Psychology Today Blogs - Can't Remember What I Forgot

Alzheimer's, uninterrupted: The risk of having genes

Sue Halpern — Wed, 22 Oct 2008 08:58:48 -0700

If Hispanics are more prone to Alzheimer’s disease, and you are not Hispanic, what does it matter to you? Plenty.

   In a much emailed New York Times story recently, reporter Pam Belluck observed that Hispanics are more likely to get Alzheimer’s than members of other ethnic groups and then proceeded to ponder why that would be.   She listed diabetes, which has been linked to dementia, as well as dislocation, which can cause social isolation, which can exacerbate memory problems. Obviously, these conditions are not limited to one ethnic group or another—they pose risks for all of us. That they are concentrated in one demographic merely serves to amplify their dangers for all of us.
   What was missing, strangely, from the Times piece, was the role genetics might play in this phenomenon. Though one physician interviewed said there was no genetic connection, research shows that he is, most likely, wrong. A few years ago, medical researchers in upper Manhattan who were surveying the residents of Washington Heights, which is the neighborhood near Columbia Presbyterian Hospital, noticed that the Hispanics they were studying were three times more likely than either whites or blacks to have Alzheimer’s disease. As the lead researcher, Dr. Richard Mayeux told me, this seemed unlikely to have been a coincidence; when you find a non-communicable disease moving through a population like that, the first things you think about are environment and genes.
   Since many of the people in Washington Heights came from the Dominican Republic, Mayeux and his team decided to go to the DR to do the same kind of epidemiological study they’d done in NYC, and also to look at the genes of those subjects and their relatives in the US. In so doing, they have amassed the largest genetic library of Alzheimer’s disease in the world.
   It was through this work that it became very clear that (no matter your ethnicity), Alzheimer’s runs in families. This doesn’t mean that if your father, say, had AD, you will too. (This would only be true if you inherited the gene that causes early-onset AD, which is very rare.) It does mean that if he had AD, your risk goes up. (If nothing else, this should inspire you to take exercise, eat right, and stay mentally fit, since not doing these things also increases your risk.)
   Once the Columbia researchers determined that there were family ties, they joined with researchers at Boston University and the University of Toronto, who had their own genetic databases, to look for what are called “risk factor” genes. Risk factor genes also do not cause disease but, rather, as their name implies, increase the chance of getting it. After many years of looking, the researchers did one, SorLa, that, they believe, accounts in some measure for the increased number of AD patients in the Hispanic community.
   This is important research for all of us, no matter our ethnicity, because it begins to show how this disease travels, opens the door to further research into the connection between genes and environment, suggests to geneticists which chromosomes to examine, and gives drug makers another target. This is all good stuff and it was, unfortunately, overlooked in the New York Times.
   If you want to read more about the search for SorLa, and the work being done to understand Alzheimer's for all us through the Hispanic community in Washington Heights, the Dominican Republic and Puerto Rico, read the piece I wrote in the December 12, 2005 New Yorker magazine called “The Gene Hunters.”

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Brain Exercises: Better than Googling?

Sue Halpern — Mon, 20 Oct 2008 07:40:07 -0700

I was giving a talk not long ago and mentioned that as far as I knew, there was only one memory trainer, developed by Posit Science (www.positscience.com), that had gone through extensive clinical trials, when a woman raised her hand and begged to differ. Well, she didn’t really beg—it was more like she insisted.

She mentioned a product called MindFit, which was developed in Israel by a psychologist named Schlomo Breznitz and his company, CogniFit (www.cognifit.com) and said that it had undergone extensive clinical testing as well. When I asked if the results of those trials had been published in peer-reviewed publications, she said she didn’t know. (When I asked a representative of the company, I was sent a couple of posters that it had presented at scientific meetings. They were definitely interesting and showed good results, but there was no independent verification.)

The Posit program, which I like a lot, even though it requires a fairly significant, short-term time commitment—about an hour a day for a little over a month—was developed by University of California San Francisco neuroscientist Michael Mezenich. Dr. Mike is an interesting character—when I met him he looked as though he might have slept in his shirt. He was a one of the inventors of the Cochlear implant, and he was one of the first scientists to actually show how the brain changes in response to learning. He’s been working on brain “plasticity” most of his professional life, and the Posit Science program comes out of that work.

