MS Speaks

Medscape has posted an interview entitled "How Memory Works (and How to Preserve It)" with the editorial director of Medscape Psychiatry interviewing Felipe De Brigard of the Duke University Institute for Brain Sciences (Durham, NC), February 19, 2015:


Excerpt:

Medscape: What strategies, both pharmacologic and nonpharmacologic, have shown the most benefit in preserving memory?

Dr De Brigard: To the best of my knowledge, we don't have solid data about pharmacologic interventions that help to prevent the normal decay of memory. However, data suggest that pharmacologic treatments help in persons with mild cognitive impairment or early dementia. We know that aerobic exercise, healthy living, and a rich and intellectual life are helpful in slowing down the progression of the memory impairments that come with age. Likewise, sleeping well and focusing one's attention on the task at hand—in other words, avoiding multitasking—help to consolidate information for future retrieval.

Our laboratory uses only behavioral and neuroimaging methods. However, a recent review by Maria Cotelli and collaborators surveyed a large number of results of nonpharmacologic interventions in amnestic mild cognitive impairment and early Alzheimer disease. They found that some forms of memory intervention therapy—which may or may not include noninvasive brain stimulation—appear to improve performance in certain tasks, particularly when combined with pharmacologic therapy. My sense, though, is that much more research is needed to fully assess the extent to which these kinds of interventions can selectively improve memory performance in pathologic and nonpathologic aging.

Medscape: Some of the strongest data on delaying or preventing dementia involve exercise and dietary approaches. Can you speak specifically about these approaches?

Dr De Brigard: As I mentioned in the previous question, a healthy lifestyle, both for the body and the mind, are the best strategies to keep our memory working well.

I also like to highlight the importance of attending to the information we want to encode. In today's world, people love to multitask. But, unfortunately, multitasking is very detrimental to memory consolidation. As I mentioned before, attention and working memory are of the essence for information to be encoded. If you divide your attention between two events, you fail to fully encode either of them; at best, you end up half-encoding both of them. When it comes to working on improving one's memory, it is important to remember all three stages—encoding, consolidation, and retrieval—because memory is not a single process.

Medscape: What about brain exercise programs or puzzles and crosswords?

Dr De Brigard: From what I understand, the evidence is very clear that these sorts of "brain training" programs and apps neither make you smarter nor slow down the progression of memory or other cognitive declines. However, there is evidence that an active life—both physically and intellectually—does help to delay many symptoms of cognitive decline, and it may even make the slope of the decline less steep. This kind of lifestyle is what I'd recommend.

The entire article, along with reference notes, should be available here.