Back when I lived in Maryland, USA a friend shared a favourite quote from her father who was a family doctor. Practicing in New England for decades, he used to say, “If you hear hooves, don’t think zebra.” That has always stuck with me, and now even more so as many people are worried about memory problems.
We often start forgetting the names of people we have just met, or even those you have known on and off for a long time. How often have you locked the house only to turn back for something you have forgotten? Unfortunately, we have been worried into thinking that every ‘senior moment’ spells doom and the dreaded diagnosis is just a matter of time.
What if we were made aware of the many causes of memory loss? What if we took sensible steps to investigate each of them before panicking (which makes matters worse as stress is a big risk factor for cognitive impairment). In this blog I will pass along research findings about 3 factors associated with memory loss (lockdown, mould & medications) and what to do about them. I end with one fun and simple way to improve memory.
Lockdown
As this was a global event orchestrated in lockstep (some would say nefariously) upon the entire planet, lockdown was and perhaps still is an experience common to many. But now that the evidence has come to light about the harms of this intervention, it is clear that memory loss ranks up there beside depression and loneliness. But let’s take a step back a bit. There was already evidence that depression and loneliness cause problems with memory prior to lockdown.
A recent UK study from a team of scientists at Coventry, Oxford and Cambridge as well as from Shanghai, China utilised data from the UK Biobank of 462,619 people (average age of 57) was published June 8th, 2022, in Neurology. Here is their conclusion:
Social isolation is a risk factor for dementia that is independent of loneliness and many other covariates. Social isolation-related brain structural differences coupled with different molecular functions also support the associations of social isolation with cognition and dementia. Social isolation may thus be an early indicator of an increased risk of dementia. [1]
A study from 2017 of 14,199 Chinese older adults (aged 65+) from the Chinese Longitudinal Healthy Longevity Survey found that:
Loneliness may predict subsequent cognitive decline, and vice versa. This loneliness-cognition relationship is partially explained by their impact on physical health. Multidisciplinary interventions aimed at reducing loneliness and cognitive decline per se and their associated risk factors as well as improving chronic illness management would be beneficial for emotional well-being and cognitive health in OAs. [2]
But did lockdown actually drive cognitive decline? The Alzheimer’s Society in the UK reported a deterioration in 4 out of 5 people with dementia symptoms out of 2,000 surveyed. In terms of published evidence of this harm, research from a team in the USA, Slovenia and Czechia explains:
Recent reports suggest that the COVID-19 lockdown resulted in changes in mental health. We measured COVID-19 lockdown-induced stress levels and the severity of depressive symptoms prior to and during the COVID-19 lockdown in different age groups and then searched for potential risk factors in a well-characterized general population-based sample. A total of 715 participants were tested for mental distress and related risk factors… Longitudinal measurements revealed that the prevalence of moderate to high stress and the severity of depressive symptoms increased 1.4- and 5.5-fold, respectively, during the COVID-19 lockdown.
This surge in mental distress was more severe in women but was present in all age groups with the older age group exhibiting, cross-sectionally, the lowest levels of mental distress prior to and during the lockdown. Illness perception, personality characteristics such as a feeling of loneliness, and several lifestyle components were found to be associated with a significant increase in mental distress.
The observed changes in mental health and the identified potential risk factors underlying these changes provide critical data justifying timely and public emergency-tailored preventive, diagnostic, and therapeutic mental health interventions, which should be integrated into future public health policies globally. [3]
Finally, a systematic review of many studies concluded:
“Lockdowns and confinement measures brought about by the pandemic have damaged the cognitive and psychological health and functional abilities of people with dementia across the world. It is urgent that infection control measures applied to people with dementia are balanced against the principles of non-maleficence.” [4]
These were some of the Key Points:
- Neuropsychiatric symptoms of people with dementia (e.g., anxiety, depressive symptoms, apathy, agitation) were found to worsen during lockdown in the majority of studies.
- Cognitive decline affecting memory, orientation concentration and communication was observed by caregivers within few weeks after lockdown.
- The deterioration reported occurred in a short window of time (between 1 and 4 months) and it is unlikely to be attributable to the natural variation of the course of dementia.
- Increase consumption of antipsychotics and benzodiazepines has occurred in people with dementia during lockdown.
- Evidence indicates that isolation measures quickly damaged people’s with dementia cognitive and mental health and probably accelerated overall decline.
As the harm from lockdowns is clearly implicated in memory problems and also in making these problems worse, the simple solution is this: Lockdowns must never be perpetrated upon the entire population again!
Mould
Practically every house in Britain has some mould somewhere – under the floorboards, behind the plaster, in the cellar. Let’s face it, Ireland is not Belfast-born William Drennan’s ‘Emerald Isle’, and England is not William Blake’s ‘green and pleasant land’ without plenty of rain!
But is it dangerous and why? Mould is a neurotoxin which means it is destructive to developing and mature nerve tissues. Mould can wreak havoc in the brain and spinal cord. Like any risk factor, some people will be more at risk for mould toxicity than other people (similarly to smoking which doesn’t give everybody lung cancer).
