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How Women Can Overcome Memory Loss at Midlife and Beyond

An interview with Elisa Lottor And review of her book, Female and Forgetful, a six-step program to help restore your memory and sharpen your mind

April 2002

By Ivy Greenwell

The section on herbs is especially interesting. While everyone knows about ginkgo and ginseng, there are promising new extracts such as huperzine A, bacopa, galantamine (derived from snowdrop or daffodil) and vinpocetine (derived from periwinkle). The book also includes brief information about drugs such as deprenyl and Hydergine.

When it comes to hormone replacement, this reviewer finds attention to thyroid deficiency, so common in midlife women, particularly praiseworthy. "I have found that thyroid hormone therapy may be a better choice than either progesterone or estrogen replacement therapy for some women who are experiencing menopause symptoms, including memory problems, cognitive changes and brain fog," Dr. Lottor asserts. She emphasizes that conventional blood tests for thyroid levels are often inadequate.

Lottor also favors the 24-hour urine collection for testing hormone levels. Likewise, she wisely recognizes the issue of individual variability when it comes to hormone replacement. "There is no single 'right' regimen for all women," she warns. Every woman needs to experiment under the guidance of a holistic practitioner in order to determine the type of replacement or hormone balancing best suited to her needs.

Finally, the section on exercise is not at all the rehash of typical advice we've been hearing for decades. Female and Forgetful singles out mind-body exercises as particularly valuable for brain function, especially in the area of attention and concentration. Martial arts are an example. For the less energetic among us, there is yoga and tai-chi.

Chronic stress kills neurons

Professional women can't be reminded enough that stress kills. First and foremost, it damages and even kills nerve cells. If you want to enjoy good memory, you must "destress and streamline." Stress is causally implicated in almost all serious illnesses, and is especially devastating to women's ability to concentrate, learn and remember. "Overloaded and overwhelmed" has become the description that fits a great number of women, especially those who work two shifts: one at a full-time job, and a "second shift" at home, taking care of their families.

The section on "the stress cascade" reminds the reader that chronic stress means chronically high levels of cortisol, and high levels of cortisol are associated with damage to the hippocampus, the primary brain center for the formation of memory. When the levels of cortisol are chronically elevated, the hippocampus actually shrinks as the neurons die.

Stress also upsets a woman's hormonal balance, and can seriously affect the function of the ovaries in premenopausal women. Chronic stress also depletes the adrenal glands, further decreasing estrogen production, particularly in postmenopausal women. "If your adrenals are depleted, you will have a more difficult menopause, a more difficult transition, and perhaps your experience of memory loss and mental decline will be more obvious," the authors warn.

Why is stress reduction so difficult? It is easy to blame modern lifestyle and information overload. Lottor and Bruning go beyond the obvious. They point out that "in a sense, overloaded women can be considered 'stressoholics'. Like any addiction, the first step to recovery is to get past . . . shame and denial." It helps to remember that "the Chinese word for 'busy' is a combination of characters meaning 'heart' and 'death'. In other words, if you are too busy, you neglect your heart until it dies." A woman who wants to prevent mental decline needs to prioritize her tasks and, very simply, do less.

Modern women are the victims of the "having it all syndrome," Lottor explains. But one can't have it all; trying to do so will overstress the brain and impair memory. Paradoxically, doing less often means accomplishing more-as well preserving mental sharpness. And it starts with a "compassionate attitude of loving kindness toward ourselves," and a vision of long decades of healthy and productive later life, unmarred by a "fried" brain that has trouble with the simplest memory tasks.

While not a substitute for stress reduction, stress-relieving supplements are yet another helpful tool in the plan to de-stress and make your brain work better. Lottor discusses calming herbs such as kava-kava, valerian and chamomile.

The book also contains simple, practical suggestions on how to compensate for impaired memory so that the impairment itself does not become another stressor. Some of the suggestions are very simple. The authors explain how to do "chunking," for instance, grouping items together into categories or simple subdivisions. Note that telephone numbers are automatically "chunked" to make recall easier. There are many other tips here, some unexpected yet very effective.

Above all, however, the right philosophy of life is a must if you want to live long and well. The authors make a wonderful statement that seems to be the corner stone of stress reduction: "There's an elegance and grace in doing one task at a time." "And doing it slowly," this reviewer wishes to add.

For optimal cognitive function, an older woman needs to stop the insanity of multi-tasking and slow down. Lottor and Bruning point out that while older women may not have the speed of learning and recall they once had, they can compensate with depth. Young people have superior "fluid intelligence": they can deal with a rush of new information. But older individuals excel at "crystallized" intelligence. "Like our relationships, our comprehension and retention of information grows deeper, richer and more meaningful with maturity," the book wisely reminds. An older woman may never be able to recall trivial details as efficiently as a younger woman can; but an older woman can offer depth and meaning instead of speed, the most essential and meaningful details rather than trivia.

The work of many artists becomes simpler and bolder as they grow older, showing the ability to focus on essentials, the authors point out. They also cite research that found that young people remembered more details of a story than older subjects, but older subjects were better at remembering the gist of the story. They brain discarded trivial details, focused on the essentials and integrated them into meaning. Once again, "less is more."

Female and Forgetful is not only a "health book." It is also a book of wisdom, written with elegance and grace. The book contains this memorable quote from an older actress: "When it comes to aging, I think the single most important component is vision in the large sense-vision of your understanding the universe and yourself, vision of what you want to be." Fulfilling that vision depends on keeping your brain sharp. The authors show how to accomplish this essential task of protecting and nurturing our most important organ.

Strange as this may sound, the idea of taking good care of one's brain is a relatively new concept. Mental decline used to be seen as "normal aging," and supposedly there was nothing you could do about it. In fact, it used to be medical dogma that "if you live long enough, you'll get Alzheimer's." Yet people who practice a healthy lifestyle, including a brain-healthy diet, neuroprotective supplements, exercise and staying mentally active, appear to be significantly more resistant to mental decline and dementia. In addition, diets rich in vitamins E, beta-carotene and vitamin C, as well certain supplements such as folic acid, have been documented to lower the risk Alzheimer's disease. Studies also show that drugs such as ibuprofen and cholesterol-lowering statins may play a significant role in preventing Alzheimer's. Even humble aspirin appears to be neuroprotective, helping prevent the tiny strokes that can lead to dementia. Thus, the situation is far from hopeless. One can take a lot of effective steps to prevent brain disease. And that is a revolutionary concept.


Lucid and warmly compassionate, filled with vivid case histories that will make women nod in agreement, Female and Forgetful brings hope and knowledge to readers striving to recover and preserve brain function. It can be done, the book says, but don't expect a "magic bullet." It takes a holistic program. Several things combined work better than just one thing. The caring tone of the book makes it easier to listen to that message without feeling that the authors are nagging us in any way, or proposing unrealistic solutions. These are gentle solutions; when combined, they can lead to very significant results.

This emphasis on an individualized combination of treatments represents the basic philosophy of the holistic movement. Holistic practitioners utilize the synergy of several treatments in several different modalities (nutrition, relaxation, exercise, supplements). Until our approach to most chronic problems becomes this kind of individualized combination of treatments, we remain in the medical dark ages.

This is an empowering book. Dr. Lottor states, "When you start my program, you start to pay attention to the most important organ of the most important person in your life-you." Women who fully assimilate this message can expect their lives to undergo a beautiful transformation.

-Ivy Greenwell