Memory Enhancement

October 31, 2007

Aspects of Memory

Before we can attempt to “improve” memory functioning, we must first understand the different processes involved in forming memories. The ability to retain information from previous experience is one of our most important abilities on which our capacity to adapt and function effectively in different situations depends. Most people tend to think of memory as a single mental function, when in fact many mental processes are involved. First, we must attend to something before we can acquire information about it. Depending on the complexity of the information, some rehearsal may be required before it can be retained. Once acquired, this information is stored in what scientists have called immediate or short-term memory, where information we have just been exposed to is retained. Beyond this is a process of storage, where information in immediate memory is consolidated and finally retained in remote or long-term memory. When in the future we are exposed to familiar circumstances, we may retrieve certain information, such as the last meal ordered at a certain restaurant, or the like. Thus, memory involves attending, acquisition, rehearsal and finally, retrieval. Disruption of anyone aspect and memory will be impaired to some degree.

Experts often refer to a distinction between semantic and episodic memory. Semantic memory involves information that is based on language, word knowledge, verbal concepts, and is independent of references to time or place. Episodic memory, in contrast, has to do with personally experienced events labeled in terms of time and place, such as a baseball game, a doctor’s appointment, or a day at the office. Scientists who have studied memory in different age groups have noted that younger individuals rely more on episodic memory, whereas older persons use semantic memory more heavily. It is also known that there are different brain centers for verbal, or language-based, information, and for nonverbal, or visuospatial information (forms, objects, geometric shapes, and directions). As we grow older our ability to deal with and recall nonverbal types of information declines, and with it our memory for shapes, forms, directions, and the like.

One can also distinguish between recent or remote memory. Recent memory refers to our ability to recall or recognize information or events within minutes, hours, or days, whereas events that occurred or information gained years ago are considered examples of remote memory. Unless some special area of the brain is damaged, our remote memories stay with us, even in the face of brain injury or neurological disease of the central nervous system. In contrast, our ability to retain recent information typically declines with age and with most diseases affecting the brain. In addition, depression can cause reversible impairments in recent memory.

Finally, whereas conscious memory for events and visual or language-based information (scientists call this declarative memory) declines with Alzheimer’s disease, the ability to learn how to do things involving habits and simple routines, is preserved. An example of this noncoscious procedural memory would be dressing, doing physical therapy exercises, or grooming sequences. However, while an Alzheimer’s patient could learn new motor behaviors of these kinds, he or she very well might not have any recollection of where or with whom the learning took place.

Memory Aids

Studies of the “normal” aging process suggest that, as we age, we may lose as much as 20 to 40 percent of our ability to deal with novel, unfamiliar situations and problems, spatial information, and recall of recent events. It also appears that older individuals stop using certain kinds of strategies for learning and recalling information that those with excellent or younger memories may use extensively. In recognition of this, psychologists specializing in the study of memory have developed some techniques for improving and enhancing memory functioning. Most of these techniques involve increasing the number of associations around the information we desire to retain. For example, making up a silly rhyme in connection with a certain word we need to remember may help us recall that word. The phrase Every good boy does fine helps us to remember the full notes E, G, B, D, F on the musical scale. Conjuring up an image that in turn is connected with some other kind of information (e.g., noting a resemblance between a certain person’s face and features of a particular animal) may facilitate memory for that information. For caregivers it is crucial to keep in mind that Alzheimer’s disease may keep the patient from generating helpful associations of either a verbal or nonverbal kind. In short, any memory improvement technique that depends upon new learning or novel experience should be regarded with caution, as the value of the approach will be quite limited.

In the case of Alzheimer’s disease, memory is progressively impaired in a generally predictable order. Recent memory, especially for unfamiliar visuospatial information will be the first to deteriorate. Whereas the Alzheimer patient will seem to have a good memory for events that occurred in childhood or in earlier adulthood, he or she may get lost repeatedly, ask the same question, or never recall phone conversations or messages. As the condition worsens, gaps in remote memory may occur, even to the point that family members may not be recognized. Ultimately, even habits such as dressing and eating are disrupted and eventually lost.

Physical Aids

The order in which memory deteriorates, from the most unfamiliar and novel to the most repetitive experiences and behaviors, gives us a strategy for dealing with the Alzheimer patient. First, any enhancement technique that depends on new learning and recent memory is likely to fail, which may only frustrate and aggravate the problem. Where new things have to be learned, use of external aids, such as taking notes, will work best. For recall of time-related events, such as appointments, a calendar and even a digital alarm (some of which can be programmed to specify the information to be remembered), can help substitute for missing functions in the Alzheimer patient.

Association Aids

For the Alzheimer patient, making new bits of information part of old, well-known, and frequently repeated routine may help cue (elicit) recall of important new information. For example, having the patient take a new prescription at a time that had originally been set aside for administering a vitamins (for example, at breakfast), or when teeth are to be brushed (which places the patient in proximity to the medicine cabinet), would make it more likely that the medicine would be taken.

Backward Chaining

Learning new locations can be particularly difficult, or even beyond the capabilities of an Alzheimer sufferer, but a method called backward chaining has been helpful with some demented patients. Normally we learn to get from one place to another by learning various cues in a forward progression, from point of origin to destination. Backward chaining involves the opposite process, where the patient is taken first to the destination on repeated occasions, then familiarized with prominent locations increasingly distant from the destination and closer to the starting point. In a hospital setting, this initially might involve taking a patient from the bed, directly under supervision to the destination-say, the occupational therapy area. Subsequently, the patient would be taken to the closest landmark along the way, which might be the nurse’s station, from which point the patient would try to get to the occupational therapy area. This backward progression or “chaining” would be continued until the patient could walk from his or her room to various destination points with minimal or no supervision.

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