Memory and forgetfulness… What’s normal?

Well – they say any hiatus is a good hiatus (…at least I hope they do), because after the world’s LONGEST hiatus we’re officially back! In the midst of moving states, two new jobs, getting engaged, travelling overseas, planning a wedding, and much, MUCH more, this poor old blog of mine got majorly relegated to the back seat of life’s priorities. So it’s time to jump back in, get writing again, and do my best to think up some interesting and relevant topics to unpack for you all.

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First off the blocks is…memory! That funny little cognitive ability that’s vital to function adequately and survive as human beings. A huge topic that, thanks to working in a memory clinic, has been very much front of mind for me recently. Whilst I most commonly work with older adults, memory complaints are not uncommon in the younger age-groups. These memory symptoms or ‘failures’ are becoming increasingly more prevalent in the current climate of chronic overstimulation, usually at the hands of technology, and/or just having too much on our proverbial plates.

I’d say you’d be hard-pressed to find an adult who hasn’t at some point complained about their memory, or perceived lack thereof. We all know someone who’s “terrible with names”, or "can’t even remember what I ate for breakfast”. Or maybe that’s you, and you’re the one consistently feeling as though your mind is a sieve.

Now it’s important to note that for the purpose of the current piece, I’m going to focus on the correct or healthy function of the memory system, rather then delve too deeply into what happens when it starts to break down. We know there are myriad reasons; including dementia, brain injury, or various other medical and developmental conditions that can impact on an individual’s memory function. Unfortunately, there are far too many to cover in today’s post! So please keep that in mind as you read on.

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What is memory? 

Memory is a cognitive function that involves the encoding, storage, and retrieval of information. For healthy individuals, all three of these components work together to promote optimal function. Let’s take remembering someone’s name as an example of how this works (which, by the way, is actually one of the more difficult tasks our memory system faces, due to the random nature of attaching a name to a face, with little to no support from our other stores of knowledge). There’s unfortunately nothing about a person that prompts you, or suggests to you what their name might be – it’s entirely arbitrary, and relies purely on our ability to remember previously learnt information.

When you’re introduced to someone and given their name, this information enters our short-term memory. Unfortunately, if you’re like me, and spend too much time concentrating on not stuffing up the handshake, or get distracted by trying to be a normal, non-socially-awkward individual, short-term memory is the beginning and end for that little piece of information, and then it’s gone soon after.

But, in other less awkward situations, that name might get rehearsed a little bit while it’s sitting in our short-term memory, which helps encode it, and transfer it to our long-term memory for storage. A week or two later, when you see this person again, their name has (hopefully) been encoded well enough, that you’re able to retrieve it easily from your long-term stores in time to say hello.

Forgetting (it’s normal!)

Funnily enough – another vital function of a healthy memory system is actually the ability to forget. Seems strange right? But think of the consequences of a memory system that was not designed to allow us to forget. Every tiny little insignificant piece of information that crossed your mind or your sensory organs from day to day would be stored, competing with more important things in the filing cabinet of your memory system. Who cares what your colleague ate for breakfast last week? Or how many times the smoke detector squealed when you burnt your toast this morning?

Whilst our long-term memory storage capacity is considered to be infinite, having some control over what information we commit to memory is definitely a good thing.

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Memory 'failures'

The ability to forget unimportant information from day-to-day is beneficial, and something we don’t even consciously realise we’re doing. However, things can become concerning (and let’s face it – annoying) when we have difficulty remembering important things, like conversations with friends and family, appointments, meetings, etc etc.

This kind of day-to-day forgetfulness in otherwise healthy individuals (i.e., not those with an underlying illness, injury or developmental abnormality) may not actually be a failure of memory retrieval, nor is it necessarily indicative of something sinister.

Attention, or lack of it, is usually the culprit in this instance. Think about it – to be committed to memory, information must be attended to, focused on, and even rehearsed a little during the encoding phase. You can’t be expected to commit something to memory if you’re thinking about a million other things, and only giving fleeting amounts of attention to information before you’re off thinking about something else. You also then can’t expect to remember or retrieve something that was never encoded or stored in the first place. 

