ADHD does not exist?

Million dollars question!

Thats actually Dr Saul’s statement.

I cant say I agree with everything he says, but it might be an opportunity to question ourselves….   no?

Dr Saul writes ” Every day my colleagues and I see more and more people coming in claiming they have trouble paying attention at school or work and diagnosing themselves with ADHD.    And why shouldn’t they?    If someone finds it difficult to pay attention or feels somewhat hyperactive, attention-deficit/hyperactivity disorder has those symptoms right there in its name. It’s an easy catchall phrase that saves time for doctors to boot. But can we really lump all these people together? What if there are other things causing people to feel distracted? ”

It would be VERY hard to prove ADHD does not exist.

Thankfully, as a neuropsychologist, my job is to try to understand WHY patients report feeling distracted or forgetful.  I dont have to debate if ADHD exists or not. My job is to take on a quest to find the nature of the underlying problem, help the person see it and maybe accept it before we search for solutions.

Here is an illustration of a case :

Imagine Joe. Joe has born missing 1 toe on a foot. It really annoys him. He relates most of his difficulties to this missing toe : its hard for him to run errands, and to practice some sports, or to just go from point A to B. He feels a foot prosthesis would help him live a “normal” life.

Joe goes to see a Dr one day to inquire about solution for his missing toe.

After talking to the Dr and doing some exams, they discover Joe has severe knee problem. The missing toe is not actually affecting his locomotion, his knee is.

After they have identified the real nature of the problem, they are both able to address and fix the problem.

And a foot prosthesis would not have fixed the problem.

Thankfully, Joe and his Dr took the time to look for other possible explanations of the problem, so they were really able to fix it.

Does ADHD exist ?

I cant say it doesnt.

But I can say people come to my office for a reason.

So lets try to address these difficulties, beyond the diagnosis.

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Assessment in Neuropsychology … so much more than IQ testing

“IQ” testing can be quite informative when trying to understand a child…

Why, then, does the term “IQ” sometimes give me the chills..?

Because using a score on a scale to define someone’s way of thinking is simply too reductionist!!

Most importantly, keep in mind that interpreting an IQ test and/or speculating about one’s IQ often wrongly assumes that all other functions are relatively well functioning….

Does the child has hearing difficulties, where he can’t hear properly, or auditory integration difficulties, where he can’t distinguish well the words of the teacher through the sounds of the class, or non-verbal difficulties, where he doesn’t understand jokes, mixed messages or prosody of language – not referring to Asperger’s syndrome here, or some specific memory difficulties slowing his ability to recall the meaning of the words of a text.

Then, is he able to pay attention in class? Is he too smart and bored? Is he too anxious to pay attention – fearing, with or without reason that he might miss the bus? Is he very preoccupied by recent peer rejection? Is he confused by the constant change of routine? Has he eaten this morning? Could he be a visual learner/thinker who would benefit a different type of learning?

Let’s say he has attention difficulties, what do you mean? Sustained attention? Divided attention? Selective attention? How would you qualify his attention when he is reading, compared to listening? Have you noticed a difference? Can he read regular words? Irregular words? Non words? Manipulate syllables? How is his grammar? Is he making attention mistakes while writing? Is he writing sloppy? Is it because of fine motor difficulties? Or maybe he thinks faster than he writes? Can he plan the writing sequence appropriately? Did he ever “memorized” the sound of each letter? Is he perceiving and integrating the letters well?

Etc. etc.

Once we have figured how the entry levels are functioning (i.e. verify that the vision, hearing, perceptual and attentional functions are well preserved) then we can venture in drawing conclusions about “higher level” cognitive skills, like reasoning and speculate about intelligenceS.

But that is another can of worm. 🙂

To be continued…

 

 

DESCRIPTION détaillée et DURÉE des services

Le type et la durée des services varient d’une personne à l’autre.

Conséquemment, les services sont facturés à l’heure à raison de 160 $ / heure. Le coût total de l’évaluation et / ou du traitement varie donc selon la durée des soins. Voici cependant quelques approximations.

