Self-Efficacy

I recently had the opportunity to teach a brain fitness class for the Osher Lifelong Learning Institute on the Coral Gables campus of the University of Miami. As part of the class, we focused a great deal on memory since that is one of the things people were most interested in.

I had anticipated strong interest in the class, but not as much as we actually had. I had thought perhaps 15-20 people would come to the class the first day, but 60 persons came the first day. As part of their participation, I asked students to complete several questionnaires about how they felt about their memory abilities as well as administered a short memory test. We did the same measures at the end of the class.

A striking finding in previous research is that memory self-efficacy is strongly related to actually memory abilities. This term refers to the extent to which you believe you have control over how your memory works and can cope with challenges. Sure enough, in our Osher class, we found that students’ memory self-efficacy was related to how well they performed on a memory class. That leaves two possibilities: people who have good memories have high levels of memory self-efficacy, or that people with high levels of self-efficacy have good memories.

Which is it? Other studies have shown that people with higher levels of self-efficacy respond better to memory training. I think the chances are that the answer to the question is one or the other, but both. Having memory problems may make you feel less well able to control your memory, but feeling as though you understand and control your memory may make you better able to cope with challenges to your memory.

How can you improve your memory self-efficacy? The short answer is to learn more about how your memory works and develop realistic expectations for yourself about how your memory should work. I like a book called The Memory Workbook by DJ Mason, ML Kohn, and KA Clark (New Harbinger, 2001). The participants in our memory class really liked it, and it includes a number of exercises that you can work through on your own.

Memory and Medications

One of the most important things I do for patients with memory problems isn’t giving them medicines. It’s actually taking them away.
Some common medications, even those that you can buy without a prescription, can have a negative effect on your memory and alertness. And some medicines that are completely safe in younger people have bad effects in older persons. One of the best things you can do for your memory is go over your medications with someone who knows about medicines and how they affect older persons.
Medications that may have a negative effect on memory are those that have anticholinergic effects. They act to decrease the effectiveness of a brain chemical called acetylcholine. Acetylcholine is a brain chemical that is essential in memory. The part of the brain with the most nerve cells that use this chemical is one of the first affected when someone has Alzheimer’s disease.

Probably the most commonly used medication used by older persons that has anticholinergic effects is the antihistamine Benadryl,® It’s a perfectly good medicine, but in its generic form diphenhydramine it’s in many over-the-counter sleep medicines. If you have memory problems and take this medicine regularly, you might want to try stopping it and see how your memory functions without it.
Another group of medications that can affect memory are the benzodiazepines. These are commonly-used medicines for anxiety and sleep such as Xanax,® Ativan,® Klonopin,® and many others. They can affect memory in a different way from diphenhydramine. If you’re taking one of these medicines regularly, it usually isn’t a good idea to stop taking it suddenly. You might want to talk to your doctor about alternative medicines for anxiety and sleep.