Memory impairment – a pathological condition associated with the inability to fully preserve, accumulate and use information obtained in the process of perceiving the surrounding world.

Memory impairment (episodic or permanent) is one of the most common disorders, familiar to almost every person and can significantly worsen the quality of life. According to statistics, about a quarter of the total population of the Earth suffers from regular memory impairments (in varying degrees of severity).

Causes of memory impairment

Memory impairment can be caused by many different factors. The most common cause of this condition is asthenic syndrome, associated with general psycho-emotional stress, anxiety and depression. In addition, memory impairment due to asthenia can also be observed during the recovery process after somatic diseases.

But memory disorders can also have a more serious origin: organic brain damage and mental illness.

So, we can highlight the following main causes of memory impairment:

  • general asthenic conditions, as a result of stress and overwork, somatic diseases and seasonal hypovitaminosis;
  • alcoholism: memory impairment due not only to lesions in the brain structures, but also to general disorders associated with the toxic effect of alcohol on the liver and concomitant hypovitaminosis;
  • acute and chronic cerebral circulatory disorders: cerebral atherosclerosis, stroke, cerebral vasospasm and other age-related disorders;
  • traumatic brain injuries;
  • brain tumors;
  • Alzheimer’s disease;
  • mental illness;
  • congenital mental retardation, both associated with genetic disorders (for example, Down syndrome) and due to pathological conditions during pregnancy and childbirth.

Memory impairment. Symptoms

Symptoms of memory loss can develop suddenly or be slowly progressive.

Memory impairment may be quantitative. Then the following symptoms are observed:

  • Amnesia: complete absence of memories of events that happened during a certain period of time. According to the temporal relationship to the traumatic event, it can be retrograde, anterograde and retroanterograde. It is also rare to experience a total loss of almost all memories.
  • Hypermnesia: an abnormal increase in memory, due to which a person is able to remember and reproduce many events and information over a long period of time.
  • Hypomnesia: partial memory loss (can be temporary or permanent).

Depending on which component of memory is affected to a greater extent, the following symptoms may be observed:

  • Fixation amnesia: the ability to fix currently occurring events and new information is partially impaired or completely lost.
  • Anekphoria: difficulty recalling previously acquired information in a timely manner.

With respect to the object of memory, to which memory impairment is directed, symptoms of partial removal of information may be observed:

  • Affectogenic amenesia: only particularly significant memories that caused strong negative experiences are removed from memory.
  • Hysterical amnesia: partial removal from a person’s memory of unpleasant and compromising events.
  • Scotomization: memories are removed partially, in fragments, but without connection to any strong emotional experiences.

Symptoms of qualitative memory impairment may also occur:

  • Pseudoreminence: this is a state when gaps in memory are replaced by memories of other events that also really happened to a person, but in a different period of time.
  • Confabulation: the patient replaces memory lapses with fictitious events. Moreover, such invented events are absolutely unreal and fantastic.
  • Cryptomnesia: missing memories are filled in by events previously heard, gleaned from books, newspapers, television and other sources, or even seen in dreams. It is even possible to assign authorship of the creation of works of art and scientific discoveries.
  • Echonesia: perceiving what is happening at the moment as something that happened before.

Memory impairment in schizophrenia

Patients with schizophrenia experience not only memory impairment, but also a general disorder of intellectual processes – the so-called schizophrenic dementia. Its key feature is its functional nature and the absence of any organic brain damage. In these patients, it is not the intellect that suffers, but the ability to use it. Also, dementia in schizophrenia is transient in nature and, with successful correction of the exacerbation of the disease, can completely regress.

In general, memory in patients with schizophrenia remains practically unchanged for quite a long time. However, short-term memory and perception of current information suffer significantly. This condition is caused by impaired concentration and a decrease in the motivational component of memory.

Also, in patients with schizophrenia, the process of generalizing received information and associative memory suffers. This is caused by the emergence of many random and non-specific associations that reflect too general features of concepts and images.

A characteristic feature of schizophrenic memory disorder is that there is a kind of “double memory”: against the background of gross destruction of some memories, other aspects of memory are preserved unchanged.

Memory impairment after stroke

When a stroke occurs, the cerebral arteries are blocked by a blood clot, or the substance of the brain is compressed by blood flowing from a ruptured artery. Memory impairment may often occur after a stroke. In the initial stage (immediately after a stroke), general memory disorders may be observed in the form of a complete disappearance of memories of the period of time preceding the disease. In rare cases (with major strokes) total transient amnesia may occur, when patients cannot even recognize close people and other well-known concepts.

