The members of the class are interested in my presentation, and we’ve done several exercises to help them learn more about what they can do to maintain and improve their memory.

Nothing is more helpful than understanding how your memory works, and probably the most critical issue for older persons and their memory is attention. Although it’s obvious (once you think about it), if you don’t pay attention to something, you can’t remember it.

Even the most commons memory complaints I hear from patients are often related to memory. The number one complaint is “I went in to another room to get something and forgot why I was there.” Whenever I mention this, I see lots of nods of recognition in the audience.

For many people, this issue is caused by failing to maintain attention on a specific task. While you’re going to the other room, your mind moves on to another topic (maybe you notice something else you’ve been meaning to do). By the time you get to the other room, you’ve lost the task you were thinking about in the first place.

The solution is to maintain focus on what you want to do, at least until you’ve been able to encode the task in your memory. This means keeping the task in mind while you go to the other room or rehearsing it several times before you move to the new room.

When we’re younger, we can depend on some things in our memory working automatically. As we get older, things that used to work automatically may require a little extra attention. Often, it’s not your memory that isn’t working, it’s how you’re paying attention.

As it turns out, there are two major explanations, and both may be partly right.

The first and most common explanation is based on an idea called cognitive reserve. The idea behind this is that Alzheimer’s is diagnosed when someone has clearly developed memory problems as well as problems in some other areas of mental or personal functioning. People with higher levels of education probably function at somewhat higher levels in memory and other cognitive domains. The distance between where they start and the point at which they have recognizable decline is greater than for people whose baseline isn’t quite as high. When their functioning declines, it takes longer for them to reach the point where doctors will say they have Alzheimer’s.

The second explanation is, I think, more interesting because it gives us a direction to go in trying to prevent Alzheimer’s disease and maybe cognitive decline more generally. People with higher levels of education may also be more intellectually active as they get older. We know that what kinds of things people do on an everyday basis is related to how likely it is that they’ll get Alzheimer’s. People who have active social lives and spend time doing intellectually challenging things are less likely to get Alzheimer’s. And people with higher levels of education may do more of these things.

This raises the question of which comes first. Is that people with more education do things that make it less likely that they’ll get Alzheimer’s, or is that people who are less likely to get Alzheimer’s like to do intellectually stimulating activities. Since most of the research is done in a way that won’t less us decide which causes which, this question is still not answered completely. We do know, however, that certain kinds of mentally stimulating activities (as well as improved physical fitness) make changes in the brain. These changes in the brain are the kind of things that should improve people’s abilities, and decrease their chances for developing Alzheimer’s disease.

Does this mean that if you don’t have a high school diploma, a college degree, or a graduate education that you’re doomed to get Alzheimer’s? Nope. If you look closely at almost any of the risk factor studies, the actual change in risk for Alzheimer’s disease is fairly small, even if it’s statistically significant. It does mean that if you’re looking to do something to reduce your risk of Alzheimer’s, following a brain fitness program might be able to reduce your chances of getting memory or other cognitive problems.