I learned a while back how the expression “first in, last out and last in, first out” describes how the loss of memory works in patients suffering from Alzheimer's disease and dementia.
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The expression, First in, last out ... Last in, first out, is a short way of explaining that the things we learned long ago, like in childhood or when we were young adults,
stay in Alzheimer’s patients’ memories longer than things they learned or experienced recently.
I never knew how this occurred, just that it did occur with persons suffering from Alzheimer's disease and other dementias.
After attending a lecture given by one of Dallas’ most knowledgeable geriatric psychiatrists I finally found out -- How and Why memory works in people living with Alzheimer's
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It turns out we form memories in a two step process. The first step is done by the hippocampus portion of the brain. When we experience something or learn something the hippocampus takes it in and registers it. Then the hippocampus sends it to other portions of the brain to be stored.
We retrieve the memory from the other portions of the brain when we remember something.
Research tells us that the hippocampus is one of the earliest portions of the brain damaged by Alzheimer’s disease. I could never figure out why the doctors made such a big deal of that, but now I know.
When the hippocampus is damaged or dying it never registers the new event or the new knowledge. It’s doesn’t recognize the event, and acts the same as if the event never happened. It never sends the message to the other parts of the brain to store the event.
You can’t retrieve what was never stored can you?
Before the hippocampus is damaged it can register events and send them to storage, so those events are there to be retrieved.
Ever wonder why mom has no idea that she had breakfast, but knows the color of the dress she wore at Easter 40 years ago? Because the old memory was stored, while the newest memory is no longer stored because the hippocampus is no longer doing its job.
It actually makes sense that mom repeats herself over and over, because her brain never registered the fact that she already asked the question or told the story before.
Biologically, the brain cannot do its job because the hippocampus is damaged.
You cannot teach mom to not repeat herself because the hippocampus cannot register the teaching or send it to the storage units of the brain -- this is caused by damage to the hippocampus.
Do yourself a favor -- think about this when an Alzheimer's patient keeps asking the same question over and over, or engages in behaviors like insisting you did not call this morning.
Recognizing why this is happening might help you overcome feelings of anger and frustration.
Please consider sharing this with family, friends and other members of the Alzheimer's community.
What is the Difference Between Alzheimer’s and Dementia
How to Test Your Memory
Problems with Balance, Walking, Falling an Early Sign of Dementia
How Do Alzheimer's Patients Die?
The First Sign of Alzheimer's Short Term Memory Loss
The Seven Stages of Alzheimer's
Carole Larkin MA, CMC, CAEd, DCP, QDCS, EICS is an expert in Alzheimer’s and related Dementia care. She is a Certified Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementia issues. Carole can consults with families via telephone nationwide on problems related to dementia. Her company, ThirdAge Services LLC, is located in Dallas, TX.
Original content the Alzheimer's Reading Room