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RADIO 4 SCIENCE TRANSCRIPTS
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CHECK UP
Thursday 2 December 2004, 3.00-3.30pm
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BRITISH BROADCASTING CORPORATION


RADIO SCIENCE UNIT



CHECK UP 2. - Memory



RADIO 4



THURSDAY 02/12/04 1500-1530



PRESENTER:

BARBARA MYERS



CONTRIBUTORS:

ROY JONES



PRODUCER:
ANNA BUCKLEY


NOT CHECKED AS BROADCAST




MYERS

Hello. Well is there anybody out there who hasn't popped upstairs to fetch something only to come back empty handed - no idea what you went for? Well that's bad enough but what if you're really struggling with names, telephone numbers, dates, words - things that should be on the tip of your tongue? Is it part of the ageing process? Is it a consequence of physical or emotional problems - neither drinking nor depression helps you remember things very clearly. Mini strokes and thyroid problems can also play havoc with memory. Or do you worry that it could be the onset of dementia? Doctors take memory loss seriously, there are now memory clinics across the country where you can go for an assessment. Hopefully you'll be reassured that you're not losing it. You may be diagnosed with what's called mild cognitive impairment and given advice about coping strategies. And if it is something more serious then there are drugs which can at least delay symptoms.



So if you have concerns about losing your memory or if you've found ways round your failing memory do call us now - 08700 100 444 or e-mail checkup@bbc.co.uk.



And here with me to answer your questions today is Professor Roy Jones. He's director of the Research Institute for the Elderly and is connected with a memory clinic in Bath. Let's go to our first call because we've got a lot of people waiting to talk to you Roy. And the first caller is Carol, Carol's in Aldershot. Hello Carol.



CAROL
Hello there.



MYERS
And your question please.



CAROL
Right well I've been up until the beginning of last year I've been working sort of most of my working life and been coping fairly well I suppose really but having to make lots and lots of notes about what I'm doing. But I am on medication for chronic back pain and I take an awful lot of these tablets - the next stage, just so you know the strength, the next stage is morphine. So they are fairly strong. And I'm wondering if that has any effect on my memory loss. I forget when I'm a conversation, I forget words that should be, as you say, on the tip of your tongue, dates, when all my family are with me my - our daughters and grandchildren - I get the names all muddled up. And I'm not - well I'm 60 at Christmas so I'm - I don't think I'm very old yet and this has been going on for some time - well a long time now and I'm really wondering what I can do. And I am really, really worried about getting dementia.



MYERS
Okay, well you put a very clear story there, let's put you over to the professor, what would you say to Carol?



JONES
Good afternoon Carol.



CAROL
Hello there.



JONES
Well the first thing to say is that if you have a painful condition then there's no doubt that pain itself can affect things like concentration and how well you are able to sort of take in information. So the actual condition for which you're taking the tablets might be one of the reasons that you're finding it harder to remember. Particularly if it's been going on for a long time, that may well be one of the issues. In terms of the drug treatments - drugs can very often have an effect on memory, now rather interestingly some of the drugs that are used to treat conditions like back pain and arthritis, there is actually some evidence they may help prevent people getting Alzheimer's disease and other types of dementia. The more significant drugs, that you mentioned, that are related to morphine and as you say you may be moving on to morphine if the pain continues, they certainly can have an effect on things like concentration - they can make you a little bit sleepy, for example, as well.



CAROL
That's one of my problems.



JONES
Is it okay. Well that may be part of the problem. I think the other thing is that you implied your memory's not been very good for a long time and so in a sense I wouldn't be so worried that you're developing a dementia if it's a longstanding problem. We're more worried about people whose memory has changed over the recent time and is getting worse. But I think you might find that you can look at and trying to find strategies to help you remember and as I mentioned concentration is so important, so that you need to really - for remembering names and things like that you need to try and concentrate very hard on what you're trying to do - try and link the name to some other aspect to try and help prompt your memory so that things like written information if you can turn it into a visual image as well you're using all sides of your brain. So there are things that you can do but undoubtedly drugs for things like pain and arthritis can have an impact as can some other drug therapies but in your case I doubt whether it's actually causing the memory problem per se.



MYERS
Thank you Carol, I hope you found that reassuring and I guess a lot of people do get muddled up with their children's names, never mind grandchildren's names and so there's a lesson there perhaps for everyone to take - take more notice as it were and commit things to memory. But if I'm not wrong, there may be a slight underlying question there about whether if you have memory loss, whatever the reason, whether you're going to be a candidate for dementia - you're going to end up with Alzheimer's. Is there any reason to think that way?



JONES
Yes I think as we get older there are changes in our memory and we all notice this and common things, as you say, like remembering names - the what we call tip of the tongue experiences where we can't actually remember something but we haven't actually forgotten it, it's just we can't bring it to mind when we want it there. And these are sort of things that we all notice if we're leading busy stressed lives and our concentration is poor - that's another reason why we may have problems. The difference between these minor problems, which are still irritating and frustrating, and dementia is, that it is a change in someone when they're developing a memory problem that's the beginning of a dementia - it's progressing, it will go on getting worse over time. It starts to interfere a lot with everyday life so that the person may have problems with practical issues - carrying out everyday functions, dealing with their finances - it starts to have an impact in other ways. And dementia isn't just a memory problem, it's more than a memory problem.



