TIME medicine

The Scary Connection Between Snoring and Dementia

Sleep disorders, including sleep apnea and snoring, can have harmful effects on the brain over the long term

If you don’t snore, you likely know someone who does. Between 19% and 40% of adults snore when they sleep, and that percentage climbs even higher, particularly for men, as we age. It’s a nuisance for bed partners, but researchers say we shouldn’t be so quick to write off snoring or other forms of disrupted breathing while asleep as mere annoyances; instead, they could be affecting the brain, according to new research.

Snoring is a form of sleep apnea, in which people stop breathing for a few seconds or several minutes dozens of times in an hour. Any disruption of breathing during sleep can affect the brain, say researchers of a new study published in the journal Neurology. They found that people with sleep apnea tended to develop memory problems and other signs of mild cognitive impairment (MCI) earlier than people without such sleep disorders.

MORE The Power of Sleep

Ricardo Osorio, MD, research assistant professor of psychiatry at NYU Center for Brain Health, and his colleagues studied 2,000 people enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI)—a population of 55 to 75 year olds, some of whom are cognitively normal, some who have mild cognitive impairment and others who have Alzheimer’s dementia. Everyone was asked about their snoring or sleep apnea, and researchers followed up every six months for two to three years to record any changes in their cognitive status.

Those who reported having sleep apnea or snoring tended to develop signs of mild cognitive impairment, including memory lapses and slower speed on cognitive skills, about 12 years earlier on average than those who didn’t report any sleep-disordered breathing. Mild cognitive impairment often precedes Alzheimer’s dementia, but not all people who develop MCI go on to get Alzheimer’s. The connection between disrupted sleep breathing and MCI remained strong even after Osorio accounted for the effects of Alzheimer’s-related genes, gender, education, depression and heart disease risk factors, all of which have been associated with increased risk of cognitive decline.

MORE Alzheimer’s Linked to Sleeping Pills and Anti-Anxiety Drugs

Osorio also saw a connection between sleep apnea or snoring and Alzheimer’s dementia, but it wasn’t as robust as the link to MCI. That might be because other studies have found that not only are sleep disorders a risk factor for Alzheimer’s, but they are also a symptom of the degenerative brain disease—so those who already developed Alzheimer’s dementia may not have been accurately reporting their sleep habits.

Osorio is careful not to implicate all snoring as a precursor to memory problems or Alzheimer’s. But particularly in the elderly, he says doctors should consider the potential effect that disrupted breathing during sleep can have on the brain. While it’s not clear how sleep disorders might be increasing the risk of MCI or Alzheimer’s, it’s possible that the cumulate effects of even the short periods when the person isn’t breathing could deprive brain neurons of critical oxygen, and Alzheimer’s has been linked to slower or abnormal blood flow caused by hypertension and high cholesterol levels. Other studies have also shown that the protein responsible for Alzheimer’s, amyloid, tends to build up during the day when the nerves are active and decline at night during deep sleep. If people are being roused from deep sleep by their apnea or snoring, then they aren’t enjoying prolonged periods of low amyloid production, so the substance can build up and potentially form plaques.

MORE Here’s How Much Experts Think You Should Sleep Every Night

Osorio also found that it’s possible to counteract some of the effects of sleep apnea or snoring. He also studied people who used a device to prevent apnea, known as a continuous positive airway pressure (CPAP) machine, which keeps airways open during sleep. Even though they snored or had sleep apnea, people who used the device developed MCI or Alzheimer’s at the same rate as those who didn’t have these sleep problems. CPAP machines are cumbersome and uncomfortable to use, and many people drop them after a few weeks. But, says Osorio, they may have more reason to stick with them now. “A lot of people don’t use them because they see no benefits,” he says, “but if they know it can improve their memory, they may definitely try to do better.”

Read next: 7 Signs You’re Not Getting Enough Sleep

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TIME Aging

The Health Perks of Arts and Crafts for Adults

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Why the elderly should go DIY

Just as coloring books for adults are starting to fly off the shelves, a new study suggests that older adults who do creative activities like arts and crafts could delay the development of memory problems in old age.

The study, which is published in the journal Neurology, looked at 256 people who were between 85 to 89 years old and did not have any memory related problems at the start of the study. The men and women were followed for four years. The people in the study reported their levels of engagement in the arts, including painting, drawing, sculpting, woodworking, ceramics, quilting and sewing. They also estimated their social life—hanging out with friends, traveling, and attending book clubs and Bible studies—as well as their computer use, which included searching the Internet and buying things online.

