By MICHELLE L. BRANDT

In a first-of-its-kind study, researchers are taking a two-pronged approach to a possible treatment for memory problems in older adults. A School of Medicine team will investigate a combination treatment program that includes a cognitive training class and a medication called Donepezil.

"We hypothesize that people on Donepezil will learn more and be able to better apply what they learned in their everyday lives," said Martin Mumenthaler, PhD, a senior research scientist on the team. "If we can make a participant's brain mimic a young brain, he'll still be able to use the lessons from the training three or five years from now."

The Stanford-designed training course will provide study participants with information on various aspects of memory and aging and will teach techniques designed to improve memory performance. Participants will be taught how to deal with anxiety (which instructor Danielle Lapp described as "enemy No. 1" of memory) and also will receive instruction in mnemonics, the creation of non-logical word associations used as reminders. The ultimate goal, Lapp said, is to have participants incorporate these strategies into their daily lives.

"Our program gives people the tools to learn and remember," said Leah Friedman, PhD, a senior research associate in psychiatry and behavioral sciences. "Participants become empowered by doing something to combat their memory loss."

Studies and anecdotal evidence indicate that the training program may help improve participants' memory performance ("Some people are totally amazed by what they learn," noted Lapp), but the researchers have found that others don't benefit as much because they have trouble learning the memory techniques themselves.

"What do you do if you're taught how to remember but you already have a memory problem?" asked Mumenthaler. "We felt that the program would be more effective if people had an easier time learning the memory techniques."

Mumenthaler and his colleagues suspected that adding a drug component could increase the program's effectiveness. They turned to Donepezil, a drug approved by the Food and Drug Administration to treat Alzheimer's patients and others who have mild to moderate dementia. Donepezil works by enhancing the cholinergic system, which is involved in cognitive processes. People with dementia often have a compromised cholinergic system.

During the study, 200 volunteers will be randomized to receive Donepezil or a placebo over 12 months; all will undergo the two-week cognitive training program in weeks 13 and 14 of the study. Participants will be tested for memory function before treatment, after 12 weeks of drug use, before and after completion of the class and again at 52 weeks. The memory tests include a series of standardized questions as well as questions about everyday tasks, such as paying phone bills and reading prescriptions.

Jerome Yesavage, MD, professor of psychiatry and behavioral sciences with postings at both Stanford and the Veterans Affairs Palo Alto Health Care System, will lead the research team.

People ages 55 to 90 with memory problems are welcome to take part in the study. Volunteers must not have been diagnosed with Alzheimer's disease or be taking Alzheimer's medications. Contact Adela Martinez at 849-0494 or e-mail stanfordmemorystudy@yahoo.com to learn more about the study.