MYERS
Thank you. Let's take another call. Sylvia David is waiting to speak us, she's in Edgware. Hello?



DAVID
Hello.



MYERS
And your question please Sylvia.



DAVID
Good afternoon. Yes my question is that I read in many - particularly health -magazines that there are drugs you can take to improve your memory and one particularly comes up very often, I think it's called coenzyme.



MYERS
Okay these are things you can buy across the chemist's counter in other words. And to improve you mean sharpen up not really to cope with serious memory loss?



DAVID
Yes not for serious memory loss but to perhaps stave off memory loss, I don't know.



MYERS
Have you been tempted to try something like this?



DAVID
Occasionally yes, my memory has deteriorated, I can still function properly.



MYERS
Okay, well are they worth taking - are they worth buying?



JONES
It's quite a difficult question to answer that. We expect for drugs that are given out on prescription very precise studies that go on over many years and the drug companies for example have to satisfy a whole number of hoops before they're allowed to have those drugs available on prescription for things like Alzheimer's Disease. And there are a lot of other health related things, you mention Coenzyme Q, there's also one that's very commonly taken called Ginko - Ginko Biloba, vitamin E and the evidence for these products is less convincing. In some ways there is some evidence, certainly for Ginko for example and vitamin E, that they may actually have some benefit but it's not as strong as the evidence for the prescription drugs and that's partly because it's quite hard to do the research studies to do that. I always get concerned with people spending a lot of money on all these vitamin related products, without there really being convincing evidence and the general thing I think is that some of them are relatively harmless, not all of them, and things like vitamin E, for example, probably doesn't do any harm and it helps your heart and other things like that. So that there may be a place for taking those products but in general I'm fairly cautious about the non-prescription drugs.



DAVID
Could I quickly ask about diet?



MYERS
Ah I'm glad you did because I was going to.



JONES
Okay well diet - there's a lot of interesting information coming about diet and I think the general phrase that we're now all using is to say that what's good for your heart is good for your brain. So that if you have a healthy diet with plenty of vitamins, oily fish, the good news is alcohol but only in moderate amounts seems to be good for the brain, which I'm encouraged by. And so a good healthy diet that is, as I say, is the sort of diet people recommend for good health with heart disease would also be good for your brain. So I think that's where I would look to try and look at things rather than things like Coenzyme Q.



MYERS
Okay, thank you very much, I hope that's helpful. Let's go on to another call. Aylesbury now and we've got Edith Westwood, hello.



WESTWOOD
Oh hello. I was diagnosed with underactive thyroid some five years ago and take 75 micrograms of thyroxin each morning. I'm 57 and have had an increasingly worse memory since my early 30s, but recently, in about the last year, I'm finding that even everyday words and the names of things are getting harder to recall. Do you think it could be - sorry - do you think it could be my thyroid or should I try and get a higher dosage of thyroxin from my doctor? I was tested in the summer and was told I didn't need to increase my dosage.



JONES
Okay that's a very good question and there is undoubtedly a link between an underactive and probably an overactive thyroid gland and memory. And we've known that for quite a long time. And obviously as you're well aware it has other important effects on your general health, so it is very important that your thyroid is working correctly. Now if your doctor is checking up on the dose that you're taking then probably you're on the right dose for you, particularly if things like your weight is reasonably steady. But if you're worried about it then certainly I would go back and see your doctor. If the thyroid gland is controlled - in other words you're taking the right dose of thyroxin - then I wouldn't expect that on its own to affect your memory any further. And you mention your memory's been bad since your 30s but you feel it's worse now and I think if you feel it has changed in the last months or ...



WESTWOOD
The last year or so I'm finding more difficulty with just everyday words really.



JONES
Well as I mentioned earlier there is a change as we get older and sometimes words is one of the particular things people find a problem with. But as I say if you are concerned then I think it is worth seeing your family doctor and just asking if you can have your memory assessed and if you can have it checked because it's important to pick up on it and there are other medical causes for memory problems and if it has changed it's important to try and check whether it's due to anything more serious.



MYERS
Hope that helps Edith and not necessarily suggesting this would apply but as women get older they go through the menopause of course, I wonder if hormonal changes, perhaps in the 50s, would make a difference to memory?



JONES
Yes I think all sorts of things that affect both physical factors and psychological factors can affect things like your concentration, you may be depressed and other things that can interfere and those things can have an effect on memory. Interestingly we know that oestrogen is quite important in the brain and in how the brain functions so that there has been a lot of interest about what happens to women at the menopause when the oestrogen stimulus goes and there's been a lot of research to try and look, for example, whether HRT either prevents you getting Alzheimer's Disease and other dementias or whether it might be useful for treatment for women with Alzheimer's Disease. The jury's still out on the questions and the more recent figures certainly suggest - the more recent study that was done in the United States has suggested that probably HRT isn't necessarily a good treatment for women with Alzheimer's Disease. But I think there are so many changes going on in the body at the time of the menopause that it's not surprising when things like memory and concentration are affected.



