http://www.azcentral.com/arizonarepublic/arizonaliving/articles/1103alzheimers03.html Alert with Alzheimer's Patients learn how to stave off debilitating disease Janie Magruder The Arizona Republic Nov. 3, 2003 12:00 AM Harold Moss plays tennis at dawn several days a week, runs a miniature train in his back yard and dances the two-step. June McAmis prefers long walks in the desert and reading weekly newsmagazines cover to cover. But Moss and McAmis have more in common than you think: They're among an estimated 85,000 Arizonans living with Alzheimer's disease. And they're doing what they can to stay as healthy as possible for as long as possible, striving to keep positive attitudes about the cards they've been dealt. "I try to do something every day that's something worthwhile," said Moss, an 84-year-old Sun City West resident who was diagnosed with the disease in May 2001. "You go to bed feeling a lot better about things if you don't sit around and weep and moan." McAmis also is having more good days than bad since her diagnosis about 2 1/2 years ago - a diagnosis she doesn't remember getting. Her husband, Charlie, who does recall, says the news was a "horrible shock." "I'm doing OK," said the 59-year-old June, who lives with her husband in a Wickenburg mobile-home park. "I'm just really blessed to have Charlie." Alzheimer's is a type of dementia characterized by serious memory loss and changes in personality and behavior, affecting mostly the aged - one in 10 people over 65 and nearly half of those over 85 have it. Yet little was known about the disease in 1982, when then-President Reagan designated November as National Alzheimer's Awareness Month; he was diagnosed with the disease himself nine years ago. The federal government spent $640 million on Alzheimer's research last fiscal year, but no definitive cause or cure has been found. Still, there are things that people with healthy brains and those in the disease's early stages can do to prolong their quality of life. A number of epidemiological studies suggest that people who monitor their diet, cholesterol levels, body weight and blood pressure, and who exercise, can reduce the risk of developing Alzheimer's. Stephen Flitman, a Phoenix neurologist, said physical and mental exercise, staying social and keeping a positive attitude are important. "People need to manage their lives and manage their stress," he said. "To do that involves taking a different attitude toward life and being more proactive than reactive. People, as soon as they get bad news, often fall to pieces. You have to accept it and look forward to when things are better." That was difficult for Moss and McAmis, who said their diagnoses took away their will to live. Moss saw a neurologist after his wife, Dorothy, noticed he was always losing his keys. "It was real catastrophic to me," he said of the diagnosis. "The doctor told me not to drive. Every year, we would drive to Canada, and we were going to go that year. Every day, I thought it was the end of the world; what's the use of living?" Moss tore up his driver's license and turned the finances over to Dorothy, no easy thing for a retired Army officer raised in the '30s. Compounding his misery was a fall that injured his left leg and sidetracked his tennis and bicycling. While hospitalized, Moss began therapy and gradually learned to overcome his depression, not worry about the future and count his blessings. He's also back on the tennis courts - and thinking about that bicycle in the garage. "I finally started talking, and it felt pretty comfortable, and slowly it changed," said the silver-haired Moss, kind eyes peering from behind large, square glasses. Sandi Lloyd, a Sun Health behavioral-health therapist who counseled Moss, said he had to learn not to obsess about every blank moment. "For most of us, we can't remember why we were standing in the kitchen, and we just blow it off. But for Alzheimer's patients, it's, 'Oh, no, I'm getting worse.' " Lloyd said. "We tell patients, 'Every day is a good day until you decide to make it not.' " The Mosses still attend early-stage support group meetings of the Alzheimer's Association's Desert Southwest chapter. Dorothy Moss gets tips on caring for her husband, and he talks with other patients about the disease. The meetings are bittersweet. "We've been to meetings, and they've asked someone how many children they have, and they didn't know," Harold Moss said. "I know that's my future, too, but on the other hand, we have to die sometime." When group members stop attending, it saddens their friends, said Josie Bosch, a counselor with the local Alzheimer's Association. "They see the changes, they recognize when somebody is talking but