Dans la plupart des pratiques nord-américaines, une évaluation neuropsychologique typique varie entre 7 et 14 heures. Cela comprend le temps d’examiner les dossiers, d’interviewer le patient et sa famille, d’effectuer l’évaluation, de noter les résultats, de préparer un rapport final résumant les constatations et d’examiner ces constatations avec le patient / client et / ou la source de référence.

 

Durée des évaluations :

Adulte (incluant le TDAH chez l’adulte) 960 $ et plus

  • Entretien clinique. 2 heures. Arrivez tôt pour remplir les formulaires de consentement et préparez-vous à remplir des questionnaires après notre réunion. Mon but : j’essaie de vous connaître le mieux possible et le plus rapidement possible!
  • (Mini) évaluation neuropsychologique. 2 à 3 heures. Nous ferons des tests d’attention, de mémoire, de langage, de raisonnement, etc. Nous essayons de comprendre comment vous traitez l’information.
  • Correction des tests et des questionnaires. Interprétation des résultats. Rédaction. 1 heure à 4 heures. Je regarde tous les questionnaires, tests et symptômes rapportés et j’essaie de trouver des liens, des explications et des solutions. Ensuite, je prépare un résumé, un rapport complet, ou une lettre pour votre médecin (pour pharmacothérapie) – selon vos besoins.
  • Session de feedback. 1 heure. Je vous donne mes impressions et hypothèses sur le diagnostic, ou nous parlons du diagnostic.
    • Les discussions sur le diagnostic peuvent durer plus d’une heure. Il est souvent bénéfique pour le patient de prendre le temps d’intégrer toutes ces informations et prévoir une rencontre de suivi quelques semaines après l’évaluation.
    • Il est aussi possible de débuter une intervention après le diagnostic (evidenced based intervention for Adult with ADHD). La remédiation cognitive pour l’adulte avec le TDAH améliore le fonctionnement et l’humeur. Peut être utilisé avec ou sans pharmacothérapie.
    • La pharmacothérapie est prescrite et contrôlée par votre médecin généraliste. C’est le médecin généraliste qui connaît votre santé physique générale. C’est donc de concert avec lui que la pharmacothérapie peut prendre place. Si vous n’avez pas de médecin généraliste, présentez-vous en clinique sans rendez-vous avec votre rapport de neuropsychologie.

 

Enfants, adolescents et jeunes étudiants 1760 $ et plus – dépendamment du temps requis

  • Entretien clinique. 1 à 2 heures Arrivez tôt pour remplir les formulaires de consentement et préparez-vous à remplir des questionnaires après notre première rencontre – j’essaie de vous connaître le mieux possible et le plus rapidement possible.
  • Évaluation neuropsychologique. 4-7 heures. La durée de l’évaluation peut être difficile à prévoir. Certains travaillent plus vite que d’autres. Certains ont besoin d’une évaluation plus détaillée que d’autres. Dans la plupart des cas pédiatriques, une évaluation globale est très importante pour identifier précisément ce qui se passe. Pour les enfants et les jeunes adultes qui étudient encore, une évaluation intellectuelle complète est essentielle, en plus des tests d’attention, de mémoire, de langage, de raisonnement, etc. But = essayer de comprendre comment vous traitez l’information. De plus, le fonctionnement scolaire doit être évalué. Il est donc utile d’apporter une copie des bulletins avec vous. Il est aussi fréquent que j’envoie des questionnaires à l’enseignant. Finalement, il est important d’évaluer le fonctionnement de la personne dans de nombreux domaines (maison, école, travail, loisirs, etc.).
  • Corriger les tests neuropsychologiques et les questionnaires. Je regarde tous les questionnaires, tous les tests, tous les symptômes que vous avez rapportés et j’essaie de trouver des patterns, des explications et des solutions. Ensuite, je prépare un rapport avec tous les résultats et recommandations pour la maison et pour l’école. Cela prend 4 heures pour un rapport complet, mais il arrive que les cas complexes prennent plus de temps.
  • Session de feedback. 1 heure. Je vous donne le diagnostic et quelques recommandations. NOTE: Je recommande au moins une séance de suivi, un mois après le diagnostic. Pour voir l’intégration à la maison et à l’école. Il est parfois difficile de mettre en place les changements: les parents et les élèves ont parfois encore besoin d’aide après le diagnostic. Rome ne s’est pas construite en un jour J
  • Si jugé nécessaire, la pharmacothérapie peut être recommandée. La pharmacothérapie doit être prescrite et contrôlée par votre médecin généraliste. C’est le médecin généraliste qui connaît la santé physique générale de votre enfant. Prenez rendez-vous avec lui et apportez une copie du rapport neuropsychologique avec vous.

