I Think My Mind Is Going

Posted 09/20/2011

It’s fairly common, actually. You walk into a room suddenly befuddled, wracking your brain, desperate to remember just why you came to this room in the first place. Or you’re telling someone about a movie you just saw the night before, really enjoyed, and now you’re clawing at your cerebral cortex trying to extricate the title, the actor, the name of the theatre.

“Am I in the foothills of Alzheimer’s?” you ask yourself, breaking into a cold sweat.

On the plus side, very unlikely. A neurologist once explained it to me. “The ‘worried well’ agonize over mild and completely normal blips in brain function. Basically these folks are all fine, just need to be reassured. Most early Alzheimer patients absolutely deny anything is wrong with their thinking because they can’t recognize it.”

On the minus side, if we don’t pay attention to our brains, we can let slip by (and likely allow to worsen) some of the decline in function now referred to as age-related memory dysfunction, which can, by the way, begin in your forties.

Most of these minor walk-into-a-room forgetfulness issues are caused by a combination of overload and inattentiveness. Let’s say you’re in Room A and you need a pencil in Room D. By the time you uncurl from the sofa and walk through Rooms A, B, and C, your mind has raced through the evening’s to-do list, your attentiveness unraveled by someone else’s TV, the day’s mail on a table, and minor background worry about the fact that your foot has fallen asleep. Or someone you live with asks as you pass through “Hey, do you remember the name of that film we saw with what’s-his-name?”

By the time you arrive in Room D, the quest for your pencil has been pushed to the back-most of your burners, you blurt “Why did I come in here!,” and you wonder “Should I be calling my doctor about this?”

Your great-great-grandmother didn’t have these issues about her pencil, and not because she didn’t use one. There’s something to be said for the simpler life: many generations ago grandma probably had just one prized pencil in her house, which contained just two rooms, A and B.

Here’s what I suggest to reclaim your brain

• Start by practicing simple mindfulness. Consciously focus on whatever you’re doing at the moment and start training your unruly thoughts to behave themselves. When you put down your keys, say aloud “I am placing my keys in this basket” (better yet, always put your keys in that basket and nowhere else) or “Pencil…I am going to get a pencil.” You don’t need to be a TV set with all your channels going at once.
• Keep challenging yourself mentally. Read complex books. Do the New York Times crossword puzzle or play Scrabble. Memorize poetry. Work memory games. One recent study showed that a key way to strengthen your mind was to learn a foreign language. Imagine your delight at never having to say Je ne parle pas Français ever again. Or the smiles on your co-workers’ faces as you leave the office on Friday with a cheery Hauskaa viikonloppua!
• If you’re really worried, make an appointment with me, Dr. Kelley, or whoever your personal physician happens to be. There are several easily treatable medical conditions, including underactive thyroid and low vitamin levels, that are associated with memory problems. Also, brain chemicals called neurotransmitters can now be measured and abnormalities corrected, usually with non-prescription and very natural products. Seeing us will also give you the opportunity to review your diet (which may be making you dumb), your alcohol intake (dumber), and your list of potentially unnecessary prescription meds (really dumb).

Interestingly, and probably in response to increased consumer demand, there are more products available, both prescription and over-the-counter, to address memory issues. Some doctors prescribe (off-label) low doses of the Alzheimer medication Razadyne (galantamine), the ADD med Strattera (atomoxetine), or the Parkinson med Eldepryl (selegiline) for age-related memory issues.

Nootropics: so-called smart drugs or cognitive enhancers

As a group, these prescription and nonprescription meds and supplements are called nootropics, and while some work better than others I wouldn’t suggest monkeying around with them on your own as a weekend to-do project. This is simply because they’re quite complex and have the potential to interact with each other or with a prescription medication you’re already taking.

The only supplement manufacturer who has actually conducted clinical studies is Quincy Bioscience, for their product Prevagen(apoaequorin). Quincy’s Madison Memory Study evaluated 218 healthy volunteers who reported memory concerns but had no specific accompanying disease diagnosis. Half were given a placebo (sugar pill) and the other half Prevagen.

At the start of the study, all 218 were given a computer-based memory test, and all 218 had about the same percentage of errors. However, 12 weeks later the test was repeated and the Prevagen group showed a 29% drop in percentage of errors. Prevagen apparently works by maintaining a healthy calcium balance in brain cells.

There were no reported physical side effects and no known drug interactions. The main emotional side effect (joking here) was attributed not to the supplement but to its price–roughly $2.30 a day.

Prevagen’s 40-mg size isn’t a prescription item but is available only through healthcare practitioners. Frankly, I don’t know why the 40-mg size isn’t available in stores, though it may have to do with the shoplifting potential of an $80 bottle of Prevagen.

Health insurance doesn’t cover nutritional supplements, but if you have a Health Savings Account at work, as a nutritional product your Prevagen would likely be covered.

Be well,

David Edelberg, MD  

P.S.  Flu shots are now available.  Call the center for details.