Memory, Cognition, Dementia

Memory is the process in which information is encoded ( registered) , stored and retrieved.

Brain areas involved in the neuroanatomy of memory are the hippocampus , striatum, mammillary bodies.

Disorders of memory  and treatment

Loss of memory is known as amnesia. Amnesia can result from extensive damage to : (a) the regions of medial temporal lobe, or ( b) midline diencephalic structures, specifically the dorsomedial nucleus of the thalamus & the mammillary bodies of the hypothalamus.

Many diseases like Alzheimer’s disease, Parkinson’s disease, vascular dementia, head injury, chronic subdural hematoma, Wernicke encephalopathy ( alcoholism ), Brain tumors can  affect the memory in a person who were otherwise normal before the onset of the disease . There are certain other diseases which affect the memory like Pick’s disease, CJD, H. Chorea, Wilson’s disease.
There are many drugs like piracetam, citicholine,  vitamine E, Cyanocobalmine , Methylcobalamine, folic acid, alpha lipoic acid, omega fatty acids, cerebroprotein lysate, galantamer, Memantine, etc which help in improving cognition and neuroprotection.
Cholinesterase inhibitors are used in the treatment of Alzheimer's disease ( Donepezil).

Even an old patient presents with a triad of symptoms: Dementia ( diminished memory/ cognitive impairment), Gait disturbance [difficulty in walking (Gait apraxia means inability to walk inspite of normal power in both the lower limbs)], urinary incontinence. Then CT scan or MRI of the brain should be advised which may reveal the diagnosis of Normal Pressure Hydrocephalus (NPH). The treatment of NPH is neurosurgery in the form of theco-peritoneal shunt or Low Pressure Ventriculo-peritoneal shunt. Low pressure ventriculoperitoneal shunt surgery improves memory in patients with normal pressure hydrocephalus (NPH).
Another cause of dementia which can be treated surgically is Chronic subdural hematoma (Chronic SDH). Bur hole evacuation of the hematoma is the treatment for chronic SDH.

Neurosurgical evacuation of chronic subdural hematoma improves the memory in a chronic SDH patient. 
Neurosurgical interventions like cartid endarterectomy ( CEA) or neurointervention like carotid stenting can help in treating vascular dementia due to carotid artery stenosis.
Moya moya disease may also present with dementia and it can be treated with neurosurgery.
Recently, neurosurgical intervention like Deep brain stimulation ( DBS ) has been reported to treat the dementia.Deep brain stimulation uses a technique in whch microelectrodes are introduced deep inside the brain to stimulate Nucleus basalis of Meynert, Fornix and entorhinal cortex in Alzheimer's disease. 
 In some cases, the Dural arteriovenous fistula ( AVF) can cause dementia. Dural AVFs are vascular malformations and in the past surgical obliteration was the treatment of choice but now a days endovascular embolization has become the first line treatment.
Stem cell transplantation is an avenue of research in treatment of Huntington chorea.

How to improve memory?

As in common  practice  rote learning , intense memorization, repetition and concentration are the ways to enhance memory. There are many other factors which influence memory.

A very useful link with details of how to improve memory:

http://www.helpguide.org/life/improving_memory

The human brain has an astonishing ability to adapt and change—even into old age. This ability is known as neuroplasticity. With the right stimulation, your brain can form new neural pathways, alter existing connections, and adapt and react in ever-changing ways.

Exercise increases oxygen to your brain and reduces the risk for disorders that lead to memory loss, such as diabetes and cardiovascular disease. Exercise may also enhance the effects of helpful brain chemicals and protect brain cells.

When you’re sleep deprived, your brain can’t operate at full capacity. Sleep is necessary for memory consolidation, with the key memory-enhancing activity occurring during the deepest stages of sleep.

Active social life , healthy social interactions , playful activities.

You’ve heard that laughter is the best medicine, and that holds true for the brain as well as the body. Unlike emotional responses, which are limited to specific areas of the brain, laughter engages multiple regions across the whole brain.

Stress is one of the brain’s worst enemies. Over time, if left unchecked stress destroys brain cells and damages the hippocampus, the region of the brain involved in the formation of new memories and the retrieval of old ones.

Meditation helps improve many different types of conditions, including depression, anxiety, chronic pain, diabetes, and high blood pressure. Meditation also can improve focus, concentration, creativity, and learning and reasoning skills.