Gradually, general phenomena pass and memory disorders associated with damage to one or another part of the brain responsible for a certain component of memory come to the fore. Violations are very diverse. For example, modality-specific memory disorders may occur (difficulties in perceiving information by one of the analyzers), short-term memory deteriorates, and difficulties arise in reproducing previously acquired information. Problems with concentration (absent-mindedness) and deterioration of the motivational component of memory are very often observed.

Despite the seriousness of memory impairment after a stroke, thanks to adequate rehabilitation, the mental functions of the brain can be restored almost completely over time.

Memory impairment in children

Memory impairment in children is associated with both congenital mental retardation and conditions acquired in childhood. Such problems can manifest themselves both in the form of a deterioration in the processes of remembering and reproducing information (hypomnesia), and a complete loss of individual episodes of memories (amnesia). Amnesia in children can occur as a result of trauma, poisoning (including alcohol), coma and mental illness.

But, most often, children experience partial memory impairment due to hypovitaminosis, asthenic conditions (often caused by frequent acute respiratory viral infections), and an unfavorable psychological climate in the family and children’s group. Such disorders are combined with a lack of perseverance and problems maintaining attention.

Children who complain of memory impairment often have problems not only with mastering the school curriculum, but also with games and communication with peers.

Memory in children with visual impairments

A person receives more than 80% of information through vision. Therefore, visual impairment leads to a significant deterioration in memory processes, especially in childhood.

Such children are characterized by a decrease in the volume and speed of memorization, faster forgetting of learned material due to the lower emotional significance of non-visual images. The average number of repetitions of information required for effective memorization is almost twice that of a sighted child.

In the process of adaptation to visual impairments, the verbal-logical component of memorization is enhanced, and the volume of short-term auditory memory increases. At the same time, motor memory deteriorates.

Memory impairment in the elderly

In old age, memory impairment is usually associated with age-related changes in blood vessels and deterioration of cerebral circulation. Also, during the aging process, metabolic processes in nerve cells deteriorate. A separate serious cause of memory impairment in the elderly is Alzheimer’s disease.

From 50 to 75% of older people complain of memory impairment. Memory loss and forgetfulness are the main symptoms of age-related memory impairment. First, short-term memory for events that just happened deteriorates. Patients develop fear, self-doubt, and depression.

As a rule, during normal aging, memory function declines very slowly and even in extreme old age does not lead to significant problems in everyday life. Active mental activity (starting from a young age) and a healthy lifestyle help slow down this process.

But, if memory impairment progresses more intensely in old age and the patient does not receive adequate treatment, senile dementia may develop. It manifests itself in an almost complete loss of the ability to remember current information and the impossibility of even ordinary everyday activities.

Memory impairment syndromes

Memory impairment can be very diverse and can be combined with other lesions of higher brain functions. The following memory impairment syndromes are distinguished:

  • Korsakov’s syndrome. The ability to fix current events is primarily impaired. Other higher functions of the brain remain unchanged or suffer slightly, and there are no pronounced behavioral disorders. It mainly develops as a result of alcoholism, trauma and brain tumors.
  • Dementia. The processes of both short-term and long-term memory are sharply disrupted. At the same time, abstract thinking suffers and the integrity of the individual is destroyed. Develops due to age-related changes in cerebral blood supply and due to Alzheimer’s disease.
  • Cyanide memory impairment. Severe memory impairment in old age, exceeding normal limits for a certain age. However, with it only memory functions suffer, but no pronounced social maladjustment occurs.
  • Dysmetabolic encephalopathies. Occurs with chronic pulmonary, hepatic and renal failure, prolonged hypoglycemia. Also caused by deep hypovitaminosis and intoxication. It has a benign course and, when the provoking factor is eliminated, regresses on its own.
  • Psychogenic memory disorders. Combined with impaired memory and intellectual performance. They arise as a consequence of severe forms of depression. With adequate treatment, depression can also be regressed.
  • Transient memory impairment. A short-term memory disorder (“memory lapses”) in which only memories of a certain period of time are lost. No other disorders of higher brain functions are observed. They occur as a result of traumatic brain injuries, epilepsy, and alcohol abuse.

Impairment of the motivational component of memory

As in any other intellectual activity, in the processes of memorization, one of the key roles is played by a person’s understanding of the meaning and necessity of his actions – the motivational component.

The importance of the motivational component of memory was experimentally proven in the 20s of the twentieth century in experiments to study the phenomenon of better memorization of unfinished actions: experimental subjects more clearly recorded unfinished actions, since there was a need to complete them later. This was the motivation.

