Memory and its disorders. Memory impairment

Sometimes memory impairment in to a greater extent the patient's relatives pay more attention than the patient himself (usually in older people, often with dementia). Doctors and patients are often concerned that memory loss is a sign of developing dementia. This fear is based on general idea that memory loss is usually the first symptom of dementia. However, in most cases, memory loss is not associated with the onset of dementia.

The most common and earliest complaint associated with memory impairment is difficulty remembering names and places where frequently used household items, such as car keys, are located. As memory loss worsens, patients may forget to pay bills or miss appointments. Severe memory impairment can be dangerous if patients forget to turn off the stove, lock the house, or lose sight of a child they are supposed to be keeping an eye on. Depending on the cause of the memory loss, other symptoms may appear, such as depression, confusion, personality changes, and difficulty performing daily activities.

There are two types of memory: declarative, explicitly oriented memory (semantic or episodic), which stores memories that can only be recalled consciously. This is necessary, for example, in order to recognize certain things (apples, animals, faces). Procedural memory does not require conscious effort to remember and recall. This is necessary, for example, for learning to play the piano.

Causes of memory impairment

The most common causes of memory impairment include the following:

• memory impairment associated with aging (most common cause);
• mild cognitive impairment;
• dementia;
• depression.

Most people experience some memory loss as they age. It becomes difficult for them to remember new information (for example, the name of a new neighbor, a new computer password). Age-related changes lead to occasional forgetfulness (such as losing your car keys) or confusion. However, mental abilities are not affected. If a patient with age-related changes memory is given enough time to think about and answer the question, then, as a rule, he copes with the task, which indicates the preservation of memory and cognitive functions.

Patients with mild cognitive impairment have true memory decline, in contrast to slower recall with relatively intact memory in age-matched patients without cognitive impairment. In mild cognitive impairment, there is a tendency to primarily impair short-term (or episodic) memory. Patients find it difficult to remember the content of a recent conversation, the place where frequently used items are stored, and they forget about appointments. However, memory for distant events usually remains intact, and attention also does not suffer (the so-called working memory - patients can reproduce a list of any objects and perform simple calculations).

Patients have difficulty finding words and/or naming objects (aphasia), performing familiar movements (apraxia), or planning and organizing daily activities such as cooking, shopping, and paying bills (executive functioning disorder). The patient's personality may change - for example, irritability, anxiety, agitation and/or intractability that was previously uncharacteristic for a person may appear.

Depression is common in patients with dementia. However, depression itself can lead to memory impairment that resembles dementia (pseudo-dementia), but such patients usually have other symptoms of depression.

Delirium is acute condition changes in consciousness, which can be caused by a severe infection, medicines(adverse event) or their cancellation. Patients with delirium may have memory impairment, but the main problem is not this, but severe global changes mental status and cognitive function.

To form declarative memory, information first reaches the corresponding association areas of the cerebral cortex (eg, secondary visual cortex) through a specific primary sensory cortical area (eg, primary visual cortex). From here, through the entorhinal cortex (field 28), this information goes to the hippocampus, which is of great importance for the long-term storage of declarative information. Through the mediation of structures in the midbrain, basal forebrain, and prefrontal cortex, this information is again stored in the association cortex. Thus, information is first stored through sensory memory by short-term memory, which can only hold it for a few seconds to minutes. This information can be transferred to long-term memory, for example, through repetition. However, such repetitions do not apply to mandatory conditions for the formation of long-term memory. Glutamate is the most important neurotransmitter in the hippocampus (NMDA receptors). Memory consolidation is provided by adrenaline and acetylcholine (nicotinic receptors). Neurotrophins maintain the viability of the neurons involved. Ultimately, memory consolidation requires a change in the influence of the synapses involved.

It is the transfer of information to long-term memory that is disrupted when the above structures are damaged due to neurodegenerative diseases (for example, Alzheimer's disease), trauma, ischemia, alcohol, carbon monoxide and inflammation. Electric shock can temporarily stop memory formation.

Lesions of the hippocampus or its connections lead to antegrade amnesia. In such patients, new declarative memory can no longer be formed from the moment of the lesion. They will remember the events before the defeat, but not the subsequent ones.

Retrograde amnesia, i.e. loss of already stored information, occurs when there are disturbances in the corresponding associative fields. Depending on the degree and location of the disorders, memory loss can be reversible or irreversible. In the first case, the patient will lose part of his memory, but it can be restored. In irreversible loss, specific elements are lost forever.

Damage to the dorsomedial nucleus results in loss of episodic memory. Transient bilateral functional disorders of the hippocampus can cause antegrade and retrograde (days or years) amnesia (transient global amnesia). With Korsakoff's syndrome (often found in alcoholism), both antegrade and retrograde amnesia can be observed. Patients often try to cover up gaps in memory with the help of fiction.