In addition to stress, depression, anxiety, and chronic worrying can also take a heavy toll on the brain. In fact, some of the symptoms of depression and anxiety include difficulty concentrating, making decisions, and remembering things. If you are mentally sluggish because of depression or anxiety, dealing with the problem will make a big difference in your cognitive abilities, including memory.

Just as the body needs fuel, so does the brain. You probably already know that a diet based on fruits, vegetables, whole grains, “healthy” fats (such as olive oil, nuts, fish) and lean protein will provide lots of health benefits, but such a diet can also improve memory. But for brain health, it’s not just what you eat—it’s also what you don’t eat. The following nutritional tips will help boost your brainpower and reduce your risk of dementia:

• Get your omega-3s. More and more evidence indicates that omega-3 fatty acids are particularly beneficial for brain health. Fish is a particularly rich source of omega-3, especially cold water “fatty fish” such as salmon, tuna, halibut, trout, mackerel, sardines, and herring. In addition to boosting brainpower, eating fish may also lower your risk of developing Alzheimer’s disease. If you’re not a fan of seafood, consider non-fish sources of omega-3s such as walnuts, ground flaxseed, flaxseed oil, winter squash, kidney and pinto beans, spinach, broccoli, pumpkin seeds, and soybeans.
• Limit calories and saturated fat. Research shows that diets high in saturated fat (from sources such as red meat, whole milk, butter, cheese, sour cream, and ice cream) increase your risk of dementia and impair concentration and memory.
• Eat more fruit and vegetables. Produce is packed with antioxidants, substances that protect your brain cells from damage. Colorful fruits and vegetables are particularly good antioxidant "superfood" sources. Try leafy green vegetables such as spinach, broccoli, romaine lettuce, Swiss chard, and arugula, and fruit such as bananas, apricots, mangoes, cantaloupe, and watermelon.
• Drink green tea. Green tea contains polyphenols, powerful antioxidants that protect against free radicals that can damage brain cells. Among many other benefits, regular consumption of green tea may enhance memory and mental alertness and slow brain aging.
• Drink wine (or grape juice) in moderation. Keeping your alcohol consumption in check is key, since alcohol kills brain cells. But in moderation (around 1 glass a day for women; 2 for men), alcohol may actually improve memory and cognition. Red wine appears to be the best option, as it is rich in resveratrol, a flavonoid that boosts blood flow in the brain and reduces the risk of Alzheimer’s disease. Other resveratrol-packed options include grape juice, cranberry juice, fresh grapes and berries, and peanuts.

For mental energy, choose complex carbohydrates

Just as a racecar needs gas, your brain needs fuel to perform at its best. When you need to be at the top of your mental game, carbohydrates can keep you going. But the type of carbs you choose makes all the difference. Carbohydrates fuel your brain, but simple carbs (sugar, white bread, refined grains) give a quick boost followed by an equally rapid crash. There is also evidence to suggest that diets high in simple carbs can greatly increase the risk for cognitive impairment in older adults. For healthy energy that lasts, choose complex carbohydrates such as whole-wheat bread, brown rice, oatmeal, high-fiber cereal, lentils, and whole beans. Avoid processed foods and limit starches (potato, pasta, rice) to no more than one quarter of your plate.

Give your brain a workout

By the time you’ve reached adulthood, your brain has developed millions of neural pathways that help you process information quickly, solve familiar problems, and execute familiar tasks with a minimum of mental effort. But if you always stick to these well-worn paths, you aren’t giving your brain the stimulation it needs to keep growing and developing. You have to shake things up from time to time! Try taking a new route home from work or the grocery store, visiting new places at the weekend, or reading different kinds of books

Memory, like muscular strength, requires you to “use it or lose it.” The more you work out your brain, the better you’ll be able to process and remember information. The best brain exercising activities break your routine and challenge you to use and develop new brain pathways. Activities that require using your hands are a great way to exercise your brain. Playing a musical instrument, juggling, enjoying a game of ping pong (table tennis), making pottery, knitting, or needlework are activities that exercise the brain by challenging hand-eye coordination, spatial-temporal reasoning, and creativity.

