Episode 210:
Show Notes 

In the second episode of the Menopause Series on Real Health and Weight Loss, Dr. Mary Barson welcomes Dr. Anne Unkenstein, PhD, a renowned neuropsychologist, to discuss the critical topic of memory, particularly as it pertains to women going through the perimenopausal and menopausal transition. Dr. Anne is an internationally recognised scientist with numerous publications in international journals, presentations at international conferences, and the author of the acclaimed book Memorywise. With over 25 years of experience at the memory clinic at the Royal Melbourne Hospital and significant research conducted at the Royal Women's Hospital, Dr. Anne brings a wealth of knowledge about memory, aging, and the specific challenges faced by women during the menopausal transition.

1. Understanding Memory Fluctuations:

• Dr. Anne shares personal anecdotes to illustrate how memory lapses can be perceived differently at various life stages. She emphasises that memory fluctuations are normal, especially during the menopausal transition, and our reactions to these lapses can vary significantly.

2. The Impact of Anxiety on Memory:

• Anxiety can disrupt the initial phase of memory, known as working memory. This phase involves registering information through our senses. Anxiety and distraction can impair our ability to hold and process information temporarily, leading to common memory lapses like forgetting why we entered a room or losing our train of thought.

3. Perimenopausal Brain Fog:

• During perimenopause, women often experience brain fog, characterised by attentional memory lapses. This can include forgetting names, words, or why they entered a room. Dr. Anne explains that these lapses are primarily due to changes in working memory and attention, rather than a decline in memory itself.

4. Memory Storage Process:

• Memory involves different stages: registering information, storing it in recent memory, and eventually moving it to remote memory. Dr. Anne highlights the importance of understanding these stages to better manage memory issues.

5. Self-Efficacy and Memory Confidence:

• Belief in one's abilities significantly affects memory performance. Dr. Anne stresses the importance of focusing on strengths and using strategies to boost confidence in memory, rather than fixating on occasional lapses.

6. Comprehensive Memory Strategies:

• Do It Now Strategy: Anticipate potential forgetfulness and address it immediately. For example, write a note about a new medication regimen and place it in a visible location.
• Organisational Skills: Maintain an organised physical environment and routine to support memory function. Being organised helps internal memory processes.
• Mnemonic Strategies: Use associations and visualisation to remember names or important information. For instance, associating a person's name with a well-known image or concept can aid recall.
• Spaced Retrieval: Practice retrieving information at intervals to reinforce memory. This technique, known as spaced retrieval, mimics natural memory reinforcement processes.

7. Addressing Health and Lifestyle Factors:

• Dr. Anne emphasises the importance of addressing individual health and lifestyle factors that can affect memory. This includes managing physical health, mental health, sleep, and nutrition to optimise memory performance.

8. Long-Term Perspective:

• Research shows that memory issues during the menopausal transition often settle over time. Dr. Anne encourages women to hold on to this perspective and use practical strategies to manage memory in the meantime.

Sharing Stories and Reducing Stigma:

• Dr. Anne emphasises the power of sharing experiences and stories about menopause and memory lapses. By talking openly with friends and peers, women can reduce the stigma and embarrassment associated with memory issues, creating a supportive environment where practical strategies and solutions are shared.

Confidence and Social Engagement:

• Building confidence in memory abilities can encourage social engagement and brain stimulation, both of which are beneficial for memory health. Dr. Anne notes that feeling more confident can lead to more social interactions, which in turn supports brain health.

Resources and Further Reading:

• Dr Mary recommends Dr. Anne's book, Memorywise, as a valuable resource for understanding and improving memory. The book is available on Amazon, Apple iBooks, and in good bookstores.

Actionable Steps:

• As a closing note, Dr. Anne encourages listeners to learn and practice simple, practical strategies such as memorising important phone numbers or names, and to engage in exercises that stimulate their memory.

By understanding the nature of memory, recognising the impact of anxiety, and employing practical strategies, women can navigate memory challenges during the menopausal transition with greater confidence and ease. Dr. Anne's insights offer valuable guidance for maintaining and improving memory health during this significant life stage.