 

 

Adultes de plus de 55 ans (1440 $ – pour l’évaluation complète avec rapport détaillé)

  • Entretien clinique. 2 heures. Arrivez tôt pour remplir les formulaires de consentement et préparez-vous à remplir des questionnaires après notre réunion – j’essaie de vous connaître le mieux possible et le plus rapidement possible.
  • Évaluation neuropsychologique. 4 heures. Tests d’attention, mémoire visuelle et verbale, praxis, langage, raisonnement, etc.
  • Correction des tests et des questionnaires. Interprétation des résultats. Rédaction. 1 heure à 4 heures. Je regarde tous les questionnaires, tests et symptômes rapportés et j’essaie de trouver des liens, des explications et des solutions. Ensuite, je prépare un résumé, un rapport complet, ou une lettre pour votre médecin (pour pharmacothérapie) – selon vos besoins.
  • Session de feedback. 1 heure. Je vous donne le diagnostic et quelques recommandations.
  • REMARQUE: Les discussions sur le diagnostic peuvent durer plus d’une heure. Il est souvent très bénéfique pour le patient de prendre le temps d’intégrer toutes ces informations. Si nécessaire, certains médicaments peuvent être prescrits et contrôlés par votre médecin généraliste. Envoyez à votre médecin généraliste ou spécialiste une copie de votre rapport. Il suivra avec le traitement pharmaceutique approprié. Il est celui qui connaît le mieux votre santé physique.

 

Vous ne savez pas si vous voulez / avez besoin d’une évaluation neuropsychologique?

Cédulez une consultation initiale en personne (2 hrs)

Il est possible qu’une évaluation neuropsychologique ne soit pas justifiée. Dans le doute, une première consultation en personne est suggérée. Cette première consultation est un rendez-vous de deux heures (320 $) au cours duquel le Dr Gagnon mènera une entrevue approfondie et un dépistage cognitif de base, au besoin. Sur la base de cette évaluation initiale, une évaluation neuropsychologique sera recommandée ou non (voir détails ci-dessus). Vous pourrez également recevoir des suggestions et des recommandations, en fonction des résultats et des impressions cliniques préliminaires.

 

Services dans les deux langues officielles

Services disponibles dans les deux langues officielles : le Français et l’Anglais.

Évaluation en français ou en anglais?

Il est possible d’obtenir une évaluation neuropsychologique ou académique en français ou en anglais. Pour les enfants en immersion en seconde langue, l’évaluation doit être réalisée dans les 2 langues (langue maternelle et langue d’immersion).

Pour les adultes et les clients plus âgés, il est essentiel de compléter l’évaluation dans leur première langue. Le devoir du neuropsychologue de compléter, dans les mesures du possible, à la langue ou à la langue natale du client. Le neuropsychologue doit compléter son évaluation de manière à respecter les préférences et la compétence langagières de son client. (Norme éthique 9.02)

Rationnel: Une évaluation neuropsychologique complète comprend une évaluation complète des capacités verbales et non verbales du langage. Par conséquent, le clinicien est capable d’évaluer, la récupération sémantique, la fluidité verbale, la compréhension verbale, le décodage non-verbal, etc. Conséquemment, la capacité d’évaluer ces domaines est directement liée au degré de confort du clinicien avec cette langue X l’expertise en évaluation neuropsychologique.