The motivational component of memory is disrupted in conditions of depressive and asthenic states, when there is a general slowness of thought processes. Motivation is especially severely reduced in patients with schizophrenia. On the contrary, in those suffering from epilepsy, the motivational component of memory is significantly enhanced.

Qualitative memory impairment

With qualitative memory impairments, distortion, twisting and distortion of remembered information is observed. Such disorders are called paramnesia.

The following qualitative memory impairments are observed:

  • Pseudoreminence is a state when gaps in memory are replaced by memories of other events that also really happened to a person, but in a different period of time. Such “memories” arise, as a rule, in patients suffering from fixation amnesia.
  • Confabulations are another version of vicarious “memories.” In this case, the patient replaces memory lapses with fictitious events. Moreover, such invented events are absolutely unreal and fantastic. Confabulations indicate not only fixation amnesia, but also a loss of critical perception of what is happening.
  • Cryptomnesia – with this type of paramnesia, the patient fills in the missing memories with events previously heard, gleaned from books, newspapers, television and other sources, or even seen in a dream. The ability to identify the source of information is lost. The patient can even take credit for the creation of works of art and the authorship of scientific discoveries.
  • Echonesia is the perception of what is happening at the moment as such, what took place before. But unlike deja vu, there is no effect of insight and a feeling of fear.

Impaired immediate memory

Immediate memory is the ability of an individual to record and reconstruct information immediately upon receipt.

The most common disorders of immediate memory include progressive amnesia and Korsakoff’s syndrome.

  • Korsakoff’s syndrome is characterized by a loss of immediate memory of current events. At the same time, previously recorded information about the past is preserved.

Due to difficulties in directly recording incoming information, patients lose the ability to orient themselves. Defects in memories are filled with real events from one’s own more distant past, fictitious or gleaned from other sources of information.

  • Progressive amnesia combines loss of immediate memory and gradually progressive loss of memories from the past. Such patients lose orientation in the surrounding space and time, and confuse the sequence of previously occurring events. Long past events are mixed with the events of the current period. This type of memory disorder occurs in old age.

Violation of mediated memory

Indirect memory is characterized by the use of a previously known concept (intermediary) for a specific person to better fix new information. Thus, memorization is based on associations of received information with previously familiar concepts.

Violation of mediated memory is clearly visible in patients with congenital mental retardation (oligophrenia). The main reason for this phenomenon is the difficulty in identifying key features in memorized information in order to associate them with previously mastered concepts.

In people suffering from epilepsy and other organic brain lesions, problems with associative memorization, on the contrary, arise due to excessive attention to detail and the inability to identify general features of the object being memorized.

Difficulties in mediated memory are also observed in patients with schizophrenia. This is due to the arbitrary endowment of new or previously known concepts with uncharacteristic features, which in turn sharply reduces the value of such an association.

Memory impairment. Forms

Based on quantitative characteristics, they are distinguished:

  • Amnesia: complete absence of memories of events that happened in a certain period of time.
  • Hypomnesia: partial memory loss (can be temporary or permanent).
  • Hypermnesia: an abnormal increase in memory, due to which a person is able to remember and reproduce many events and information for a long period. As a rule, the ability to perceive numbers increases.

Amnesia, in turn, can be partial (affects only a certain period of time) and general (loss of almost all memories).

Types of amnesia:

  • Retrograde amnesia: loss of memory for events before the onset of the disease (or injury);
  • Anterograde amnesia: loss of memory in the period after the onset of the disease;
  • Retroanterograde amnesia: loss of memory in the period before and after the onset of the disease;
  • Fixation amnesia: lack of ability to remember current events. At the same time, memory for events of an earlier period is preserved;
  • Progressive amnesia: gradual loss of memory. At the same time, events that occurred in an earlier period persist longer;
  • Total amnesia: complete loss of all information from memory, including information about one’s own person;
  • Hysterical amnesia: partial removal from a person’s memory of unpleasant and compromising events.

Separately, there are qualitative memory impairments, as a result of which both the temporary perception of actually occurring events and the filling of memory gaps with fictitious memories are disrupted.

Modality-specific memory impairment

This is a partial loss of the processes of storage and subsequent reproduction of information perceived by only one sensory system (belonging to a specific modality). There are disorders of visual-spatial, acoustic, auditory-verbal, motor and other types of memory. They arise as a consequence of pathology of the cerebral cortex in the areas of the corresponding analyzers, caused by injuries, tumors or other local influences.

Modality-nonspecific memory impairments

Modality-nonspecific memory impairments are manifested by general lesions of all types of memory (regardless of their modality) in the form of difficulties in memorizing, retaining and reproducing current information. Disorders occur with both voluntary and involuntary perception of information.