Link to Menopause checklist: https://www.rlmedicine.com/checklist

Link to Dr Anne Unkenstein's book: https://www.allenandunwin.com/browse/book/Dr-Anne-Unkenstein-Memory-wise-9781760296384

Episode 210: 
Transcript 

Dr Mary Barson Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson Barson.

Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.

Both (0:16) And this is the Real Health and Weight Loss podcast!

Dr Mary Barson Barson (0:23) Hello, lovely friend! Welcome to this episode of Real Health and Weight Loss. I am Dr. Mary Barson and I'm very excited to be joined by a special guest today, the fabulous Dr. Anne Unkenstein, PhD and neuropsychologist who is going to talk to us today about memory. This incredibly important human facet is called memory. Anne is an internationally recognised scientist. She has published in international journals and presented at international conferences and she has written a fabulous book called Memorywise. She's been working for the last 25 years in a memory clinic at the Royal Melbourne Hospital and has done some fabulous research at the Royal Women's Hospital, looking at women going through the perimenopausal menopausal transition and their memory. And so lovely Dr. Anne, thank you for coming on today. Could you tell us a little bit more about yourself and about your interest and passion in memory, particularly for women during the perimenopausal menopausal transition?

Dr Anne Unkenstein (01:15)  Of course, and thank you for having me here, Dr Mary. It's lovely to be here today to talk about all things memory. I think it's a topic that's relevant to all of us and our memory does fluctuate from time to time, particularly through the menopausal transition. But I wanted to start by sharing something with you today that just happened in my household about an hour ago. My 20-year-old daughter's at home. She's now in her mid-semester break. She had an exam yesterday. And she said to me – Oh mum, I forgot to take my tablet. And I said –Ah well, that's all right just take it. And she said– Ah I was probably distracted with my exam yesterday. And there was no hint of worry or concern or fear about that little memory lapse that she had. Whereas I think, me being a middle-aged woman transitioned through the menopause transition, still feeling a little bit concerned every now and then with memory lapses.

Dr Anne Unkenstein (02:14) I think I might have used that as more fodder for my theory that my memory is not working so well. And I might have got quite worried about it and thought – oh my goodness, I'll have to make sure I have some special technique for remembering that tablet tomorrow so I don't forget it. So it's just interesting to think back as a midlife woman to how I must have been in my twenties when I was a bit more carefree about my memory and not so worried about lapses that I had and how our reactions to our memory lapses that are often just normal little lapses and happen for very explainable reasons like you were distracted, how our reactions change as we get older. And that's one of the main interests I have and one of the passions that I have with my work is helping people to feel more confident about their memory. Because it's very easy to get very anxious about these lapses that can occur. Particularly around midlife, but also as we get older and a lot of my work over these 30 plus years has been with older people. A lot of my work is diagnosing dementia. So yeah, I've got those two strings to my bow, the work that I've done with people around my own age and younger around midlife, and then also the work that I do with people who have more significant memory illnesses.

Dr Mary Barson (03:36) That is so fascinating to hear you say that. So we, you know, I think self-efficacy and people's belief in their abilities is an incredibly important part of making healthy changes and sort of living the life that you want to live and often whether you believe you can or believe that you can't, you're right. And, but so how is it if people are, you know, really worried and anxious about their memory, how can that affect their lives and how can that affect their memory?

Dr Anne Unkenstein (04:09) Yeah, well, when you're anxious, it affects the very first phase of remembering. So if we think about how your memory works, I think it's useful to just talk about the flow of information into memory and hopefully out again when you want to get it later. But let's just break it down just to start off to get everyone thinking in the same way about memory of how it happens. So say you want to put something new into your memory. It might be that you meet me at a party and I say– Hi, my name's Anne. The very first thing you have to do, obviously, is to register my name and you use your senses to do that. So often it's with names, it's hearing. So hearing can be a bit of a culprit, particularly as we get older.  And sometimes even through midlife and sometimes even through midlife, and the only reason I mention it when we're talking about this perimenopausal phase is that I did have one woman who is in one of my memory groups who listened to me talking about the senses and hearing and went and got her hearing checked. And then a couple of weeks later came back and said– Oh my goodness, I've actually been missing so much because my hearing, even in her fifties, was giving her trouble. So it's not just when we're older.