People who exercised their artistic muscle were 73% less likely to develop mild cognitive impairment, a condition that can mean memory problems and reduced mental function, than those who didn’t partake in artistic activities. People who did a lot of crafts like woodworking and quilting were 45% less likely to develop mild cognitive impairment than people who did not, and computer users were 53% less likely to develop it compared to adults who didn’t use the computer. Social adults were 55% less likely to have memory problems later on than their antisocial peers.

The researchers also found that other risk factors, like having high blood pressure and depression in middle age, also increased the risk of mild cognitive impairment later in life.

Education may increase the mind’s resilience, which can keep memory loss symptoms at bay, the researchers say. “The reduced risk with computer use and with artistic or crafts activities suggest that these activities should be promoted throughout life,” the authors write. “These activities may also increase cognitive reserve, maintain neuronal function, stimulate neural growth, and recruit alternate neural pathways to maintain cognitive function.”

Kids are encouraged to express their creativity, but arts and crafts may stimulate the minds of adults, too. “There have been a number of studies both in older and somewhat younger individuals suggesting that physical but also mental activity may help prevent development of dementia,” says Dr. James Leverenz, director of the Cleveland Center for Brain Health at the Cleveland Clinic. (Leverenz was not involved in the research.) “We know [mental activity] doesn’t harm anyone, so I encourage it,” he says. “Sometimes that’s just getting out and being social and not sitting around the house all day.”

According to Leverenz, some science suggests that having the brain being stimulated both socially and physically increases growth factors that are important for brain health. At the same time, Leverenz says that the group of adults analyzed in the study was fairly unique since they had no memory problems at their old age. It also should be noted that cause and effect could not be determined in the study. “One of the earliest symptoms of the disease is a loss of interest in activities,” says Leverenz. “It might be that it’s not the loss of activities that cause them to transition, but actually it’s the very early stages of the disease that cause them to be less active.”

While further research is needed, this new study is your best excuse to dig out that artwork—or finger paints—you only thought you grew out of.

TIME Research

Can You Draw the Apple Logo From Memory?

In one study, only 1 out of 85 participants could

Corporate logos are designed to be not only recognizable but also memorable. So why is it that so few people are able to accurately reproduce logos when put to the test?

Researchers say it’s most likely because memories are recorded in broad strokes, while details are often forgotten, according to a new study published in the Quarterly Journal of Experimental Psychology.

Over the course of the study, 85 UCLA undergraduates were asked to reproduce an Apple logo from memory. Only one was able to draw the image correctly.

Here are some of the versions they came up with. Only one is correct — can you tell which one?

“There was a striking discrepancy between participants’ confidence prior to drawing the logo and how well they performed on the task,” said Alan Castel, a senior author of the study. “People’s memory, even for extremely common objects, is much poorer than they believe it to be.”

Try it for yourself.

[Science Daily]

TIME memory

Scientists May Be Able to Turn Your Bad Memories Into Good Ones

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So far it only works for mice

Scientists have found a way to create happy memories in the brains of sleeping mice, raising hopes of similar treatment for people suffering from stress disorders.

Neuroscientists from the French National Center for Scientific Research (CNRS) and ESPCI ParisTech recently conducted an experiment where they placed electrodes in the brains of sleeping mice who had navigated a maze earlier in the day. As the mice consolidated the maze information into memory, the scientists activated the reward center of their brains to create a positive association with certain areas on the map. The next morning, the mice ran straight for those places.

“The learning we induced during sleep was just to change the emotional value of the different locations of the environments,” Dr. Karim Benchenane, a neuroscientist at CNRS and one of the study’s authors, told The Huffington Post. “Indeed, during waking hours, all the locations were neutral. What we made them learn during sleep is that a particular location is now associated to a reward.”

This breakthrough could potentially do much more for humans than tricking us to expect food when we walk into our living room. If scientists can associate different emotions with memories, that could help treat people suffering from post-traumatic stress disorder. But it may be a while before the treatment can safely be used on humans.

TIME Mental Health/Psychology

Why 40% of Americans Misremember Their 9/11 Experience

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'Human memory is not like a computer.'

Where do you think you were on September 11, 2001? Turns out there’s a good chance you’re wrong, according to a new study in the Journal of Experimental Psychology.