Sur ce sujet, voir aussi

  • Brickman et Cabo (2006)
  • Artiola, Fortuny et Mullaney (1998)

Evaluation Neuropsychologique

La neuropsychologie est une science qui étudie la relation entre le cerveau et le comportement humain. Elle s’intéresse à la fois au fonctionnement normal et anormal du cerveau.
La neuropsychologie est aussi une discipline clinique qui vise à appliquer les connaissances cliniques et scientifiques de la psychologie et des neurosciences dans le but de venir en aide aux personnes qui ont un trouble neurologique développemental, acquis ou dégénératif. Cette aide peut prendre la forme d’une évaluation, d’un suivi ou de réadaptation.
Les neuropsychologue font l’évaluation des fonctions cognitives. Les fonctions cognitives sont les capacités de notre cerveau qui nous permettent notamment de communiquer, de percevoir notre environnement, de se concentrer, de se souvenir d’un événement ou d’accumuler des connaissances.
Formation pour l’évaluation des troubles neuropsychologiques maintenant exigée est une formation de niveau doctorale.
Une formation théorique et pratique permettant d’acquérir une compréhension des éléments suivants :
– Les modèles, les théories et les principes en neuropsychologie;
– Le développement et le fonctionnement du cerveau normal;
– La neuroanatomie fonctionnelle;
– Les diverses dysfonctions neuroanatomiques, neuropathologiques, neurochimiques et athophysiologiques y compris les symptômes, l’évolution, l’évaluation, le traitement et l’intervention;
– Les troubles de l’attention, du langage et de la mémoire, les gnosies, les praxies, les fonctions exécutives et les divers processus émotionnels, sensoriels ou moteurs volontaires et involontaires;
– Les méthodes et techniques d’évaluation, notamment en psychométrie.
Le corpus de connaissances théoriques ainsi que la période d’apprentissage par stage ou internat doivent permettre au psychologue de développer un esprit critique et la maîtrise requise pour évaluer les troubles neuropsychologiques.
La pratique de le neuropsychologie clinique est une science relativement nouvelle et complexe. Les neuropsychologie vont parfois aussi poursuivre des formation de niveau de niveau post-doctorales et sont tennis de rester à jour en suivant de la formations professionnelle continue.
L’ordre des psychologues doit évaluer les dossiers des candidats et émettre des permis de pratique spécifiques à la pratique de la neuropsychologie clinique.
Références.
  1. Ordre des psychologues du Québec (OPQ)
  2. Associations des neuropsychologie du Québec (AQNP)

Do You Wonder About ADHD?

These symptoms look just like you? Just like your loved one? Teachers says your child might have ADHD?

Great news : here is an opening for growth so don’t be lazy: hasty conclusions are too easy. Many neuropsychological disorders will look like ADHD, in child and in adults. Many psychological disorders will look like ADHD, in child and in adults. Even challenges with relationships can make you wonder about ADHD. Understandably. Because there are a xillion reasons why one can exert a certain set of “symptoms”. Is it dyslexia, intellectual giftedness, memory impairment, depression, adjustment disorder, non verbal syndrome, asperger, visual agnosia, a visual spatial learning style, or ADD / ADHD…how will you know?

Some authors will say “ADHD does not exist”. Others will blame the “over-diagnosis of ADHD in adults

Both positions highlight that “ADHD” can actually be many other things! This diagnosis should be one of exclusion: a professional has to rule out all other possible causes for inattention, impulsivity or disorganization, before jumping to conclusions. For a valid diagnosis, all other probable causes should be assessed and ruled out. This means assessing attention, intellect, language, memory, mood and so forth. Without proceeding to careful evaluation, we might over-diagnose ADHD – like we currently do.

So now what do I do?

Ask a neuropsychologist. Take the time to do this process of discovering yourself / your child. Take the time to evaluate all the options and see what really makes you think you/your child have ADHD? In short, what’s bugging you? Is it interfering with your functioning? How? Be ready to ask yourself questions and keep an open mind for the answers.

Ask your Family Doctor for a reference.

You have 2 options: public or private.

Find one in the public system? Nowadays, there are very little neuropsychologist in the public system. Most will only work with complex cases and do not accept reference from the general population. Try your luck and ask your doctor. But also be ready for option 2.
Go private? Just like going to the dentists: it can get a bit expensive, but its worth it. Services are covered by most insurance package (under “psychologist”).

Here is how to find a neuropsychologist, the only professionals that can asses and diagnose neuropsychological disorders (bill 21) https://www.ordrepsy.qc.ca/web/ordre-des-psychologues-du-quebec/trouver-de-aide

One last thought: ADHD is hardly diagnosed in a 15-45 min consultation. Its an exclusion diagnosis. We have to look at other options or else we might miss the point and never really address the problem with the right interventions.