Dr Anne Unkenstein (05:32) But getting back to your point about anxiety, the next stage, once we've sensed the information, is it goes into this kind of temporary holding bay, which psychologists like to call working memory. And it's this holding bay that only holds a limited amount of information. And the next bit of information you put into it wipes out what you put into it initially. And this type of memory that's very sensitive to anxiety and it's sensitive to distraction as well. So maybe I could get you to have a go at doing it together, dear listeners, just to get a bit of an understanding of what working memory is. I'm going to say some numbers and letters, and then I want you to just say them back to yourself after I've said them. So the letters are I, J, M, O, five, three. So just say them back to yourself. And now I'm going to ask you to do something else. I'm going to say some more numbers and then I want you to say them back to yourself backwards. So if I said one, two, three, you'd have to say three, two, one. Okay. So here are the numbers. Seven, one, nine, six.

Dr Anne Unkenstein (06:56) So say those numbers back. And what you should find, yes, is if you're feeling anxious or even if you're not, if you're feeling totally relaxed, the normal process there is that now you've done the second thing, those first numbers and letters should be gone. They're gone. It's like when you are doing some online banking and you have to put the verification code in, you know, get it off your phone, put it into the computer, whatever. It's that, that is working memory. And that is the main culprit when it comes down to brain fog and memory issues through perimenopause. They are usually concentration and attention issues. So it's like you've gone into a room and you've had what a dear old man called the hereafter experience. But what am I hereafter? What did I come in here for? Or you're talking to a friend and you lose your train of thought and you say to your friend, I was just going to say something and I've, what were we talking about? And I do love it when your friend says, I can't remember either. So it's these are very typical perimenopausal brain foggy kind of memory lapses that can happen. The other one that often happens is you're wanting to say a word, a particular word, and it won't come. So I was in the supermarket observing, this very funny episode, which wasn't very funny for the woman. But you know, when you go to the self checkout and you do the fresh produce and you have to put in what the fresh produce is into the cash register, this woman had a glitch for what the word is for avocado. So she couldn't buy her avocado without asking the person next to her, what's the name of this vegetable or fruit or whatever we call an avocado. So they're all the culprits and a lot of them are around this very first phase of memory, of putting information in through your working memory. So it's like a filtering system and often we say we're having memory lapses, but what we're having is we're having some murkiness around that filtering system, which leads to these classic sort of attentional memory lapses. So that gives us a bit of a clue for what we can do to get more out of our memory. Yeah, yeah.

Dr Mary Barson (09:14) Yeah, I love that.

Dr Anne Unkenstein (09:17) And then after you've taken your memory in there, then it goes into a more durable store, which you might call Recent Memory. So that's when you've heard the name a few times or you've heard that silly number and letter sequence a few times. And that letter and number sequence was actually one of my family's first car registration numbers. So I had to learn that.

Dr Mary Barson (09:40) There you go. Excellent. Yes.

Dr Anne Unkenstein (09:43) So I went over it a few times when I was younger and I put it into my memory and it's in my more, you know, it was into my recent memory, which is more durable. And then over time, as we had that car for years and years, that yellow Tirana, it got into my remote memory or lifetime memory store, which is this much more durable store. And it's a very useful kind of memory store to think about when we're feeling a bit anxious about memory and thinking, gosh, you know, I forgot to take that tablet or I couldn't remember the word for avocado, to draw on the strengths because there are many aspects of memory that are really strong and stay strong. We can use lots of those strengths in our memory to get around the issues that we have with other aspects of memory. One of the other things to think about too is that, when we're going through the menopause transition, we're in our sort of late 40s, early 50s usually, and we're also experiencing a little bit of just normal age related change in the brain system. So, unfortunately, there are lots of aspects of processing information and memory that can change from our 30s onwards. And we know this, you know, we get younger people to do a task and then we get older people to do a task and surprise surprise, older people can still do it but they take longer. So we know with memory that it's normal to have a little bit of slowing with your ability to take new stuff in and to get it out later but you have to remember that you can still do it, it just takes longer. It's also normal to have just normal aging retrieval glitches for people's names and words.