The brain exercising activity you choose can be virtually anything, so long as it meets the following three criteria:

1. It’s new. No matter how intellectually demanding the activity, if it’s something you’re already good at, it’s not a good brain exercise. The activity needs to be something that’s unfamiliar and out of your comfort zone.
2. It’s challenging. Anything that takes some mental effort and expands your knowledge will work. Examples include learning a new language, instrument, or sport, or tackling a challenging crossword or Sudoku puzzle.
3. It’s fun. Physical and emotional enjoyment is important in the brain’s learning process. The more interested and engaged you are in the activity, the more likely you’ll be to continue doing it and the greater the benefits you’ll experience. The activity should be challenging, yes, it should also be something that is fun and enjoyable to you. Make an activity more pleasurable by appealing to your senses—playing music while you do it, or rewarding yourself afterwards with a favorite treat, for example.

Use mnemonic devices to make memorization easier

Mnemonics are clues of any kind that help us remember something, usually by helping us associate the information we want to remember with a visual image, a sentence, or a word.

Mnemonic device	Example
Visual image – Associate a visual image with a word or name to help you remember them better. Positive, pleasant images that are vivid, colorful, and three-dimensional will be easier to remember.	To remember the name Rosa Parks and what she’s known for, picture a woman sitting on a park bench surrounded by roses, waiting as her bus pulls up.
Acrostic (or sentence) - Make up a sentence in which the first letter of each word is part of or represents the initial of what you want to remember.	The sentence “Every good boy does fine” to memorize the lines of the treble clef, representing the notes E, G, B, D, and F.
Acronym – An acronym is a word that is made up by taking the first letters of all the key words or ideas you need to remember and creating a new word out of them.	The word “HOMES” to remember the names of the Great Lakes: Huron, Ontario, Michigan, Erie, and Superior.
Rhymes and alliteration - Rhymes, alliteration (a repeating sound or syllable), and even jokes are a memorable way to remember more mundane facts and figures.	The rhyme “Thirty days hath September, April, June, and November” to remember the months of the year with only 30 days in them.
Chunking – Chunking breaks a long list of numbers or other types of information into smaller, more manageable chunks.	Remembering a 10-digit phone number by breaking it down into three sets of numbers: 555-867-5309 (as opposed to5558675309).
Method of loci – Imagine placing the items you want to remember along a route you know well or in specific locations in a familiar room or building.	For a shopping list, imagine bananas in the entryway to your home, a puddle of milk in the middle of the sofa, eggs going up the stairs, and bread on your bed.

6 Mnemonic devices
Visual image - Associate a visual image with a word or name to help you remember them better. Positive, pleasant images that are vivid, colorful, and three-dimensional will be easier to remember. Example: To remember the name Rosa Parks and what she’s known for, picture a woman sitting on a park bench surrounded by roses, waiting as her bus pulls up.
Acrostic (or sentence) - Make up a sentencein which the first letter of each word is part of or represents the initial of what you want to remember. Example: The sentence “Every good boy does fine” to memorize the lines of the treble clef, representing the notes E, G, B, D, and F.
Acronym - An acronym is a word that is made up by taking the first letters of all the key words or ideas you need to remember and creating a new word out of them. Example: The word “HOMES” to remember the names of the Great Lakes: Huron, Ontario, Michigan, Erie, and Superior.
Rhymes and alliteration - Rhymes, alliteration (a repeating sound or syllable), and even jokes are a memorable way to remember more mundane facts and figures. Example: The rhyme “Thirty days hath September, April, June, and November” to remember the months of the year with only 30 days in them.
Chunking - Chunking breaks a long list of numbers or other types of information into smaller, more manageable chunks. Example: Remembering a 10-digit phone number by breaking it down into three sets of numbers: 555-867-5309 (as opposed to5558675309).
Method of loci - Imagine placing the items you want to remember along a route you know well or in specific locations in a familiar room or building. Example: For a shopping list, imagine bananas in the entryway to your home, a puddle of milk in the middle of the sofa, eggs going up the stairs, and bread on your bed.

