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Thanks for the Memory: Researcher helps older adults boost powers of recall and stay mentally fit

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Eat blueberries, strawberries and spinach, learn bridge, do crossword puzzles and yoga, walk, take part in volunteer and social activities, shout out the answers while watching game shows and laugh often.

These are just a few of the memory “boosters” that Vincent Bali has learned as a participant in a School of Nursing study on improving memory.

Graham McDougall
Dr. Graham McDougall, professor of nursing at The University of Texas at Austin, has spent the last few years trying to find out whether memory training affects memory performance. His memory intervention study was the first in the country to include a tri-ethnic sample of white, Hispanic and African American seniors.

Photo: Alex S. Labry

And because enjoying the small things of life can help alleviate the stress that can cause memory dysfunction, Bali is already ahead of the game.

The 72-year-old retired military police officer and salesman teaches salsa, polka, ballroom, mambo, waltz and the electric slide line dance at the Conley-Guerrero Senior Activity Center in east Austin. He also is a “certified” comedian who has performed at the Capitol Comedy Club and is a member of the Toastmaster Club.

“I used to do the crossword puzzles, but they got too easy,” said Bali, who joined the study because he was sometimes worried about his memory.

He is not alone. One of the most common fears among seniors is loss of memory and how it could affect health, well-being and relationships.

People can take some control over their own destinies and remain mentally fit with constant self-education and putting themselves in mentally challenging environments, said Dr. Graham McDougall, a professor in the School of Nursing and principal investigator of the study.

“You don’t have to accept memory loss as you get older,” he said. “Don’t be passive—take action.”

As baby boomers—the 80 million Americans born between 1946 and 1964—age, the interest in memory loss will only increase. McDougall has been interviewed by Matt Lauer on the Today Show and has been quoted in Oprah Magazine and numerous other media outlets.

He is one of 100 research scientists nationwide invited to participate in the National Academies Keck Futures Initiative conference in November. The event, to be held in Irvine, Calif., will provide an opportunity for researchers from different disciplines to focus on new possibilities in the fields of aging and longevity.

McDougall’s five-year, $2.4 million study funded by the National Institutes of Health began in 2002 and is known as the SeniorWISE program. He wanted to find out whether memory training affects memory performance.

You don't have to accept memory loss as you get older. Don't be passive--take action. Dr. Graham McDougallIn the course of the next few years, 265 people—65 years of age and older—participated in the research. It was the first memory intervention study in the country to include a tri-ethnic sample of white, Hispanic and African American seniors, said McDougall.

The short-term goals of the study were to improve participants’ memory performance, increase memory confidence and reduce anxiety. But the underlying objective was to improve their ability to perform day-to-day operations like using the phone, paying bills and taking medications properly.

“As age and memory loss increase, serious problems with activities of daily living begin to emerge,” said McDougall. “We felt that important daily tasks could be enhanced through memory interventions.”

Participants were tested on immediate recall, delayed recall and recognition memory. Memory assessments also included remembering a story, a route, hidden objects and future intentions, and connecting random numbers and letters. The participants also were tested on filling grocery lists, making change, balancing checkbooks and refilling prescriptions by telephone.

“Older adults are capable of improving their memory, but whether a program like this can assist them to improve or maintain their instrumental activities of daily living was not known,” McDougall said.

The participants improved on memory performance and on average improved their belief and confidence in everyday memory tasks. In addition, it was found that participants who had less formal education improved their general mental health scores.

“One of the most important results we found, however, was that the study helped people improve their overall knowledge of health-related topics like depression, stress and medications,” McDougall said.

Velma Cotton with her miniature Schnauzer, Maribelle
As a participant in the memory study, Velma Cotton learned about internal memory strategies, such as using imagery to form interactions and using association or “chunking”—grouping things together. She is seen here with her miniature Schnauzer, Maribelle.

“If we can help elders learn more about their health and help them maintain independence, then hopefully we will keep them out of hospitals and nursing homes.

“Once they go to these environments, their mental state starts rapidly declining.”

Most senior adults want to live independently in the community for as long as possible, and memory loss is one of the factors that make them at high risk for assisted living, McDougall said, adding that prospective memory—or remembering to do things—is especially important for maintaining independence.

In addition to testing, memory improvement strategies were taught during class, and learning was reinforced through booster sessions.

“There are several externally derived memory strategies like keeping a calendar, writing a list or asking someone to remind you of something,” said McDougall. “But we want older adults to learn more internal memory strategies, such as using imagery to form interactions and using association or ‘chunking’—grouping things together.”

Eighty-five-year-old Velma Cotton lives by herself with her miniature Schnauzer, Maribelle, and wants to keep it that way.

“I can remember way back yonder when I was growing up, but it was beginning to be hard to remember what happened more recently,” she said.

Cotton, who had gone back to school and received a General Educational Development diploma at age 62, decided she wanted to help herself and joined the university memory study.

“What they taught me helped a lot,” she said. “I didn’t want to give up on my short-term memory just because things were getting difficult.