MYERS
And having gone through the menopause might you find that you recover some of your good memory function?



JONES
Yes I think that's quite likely, although then you've got the impact of ageing on that as well but yes it shouldn't be a permanent - and it shouldn't be a progressive change, I think that's the important factor.



MYERS
Another caller now - Janet White, hello Janet.



WHITE
Hello, good afternoon.



MYERS
Would you put your question please to the professor?



WHITE
Yes. I wonder if there's a drug that can be given to help stop constant crying and screaming of my mother who's in the late stages of dementia?



JONES
Right, well that's a very difficult question in terms of the degree of stress that I'm sure that does cause you and it's unfortunately not uncommon for people with the later stages of dementia to have quite disturbing behavioural problems and to cause a huge amount of stress to their families and it can be extremely difficult for you. The drugs that are available for the treatment of earlier Alzheimer's Disease may sometimes be of help in some of the behavioural disturbances and crying and agitation that sometimes people have and there are other drugs that can be used. But actually if it's possible it's always better to try and avoid drugs under these circumstances and try and look at other reasons and I'm sure you have tried to do this but I think it's a question of trying to see if you can understand why your mother's crying - is it because she's feeling insecure, because she's nervous about something?



WHITE
Well she's in a home, she's been in it for six years with wonderful care, absolutely wonderful but it's not a definite pattern but a slight pattern - she's calm in the morning, then about lunchtime it starts and it goes on for hours and hours and they've tried everything.



MYERS
Very distressing, alright. Could I bring another caller in - not to put you off Janet so stay with us - but Beatrice joins us from Bath and I believe Beatrice you do work in a home with people with dementia, I don't know if you heard Janet's point and whether this is something that is a familiar pattern to you and whether there are ways that you can see to help people in this situation.



BEATRICE
Yes I don't actually work in a home, I work with residential and nursing homes to help with some of the problems which arise. This would be the sort of problem we might get referred to us. And an idea that's been tried is sitting and massaging the person's hands with aromatherapy oils ...



WHITE
Yes I've done it.



BEATRICE
Did it help at all?



WHITE
No, myself and the home have tried absolutely everything - absolutely everything.



MYERS
But you'd say Beatrice that it does indeed help some people?



BEATRICE
It helps some people - just talking to them, even if they can't respond and sometimes playing a tape of a family conversation can help to soothe people. A lot of people with dementia are actually in pain but of course they can't say they're in pain, so it might be worth checking - having her very thoroughly checked to see if there's any cause.



WHITE
I think they've done all that.



BEATRICE
Oh right.



JONES
I think the other thing that you describe which is actually very common is this issue about it getting worse as the day goes on - in America they call it the sundown syndrome and some of that is related to the fact that as the day goes on the person gets a bit tired, also as it gets darker often they lose some of the cues that they would otherwise get. So it is actually quite common for it to get worse towards the end of the day. But it is a difficult issue to deal with.



WHITE
Could I just say something else? With all the publicity on drugs and many being over drugged I wonder if it could have the other side of the coin for my mother, you know.



JONES
Sorry is she taking drugs?



WHITE
Yes she is, she's on drugs. I really - and my family - would rather see her more drugged than have all this because it's horrendous.



JONES
Yes it is very difficult to get the balance right and for example the drugs that we use actually to treat the memory related problems of people with dementia and Alzheimer's Disease, some of those do actually have an effect on what we call agitation and the kind of distress that you're describing. There are other drugs that are more specifically designed to damp down the agitation but increasingly we're wary about using those on people because of the negative effects. But it is a difficult balance and I think it's - without knowing the exact drugs and the details it's hard to deal with it but unfortunately there are one or two patients where it's very difficult to find the right combination. The only thing I can say is that maybe things do change with the way people are - this is a changing situation and it may be that although this has been very distressing for you now that in weeks to come you'll find that suddenly it does change and it's no longer a problem and I think that's something to hope for.



WHITE
I hope so because it's been over a year, the constant ...



MYERS
Janet you have our sympathy obviously, it's a very difficult situation for you, thank you at least for sharing it with us and indeed for Beatrice joining in. And in a way that the sort of thing that's going to scare people because that is late on in Alzheimer's Disease and the sort of thing that people do worry about. I wonder if you've got a thought for Virginia who's e-mailed us saying that her father has this week been diagnosed with Alzheimer's - mild Alzheimer's. He's on drugs now to help manage but she's asking are there any lifestyle changes which they can deploy which might help them and him cope with the diagnosis and with what the future may hold?



