Clinical Issues and Memory Testing

LEARNING OBJECTIVES

• What is the difference between normal and abnormal memory aging?

• What is the connection between memory and mental health?

• How is memory affected by nutrition and drugs?

atarra’s children are concerned. Latarra is 80 and is becoming more and more forgetful. With the scare of Alzheimer’s disease so salient in our society, they are concerned that their mother is its next victim. What should they do? A friend tells them that memory decline is normal with aging. But to ease their concerns they make an appointment for a clinical screening for their mother. This could reassure them that it is only normal aging causing her forget­fulness, and not Alzheimer’s disease.

To this point we have been trying to understand the changes that occur in normal memory with aging. But what about situations where people have serious memory problems that interfere with their daily lives? How do we tell the difference between normal and abnormal memory changes? These are but two of the issues that clinicians face. Latarra’s children are facing this critical issue. Like Latarra’s children, clinicians are often confronted with rela­tives of clients who complain of serious memory difficulties. Clinicians must somehow differentiate the individuals who have no real reason to be concerned from those with some sort of disease. What criteria should be used to make this distinc­tion? What diagnostic tests would be appropriate to evaluate adults of various ages?

Unfortunately, there are no easy answers to these questions. First, as we have seen, the exact nature of normative changes in memory with aging is not yet understood completely. This means that we have few standards by which to compare people who may have problems. Second, there are few comprehen­sive batteries of memory tests that are specifically designed to tap a wide variety of memory func­tions (Mayes, 1995). Too often clinicians are left with hit-or-miss approaches and have little choice but to piece together their own assessment battery (Edelstein & Kalish, 1999).

Fortunately, the situation is changing. Since the mid-1980s researchers and clinicians have begun to work closely to devise better assessments (Mayes,

1995) . This collaboration is producing results that will help address the key questions in memory assessment: Has something gone wrong with mem­ory? Is the loss normal? What is the prognosis? What can be done to help the client compensate or recover?

In this section we consider some of the efforts being made to bridge the gap between laboratory and clinic. We begin with a brief look at the dis­tinction between normal and abnormal memory changes. Because abnormal memory changes could be the result of a psychological or physical condi­tion, we consider links between memory and men­tal health. After that, we discuss how memory is affected by nutrition and drugs.