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Memory Loss

Memories of persons vary depending on the individual's state of mind and the content of the information. There are 2 basic types of memory - Implicit which refers to the unconscious level occurring in basal ganglia and the Explicit that refers to the conscious level (occurring in medial temporal structures). Episodic memory refers to the record of events (episodes) and the relationship with the person. Short term memory is synonymous with working memory. This is a specialized term referring to information about the current task. Commonly also referred to as amnesia, memory loss can be described as a degree of forgetfulness or failure to recall past events which is above the normal level. At times, memory loss is limited to an inability to recall events that are recent, but sometimes it could also be for events from the past or both.


Types of memory loss

Depending upon its cause, memory loss could be sudden or gradual, and permanent or temporary. A transient global amnesia is rare and is a complete but temporary memory loss. In anterograde amnesia on the other hand, the individual cannot recall recent events occurring after a trauma but can recall events of distant past. Retrograde amnesia is when the individual cannot recollect events preceding or leading up to the trauma. But he/she can recall all subsequent events. A transient global amnesia is rare and is a complete but temporary memory loss.


Causes for short term memory loss

Short term memory loss is a symptom of many possible causes including disease, dyslexia, depression, injury or chronic drug and alcohol abuse. Other possible causes for amnesia can be Alzheimer's disease, brain tumor, Creutzfeldt-Jakob disease, meningitis, Parkinson's disease, Pick disease, epilepsy, stroke and West Nile virus. A stroke is construed as one of the most serious reasons for a short term memory loss.


Research findings have established that the structural differences in cortical neurons depend on gonadal hormones in laboratory animals. Other studies on women show that their cognitive tasks changed throughout the menstrual cycle based on the fluctuating estrogen levels.

A head trauma can sometimes result in short term memory loss and this can happen even when concussion is not sustained. Psychiatric disorders such as dissociative fugue, dissociative identity disorder and other types of amnesia can cause short term memory loss. Severe psychological stress can push a person beyond his/her coping abilities can cause memory loss among other mental disturbances. Research reveals that stress hormones kill or inhibit the growth of brain cells adversely affecting memory. The more prolonged the depression, the more extensive the damage. Hormonal imbalance can play havoc and lead to short term memory loss. During menopause, memory loss symptoms are often seen in women.

Treating memory issues

Mental exercises, herbal supplements, certain drugs as well as a healthier lifestyle can all help in treating short term memory loss. If the memory loss is chronic and it interferes with everyday life then it is essential to consult the doctor to identify the cause and eliminate the serious condition.

Alzheimer's disease

Alzheimer's disease is a progressive mental disorder that brings about changes in the brain slowly leading to dementia. Named after the German physician Alois Alzheimer, Alzheimer's disease has 2 characteristic neuronal changes : Loss of cholinergic cells in the basal forebrain and the development of neuritic plaques in the cerebral cortex. Neurofibrillary tangles can also occur due to Neuritic plaques.

Here the brain cells degenerate and die thus causing a decline in the mental functioning and memory of a person. Alzheimer's disease (AD) or Presenile dementia as it was earlier known as, is one of the primary causes of dementia. The levels of the brain neurotransmitters serotonin, norepinephrine and acetylcholine are found to be low in AD. This kind of brain disorder causes loss of social and intellectual skills of a person. In severe cases it interferes with the day-to-day activities of a person.


Alzheimer's disease causes

  • Most scientists believe that Alzheimer's disease is caused due to increase in production and accumulation of a protein called beta-amyloid protein. The accumulation of this protein leads to nerve cell death.
  • Environment factors that causes a change in the brain's functioning can also lead to Alzheimer's disease
  • Genetic causes
  • Abnormal levels of elements like aluminum and lead
  • Chronic cerebrovascular condition resulting from high blood pressure can lead to cerebral microbleeds. These microbleeds over a long period can result in mild cognitive impairment.
  • Head injury
  • Some viruses
  • Lifestyle changes that causes change in the brain's functioning can also lead to Alzheimer's disease


There are 4 major cognitive deficits arising out of AD :

1. Amnesia : Memory loss is probably the most common symptoms of Alzheimer' disease.
2. Aphasia : Loss of Language - Failure to recollect names of objects
3. Apraxia : Inability to perform voluntary movements
4. Agnosia : Inability to recognize people and places


Alzheimer's disease symptoms
  • Forgetfulness, unusual difficulty in remembering things
  • Mild confusion
  • Occasional memory lapse
  • Disorientation day, date, etc.
  • Problem with speaking and writing
  • Problem in thinking and reasoning
  • Decision making problems
  • Depression, anxiety, mood swing and many such behavioral problems
  • Problems with cognitive skills like calculating, judgment, etc


Alzheimer's disease diagnosis

1. A physical examination and a neurological examination to check:


  • Muscle tone and strength
  • Sense of touch and sight
  • Reflexes
  • Balance
  • Coordination, etc.

2. Brain imaging (CT scans, MRI) to check for tumors, etc.
3. Lab tests for thyroid etc so as to rule out other possibilities for memory loss


Treating Alzheimer's disease

As this disease is of degenerative nature, there is no permanent cure. Early diagnosis and changes in lifestyle can slow down its progression or improve the quality of life for the afflicted.