Dr Anne Unkenstein (11:34) So there are some changes with memory. There's also this change that happens as we get older, which is very annoying in our ability to divide attention. So you might think of multitasking with that so that it's much harder to sort of not pay attention to things that you don't want to pay attention to. So for example, you're cooking a new recipe, you tell people not to talk to you and you turn the radio off because you really need to focus. So they're just some of the normal changes that can happen. But then we can also have lots of things that keep getting better, like our lifetime memories. Like, you know, that's what we often say about older people. They're so amazing with their knowledge, their built up knowledge and their experience and their perspective on things that we really value. Yeah.

Dr Mary Barson (12:23) I love it. And drawing on that, the strength, being strength-based is going to be so much more helpful rather than focusing on the things that are a bit slower. But that multitasking aspect that you described, our ability to multitask declines with age seems in my mind kind of particularly cruel. You know, a woman who I'm approaching my mid-forties and I, like many women around my age and older, can find myself having more demands on me than I ever have in my life. I'm still a working mum. I'm a mum for toddlers, but I've also got aging parents and I'm kind of sandwiched between all of these roles and having to wear all of these hats at the same time that my natural speed of multitasking is naturally diminishing. It seems a bit mean. Mm.

Dr Anne Unkenstein (12:57)  Yep. It is mean and it's something to really recognise and it's part of all of us. There is so much overload at midlife. As you say, you've got children potentially at any age but often through the perimenopausal stage, they're teenagers. You can get a bit of flak from them too –mum, you didn't remember what I told you last night. What have you got Alzheimer's or something? This sort of thing.

Dr Anne Unkenstein (13:43) So it's really important to think of not only our reactions to ourselves when we have a memory lapse, but also just be cognisant of people around you and how they're reacting towards you and how that makes you feel and if you're comfortable to actually let them know how that makes you feel, because, through midlife, it's going to be very, very unlikely that we've got Alzheimer's. You know, like if we look at the prevalence of Alzheimer's in our community in Australia and in the world. The statistics for like 40 to 60-year-olds, it's less than 2% of the population have dementia at that age. So when your teenager gives you the, you must have Alzheimer's mum, just know in your heart that that's very unlikely and maybe just politely explain to them why you forgot the party that they were going to and that they needed a lift to on Saturday night because you were actually in the middle of watching a TV program that you were enjoying or something like that. Yeah.

Dr Mary Barson (14:44) That's alright. That's alright. Could you tell us a bit more about in particular, the perimenopausal period for women, what is in your research, what have you found that has come out for women in this time about, about their memory and about, I guess their feelings about their memory. Cause we've just discussed how incredibly important that is as well. Tell us more about this.

Dr Anne Unkenstein (15:13) Yeah. Absolutely, yeah. Yeah, so the feelings are the ones that I found the most significant findings in. So I looked at women and kind of categorised us into premenopausal, perimenopausal when your hormones start to fluctuate and your cycle goes all over the place and then postmenopausal, so after the last menstrual period, I gave women questionnaires about how they were feeling about their memory. And it came through quite significantly that in the group who were undergoing the transition and having hormonal fluctuations, 82% of them acknowledged that they were worried about their memory and were experiencing forgetfulness. And when these similar studies are done in other studies all over the world, the general figure is about at least two-thirds of women going through the transition will report forgetfulness. So it's very high. It's the majority of women. So we're all in it together, really. What I also did for this same group of women was these poor women, they had to do a full neuropsychological assessment, which took an hour and was tested. So you know what I'm talking about. Yeah. And it's hard. good on you. Yeah. So you know what I'm talking about. And...

Dr Mary Barson (16:18) Yep. I've done one of those. Yeah. Yep. I had a really good concussion in my twenties. I had to have one after that. Yeah. Yep. Yep. I do. Yeah.

