Unlocking the secrets of memory

Fear of dementia
Memory is hot.

We are obsessed with it, from movies ("Memento," "50 First Dates," "The Bourne Identity," "Eternal Sunshine of the Spotless Mind") to best-selling books to unproven memory aids like ginkgo biloba, one of the most popular supplements in the United States, with $109 million in sales in 2005.

In fact, the Web hums with "brain-boosting" products, such as Focus Factor, Memory Formula, and Alert! Nintendo has sold over 17 million copies worldwide of its Brain Age and Brain Age 2 games, including 5 million in 2007. Nintendo also offers enrollment in "Big Brain Academy" for the Wii, a virtual college with memory games and quizzes.

The fascination extends beyond pop culture. The best, brightest, and most ambitious scientists and students, perhaps sensing the potential for Nobel prizes and pharmaceutical riches, have made memory research the "it" field of brain study. "Just this month alone, there are three new textbooks on the neurobiology of learning and memory," says James McGaugh, M.D., a neuroscientist at the University of California at Irvine. "Ten years ago, there wasn't a single one."

What happened? Why are we suddenly so aware of this obscure corner of brain research, once the realm of lobotomies and weird experiments with cadavers and electrodes, and why are researchers so impassioned about pursuing it?

One answer is fear. "People are worried," says Barry Gordon, M.D., Ph.D., founder of the memory clinic at Johns Hopkins University. "If you look back to the 1930s, young men were dying in their 20s of tuberculosis. Nobody was worrying about Alzheimer's or senility." Then came the nightmarish notion of early onset Alzheimer's. Suddenly the dread of permanent forgetfulness gripped the young as well as the old. Doctors were bombarded with calls from patients terrified by tip-of-the-tongue moments and misplaced car keys.

Never mind that developing early onset Alzheimer's is as likely as being struck by lightning, or that absentmindedness often has more to do with stress and overtaxed minds than physical disease. The fear of Alzheimer's became almost phobic. "Dementia paranoia" was born.

A 2006 survey by the MetLife Foundation bears out the public's obsession: U.S. adults now fear Alzheimer's and its accompanying memory loss more than heart disease, stroke, or diabetes. Among adults over 55, Alzheimer's tops the list of most dreaded diseases.

The kicker is that the people who worry most about their memories are actually less likely to have trouble. "If you really had a serious memory problem, then you would not remember what you forget," says Dr. Gordon. So the fact that you recognized that you forgot an appointment indicates that your memory is probably functioning just fine. The lapse is probably due to other factors — too much on your plate, for example, or distractions. The true test is not whether you are worried. "If your spouse or friends do not notice anything wrong with your memory, then you can relax," Dr. Gordon says.

But fear isn't the only factor driving our memory obsession. More and more, we see good cognitive function as a career necessity.

"The world is demanding that we think better," notes Dr. Gordon in his book Intelligent Memory. "There's an intellectual race going on, especially in the workplace."

The result, adds Dr. McGaugh, is that "you have a new generation of people who are focusing on memory as an asset, in addition to money, houses, and cars."

The desire to increase the value of that asset accounts for the proliferation of memory-enhancing products. "Why are supplements like ginkgo biloba and computer programs like Brain Booster selling?" Dr. McGaugh asks. "Because people want an edge on memory."

Finally, experts say, people recognize more than ever the crucial role memory plays in health and happiness. "All we do as humans is based on memories," says Esther M. Sternberg, M.D., the author of "The Balance Within: The Science Connecting Health and Emotions." "You create your sense of self from accretions of many different memories. Memories of what you've done, of your emotional reactions to those experiences, and of the settings where they took place are all intimately connected to feelings of well-being and happiness."

For confirmation, says Dr. McGaugh, "all you have to do is look at people who have lost their memories and you can see they're no longer themselves. All that we do as humans is based on memory. Without it, we're nothing. Memory is hot because people have come to understand that it is our most important human capacity."

Unable to remember
Before his memory became as fragile and impermanent as a snowflake, Bob and his colleague Lester "Skip" Binder, Ph.D., used to refer to their work by joking, "If I remember correctly, I study Alzheimer's disease." It was funny then. Now it's a sad reminder of what Bob lost on July 29, 2006.

"You have to understand that Bob was a very bright man and a very high-functioning person," says Binder, who continues to run the neuroscience lab that he and Bob built into a cutting-edge center for Alzheimer's research. "He had a razor-sharp wit — really quick. Now he has trouble remembering whether he shaved in the morning. He can't take a walk because he'll forget where he is." Once upon a time, the pair would bat around their latest theories on brain function over a lunch martini. Now, says Binder wistfully, "he has the same core personality but he's not really Bob anymore."

The technical name of Bob's condition is anterograde amnesia, or the inability to form new memories as a result of damage to the hippocampus. So he knows what breakfast is, but he can't tell you what he ate on a given morning. He can be told that his parents are dead, and ask 5 minutes later if he can talk to his father. Bob also suffers somewhat from retrograde amnesia, meaning he has holes in his past. He knows that he worked in some capacity at Northwestern, for example, but he can't remember any of his research or that of his colleagues. Frankly, Bob's cognitive therapist at Northwestern, Linda Laatsch, Ph.D., is amazed by the inconsistencies in his memory. Sometimes he says he's living in Texas, sometimes he correctly recalls that he now lives in Oak Park and that he had a heart attack. Amnesia is not all or nothing.

INTERACTIVE The brain An interactive road map to the mind

I visit Bob at his home just outside Chicago. He's wearing jeans and a sweater vest, and as he sits there working on a crossword puzzle by the fire with his reading glasses low on his nose, he looks every bit the college professor and scientist. He reminds me a little of Hal Holbrook in "Our Town," in fact, poised to pass along some Grover's Corners gossip.

He looks up when Donna introduces me. "Bob, do you remember I told you about Bryan?" she asks. He glances at me, and then back at her. "Not really, no," he says, with an apologetic smile. She warned me that he wouldn't know who I was — and that even after she introduced me, he would forget, within a couple of minutes, why I was there. As she shows me through the home, I realize she wasn't exaggerating the extent of Bob's condition.

On almost every wall, pink and yellow Post-it notes curl out, symbols of Bob's fleeting memory. "This is Bob's room," reads one, underlined by a hand-scrawled arrow. This is Oak Park," says another. A bathroom note spells out his morning routine: "Shower, Shave, Deodorant, Dress." A fact sheet describes Bob's life in kindergarten prose: "Bob lives in Oak Park. Bob is 62 years old. Bob had a cardiac arrest on July 26, 2006. Bob has amnesia because of that."

As she reaches the kitchen, Donna pauses for a moment. She wants me to know how deeply grateful she is that Bob survived, and how lucky she and Bob both feel that he at least has some memories intact. "Most people just die on the spot," she says.

Still, she admits that life with an amnesia victim can be trying: having to constantly monitor Bob to make sure he doesn't wander from home and get lost; needing to remind him again and again to dress so that he can make his therapy appointment on time; being mistaken by him for someone else after she's lived with him for so many years.

Stopping in front of the refrigerator, she shows me her last line of defense when life becomes too tough. It's a bit of dark humor she knows Bob would have appreciated once upon a time. "Phillip's Milk of Amnesia," the fridge magnet reads. "For people who can't remember shit."

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