  • Drugs to deal with cognitive changes and memory symptoms
  • Drugs to increase acetylcholine or butylcholine levels. eg; Donepezil hydrochloride or rivastigmine, a cholinergic agonist or Cholinesterase inhibitor.
  • Vitamin E combined with Cholinesterase inhibitors
  • Alternate medicines like Ginkgo Biloba, Brahmi, Gotu kola, Ginseng and St. John's Wort
  • Exercise
  • Well balanced and nutritious food
  • Lifestyle changes that help deal with and improve the current condition

Pick's Complex

This is a less common form of dementia, more prominent in those under the age 65. Frequently misdiagnosed as Alzheimer's disease, Pick's patients initially exhibit marked personality and behavioral changes. And gradually the ability to speak coherently declines.


Although there is no cure for Pick's complex presently, it can however be managed well and the quality of life improved. According to Arnold Pick, who first described the disease in 1892, Pick's disease causes an irreversible decline in a person's functioning for several years. Pick's affects adults between the ages of 40 and 60 and is more common in women than men.


Causes

The frontal and temporal lobes of the brain control a person's speech and personality. Excess protein build-up in these parts causes slow atrophy in these regions. The cause for this build-up of protein is unknown. Other than causing speech and behavioral changes, Pick's disease can also cause memory loss quite like those with Alzheimer's as well as socially inappropriate behavior, poor decision making, progressing to severe impairment in intellect, speech and memory. Some opine that Pick's disease may have a genetic or heredity component although not all family members are affected.


Symptoms of Pick's disease

The first sign of Pick's complex is personality changes and decline of basic functioning. Pick's can occur in an age earlier than Alzheimer's and memory loss need not be a predominant early sign of Pick's disease. Although there could be reports of Pick's occurring as young as 20 years of age, the progression is slower in Pick's disease. However, there are cases where symptoms could worsen over time and brain cells degenerate. More severe symptoms appear at later stages of Pick's. Some noticeable behavioral symptoms of Pick's disease are poor judgment, extreme restlessness especially in the early stages, overeating or drinking, lack of personal hygiene, sexual exhibitionism, decreased interest in daily activities and obsessive behavior.

Mood swings, lack of empathy, apathy, rudeness, impatience and aggression, easy distraction and being unaware of strange behavior and memory loss are some of the prominent emotional symptoms of Pick's disease. Loss of vocabulary, difficulty in speaking and understanding, uncoordinated speech and decrease in the ability to speak and write are some serious signs of Pick's.


Diagnosis of Pick's Complex

Other than careful symptomatic evaluation, brain scans and EEG, three of the following five characteristics are found to be present in the early stages. They include:


    Onset before age 65
    Personality changes
    Lack of normal behavior / Loss of control
    Lack of inhibition
    Roaming behavior
    When compared to Alzheimer's, memory loss and mental impairment occur later in Pick's.

Diet and activity

There should be a restriction on foods with high sugar content. There could be carbohydrate cravings in some. While in Alzheimer's and Parkinsons, a diet relatively high in fat and protein and low in carbohydrates is necessary, it is unclear if the same is recommended for Pick's complex. It is better to get a doctor's opinion on an appropriate heart-healthy diet. A regimen of therapeutic exercises such as brisk walking can help to regulate the patient's mood and benefit on cognitive function.


Treatment

Pick's disease, like any other dementia progresses rapidly and life gets shortened about six to eight years, although some do live for as long as twenty years. As currently there is no cure for Pick's like Alzheimer's, the aim is to maximize quality of life by way of medications to manage particular symptoms, regular supervision, and assistance.

Emotional and substantive support is an important aspect of the treatment. The family of the affected may help with the following control symptoms:


  • Eyeglasses and hearing aids to bolster the failing senses.
  • Positive behavior when symptoms set in by creating a calm and soothing atmosphere so that the patient feels safe and less anxious.
  • Speech therapy or any other physical therapy that can improve communication and movement.
  • Selective antidepressants that can provide some relief from apathy and depression and help reduce food cravings, impulse control and compulsive activity.
  • Treatment for other disorders such as anemia, thyroid disorders and kidney or liver diseases.
  • Stopping medications like paracetamol, NSAIDS, anti-cholergenics or changing them under medical guidance.

Tips for coping with Pick's complex

Being diagnosed with Pick's complex can be overwhelming especially when it involves any form of dementia. It is good to learn more about Pick's disease and frontotemporal dementia. In this way, more control can be exhibited and they will be better prepared to manage symptoms.


  • Music therapy, meditation, deep breathing exercises can help control stress and anxiety.
  • Pet therapy and visits from specially trained animals can help relieve stress and improve mood.
  • Treating depression can make it easier to handle other challenges of the disease.
  • Reaching out to family and friends for emotional support can help avoid isolation. A support group of similar patients can help overcome feelings of depression and isolation and provide a wealth of coping tips. Staying socially active will lighten the load and increase patient comfort.
  • Playing cards and word games such as scrabble, crossword and Sudoku puzzles can exercise the brain and help slow cognitive decline.
  • It would be wise for a Pick's patient to avoid medical, financial and legal confusion and instead create a design plan and discuss and document end-of-life preferences with doctors and family members.

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Bibliography / Reference

Collection of Pages - Last revised Date: October 22, 2019