Dr Anne Unkenstein (16:41) And some of your listeners will too, but it's basically giving people sort of school-type tasks that are designed to measure different aspects of memory. And I'm not the only one who's done this. There's been a lot of research coming through, particularly recently looking at, whether can we measure this memory change. Can we measure this brain fog? And it doesn't come through very strongly on the neuropsychological measures, particularly when you're doing what's called a cross-sectional study, when you're giving the same tests, to different groups of people. It comes through a little bit more, but it's still subtle when we watch the same person over time and give them tests at different time points through the transition. But I think the encouraging thing is that the research is showing that it settles. And I think that's what we need to hold on to. So we're going to go through this time when our fluctuations in our hormones occur and we experience this sense of loss of confidence in our memory and actual embarrassing memory loss and there's a lot of stigma about it as well. We don't talk about it because we're embarrassed. We think we've got early Alzheimer's. All that sort of stage, it has been shown with the research that does settle with time. So it's something to hold on to. And in the meantime, while it's happening, arm yourself with as many strategies as you can to improve your confidence that you will negotiate life. And we don't need to remember everything, but the things we want to remember, then we have techniques. We know that we can do things.

Dr Mary Barson (18:09) Fabulous! I'd love for you to share more about what are these techniques if we feel that we're having problems with our memory and we're losing confidence in our memory during this transition, what can we do?

Dr Anne Unkenstein (18:20) Yeah, yeah, yeah, sure. Yeah. absolutely. Yeah, yeah. And that was the other arm of the research that I did at the Women's Hospital. I ran this four-week program for several groups of women where they'd come in once a week and we'd have a two-hour session and we'd talk about things like, you know, what we've already talked about right now. We'd sort of set a framework around memory and talk about how it works and why it lets us down. And then we'd talk about specific memory strategies that can help. But even before that, we would talk about how life can get in the way of memory. And it's not just the hormonal fluctuations during the menopause transition. We're all different and we're all complicated. And we all have lots of things going on in our lives that can make it play out, even more, the sort of natural changes that can happen through the transition. So it might be that we've got lots of other physical health issues. It might even just be that we've got a big infection, a UTI or the flu or COVID that makes those memory lapses happen more often. Or it might be that you know, we've had a problem where we've got some pain issues, like pain issues can definitely detract from our ability to focus. It might be that we're going through a period where our sleep is really poor and it's a bit chicken and the egg, but sleep can be poor just because of the menopausal transition and the hormonal fluctuations, but it can also be poor because of other symptoms of menopause like the hot flushes and the horrible night sweats that keep us awake. Or it might be poor because we're experiencing significant anxiety or we've had past trauma that's resurfacing or that we're experiencing depression. So, so many reasons why sleep can be poor. But we know that sleep's so important to our brain and there's some amazing research coming through talking about how our brain just keeps working while we're asleep, but it doesn't go to sleep. And it does work on consolidating the memories from that day, you know, it keeps working on making a recording if we get refreshing sleep. And the other thing that our brain does is that, as you know, Mary, it has the sort of waste clearance, spring cleaning each night too, through the, what's called the glymphatic system. So sleep is really important. And then also mental health, we've touched on, you know, trauma and anxiety and depression, which is so common and grief, you know, we might be experiencing grief.  And we've all experienced that at different times of our lives. 