Where most brain trainers engage you in activities designed to exercise a particular part of memory—i.e. lists of words for short term memory—Posit works off a different idea altogether. Dr. Merzenich’s hypothesis is that as the brain gets older it has a harder time filtering out distractions. It’s noisy, full of static, and as a consequence, information doesn’t get into the brain efficiently, if at all. What the first Posit program (there are two now) does, is work on helping you make fine distinctions with your ears and really improve your auditory processing. The idea is that once your brain is trained to hear more clearly, you will also remember more clearly. In a trial at the Mayo Clinic and the University of Southern California of nearly 600 participants, that is exactly what happened. The way one of the researchers explained it to me was that after going through the Posit protocol, participants tested “ten years younger” on their memory tests. You can read about the study in the Proceedings of the National Academy of Science.

Not being peer-reviewed doesn’t mean that a program doesn’t work. Being peer-reviewed simply means that the results of a clinical trial have been vetted. (You can make up your own mind, extrapolating, say, to politics, what the consequences of limited vetting might be….) And, truth be told, MindFit is a fun, not especially labor-intensive program. You’ll have to take it on faith when the company says that its programs are better for the mind than traditional computer games like Tetris. In the CogniFit clinical trial, participants showed improvement in spatial short-term memory, spatial learning and focused attention—all good things. But the group using the classic computer games showed gains, too, only not as much.

Of course the big news in the brain training biz this week is that Dr. Gary Small, at UCLA, has shown that surfing the web is good for the aging brain, too. After scanning a group of seniors some of whom had been reading and others web-surfing, “The researchers found that both reading and searching the Internet increased activity in parts of the brain that control language, reading, memory and visual abilities. However, searching the Internet also boosted activity in the frontal, temporal and cingulate parts of the brain and that activity was two times more pronounced in those with experience using the web.”

Whether, in the end, this will turn out to be meaningful no one can yet say. After all, maybe looking things up in the Yellow Pages stimulates the frontal lobes, too. No one has done that study yet.

You remember the Yellow Pages, don’t you?

Drinking Causes Your Brain To Shrink? What else is new?

Sue Halpern — Tue, 14 Oct 2008 11:13:34 -0700

Turns out all you need to do is have two drinks (or more) a day and, voila!, honey you've shrunk your brain. Such is the news coming out today from a study of about 2000 adults: teetotalers have bigger brains (in volume) than either light drinkers or heavy drinkers, while the brains of heavy drinkers are smaller. Before you and your shrunken brain pour that bottle of pinot noir down the drain, and retreat to the sun deck to nurse a glass of milk , though, consider this: doctors have long known that heavy drinking can contribute to dementia. One of my favorite brain slides shows two brains, side by side. They both have a lot of cerebral spinal fluid between the cortex and the skull, and they both have a lot of CSF in the ventricles (which are essentially the brain's waste-water facility). To an untrained eye, the brains look identical, and if you were to have met their owners when they were still alive, they very well might have behaved in a similar way because both were demented. Only the one on the right had Alzheimer's, while the one on the left was suffering from alcohol-induced dementia. (This slide should be part of the standard health curriculum at everyhigh school.)

What's new about the study just published in the October issue of the Archives of Neurology is that it seems to be showing an effect at moderate levels of alcohol consumption, the very moderate levels that we've been told are good for our heart. But don't give up that one glass of wine with dinner just yet. First of all, the amount of brain shrinkage reported by the researcher isn't great--about 1.5% difference between for those who drink heavily and those who don't drink at all. While it's possible that that degree of difference will turn out to be significant, that remains to be seen. Second, this is a correlation study, not a causation study. No one is saying that drinking a glass or two of wine with dinner, or having a couple of beers while watching the presidential debate, will lead to dementia. The connection between brain size and dementia still needs to be explored in a systematic way. Until it is, moderation in most things. Interestingly, what the researchers had hoped to find was that moderate drinking had a protective effect on the brain--that it possibly slowed down normal, age-related brain shrinkage. Turns out that it doesn't.

The alcohol-shrinks-your-brain theme is good for grabbing headlines, but right now it's just an interesting "finding." Skol!

Brain exercises: Do They Work (chapter 5)

Sue Halpern — Mon, 13 Oct 2008 18:48:23 -0700

By my count, there are three kinds of brain fitness programs--and, sorry to say, very little scientific evidence that they work.