JONES
Absolutely and I think this is one of the reasons why it's important to try and get a diagnosis as early in the disease as possible, though actually it's quite difficult to do that, and often we do have to wait to try and be more confident about whether the person does have something like Alzheimer's Disease. But the earlier the diagnosis is made it does allow you to plan a bit for the future. Now obviously it depends very much on the circumstances under which the person's living, but, for example, it may be worthwhile thinking about moving to simpler accommodation, it may be worthwhile thinking about moving closer to family, for example, looking at perhaps whether the person might even consider things like residential care. There are practical issues like driving, for example, which is often a major problem in older people, particularly if they have dementia. So there are things that can be done to try and prepare the way. One thing that I really think I must mention though, which may or may not have been done, and that is to look at things like financial affairs because often we see patients very late in the disease where they no longer can deal with their financial affairs and the family haven't actually sorted out the problems earlier. And there is a thing called an enduring power of attorney which is actually designed for people to take out when they are able to understand what's involved so that someone can deal with their finances in the future, it's in fact something we all ought to do in case something happens to us in the future. But that sort of thing - financial planning and trying to simplify some of the issues, perhaps putting bills onto direct debits and some of those things to make things - there's a whole range of things.



MYERS
Can I mention an e-mail from Clare who's got a very practical tip to share, which is that her grandmother has dementia and the difficulty has been taking her tablets because she might have a nap, wake up and think she hasn't taken her tablets. So they have found an automatic pill dispenser which has an alarm and it only alarms when she's due to take her pill and won't let her take it unless she's due to take it. So practical things like that are available.



JONES
And increasingly technology is going to help us, although the current group of older people find technology sometimes a bit frightening but there is quite a lot of research going on now, for example, there are telephones where you can have a picture of someone in the family on the phone rather than a number or a letter or whatever, so you just press the picture and you're talking to your daughter or your son. So I think increasingly we're going to find that technical solutions may offer some help to people.



MYERS
Thank you. We'll go to Hampstead and Mrs Pixner - hello.



PIXNER
Hello.



MYERS
And you've got a comment for us I think.



PIXNER
Yes, about three years ago I found my memory for numbers, telephone numbers, and such was going. I mentioned it to my doctor and she said well you're getting older, people's memories do get weaker and so on.



MYERS
And are you getting older?



PIXNER
I'm 90.



MYERS
Okay, that's getting older.



PIXNER
Pardon?



MYERS
Yes that's getting older.



PIXNER
It is. But she said some people say that Ginko Biloba can help but she couldn't prescribe it because it's classed as a nutrition supplement and not a drug. Anyway I bought a year's supply and started taking one a day - one capsule a day. And nothing happened for about half a year, I wasn't really expecting it to. But then after about half a year I suddenly noticed one day I'd remembered a telephone number for about a minute and this was encouraging and so I continued and I can now remember telephone numbers for hours, if not days, and also names, my power of recall of words and names, people, books and so on...



MYERS
And do you put this down to the Ginko or is there something else that's changed in your life?



PIXNER
No, no it's the Ginko - nothing else.



MYERS
Alright, well you found it works for you.



PIXNER
A hundred and twenty milligrams extract and it does. My doctor says it doesn't work for everyone.



MYERS
Exactly, I don't think we can prove it one way or the other but certainly if it works for you...



PIXNER
It certainly does for me and it has relieved this awful feeling of not being able to rely on your own memory, it's so distressing and so - well demoralising.



MYERS
Alright, we'll leave it there, thank you very much indeed. That was a very nice contribution and there may be no proof but if you find it works for you there certainly is no harm in it. Let's take another call and we go to Suffolk and Lyn Brisco. Hello.



BRISCO
Hello.



MYERS
And what's your question or comment please?



BRISCO
Well I'm only 50 and I'm suffering from memory loss to the point where I repeat myself with friends and family. I recently couldn't remember how to get to my car that I'd parked and I've mentioned this to my doctor and he just sort of laughed it off and said oh it's our age. And I just think at my age I shouldn't be having this sort of problem.



MYERS
Okay let's get a very quick answer, what could be the problem?



JONES
I think you're absolutely right, you should not put memory problems that worry you just down to your age. And I think the real issue if it's something that's progressing over the coming months and if you feel that it is changing and progressing then it's something you ought to ask your doctor to refer you to someone so that it can be assessed properly. Hopefully you'll find that it is not a major problem.



MYERS
And we have to stop there. Thank you very much indeed for your call. Thanks to everyone who's phoned today and to our guest Professor Roy Jones. There's more information on memory on our free and confidential help line, that number is 0800 044 044 or you can visit our website bbc.co.uk, follow the trail to Check Up where you can listen again.



And if you go to our website you'll see there details of a special programme for the festive season. To celebrate the New Year I'll be here with GP doctor Keith Hopcroft to discuss the health problems that you can't quite bring yourself to go to the doctor about - you know the sort of thing I mean - fungus under the toenails or maybe a strange lump on your hand - some symptom that you just think sounds a bit too vague to go to see your doctor about or maybe you're embarrassed. Well to make this programme we need to hear from you and we need to hear from you right now. So please pick up the phone and tell us what it is that's worrying you. The number is 08700 100 444 and the phone line will be open for the next half hour. Next week we'll be back with problem knees.