In the days following the 9/11 attacks, researchers from more than a dozen universities asked 2,100 Americans across the country about their personal 9/11 experience—questions like where they were, who they were with and how they responded. Forty percent of people in the study changed their stories and gave fundamentally different answers when the researchers followed up at 1-year, 3-year and 10-year intervals.

“Human memory is not like a computer,” says study author William Hirst, PhD, a professor of psychology at the New School for Social Research. “Human memory is extremely fallible.”

The tendency to misremember is likely the result of a “time-splice error,” Hirst explains. In other words, people remembered facts about their 9/11 experience, but they forgot how pieces fit together. In the survey, one man remembered being on the street when he heard news of the attack but was actually in his office. The man probably spent time in both places at some point that day, but his memory of the truth blurred with time, Hirst says.

Once people have come up with an inaccurate but coherent narrative, they often stick with it, the study finds. While many people’s memory of their experiences changed in the year following 9/11, they tended to continue telling the same false memory in the decade that followed.

“You begin to weave a very coherent story,” says Hirst. “And when you have a structured, coherent story, it’s retained for a very long period of time.”

In contrast to poor memory of personal details, Americans recalled the actual events of 9/11 remarkably well. Researchers found that the people surveyed recalled event information about 80% accurately at all time intervals after the initial survey. Some inaccurate memories tended to be corrected over time, likely a consequence of frequent media reports on the topic, Hirst says.

The study may also help explain why suspended NBC anchor Brian Williams retold a false narrative about his time in Iraq, says Hirst. Williams’ evolving story is consistent with the patterns in the study, he says.

There’s no way to tell for certain whether your 9/11 memories are accurate, Hirst says. “We don’t have a memory that allows you to check things so easily,” he says. “In fact, one could argue that the whole notion of accurate memory is some invention of technology.”

Read next: We’re Not Doing Enough To End Hate Among Our Children

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TIME Addiction

How to Make Cocaine Less Addictive

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Researchers learn more about the brain on cocaine

New research in rats suggests that it might be possible to dull the vivid memories of cocaine, a finding that could lead to potential therapies that might one day make drugs less addictive.

In the new study, published in the Journal of Neuroscience, researchers at Washington State University experimented with rats and showed that it’s possible to interfere with the brain’s memory creation process, which is involved in cocaine addiction. Altering this process could make the drug less desirable.

The researchers gave a group of rats cocaine while they were in a specific cage. The rats learned to associate their home with cocaine and memories of those experiences—something humans do, too, says study author Barbara Sorg, a professor of neuroscience at Washington State University Vancouver.

“When people take drugs, they end up accumulating memories of where they took the drug, the people they took the drug with, the sights, the smells, the feeling of increased heart rate or the rush,” says Sorg. “All those things are creating memories.”

Sorg says that people who become dependent on drugs often want to relive a memory they have of that drug. “People talk about chasing that original high, that euphoric response that they can’t seem to get back, so they take higher and higher levels of drugs.”

During the study the researchers also removed a part of the brain in some of the rats called the perineuronal nets. These nets are located in the brain region associated with attention, learning and memory. The researchers found that without their perineuronal nets the rats found the drug cages less desirable, suggesting the nets are both involved in drug-related memories, and that removing them can blunt those memories.

“We are trying to get to a basic understanding for what structures might be responsible for expressing cocaine-associated memory,” says Sorg. If those memories can indeed be dulled, then there may be an pathway for therapies to curb cocaine’s addictiveness in the brain. A drug that targets one of the building blocks of the nets could be a possible option one day, Sorg says, though this research is still very preliminary.

These findings, if replicated in humans, could have implications for people trying to recover from addiction, Sorg says. Sometimes people who succeed in rehab relapse once they are put back in the environment where they were using drugs, Sorg says, possibly due to all the cues around them that they associate with the experience.

“If we can understand the components of these nets and how they are regulated by cocaine, or how they’ve changed by taking cocaine, then we can understand the next step which would be developing therapeutics,” Sorg says.