With lesions of the hippocampus, procedural (implicit) memory does not suffer. This makes imprinting, skill acquisition, sensitization, adaptation, and formation possible. conditioned reflexes. Depending on the task at hand, the cerebellum, basal ganglia, amygdala, and cortical fields may be involved. When mastering a skill important role played by the cerebellum and basal ganglia. The corresponding impulses reach the cerebellum through the olive and pons nuclei. The memory capacity of the cerebellum can be lost, for example, due to toxic damage, degenerative diseases and injuries. Dopaminergic projections of the substantia nigra also play a certain role in the formation of procedural memory.

The amygdala is involved in the formation of conditioned anxiety reactions. They receive information from the cortex and thalamus and through reticular formation and thalamus influence motor and autonomic functions (eg, muscle tone, heart rate [tachycardia alert], goose pimples). Shutting down the amygdala (for example, due to trauma or under the influence of opiates) erases conditioned anxiety reactions. Bilateral shutdown of the amygdala along with parts of the hippocampus and temporal lobe leads to amnesia and relaxed behavior (Klüver-Bucy syndrome).

Examination for memory impairment

The most important thing is to identify delirium that needs emergency treatment. Assessment then prioritizes differentiation between the less common mild cognitive impairment and early dementia and the more common age-related memory changes and common forgetfulness. Full examination Detection of dementia usually requires more time than the 20-30 minutes allocated for an outpatient appointment.

Anamnesis. Whenever possible, the history should be obtained separately from the patient and family members. Patients with cognitive impairment are not always able to provide detailed and exact information, and relatives may experience difficulties in impartially presenting the anamnesis in the presence of the patient.

The medical history should include a description of the specific types of memory impairment (eg, forgetting words or names, times when the patient got lost) and their time of onset, severity, and progression. The extent to which these symptoms interfere with daily activities at work and at home should be determined. It is important to check for changes in speech, eating, sleep, and mood.

Information about organs and systems can help establish the presence of symptoms in the anamnesis that make it possible to suspect certain type dementia (eg, parkinsonian symptoms in dementia with Lewy bodies, focal deficits in vascular dementia, paresis of upward gaze and falling with progressive supranuclear palsy, choreiform hyperkinesis with Huntington's disease, gait disturbances with normal pressure hydrocephalus, imbalance and fine motor skills with vitamin B deficiency 12).

The medical history should include information about previous diseases And full information about medications (both prescription and over-the-counter) that the patient received.

Family and social history should include information about baseline the patient's intelligence, education, work and social functioning. It is necessary to clarify the presence of a history or current abuse of alcohol or drugs. It is necessary to find out whether there is a family history of dementia or early cognitive impairment.

Physical examination. In addition to a general physical examination, a complete neurological examination with a detailed mental status assessment is performed.

A mental status assessment involves the patient following specific instructions to check the following:

• orientation (the patient is asked to state his name, date and place in which he is located);
• attention and concentration (for example, the patient is asked to repeat a few words, do simple calculations, say the word “earth” backwards);
• short-term memory (for example, the patient is asked to remember and reproduce after 5, 10 and 30 minutes a list of several words);
• speech (for example, naming common objects);
• praxis and executive actions (for example, performing an action consisting of several stages);
• constructive praxis (for example, copy a drawing or draw a clock).

Various scales can be used to assess these aspects.

Warning signs. Should be paid Special attention to the changes listed below:

• disturbances in daily activities;
• decreased attention or altered consciousness;
• symptoms of depression (eg, loss of appetite, lethargy, suicidal thoughts).

Interpretation of survey results. The presence of actual memory decline and impairment of daily activities and other cognitive functions allows us to separate age-related memory impairment from mild cognitive impairment and dementia. Differentiating depression from dementia can be challenging until memory impairment becomes more severe or other neurological disorders (eg, aphasia, agnosia, apraxia) develop.

Decreased attention allows delirium to be distinguished from early stages dementia. In most patients with delirium, memory loss is not a leading symptom. However, delirium must be excluded to make a diagnosis of dementia.

If the patient himself sought medical help, because... he began to worry about forgetfulness; the most likely reason is age-related memory loss. If medical examination was initiated by a family member of the patient, and he himself is less concerned about memory loss, then in this case the presence of dementia is more likely.

Additional research methods. The diagnosis is made primarily based on clinical picture. However, the results of any brief mental status examination are influenced by the patient's level of intelligence and education, and therefore such tests are not very accurate. Thus, patients with a high level of education may score an inflated number of points, while those on the street low level education it may be underestimated. If the diagnosis is unclear, formal neuropsychological testing should be performed, the results of which have high diagnostic accuracy.

If possible reason violations is the use of the drug, it can be discontinued or the patient can be prescribed another drug.

If the patient has neurological symptoms (for example, paresis, gait disturbance, involuntary movements), then an MRI or CT scan is necessary.

