Bob Lansing started noticing his memory problem after he landed a job as an engineer at one of the county's largest aerospace firms. During presentations to his superiors, he forgot words, sentences and sometimes his whole speech. At one point, he heard someone in the audience try to complete his sentences for him.
Then he noticed a broader memory gap. Lansing, who asked that his real name not be used, would spend a month reading a Tom Clancy novel, then find immediately afterward that he couldn't remember the main character's name. In conversations, he would often forget the point that he was trying to make and have to ramble for a while until it came to him.
The more Lansing worried about forgetting, the more he forgot. The memory problems, along with the routine stress of job and family responsibilities, made him so anxious that one day he experienced a panic attack returning from a business trip and had to find a quiet corner of the airport to calm himself.
That's when the middle-aged executive's doctor referred him to the Memory Disorders Clinic at UC Irvine.
The 5-year-old clinic is one of only about half a dozen diagnostic centers in the country that experimentally treat people with memory problems. Each year, its physicians see about 100 patients referred by doctors who have not been able to diagnose or treat certain neurological problems. When the normal medical channels are exhausted, it's time for the experimental approach of the clinic.
With state-of-the-art diagnostic equipment and the UCI College of Medicine's staff at its disposal, the clinic helps people with memory problems big and small, from the woman who keeps losing her car keys to the man with Alzheimer's disease who can't remember his wife's name.
"The clinic has helped people who have debilitating memory problems show significant recovery," says Dr. Curt Sandman, assistant director.
Nelson Butters, who as chief of psychology services at the Veterans Administration Hospital in San Diego often refers patients to the clinic, says it has been effective in finding causes of problems that have puzzled both patients and physicians.
"The clinic can determine the source of the problem, which is important because most physicians are not trained to diagnose the cause of memory disorders," Butters says.
"We pin down exactly what process in the brain is awry," Sandman says. "It's a very difficult diagnostic challenge."
Dr. Arnold Starr, director of the clinic and chairman of UCI's department of neurology, estimates that perhaps 20% of the population has some form of memory loss.
But many people who think they have a memory problem or even Alzheimer's disease may instead have a temporary condition triggered by drugs, stress or a head injury. Some patients who have trouble processing information turn out to have Parkinson's disease. And others are just losing their memory as a natural part of aging.
Therapy usually involves weaning patients off drugs known to impair memory, encouraging them to keep written reminders, teaching them "memory tricks," such as word associations, and taking them through some highly individualized therapies for specific disorders.
"Most memory problems can be treated simply," Starr says. "Even those with Alzheimer's disease may be helped by paying attention to the small things. Most patients are very embarrassed and sometimes become angry rather than working around their difficulties."
Joseph Allen, a retired lawyer living with his wife in an oceanfront Laguna Beach home, is one of the many Alzheimer's patients following Starr's simple approach. Shortly after retiring a few years ago, Allen (not his real name) found his memory faltering. He forgot appointments, simple financial transactions, phone numbers and dates. Soon he was forgetting the names of friends and family and losing keys and important papers.
After seeing several doctors, Allen was diagnosed with Alzheimer's disease and referred to the Memory Disorders Clinic for therapy.
"The doctors there told me the best thing for me to do to live with my problem was to keep lists and notebooks and write everything down," says Allen, who is in his late 60s. "That's what I've been doing ever since, and I can keep track of everything now with the lists. I do all my own banking, write my own checks and make my own appointments. But I don't know what will happen in the future."
Starr says treatment during later stages of Alzheimer's disease often shifts away from the patient, who may be less able to take care of himself, and toward the family, which is instructed on how to help.
Memory is the process of receiving, storing and retrieving information. Humans and some animals have the power to remember and tuck away the information in the neurochemical stew of cells and proteins of the brain. Scientists believe human memory is a process involving millions of chemical communications relayed among brain cells. What they don't know is how or where the information is stored and how it is retrieved.