Read next: Senators Introduce Historic Bill to Allow Medical Marijuana

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TIME politics

Another Conflict in Ukraine: Differing Versions of History

Angela Merkel And Francois Hollande Hold Ukraine Crisis Talks With Vladimir Putin
Sasha Mordovets—Getty Images Russian President Vladimir Putin (C) attends a meeting with German Chancellor Angela Merkel (L) and French President Francois Hollande (R) on Feb. 6, 2015 in Moscow, to discuss the conflict in Ukraine

Why it's hard to rely on historical memory

The 21st century has not started well. But we can’t be accused of forgetting how bad the last one was. Recently, even as we have witnessed both a glut of violent crises, from Syria to Ukraine, we’ve also seen a surge of public commemoration. The same month that the head of the United Nations refugee agency stated that the agency “has never had to address so much human misery in its 64-year history” also saw momentous worldwide observation of the anniversary of the liberation of Auschwitz.

Still, there’s memory and then there’s memory. Just because the past is commemorated doesn’t mean it’s settled. In fact, the Auschwitz anniversary was the occasion for an inept tussle between Poland, Ukraine and Russia over who exactly liberated it the most. Between a peak of refugee distress and using Auschwitz for politics, the hope that remembering the past will improve our future is clearly embattled — literally.

Behind this brawl over the largest Nazi death camp is the grim war now raging in eastern Ukraine’s wintry fields, Europe’s — and perhaps the world’s — most dangerous hotspot since the end of the Cold War, where geopolitical strategies collide and memories clash. As to geopolitics, the stakes are high and rising. Russia denounces western encirclement; the West condemns Putin’s aggression. Hopes for growing cooperation — still alive, it seems, only yesterday — are dead. So are over 5,350 fighters and civilians. German intelligence sources have leaked an estimate for military and civilian casualties of 50,000, implying that Ukraine’s official figures are misleading. The dead, in any case, form only the tip of a swelling iceberg of the wounded, crippled and displaced. Russian planes and ships prod NATO provocatively. Some western experts, commanders and publicists demand weapons for Ukraine, which, Russia says, might lead to “catastrophe.” Mikhail Gorbachev, crucial in ending the Cold War, is now warning of a hot war between the West and Russia.

With a present that alarming, what use is there for the past?

Alas, too much. The row over Auschwitz was symptomatic: tragedies of the past have become positions in memory wars. It’s not only the Holocaust, but also World War II and the horrendous, policy-induced Soviet famine of 1932-33, which killed millions of victims in Ukraine (and beyond). The scale of these catastrophes partly explains their resonance. Globally, the Second World War brought violent death to more than 60 million people, the majority civilians. The Holocaust meant the mass murder of 6 million. In what was then Soviet Ukraine, that regime-made famine killed between 2.6 and 3.9 million victims; counting beyond Ukraine adds millions. Moreover, behind these numbers loom the long shadows of modern Europe’s totalitarian behemoths — of Nazi Germany and the Stalinist Soviet Union, of violent ethnic nationalism, of Communist authoritarianism beyond Stalinism, and of Europe’s long Cold War division.

Between 1945 and 1989, the continent was split not only by walls and barbed wire, but also by different ways of remembering and forgetting its brutal and often — as eminent historian Istvàn Deák’s new Europe on Trial reminds us — shameful past. While in the current crisis Ukraine’s internal divides or cohesion are debated, its uncanny power to bundle Europe’s anxieties not only about the future but also the past stems from this larger division. In Europe’s Cold War East, it was almost entirely forbidden to openly name the crimes of Communism or mourn its victims, while the crimes of Nazism — and the victory over it — became a cornerstone of official memory. Yet the Holocaust, while not denied, was also downplayed. The victims were often posthumously deprived of the Jewish identity for which they had been murdered. Also neglected were the perpetrators’ special anti-Semitic motives and the facts of local collaboration in hunting, plundering and killing Jews.

In the West, meanwhile, at least in the later postwar decades, a tendency developed to make the Holocaust a symbol of the crimes of Nazism in general. Facing the Soviet Union as a potential adversary, it was certainly not forbidden to name the crimes of Communism, including the Soviet alliance with Nazi Germany between 1939 and 1941 and the subjugation of Eastern Europe after the war. Yet many western Europeans chose, deliberately or inadvertently, to be less interested in Communist crimes and their victims. With regard to Communist crimes, one half of Europe was not allowed to talk about them, the other was not always eager to hear about them.

When, one generation ago, the Cold War was suddenly over, Europe faced a challenge: East and West shared what is, historically speaking, a new and unusual state of mind: the conviction that a recent, deeply compromised past was crucial to who they were. But they did not see eye to eye on the meaning of that past.