There are games and puzzles that are marketed as being mentally stimulating and therefore good for your memory; there are online programs that build exercises around specific parts of memory, like visual memory, or processing speed, or digit span, and that are meant to mimic parts of the IQ and neuropsychological tests; and there are programs that start with a different premise altogether—that memory problems can’t be fixed by getting better at memory-related activities directly, but by addressing the root cause of the memory problem.

The first two kinds of programs are what’s commonly available. They work off the premise that your mind is a muscle that can be toned and bulked up. This is a common perception and it’s a useful and helpful metaphor., especially if you accept the idea of “cognitive reserve”—that you can essentially “bank” neural pathways throughout your lifetime buy engaging in the activities of life itself, so that when your brain is under assault from, say, Alzheimer’s or stroke, some of those pathways can be blocked off and there will be plenty others on which to rely. I like to think of a brain with cognitive reserve as the map of Manhattan—if the Lincoln Tunnel is closed there are still plenty of other ways into the city—and a brain without cognitive reserve as the map of South Dakota—not a lot of roads there, so if one is closed it’s a long detour to find another.

Cognitive reserve is a hard thing to prove conclusively, but the correlation studies are strong, and if you’re interested in learning more about it, check out the work of Dr. Yaakov Stern at Columbia University. As I’ve mentioned before, there’s very little clinical evidence linking games, puzzles and brain software to better scores on memory tests or, more importantly, to better functioning in life. In part this is a function of the testing process itself—it’s expensive to do it right and not a lot of companies are going to invest in a full-fledged clinical trial.

About two years ago, the Journal of the American Medical Association published the results of a trial of various kinds of cognitive training on older adults. The question was: could structured cognitive exercises help people with the activities of every day life. The answer was: not much. The more than 2000 participants were divided into four groups, a control and training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); with booster sessions at 11 and 35 months after training in a random sample of those who completed training. Interestingly, only the group that had been given reasoning training reported an improvement in the tasks of everyday living. On the other hand, the group that had been given the processing speed training plus the booster training did improve on tests of speed processing, though this didn’t seem to translate past the testing room.

I like to think of speed processing as the equivalent of mental reflexes. The effect may be so subtle than participants did not notice it in their day-to-day activities. In my own experience, as my processing speed increased from doing cognitive exercises, I was sometimes able to win a game of ping pong against my husband. This is not inconsiderable in our house, but maybe not exactly what the researchers meant when they asked the subjects if the training had improved their lives.

Brain Exercises: Do they work? (chapter 4)

Sue Halpern — Tue, 30 Sep 2008 08:57:40 -0700

It’s safe to say that mental fitness has graduated in status from cottage to full-blown industry. It’s grown fast, and without much oversight.

Anyone can move in to your town and set up a brain “gym,” just as anyone can set up a mental fitness “club” on the internet, and there’s no one around to validate the “lose ten years off your memory in just seven sessions” claims that often come with them. So far there is no industry standard, and no watchdog group.
   This is not a problem if you don’t really care if there is any science behind the exercises you’re doing, or if they are having a deeper effect than giving you pleasure and making you feel that you are taking charge of your life. I have games on my Ipod that are entertaining and seem to stretch my brain, but I’m under no illusion that they will, for instance, boost my score on a standardized memory test or, more crucially, help me remember to bring home brown sugar and beets from the market.
   One way that companies get around the fact that their products are not backed up by rigorous, unbiased science, is to put together what they call a scientific advisory board, as if having people with doctorates or medical degrees on their masthead automatically confers authenticity. Caveat Emptor.
   As I mentioned earlier, I am a fan of a website called My Brain Trainer that has lots of engaging exercises. Anecdotally—and this is the key word—people say that doing these exercises makes them “sharper.” This may or may not be true, and there is no way to know, and no way to know what, precisely, sharper means. On the site there is reference to a study done five years at place called the DeLos Mind-Body Institute in Texas. There were fifty subjects in all, ages 44-48, some assigned to a control group, the others to do 21 sessions of MBT exercises. Their IQ was tested using something called Virtual Knowledge software. After a month, according to the researcher, Dr. Marshall Voris, those doing the brain exercises had a nine-point increase in IQ, while the control group had a 1 percent increase.
   This is an impressive outcome, until you devote a corner of your own IQ to sorting it out. There were fifty participants, total, and it’s not clear how many were controls and how many did the exercise. Whatever the breakdown, the number itself is probably too small to draw widely applicable inferences from. But, more important is the sample itself: the fifty subjects are between 44 and 48 years old, which is hardly a random sample. Enough said.
   This is not to say that brain trainers don’t work, just that the measures that are used to sell them to you are often less than satisfying. One question that you have to ask yourself before plunking down your cash is “what do I want to get out of this.” If you’re hoping for some reason to raise your score on an IQ test, that’s one thing. If you want to bring home brown sugar and beets, that’s another.

