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How the Loss of Memory Works in Alzheimer’s Disease, and How Understanding This Could Help You

Posted Jan 25 2011 12:00am

“First in, last out ... Last in, first out”


I learned a while back how the expression “first in, last out and last in, first out” describes how the loss of memory works in patients suffering from Alzheimer's disease.

By Carole B. Larkin

The expression, First in, last out ... Last in, first out, is a short way of explaining that the things we learned long ago, like in childhood or when we were young adults, stay in Alzheimer’s patients’ memories longer than things they learned or experienced recently.

I never knew how this occurred, just that it did occur with persons suffering from Alzheimer's disease and other dementias.

Recently, I went to a lecture given by one of Dallas’ most knowledgeable geriatric psychiatrists and I finally found out -- How and Why.


It turns out we form memories in a two step process.

The first step is done by the hippocampus portion of the brain.

When we experience something or learn something the hippocampus takes it in and registers it. Then the hippocampus sends it to other portions of the brain to be stored.

We retrieve the memory from the other portions of the brain when we remember something.

Research tells us that the hippocampus is one of the earliest portions of the brain damaged by Alzheimer’s disease. I could never figure out why the doctors made such a big deal of that, but now I know.

When the hippocampus is damaged or dying it never registers the event or the knowledge. It’s doesn’t recognize the event, and acts the same as if the event never happened. It never sends the message to the other parts of the brain to store the event.

You can’t retrieve what was never stored can you?

Before the hippocampus is damaged it can register events and send them to storage, so those events are there to be retrieved.

Ever wonder why mom has no idea that she had breakfast, but knows the color of the dress she wore at Easter 40 years ago? Because the old memory was stored, while the newest memory is no longer stored because the hippocampus is no longer doing its job.

It actually makes sense that mom repeats herself over and over, because her brain never registered the fact that she already asked the question or told the story before.

Biologically, the brain cannot do its job because the hippocampus is damaged.

You cannot teach mom to not repeat herself because the hippocampus cannot register the teaching or send it to the storage units of the brain -- this is caused by damage to the hippocampus.

Do yourself a favor -- think about this when an Alzheimer's patient keeps asking the same question over and over, or engages in behaviors like insisting you did not call this morning.

Recognizing why this is happening might help you overcome feelings of anger and frustration.

Your comments and reaction are welcome in the ADD New Comment section below.

Think about about this article and how the brain works; and then, let me know if this article was of help to you.

Also consider sharing this with family, friends and other members of the Alzheimer's community.



Carole Larkin MAG, CMC, CDP, EICS,
is a Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. ThirdAge Services LLC , is located in Dallas, TX.
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