Top 10 Memory Boosters
  1. Eat blueberries, strawberries and spinach. They’re rich in antioxidants, believed to prevent disease and tissue damage.
  2. Engage in social and other leisure activities to keep the mind challenged and focused on others, rather than on your own worries.
  3. Learn bridge or take on another mentally challenging task.
  4. Engage in physical exercise, such as walking or stretching, every day.
  5. Set aside time each day to relax whether it’s listening to music or doing yoga.
  6. Don’t obsess about what you can’t remember or judge yourself on the memory you had when you were younger.
  7. Understand that worry, fatigue and depression can hamper memory. For momentary relief, take a deep breath and count to 10. This distracts you and improves oxygen flow to the brain.
  8. Sleep an average of seven hours a night.
  9. Stay organized by keeping a calendar, making lists and eliminating clutter. Keep keys and other frequently used objects in the same place so you don’t waste mental resources worrying.
  10. Laugh often. It’s a great way to relieve stress-inducing forgetfulness.

“Now, when I meet someone new, I dwell on the person’s name for a while and then connect it with something else. That way, I’ll have a better chance of remembering it.”

In other words, she chunks.

Some people have been saddled with forgetfulness their whole lives, while others seem to acquire it slowly with age, said McDougall.

“You may constantly forget where you left your car keys or have a hard time remembering people’s names,” he said. “It doesn’t necessarily mean you are on the road to developing dementia or Alzheimer’s disease, but keeping your memory in top working condition is the best prevention for future problems.”

Education is a buffer to delay the onset of cognitive impairment, said McDougall.

One of the most important aspects of improving memory is boosting memory confidence. Studies have shown that 80 percent of the elderly worry about their memories.

“As we get older, we tend to lose confidence in our ability to remember,” said McDougall. “We forget a familiar name or face and think we’re ‘losing it.’ We set out to do something, forget what it was, and wonder if we have just witnessed an early hint of dementia.”

Just being a participant in the study helped boost confidence, he said.

“It helped to see that other people like yourself had similar concerns,” he said. “You realized you are not alone.”

Throughout the study, participants were tested to see if there was an enhancement in how they feel about themselves, and more specifically, about their memory efficacy.

The researchers saw an increase in memory performance after individuals attended just a few classes.

“We know that the more confidence people have in their memory function the better they perform on memory tasks, and when they have strategies to help them think more positively about their memory skills, the better they perform,” said McDougall.

Seventy-six-year-old Jewel Caldwell plays a game of dominoes with a friend at the Conley-Guerrero Senior Activity Center in Austin
Seventy-six-year-old Jewel Caldwell plays a game of dominoes with a friend at the Conley-Guerrero Senior Activity Center in Austin. The city’s center offers a variety of classes and activities to older adults, including nutrition programs and computer classes. Caldwell has been playing dominoes for more than 12 years.

“If people believe they can remember things fairly well, then they tend to have more confidence in their memory skills and they engage in activities that are often more challenging.”

Vonnette Austin-Wells, who helped teach the memory training, said easing the mind of the participant was a main objective.

“Fear and concern about memory problems was what got them here,” she said.

“Research tells us that the majority of older adults will never have memory problems that will adversely affect their lives—with only 20 percent being really impaired,” said Austin-Wells. “We reminded participants of these statistics often.”

Mental training can be delicate, McDougall said.

“If people attempt a task and have difficulty,” he said, “they may become overly anxious or even depressed and stop challenging themselves in the future. The key is not to obsess over what you can’t remember or judge yourself on the memory you had when you were younger.

“After all, what’s done is done, so it’s time to focus on the future.”

Keep in mind, too, that worry, fatigue and depression can hamper memory, McDougall said.

“For momentary relief,” he suggested, “take a deep breath and count to 10. This will distract you, while improving oxygen flow to the brain.

“Stress and anxiety can also make someone have memory lapses,” he said. “But forgetfulness caused by these emotions is usually temporary and goes away when the feelings fade.”

Hearing loss, poor diet, adverse reactions from medication or excessive alcohol consumption may cause some memory problems.

We know that the more confidence people have in their memory function the better they perform on memory tasks. Dr. Graham McDougall“Risk levels increase when people are depressed, taking multiple medications or living alone,” McDougall said. “It may be time for a medical consultation in some cases.”

Using statistics generated by the study, McDougall found that moderate alcohol consumption among older women—two or fewer drinks a day—actually can benefit memory. Moderate drinkers reported less depression, had higher self-reported health, performed better on instrumental everyday tasks, had stronger memory confidence and performance.

Another component of McDougall’s study was looking at the effectiveness of nutraceutical products or herbal supplements marketed for memory enhancement.

“We know that people spend a lot of money on these products and yet we believe they have little positive effect,” he said.

Until more research is available, he recommends that professionals exercise caution in recommending these products to patients, particularly because some are known to contain products such as caffeine and may compromise health.

McDougall has already begun testing his memory intervention with a group of cancer survivors.

“There is documented evidence that some people develop memory impairment—sometimes referred to as chemo fog—as a result of chemotherapy,” he said. “But no one has attempted to test whether these memory problems can be corrected or reversed with memory training.”

Meanwhile, Bali has gotten a part-time job selling wireless phones at local grocery stores. He went through computer training with AT&T to learn about various models.

“I like being active because it helps keep my mind open,” he said. “I want to do something every day and stay as healthy as possible.”

McDougall agreed that it’s the intellectual curiosity of wanting to learn new things that really keeps us going.

“I think anything that challenges your mind and gets you out of your routine is positive.”

By Nancy Neff

Banner photo and photos of Velma Cotton
and Jewel Caldwell: Christina Murrey

On the banner: Vincent Bali teaches a dance class at the
Conley-Guerrero Senior Activity Center in east Austin.

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  Updated 18 December 2007
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