Now the war in Ukraine is turning into a catalyst for accelerated paradigm shift. Insisting on understanding World War II solely as the valiant fight against Nazism to which the Soviet Union contributed decisively at horrendous cost, Putin’s regime, fond of crude propaganda, seeks to exploit its idea of a Good War as cover for its current aggression. This strategy tends to credit only Russia with Soviet achievements and to trump up even Stalin as a symbol of patriotic statesmanship, glossing over his breathtaking record of violent despotism. Unfortunately, it has popular appeal as a recent poll shows. Meanwhile, post-Maidan Ukraine and its supporters, particularly among the former Soviet satellites, emphasize the collusion between Nazism and Stalinism, the evil of Soviet imperialism, and the fact that the sacrifices of defeating Nazism were not borne by Russia alone, but also by the other nations making up the Soviet Union, prominently including Ukraine.

There’s an irony here: A generation after the Cold War ended, with new confrontation looming, Europe’s foundational memories have received a violent jolt from the East pushing them toward convergence. Putin’s blunt armed aggression is likely to permanently tilt important segments of public opinion in western Europe not only against his regime, but also against its version of history.

This is not a simple happy end, for two reasons. First, it is tempting to confuse Putin and Russia and forget that the latter is a part of Europe too. In the long run, Europe cannot consolidate a shared memory by making Russia its abhorred foil. Secondly, no memory is flawless, and that also goes for the one favored by Ukraine and its supporters. In Ukraine, World War II nationalism, a proudly authoritarian and violent movement with strong anti-Semitic features that engaged in ethnic cleansing, is now officially presented as nothing but a noble national liberation effort. Yet there is no principal difference between whitewashing its leader, Stepan Bandera, into a mere “patriot” in “hard times” and doing the same for Stalin. Indeed, in the name of national unity and to make use of those volunteer fighters who are extreme nationalists and even Neo-Nazis, the Ukrainian government and media are now often turning a blind eye to the far right. Supporters of Ukraine do it no favor by abetting this bias. The present is an intensifying tragedy with a growing potential for catastrophic escalation, also beyond Ukraine. Putin is mobilizing manipulated memories as a weapon. Tacitly condoning a tit-for-tat response in the West offers us nothing except another way to raise the stakes. In a shooting war, memory may not strike us as the most important factor. Yet memory wars will only make finding peace harder.

Tarik Cyril Amar, Assistant Professor, Department of History, Columbia University, has lived and worked for five years in Ukraine. He holds degrees in History and International History from Oxford University, the London School of Economics and Political Science, and Princeton University. His book The Paradox of Ukrainian Lviv: A Borderland City between Nazis, Stalinists, and Nationalists will be published this fall by Cornell University Press. He comments regularly on the crisis in Ukraine.

TIME Careers & Workplace

3 Science-Backed Ways to Remember Anything

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Our ability to memorize is taking a back seat to convenience, but there must be a balance between the two


This post is in partnership with The Muse. The article below was originally published on The Muse.

In this age of smart phones, smart TVs, smart watches, smart glasses—the list is becoming endless—the only thing that seems to be getting duller may be our own brains.

Think of all the things we used to be forced to memorize, which have become relics of a quaint and incomprehensible past. Can you imagine actually memorizing someone’s phone number anymore? And we all know that person who can’t find his own friend’s house without staring at his GPS.

Our ability to memorize is taking a back seat to convenience, and if you’re like me, you’ve noticed the detrimental effects.

It’s not all bad—professor of psychology Daniel Wegner has argued that new technology and search engines may be becoming helpful “virtual extensions of our memory” (sort of like what you do when you leave it to your significant other to remember important dates).

But there are disturbing consequences. A 2013 poll from The Trending Machine National showed that Millennials age 18-34 are “significantly more likely than seniors ages 55 or older to forget what day it is (15% vs. 7%), where they put their keys (14% vs. 8%), forget to bring their lunch (9% vs. 3%), or even to take a bath or shower (6% vs. 2%).”

A balance between memory and convenience must be achieved, and it is clearly time to fight back.

Here are three tips based on new scientific research that you can use to gain back control over your memory.

1. Associate Your Memories With Physical Objects

Here’s a common memory problem that can cause you huge embarrassment at the office: forgetting someone’s name. Whether you’re meeting a new employee or on the phone with an important client, finding a way to remember names can be the difference between making a great impression or committing a serious social blunder.