If a patient is diagnosed with delirium or dementia, then further examination is necessary to clarify their causes.

Treatment of memory impairment

Patients with age-related memory loss need support. Patients with depression require medication and/or psychotherapy. As depression is eliminated, there is a tendency for memory impairment to level out. Delirium should be treated according to its cause. In rare cases, dementia can be reversed with the help of specific therapy. The remaining patients with memory impairment receive supportive treatment.

Patient safety. Rehabilitation and physical therapy specialists can evaluate a memory loss patient's home for safety to help prevent falls and other incidents. You may need to take safety precautions (for example, hide knives, turn off the stove, remove the car and its keys). Some countries require notification to regulatory authorities regarding traffic about patients with dementia. If the patient is at risk of getting lost, a tracking system can be used or the patient can be enrolled in a safe return program.

Finally, outside help (eg, a home health worker or home social worker) or changes to the environment (eg, moving to a step-free home or placing the patient in a general care or skilled nursing facility) can be used.

Change measures environment. People with dementia feel more comfortable in familiar surroundings, in settings that help them find their way, in bright and cheerful surroundings and with regular activity. The patient's room should contain sources of sensory stimulation (eg, radio, television, night light).

Health care staff in care facilities should wear a large name badge and be reintroduced to the patient when necessary.

Features in elderly patients

The prevalence of dementia increases from approximately 1% in people aged 60 to 64 years to 30-50% in people over 85 years of age. The prevalence of dementia in people living in residential care homes is about 60-80%.

– this is a decrease or complete loss of the function of recording, storing and reproducing information. With hypomnesia, disorders are characterized by a weakening of the ability to remember current and reproduce past events. Amnesia is manifested by the absolute inability to retain and use information. With paramnesia, memories are distorted and distorted - the patient confuses the chronology of events, replaces the forgotten with fiction, stories from books and television shows. Diagnosis is carried out by conversation and special pathopsychological tests. Treatment includes medication and psychocorrectional classes.

ICD-10

R41.1 R41.2 R41.3

General information

Memory is a key mental process that provides the ability to accumulate and transfer experience, knowledge of the surrounding world and one’s own personality, and adaptation to changing conditions. Complaints of memory loss are most common among neurological and psychiatric patients. Disorders of this group are regularly detected in 25-30% of young and middle-aged people, and in 70% of older people. The severity of the disorders varies from minor functional fluctuations to stable and progressive symptoms that impede social and everyday adaptation. IN age group For 20-40 years, astheno-neurotic syndromes, which are reversible, prevail; in patients over 50 years of age, memory impairment is often caused by organic changes in the brain, leading to persistent cognitive deficits and difficult to treat.

Causes

Memory problems can be caused by many factors. The most common cause is asthenic syndrome caused by daily psycho-emotional stress, increased anxiety, physical illness. The pathological basis for a pronounced decrease in memory functions is organic diseases of the central nervous system and mental pathologies. The most common causes of mnestic disorders include:

• Overwork. Excessive physical, mental and emotional stress becomes a source of stress and functional decline in cognitive processes. The likelihood of memory impairment is higher with an unbalanced diet, lack of sleep, and staying awake at night.
• Somatic diseases. Physical ailments contribute to the development of general exhaustion. Difficulties in remembering can be caused by both asthenia and a shift in attention from information coming from outside to sensations in the body.
• Bad habits. Memory is weakened due to brain damage, toxic liver damage, and hypovitaminosis. With long-term alcohol and drug addiction, persistent cognitive deficits develop.
• Cerebral circulation disorders. The cause may be spasm or atherosclerosis of cerebral vessels, stroke and other age-related disorders. Patients with hypertension are at risk.
• Traumatic brain injuries. Memory is impaired in the acute and long-term period of TBI. The severity of the disorder ranges from mild difficulties in memorizing new material to the sudden loss of all accumulated knowledge (including first and last names, faces of relatives).
• Degenerative processes in the central nervous system. During normal aging, the brain undergoes involutional changes - tissue volume, number of cells, and metabolic rate decrease. There is a weakening of memory and other cognitive functions. Severe persistent dysfunction is accompanied by degenerative diseases (Alzheimer's disease, Parkinson's disease, Huntington's chorea, etc.).
• Mental disorders. A cognitive defect is formed in various dementias and schizophrenia. Epilepsy, being a neurological disease, affects the psyche, including causing memory changes.
• Mental retardation. May be associated with genetic pathologies, complications during pregnancy and childbirth. Mnestic disturbances are most pronounced in moderate and severe forms of oligophrenia.

Pathogenesis

Memory processes are realized with the participation of modality-specific centers of the cortex, where information is received from analyzers, and non-specific structures - the hippocampus, thalamus optica, and cingulate gyrus. Specific (according to the modality of analyzers) cortical sections interact with speech zones, as a result of which memory moves to a more complex level of organization - it becomes verbal-logical. Memory selectivity is ensured by activity frontal lobes, and the general ability to remember and reproduce - by the stem sections and reticular formation.