Workshops by Drs Lamarre and Gagnon

Workshops Now Available!

Drs Lamarre, psychologist, and Gagnon, neuropsychologist, offer workshops to help tackle some of the emotional, cognitive and behavioral aspects of productivity. 

G. Gagnon, L. Lamarre (2016) Protect your brain from stressful life. Conference on work productivity.

  • First half of the conference is on Brain Health: the variables associated with brain health and motivation to change. Second half of the conference is designed to help participants understand the functioning of attention and memory, as well as to optimize their focus and concentration at work. 

G. Gagnon, L. Lamarre (2016) Stay focused. Conference on work productivity.

  • Conference designed to help participants understand the functioning of attention and memory, optimize their focus and concentration and give great interviews.

G. Gagnon, L. Lamarre (2015) Master procrastination. Conference on work productivity.

  • Procrastination is not just a problem of time management. It is a complex process that involves affective, cognitive, and behavioral components (Fee & Tangney, 2000).

Also available:

G. Gagnon (2013). The effect of depression and anxiety on memory and attention. Scientific Knowledge translation. 

  • Information on brain health and the effect of anxiety on functioning at work and daily living.

Workshops of 2-3 hours each.

All available in French and in English.

Workshops offered at La Passerelle Employment & Career Transition Center, Montreal. Canada (Aug 2015, Jan 2016, May 2016,  Aug 2016, Nov 2016) and at Government of Canada , Toronto, Canada (May 2013, April 2016). – contact us to book yours. 

Contact us to set up these two workshops in your business!

 

”Twentysomething” … Strategies to Help your Memory

Twentysomething Strategies to Help your Memory

 

 Strategies to help your memory (for all ages!)

 A variety of strategies have proven highly effective in helping people improve their memory and/or learn new information and skills.

 

Some of them are detailed below. They are organized in four main sections: memory techniques, effective learning strategies, external help for your memory, and memory techniques.

 

  • Memory Techniques

Little tricks that some students use to learn a great amount of information can help improve your everyday memory.

 

  1. Use acronyms. Use the first letter from all the words/things you have to remember and make one sentence with them. Here is a classic example: “My Very Easy Method Just Set Up Nine Planets” represents the names of the nine planets in the solar system. These tricks worked for us when we were children. And, they still do.
  1. Associations. Link the information you need to remember through association. For instance, use numbers that are significant to you, such as dates. Make connections between the different things to remember: e.g. PIN 36912 → multiples of 3. PIN 2510 → 2X5=10. When you generate possible links between the items you need to remember, you are creating a richer memory trace. These self-generated links between the items might serve as cues for retrieving the information later. This technique can be used with numbers as well as with words or concepts. Be imaginative!
    1. Story-making. Making up a story with the information you need to remember will make the information meaningful and organized, which can help you remember it later. Also, you could imagine the story involving many of your senses, hence using different regions of your brain and making it much more likely that you will later be able to recall the information.

 

Let’s say you need to remember to ask your friend three things when you see her. You have an important diner next week and you need to organize a few things before then. You want the name of a good cook for the event as well as a good hair-dresser and you want to ask your friend to give you back the suit you lent her so that you can wear it to your diner. You can picture a cook with a very big and extravagant hairstyle wearing your suit! When following the advice we mentioned earlier, take the time to work on this mental image and to make it funny so it stays in your imagination. Imagine the suit way too big or the hairstyle extremely original; think about how the suit might be odd on this funny character. You are creating the image in such a way so as to later remember it.

  1. Method of Loci. Visualize a route you know very well. Place the things you have to remember on this route in your mind. To remember the info, go through this route again in your head and recollect the items you need to remember. See the TED Talk by Joshua Foer to inspire you http://on.ted.com/gGbw or ask neuropsychologist Dr. Sylvie Bellevile about her MEMO memory program.
  2. The SQ3R Method. Survey, Question, Read, Recite, and Review: the golden rule to learn a text efficiently. Some students do this without even realizing it and it is the key to learning a substantial amount of information. Excellent for students! Here is how it works: 1) Survey – get an overview of the material. 2) Formulate a question based on what you’ve just read. 3) Read the text. 4) Recite out loud the key point(s) of what you have just read. 5) Review the information the next day, or a few hours later.