Tips for enhancing your ability to learn and remember

• Pay attention. You can’t remember something if you never learned it, and you can’t learn something—that is, encode it into your brain—if you don’t pay enough attention to it. It takes about eight seconds of intense focus to process a piece of information into your memory. If you’re easily distracted, pick a quiet place where you won’t be interrupted.
• Involve as many senses as possible. Try to relate information to colors, textures, smells, and tastes. The physical act of rewriting information can help imprint it onto your brain. Even if you’re a visual learner, read out loud what you want to remember. If you can recite it rhythmically, even better.
• Relate information to what you already know. Connect new data to information you already remember, whether it’s new material that builds on previous knowledge, or something as simple as an address of someone who lives on a street where you already know someone.
• For more complex material, focus on understanding basic ideas rather than memorizing isolated details. Practice explaining the ideas to someone else in your own words.
• Rehearse information you’ve already learned. Review what you’ve learned the same day you learn it, and at intervals thereafter. This “spaced rehearsal” is more effective than cramming, especially for retaining what you’ve learned.

GET RID OF BAD MEMORIES

Get rid of bad memories in order to create space for memories of pleasant experiences in future. Is it really  possible for somebody to selectively delete the scars of the past bad experiences?

Forgiveness, Yoga, a positive approach, an optimistic attitude are definitely helpful in fading the scars of the past memories. 

A frequent exposure to bad situations may further deteriorate the situation, so if possible, one should avoid the repetition of past  unpleasant situations. A fresh and novice place or circumstance is like a blank page where one can write an entirely new beautiful story.

Deliberately avoiding of a particular fact is not a lie. If someone wants not to tell the truth then he or she is not a coward. Many truths may be eternal and like rule of thumb like any person who takes birth will die one day. In fact, we all will die sooner or later, but biggest pleasure is thinking about the life. By deliberately avoiding this fact that death is certain, it is easy to do things positively and help in creating good life experiences like pleasures of wealth, health, knowledge , charity, etc.

Distancing from the bad event also helps to delete the past bad memory. It helps somebody to heal. The distancing may in terms of place, person or time. Time is the biggest healer. As time passes the agony of the trauma gradually subsides. Similarly , if you remain away from a person associated with a  bad memory, gradually the bad memory fades and it will not trouble you. And, definitely the pleasant experiences will overshadow it.

Your attitude makes the difference. Same event affects the different person differently depending on their attitude.  For a  positive person, failure is an opportunity to take rest, review , learn and then again pursue with extra and renewed vigour and achieve extraordinary success by learning from mistakes. For that person the bad memory is just like a warning signage. And, that person is fully aware of the situation and becomes the only solver of that ugly situation. So, he or she becomes the role model for the people who are facing that problem in their life or business.

Self belief , trust yourself and trust someone else . Love yourself and love somebody else also. Everybody is not same. If you have been harmed donot harm others. Negativity is perpetual it means that to become a negative person you need not to make effort. It is like decay. But to become a positive and lovable  person you have to make lot of effort. Be happy, love being happy , believe in positivity like non-violence, charity, education, faith, and compassion. Gradually you will get reward of your actions and you will be in the company of good people with positive attitude and you will need not to make lot of efforts for remaining nice.

Many persons with  violent  and aggressive childhood  have changed themselves in amazing sportpersons, especially boxers. This phenomenon is is called sublimation. 

As a human being we are albeit different from other animals in terms of intellect , memory and ability to adopt.

I personally feel that all of us suffer from selective dementia. I am using this term for the first time as my own hypothesis. As we ignore certain learned activies or we do not want to learn then it becomes gradually difficult  and almost impossible to recall. For example, if someone ignores learning music or stops practicing mathematics then it becomes more difficult to do such things in later stage of life. It starts as a voluntary activity ,i.e., deliberately ignoring or avoiding and later it becomes unvoluntary action. In the similar way if somebody will ignore a bad experience it will gradually  just remain as a small piece of information placed in the recycle bin of the large capacity software of the brain.

Some people tackle the problem head-on. Take  the bull by the horns. Face the problem straightway and  win over it . No longer ashamed of what happened to them. Not allowing the incidence affect their performance. Tell the world the real truth and put off the burden off their head. I observe that it is a very common phenomenon in the society. Most of the  leaders and role models of the society had sooner or later realized that they were not the only one who had such problem in the past. Getting strength to tell the truth automatically end the fear. A coward and fearful person immediately becomes a role model and lot of people start relating with these iconic personalities . Many people start admiring these  heros. A stigma becomes an opportunity to lead. World is full of such examples. Many high achievers never mince words in expressing their hardship and bad experience in the past.

Sources:

http://www.helpguide.org/life/improving_memory

Wikipedia