Monday, November 9, 2026
Perhaps the most critical and valuable function of the brain is our ability to learn and remember. Memory enables us to create a life story and our ability to both access and share that story provides us identity, familiarity, and connection. I have often defined Alzheimer’s disease as “a brain that has lost access to its life story.”
Clinical science has taught us that there are different types of memory systems. The most common memory system is known as Declarative Memory that is characterized by our ability to process information and then recall it back-we declare what we heard or processed. Sometimes this is also known as Episodic Memory because we essentially are learning and remembering episodes of our life. This is a conscious and intentional memory system. The hippocampus (see Illustration), which sits deep inside the middle region of each of your temporal lobes, is the structure that enables new learning and declarative memory.
Another memory system is known as Procedural Memory, which relies on a subconscious process, is more automatic and involves habits, procedures, and motor functions. I was taught about a patient who had his hippocampus surgically removed so he could not learn or recall episodes. He was also a scratch golfer, which means he was very good. The patient went to play golf with the scientist who was working with him, and they drove their golf cart up to the first hole. The patient got out of the cart and selected the appropriate club to swing and drive his golf ball quite well down the middle of the fairway. He then placed his club in the back of the cart, sat down in the cart, and immediately got back out of the cart, selected the appropriate club to drive the ball once again. He performed all the steps that are required to swing and strike a golf ball successfully, but he forgot that he already struck the ball! He had intact Procedural Memory (he knew the procedures of selecting the appropriate club, teeing the ball up, and hitting a golf ball better than most), but impaired Declarative Memory (he forgot he hit the golf ball).
Our ability to recall the details of when and where we were when something occurred is known as Source Memory. Implicit Memory is non-procedural information that is recalled from a subconscious level or gets stimulated by another event even though we cannot recall it spontaneously or consciously on our own. Finally, Autobiographical Memory really pertains to our identity, such as our name, date of birth, age, family members, etc. The latter is typically affected by trauma or psychological stressors, as we learned in last month’s column.
Most of the conditions that affect memory tend to impair our declarative system and create challenges for us to remember new information, impair our learning and can cause rapid forgetting. This is because our hippocampus is impaired, which can be negatively affected by different conditions. These include dementia caused by Alzheimer’s, other types of dementia, hypoxia, traumatic brain injury, alcohol or substance abuse, depression, chronic anxiety, PTSD, medication side effects, acute medical illnesses such as urinary tract infection, seizure disorder, etc. It is uncommon for our remote memories to be affected other than by psychological or emotional trauma.
What is Normal and Abnormal?
For many, the concern of memory impairment is real, and this is particularly true as we get older. Some practical guidelines to differentiate normal age-related changes of memory versus what is more consistent with disease or need of medical attention are below:
Because memory is simultaneously such a critical and yet sensitive brain function, it can be affected by so many factors. Lack of sleep, pain, stress, medical issues, medication side effects, other substances, relationship issues, financial strain, etc., are examples of how our experiences can affect memory. It is easy to get concerned about “hiccups in memory and other cognitive functions” but it is not helpful for you to make your own decision as to what is normal and abnormal. For most of my public career, I have advocated for the need of annual cognitive screens starting at age 50! It is the one assessment that tells us about what your brain is actually doing and how that compares to your expected ability. Men and women are taught to get different parts of their body checked at different ages, but somehow, we left the brain out of the story.
What Do I do if I am Concerned About my Memory?
Contact your Primary Care Physician (PCP) and have an honest discussion about your concern. Common medical explanations can be evaluated and treated as needed.
Follow the next steps from your PCP which will likely include blood sample analysis, neuropsychological screen, and possible medical treatment such as medication.
Get a neuropsychological (cognitive and emotional) exam to establish your baseline at a minimum and to generate empirical or objective data on exactly where your memory and cognitive/emotional functioning is relative to where it should be.
Get more sensitive testing done such as specific blood protein analysis from the blood and structural imaging of the brain, if your PCP or neurologist orders.
Engage in a Brain Health Lifestyle® regardless of findings since this is the most beneficial and proactive approach we can follow to promote the health of our brains and to delay onset of cognitive decline. This includes staying physically active, social, mentally engaged, spiritual and stress reducing, and eating healthy (MIND Diet).
Make good decisions and create a life plan so you have all financial, housing, health, and legal matters in order even if you are the healthiest person on the planet.
If treatment is started for cognitive impairment or if you have no cognitive impairment, get an annual cognitive and emotional screen to keep empirical measures of how your brain is doing.
If your PCP or neurologist recommends medication or other treatment for your cognition, follow the advice and provide the doctor with feedback on how the treatment is working.
It is always best for you to stay proactive and to not let fear stop you from doing what is necessary and important for your health. This is true for all aspects of your health and the same is true for your brain. There are always lifestyle steps, medical treatments, and psychosocial changes we can make to improve our health including brain health. The only way these changes can occur is to first establish where our memory and cognitive function is so do not be afraid to step forward and attend a community memory screen, talk to your PCP, or trusted clinical professional.
Author’s note:
MDR Your Brain Health Matters will be hosting a free community Memory Screen on Thursday, November 12, 2026, and again on Friday, November 13, 2026, from 9:00 AM-1:00 PM at the MDR Champagne Center for Brain Health on Marco Island. Please monitor the MDR Facebook and Instagram social media pages as well as our website for registration information.
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