Page 147 - The Memory Program How to Prevent Memory Loss and Enhance Memory Power

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better, even on those tests that seemed hard to do the first time. This is the practice effect, which
means that repeated testing results in superior performance because the brain automatically (even
without conscious learning) begins to figure out how best to do the test. In people with little to no
memory loss, the practice effect can last for many months after only a single testing session.
Therefore, if neuropsychological test performance is compared before and after medication (or other)
treatment for memory loss, there will often be some improvement due to the practice effect. If,
however, active medication is compared to placebo, subtracting the change on placebo from the
change on active medication gives us the real medication effect, thus accounting for the practice
effect, which is assumed to be equal in people on active medication and people on placebo.

“I Don't Take Any Medications”: Robert's Story

Robert Molson, a fifty-six-year-old man living in Greenwich Village, came to see me, stating that his
memory had begun to decline, he was forgetting names more easily, and he was misplacing things
more often. He was afraid he was getting Alzheimer's disease. He worked as a paralegal and hadn't
yet run into problems at work, but he did point out that nothing short of a disastrous performance on
his part would even be noticed in the New York City court system. He also had financial problems
that were a source of constant worry.

He had no risk factors for dementia, and no neurological or psychiatric signs or symptoms on
examination. I asked him if he was taking any medications.

“No,” he replied bluntly.

Unfazed, I systematically went through a checklist of all possible medicines that people take for
memory loss.

“Do you take ginkgo biloba?” I asked.

‘‘Oh, ginkgo? That's a natural substance I get in a health food store; it's not a medicine,” he stated
categorically.

“Anything else you get regularly from a health food store?”

“I've tried ginseng a few times. And I take saw palmetto because I want to prevent prostate
problems as I grow older,” he explained. “And when I have a sleep problem, I sometimes take
melatonin.”

On neuropsychological testing, he performed very well. I reviewed the results with him, and he
was relieved to learn that he did not have Alzheimer's disease. Since his main fear was resolved, he
decided that there was no point in learning more about preventing age-related memory loss; that was
the last I saw of him.