They develop when the functioning of the subcortical structures responsible for maintaining the tone of the cortical parts of the brain is disrupted. The main reason is organic brain damage due to circulatory disorders, intoxication, and Alzheimer’s disease.

Impaired memory and attention

The ability to concentrate plays one of the primary roles in the process of memorizing information. Therefore, attention disorders lead to deterioration in memorization of current information and events.

The following attention disorders are distinguished:

  • Instability of attention: rapid switching of attention, inability to concentrate on a specific task for a long time, distractibility. Happens more often in children.
  • Slowness of switching: the patient has difficulty distracting himself from the current topic or activity, he constantly returns to it. Typical for patients with organic brain lesions.
  • Insufficient concentration: attention is scattered, difficulties with long-term concentration. It happens in asthenic conditions.

Based on the cause of occurrence, a distinction is made between functional and organic disorders of memory and attention.

Functional disorders develop due to mental overload and fatigue, exhaustion, stress and negative emotions. Such problems occur at any age and, as a rule, go away without any treatment.

Organic disorders of memory and attention develop due to damage to the cerebral cortex by various pathological processes. They are more common in older people and are persistent.

Impaired memory and intelligence

Intelligence is a complex concept that includes not only the ability to remember information (memory), but also the ability to integrate it and use it to solve certain problems (abstract and concrete). Naturally, with intellectual impairment, memory function suffers.

Memory and intelligence disorders can be acquired or congenital.

Dementia is an acquired progressive deterioration of memory and intelligence, leading to the patient’s inability to perform not only social functions, but also to complete disability. Occurs with organic pathology of the brain and some mental illnesses.

Acquired disorders (oligophrenia) are characterized by brain damage up to the first three years of a person’s life. It is expressed in underdevelopment of the psyche as a whole and social maladjustment. It can be mild (debility), moderate (imbecility) and severe (idiocy).

Visual memory impairment

Visual memory is a special type of memory responsible for fixing and reproducing visual images and using such images for communication.

Visual memory impairment may occur due to destruction of parts of the cerebral cortex in the occipital region, which is responsible for storing visual images. This usually happens due to traumatic exposure or tumor processes.

Visual memory impairments manifest themselves in the form of disturbances in visual perception of the surrounding world and the inability to recognize previously visible objects. Optical-mnestic aphasia may also occur: the patient cannot name the objects shown to him, but recognizes them and understands their purpose.

Disturbance of memory processes

There are three processes that carry out the function of memory: memorization of information, its storage and reproduction.

Problems with memorization occur due to impaired attention and concentration on incoming information. Their causes are mainly overwork and lack of sleep, abuse of alcohol and psychostimulants, and endocrine disorders. Such processes do not affect emotionally significant information.

Impaired information storage occurs when the temporal lobes of the cerebral cortex are damaged. The most common cause is Alzheimer’s disease. With such a violation, incoming information cannot be stored in memory at all.

Disturbances in the reproduction of information occur mainly in old age as a consequence of malnutrition of the brain. In this case, the information is stored in memory, but difficulties arise in reproducing it at the right time. However, such information may be recalled when a reminder association occurs or spontaneously. Such impairments are rarely significant but do significantly impede learning.

Impaired short-term memory

Memory functionally and anatomically consists of short-term and long-term components. Short-term memory has a relatively small volume and is designed to retain semantic images of received information for from a few seconds to three days. During this period, information is processed and transferred to long-term memory, which has an almost unlimited capacity.

Short-term memory is the most vulnerable component of the memory system. It plays a key role in remembering. When it is weakened, the ability to record current events is reduced. Such patients develop forgetfulness, making it difficult to perform even simple everyday tasks. The ability to learn is also greatly reduced. Deterioration of short-term memory is observed not only in old age, but also due to overwork, depression, vascular diseases of the brain, intoxication (including regular alcohol abuse).

Temporary amnesia due to severe alcohol intoxication, traumatic brain injury, and other conditions leading to an eclipse of consciousness is also caused by a transient complete shutdown of short-term memory. In this case, events that do not have time to move into long-term memory disappear.

Complete loss of short-term memory (fixation amnesia) is observed in Korsakoff syndrome. Characteristic of dementia and advanced stages of alcoholism. Such patients completely lose the ability to remember current events and are therefore completely socially maladjusted. At the same time, events preceding the onset of fixation amnesia are stored in memory.

Impaired auditory-verbal memory

The peculiarity of the functioning of the auditory analyzer is such that in order to adequately perceive the meaning of heard speech, structures are needed to retain information while its content is analyzed. Such structures are located in the left temporal lobe of the cerebral cortex. The destruction of these structures leads to a violation of auditory-verbal memory – the syndrome of acoustic-mnestic aphasia.