Memory disorders are characterized by dysfunctional brain structures. With a decrease in tone, diffuse organic processes and damage to the subcortical-stem sections, all types of mnestic processes worsen: fixation, retention and reproduction. The localization of the focus in the frontal zones affects the selectivity and purposefulness of memorization. Pathology of the hippocampus is manifested by a decrease in long-term memory, impaired processing and storage of spatial information (disorientation).

Classification

Taking into account the characteristics of the clinical picture, memory disorders are divided into hypermnesia (increase), hypomnesia (decrease), amnesia (absence) and various subtypes of paramnesia - qualitative changes in stored information. A classification focused on pathogenetic mechanisms was developed by Alexander Romanovich Luria and includes the following types violations:

• Modal-nonspecific. They manifest themselves as inadequate preservation of traces of influences of various modalities (auditory, visual, motor). The disorders are caused by damage to deep nonspecific brain structures, pathological increased inhibition of traces. An example is Korsakoff syndrome in alcohol poisoning.
• Modal-specific. Problems arise when storing and reproducing information of a certain modality. Disorders develop on the basis of lesions in the cortical zones of the analyzers; the inhibition of traces is the result of interfering influences. Acoustic, auditory-verbal, visual-spatial, and motor memory may be pathologically altered.
• System-specific. Pathologies of this group are caused by damage to the speech areas of the brain. Systematization and organization of incoming information using semantic verbal processing turns out to be impossible.

Symptoms of memory disorders

Hypomnesia is a decrease in the ability to store, remember, and reproduce information. It manifests itself as a deterioration in memory for names, addresses, dates and events. It is especially noticeable in conditions that require quick formulation of an answer. Mnestic deficit is associated primarily with events of the present, information from the past becomes poorer in details, sequence, order, and time reference are forgotten. As a rule, patients themselves are the first to notice the disorder. When reading a book, they need to periodically return to the previous paragraph to reconstruct the plot. To compensate for hypomnesia, they keep diaries, planners, use stickers and alarm clocks with reminders.

Amnesia is complete loss of memory. With the retrograde form, memories of events immediately preceding the disease are lost. Information about life over several days, months or years falls out. Earlier memories are preserved. Anterograde amnesia is characterized by a loss of information about situations that occurred after an acute period of illness or injury. Patients cannot remember what happened to them over the past few hours, days or weeks. With fixation amnesia, the ability to remember current information is lost.

The progressive form is manifested by the destruction of the memorization skill and the increasing depletion of information reserves. At first, patients forget situations and information received recently. Then the events of the distant past are erased from memory. In the end, information about the entire life lived is lost, including given name, faces of loved ones, episodes from youth and childhood. In selective, affectogenic, hysterical forms, memories of individual periods are erased - traumatic situations, negative experiences.

Qualitative memory disorders are called paramnesias. These include confabulations, cryptomnesia and echonesia. With confabulation, patients forget what actually happened and unintentionally replace them with fiction. The fantasies of patients may seem very plausible, associated with everyday, everyday situations. Sometimes they are fantastic, unrealistic in nature - with the participation of aliens, angels, demons, with mystical reincarnations characters. Elderly patients are characterized by ecmnestic confabulations - the replacement of forgotten periods of life with information from childhood and adolescence. With cryptomnesia, patients consider events described in books, dreams, films or television programs to have actually been experienced in the past. Echonesia is the perception of current situations as having taken place before, repeating. A false memory arises.

Complications

Severe and severe memory impairments that develop with long term illness and the lack of treatment and rehabilitation measures lead to the disintegration of complex motor skills. Such conditions are often accompanied by a general intellectual deficit. At first, patients experience difficulty writing, reading, and counting. Gradually, problems arise in spatial orientation and time planning, which makes it difficult to move independently outside the home and reduces social activity. On late stages patients lose speech and everyday skills, cannot eat food on their own, perform hygiene procedures.

Diagnostics

Primary research into memory disorders is performed clinical method. A psychiatrist and a neurologist collect anamnesis, conduct a conversation, based on the results of which they assess the preservation of cognitive functions and the severity of impairments, receive information about concomitant diseases, previous neuroinfections and traumatic brain injuries. To identify the causes of memory changes, the neurologist, if necessary, refers the patient to MRI of the brain, EEG, duplex scanning of the brachiocephalic arteries, examination cerebrospinal fluid, fundus examination. Specific diagnosis of memory disorders is carried out by a pathopsychologist, and if local brain damage is suspected, by a neuropsychologist. Several types of memory are tested:

