe your worries about issues with your memory, the less likely you actually have a serious problem

If your spouse’s or friend’s evaluation suggests you should see a doctor, then you must. 

For each question, both you and your spouse/friend should circle the most appropriate answer.

For some questions, there will be specific advice for each of you.

For others, the same findings/advice will apply to both of you. 

Follow the specific advice where it’s given — the answers to other questions will help create a picture of the problem, if there is one.

(Note, these checklists are not a substitute for a doctor’s opinion.)

QUESTION 1

How old are you?

If you have memory problems under the age of 45 it is most likely to be due to over-work and stress, or depression

(a) Under 45

(b) Between 46 to 65

(c) 65 to 75

(d) 76 or older

WHY THIS MATTERS (both you and your spouse/friend should read this section):

If the answer is (a):

The good news is that dementia is rare at this age. If you have memory problems now it’s most likely to be due to over-work and stress, or depression.

If the answer is (b):

This is when you can begin to have problems such as remembering names — this happens as some brain connections slow down and we have more names to remember. This is normal.

Serious brain diseases such as Alzheimer’s are extremely rare before the age of 60 and still unusual at 65.

Depression, anxiety and overwork may be behind memory lapses.

If the answer is (c):

The risk of Alzheimer’s increases, but your risk is still less than 1 per cent.

Depression remains a possible cause of memory problems. There’s also a higher risk of stroke and heart disease, which can affect the brain and memory as a result of damage or poor blood flow to the brain. 

This age group is more likely to be on medication, which can hamper thinking and memory.

If the answer is (d):

Forgetfulness is an expected part of ageing. But after 75, and particularly after 80, the risk of Alzheimer’s is much higher — up to 40 per cent of people will develop it.

That being the case, if the answers to the questions below suggest a cause for concern, there is more reason to take memory loss seriously.

QUESTION 2

How would you rate your/their memory?

In general, the worse you think your memory is, the less likely it is you have a serious brain problem

(a) Really bad — I forget everything!

(b) Not too bad — but I forget more often than most people.

(c) Normal. Like everyone, mostly I remember, but sometimes I forget.

WHY THIS MATTERS (for you to read)

If the answer is (a):

You can relax a bit. In general, the worse you think your memory is, the less likely it is you have a serious brain problem. 

If you did, you wouldn’t remember what you’d forgotten.

If the answer is (b):

You may have a realistic appraisal of your memory. 

But if you’re concerned it’s worse than other people’s — or it has deteriorated in the past year — then getting it checked is reasonable.

If the answer is (c):

You may well be normal. But if you had Alzheimer’s, you might think you are normal — the key is how your spouse or friend answers question 2: if they answer (a) or (b), it’s best to get checked.

WHY THIS MATTERS (for your spouse/friend to read)

If the answer is (a):

If this is a change for this person, it’s a major danger sign about their memory. I would urge you to convince them to seek a medical opinion.

If the answer is (b):

If you believe their memory is worse than other people’s — and have known them long enough to be able to say that — they should see a medical professional. 

It may be due to ageing, depression, excessive medication, poor diet or inactivity. But it should be checked.

If the answer is (c):

You almost certainly don’t need to be concerned about this person’s memory — and they shouldn’t worry either.

QUESTION 3

What kinds of things do you/they forget? For example, work projects, turning off the stove (more than just once) or people’s names?

Forgetting important things such as turning off the stove can be a sign of a more severe memory problem than forgetting things of no consequence

WHY THIS MATTERS (both read this):

Forgetting important things such as turning off the stove can be a sign of a more severe memory problem than forgetting things of no consequence. 

But it’s not a guaranteed sign of a serious medical problem such as Alzheimer’s.

Depression, for example, can sometimes cause major memory lapses. So take this in the context of answers to other questions.

QUESTION 4

Did your/their memory problem begin suddenly or gradually?

Sometimes, people suddenly notice problems that have been there for quite a long time. It may be they experience a particular episode that highlights their forgetfulness

(a) Suddenly, within hours or a day or two.

(b) Gradually, so slowly I’m not actually sure when it began.

WHY THIS MATTERS (you read this):

If the answer is (a):

Sometimes, people suddenly notice problems that have been there for quite a long time. 

It may be they experience a particular episode that highlights their forgetfulness. 

But memory problems that seem to begin suddenly — in a few hours or a day — could have been caused by an injury (that the person may have forgotten) or a stroke in an area of the brain that affects memory only — so see a doctor.

If the answer is (b):

Often it’s hard to remember when the problem began because of the memory loss or because it began so slowly.

In memory loss due to ageing, people are often fairly certain their memory five or ten years ago was better, but hasn’t changed that much.

With dementia, it worsens more quickly — usually within a year or two — but the sufferer may not be aware of this. 

If you’re aware of gradual changes, but your answers to other questions don’t indicate a problem, there is likely to be no cause for concern.

WHY THIS MATTERS (for your spouse/friend to read):

If the answer is (a):

Sometimes memory loss might seem sudden, but the problem has been there for a while. 

It usually happens after an illness — often a hospitalisation when the person is in new circumstances. 

An inability to adapt to new situations signals problems with memory and other functions — the person can’t keep up when their circumstances become unfamiliar.

Genuine sudden memory loss indicates a medical condition such as a stroke.

If the answer is (b):

The memory loss due to Alzheimer’s creeps up, but then progresses more quickly than that caused by ageing. 