Brain Exercises: Do They Work (chapter 3)

Sue Halpern — Mon, 15 Sep 2008 04:34:51 -0700

    Of all the online brain gyms I’ve joined, the one I’ve been drawn back to over the years is “My Brain Trainer” (www.mybraintrainer.com). It has what I like to think of as the “Nautilus effect” –exercises that are quick and almost fun, rather like the difference between working out on Nautilus machines instead of doing endless repetitions with free weights.
   My Brain Trainer has dozens of online exercises to engage visual memory, working memory, short term memory, processing speed and other domains. Like a real gym you can move around at will—there’s no set order—and you can spend as much or as little time on any of the drills. If you don’t do well on one, you can move on or you can repeat it. And it’s always keeping score, telling you how you’re doing against yourself, against others in your age cohort, and against all the other gym members. (Like a non-virtual gym, there’s a fee.) The other day, for instance, I performed a few points below the mean on a test of visual memory. Displeased with this result, I went through the exercise again. This time I scored twenty points above my peers. Bingo! I was back in business.
   Say what?
   Did my brain suddenly grow new synapses? Did one go-round on the visual memory machine instantly build mental muscle? Well, no. A better explanation is on the second round, motivated by my low score, I really paid attention. Which is to say that the first time I did the exercise some part of my mind was somewhere else; I wasn’t fully—as they say—“attending” to the matter at hand.   The simple rule of thumb is that you can’t remember something if you haven’t paid attention in the first place. Is this obvious? Not often enough to people who are worried about their memory.
   This cannot be stressed enough: a lot of memory problems are actually attention problems. This is as true for people with ADD as it is for people as they age (when the filtering capacity of the prefrontal cortex declines) as it is for people who lead busy, complicated lives. But if you can make yourself pay attention, as I did, or if you can learn to pay attention—which is the premise of the brain training software developed by Dr. Michael Merzenich, which I’ll write about at another time--memory improves.
   My visual memory is pretty good when I muster sufficient mental resources. It’s pretty lousy when I don’t. If the half hour I spent pressing the down arrow on my keyboard every time the light on the screen went from green to red, and pressing the right-hand arrow when a word flashed on the screen had been in the list of seven words shown a few minutes before, had any instant effect, it was to remind me to keep my head in the game.

Brain Exercises: Do They Work (chapter 2)

Sue Halpern — Thu, 04 Sep 2008 20:23:33 -0700

A number of years ago, I met a Manhattan psychologist who had the idea of adapting stroke rehab software for average folks who were experiencing memory problems. These were not people who were sick but, rather, people in middle age who were not as sharp as they once were. They would come to his office and sit in front of a computer screen for an hour, negotiating mazes and manipulating images. The psychologist convinced me that this was the wave of the future, and that some day, in addition to working out at the health club, we'd be working out at the brain gym. Of course now that we know that physical exercise improves memory and may even slow dementia, there's reason to question if brain gyms will become obsolete before they become mainstream.

While the Manhattan doctor's approach--take something that was made for people with brain injuries and tailor it for people whose pathology was simply that they were getting older--attempted to be based in science since the software had been tested on and was known to work for stroke victims, the doctor wasn't trying to figure out if, in fact, his approach really worked. In other words, he wasn't doing a placebo controlled double blind study to assess whether the exercises he was using actually improved anyone's memory.

This is true, it turns out, for most brain exercise promoters. This is worrisome, because people with memory problems can be desperate, and reach for any rope that's tossed their way, even if it's expensive as well as unproven. If you find yourself tempted to plunk down a couple of hundred dollars for a hand-held brain game machine, don't settle for some user testimonials or the manufacturers hype: ask the company to direct you to the research on which it make its claims. Make sure the research wasn't done by someone affiliated with the company, that it was done in a reputable place by reputable researchers, with a super-long digit span of participants. Chances are the company--though it will tout its board of scientific advisors--will come up empty-handed. Caveat emptor.