Next time you meet someone, try to associate his or her name with a physical object, like signs, buildings, billboards—basically anything that you can see, feel, or touch counts. Essentially, you’re connecting something tangible with more abstract information such as names, numbers, dates, or appointments, making them easier to remember.

So, if you meet Pete, for example, and he’s got a pen in his pocket, think of him as Pen Pete. The possibilities for object association with abstract information is nearly infinite, so get creative. (In my case, the more ridiculous my associations are, the more memorable they become.)

You’re probably used to using this physical object strategy when trying to remember directions—“turn left at the big red sign.” This is a natural association that has worked beautifully for the entirety of human existence. So why not apply it elsewhere?

2. Don’t Just Memorize by Repetition—Also Pay Attention to Nuance

Everyone is familiar with the old saying, “practice makes perfect.” Interestingly, scientists have found that while repetitive practice can enhance your ability to remember the “big picture” outline of an object, it is detrimental to remembering the minute details.

New research suggests that, although developing “muscle memory” is an efficient method for memorizing information and learning new tasks in a general way, it will impair your ability to memorize and learn in a thorough manner.

Think about it: If you’ve ever memorized a presentation without actually understanding what you’re saying, you know what happens. You either can’t remember what you’re supposed to say, or you come off sounding like a robot. God forbid that you get interrupted and can’t find your place again.

When it comes to memorization, rote repetition is not enough. Repetition needs to be complemented by an understanding of the details to successfully present in a way that commands your audience.

So what should you do? Practice repetitively—but ensure that your repetition is supported by a solid foundation of understanding.

3. Doodle Like Crazy

This will seem counterintuitive to some of you, but my fellow doodlers have known this truth for a long time—doodling while ingesting non-visual information helps to increase memory retention rate significantly.

A 2009 study in Applied Cognitive Psychology demonstrated that people who were asked to doodle while listening to a list of names were able to recall 29% more of the names on average over non-doodlers. Doodles don’t even have to be related to the topic at hand. Per The Wall Street Journal, “Jesse Prinz draws people’s heads to help himself pay attention during lectures and the speeches at conferences he attends.”

How can doodling be this effective? Studies suggest that the act actually helps you to remain more focused and retain more information because it helps your brain retain a baseline of activity that may otherwise vanish during a dry lecture or speech. In other words, doodling keeps you awake and focused!

So next time you’re in a meeting, bust out a writing utensil and start drawing—though you may want to sit toward the back!

As we continue our journey into the 21st century, improving technology will only make the world even more convenient. We’ll have to remember less and even begin to rely heavily on automation in every facet of our lives.

While it would be easy to settle in to all of this convenience, aim to keep your memory sharp and your wits about you.

More from The Muse:

TIME Research

This Is How You Can Lose Weight Using Just Your Mind

Tom Grill—Blend Images/Getty Images

It’s simple — just remember what you’ve already eaten and you feel less hungry

People may be able to control their hunger pangs (to an extent) if they try to remember the last food they’ve eaten, a psychologist has found.

Eric Robinson says psychological factors can impact how much you eat and believes appetite is formed in the mind as much as it is in the stomach, the BBC reports.

The University of Liverpool scientist studied people who suffer from anterograde amnesia and found that they still have a sensory memory of the food they have eaten, even though they have no conscious memory of it.

Similarly, those who were made to mediate on the food they’ve already eaten throughout the day felt less of a need to consume more.

Read more at the BBC.

TIME Aging

What You Should Know About Early-Onset Alzheimer’s

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The condition affects about 200,000 people in the United States

Julianne Moore won a Golden Globe Sunday for her portrayal of an early-onset Alzheimer’s patient in the film Still Alice. Moore’s character, Alice Howland, is just 50 when she is diagnosed, and the movie follows her and her family’s struggle to cope as her memory and mental state decline.

But what is early-onset Alzheimer’s disease, and who is at risk? Here’s what you should know about the condition that affects about 200,000 people in the United States.

HEALTH.COM: 25 Signs and Symptoms of Alzheimer’s Disease

Not just for old people

Alzheimer’s disease is usually thought of as something senior citizens get. While that is often true, it’s not always the case: Up to 5% of people diagnosed with Alzheimer’s are under age 65—usually in their 40s or 50s—and are considered to have an “early onset” or “younger onset” of the disease.