Dr Anne Unkenstein (21:12) So our mental health, our physical health, the part you're an expert in, our nutrition, is so important. And then, yeah, our attitude. So thinking about all of that, what can we do to make ourselves feel a bit better? So first of all, we can tend as much as possible to those parts of us that are very individual to us, all those health, physical, mental health bits and pieces that happen from time to time. Sometimes a whole lot of it comes at once. So working with our medical support team around us and our psychological support team around us to calm some of those issues down if possible, to get more out of memory in the first place. But then we need to do just really practical things that are things that get around this problem with attention mainly. The best thing to do is to talk to other people about what they do as well because we've all got techniques and we don't need techniques for everything in life, but there are a few things that we can do. We know that a lot of memory lapses are about paying attention. So we can consciously say to ourselves, I need to pay attention now. And it might be that we've been given a new medication regime that we have to get used to. So that's very important. That is something we have to remember. So we might use a strategy, which I like to say is the Do It Now strategy. So predict you're going to forget it later, do something about it now so you will remember it later. Do it now. So for medicine, it might be that you write a little note out for yourself and you keep it on the bathroom bench that says this is the new regime. Do something about it now so you remember it later. And writing notes is not to be underestimated. It makes us feel confident. I am too. Yeah. And look, often just the fact that you've written the note means that you've paid attention more. So you're less likely to forget it because you've encoded it more deeply you've written the note and taken that step. But the Do It Now one is important. And then being organised, you know, the more organised you feel in your physical environment with your diary and how your house is set up, the more organised you tend to feel internally. So when we're in a good routine, we tend to remember better. When we're in a period of our life where our routines are out the window, we don't remember as well. And we have to just go easy on ourselves. You know, like you might have moved house or you might have started a new job and that just puts a lot more load on memory. Yeah. We can use fancy memory strategies if we want. 

Dr Mary Barson (24:17) I love simple, fancy is good too.

Dr Anne Unkenstein (24:33) So if you wanted to go in, yeah, simple is good. Fancy is good for things that are really annoying us. So let's say there's a name of a neighbour that's just moved into your area and this neighbour. They keep having conversations with you and they call you by name and you keep forgetting their name and you're thinking, gosh, you know, I really, I really should remember their name. They're going to think I'm hopeless and you want to feel confident about it and learn it. So then you might just do a little bit of homework using what we would call a Mnemonic Strategy. So this is when it's the kind of strategy you would use when you're studying for exams. So you should do some homework on it. So you'd find out the name and you'd associate it with something. So an example I can give is a woman who came to one of my groups and she was saying, I feel so bad. I keep going to this motorbike repair place because my motorbike, I'm trying to get something fixed on it. And the guy there, he knows my name and he calls me by name every time and I keep forgetting his name. So I said to her, well, what's his name? And she said, James. And immediately I had this image of James Dean in his leather jacket on the motorbike. And I said that to her and she said, I'm never going to forget it now. So we've all done this, haven't we? You know, you just, you make a little association with something and usually the more bizarre and the more visual, the better. And then you can practice, practice retrieving that information. And then the thing is, once you've practised it and you've got it, you can use it. and you can feel really good about yourself. So that the next time you have a little glitch, you can think, that's all right. I've got my techniques. I can do something about this to help me remember it. Yeah.

Dr Mary Barson (26:02) I do love that. Yes. And the doing the homework aspect certainly appeals to me having done lots of exams in my life. I could, from my own study, I've learned that the best way to remember something is to remember it. So to practice, practice retrieving it. And then you, you know that it's already there and then you can retrieve it when you need it.

Dr Anne Unkenstein (26:25) Mm, yes. Absolutely. And they're teaching kids that at school now too. And you know, they've got the term for it, Spaced Retrieval. And yeah, it's just mimicking what we do naturally anyway, isn't it? For example, phone numbers, you know, before we all stored our phone numbers in our phones and just touched the person's name, we actually had to, well, I can remember dialling those numbers on an old-fashioned phone. And the more that you would dial them, the more you would get the sort of muscle and kinesthetic memory of the dialling plus the number going in. But now it's something I would actually encourage everyone to do is to learn a mobile phone number that you might need to learn in case of emergency when you haven't got your phone or your phone's dead and you have to use someone else's phone to ring someone. And you know, when we're feeling like our memory is letting us down and we're feeling underconfident, that can seem like a really difficult challenge to learn a mobile phone number of 10 numbers, but it certainly can be done. And I'm sure many of you have done it. And, you know, first of all, it's not 10 numbers because the first two numbers in Australia, at least, are always zero four. And then we can, again, use those techniques that we used back at school. We can chunk it into a smaller amount of numbers like, you know if there was a five, six in it, you could think of something that happened in 1956, like the Olympics were in Melbourne then, you know, so something like that. You add meaning to it and again, you do the space retrieval and you show off and you know that number and it makes you feel good.