One online set of "brain" exercises that attracted me right off the bat was one that promised to help me improve my "digit span." A digit span is a string of random numbers, like 23938393835575, that one can hold in one's memory. Typically people can remember 7 numbers going forward and six in reverse. Testing digit span--which happens, for instance, when you take an IQ test--is a way of getting at how good your working memory is. It stands to reason that the longer the span you can recall, the better your memory. It also stands to reason that you can both boost your memory and increase your IQ if you can increase the number of numbers you can recall.

It was with this in mind that I spent about half an hour a day for a month, sitting in front of my computer, learning to remember longer and longer strings. Was I able, at the end of the month, to increase my base-line digit span? Absolutely, just as the company and its august board of advisors claimed, and for this reason the exercises could be considered a success. But did this translate into remembering to buy avocados at the grocery store? Well, no. Did it make me smarter--not obviously, though if I were to take an IQ test before and after my score might have have gone up considerably. (That should suggest something about the fallacy of quantifying intelligence.)

But here is another thing that happened: armed with my newfound ability to recall twenty numbers at a time, I showed up one day to participate in a memory study at New York University. One part of the study required participants to go through a battery of neuropsychological tests, and one of those tests was of digit span. I was pretty psyched, since I knew I'd do well, which would boost my overall score, which could be the difference between being told I had some kind of cognitive impairment and being told I was normal or even better than that.

The tester said a bunch of numbers and instead of zipping them back to her, I was lost. I could remember a couple at the beginning and a couple at the end and that was that. This is because the brain gym I was using not only spoke the numbers outloud, it flashed the string on the screen. I heard them, I saw them, and then, when I said them outloud to myself, I heard them again. No wonder my digit span expanded--I was processing the numbers three times, using two different senses. But in the testing room there was only one modality and it was not enough. In the end, despite my efforts, I pretty much remembered the same number of numbers as everyone else, which made me, well, average.

Brain exercises: Do They Work (chapter 1)

Sue Halpern — Fri, 29 Aug 2008 10:07:15 -0700

When I was writing my book "Can't Remember What I Forgot," the seminal question that friends and acquaintances asked me was whether doing crossword puzzles was really going to help them avoid Alzheimer's and other kinds of cognitive decline. Now that the book is out, that's the question that journalists are most keen to ask as well. It's easy to understand why people think crosswords are protective: a number of years ago a famous study of nuns was published that showed that those who lived the longest without cognitive impairment were also those who did the crossword puzzle every day. To readers, it looked like cause and effect, but of course it was only a correlation, and correlations don't "prove" anything, though they're provocative. In fact, in this case, the correlation could have come from a different cause altogether: that those nuns who did the crossword puzzle were always more verbally and mentally endowed, which is why they were drawn to the challenge of the puzzle in the first place, and that endowment was what kept them from succumbing to cognitive decline. (This hypothesis was given a boost when it was found, on autopsy, that some of those mentally fit, crossword puzzle playing sisters had some of the physiological signs of Alzheimer's, like plaques in the brain.)

The crossword puzzle question raises a bigger one: can you exercise your brain in such a way to hold AD and cognitive decline at bay. It's this question that is driving what's fast becoming its own industry, as online brain trainers, and software, and machines like Nintendo's Brain Age, and brain gymn programs at workout gyms proliferate. The short answer is that because the brain is "plastic"--that is, able to change in response to experience and learnng--it can be aided by brain exercises. This is the premise of the kinds of cognitive rehab exercises designed for stroke victims. But what kind of exercises, and for how long, and when? This new "industry" is unregulated. How do you know what works, and how do you even know what it means for these exercises to be working?

When I was writing my book, I joined a number of brain gyms, bought memory training book, software and gadgets. Right now I'm spending 45 minutes a day going through Posit Science's Brain Fitness Program. In the next few weeks I'm going to be writing about these products and how they can or don't help. As for the crosswords, well, the bottomline comes from another correlation study. It was looking for connections between lifestyle activities like reading, dancing, crosswords and bingo, and a life without significant cognitive declne. What the researchers found was that those who did crosswords were just as likely to get AD as those who did not. Still, as one researcher told me: "There's nothing wrong with doing crosswords. If they make you happy, do them, you're brain will get a nice ping of dopamine and you'll feel good." Nothing wrong with that.

Sweet dreams John McCain, or what?