 

*** If you feel your attention drifting, get a highlighter! Reading with a highlighter or a pen, and highlighting the important points/words, will help you read actively. Being an active reader will help your attention hence your memory!

 

HAVE YOU EVER EXPERIENCED THIS : You know it is there but you just can’t find it?? You know the name but you just can’t find it??

Sometimes the information is available in memory but it’s just not accessible. This phenomenon (called “blocking”) is observed at all ages and has been greatly studied. When you are looking for someone’s name and you can’t find it, it’s not that you have forgotten the name – it’s merely that the name is hard to access at the moment. This is a form of difficulty with “retrieval” of the information from your memory. Below are a few possible solutions:

  1. Recreate the context. Walking into a room and forgetting why you went there is a classic problem. A possible solution is to try to recreate the context of what you were thinking when you realized you needed to go there.
  2. Talk about it. Let’s say you forgot a word or a person’s name. Talk about it using other words. Give details about this person and his or her physical attributes; describe the word your memory is targeting. Talk about things associated with the “target” as this dialogue can conjure up cues to remember.

 

***The concept of cues. This is a very important idea in memory. It explains a lot of things about HOW we remember things – i.e. what the PROCESS of remembering is. To enable a conscious remembering of something, we often use cues, or things around us that make us remember. For example, seeing someone on the street opening an envelope makes us remember that we forgot to pick up our mail. Or, smelling someone`s perfume reminds us of another memory. The smell is the cue that automatically activates the memory.

 

  • Effective Learning Strategies

 

  1. Repeat information to yourself. If you want to memorize something, repeat it to yourself several times. Or, take time to notice and rehearse the information. If you have to remember a phone number, repeat it to yourself a few times.
  • This is a very simple strategy. But, it is not necessarily the most efficient. I once heard a teacher say: “Not everything needs to be It’s better to understand.” So true!
    1. Make things meaningful. If you want to remember a name, think about what the name means or associate it with someone or something that reminds you of that name. Still trying to render that phone number? Associate it with dates that mean something to you or associate it with the dates you know by heart. Are you a hockey fan? Associate phone numbers to hockey players’ numbers, if you know them very well!
    2. Visualize it. Create a mental image of what you are trying to remember. Make it funny or strange and it will help you remember it. You’ll be surprised how much this works! Ask Joshua Foer, a memory champion how it worked for him! When you visualize something, try to involve as many of your senses as possible. Or better yet, smell it and feel it in your head. Involving vision, touch, or emotions will activate different regions of your brain and can cause the information to be stored in many different areas of your brain, making this information much more resistant to forgetting. Involving many senses makes it more likely that you will later be able to recall the information.
    3. Take time to understand the information: Taking the time needed to understand an idea and the logic behind it will make it easier to remember. This is because it has become meaningful and you have put effort into understanding it. The results of the most fundamental studies in human memory are very clear: by giving better attention to something, you increase your chances of remembering it.
    4. Pay attention. It is hard to remember something you did not pay full attention to in the first place. Make a point of focusing your attention on information you want to remember – such as the name of someone you meet for the first time or where you parked your car. Pause for a few seconds and pay attention.
    5. Talk to yourself. Have you ever left the house and wondered whether or not you locked the door? To prevent worrying about it, say to yourself (silently or out loud) the task that you intend to do or are currently doing. This will help you keep track of and remember it.
    6. Limit distractions. We have all walked into a room only to realize we have forgotten the reason why we went there. Why is this? You might have gotten distracted.
  • You’ll notice that sometimes remembering to do something is more difficult if there are distractions standing in the way of your goal. For example, if someone starts talking to you while you are going to get something in another room, you might forget what you initially wanted to do. Why? Did you get distracted from your initial goal?
  • Limiting distraction is also good for your attention; hence, it might help you better memorize… as you will be better able to focus on the information you need to remember. Makes sense, right?
  1. Spaced retrieval. Every time you try to consciously remember something, you make that memory stronger. Practice “spaced retrieval” by gradually spreading out the repetitions over longer and longer intervals. Also, learning that is spread out over time (spaced rehearsal) is more durable than learning that is concentrated within a short period (massed trials).
  2. Be patient. Take the time you need to learn new information. Give yourself time to understand new information. If it takes more time and more questions for you to remember, so be it. Be patient with yourself! 😉