• Mechanical. The “10 words” technique is used, memorizing syllables, memorizing two rows of words. Tests reveal fluctuations in dynamics mental activity, exhaustibility. The result is presented in the form of a curve. It has the character of a steadily reduced plateau in dementia, can be normally high in mild mental retardation, zigzag in vascular pathologies, post-infectious and post-intoxication conditions, and in a separate period of TBI.
• Semantic. Tests are used to retell the content of texts of varying complexity. A decrease in the result indicates a violation of complex forms of memory caused by abstract thinking and speech. While mechanical memorization is relatively intact, semantic memorization is impaired in mental retardation and epilepsy. results long time remain normal in people with vascular diseases, asthenic syndrome.
• Indirect. The test subject's ability to remember material using an intermediate symbol is studied. Diagnostic tools – “pictograms”, Vygotsky-Leontiev method of studying mediated memorization, double stimulation method. The introduction of an intermediate stimulus makes it difficult to perform a task in schizophrenia due to a decrease in focus, in epilepsy due to torpidity and inertia mental processes, “getting stuck” on details.
• Figurative. The test is in demand when examining children with undeveloped speech and patients with severe speech defects. Sets of images of objects, people, and animals are used. The technique is aimed at assessing the ability to memorize material and retain it over a period of several minutes to an hour. The result is used to distinguish between total and partial cognitive defects.

Treatment of memory disorders

Therapeutic and corrective measures are selected individually and are largely determined by the cause - the leading disease. In case of asthenic syndrome, it is necessary to restore the normal regime of rest and work; in case of memory deterioration due to alcohol intoxication, liver diseases - follow a diet, for hypertension - maintain normal blood pressure. General methods Treatments for memory disorders include:

• Drug therapy. For used various groups drugs aimed at eliminating the primary disease. There are also special medications (nootropics) that stimulate cognitive processes by improving blood circulation and metabolic processes in the brain. This group includes substrates of energy metabolism (provide nerve cells energy), classic nootropics (normalize metabolic processes) and herbal remedies (support metabolism).
• Psychocorrection. Mnemonics are actively used to train and restore memory - special moves, facilitating the process of memorizing information, increasing the volume of stored material. Compensatory mechanisms are activated, such as aids Vivid visual and sound images, strong and unusual sensations are used. Basic techniques - creating meaningful phrases from the first letters, rhyming, Cicero's method (spatial imagination), Aivazovsky's method.
• Maintaining healthy image life. Patients are advised to take daily walks fresh air, moderate physical exercise, active communication, good sleep. These simple activities improve cerebral circulation, ensure regular supply new information which needs to be understood and remembered. Patients are recommended to have regular intellectual exercise; it is useful to read high-quality literature, watch and discuss popular science television programs, documentaries (retell, analyze, draw conclusions).

Prognosis and prevention

Mnestic disorders can be successfully treated in the absence of a progressive underlying disease (senile dementia, unfavorable forms of schizophrenia, epilepsy with frequent seizures). The leading role in the prevention of memory impairment belongs to maintaining health, including quitting smoking and alcohol abuse, playing sports, timely seeking medical help for somatic and mental illness. It is important to maintain a rational work and rest schedule, sleep at least 7-8 hours a day, devote time to intellectual stress, reading books, solving crossword puzzles, and applying the information received in life.

Memory disorders are one of the complex neuropsychiatric disorders that complicate life. In older people, memory loss is a natural process of aging. Some disorders can be corrected, while others are a symptom of a more severe underlying condition.

Memory impairment in psychology

Mental memory disorders are a group of qualitative and quantitative disorders in which a person either stops remembering, recognizing and reproducing information, or there is a noticeable decrease in these functions. In order to understand how certain disorders affect a person’s memory of information, it is important to understand what memory is. So, memory is the highest mental function, which includes a complex of cognitive abilities: memorization, storage, reproduction.

The most common memory disorders are:

• hypomnesia– reduction or weakening;
• paramnesia– errors in memory;
• – loss of events (before or after).

Causes of memory disorders

Why are memory disorders observed? There are many reasons for this, both psychological and pathological nature, traumatic effects on humans. Memory impairment – ​​psychological causes:

• psycho-emotional stress;
• overwork due to mental or heavy physical work;
• a psychotrauma that once occurred, causing a defensive reaction - repression;

Disorders of memory functions – organic causes:

• long-term toxic effects on the brain of alcohol and drugs;
• unfavorable environment;
• various circulatory disorders (stroke, atherosclerosis, hypertension);
• brain oncology;
• viral infections;
• Alzheimer's disease;
• congenital mental illnesses and genetic mutations.

External influences:

• traumatic brain injuries;
• difficult birth with forceps applied to the baby's head.

Types of memory impairment

Many people are familiar with the concept of amnesia, because the word itself very often appears in various films or TV series, where one of the characters loses his memory or pretends not to remember anything, and meanwhile, amnesia is just one type of memory impairment. All types of memory disorders are usually divided into two large groups:

1. Quantitative– hypermnesia, amnesia, hypomnesia.
2. Quality– confabulation, contamination, cryptomnesia, pseudoreminiscence.

