Elixirs for Your Memory

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Tired of frantically searching for your keys? Or of rushing into a room only to forget what you were looking for? If you're worried about memory lapses, just flick on the TV. There are Annie Potts, former star of Designing Women, and Hector Elizondo of Chicago Hope hawking dueling versions of the herbal supplement ginkgo biloba. Or click on the website www.braingum.com, where you can read about a delicious supplement derived from the compound phosphatidyl serine. All offer hope for improving memory and brain function.
The graying of America has created a whole new industry aimed at people worried about remembering and concentrating. In health-food stores, you'll find dozens of products that claim to do wonders for your brain. They range from vitamins to exotic herbal concoctions. But at the head of the pack is the enormously popular ginkgo biloba--a derivative of a leafy ornamental tree originating in eastern China that racked up $240 million in sales in 1997.

Countless people swear that ginkgo has changed their lives. So effective has the advertising blitz been that ginkgo products seem to be leaping off the shelves. Even old-line pharmaceutical houses are offering their versions of brain boosters. In their first year on the market, Bayer Consumer Care's new vitamin pills, spiked with ginkgo--and sold under the label Memory and Concentration Formula--took in a cool $8 million.

The no-brain question: Does any of this stuff actually work? Traditional healers have no doubts about ginkgo, a staple of Chinese medicine. Nor do manufacturers of so-called nutriceuticals--the unregulated natural medications found in health-food stores and supermarkets. They say it somehow improves memory by increasing the flow of blood to the brain. Leading memory experts, however, are skeptical about ginkgo and other brain boosters. Most of these products have not been investigated to any significant extent that would warrant the claims that are being made,'' says Dr. Ronald Petersen, a neuroscientist at the Mayo Clinic in Rochester, Minn. Other geriatricians are more blunt. All the hoopla, they say, is merely a case of the placebo effect run amuck: people want their memories to get better, so they do. Give them a sugar pill, and they probably wouldn't know the difference.

Government researchers are understandably concerned that millions of people are gulping supplements without any idea what their effects are, positive or negative. The National Institutes of Health is undertaking a study of the effects of ginkgo on elderly people with mild memory impairment. But it could be years before results are in.

Meanwhile, what are healthy souls in search of a quick boost to do? Consumers have little to go on other than manufacturers' claims and inconclusive research. Moreover, since ginkgo and other supplements are not regulated by the Food and Drug Administration, potency and purity vary from brand to brand. Most troubling, however, is that few people read labels. The list of don'ts for ginkgo biloba include the warning that those taking aspirin or other blood thinners should first consult their physician. Why? Because ginkgo, which has anticlotting characteristics, when taken in combination with a blood thinner can cause internal bleeding.

The one thing generally agreed on is that too little is known about most memory supplements to assess their risks. So far, the research has focused on humans with Alzheimer's and lab animals like Princeton's Doogie mice. Scientists are only now beginning to examine what happens to memory in normal people during the aging process. People jump to the conclusion that if it helps my grandfather, it must help me, says Dr. Jerry Cott, a neuropharmacologist at the National Institutes of Health. But it's a lot more complicated than that.

Much of how memory works remains murky. We know, though, that memory involves chemicals called neurotransmitters--one of which is acetylcholine--and the signals they carry through the brain. As people learn, the synapses--interconnections between brain cells--are reinforced, creating a complex network of associations. But with age, the synapses somehow falter--about 25% of them between ages 25 and 55--and so does the ability to effectively retrieve memories.

One day it may be possible to delay or even reverse the course of Alzheimer's with medication. Two FDA-approved drugs are currently available for treating the symptoms of Alzheimer's disease--donepezil, marketed under the brand name Aricept, and tacrine (Cognex). Both block an enzyme that destroys acetylcholine, and have been shown to sometimes slow the progress of the disease. Animal tests suggest that the drugs might also make a difference in less serious memory disorders. But the side effects are no picnic. Cognex builds up an enzyme that can lead to liver damage. And though many patients can better tolerate Aricept, the newer of the two drugs, it can cause diarrhea and vomiting.

The National Institute on Aging is embarking on a study to determine if Aricept can help people with mild cognitive impairment. If you suffer from MCI, you might consistently come out of the mall and not remember where you parked your car (with dementia, you'd forget that you even owned one in the first place). Fifty percent of people over age 65 with MCI will develop Alzheimer's within five years. An estimated 4 million Americans are afflicted with Alzheimer's, which is characterized by an accumulation of protein that gums up the brain so the neurons can't fire. Eventually, what began as problems remembering names or telephone numbers ends in full-scale dementia.

Memory-loss experts around the country are testing an array of treatments in the hope of finding that one universal brain tonic that will arrest those changes. Scientists speculate that megadoses of antioxidants such as vitamins E and C may reduce the cell damage associated with severe memory loss. The theory is that antioxidants soak up tissue-damaging chemicals called free radicals. But as with so much of what makes memory tick, no one knows for sure.

In some studies, high doses of vitamin E slowed the progress of Alzheimer's for up to seven months. That may not sound like a big deal, but if you have a parent suffering from Alzheimer's, it's a godsend. Many geriatricians recommend vitamin E for mild cognitive decline. There is nothing absolutely known, says Dr. Barry Gordon, director of the memory clinic at Johns Hopkins Medical Institutes and author of the self-help book Memory (MasterMedia Limited; $14.95). But physicians feel this has enough evidence in its favor and few enough known side effects.

Physicians also recommend prescription doses of anti-inflammatory agents such as Naprosyn and ibuprofen to reduce Alzheimer's-related inflammation. Meanwhile, a dozen brain-boosting therapies ranging from estrogen replacement (which may promote the growth of some neurons) to entirely new drugs are at various stages of development. In the near future, two new cholinesterase inhibitors, ENA 713 (Exelon) and metrifonate, are expected to become available. Memory researchers have also been looking at the NMDA receptor, target of the Princeton experiment. But tests of possible drugs to enhance memory have been inconclusive. Says Bill Thies, vice president for medical and scientific affairs at the Alzheimer's Association: I think in a 10-year window we'll see some revolutionary stuff to prevent the disease.

What can you do while waiting? To fend off normal age-related memory loss, follow the adage Use it or lose it, the experts say. Simply reading a book or working a crossword puzzle on a regular basis can do wonders, even if it's not clear why. The most solid piece of advice is to stay active, says Patricia Tun, associate director of the memory and cognition lab at Brandeis University. In the long run, a common-sense diet and healthy lifestyle may be the best memory boosters of all.

Reported by William Dowell/New York