Information in your short-term memory is at its most vulnerable – to distraction, interruptions, and attentional failures. Your short-term memory is also a finite, limited store, so each new piece of information is fighting to stay front of mind, before it's replaced by something else. Ever walked into a room and forgotten why you were there? Say hello to a prime example of an attentional fail. It isn’t your memory letting you down in this instance, it’s because you may not have payed much attention to the thought in the first place, and a new piece of information has since taken its place. 

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What impacts attention and memory?

In this day and age, many of us live busy, high-stress lives, with a million things on our plates. Keeping on top of work, family, kids, friends, partners, exercise, travel, mental health; it’s difficult just to stay afloat. Throw technology and constant stimulation into the mix – you’ve got yourself a cocktail of stress and distraction that can wreak havoc on your memory. 

Ever tried to hold a conversation whilst reading something or texting on your phone? Good luck remembering what was said to you (and avoiding an argument about it later). And who else forgets to pack their lunch in the chaos of coordinating seventeen (or maybe seventy) other things before you leave the house in the morning? In both instances, our short-term memory is inundated, and various bits of information are competing heavily for just a little sliver of our undivided attention. 

Poor sleep, hunger, fatigue, stress (this one’s a big one), worry, anxiety, low mood, sadness, grief, frustration, pain, and alcohol can all significantly impact our attention and concentration, and therefore the ability to remember. 

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What can I do about it?

From a functional perspective, using a diary, calendar, setting reminders, or simply writing notes to yourself and placing them strategically around the house all work a treat. We all rely on memory aides – and as our lives get busier, our need for them increases.

Meditation is another way to help clear your mind and pave the way for the important stuff to be able to ‘stick’ in your memory. Frequent, simple mindfulness practices have been shown to improve memory function in healthy individuals, both young and old. I even decided to venture into the world of meditation last year, which you can read about here.

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Simple mindfulness strategies you can try:

• Take Ten Breaths - Pause and take ten slow, deep breaths, while bringing your focus to the sounds and sensations of your breath. Try to let other thoughts come and go, as though they are passing cars. You can then try expanding your awareness, by simultaneously noticing your breathing and sensations in your body. 

• Notice Five Things – Pause for a moment and look around, noticing five things you can see, hear, and feel in contact with your body (your watch against your wrist, your legs against your chair). Try noticing these sensations simultaneously. 

• Drop Anchor – Plant your feet into the floor, pushing them down, noticing the floor supporting you beneath your feet. Notice the muscle tension in your legs as you push down, then notice the feeling in your entire body, as gravity flows down through your head, spine, legs, and feet. 

Mindfulness meditation also has far-reaching benefits for psychological wellbeing, and has demonstrated efficacy in the treatment of depression and anxiety disorders. Importantly, the alleviation of depression and anxiety symptoms has also been shown to significantly improve memory function.

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Just remember...

The moral of the story here is that it’s ok to forget! For healthy individuals, forgetting is a normal bi-product of a healthy, well-functioning memory system. But, if you’re finding yourself increasingly frustrated by forgetfulness and difficulty remembering more important information – take pause and have a look at what else might be competing for your attention. 

Also, remember to be kind to yourself! Don’t beat yourself up, because there’s usually a simple explanation for why something slipped through the cracks, and more often than not, it’s nothing to be concerned about.




If you or someone close to you is experiencing memory symptoms that appear to be more serious, consult your doctor for further information.

Booze and brains: does alcohol really kill brain cells?

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Whether we like to admit it or not, most of us are guilty of having had a little bit too much to drink at one time or another. You might have drowned your sorrows and stress after a hard week at work, or been caught up in celebrations and indulged in a few too many at a wedding. Or maybe, it was by complete accident that you suddenly found yourself lit up like a Christmas tree, and arrived at work on Monday morning claiming fewer brain cells than you went home with on Friday afternoon.

But what do we actually know about the effects of alcohol on the brain? Does it really ‘kill’ our brain cells, or is it a little more complicated than that?