An interesting study from Finland found that:
Finland has the highest death rate from dementia in the world and its environmental features can be instructive in understanding hidden causes of dementia. Environmental factors there include:
1) A climate that is both very cold and humid resulting in housing frequently harboring molds that are capable of producing a neurotoxic mycotoxin.
2) The Gulf of Finland as well as Finnish lakes harbor cyanobacteria that produce the neurotoxin, beta-N-methyl amino-L-alanine, known to cause dementia and related disorders.
3) The aforementioned toxins can be potentiated by the presence of mercury and methyl mercury which can be found in Finnish waters.
4) Soil in Finland is naturally low in selenium and selenium deficiency and may reduce the quantity and effectiveness of glutathione’s ability to protect against neurotoxins.
Finland’s high rate of fatal dementia could be the consequence of these environmental factors [3].
Medications
The next time you hear of a prescribed medication being touted as ‘safe and effective’ be wary and check it out for yourself. IF ingredients are known and listed on the packaging, check to see if cognitive impairment or memory problems are listed in the possible side effects. Well-known culprits are proton pump inhibitors (PPIs), metformin and statins.
- Studies have shown that proton pump inhibitors (PPIs) increase the brain burden of amyloid-beta and also create vitamin B12 deficiency. Both phenomena affect cognition and Alzheimer’s disease.
A 2013 study found that PPIs can enhance the production of beta-amyloid proteins, a hallmark of Alzheimer’s. Three years later the JAMA Neurology study of 74,000 Germans over 75 found that regular PPI users had a 44% higher risk of dementia than those not taking PPIs [4].
A study in 2015 on 60 volunteers tested 5 different classes of PPIs with one control group. “We found statistically and clinically significant impairment in visual memory, attention, executive function, and working and planning function. All PPIs had a similar negative impact on cognition.” The study revealed for the first time that “different PPIs have varying degrees of influence on different cognitive domains and have associations with AD.” [5]
Cognitive effects may also be due to polypharmacy by elderly patients. A study of 6 residential care homes in England found that almost 10% of older people with dementia were prescribed 2 or more potentially inappropriate medications, including PPIs and long-lasting benzodiazepines. It is known that long-term use of benzodiazepines might increase dementia risk.
It is necessary to determine the previous cognitive status of patients and whether they have risk factors for dementia, as well as drug interactions. Altogether, it is necessary to consider the risk–benefit of chronic PPI use and establish an adequate therapeutic indication [6, 7].
Furthermore, a 2017 study examining PPI use by first responders of the World Trade Center found an association with severe cognitive impairment. This association was mediated by the severe and chronic stress of responders with post-traumatic stress disorder (PTSD) [8]. In summary, a Harvard blog recommends you consult with your doctor if you currently take PPIs every day or have for more than 18 months to see whether or not you need to continue [9].
- Metformin is prescribed for people with (or at risk for) diabetes. Metformin use in older adults was found to be associated with an increased risk of cognitive dysfunction – poorer cognitive performance, and B-vitamin deficiency may be implicated. Fortified foods can optimize B-vitamin status and may be beneficial for maintaining better cognitive health in older people with or at risk of diabetes [10].
- Statins are routinely prescribed cholesterol-lowering drugs if someone is diagnosed with high cholesterol. (Statins are also one of the most commonly prescribed and most profitable drugs in the world.) The lowering of cholesterol is claimed to prevent heart attacks, yet a Minneapolis Heart Institute Foundation study published in JAMA in 2017 found most major heart attacks happen to people with normal cholesterol levels. The top 5 causes of heart attacks are inflammation, oxidation, sugar, transfats and stress (further reading: The Great Cholesterol Myth by Bowden and Sinatra, and The Great Cholesterol Con by Kendrick).
From a brain health perspective, the brain needs cholesterol, so statins are counterintuitive. Cholesterol is required to make neurotransmitters, chemicals that brain cells use to communicate with each other.
High total cholesterol levels in late life are associated with a reduced risk of dementia [11].
About one in 4 adults take statins and a wide range of adverse effects are claimed. These include depression, aggressiveness, suicidal ideation, erectile dysfunction, exertional fatigue, decreased energy, constipation, muscle aches and pains, and an increased incidence of cancer, diabetes, cataracts, hepatitis and strokes. Dementia-like symptoms often cited are memory loss, learning difficulties and fuzzy thinking.
Studies also recognised that statins could potentially decrease the risk for dementia (but only for certain people) while simultaneously raising the risk for others [12].
Mnemonics
How often do you meet someone new and within seconds you have forgotten their name? This is a very common occurrence for many people if we don’t use some type of mnemonic to help us remember. My rule of thumb is to use the person’s name at least 3 times during that first encounter.
