Alzheimer's disease: Prevention, symptoms and treatment, plus one family's story

New diagnostic options
Although my dad was diagnosed with Alzheimer's in 2005 using the same elimination method that was used on my mom, new techniques are being developed that could soon offer more diagnostic options; for example, researchers are working on ways to detect the hallmark beta-amyloid in spinal fluid, in the blood, the eyes and elsewhere.

There are also new tests to uncover mild cognitive impairment (MCI), a condition that, in many cases, is a precursor to Alzheimer's disease – if detected early, a better outcome is likely. "There's going to come a time when people with MCI are going to be treated with drugs that will hopefully prevent them from developing Alzheimer's," says Diamond.

Brain imaging, too, can now help diagnose the disease in a living patient; no more waiting for an autopsy to confirm the Alzheimer's. A chemical injected into the blood attaches to the plaques in the brain and makes these plaques visible by advanced positron-emission tomography scans, says Diamond.

Risk factors
My dad, like my mom, had some key risk factors for Alzheimer's disease. Neither was well educated so they weren't challenged intellectually, and both were getting on in years. My dad is believed to have suffered a head injury and concussion as a child, while my mom had high blood pressure and a family history of Alzheimer's (at least two of her relatives had it).

Other risk factors include poor diet, strokes, high cholesterol and Down syndrome. Once linked to Alzheimer's, aluminum has generally been exonerated, but the role played by iron and other metals is still being investigated. Scientists are also looking at acrylamide, a synthetic chemical increasingly documented in a wide range of foods, from French fries to coffee, and known to cause nerve damage in humans.

Alzheimer's behaviour
Unlike my mom, who seemed to accept her condition, my dad fights it every step of the way. Such variations in presentations of the disease are typical. Some scientists, including Dr. Howard Feldman, a professor of neurology at the University of British Columbia, believe that there are indicators that Alzheimer's may be a syndrome rather than a single disease.

One of the toughest things about caring for my dad is his obsessions. Recently, he became fixated with odours. "Come and smell this," he says insistently. I come and sniff. "I don't smell anything," I reply. "You mean you don't smell it? Your nose must smell things differently than mine." One night he called 911 about what he considered a particularly foul smell. The next morning I hid the phone. He has barely noticed.

And then there are his repeated questions (the short-term memory of Alzheimer's patients is so poor that they may not remember what they've just said). According to a recent Canadian survey of Alzheimer's caregivers, verbal repetition is the most common symptom of Alzheimer's, next to forgetfulness. It's a symptom that can cause caregivers like me no end of distress. I calmly answer my dad's questions, trying not to sound exasperated. I've written down the answers to some of his frequently asked questions on a sheet of cardboard, which I leave for him to find and refer to. This alleviates the problem a bit.

Coping strategies
Being able to laugh at the disease is vital for my sanity. Once, my father, angry that I had taken away his bankbook, chased me around the house. As he yelled at me, his loose-fitting dentures kept falling out, a sight that had me on the floor in stitches.

I learned several lessons from watching my mom's mental decline. One big one is that I can't do this alone (my brother is unable to provide much help as he works full time and cares for his partner, who has multiple sclerosis.) I have arranged for Red Cross employees to come twice a week to bathe my father and to wash his clothes. Dad also attends a day program for dementia patients twice a week at a local nursing home. The program involves physical and mental exercises such as memory and word games and easy puzzles.

Page 3 of 5