Memory concern in the age of [too much] information

Neuropsychologist Michael Saling explains that even though concerns about memory function are frequently expressed by generally well people, we probably don't need to worry as much as we do about minor forgetfulness.

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This article originally appeared in Voice, Volume 11 Number 6.
View the original here.

Neuropsychologist Michael Saling explains that even though concerns about memory function are frequently expressed by generally well people, we probably don't need to worry as much as we do about minor forgetfulness.

There is an intense focus on the "dementia epidemic" in the public arena, by experts, as well as the entertainment and publishing industries. While public information is essential, there is a tendency to emphasise the enormity of the issue, leading the public to equate forgetfulness with conditions such as Alzheimer's Disease.

In our outpatients neuropsychology clinics we frequently see cognitively intact people who have experienced a memory glitch or two, and who present with a sometimes intense fear, or even conviction, that they are suffering from a sinister and progressive brain disease.

While it is always important to seek appropriate clinical attention if a person, or a person's significant other, is concerned about his or her memory, it was my aim during a recent lecture to encourage in the general public a more nuanced view of the relationship between forgetfulness and dementia, and to explain why non-pathological forgetfulness is essential for the operation of a normal memory system.

Memory Concerns

Subjective memory concerns expressed by individuals attending an outpatients clinic disclose a variety of experiences of forgetfulness.

These range from a rather unstated and tentative complaint that might have been developed over the past year, to a very outspoken, sometimes even strident, and overgeneralised complaint (such as, I used to have an excellent photographic memory, and now my memory is completely shot) that has emerged in the relatively recent past.

While there are no hard and fast diagnostic rules relating to complaints, the former complaint is more concerning than the latter, although this pattern seems counter-intuitive.

All other things being equal, it is usually the case that very serious memory difficulties tend to produce the faintest of complaints.

So, not all memory complaints signal a memory disorder.

For example, forgetting one's intentions in the very short term ("I walk into a room and I forget what I wanted to do there") are more likely to be caused by preoccupation, multitasking, ruminating about a source of regret, and the like. In other words, the result of an overloaded attentional system.

A phenomenon is the emergence of what I have loosely termed the "workplace memory culture".
When workers admit to forgetfulness in the workplace, this sometimes leads to a focus, by management and/or peers on that worker's "bad memory" as an explanation for organisational failures that might not be the fault of the targeted worker. This can easily evolve to bullying, discrimination, marginalisation, or even threats of job loss. In cases I have seen, the mental health implications for individuals with perfectly normal memory can be serious.

Societal expectations of memory function

Perhaps because of our daily encounters with devices – such as computer hard drives – that have perfect memory retention we have come to believe that our all-too human memory system should behave the same way. This, together, with the explosion of information we are required to deal with (or ignore), has been paralleled by what might well be a form of stress. This stress manifests in a tendency towards an over-awareness ("over-monitoring") of our memory, in which almost any instance of forgetting is taken to be a sign of an impending dementia.

This is often heightened when the individual has a model of memory disorder in mind, such as a relative who might have had a stroke, brain injury, or dementia. Carers working in old age facilities are particularly vulnerable.

While concerns about information overload are not specific to our age, the speed and quantity of the evolution of information in our age is unprecedented. The following quote from neuroscientist Daniel Levitin, best illustrates this:

"Since 1986, the amount of information we absorb has increased fivefold and our options for getting more have become almost limitless. All this choice and access to data might seem like a luxury of contemporary life – and in some ways it is – but recent neuroscience studies have shown it's making our brains work overtime. As it turns out, we aren't just bad at multitasking, we're not equipped for it at all. In fact, we're just switching between tasks, which uses up neural resources that would otherwise go towards actual problem-solving." (Daniel Levitin, thersa.org)

Can our ancient brain cope?

The human brain in its present form emerged between 200,000 and 130,000 years ago. Our brains have 85 billion neurons and 100 trillion interconnections.

While we have an unlimited capacity to store a lifetime of experiences, the pre-processing system (working memory) that determines what we remember from moment to moment, and therefore what we retain in the long-term, has a very limited capacity. It also allows us to focus on one thing at a time.
This limitation has long been a puzzle for neuroscience, but lies at the heart of Levitin's contention that we cannot multi-task. It also leads to situations in which the working memory system is easily overloaded, dramatically reducing our ability to focus on to-be-remembered events and thoughts.
Depression, anxiety, pre-occupation, and distraction are the commonest causes of overload, and therefore the commonest causes of forgetfulness.

In other words, you could say our working memory limitations, and our resulting tendency to forget in normal life, confer on humans a unique capacity for flexible and complex cognition.

Professor Michael Saling AM is an international expert in memory and language function in epilepsy and Alzheimer's disease. He is Director of the University's Postgraduate Program in Clinical Neuropsychology, and Director of Neuropsychology at Austin Health. He is a Senior Neuropsychological Consultant in the Comprehensive Epilepsy Program at Austin Health, and an Honorary Professorial Fellow at the Florey Institute for Neuroscience and Mental Health.
psychologicalsciences.unimelb.edu.au/

www.austin.org.au
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