What can be done to minimize problems?

Unfortunately memory is not like a muscle which will improve with exercise. Rehearsing chunks of poetry or giving oneself memory tests will certainly not make memory more efficient.

While keeping mentally active is obviously a good idea, this should be through enjoyable activities and normal social interaction, rather than formal memory training. Structured memory exercises may have a role in reassuring the "worried-well" with subjective complaints of memory loss, but memory training tends not to generalize beyond the specific material learned during treatment and merely causes frustration and irritation in patients with dementia.

Maintaining general well-being by continuing with regular valued leisure and social activities and maintaining physical health will all help to provide the optimum environment for memory functioning.

People who are anxious, depressed, stressed or over-tired frequently complain of forgetfulness and the severity of subjective complaints of memory difficulties relates far better to mood than ability. Eat a healthy diet with regular meal times. Exercise regularly. Assure that you put into place the opportunity for adequate amount and quality of sleep.

Try to be well organized, to keep things in the same place and to follow a regular routine is obviously advantageous. Knowing what to expect reduces the demands on memory and planning for change well in advance will minimize disruption. The fear and embarrassment of saying or doing something foolish or of letting someone down and the constant effort of trying to cover up for mistakes can be very wearing.

The associated loss of confidence, anxiety and stress will only make the problem worse and life more difficult. It is nearly always helpful to be honest when the mind goes blank or some detail or name cannot be recalled. Saying something like "I'm afraid my memory is sometimes unreliable and it would help if you could just remind me" will rarely cause irritation and solves the problem promptly and efficiently.

Using external and environmental aids

Most people tend to make use of some memory aids in their everyday life. These generally take the form of external aids such as shopping lists, using a diary, writing a note on your hand, or asking other people to remember things for you. The reason that healthy older people left to their own devices are often more reliable than young at remembering appointments and birthdays is because they make greater use of external cues and reminders.

Make maximum use of prompts, memory aids and other techniques to help retention. All these memory aids reduce the pressure to remember and anxiety about forgetting and enable the individual to get on with life. They are especially valuable for those with age-associated memory impairment or early dementia.

Useful memory aids that might be considered include:

• Using a notebook or memory diary during the day to record new information and act as a source of reminders as to what has happened and what needs to be done.

• Keeping a notepad next to the telephone to immediately write down messages.

• Placing a notice board, wipe-clean memo board or wall calendar in a prominent position at home where it will be seen frequently and can be regularly updated.

• Writing lists of things to do or issues to be discussed, for example before a telephone call is made or an appointment.

• Using brightly colored post it notes as a simple reminder which can be placed in a prominent position or stuck to the subject of concern.

• Carrying important items around, for example having reading glasses on a cord around the neck

• Use of electronic devices such as a electronic organizers and palm pilots that provide on-screen information, timers; etc. can also be of benefit.

• Wearing a watch with an alarm that can be used to sound at a particular time. This may be helpful as a prompt, especially for remembering regular events such as taking medications.

• Use simple tape recorders or hand-held dictation instruments to store information for later reference and to provide prompt s and explanations as to what is to be done.

• Leaving things in special or unusual but readily visable places as reminders to perform a certain task.

To make the most of memory . . .

Make sure that information is clear, simple and relevant. It is a waste of time and effort trying to remember trivial and unimportant information.

Allow sufficient time, minimize distractions and maximize attention. Little and often is likely to be most effective in improving memory. Don’t overload yourself.

Break down information to be learned into smaller pieces and aim to learn one piece at a time. Information can be repeated back out loud, written down, re-read to oneself and reviewed later to assure that it is understood and to help with storage.

Don’t dwell on what has been forgotten or test out your memory. It merely increases frustration and undermines confidence. Accept that some slips of memory are normal.