Cognitive memory disorder

Memory refers to cognitive functions human brain. Any memory disorders will be cognitive and leave an imprint on all human thought processes. Cognitive memory disorders are usually divided into 3 types:

• lungs– amenable to drug correction;
• average– occur earlier than in old age, but are not critical, often associated with other diseases;
• heavy– these disorders occur with general damage to the brain, for example as a result of progressive dementia.

Quantitative memory disorders

Memory impairment - dysmnesia (quantitative disorders) is divided by psychiatrists into several types. The largest group consists of various types of amnesia, in which memory loss occurs for a certain period of time. Types of amnesia:

• retrograde– occurs on events preceding a traumatic, painful situation (for example, the period before the onset of an epileptic seizure);
• anterograde(temporal) – a loss of events occurs after the traumatic situation has occurred; the patient does not remember the period of how he got to the hospital;
• fixative– memory impairment, in which current impressions are not remembered; a person at this moment can be completely disoriented in space and after a few seconds all actions in the current moment are forgotten by the patient forever;
• congrade - loss of state memory during delirium, oneiroid, amnesia in this case can be total or fragmentary;
• episodic - it also happens to healthy people when they are tired, for example, drivers who have been on the road for a long time; when remembering, they can vividly remember the beginning and end of the journey, forgetting what happened in the intervals;
• children's– inability to remember events occurring before 3–4 years of age ( normal phenomenon);
• intoxication– with alcohol and drug intoxication;
• hysterical(katathym) – turning off traumatic events from memory;
• affective– loss of events occurring during the affect.

TO quantitative violations memory disorders include the following:

• hypomnesia(“perforated memory”) – the patient remembers only important events; in healthy people this can be expressed in weak memory for dates, names, terms;
• hypermnesia– increased ability to remember past events that are irrelevant at the moment.

Impaired short-term memory

Disorders short term memory psychiatry associates it with many factors and causes, often with concomitant diseases and stress factors. Short-term or primary, active memory is an important component of memory in general, its volume is 7 ± 2 units, and the retention of incoming information is 20 seconds; if there is no repetition, the trace of information becomes very fragile after 30 seconds. Short-term memory is very vulnerable, and with amnesia, events that happened 15 seconds to 15 minutes ago are lost from memory.

Memory and speech impairment

Auditory-verbal memory is based on imprinted auditory analyzer images and memorization of various sounds: music, noise, speech of another person, severe memory and speech disorders are characteristic of mentally retarded children and due to damage to the left temporal lobe of the brain due to injury or stroke, which leads to the syndrome of acoustic-mnestic aphasia. Oral speech is poorly perceived by patients and out of 4 words spoken aloud reproduces only the first and last (edge ​​effect).

Thinking and memory disorders

All cognitive functions of the brain are interconnected, and if one function is impaired, over time, others begin to suffer along the chain. Memory and intelligence disorders are observed in Alzheimer's disease and senile dementia. If we consider how a violation occurs, we can cite as an example that a person performs many operations in his mind, which are stored in the form of experience with the help of short-term and long-term memory. With memory impairment, there is a loss of this experience synthesized by memory and thinking.

Memory and attention disorder

All attention and memory disorders negatively affect the memory of events, situations and information. Types of memory and attention disorders:

• functional– occur when it is impossible to focus on a specific action, which is manifested by a deterioration in memory, typical for ADHD in children, stress;
• organic- for mental retardation, Down syndrome, and the development of dementia in older people.

Memory disorders due to brain damage

In case of defeat different departments brain, memory disorders have different clinical manifestations:

• damage to the hippocampus and the “Peipets circle” - severe amnesia occurs for current everyday events, disorientation in space and time, patients complain that everything falls out of memory, and they are forced to write everything down in order to remember;
• damage to the medial and basal parts of the frontal lobes - characterized by confabulations and memory errors, patients are not critical of their amnesia;
• local lesions of the convexital sections - a violation of mnestic function in any specific area;
• Memory impairment after a stroke can be verbal (the patient cannot remember the names of objects, names of loved ones), visual - there is no memory for faces and shapes.

Memory impairment in a child

Basically, memory development disorders in children are associated with asthenic syndrome, which together represents a high psycho-emotional stress, anxiety and depression. An unfavorable psychological climate, early deprivation, and hypovitaminosis also provoke amnesia in children. Often, children experience hypomnesia, expressed in poor absorption educational material or other information, while all cognitive functions suffer along with memory impairment.

Memory disorder in older people

Senile dementia or senile memory disorder, popularly called senile marasmus, is one of the most common memory disorders in the elderly. Dementia is also accompanied by diseases such as Alzheimer's, Parkinson's and Pick's diseases. In addition to amnesia, there is a decline in all thought processes, dementia sets in with personality degradation. Unfavorable factors in the development of dementia are cardiovascular diseases, atherosclerosis.

