Alzheimer's: new hope for preventing--or delaying--the disease.

Many years ago my father set out one evening for a men's club supper at church, but he never arrived. Our family spent a sleepless night trying to find him or anyone who might know where he was. It wasn't until the following day that my mother received a phone call from the police in a city, several hours away saying that my father was safe and that the family could come for him.

The reason we got him back at all was because of a caring service station owner. When my father pulled in for gas, the owner saw he was in distress, took his keys away, and escorted him to the police station. On the seat of Dad's car we found a ticket he'd gotten that night for driving the wrong way on the Interstate.

A few years later my mother's link with reality began to slip as well. She could no longer remember ordinary things such as the day of the week or why she was living in a retirement community--even though she'd chosen to move there.

As you can see, I have a personal interest in learning all I can about Alzheimer's disease and finding out if there's hope of preventing or treating it.

Unfortunately, there's still no sure way to predict who will or won't become a victim of the disease. Even family history is not a true forecaster. But there is hope for delaying, treating, and perhaps even escaping it.

Relative Risk

"What I always tell families is this," says Richard Powers, M.D., chief of the Bureau of Geriatric Psychiatry, Department of Mental Health, Tuscaloosa, Alabama. "Your relative risk is related to the number of family members who've had it, the proximity in the bloodline, and the age of onset. Let's say you had an aunt who got it when she was 82 years old. Well, your risk is slightly higher than that of the general population, but not appreciably so. On the other hand, let's say that your father got it when he was 49, and his brother got it when he was 52. That history does actually increase your risk, but it does not necessarily mean you'll get it."

There are ways we can better our chances of avoiding Alzheimer's even if our family history is discouraging. The first is maintaining a healthy lifestyle. It's now believed that what's good for the heart--regular exercise, a healthy diet, stress management, and keeping blood pressure and cholesterol at recommended levels--may indeed make a difference in whether we get Alzheimer's or one of the diseases that mimics it (see "Beware of Illnesses that Mimic Alzheimer's Disease").

"There are a few things you'd probably be well advised to do as you grow older," says Dr. Powers. "First, every study that has looked at high blood pressure has demonstrated a relationship between poor treatment or no treatment for hypertension, and dementia. It probably stems from the fact that tiny blood vessels in the brain take a beating when you have untreated hypertension.

"So the first thing you can do to spare your brain is spare your blood vessels," he says. "You can do that by doing what's necessary to control your high blood pressure. Same thing for heart disease and cardiovascular disease, which is oftentimes tied to hypertension. You gotta take good care of your heart."

Mind and Body

Exercise is important, too. "Studies show, for instance, that walking 30 minutes per day substantially reduces your risk of hospitalization from heart disease if you're over age 65. So exercise regularly and control your hypertension. If your doctor tells you that you've got irregular heartbeats (atrial fibrillation) and advises you to take medicine, take the medicine."

Dr. Powers adds, "As people get older, their intellectual repertoire seems to be simplified, and that's not a good thing. What you really need to do is keep your brain toned up by exercising it. Do new things. Take up a new hobby. Learn a language."

He advises seniors to buy a computer. "It's like a new language. It opens a whole new world. If you become a shut-in, you're never shut in if you're online."

Working crossword puzzles may also be useful, he says. "It's not an insurance policy, but I think it's a form of novel intellectual stimulation. I know my 90-year-old mother works a crossword puzzle every day. And she's pretty sharp."

Reading may help, too. "I think that the more you stimulate your brain the better, and reading stimulates it." He goes on to say that newer studies suggest that people with ongoing lifetime intellectual stimulation probably have diminished risk of dementia.

Close personal relationships also keep us mentally stimulated whether they're with family members, friends, or others whose company we enjoy.

Slow but Steady

Physical activity matters, but it doesn't have to be strenuous. "Walking regularly at age 70 and beyond can help keep the mind sharp and ward off Alzheimer's disease, according to research suggesting that what's good for the heart is also good for the brain," writes Lindsey Tanner in an article for the Associated Press, published in September 2004. "One study, involving 2,257 retired men ages 71 to 93, found that those who walked less than a quarter mile a day were almost twice as likely to develop Alzheimer's or other forms of dementia as men who walked more than two miles daily.

