by Rodney Pearlman

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As people are living longer, working longer and being confronted with more complicated tasks due to the information explosion, our mental abilities are being challenged much more than in previous times. We particularly notice these challenges as we age, because the aging process affects not only physical abilities, but also mental functions.

Amongst the more noticeable brain functions that slow down with age are memory formation and recall. Now, while these processes decline relatively slowly — over many years and decades — noticing the decline or measuring it is quite difficult. Normal decline in memory function is quite distinct from the severe forms of memory loss that occur with Alzheimer’s Disease or other forms of dementia. While people often fret as to where they misplaced their keys, and are annoyed when they can’t readily remember a person’s name, these are not signs of anything more than the normal process of aging.

So, let’s step back and discuss how “memories” are formed. When a piece of information is observed, it is placed into short-term storage and then sent to long-term storage in another part of the brain. This process of long-term storage is referred to as memory consolidation, and occurs during sleep. If a memory can’t be consolidated, then the person has no recall of a particular event. An interesting analogy is that short-term memory is similar to random access memory in a computer. While you are working on a word processor, the memory is being stored in an electrical form. It is not until you hit “save” that the paragraph is written to the magnetic disc, and thus stored in a stable and retrievable form.

While the slowing of brain function as we age is inevitable, there are a number of ways to slow the decline in memory and mental function.

Diet. The first is eating a healthy diet, rich in protein, low in fats — and keeping weight under control. Too much fat and too many carbohydrates are the cause of several problems. Fats tend to induce inflammation — particularly of the lining of the blood vessels — which can lead vto hardening of the arteries and micro blood clots. The effects of atherosclerosis on the vessels lining the heart are well known, but this condition also leads to problems in brain function.

A diet high in fats and carbohydrates, apart from leading to potential weight gain, can also put a person at higher risk of contracting diabetes. The high glucose observed in diabetes affects a region of the brain involved in memory formation. Glucose control naturally declines with age, so as we get older it is more important than ever to carefully watch nutrition, and to engage in regular exercise. 

Exercise, both mental and physical. A number of studies of elderly subjects show that physical activity and mental stimulation may both improve memory scores. Physical activity includes simple exercises such as walking, as well as aerobic exercise; such exercise helps improve blood flow and also may help by keeping weight under control. 

A lot has been written about mental exercises — from crosswords, to Sudoku, to computer games that have been devised to challenge memory. One important finding has been that the best approach to the use of mental exercises is in a cross-training mode. It’s most effective to use a variety of tests that “exercise” different regions of the brain. For example, tests that rely on memorizing lists or pictures work on one region of the brain, and tests that require logic and reasoning to solve a puzzle involve quite different areas. Performing different tests will exercise all of the regions.

Drugs. At present, there are very few conclusive, well-controlled clinical trials showing that any drug or dietary supplement has a clear and lasting effect on cognitive performance. Drugs that are used in treating Alzheimer’s Disease have only short-lived effects on improving memory function in normal, elderly subjects, and the drugs’ severe side effects make them completely unsuitable for use in normal patients.

There are a number of drugs currently in clinical testing, examining their effects on memory and cognition in a variety of diseases. While there have been some promising hints of efficacy, it will be many years before any of these drugs are approved for use in treating real diseases — let alone for use in improving memory in aging adults. 

The food supplement phosphitidyl serine has shown some benefit in improving cognitive function in studies of elderly adults. Ginkgo biloba has been studied in a number of clinical trials, some showing positive results and some negative, so it is hard to recommend this plant extract. Other chemicals available in foods, like caffeine or nicotine, have been shown to transiently improve attention, but the effects last for under half an hour.  

While there are no drugs proven to improve memory and cognitive function in normal, aging adults, there have been a number of clinical trials with mixed outcomes. It is believed that the class of drugs called statins — such as Mevacor, Lipitor and Crestor — may reduce blood vessel wall inflammation and may lead to improving blood flow in the brain. However, these drugs also have significant side effects, and are only prescribed for their effects on cardiovascular disease. Non-steroidal anti-inflammatory drugs may also work in a like fashion. 

One important point is that we often fret or worry about memory loss. Small lapses of memory are quite normal aspects of living a busy life or being distracted. There are a number of excellent books that offer guides to improving memory as well as describing the effects of memory lapses, and place them in the context of normal aging. Conversely, severe memory impairment can be evaluated clinically and is of great concern.  So, while the gradual decrease in memory and cognition affects us all, with good nutrition, and both physical and mental exercise, people will be able to slow down the inevitable effects of an aging brain — just like we can with other organ systems in the body.

For more information:

The Memory Bible: An Innovative Strategy For Keeping Your Brain Young, by Gary Small 

The Seven Sins of Memory: How the Mind Forgets and Remembers, by Daniel L. Schacter

Rodney Pearlman is CEO of Nuon Therapeutics. Prior to that he was CEO of Saegis Pharmaceuticals, a company that developed a novel drug to improve cognition in schizophrenics, which is currently in clinical trials in Europe. You can contact him  at rpearlman@nuontherapeutics.com.