Symptoms of memory impairment

The symptoms of disorders are varied and depend on the forms in which memory disorders manifest themselves; in general, the symptoms can be as follows:

• loss of information and skills, both ordinary (brushing teeth) and related to the profession;
• disorientation in time and space;
• persistent gaps for events that occurred “before” and “after”;
• palimpsest – loss of individual events during alcohol intoxication;
• Confabulation is the replacement of memory gaps with fantastic information that the patient believes.

Diagnosis of memory disorders

The main memory disorders should be diagnosed by a doctor so as not to miss a serious one. concomitant disease(tumors, dementia, diabetes). Standard diagnostics includes a comprehensive examination:

• blood tests (general, biochemistry, hormones);
• magnetic resonance imaging (MRI);
• computed tomography (CT);
• positron emission tomography (PET).

Psychodiagnosis of memory disorders is based on the methods of A.R. Luria:

1. Learning 10 words. Diagnostics of mechanical memory. A psychologist or psychiatrist slowly names 10 words in order and asks the patient to repeat in any order. The procedure is repeated 5 times, and when repeated, the doctor notes how many of the 10 words were correctly named. Normally, after the 3rd repetition, all words are remembered. After an hour, the patient is asked to repeat 10 words (normally 8–10 words should be reproduced).
2. Associative series “words + pictures”. Impaired logical memory. The therapist names the words and asks the patient to choose a picture for each word, for example: cow - milk, tree - forest. An hour later, the patient is presented with pictures and asked to name the words corresponding to the image. The number of words and complexity-primitiveness in compiling an associative series are assessed.

In psychology, memory is a set of information that reflects events, emotions, and any knowledge experienced by an individual previously.

What is memory and its impairment

Thanks to it, we have experience, and a person is the person that others know him to be. Memory loss or memory impairment causes great discomfort to the individual.

Memory impairment in psychology is a fairly common disorder that brings a lot of problems to a person and, of course, worsens the quality of his life. This disorder underlies many diseases. mental nature.

Main types of memory disorders

There are two main types of human memory impairment.

Qualitative dysfunctions involve confusion in the patient's mind due to the inability to distinguish true memories from fantasies. The patient does not understand which events are real and which are a figment of his imagination.

Quantitative defects are reflected in the strengthening or weakening of memory traces.

There are a huge number of types of memory disorders. Most of them are characterized by short duration and reversibility. They can be caused by such trivial reasons as overwork, frequent stressful situations, drug abuse, as well as alcoholic beverages.

Others require a serious approach to treatment.

Causes of memory disorders

What are these reasons that can cause memory impairment? In psychology, there are several of these.

For example, a person has asthenic syndrome, which is accompanied by rapid fatigue and exhaustion of the body. It can be a consequence of traumatic brain injury, long-term depression, vitamin deficiency, alcohol and drug addiction.

In children, memory disorders are most often the result of brain underdevelopment, physical or mental head trauma. Such children have problems with memorizing information and its subsequent reproduction.

Types of Memory Disorders

What are the symptoms of memory impairment? This is forgetting and the inability to reproduce events from personal or other people's experience.

Paramnesia is a loss in time, when an individual confuses the events of the past and the present, cannot understand which events in his head took place in the real world, and which are fictitious, projected by the brain based on information once received.

Dysmnesia is a disorder that includes hypermnesia, hypomnesia and amnesia. The latter is characterized by forgetting certain information and skills for a certain period of time. Memory problems are episodic, after which memories partially or completely return. Amnesia can also affect acquired skills, for example, the ability to drive a car, ride a bicycle, or cook any food.

Types of amnesia

Retrograde amnesia manifests itself in forgetting events for a certain period of time preceding the occurrence of the injury. For example, a person who has suffered a head injury may forget everything that happened to him a week or more before the accident.

Anterograde amnesia is the opposite of the previous one and involves memory loss for a period after injury.

Fixation amnesia is when the patient is unable to remember incoming information. He perceives reality quite adequately, but forgets information within a few minutes or seconds after receiving it. This causes problems in time orientation, as well as in remembering surrounding people.

With total amnesia, a person is unable to remember anything from his past life. He doesn't know his name, age, address, who he is or what he did. As a rule, such a mental disorder occurs after receiving a severe skull injury.

Palimpsest occurs as a result of alcohol intoxication, when the individual cannot remember certain moments.

With hysterical amnesia, a person forgets difficult, painful or simply unfavorable memories. It is characteristic not only of mentally ill people, but also of healthy people of the hysterical type.

Paramnesia is a type of memory disorder in which the gaps that arise are filled in with different data.

Ecmnesia and cryptomnesia

Ecmnesia is a phenomenon when a person experiences long-past events as a phenomenon of the present time. It is typical of older people who are beginning to perceive themselves as a young person and are preparing for university, marriage, or other events that were experienced at a young age.

