Sorry, I forgot

Updated: 24 November, 2019 07:49 IST | Arita Sarkar | Mumbai

Poor sleep hygiene, stressful work hours and extra screen-time means that Mumbai's 40 and 50-year-olds can't remember what they did recently. The good thing is that it can be reversed

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At 50, Mohini (name changed on request), a share market trader, has everything going for her, except for memory. Her job has always been stressful. But, she didn't realise when the long hours on the computer and phone, started taking a toll on her brain. "It all began when I forgot to give my son something that I had brought for him," says the Malabar Hill resident. This pattern of forgetting kept recurring, until she visited the doctor.

Mohini has been diagnosed with mild cognitive impairment. The symptoms include misplacing objects, forgetting to go for planned activities and appointments.

Mumbai's neurologists say they have observed a spike in the number of memory dysfunction cases—previously common among patients in their 70s—in middle-aged Mumbaikars. KEM Hospital in Parel, in fact, receives an average of five cases every month. Most of these are attributed to poor lifestyle choices, including lack of sleep and deficiency of vitamin B12. Fortunately, the effects are reversible.

illustration/UDAY MOHITEIllustration/Uday Mohite

While degenerative mental illnesses like dementia and Alzheimer's occupy one end of the memory dysfunction spectrum, the other end comprises mild cognitive impairment.

In order to understand memory loss, Dr Joy Desai, director and head of the neurology at Jaslok Hospital, says that it is important to first understand how memory works. Storing memory begins with a crucial part of the brain's anatomy called the hippocampus, which is a part of the body's limbic system and is responsible for storing cognitive maps—mental maps of spatial environment—and encoding memories.

Dr Joy Desai, director and head of the neurology at Jaslok Hospital, says that the hippocampus in the brain functions like a pen drive. It serves as a temporary storage for memories, which have to be emptied before the next day. “This transfer happens when we sleep. The data is transferred to the frontal and parietal lobes depending on the type of information,” he says. Lack of sleep can disrupt this cycle. PIC/SURESH KARKERA
Dr Joy Desai, director and head of the neurology at Jaslok Hospital, says that the hippocampus in the brain functions like a pen drive. It serves as a temporary storage for memories, which have to be emptied before the next day. “This transfer happens when we sleep. The data is transferred to the frontal and parietal lobes depending on the type of information," he says. Lack of sleep can disrupt this cycle. Pic/ Suresh Karkera

Simplifying it, Desai says, "The hippocampus in our brain functions like a pen drive. It serves as a temporary storage for memories, which have to be emptied before the next day. This happens when we sleep; the data is transferred to the frontal and parietal lobes depending on the type of information."

According to Desai, the consolidation of memory takes place through sleep spindles, which are like USB cables. The frontal lobe, which stores memories related to executive decision and judgement, and the parietal lobe, which interprets visual information and processes language, serve as the hard drive of the brain.

Sudoku

Neural activity generates two proteins, amyloid-beta and tau, and these are drained by the brain's glymphatic system during sleep. Erratic sleep patterns lead to a build-up of these proteins, which then disrupt the functioning of brain cells, typically experienced among patients with degenerative diseases like Alzheimer's.

Apart from the transfer of data, the brain also witnesses hippocampus ripples, which refers to the brain reliving the experiences of the day in quiet wakefulness or when the mind is idle. "During REM [rapid eye movement] sleep, the brain shuffles through the day's emotional memories. Lack of proper sleep coupled with stress can lead to mood swings and it makes people emotionally labile," he says, adding that over the last few years, he has seen symptoms among patients aged 40 to 60. He has also had a few cases of patients in their late 30s.

Stressing on the importance of eight hours of sleep, Desai says, "People have poor sleep hygiene for a variety of reasons, including the growing use of online entertainment platforms. As a result, they have less than efficient memory retention."

At KEM Hospital, too, neurologist Dr Neeraj Jain has seen a rise in the number of patients facing cognitive problems.

DR PRADYUMNA OAKDR Pradyumna Oak and Karishma Jethmalani

While sleep is a big factor, other causes for loss of short-term memory include a combination of unhealthy lifestyle choices. Karishma Jethmalani, neuropsychologist at Sir HN Reliance Foundation Hospital, says, that diabetes, deficiency of vitamin B12, which helps maintain healthy nerve cells and red blood cells, thyroid levels, depression, anxiety and multi-tasking, can affect memory, judgement and planning. Jethmalani adds that if treated earlier, the symptoms can be nipped in the bud within a year's time.

Doctors say physical and mental exercise can positively impact mental health. Dr PP Ashok, head of the neurology at Hinduja Hospital, Mahim, says the brain can only be challenged with unconventional exercises.

Mohini, for instance, has started following a more disciplined routine. "I sleep at 11 pm and wake up by 7 am every day. I have also started solving Sudoku and crossword puzzles regularly, and have taken up yoga and meditation. It's a work in progress," she shares. Desai also suggests taking up cardiovascular exercises, since they can help the hippocampus grow.

Studies have shown that there are various activities that keep the brain active and lead to regeneration of nerve cells. Dr Pradyumna Oak, neurologist and head of the stroke clinic at Nanavati Hospital, says, "I advise my patients to learn a new language or instrument or even take up a new hobby."

Dr Pradyumna Oak - Advises patients to learn a new language or instrument

Karishma Jethmalani - Says diabetes and vitamin B12 drop can affect memory, judgment and planning

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First Published: 24 November, 2019 07:21 IST

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