BRITISH BROADCASTING CORPORATION


RADIO SCIENCE UNIT



CHECK UP 2. - Memory



RADIO 4



THURSDAY 02/12/04 1500-1530



PRESENTER:

BARBARA MYERS



CONTRIBUTORS:

ROY JONES



PRODUCER:
ANNA BUCKLEY


NOT CHECKED AS BROADCAST




MYERS

Hello. Well is there anybody out there who hasn't popped upstairs to fetch something only to come back empty handed - no idea what you went for? Well that's bad enough but what if you're really struggling with names, telephone numbers, dates, words - things that should be on the tip of your tongue? Is it part of the ageing process? Is it a consequence of physical or emotional problems - neither drinking nor depression helps you remember things very clearly. Mini strokes and thyroid problems can also play havoc with memory. Or do you worry that it could be the onset of dementia? Doctors take memory loss seriously, there are now memory clinics across the country where you can go for an assessment. Hopefully you'll be reassured that you're not losing it. You may be diagnosed with what's called mild cognitive impairment and given advice about coping strategies. And if it is something more serious then there are drugs which can at least delay symptoms.



So if you have concerns about losing your memory or if you've found ways round your failing memory do call us now - 08700 100 444 or e-mail checkup@bbc.co.uk.



And here with me to answer your questions today is Professor Roy Jones. He's director of the Research Institute for the Elderly and is connected with a memory clinic in Bath. Let's go to our first call because we've got a lot of people waiting to talk to you Roy. And the first caller is Carol, Carol's in Aldershot. Hello Carol.



CAROL
Hello there.



MYERS
And your question please.



CAROL
Right well I've been up until the beginning of last year I've been working sort of most of my working life and been coping fairly well I suppose really but having to make lots and lots of notes about what I'm doing. But I am on medication for chronic back pain and I take an awful lot of these tablets - the next stage, just so you know the strength, the next stage is morphine. So they are fairly strong. And I'm wondering if that has any effect on my memory loss. I forget when I'm a conversation, I forget words that should be, as you say, on the tip of your tongue, dates, when all my family are with me my - our daughters and grandchildren - I get the names all muddled up. And I'm not - well I'm 60 at Christmas so I'm - I don't think I'm very old yet and this has been going on for some time - well a long time now and I'm really wondering what I can do. And I am really, really worried about getting dementia.



MYERS
Okay, well you put a very clear story there, let's put you over to the professor, what would you say to Carol?



JONES
Good afternoon Carol.



CAROL
Hello there.



JONES
Well the first thing to say is that if you have a painful condition then there's no doubt that pain itself can affect things like concentration and how well you are able to sort of take in information. So the actual condition for which you're taking the tablets might be one of the reasons that you're finding it harder to remember. Particularly if it's been going on for a long time, that may well be one of the issues. In terms of the drug treatments - drugs can very often have an effect on memory, now rather interestingly some of the drugs that are used to treat conditions like back pain and arthritis, there is actually some evidence they may help prevent people getting Alzheimer's disease and other types of dementia. The more significant drugs, that you mentioned, that are related to morphine and as you say you may be moving on to morphine if the pain continues, they certainly can have an effect on things like concentration - they can make you a little bit sleepy, for example, as well.



CAROL
That's one of my problems.



JONES
Is it okay. Well that may be part of the problem. I think the other thing is that you implied your memory's not been very good for a long time and so in a sense I wouldn't be so worried that you're developing a dementia if it's a longstanding problem. We're more worried about people whose memory has changed over the recent time and is getting worse. But I think you might find that you can look at and trying to find strategies to help you remember and as I mentioned concentration is so important, so that you need to really - for remembering names and things like that you need to try and concentrate very hard on what you're trying to do - try and link the name to some other aspect to try and help prompt your memory so that things like written information if you can turn it into a visual image as well you're using all sides of your brain. So there are things that you can do but undoubtedly drugs for things like pain and arthritis can have an impact as can some other drug therapies but in your case I doubt whether it's actually causing the memory problem per se.



MYERS
Thank you Carol, I hope you found that reassuring and I guess a lot of people do get muddled up with their children's names, never mind grandchildren's names and so there's a lesson there perhaps for everyone to take - take more notice as it were and commit things to memory. But if I'm not wrong, there may be a slight underlying question there about whether if you have memory loss, whatever the reason, whether you're going to be a candidate for dementia - you're going to end up with Alzheimer's. Is there any reason to think that way?



JONES
Yes I think as we get older there are changes in our memory and we all notice this and common things, as you say, like remembering names - the what we call tip of the tongue experiences where we can't actually remember something but we haven't actually forgotten it, it's just we can't bring it to mind when we want it there. And these are sort of things that we all notice if we're leading busy stressed lives and our concentration is poor - that's another reason why we may have problems. The difference between these minor problems, which are still irritating and frustrating, and dementia is, that it is a change in someone when they're developing a memory problem that's the beginning of a dementia - it's progressing, it will go on getting worse over time. It starts to interfere a lot with everyday life so that the person may have problems with practical issues - carrying out everyday functions, dealing with their finances - it starts to have an impact in other ways. And dementia isn't just a memory problem, it's more than a memory problem.