Cryptomnesia is a disorder in which a person passes off heard or read ideas as his own, sincerely believing in his authorship. For example, patients can appropriate the books of great writers they have read in their imagination, assuring others of this.

A type of cryptomnesia can be a phenomenon when a person perceives an event from his own life as something he read in a book or saw in a movie.

Treatment of memory disorders

The classification of memory disorders is a fairly large amount of information in psychology; there are many works on the study of such phenomena, as well as on methods of their treatment.

Of course, it is easier to engage in preventative actions than the treatment itself. For these purposes, experts have developed many exercises that allow you to keep your memory in good shape.

Proper nutrition and lifestyle also contribute to normal brain function.

As for the direct treatment of memory disorders, it will depend on the diagnosis, the degree of neglect and the causes of occurrence. Treatment with drugs begins only after a thorough diagnosis carried out by a medical specialist.

Memory is called one of the highest functions of the human brain. Thanks to the features of the central nervous system(CNS), memory is capable of remembering and storing information from a person’s experience, and using it when necessary. One of the most common symptoms of various human brain diseases is memory disorder. About a third of the world's population experiences similar disorders, most often elderly people.

The main problem is that memory impairments are symptoms of a wide range of diseases. And these diseases can affect completely different organs and systems, and are also accompanied by other lesions, for example:

• metabolic disorders;
• dyscirculatory encephalopathy;
• problems of the extrapyramidal system.

If memory impairment is caused by psychogenic diseases, then probable reasons- depression and severe mental disorders.

Depending on the duration of memorization, there are two types of memory: short-term and long-term. Short-term memory is more accurate, but memories are not retained for long, only a few minutes or a couple of hours. Such memory has a limited “capacity”, which is usually equal to approximately seven structural units (for example, visual memories, words, phrases).

This volume can be made larger by increasing the size of the structural units, but to improve memory as such, similar method will not lead. To transfer information from short-term memory to long-term memory, it will be processed by the central nervous system. The more correct and adequate the memorization strategy is, the more effective this processing is.

Storing information for long-term memory lasts up to 24 hours. At this time, various changes occur in the central nervous system, allowing the stored trace to be preserved for for a long time. The “volume” of long-term memory is not limited; information can be stored for a very long time. In long-term memory, the event is stored together with the semantic component, in short-term memory - only the sensory image.

Long-term memory is divided into: procedural and declarative. Procedural memory is responsible for learning and the ability to acquire new skills, and declarative memory is responsible for specific facts.

In addition, it is customary to isolate memory mechanisms. This is the storage of information in memory, its further storage and reproduction. When an impression appears in memory, the central nervous system processes it and then decodes it for further reproduction.

The most serious disorder is Korsakov's syndrome, which manifests itself in disorientation in time, place and environment of the patient. However, intelligence, speech and other higher manifestations of brain activity remain intact or change slightly. As a rule, there are no obvious disturbances in human behavior with Korsakoff syndrome. It is this feature of this that makes it very easy to distinguish it from other diseases (in particular, dementia).

The main cause of memory disorders in people with these syndromes is anterograde and fixation amnesia. Their combination creates a similar adverse effect on a person’s mental abilities. Confabulations and retrograde amnesia have minimal pathogenic effects, in contrast to fixation amnesia. It is extremely difficult for the patient to remember events that occurred during the period after the illness, but long-ago incidents are remembered relatively easily. Typically, the “volume” of memorized information, various abilities and learning ability are preserved during CS. The patient will be able to retain an amazing amount of information in his memory with the proper level of concentration.

Chronic alcoholism may be the cause of Korsakoff syndrome. In addition, this disorder is caused by various pathologies hippocampus, also an insufficient amount of thiamine in the body or brain damage due to injury, tumor development. Another reason may be poor blood circulation in the brain and, as a consequence, hypoxia. Therefore, Korsakoff syndrome often occurs in older people.

Dementia as one of the causes of memory impairment

Dementia is a disorder of higher mental functions. This disease greatly complicates daily life sick.

Dementia is usually divided into: subcortical and cortical. During cortical dementia, disorders of consciousness develop, first with forgetfulness of present events. A little later, cognitive impairment is added to the symptoms.

Subcortical dementia leads to a deterioration in a person’s reaction and concentration, the patient quickly gets tired, characteristic manifestations are: emotional disorders. A patient with a similar disorder has a violation of voluntary and involuntary memorization of information. Semantic memory is preserved, but active recall does not occur. In this case, you can increase memorability and productivity if you memorize information and create logical chains.

Dysfunction of the frontal lobes of the brain also leads to memory disorders in dementia.

These disorders most often occur in people after 55-60 years of age. Senile memory impairment is not dangerous and does not lead to amnesia. Memory deterioration with age is an absolutely normal phenomenon, which is associated with a decrease in the level of reaction and speed.

Among the causes of memory problems are also identified.