If this describes your loved one, they should see a doctor. 

Memory loss that doesn’t change dramatically over a year means whatever is causing it is very slow or is itself not changing. 

It makes Alzheimer’s less likely — so take this into the context of age and your answers to other questions.

QUESTION 5

Have you/they had periods of time in the past year when memory improved dramatically — such as at the weekend or on holiday?

If you think you have a memory problem, yet it has significantly improved when you spend time with friends or are on holiday, it’s usually a sign that it’s not your brain causing the issue

(a) Yes

(b) No

WHY THIS MATTERS (both read this):

If the answer is (a):

Everyone’s memory ability fluctuates, but if you think you have a memory problem yet it has significantly improved at times, it’s usually a sign that it’s not your brain causing the problem, but that you’re depressed or anxious and need treatment for that.

If the answer is (b):

Lack of improvement does not mean there is a serious memory problem or disease affecting memory. 

Even mild problems can persist unchanged so take into account answers to other questions.

In this section, there are separate questions for you and your spouse/friend to answer. 

These may sound similar to Question 2, but they are subtly different and are an important indication of the state of your memory.

QUESTION 6

For you to answer: How do you think your spouse or close friends/relatives would rate your memory?

If you feel those who know you well think your memory is bad, consider seeking a medical opinion

(a) Really bad — I forget everything!

(b) Not too bad — but I forget more often than other people.

(c) They think it’s normal. Like everyone, mostly I remember, but sometimes I forget.

WHY THIS MATTERS

If the answer is (a):

If you feel those who know you well think your memory is bad, consider seeking a medical opinion.

If the answer is (b):

If they think you’re more forgetful than other people, then they’re probably right. 

It may be nothing more than normal ageing (distressing as that may be), depression, medication side-effects or a boring lifestyle. 

In any case, a check-up might be worth it.

If the answer is (c):

This is good, but if it turns out that your spouse/friend’s evaluation of your memory is significantly different from yours (from Question 2), then you should question why your impressions differ.

Are you hiding things from them so they can’t tell how bad your memory really is? Again, if this is the case, it’s worth seeking out a medical opinion.

For your spouse/friend to answer: How will this person think you’ll rate their memory?

(a) Their memory is much worse than they think

(b) Their memory is the same as they rate it or better than they rate it.

WHY THIS MATTERS

If the answer is (a):

This is a cause for concern. Not only do you think their memory is bad, it also implies they are not a very good judge of their own abilities.

Diseases such Alzheimer’s destroy not only memory, but also judgment and self-awareness.

If the answer is (b):

How you rate their memory is probably more accurate than their own rating, so if it’s better than they think, this is a good sign. 

If it’s the same, what this means depends in part on how good or bad you think this person’s memory is.

If you both think it’s bad, then it deserves an evaluation. If you’re both agreed on good, then relax.

QUESTION 7

Do you/they tend to recall something you/they forgot once reminded about it — eg forgetting going to an event or the plot of a book?

If you can remember an event after a reminder, it’s a clue your memory problem is relatively mild, so there’s little cause to worry

(a) Yes, all or almost all the time

(b) Sometimes

(c) Never

WHY THIS MATTERS (you read this):

If the answer is (a):

If you can remember after a reminder, it’s a clue your memory problem is relatively mild, so there’s little cause to worry.

If the answer is (b):

A more troubling sign, but something as simple as distraction or absentmindedness could be to blame. See how you fare with other questions.

If the answer is (c):

This may mean your memory loss is more severe. Seek your doctor’s opinion.

WHY THIS MATTERS (for your spouse/friend to read):

If the answer is (a):

This is a good sign, so don’t worry.

If the answer is (b):

A cause for some concern and worth taking into account with the results of any other worrying answers.

If the answer is (c):

Definitely concerning and another thing to mention when you are seeking a medical opinion.

QUESTION 8

Are you/they a regular heavy drinker?

Drinking to excess frequently can make your memory worse, says the National Institute on Alcohol Abuse and Alcoholism

Drinking to excess frequently can make your memory worse. 

In a study conducted at the National Institute on Alcohol Abuse and Alcoholism, each extra drink of alcohol was associated with the equivalent of ageing an additional 2.4 to 3.7 years due to the damage to memory.

COULD A HEARING AID IMPROVE YOUR MEMORY?  

Want to sharpen up your memory? Here are some practical steps that might help:

• Make sure you are hearing and seeing properly. ‘It is amazing to me how many people ignore this obvious point,’ says Professor Gordon. ‘It should not be a surprise to anyone that not being able to hear or see well can cause problems with memory.’ This is because you can’t absorb the information properly the first time around.

• Some medication, including codeine, sleeping pills and statins, may dull your mind or your memory — consult with your doctor to review your medications.

• Pay attention! You will not remember something if you do not hear it or are thinking of something else. To remember something, you must concentrate.

• Follow a Mediterranean diet. ‘There is an increasing amount of evidence to indicate eating a healthy diet that’s rich in oily fish, fresh veg and nuts is good for your brain and can help maintain your memory as you get older,’ according to the Alzheimer’s Society.

• Exercise keeps your respiratory system and circulation strong. This not only gets vital blood and oxygen to the brain cells, but can improve your mood and reduce stress.

• Examine your sleep patterns, says Professor Gordon. ‘Sleeping problems are a big issue in memory, and sleep is certainly something most of us aren’t getting enough of.’