 

  • External help for your memory

 

  1. Write things down. Writing things will not necessarily make your memory lazy. When you write down information or take notes during a meeting (at work or at your doctor’s office), you are actually working on the information you need to remember, thereby making the memory trace richer and more solid. By giving the information good attention, you are elaborating the memory trace. Also, when you will look at the info later, you will remember what it meant, making the memory trace stronger (read point number 15 again!)
  2. Buy an alarm. Then, set alarms. Do you often forget to take your pill or supplement? Buy an alarm at the dollar store, set it, and leave it next to the bottle. Strategies don’t have to be complicated to work.
  3. Use the options on your phone. Use the calendar option on your phone or a pocket day planner to keep track of your schedule, frequently used phone numbers, etc. You can also take notes, make a list of questions to ask your doctor at your next appointment or of medications you currently take or note of any other important information. This way, you can have it with you at all times! Feel free to take pictures of important business cards too: then, you will always have them with you.
  • Using available technology to support your memory is an excellent and very reliable memory strategy to make sure you have access to important info and that you get to your appointments on time and well-prepared.
  1. Reach out. If you don’t feel comfortable with all the apps on your phone or pocket day planner, ask someone to show you! You might be surprised of their enthusiastic answer!
  • Try to reach out to people when they have time to help you J
  1. Routine is the key. Memory strategies work best when they are used consistently: Use your day planner every day. Practice is key!

 

Organize information …and your environment!

 

  1. Routine is the key (again). Keep items that can be easily misplaced (like keys!) in a consistent and visible location. Make a habit of always returning the items to those places (consistency!). Seems too simple of a strategy? Maybe that is why it always works!

 

DID YOU KNOW…  that many researchers from the last decade have shown that the brain can tolerate some accumulation of Alzheimer’s disease pathology without a person showing any symptoms!

 

Interestingly, recent research has focused on identifying factors that would make some people more resistant to Alzheimer’s disease pathology..

 

In 2010, the United States National Institutes of Health systematically reviewed scientific data on the relationship between various personal/environmental factors and cognitive decline (like memory loss). They wanted to better understand the memory problems, or other cognitive problems, sometimes seen in aging folks. They found that diabetes, smoking, depression, cognitive engagement, physical activity, and diet can all contribute to these problems.

In 2014, Chen and collaborators identified Modifiable Risk Factors for Alzheimer’s disease and Subjective Memory. Mood, cognitive stimulation, physical exercise, and cardiovascular conditions like hypertension are significantly associated with subjective memory. See their article in PLOSone (free). Let’s look at the meaning and implications of all this.

 

 Healthy mind in a healthy body

A very efficient way to maximize your chances of aging well and prevent cognitive decline is to keep your heart and body healthy. The brain is an absolutely fantastic organ – but it’s also part of the body and thus greatly depends on the efficiency of the cardiovascular system. If your heart and blood vessels are not doing a good job of providing the brain with blood, chances are your brain will not be aging as well as it could. By keeping your heart healthy, you contribute to keeping your brain healthy. The opposite is also unfortunately true.

 