The physiology

Alcohol is a central nervous system depressant. In other words, it has a ‘slowing down’ effect on brain function. This might seem a little strange; alcohol is commonly seen as a ‘pick-me-up’, because in the initial stages of consumption, we become more animated and less reserved. However, the opposite of this occurs when we continue to drink and more alcohol enters the brain.

In the brain, alcohol easily crosses the blood-brain barrier, an important membrane separating the blood from the fluid surrounding our brains. The purpose of the blood-brain barrier is to protect the brain from harmful substances. When it crosses this barrier, alcohol directly affects our neurotransmitters and receptors of neurons, and therefore interrupts the successful transmission of signals from the brain to the body, and the body to the brain.

Our neurotransmitters (NTs) can either be excitatory (causing an increase in activity) or inhibitory (causing a decrease in activity). Alcohol promotes the effects of our inhibitory NTs, while simultaneously reducing the effects of our excitatory NTs; hence its depressant effect on our nervous system. Alcohol also increases the amount of dopamine (one of our ‘feel-good’ chemicals) in the brain’s reward system, creating the feeling of pleasure that occurs when we drink.

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Binge drinking and the brain

The short-term effects of alcohol consumption are well known, and have likely been experienced by many of us. A pattern of drinking is considered ‘binge drinking’ after 4 or more drinks are consumed on one occasion for women, and 5 or more drinks for men. But what's actually happening in the brain after we've thrown back those four or five drinks?

Slowed reaction times, lowered inhibitions, difficulty concentrating, slurred speech; these commonly experienced side effects of alcohol consumption are a direct result of misfiring brain signals being unable to get from A to B as easily as they should. Alcohol simply reduces the efficiency and effectiveness of the brain signals that allow us to function normally, both physically and mentally.

Ever wondered why memories of the night before are never quite as good as we hope they would be? That’s because when we drown our cells in alcohol, our poor hippocampi can’t do their thing and consolidate these memories while we sleep.

While sessions of binge drinking in the short-term don’t necessarily ‘kill’ our brain cells, they certainly get in the way of our brain’s ability to function optimally.

Long-term use or abuse

We know that many of the immediate effects of alcohol consumption resolve when we sober up. However, when a person drinks heavily over a prolonged period of time, some of these impairments may persist long after sobriety is achieved.

Long-term drinking can lead to brain atrophy (shrinkage), and permanent damage of the fibres that transmit signals and carry information from one neuron to the next. Many long-term alcoholics also develop a neuropsychological condition called Wernicke-Korsakoff Syndrome (WKS), which is caused by a thiamin deficiency (a B vitamin). People with WKS experience vision changes (nystagmus), problems with walking and coordination (ataxia), and significant cognitive disturbance (dementia). Fortunately, some of the acute symptoms of WKS can resolve when an individual’s thiamin returns to a healthy level.

via giphy.com

The hungover brain
Dehydration is the known culprit for that shocking hangover we’ve all woken up with. But what many don’t know is that our brains are actually to blame for causing this dehydration in the first place.

When alcohol crosses the blood brain barrier, it causes our pituitary gland to block the creation of vasopressin, the antidiuretic hormone. Without vasopressin, the brain tells the kidneys to send water directly to the bladder without letting it reabsorb back into the body. And that headache we all know and dread? That’s our organs making up for their lack of water by stealing water from the brain. This causes our brains to shrink a little, and pull on the membranes connecting the brain to the skull. Hello headache!

Are our brain cells safe?

The odd night out drinking or accidental over-indulging in the alcohol stakes aren’t quite enough to ‘kill’ our precious brain cells. However, long-term serious alcohol use (or addiction) can certainly lead to permanent damage to the cells in our brain, and associated physical and neuropsychological symptoms.

The important thing to remember is everything in moderation, and for the sake of future you, doing everything possible to prevent or alleviate that hangover when you have indulged. Drink plenty of water throughout the night (and the following day) to replenish the water lost in the brain and the body, and there’s certainly no harm in downing some vegemite toast before bedtime if you’re worried about those thiamin levels. 