"A study of 16,466 female nurses ages 70 to 81 found that even women who walked a leisurely one and a half hours a week did better on tests of mental function than less active women."

Although memory loss is associated with Alzheimer's, it can also simply be a by-product of age, not necessarily an indication of Alzheimer's. In the Los Angeles Times, Benedict Carey writes, "Starting around age 28, our scores on memory tests decline steadily, researchers say; by 55, our ability to associate names with faces or memorize new phone numbers has slipped by 20 percent."

On the other hand, he continues--and this is encouraging--"when stimulated in the right way, brains of almost any age can give birth to cells and forge fresh pathways to file away new information."

If you're concerned that you might have Alzheimer's, get a memory screening, even if it's only for your own peace of mind. The Alzheimer's Foundation of America (AFA) offers an annual memory screening. "It's always the third Tuesday of November," reports Eric J. Hall, CEO of AFA. "People can stop in, have a memory screening, then learn about memory, mental, and brain health.

"They go to this very comfortable setting where there's no pressure and there's anonymity. They're able to ask questions and get information." And, if need be, he says, "they will be referred back to their primary care physician for further diagnosis." Or, if patients prefer, they can go to their own physician for an evaluation. "It's all done on paper," he says, may take only 7 to 10 minutes, and is an indicator of whether there's a concern or an issue." For more information, call AFA at 1-866-232-8484 or visit www. nationalmemoryscreening.org.

Signs and Symptoms

Some of the symptoms of Alzheimer's, besides forgetfulness, says Hall, includes "getting confused about time and place--for example, maybe getting lost trying to find one's own home. Another is experiencing erratic changes in mood or behavior, becoming angry or depressed, maybe becoming agitated.

"Another sign might be having trouble with routine tasks--buttoning a shirt or other daily activities--having difficulty communicating, forgetting common words, or using the wrong words, experiencing changes in personality like feeling afraid or suspicious, and lack of sound judgment like wearing inappropriate clothes for the season.

"The interesting thing is when we talk to families about this and we mention these symptoms, they'll say, 'You know, I didn't know what was going on, but that's true.'

"The treatments that are available for Alzheimer's," he says, "seem to be effective at staving off the progression of the symptoms for a number of years." But, he adds, people are often unaware that there is treatment and hope.

One of the problems with Alzheimer's, Hall adds, is that it doesn't follow a set pattern. "Some people have agitation, while others are docile. Some become hyperactive, and some wander."

Those who are caring for Alzheimer's patients need to know that there is assistance available. "Families or individuals can't do this alone," says Hall. "There are local resources and professionals who are experts in this field, who've lived this 24/7." Knowing what's going on, he adds, makes it less frustrating.

Caring for Caregivers

Caregivers need to be trained in how to give proper care, and support groups fill a vital role. In a support group you can learn from others who are experiencing--and handling--the same situations you face. Sometimes just knowing you're not alone is enough to make you weep with relief.

Hall stresses that caregivers need to take good care of themselves. "Studies show that caregivers who are well cared for themselves do a better job and give a better quality of care to their loved one. So it's important to get out, have mental space. It's important to bring in a home-health aide so you can get a couple hours to go to the beauty shop or take the car to get washed or whatever. If there's one thing about this disease that actually leaves me awestruck," he adds, "it's the depth and length that people will go to to provide care for their loved one."

Time for yourself is not a luxury; it's a necessity. If we take time for ourselves, our loved one will benefit from it as much as we will.

There are many victims of Alzheimer's disease. With proper understanding and training, the illness's impact on everyone involved can be minimized.

Beware of Illnesses that Mimic Alzheimer's Disease

Multi-infarct dementia: This can be a series of strokes within the brain that are so small that the person who has them may be unaware of any change. Yet they destroy brain tissue and impair memory and intellectual function.

Depression sometimes resembles Alzheimer's by causing memory loss, impaired mental function, and confusion.

Pick's disease causes personality changes and is relatively rare.

Huntington's disease is a genetic disease that usually develops between the ages of 30 and 50, although it may begin later. Symptoms include short-term memory lapses, depression, uncontrollable muscular movements, stumbling, and clumsiness.

Peggy Rynk writes on health topics from Charlotte, North Carolina.