  1. Exercise regularly, by doing something you enjoy. Walk or bicycle instead of driving or riding the bus. Take a half-hour walk daily around the neighborhood in the evening or during your lunch break. Take an exercise class or join a health club. Scientific studies have shown that participants with higher cardiovascular fitness perform better on attention-based tasks. If the brain gets its oxygen and nutrients, it functions better.
  • To help Canadians move towards healthier lifestyles, the Public Health Agency of Canada supported the Canadian Society for Exercise Physiology (CSEP) are reviewing the scientific evidence on physical activity and developing new physical activity guidelines. See the Health Canada website for more details.
  • It is recommended that adults accumulate at least 2 1/2 hours of moderate to vigorous physical activity each week and that children and youth accumulate at least 60 minutes per day.
  1. Eat a well-balanced diet that includes lots of fruits and vegetables. This will help your brain get the nutrients it needs and keep your heart healthy.
    • Most recent literature suggests that a Mediterranean diet comprised of vegetables, fruits, whole grains, fish, and legumes is linked to good cognitive aging and perhaps lower rates of depression (Skarupsi et al 2014).
  2. Get your sleep. We consolidate learned information while we sleep. Talk to your doctor if you think you have sleep apnea. Try to have a routine before going to bed (this will prepare your mind for going to sleep and ease the transition). Try drinking something hot, such as a cozy cup of chamomile tea or a glass of warm milk, to help prepare you for going to bed. Keep a consistent sleep schedule, if possible. Exercise in the morning if you can. It enhances your alertness at the beginning of the day and makes for better sleep at night. Avoid daytime naps or make them brief (30 minutes or less). Lower temperatures and a darker room promote sleep.
  3. Try not to smoke and drink too much. These habits constrict the blood vessels going to the brain. In the long run, this limits the efficiency with which the blood vessels irrigate the brain.

Alcohol also disturbs sleep architecture, leading to fragmented sleep, more frequent awakenings, and thus more tiredness in the morning even after the same amount of sleep.

  1. Get regular medical check-ups. Your general physician will help you control existing medical conditions like diabetes or cholesterol. Controlling these medical conditions will help limit their impact on your body and brain health. Your general physician can help you with these things. Make your annual appointment now if you have not already done so. If you don’t have a general physician, go to a nearby clinic and get put on a list. Or register online.

http://sante.gouv.qc.ca/en/programmes-et-mesures-daide/inscription-aupres-d-un-medecin-de-famille/

 

 

 

Food for thought…

It’s all about the attitude!

In their Study of Aging, the Chicago Rush Memory Clinic asked 246 older people in the community about their purpose in life and tested their memory as well as the amount of Alzheimer’s disease pathology present in their brains. Results show that participants with higher levels of purpose in life exhibited better cognitive functions, even at more severe levels of Alzheimer’s disease. In fact, a higher purpose in life was a protective factor for the clinical expression of Alzheimer’s disease. Indeed, people with a higher purpose in life showed less cognitive changes, even with a high level of Alzheimer’s disease in their brain. One’s purpose in life, or the meaning derived from life experiences and goal-seeking, is a component of well-being that has long been associated with positive health outcomes.

Reference: Boyle and collaborators in Archives of General Psychiatry (2012)

 

  1. Keep your mind active. Engage in activities that make you think or activities that make you learn new things, such as playing games (e.g., puzzles, cards, chess) and reading books. Activities like socializing and attending cultural events are incredibly stimulating for your brain and might also be good for your mood.

 

  1. Maintain a positive outlook. There are things you can do to improve your memory. You have more control than you think! And, you have already started to take control as you read this and think about ways to make your memory better! People with positive attitudes toward their memory find it easier to learn and remember.
    • Consult your doctor (physician or psychologist) if you are feeling depressed and unable to achieve a positive attitude. You can and do have control over your life. Someone can help you change your attitude, if needed!

Find someone in Quebec https://www.ordrepsy.qc.ca/en/public/find-a-professional2/index.sn or in Ontario https://members.cpo.on.ca/public_register/new . Or, ask a friend for a reference!

  1. Find healthy ways to manage your stress. Learn relaxation techniques such as deep breathing, meditation, and yoga. Take some time for yourself every day. Especially when going through stressful times, keep engaging in activities you find relaxing, such as going for a walk, listening to music, or reading a book.
    • Overwhelmed and have no time to do anything? You can always take 15 minutes to go for a walk. Solutions don’t have to be complicated.

 

 Set yourself a goal: pick 2 points and set yourself the goal of implementing these 2 things in your life.

 Rome wasn’t built in a day: start with the beginning. A small change is better than no change at all.

 You have more power than you think!

 

 

Thoughts and advices by Dre. G. Gagnon, Neuropsychologist and colleagues froom the Douglas Institute. Please do not reproduce or distribute – work in progress! Thank you!