The syndrome is characterized by difficulties in perceiving oral speech, while maintaining the effectiveness of other channels for obtaining information (for example, through the visual analyzer). Thus, out of four words heard in a row, the patient will remember two, and only the first and last (edge ​​effect). At the same time, words perceived by ear can be replaced with similar ones in meaning or sound.

Impaired auditory-verbal memory leads to significant difficulties in oral verbal communication and the inability to normally understand and reproduce sound speech.

Diagnosis of memory impairment

The primary stage of studying memory disorders is collecting anamnesis – identifying complaints and other information that the patient can provide independently. Also, during a free conversation, the doctor can roughly determine which component of memory is suffering.

Next, detailed testing begins. There are many tests to determine types of memory impairment. The most common of them are:

  • Testing short-term memory: repeating words aloud immediately after they are spoken by the tester. The norm is 100% repetition.
  • Ten word method: ten simple words that have no connection with each other are spoken. After this, the patient is asked to repeat them in any order. Next, the doctor again calls the same words, and the subject tries to repeat them. This cycle is repeated up to 5-6 times. Normally, at the first repetition, at least half of the words should be remembered, and after the fifth repetition, all of them.
  • Study of mediated memory using the pictogram method: the subject is told 10-15 abstract concepts, and he draws a simple drawing on a piece of paper, which is designed to help restore this word in memory. Next, using what you have drawn, you need to reproduce the words. The same playback is repeated after 1 hour. Normally, you need to reproduce 100% of words immediately and at least 90% after an hour.
  • Memory studies using texts: a simple plot text of 10 – 12 sentences is used. This makes it possible to study separately visual (the patient himself reads the story) and auditory memory (the text is read to the subject). Then they immediately offer to retell it: normally there can be no more than 1 – 2 errors. After another 1 hour, the retelling is asked to be repeated. The norm is no more than 3–4 inaccuracies.

Further, instrumental methods for examining brain functions, such as an electroencephalogram, can be used. It allows you to determine the activity of certain areas of the brain at rest and under stress. Computed tomography and magnetic resonance imaging of the brain are also widely used.

Since memory impairment is often a secondary process, research is also aimed at identifying the somatic disease that led to this condition. General analyzes and instrumental examinations are used here.

Memory impairment. Treatment

In choosing treatment tactics for memory disorders, identifying the cause of such problems plays a paramount role. After all, memory loss is always a secondary consequence of the development of many somatic or mental diseases and conditions. Therefore, without adequate treatment of primary diseases, it is impossible to achieve any lasting results in the correction of memory impairment.

Treatment for such patients should always be selected individually, taking into account the type and nature of the disorders, aimed at correcting diseases that have led to memory impairment, and designed for long-term and sometimes lifelong therapy.

In any case, self-medication is unacceptable, since at the initial stage many serious diseases (including those accompanied by memory impairment) have fairly harmless symptoms. Only a specialist can recognize such diseases and prescribe effective therapy. Therefore, early access to a doctor contributes to the effective correction of memory impairment and prevents the development of deep advanced stages of dementia.

In addition to the specific treatment of pathology that has led to memory impairment, general correction measures aimed at normalizing memory functions are also used in parallel.

Regimen and diet for memory impairment

For patients with memory impairment, it is very important to lead an active lifestyle, maintaining it until old age. Walking in the fresh air, hard work, playing sports and other active activities not only contribute to strengthening general well-being and improving blood supply to the brain. Such activity is accompanied by the receipt and processing of a significant amount of information, which in turn contributes to memory and attention training.

Intellectual activity has a positive impact on a person’s thinking abilities: reading books, printed and electronic media, solving crossword puzzles, and other favorite activities and hobbies.

Maintaining active communication of the patient with relatives and friends, social activity is also very important for strengthening memory, developing its motivational component.

For people suffering from psychogenic memory disorders, a gentle daily routine, avoidance of overwork at work and stressful situations, and correction of the psychological atmosphere at work and in the family are very important. Also very important is high-quality, full sleep that corresponds to the individual norm, but not less than 7 – 8 hours a day.

The diet of patients with memory impairment must be balanced and contain sufficient amounts of proteins, fats and carbohydrates, vitamins and microelements. Since the human brain consumes about 20% of the total energy produced in the body, diets that are extremely low in calories significantly reduce its performance.

Fatty varieties of sea fish are very useful: salmon, herring and others. They contain a lot of iodine and polyunsaturated fatty acids, including omega-3, which are part of the structure of all nerve cells

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