Food for thought: how our diet affects our brain

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The brain is always ‘on’ – it controls our movements, thoughts, feelings and actions, our heartbeat and breathing, our sleep, and our senses. As a result, our brains need a constant supply of fuel, which it sources from the food that we eat.  The brain is the most metabolically active organ in the body. It comprises only 2% of our body weight, but this metabolic powerhouse manages to consume 25% of all the glucose in our blood.

The effects of some foods on how we think, act, and feel are well known; sugar gives us a ‘high’, caffeine stimulates the brain, and chocolate makes us happy. More recently, the idea that nutrition can elicit non-observable effects on the brain has emerged. A growing body of evidence now exists to demonstrate the effects of nutrition on brain development, mood, cognition, and ageing.

How our food affects our mood.

Our mood is the product of chemicals in the brain, including various neurotransmitters. Serotonin, known as the ‘happy hormone’, is produced in the brainstem, but has widespread effects on the brain and the body. Serotonin helps control our mood (feeling happy as well as sad), our sleep, appetite, and our memory.

Serotonin is made from tryptophan, which is an essential amino acid. Essential amino acids cannot be produced by the body, so we need to get them from the foods that we eat. Foods like chicken, fish, red meat, cheese, nuts and seeds are high in tryptophan, so their consumption allows the production of serotonin in the brain and the body.

Whilst eating a diet rich in tryptophan doesn’t necessarily increase the amount of serotonin in the brain, the inverse can have dramatic effects. The brain can’t cope with a tryptophan-free diet, and levels of serotonin will quickly decrease, resulting in irritability, anger, lowered mood, and poor memory.  

Interestingly, about 90% of the serotonin in our bodies is produced in the gastrointestinal tract, not the brain. Recently, the gut has become known for a lot more than simply digesting our food. Now dubbed the ‘mini-brain’, the gut has been shown to play a role in regulating our mood, appetite, and cravings for particular foods via the brain-gut-axis. Studies have also shown that when people supplement their diets with probiotics, or ‘good’ bacteria for the gut, they experience decreased anxiety, and improved mental outlook.

The typical ‘Western’ diet consists of highly processed food, which is high in refined sugar and saturated fats. Research has shown that this type of diet can actually affect the gut-brain signals about internal states like hunger and satiety, making it more difficult for our brain to recognise when we are full. 

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Nutrition and neuropsychology.

Nutrition can alter brain function in the short-term, by altering levels of neurotransmitters and subsequent firing of neurons, but it can also alter brain structure and function in the long-term.

The importance of proper nutrition during brain development in infants and children is well established; in babies, around 87% of their daily energy intake supplies the brain. Throughout infancy to early childhood, the growth of neurons and neuronal connectivity is at its greatest, and therefore glucose requirements are high. Poor nutrition has been shown to put children at a greater risk for mental illness, and behavioural problems like aggression and attention deficit hyper-activity disorder (ADHD). 

The food we eat has a direct effect on our cognitive functions, such as memory, attention, concentration and cognitive control. The effects of poor diet on sleep, energy and mood can also indirectly affect our daily cognitive function. Those who eat diets high in processed food, saturated fats and refined sugars have been shown to have poorer memory than those adopting a healthy, balanced diet.

The lack of sufficient nutrients can also have a toxic effect on the brain (neurotoxicity), particularly for older individuals, which predisposes the brain to atrophy (shrinkage) and premature neuronal loss. A longitudinal study found that low intake of nutritious foods, and high intake of unhealthy foods were each associated with smaller hippocampal volume; the memory centre of the brain. Recent research has focused on specific nutrients that may confer neuroprotective effects in later life, which may ameliorate neuronal loss in particular brain regions, and slow cognitive decline.

Food for thought, and healthy brain function.

A number of specific foods and nutrients have been identified to positively influence brain health, and protect against the effects of ageing on the brain.

Omega 3 fatty acids

Known as the “good fats”, Omega 3 fatty acids are found in fish, avocado and flaxseed.