Dr Mary Barson (28:01) Yep and builds that self-efficacy, that self-confidence that, hey, my memory can work and that can become your self-fulfilling prophecy. I love that. Yes.

Dr Anne Unkenstein (28:13) Yeah, yes, exactly. And also the writing things down, which is the one we all do. Like when you look at the research, when they do questionnaires on people in the community about the types of memory strategies that they just naturally use, of course, it's the external strategies, the ones that are outside of your brain that most people will use on a day-to-day basis. But some people think that's being lazy. They say, if I just put everything in a diary or into my phone, reminder system, that's just being lazy and I'm use it or lose it. I'm not using my brain enough and I'm not using my memory and it'll just get worse. But we know it's not like that. It's basically you're parking something out of your brain so you can feel confident that you'll remember it. And then that frees up your brain for doing much more exciting things than remembering what time your doctor's appointment is next Thursday.

Dr Mary Barson (29:12) Yes, I openly refer to my journal as my external brain. I think it's a very good way to remember things. Yes.

Dr Anne Unkenstein (29:14) Hmm. yeah, yeah. And you see, you know, you see people walk around with their phones and calling their phones their brain. I've got my brain in my pocket and that sort of thing too. I particularly like the phone, I still use paper for my diary because I like the visuals. I don't like the templated sort of formats on the phone. But lots of people use their phones because they have other benefits like being able to sync them to other family members and that sort of thing. The phone one's great for what we call prospective memory, which is remembering to remember to do something at a certain time on a certain date because you can just use the simple reminders app and type in exactly what you have to do and program it to pop up with the notification, you know, five minutes before you have to do it sort of thing. But all those ideas are good and it's good having a whole sort of portfolio of strategies that you can draw on for different things because different strategies work well for different things. Yeah.

Dr Mary Barson (30:13) Yes, yes and dip in and out of the ones that you need when you need them. I love that.

Dr Anne Unkenstein (30:14) Well, it just sort of makes you feel more confident by doing it. And then that confidence means that you're more likely to get out there and be social and stimulate your brain and do all those things that are good for your brain as well

Dr Mary Barson (30:27) Yep. Yes, confidence is key. Thank you so much for all those really practical strategies. And before we wrap up, are there any final thoughts that you would like to give our listeners about memory and how they feel about memory and how they can improve?

Dr Anne Unkenstein (30:58) Yeah, I just think that there's a lot of power in sharing our stories. I think for a long time around menopause in particular, we've sort of, you know if you think of past generations, they didn't really talk about it very much at all, let alone the symptoms of the memory and the brain fog. And I'm so thankful that we are feeling more free to talk about that now, because I think it helps, you know, a problem shared is a problem halved, as they say. And I think that if we talk to our friends about what we're experiencing, then it just takes away a lot of that extra layer of stigma and embarrassment about the memory lapses. And we can share really positive strategies with each other.

Dr Mary Barson (31:39) Yeah, we can help each other and that shame, it hates the light. So shine a light on your experience and share it. That's wonderful.

Dr Anne Unkenstein (31:51)Yeah, that's lovely.

Dr Mary Barson (31:55) Gorgeous people, if you want to learn more about all of these wonderful tips, tricks, and strategies and learn more about how your memory works and how to improve it, you can check out Dr. Anne Unkenstein's book, Memorywise. It's available at Amazon and I bought my ebook on Apple iBooks. It's available in good bookstores as well and it's full with some fabulous information. Dr. Anne, thank you so much for coming in today and sharing your wonderful wisdom, expertise and insights. I've really enjoyed it. I think our listeners are going to find all of this really valuable. Thank you so much.

Dr Anne Unkenstein (32:38) That's my pleasure and everyone enjoy learning your in case of emergency numbers and that name, that name of that person. Thank you.

Dr Mary Barson (32:45) Yes. Excellent. Love some homework and actionable steps. Bye bye. Gorgeous words. See you later.

Dr Anne Unkenstein (32:51) Bye, thanks Mary.

Dr Lucy Burns (33:08) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.

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