MYERS
Thank you. Let's take another call. Sylvia David is waiting to speak us, she's in Edgware. Hello?



DAVID
Hello.



MYERS
And your question please Sylvia.



DAVID
Good afternoon. Yes my question is that I read in many - particularly health -magazines that there are drugs you can take to improve your memory and one particularly comes up very often, I think it's called coenzyme.



MYERS
Okay these are things you can buy across the chemist's counter in other words. And to improve you mean sharpen up not really to cope with serious memory loss?



DAVID
Yes not for serious memory loss but to perhaps stave off memory loss, I don't know.



MYERS
Have you been tempted to try something like this?



DAVID
Occasionally yes, my memory has deteriorated, I can still function properly.



MYERS
Okay, well are they worth taking - are they worth buying?



JONES
It's quite a difficult question to answer that. We expect for drugs that are given out on prescription very precise studies that go on over many years and the drug companies for example have to satisfy a whole number of hoops before they're allowed to have those drugs available on prescription for things like Alzheimer's Disease. And there are a lot of other health related things, you mention Coenzyme Q, there's also one that's very commonly taken called Ginko - Ginko Biloba, vitamin E and the evidence for these products is less convincing. In some ways there is some evidence, certainly for Ginko for example and vitamin E, that they may actually have some benefit but it's not as strong as the evidence for the prescription drugs and that's partly because it's quite hard to do the research studies to do that. I always get concerned with people spending a lot of money on all these vitamin related products, without there really being convincing evidence and the general thing I think is that some of them are relatively harmless, not all of them, and things like vitamin E, for example, probably doesn't do any harm and it helps your heart and other things like that. So that there may be a place for taking those products but in general I'm fairly cautious about the non-prescription drugs.



DAVID
Could I quickly ask about diet?



MYERS
Ah I'm glad you did because I was going to.



JONES
Okay well diet - there's a lot of interesting information coming about diet and I think the general phrase that we're now all using is to say that what's good for your heart is good for your brain. So that if you have a healthy diet with plenty of vitamins, oily fish, the good news is alcohol but only in moderate amounts seems to be good for the brain, which I'm encouraged by. And so a good healthy diet that is, as I say, is the sort of diet people recommend for good health with heart disease would also be good for your brain. So I think that's where I would look to try and look at things rather than things like Coenzyme Q.



MYERS
Okay, thank you very much, I hope that's helpful. Let's go on to another call. Aylesbury now and we've got Edith Westwood, hello.



WESTWOOD
Oh hello. I was diagnosed with underactive thyroid some five years ago and take 75 micrograms of thyroxin each morning. I'm 57 and have had an increasingly worse memory since my early 30s, but recently, in about the last year, I'm finding that even everyday words and the names of things are getting harder to recall. Do you think it could be - sorry - do you think it could be my thyroid or should I try and get a higher dosage of thyroxin from my doctor? I was tested in the summer and was told I didn't need to increase my dosage.



JONES
Okay that's a very good question and there is undoubtedly a link between an underactive and probably an overactive thyroid gland and memory. And we've known that for quite a long time. And obviously as you're well aware it has other important effects on your general health, so it is very important that your thyroid is working correctly. Now if your doctor is checking up on the dose that you're taking then probably you're on the right dose for you, particularly if things like your weight is reasonably steady. But if you're worried about it then certainly I would go back and see your doctor. If the thyroid gland is controlled - in other words you're taking the right dose of thyroxin - then I wouldn't expect that on its own to affect your memory any further. And you mention your memory's been bad since your 30s but you feel it's worse now and I think if you feel it has changed in the last months or ...



WESTWOOD
The last year or so I'm finding more difficulty with just everyday words really.



JONES
Well as I mentioned earlier there is a change as we get older and sometimes words is one of the particular things people find a problem with. But as I say if you are concerned then I think it is worth seeing your family doctor and just asking if you can have your memory assessed and if you can have it checked because it's important to pick up on it and there are other medical causes for memory problems and if it has changed it's important to try and check whether it's due to anything more serious.



MYERS
Hope that helps Edith and not necessarily suggesting this would apply but as women get older they go through the menopause of course, I wonder if hormonal changes, perhaps in the 50s, would make a difference to memory?



JONES
Yes I think all sorts of things that affect both physical factors and psychological factors can affect things like your concentration, you may be depressed and other things that can interfere and those things can have an effect on memory. Interestingly we know that oestrogen is quite important in the brain and in how the brain functions so that there has been a lot of interest about what happens to women at the menopause when the oestrogen stimulus goes and there's been a lot of research to try and look, for example, whether HRT either prevents you getting Alzheimer's Disease and other dementias or whether it might be useful for treatment for women with Alzheimer's Disease. The jury's still out on the questions and the more recent figures certainly suggest - the more recent study that was done in the United States has suggested that probably HRT isn't necessarily a good treatment for women with Alzheimer's Disease. But I think there are so many changes going on in the body at the time of the menopause that it's not surprising when things like memory and concentration are affected.