Sue Halpern — Wed, 20 Aug 2008 20:29:18 -0700

Last May, in an article that was pretty much overlooked during the heated last days of the Democratic presidential primary, ABC News reported that the presumptive Republican nominee, John McCain, relied on the drug Ambien to get to sleep, particularly on overnight flights.

Last week, in an article that got both chuckles and knowing shakes of the head, the long-time New York Post gossip columnist, Cindy Adams, described her own experience with Ambien on a flight she took recently to Europe with Barbara Walters. Walters, it should be noted, took the drug, got some sleep, and emerged from the plane ready for the new day. It was a good thing, too, since Adams was not exactly compis mentis.

“Not used to the stuff and too drowsy to understand anything, I helped myself to a second one,” the 83 year old Adams wrote. “Boyohboyohboy did I fall back to sleep. Morning came. Passengers got up and stretched. I slept. Barbara had scrambled eggs. I slept. The plane was landing. I slept. She tried to wake me. The flight attendant tried to wake me. I slept. Finally my delicate friend yelled in my ear, "Breakfast!" That did it. Glassy-eyed, I sat up. "Eggs. Where's the eggs?" I'm told I mumbled. "Too late," she said. "We're landing."She tried to pour black coffee down my swanlike throat. "I like milk in mine," I'm told I dribbled. She hand-fed me a croissant. I think. I don't remember. Because as it made its way down my swanlike throat I dozed off again. She says she tried to get me to stand. Forget it.”

The piece goes on. It’s pretty funny until you remember that the man who is asking to run the world takes this stuff.
"The only potential issue is if there is an emergency in the middle of the night, but honestly, I am not sure it is worse than being sleep-deprived there too. Of course, Ambien can have side effects, for example on memory — sleep deprivation too. Life is a trade off," Stanford professor Dr. Emmanuel Mignot told ABC News in May.

Life is a trade-off, sure, but do you want the person with his finger on the button, the one who has to take that 3 am phone call, to be relying on a medication that has been implicated in countless cases of bizarre and unremembered behavior (sleep-eating, sleep-driving, sleep-cooking, sleep-stealing)—so many, and with such devastating consequences that the maker of the drug is now the subject of a class action suit with 100 named plantiffs?

Sleep on it.

Rape, robbery, memory

Sue Halpern — Wed, 13 Aug 2008 11:27:05 -0700

A few weeks before boarding a ship in Argentina to cross the notorious Drake Passage on the way to Antarctica, I asked my doctor for a couple of scopolamine patches in case the going got rough. Scopolamine is the drug of choice for those of us who are prone to seasickness; worn behind the ear, it's more effective than over-the-counter anti-nausea drugs, and once it's on, you pretty much forget about it. The problem is that you pretty much forget about everything else, too. I had no idea. I put on the patch and went about my business. The boat crossed a calm Drake, we made it to the Antarctic Peninsula in record time, and before long I was standing on Penguin Island looking at...penguins. Good thing I was taking notes and taking pictures, because the next day, while I recalled stepping off on to the island, and the multitude of wildlife there, it was a fuzzy memory at best, like a picture that's almost in focus. What I didn't know--what, in fact, pretty much none of the other passengers didn't know--was that scopolamine interferes with memory. This is because it's an anticholinergic agent, and blocks the neurotransmitter acetylcholine. By way of contrast, the Alzheimer's drug Aricept is designed to increase acetylcholine, which is in short supply in Alzheimer's patients. Boosting acetylcholine is thought to boost memory.

The patch I wore released scopolamine into my body in a very low, continuous dose. Aside from my fuzzy memory, it was otherwise benign. But scopolamine in higher doses is being used, now, to commit crimes--rape, kidnapping, and robbery most prominently--usually by slipping it into food or drink. When I was in Italy this summer, an elderly man, traveling with his wife, was killed after "waking up," at a train station, finding that he and his wife had been robbed, and falling onto the train tracks into the path of an oncoming train. His wife remembered accepting a cappuccino from a stranger who had befriended them, and that's about all. The police surmised that they had been slipped scopolamine or something like it.

The drug has also been implicated in the large number of cruise ship rapes. Criminals like it precisely because it causes short-term memory loss: victims can't identify them or testify against them. Blocking memory is like wiping away fingerprints. But don't be fooled--it's not that victim has no knowledge of being victimized, it's that the victim has no idea how such a thing could have happened. Scopolamine is also known as "Devil's Breath." That pretty much says it all.