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B vitamins and Folate

Folate has been shown to reduce the risk of age-related cognitive decline, and enhance the effect of antidepressant medications when used concurrently, while B vitamins are essential for a number of cellular and metabolic processes. High concentrations of folate can be found in green leafy vegetables, legumes, nuts, yeast, and wholegrains. Nuts and wholegrains are also rich in B vitamins, as are unprocessed meats, cheese, and eggs.  

Plant-based antioxidants

Various plant-based micronutrients have antioxidant properties, which can prevent oxidisation and cell damage in the brain and body. Some examples of these micronutrients include:

Polyphenols

Polyphenols are predominantly found in fruits and vegetables, especially blackberries, blueberries, raspberries and goji berries; mangoes, grapes, garlic, onions and kale. They are also found in green and black tea, as well as coffee and dark chocolate (yay!).

Curcumin

Curcumin is found in turmeric, and has been shown to promote healthy brain ageing via its anti-inflammatory properties.

Vitamin E

Vitamin E is another antioxidant that has been shown to promote healthy function in the ageing brain. You will find it in green leafy vegetables, nuts and some plant-based oils like grapeseed, sunflower, and olive oil.

Minerals

Minerals like zinc, iron and magnesium all play important roles in promoting optimal brain health and neurological function. Zinc is abundant in lean meats, seeds, nuts and oysters, while iron is found predominantly in red meats, as well as grains, nuts, and spinach. Nuts, legumes and leafy greens are also rich in magnesium.

Thankfully, there are plenty of foods on offer that are rich in nutrients that promote neurological function and healthy brain ageing. Whilst it doesn't mean we should go out and gorge on good fats until the cows come home, the next time you accidentally eat a little too much dark chocolate, or one (seven?) too many almonds, you can rest assured that your brain might actually thank you for it in the long term.

No pain, no brain: the neuropsychology of exercise

#brainspo

Most people are well acquainted with the positive effects of exercise on the body and the cardiovascular system. But how does exercise affect the brain and its cerebrovascular system; the workhorse that carries blood from the body to the brain?

There’s plenty of evidence out there telling us that what’s good for the heart is good for the brain, and that so much more is going on during exercise than that post workout high alone.

The short-term effects.

As your heart rate climbs during periods of voluntary movement and exercise, there’s an immediate and parallel increase in the production of various neurotransmitters (brain chemicals) that can have both temporary and long lasting positive effects on the brain, the mind, and the body.

Exercise is associated with increased production and release of neurotransmitters and neurotrophic factors (proteins that support the growth and survival of neurons) in the brain. There is also evidence to suggest that increases in both of these things can promote neuronal growth and neuroplasticity (the brain’s ability to reorganise itself by forming new neural connections). So in much the same way as consistent exercise promotes muscle strength and growth in the body, it also creates a parallel growth and strengthening of neural connections within the brain.

Consistent with the ‘brain-as-a-muscle’ analogy, many studies have suggested that the areas of the brain that underpin higher-order thinking skills (the pre-frontal cortex) and memory abilities (the medial temporal lobes and hippocampi) are larger in individuals who exercise regularly.

While endorphins get most of the credit for the post-exercise rush, these pain-fighting, mood-enhancing peptides actually only play a minor part. Increases in other types of neurotransmitters have various and combined effects on the brain, and in turn, our mood. For example, dopamine and norepinephrine work together as the ‘feel-good’ combo that results in ‘runners-high’, while GABA (Gamma-Aminobutyric Acid) acts as a ‘calming’ or inhibitory chemical that can increase relaxation and help build immunity to stress.

While all of these positive chemicals are increasing in concentration in the brain during exercise, our stress hormones (cortisol and adrenaline) decrease after regular exercise, further enhancing the stress-relieving, neuroprotective benefits we reap in the aftermath.

The longer-term bonuses.

The neurogenesis and neuroplasticity that exercise promotes are not limited to short-term effects. Neuronal growth, strengthening and reorganisation can increase stress tolerance and enhance cognitive function (e.g. memory, attention, concentration, mental flexibility, and inhibitory control) long after you’ve finished your run. As a result, evidence has shown that exercise promotes improved cognition and academic performance in children, increased productivity in adults, and delays cognitive decline in older individuals.