Symptoms of early-onset Alzheimer’s are no different than symptoms of more traditional cases, says Mary Sano, PhD, professor of psychiatry and director of Alzheimer’s disease research at Mount Sinai School of Medicine in the Bronx, whom Moore consulted during her research for Still Alice. But because the condition is so rare in adults under 65, the signs may not be recognized as quickly by patients themselves, or by those around them.

“By the time people ask for help, something strange has probably been going on for at least six months,” says Sano. “And often, it’s family members and close friends who can provide a point of view that a change has occurred, which can allow that person to realize something is wrong.”

HEALTH.COM: 7 Ways to Protect Your Memory

Because early-onset Alzheimer’s disease is so uncommon, diagnosis may also require testing above and beyond what a senior citizen might undergo. “We want to demonstrate that what’s really present is a cognitive problem and not a psychological or physical problem,” says Sano. “For a younger person, we’ll do a more rigorous workup, including imaging and other tests, because we want to make sure we get this right.”

Early-onset disease has a strong genetic component, so family history—if the patient knows enough about it—can be a big part of a person’s diagnosis, as well. A blood test can determine whether someone has a gene mutation that puts them at higher risk for familial Alzheimer’s, but cannot prove whether they have (or will get) the disease.

What it’s like—and what it’s not

First things first: Early-onset Alzheimer’s disease is uncommon, and it’s not responsible for most cases of middle-aged forgetfulness—like not being able to remember where you put your keys, or the name of someone you met at a cocktail party last night, for example.

Episodes like these, says Sano, are most likely due to preoccupation or periods of temporary stress, and usually aren’t anything to worry about.

When you should be concerned, she says, is when problems with your memory begin to interfere with your ability to do the things that are most important to you, or when you start to have difficulty completing common, everyday tasks. “It’s the persistence and the erratic nature of the symptoms that’s the real warning sign.”

In fact, Sano says, people with early-stage Alzheimer’s disease often subconsciously modify or adapt their routines to the point where they don’t even notice specific red-flag incidents. According to the Alzheimer’s Association, warning signs may include the regular use of memory devices, relying on friends and family to do things you used to handle yourself, or withdrawal from work or social activities.

HEALTH.COM: 12 Unexpected Things That Mess With Your Memory

Symptoms are different for everyone, but one thing to watch for is difficulty remembering and retaining new information, says Sano. “Not being able to learn your new computer password, or to learn a new activity or take on a new project—those are usually the challenges at the earliest stages of the disease,” she says.

As the disease progresses, however, all forms of memory are affected. In Still Alice, Moore’s character becomes concerned when she—a linguistics who is known for her mastery of speech—loses her train of thought during a presentation and cannot think of the words to continue. In other scenes throughout the movie, she gets disoriented while out for a jog, forgets her daughter’s name, and, yes, misplaces her keys.

As the movie shows, early-onset Alzheimer’s can be especially devastating because people in their 40s and 50s are often still working and caring for children. “They’re at risk for having more functional loss, and having their life and their family’s lives affected much more than someone who’s several decades older,” says Sano. “And so the management of the disease really requires a lot of thoughtfulness and a lot of extra service.”

Treatment and hope

There is no cure for Alzheimer’s disease, no matter what age onset occurs. But there are drugs that can slow its progression, and there are ways in which Alzheimer’s patients and their families can better manage living with the disease.

Staying physically, socially, and mental active can also provide protection against the disease and may help people with early-stage Alzheimer’s disease maintain their cognition longer, says Sano. Specifically, research has shown that doing crossword puzzles and speaking a second language may help slow declines in thinking and memory.

In addition, there are many opportunities for Alzheimer’s patients to take part in ongoing research, says Sano, which may lead the way to better treatment options. She recommends talking to your doctor or visiting the National Institutes of Health’s Alzheimer’s Disease Education and Referral Center online for information about clinical trials happening near you.

Sano hasn’t seen Moore’s performance in Still Alice (the movie will be officially released on Friday), but she’s glad the actress did her due diligence when preparing for the part. “When we worked with her, we were impressed with her awareness of the impact of the disease—not only on the individuals, but on the people around them as well,” she says.

She’s also grateful for the opportunity the film provides to show people another side to Alzheimer’s disease. “Many people don’t know what this is and so they don’t seek advice when they see victims,” she says. “It’s critically important to allow people to find out about the disease, and raise awareness about something they need to pay attention to—something they may even be living through.”

HEALTH.COM: 15 Diseases Doctors Misdiagnose

This article originally appeared on Health.com.

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