This is not difficult. You meet someone and they tell you their name. Address them by name in your very next sentence. “Nice to meet you Carl… Do you cycle to the café often Carl? I live in Cockerham, what part of Lancashire have you cycled from Carl?” and so on. And be sure to include their name when parting. At the same time while you are speaking to them, create a mental visual that ties their name to some physical feature of them – their clothes, their mode of transport, hair colour… you name it, the possibilities are endless.
I picked this up from Art Linkletter who used his own name as an example. When you think of a string of letters linked together and hovering over his head, you can remember ‘Linkletter’ years later. For this chap Carl who arrived at the café on a bicycle it was easy to see the bicycle wheels as letter “C’’s – one “C” for Carl and the other for meeting him at the Café – in case I bump into him out and about… not literally bump into him as we’d both be cycling!
Search for mnemonics online and find a system that is fun, enjoyable and works for you. I found this website useful: http://www.developgoodhabits.com/mnemonic-devices/ (no affiliation).
Where to go from here and can a Health Coach help?
Lockdowns must never be repeated. Public health measures have been used successfully for decades – isolate and treat the most vulnerable while society carries on with life to reach herd immunity. If you have experienced memory loss in the last few years, consider that it may be lockdown related and you may need to address loneliness, depression and isolation under the care of a holistic practitioner. If needed, a Health Coach can support you in setting and reaching goals.
Mould may be contributing to memory problems. A mould toxicity test can be sought through your practitioner to confirm the types present and initiate a detox protocol. If the mould remediation job is too daunting for you, a removal specialist may need to be called in to help. In extremely toxic situations some people have to get rid of belongings and move house to recover their health. If the whole project feels overwhelming and you could use support, a Health Coach can provide that.
Medications may also be contributing to memory problems. Your practitioner can review your meds and see what can be stopped or reduced. Adopting a healthy active lifestyle around healthy eating and exercise, improved sleep and social interaction can reduce the need for medications. This is where a Health Coach can support you by helping you identify your goals and reach them.
Mnemonics are a sort of brain training. There are numerous ways online to creatively learn various practices to help yourself remember.
Health Coaching is a great way to define your goals and work towards them. So if you learn more easily with goals, structure and encouragement, then a Health Coach can surely help!
We hoped you enjoyed this Dementia Health Coach blog! You can find more blog posts here: http://www.dementiapioneers.wordpress.com
Please subscribe so you don’t miss future blog posts.
Or email dementiapioneers@gmail.com directly for a free consultation!
REFERENCES
[1] Shen C, Rolls E, Cheng W, Kang J, Dong G, Xie C, Zhao X-M, Sahakian B, Feng J (2022) Associations of Social Isolation and Loneliness With Later Dementia. Neurology, 10.1212/WNL.0000000000200583.
[2] Zhong BL, Chen SL, Tu X, Conwell Y (2017) Loneliness and Cognitive Function in Older Adults: Findings From the Chinese Longitudinal Healthy Longevity Survey. J Gerontol B Psychol Sci Soc Sci 72, 120-128.
[3] Eiser AR (2017) Why does Finland have the highest dementia mortality rate? Environmental factors may be generalizable. Brain Research 1671, 14-17.
[4] Gomm W, von Holt K, Thome F, Broich K, Maier W, Fink A, Doblhammer G, Haenisch B (2016) Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis. JAMA Neurol 73, 410-416.
[5] Akter S, Hassan MR, Shahriar M, Akter N, Abbas MG, Bhuiyan MA (2015) Cognitive impact after short-term exposure to different proton pump inhibitors: assessment using CANTAB software. Alzheimers Res Ther 7, 79.
[6] Ortiz-Guerrero G, Amador-Munoz D, Calderon-Ospina CA, Lopez-Fuentes D, Nava Mesa MO (2018) Proton Pump Inhibitors and Dementia: Physiopathological Mechanisms and Clinical Consequences. Neural Plast 2018, 5257285.
[7] Weintraub K (2017) Stomach Upset. Sci Am 316, 22-23.
[8] Clouston SAP, Shapira O, Kotov R, Lei L, Waszczuk M, Bromet EJ, Luft BJ (2017) Proton pump inhibitors and the risk of severe cognitive impairment: The role of posttraumatic stress disorder. Alzheimers Dement (N Y) 3, 579-583.
[9] Solan M (2016) in Harvard Health Blog.
[10] Porter KM, Ward M, Hughes CF, O’Kane M, Hoey L, McCann A, Molloy AM, Cunningham C, Casey M, Tracey F, Strain S, McCarroll K, Laird E, Gallagher AM, McNulty H (2019) Hyperglycemia and metformin use are associated with B-vitamin deficiency and cognitive dysfunction in older adults. J Clin Endocrinol Metab.
[11] Mielke MM, Zandi PP, Sjögren M, Gustafson D, Östling S, Steen B, Skoog I (2005) High total cholesterol levels in late life associated with a reduced risk of dementia. Neurology 64, 1689.
[12] Schultz BG, Patten DK, Berlau DJ (2018) The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms. Transl Neurodegener 7, 5.
Back on track 
Leave a Reply