Exercise also reduces your cardiovascular risk factors; it helps lower blood pressure, heart rate and cholesterol. This reduces the chance of stroke and heart disease, while preserving cognitive function and quality of life across the lifespan.

In an interesting recent study, researchers found exercise to increase levels of GABA and glutamate (another neurotransmitter), both of which are known to be depleted in the brains of individuals with mood and anxiety disorders. Using MR spectroscopy, they demonstrated increased concentrations of GABA and glutamate after exercise in areas of the brain that underpin processing of visual information, emotions, and specific cognitive functions.

Improved mood and lowered anxiety have also been shown to promote adherence to regular exercise programs, showing us that it’s not just an empty motivational spiel, but working out does actually get easier the more you do it!  

Finally, regular exercise can also increase your pain tolerance, and who wouldn’t say yes to that? A recent meta-analysis demonstrated that while athletes experience pain similarly to other active adults, their ability to withstand pain was significantly greater. Another study showed that in a group of healthy adults following a 6-week structured training schedule, pain tolerance increased significantly at the completion of the program.

The verdict's in...

The brain, the mind and the body all reap countless benefits from regular exercise, and there’s no shortage of evidence to prove the case. The best part is, even 20 to 30 minute bursts of regular exercise are all you need to get your brain and body pumping to their maximum potential.

Welcome!

Image via Instagram (@trishathompsonadams)

Hello!

Thanks for stopping by and checking out my new brainchild that is the Brain, Mind & Body blog. This is just a quick post to say hello and to introduce myself, and a little of the inspiration behind BM&B.

My name is Cynthia and I’m a clinical neuropsychology registrar currently working in clinical research into Frontotemporal dementia and related disorders (among other things). I live in Sydney with my partner, but Melbourne has my heart and will always be ‘home’ for me.

So why blog?

There are a couple of reasons I decided to start this blog, the first of which is my revived love of writing. Throughout university and since graduating, the only writing I’ve been required to do has been ‘scientifically’ oriented, which imposes certain restrictions on creativity and flair. Whilst scientific writing obviously has its place in academic journals, theses and the like, it doesn’t flow quite as freely, nor is it quite as accessible for everyone.

I was recently lucky enough to write an article for The Conversation (I’ve since posted it here), who are an online source of news and reviews written by those in the research community delivered in plain language direct to the public. Their byline is “academic rigour, journalistic flair”. It wasn’t until I sat down to write the article that my enjoyment of writing in this style was properly realised.

The second reason for this blog is my love and passion for all things brain. Having dedicated my studies and career so far to the inner and outer workings of the brain, I’m yet to learn something about it that doesn’t interest and inspire me. The mind and body are inherently and reciprocally connected to the brain; you can’t have one without the other. It’s this reciprocal relationship between the three that inspired me to combine my knowledge and passion for writing and start communicating what I know.

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So much of what is discovered via research is hidden away in academic and scientific journals, making it difficult to access for anyone other than those in an academic institution. I want this blog to serve as a gateway, from research to practice, and from science to real-life knowledge and application of what is known about the brain, mind and body.

What will you find here?

Variety! From memory, sleep, exercise, food and brain health, to neuroplasticity, mindfulness, hardwiring happiness, brain training, dementia, to the effects of depression, anxiety and stress on the brain and body; the possibilities are endless! My goal is to translate this knowledge into meaningful real-world application to promote healthy brains, minds and bodies.

So stay tuned, I plan on making my way through a whole range of different and diverse topics that I hope will be relevant to all of you.

I hope this little intro has been helpful, and that it has given you some insight into who I am, and what makes me tick. Please feel free to leave questions, comments and thoughts on any or all of the topics I touch on.

Happy discovering!

Cynthia xx

P.S. Creating this blog was in part inspired by a friend and colleague who gave me the encouragement I needed to follow the ‘YESes’ and do something that excites me. She has created a phenomenal mind, body, soul coaching business and you can find her website here.

Special mention also goes to another friend, colleague and fellow researcher whose own experience of having a blog inspired me to start my own. I love reading her posts, and you can find her blog over here.