MYERS
And having gone through the menopause might you find that you recover some of your good memory function?



JONES
Yes I think that's quite likely, although then you've got the impact of ageing on that as well but yes it shouldn't be a permanent - and it shouldn't be a progressive change, I think that's the important factor.



MYERS
Another caller now - Janet White, hello Janet.



WHITE
Hello, good afternoon.



MYERS
Would you put your question please to the professor?



WHITE
Yes. I wonder if there's a drug that can be given to help stop constant crying and screaming of my mother who's in the late stages of dementia?



JONES
Right, well that's a very difficult question in terms of the degree of stress that I'm sure that does cause you and it's unfortunately not uncommon for people with the later stages of dementia to have quite disturbing behavioural problems and to cause a huge amount of stress to their families and it can be extremely difficult for you. The drugs that are available for the treatment of earlier Alzheimer's Disease may sometimes be of help in some of the behavioural disturbances and crying and agitation that sometimes people have and there are other drugs that can be used. But actually if it's possible it's always better to try and avoid drugs under these circumstances and try and look at other reasons and I'm sure you have tried to do this but I think it's a question of trying to see if you can understand why your mother's crying - is it because she's feeling insecure, because she's nervous about something?



WHITE
Well she's in a home, she's been in it for six years with wonderful care, absolutely wonderful but it's not a definite pattern but a slight pattern - she's calm in the morning, then about lunchtime it starts and it goes on for hours and hours and they've tried everything.



MYERS
Very distressing, alright. Could I bring another caller in - not to put you off Janet so stay with us - but Beatrice joins us from Bath and I believe Beatrice you do work in a home with people with dementia, I don't know if you heard Janet's point and whether this is something that is a familiar pattern to you and whether there are ways that you can see to help people in this situation.



BEATRICE
Yes I don't actually work in a home, I work with residential and nursing homes to help with some of the problems which arise. This would be the sort of problem we might get referred to us. And an idea that's been tried is sitting and massaging the person's hands with aromatherapy oils ...



WHITE
Yes I've done it.



BEATRICE
Did it help at all?



WHITE
No, myself and the home have tried absolutely everything - absolutely everything.



MYERS
But you'd say Beatrice that it does indeed help some people?



BEATRICE
It helps some people - just talking to them, even if they can't respond and sometimes playing a tape of a family conversation can help to soothe people. A lot of people with dementia are actually in pain but of course they can't say they're in pain, so it might be worth checking - having her very thoroughly checked to see if there's any cause.



WHITE
I think they've done all that.



BEATRICE
Oh right.



JONES
I think the other thing that you describe which is actually very common is this issue about it getting worse as the day goes on - in America they call it the sundown syndrome and some of that is related to the fact that as the day goes on the person gets a bit tired, also as it gets darker often they lose some of the cues that they would otherwise get. So it is actually quite common for it to get worse towards the end of the day. But it is a difficult issue to deal with.



WHITE
Could I just say something else? With all the publicity on drugs and many being over drugged I wonder if it could have the other side of the coin for my mother, you know.



JONES
Sorry is she taking drugs?



WHITE
Yes she is, she's on drugs. I really - and my family - would rather see her more drugged than have all this because it's horrendous.



JONES
Yes it is very difficult to get the balance right and for example the drugs that we use actually to treat the memory related problems of people with dementia and Alzheimer's Disease, some of those do actually have an effect on what we call agitation and the kind of distress that you're describing. There are other drugs that are more specifically designed to damp down the agitation but increasingly we're wary about using those on people because of the negative effects. But it is a difficult balance and I think it's - without knowing the exact drugs and the details it's hard to deal with it but unfortunately there are one or two patients where it's very difficult to find the right combination. The only thing I can say is that maybe things do change with the way people are - this is a changing situation and it may be that although this has been very distressing for you now that in weeks to come you'll find that suddenly it does change and it's no longer a problem and I think that's something to hope for.



WHITE
I hope so because it's been over a year, the constant ...



MYERS
Janet you have our sympathy obviously, it's a very difficult situation for you, thank you at least for sharing it with us and indeed for Beatrice joining in. And in a way that the sort of thing that's going to scare people because that is late on in Alzheimer's Disease and the sort of thing that people do worry about. I wonder if you've got a thought for Virginia who's e-mailed us saying that her father has this week been diagnosed with Alzheimer's - mild Alzheimer's. He's on drugs now to help manage but she's asking are there any lifestyle changes which they can deploy which might help them and him cope with the diagnosis and with what the future may hold?



