Coping with my failing memory

“I don’t remember that, but I believe you.”

I say this a lot nowadays and mean it. As I’ve gotten older, I’ve had to release something I used to associate with my identity — the ability to remember things better than most other people. There are things I can still remember pretty well, like the words to “The Humpty Dance” (one of my favorite rap songs of all time!) However, I have difficulty remembering past events, and even ones I do remember seem to get fuzzier by the day.

Of course, some of this is viewed as a normal part of being over 50, and science is trying to explain it.

Our ability to remember new information peaks in our 20s, and then starts to decline noticeably from our 50s or 60s. Because the hippocampus is one brain region that continues producing new neurons into adulthood, it plays an important role in memory and learning. The section called the dentate gyrus is where the new neurons are created. Many are produced during childhood, but activity in the dentate gyrus slows down as we age. The reason for memory decline isn’t known but may involve this decreased rate of neurogenesis.
— Queensland Brain Institute

I find that my memory is likely worse than others my age. When conversing with old friends, I wince almost every time I hear a sentence start with “Remember when…”

Given that I spend more time with Marsha than anyone else, I feel this way at home all the time, as Marsha’s memory is now much better than mine.. A Mayo Clinic study found that “Memory was worse in men than in women overall (P < .001) and more specifically beyond age 40 years.” Lovely.

In computer terms, my memory may be bad, but my CPU still seems to be OK. As such, I’ve probably spent more time than most trying to “process” what might be happening to me.

Below is a “top 5” list I’ve been keeping for what might be happening with me physically, mentally, and emotionally:

• Sleep apnea. I’ve written about a previous post “Do you have sleep apnea?” When I told my neurologist as part of a UCSF study that I was having memory lapses, he ordered a sleep study, and it turns out my oxygen was getting as low as 71% at night, depriving my brain of oxygen!

“After adjusting for other factors that could affect memory and thinking problems, such as age, race, gender and education, researchers found that people who reported sleep apnea symptoms were about 50% more likely to also report having memory or thinking problems compared to people who did not have sleep apnea symptoms”
— American Academy of Neurology

• Diabetes. It appears a real problem for the brain is insulin resistance, independent of high blood glucose. So, even though my glycemic control has been decent through drugs, I remain insulin-resistant, and my insulin levels are high as a result. Memory loss is observed more broadly for people in my situation, and it could develop into dementia.

”Even in the absence of hyperglycemia, declarative memory impairment has been observed in individuals with chronic hyperinsulinemia (21), consistent with a deleterious role of insulin resistance on cognitive function. Subtle cognitive changes that can accompany early stages of insulin resistance due to aging, type 2 diabetes, and other factors may eventually develop into clinically significant cognitive impairment, including dementia.”
— Cholerton, et al in Diabetes Spectrum

• Chronic Kidney Disease (CKD). I have stage 4 CKD (eGFR < 30). It turns out that CKD has a pretty strong association with memory problems and cognitive decline for a variety of reasons that are complex, multi-faceted, and not completely understood.

“Cognitive impairment is common in patients with CKD and negatively affects health-related quality of life and other health-related outcomes. It is imperative that clinicians recognize the value of early screening for cognitive impairment and initiate preventive and treatment measures. Importantly, the decline in cognitive function appears to be multifaceted with a major involvement of vascular dysfunction in a unique CKD metabolic milieu that predisposes patients to an accelerated cognitive decline.”
— Bronas, et al in BioMed Research International

• Personal family history (PFH) of dementia. I’ve written about how my dad suffered from dementia. As such, my risk of developing dementia is likely double that of those without this personal family history due to a combination of genetic and lifestyle factors.

“The average lifetime risk of developing dementia is 10%–12% and increases to 15%–25% for individuals with a family history of dementia. This increased risk can be explained by both genetic and lifestyle factors, which are passed on from parents to offspring. The Apolipoprotein E (APOE) ɛ4 allele is one of the genes to be consistently shown to increase the risk for dementia. Individuals with a PFH of dementia are more often carriers of this allele compared with individuals without a PFH of dementia. Nevertheless, several studies have shown that individuals with a PFH of dementia have an increased risk, independent of their genetic risk.”
— Vrijsen, et al in BMJ Open

• Emotional numbness. I wrote before about how I score as an INTP in Myers Briggs. Unfortunately, people of my personality type may become emotionally numb as a defense mechanism to avoid confronting overwhelming emotions. I believe I am falling victim to this emotional numbness, which can lead to weaker memory encoding and retention, particularly during emotionally-charged situations where I might be feeling flooded.

“Ever feel like you’re spiraling down a path of so much stress and anxiety that your brain takes a sharp left to la-la land? This is a psychological phenomenon known as emotional numbness. It’s something our mind does to help us cope when we’re flooded with big emotions.
…
Emotional numbness is a form of a mental health condition called dissociation. By itself, dissociation isn’t uncommon. Remember the last time you drove to the grocery store and couldn’t remember getting there? That’s a form of dissociation. In fact, if you’ve ever zoned out, lost track of time while reading a good book or daydreamed during your afternoon walk, you’ve experienced a form of dissociation.”
— “A Therapist Explains Why We Shut Down When Flooded with Big Emotions”, UnityPoint Health

I am sure there are even more reasons I could list here as possibilities for memory loss. At a higher level, I have been trying to determine whether these things are all “excuses” or if they are reasons to give myself some “self-empathy.” Either way, I’ve been putting work into all of these items, as I’ve been working to treat my sleep apnea, diabetes, and chronic kidney disease through healthcare. I have been attempting to mitigate the influence of my personal family history through lifestyle changes, including retiring early! To combat episodes of emotional numbness, I’ve been working on myself (admittedly perhaps too much to the point where I got to “therapy burnout.”)

Also, I believe this Substack plays a role toward keeping my mind functioning better. A 2001 post on the American Psychological Association website commented on some research done that same year on the benefit of expressive writing about stressful life events. The concept is that writing helps to simplify and organize fragmented memories, thus freeing cognitive resources for other mental activities and improving working memory.

“The new results hint at a way to short-circuit that destructive process [associated with a stressful event], says co-author Adriel Boals, now a postdoctoral fellow at Duke University. ‘They suggest that at least for fairly minor life problems, something as simple as writing about the problem for 20 minutes can yield important effects not only in terms of physical health and mental health, but also in terms of cognitive abilities,’ he says.”

Thank you for reading this Substack and motivating me to keep writing! Hopefully, writing will serve to improve my working memory!