Q: WHAT IS ALZHEIMER'S DISEASE? "Alzheimer's disease is a disorder of memory and other thinking problems, which is severe enough to affect life on a daily basis. It involves loss of short-term memory but also other things like the ability to express yourself with language, the ability to perform certain routine tasks like getting yourself dressed or operating a piece of equipment. It has a lot of emotional symptoms that can go along with it as well such as depression or anxiety, sleep disturbance, agitation, and so forth. Alzheimer's disease is not an inevitable part of aging, it's a disease process. And when people are concerned about how their memory is functioning or concerned about a loved one who seems to have trouble with their memory and their thinking, they shouldn't just assume that it's due to old age. They should go to their doctor and have an assessment done. That assessment may be reassuring to them or, it may indicate that a problem exists that needs further diagnosis and treatment. But it is important to get that assessment early on rather than to wait until things have progressed to a significant degree." Q: WHAT ARE THE NORMAL SIGNS OF AGING AND WHAT'S CAUSE FOR CONCERN? "Many people worry that when they forget where they put their car keys or can't think of someone's name, this may mean the beginning of Alzheimer's or some other dementia. This is usually not the case. In fact, it's common for people as they age to have a little more trouble with their short-term memory. It's also normal to have less ability to recall names or think of words as quickly as they once could previously. While this can be annoying or frustrating, or embarrassing, it may simply be a phenomenon of normal aging. There are also many other medical conditions, both physical and psychiatric, that can cause some impairment in the ability to think and remember. The symptoms may not indicate a primary memory problem at all, but could be a result of a condition like depression or side effects from a medication. Once the cause of these symptoms is identified they can, in most cases, be successfully treated." Q: WHAT ARE SOME OF THE SIGNS AND SYMPTOMS OF ALZHEIMER'S DISEASE? "The most common symptom associated with Alzheimer's disease is loss of short-term memory. People may remember what they did decades ago but can't recall things that happened in the last five minutes or the last couple of days. Other changes that may develop include loss of interest in activities, general withdrawal, or apathy. Difficulties with language, such as not being able to speak clearly and convey ideas with words frequently occurs as well. People also may develop difficulties performing routine tasks such as driving a car, shopping, cooking and operating the TV remote control or other pieces of equipment. Eventually, as the disease progresses, more fundamental daily functions are affected such as being able to eat, get dressed, take a bath, walk, or use the bathroom." Q: WHAT KIND OF RESEARCH IS BEING DONE REGARDING THIS DISEASE? "Here at Dartmouth-Hitchcock Medical Center, we are doing some very exciting research looking at individuals who have mild cognitive impairment as well as early Alzheimer's disease. We're studying them using a wide variety of neuro-psychological tests, MRI scans of the brain, and a new technique called functional magnetic resonance imaging or functional MRI. We're observing people as they perform various memory and thinking tasks and we're able to observe what's going on in their brain at the time they're engaged in those activities. We can see differences in people with no cognitive impairment and those who have even very mild cognitive problems. This technique, although currently experimental, should help us be able to diagnose people very early on and to understand more about the function of the brain areas that are most involved in Alzheimer's disease.

Q: HOW IMPORTANT IS EARLY DIAGNOSIS? "It's very important for people who have a problem with their thinking and memory to get evaluated. If they are unfortunate enough to have the disease, it is important to get diagnosed and begin treatment as early as possible. We now have several medications to help control symptoms like memory loss and delay the progression of the disease." "Slowing the disease progression is very important because this is a disease that otherwise just gets worse over time. We found that the earlier we start treatment the more likely someone is able to maintain independence longer, participate in their own health care decision making and other life decisions, and generally function better for a longer period of time." Q: HOW FAR ARE WE FROM A CURE? "Currently, there is no cure for Alzheimer's disease, but there is a tremendous amount of research going on around the nation and around the world and one day I hope we will have a cure. We are beginning to understand more about some of the biochemical abnormalities that are occurring in the brain, which seem to be the starting point of the disease. However, we're not yet at a point where we can interrupt, reverse or cure these abnormalities or identify the people who are developing those abnormalities before showing any clinical signs." Q: WHAT SUPPORT GROUPS ARE AVAILABLE FOR CAREGIVERS, FAMILY MEMBERS AND PEOPLE DEALING WITH THE DISEASE? "Alzheimer's disease is an extremely trying condition, not only for the person who suffers from the disease but for the family as well. It really is a family illness. The primary caregiver, the spouse or adult child of someone who has Alzheimer's, really has a great deal on their hands. They are trying to provide care and support and maintain a relationship with someone whose memory and ability to function independently is fading. It's extremely stressful and we know that caregivers suffer a great deal of emotional distress themselves. There are support groups all over the nation, and right here in the Upper Valley there are a number of them. At Dartmouth-Hitchcock Medical Center, we have a support group where people affected by the disease get together, share stories and learn new ways of coping. Research has shown that people who attend support groups not only do better over time, but their loved one who has Alzheimer's disease also does better. It's very important for family members dealing with this disease to reach out for some help for themselves as well as for their loved one with the disease." Q: LAST THOUGHTS? While Alzheimer's disease isn't curable at this point, there's much that can be done to help manage the disease to help with symptoms, perhaps to slow it down or even improve some of the memory problems and other difficulties. And there's much that can be done for the caregiver stressed by this disease. A great deal of help is available both from the medical community as well as from the Alzheimer's Association and other resources. People should seek help if they are concerned they may have symptoms of Alzheimer's disease or if they are suffering from memory impairment, or have a loved one who is.