JONES
Absolutely and I think this is one of the reasons why it's important to try and get a diagnosis as early in the disease as possible, though actually it's quite difficult to do that, and often we do have to wait to try and be more confident about whether the person does have something like Alzheimer's Disease. But the earlier the diagnosis is made it does allow you to plan a bit for the future. Now obviously it depends very much on the circumstances under which the person's living, but, for example, it may be worthwhile thinking about moving to simpler accommodation, it may be worthwhile thinking about moving closer to family, for example, looking at perhaps whether the person might even consider things like residential care. There are practical issues like driving, for example, which is often a major problem in older people, particularly if they have dementia. So there are things that can be done to try and prepare the way. One thing that I really think I must mention though, which may or may not have been done, and that is to look at things like financial affairs because often we see patients very late in the disease where they no longer can deal with their financial affairs and the family haven't actually sorted out the problems earlier. And there is a thing called an enduring power of attorney which is actually designed for people to take out when they are able to understand what's involved so that someone can deal with their finances in the future, it's in fact something we all ought to do in case something happens to us in the future. But that sort of thing - financial planning and trying to simplify some of the issues, perhaps putting bills onto direct debits and some of those things to make things - there's a whole range of things.



MYERS
Can I mention an e-mail from Clare who's got a very practical tip to share, which is that her grandmother has dementia and the difficulty has been taking her tablets because she might have a nap, wake up and think she hasn't taken her tablets. So they have found an automatic pill dispenser which has an alarm and it only alarms when she's due to take her pill and won't let her take it unless she's due to take it. So practical things like that are available.



JONES
And increasingly technology is going to help us, although the current group of older people find technology sometimes a bit frightening but there is quite a lot of research going on now, for example, there are telephones where you can have a picture of someone in the family on the phone rather than a number or a letter or whatever, so you just press the picture and you're talking to your daughter or your son. So I think increasingly we're going to find that technical solutions may offer some help to people.



MYERS
Thank you. We'll go to Hampstead and Mrs Pixner - hello.



PIXNER
Hello.



MYERS
And you've got a comment for us I think.



PIXNER
Yes, about three years ago I found my memory for numbers, telephone numbers, and such was going. I mentioned it to my doctor and she said well you're getting older, people's memories do get weaker and so on.



MYERS
And are you getting older?



PIXNER
I'm 90.



MYERS
Okay, that's getting older.



PIXNER
Pardon?



MYERS
Yes that's getting older.



PIXNER
It is. But she said some people say that Ginko Biloba can help but she couldn't prescribe it because it's classed as a nutrition supplement and not a drug. Anyway I bought a year's supply and started taking one a day - one capsule a day. And nothing happened for about half a year, I wasn't really expecting it to. But then after about half a year I suddenly noticed one day I'd remembered a telephone number for about a minute and this was encouraging and so I continued and I can now remember telephone numbers for hours, if not days, and also names, my power of recall of words and names, people, books and so on...



MYERS
And do you put this down to the Ginko or is there something else that's changed in your life?



PIXNER
No, no it's the Ginko - nothing else.



MYERS
Alright, well you found it works for you.



PIXNER
A hundred and twenty milligrams extract and it does. My doctor says it doesn't work for everyone.



MYERS
Exactly, I don't think we can prove it one way or the other but certainly if it works for you...



PIXNER
It certainly does for me and it has relieved this awful feeling of not being able to rely on your own memory, it's so distressing and so - well demoralising.



MYERS
Alright, we'll leave it there, thank you very much indeed. That was a very nice contribution and there may be no proof but if you find it works for you there certainly is no harm in it. Let's take another call and we go to Suffolk and Lyn Brisco. Hello.



BRISCO
Hello.



MYERS
And what's your question or comment please?



BRISCO
Well I'm only 50 and I'm suffering from memory loss to the point where I repeat myself with friends and family. I recently couldn't remember how to get to my car that I'd parked and I've mentioned this to my doctor and he just sort of laughed it off and said oh it's our age. And I just think at my age I shouldn't be having this sort of problem.



MYERS
Okay let's get a very quick answer, what could be the problem?



JONES
I think you're absolutely right, you should not put memory problems that worry you just down to your age. And I think the real issue if it's something that's progressing over the coming months and if you feel that it is changing and progressing then it's something you ought to ask your doctor to refer you to someone so that it can be assessed properly. Hopefully you'll find that it is not a major problem.



MYERS
And we have to stop there. Thank you very much indeed for your call. Thanks to everyone who's phoned today and to our guest Professor Roy Jones. There's more information on memory on our free and confidential help line, that number is 0800 044 044 or you can visit our website bbc.co.uk, follow the trail to Check Up where you can listen again.



And if you go to our website you'll see there details of a special programme for the festive season. To celebrate the New Year I'll be here with GP doctor Keith Hopcroft to discuss the health problems that you can't quite bring yourself to go to the doctor about - you know the sort of thing I mean - fungus under the toenails or maybe a strange lump on your hand - some symptom that you just think sounds a bit too vague to go to see your doctor about or maybe you're embarrassed. Well to make this programme we need to hear from you and we need to hear from you right now. So please pick up the phone and tell us what it is that's worrying you. The number is 08700 100 444 and the phone line will be open for the next half hour. Next week we'll be back with problem knees.

[NB: Gingko Biloba does not suit everyone.  Please read the label on the packet.  It should not be taken with certain prescription drugs - please consult your doctor. ]

ENDS

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