not making sense anymore. Dealing with it in an open way is the only way to do it. It's the nature of the disease, that it will get worse." The groups offer social opportunities that are important to both patients and caregivers, Bosch said. "Most everyone feels they are off by themselves. " 'What did I do wrong to deserve this? How did I not take care of myself to prevent this from happening?' This allows people to see that other normal people get this disease." The McAmises also attend group sessions. June, a former psychotherapist, was diagnosed after she started getting lost while driving to work. Eventually, she couldn't manage her caseload and was let go by her employer. The couple were better prepared for her diagnosis, Charlie said, because June's mother died of Alzheimer's about 12 years ago. He believes that his wife's memory has improved as a result of her taking memantine for the past year in a test group. The drug was approved by the FDA last month. "She was losing a lot of the real close memory - her memory fades five minutes after we talk, but she may remember it tomorrow," he said. Not working has been a difficult adjustment, June admitted tearfully. A voracious reader of non-fiction - she can no longer follow the threads of fiction - she walks most mornings, relishing the solitude of the nearby desert, and attends neighborhood functions, to which Charlie, 72, brings homemade banana pudding. "A lot of them know my name," she said sheepishly, "but I don't know their names." Reach the reporter at (602) 444-8998. ---------------------------------------------------------------- Stuff you can do to slow down Alzheimer's disease http://www.azcentral.com/health/news/articles/1103alzheimers1103side-CP.html Race is on to solve disease that may 'cripple' health care Janie Magruder The Arizona Republic Nov. 3, 2003 12:00 AM Researchers are in a race against time to discover the causes of Alzheimer's disease and to develop treatments that can slow its progression, if not stop it altogether. An estimated 4.5 million Americans have Alzheimer's, but that number will likely triple by mid-century, according to recent projections, as the nation's 75 million baby boomers age. Prevention methods and a cure can't come too soon, said Sheldon Goldberg, president and CEO of the Alzheimer's Association in Chicago, sponsor of National Alzheimer's Awareness Month, being observed in November. "This disease is going to . . . cripple the U.S. health-care system," Goldberg said. A cure for the disease is "a long ways off," said Creighton Phelps, director of the National Institute on Aging's Alzheimer's Disease Research Centers Program. But vaccines that would slow or stop its progress may be just five years from clinical trials. "We're trying to push the margins of science," Phelps said. "If we could just slow it down, that would help some patients have longer lives with better health and reduced cognitive deficits, which would require less care and less expense." About $659 million in federal funds will be spent this year on Alzheimer's research, a far cry from the $1 billion Goldberg's association urged Congress to approve this fall. Arizona institutions will receive nearly $6.5 million in new funding this year to continue research on the disease. Banner Good Samaritan Medical Center announced a $4 million grant renewal from the National Institute of Mental Health to extend its five-year brain-imaging study through 2007. Additionally, a $2.5 million, five-year grant from the National Institute on Aging has been made to the Translational Genomics Research Institute to compare the brains of Alzheimer's patients with those who've died from other causes. Despite the scale of the problem, Goldberg said there are reasons for optimism, including: • Duke University Medical Center researchers identified a gene that influences the age at which individuals first show symptoms of Alzheimer's and Parkinson's diseases. Their findings will be reported at a meeting of the American Society of Human Genetics this week in Los Angeles. • The FDA last month approved memantine, the first drug that may help ease symptoms for those with moderate to severe Alzheimer's. The drug, expected to be available in January, appears to regulate the activity of glutamate, a brain chemical that may contribute to memory problems and damage or destroy nerve cells when imbalanced. • A September study indicated that participation in leisure activities during early and middle adulthood may lower the risk of developing Alzheimer's. From reading to playing sports, keeping active appears to boost mental fitness because it keeps the brain's blood vessels in shape and blocks damage from Alzheimer's. Researchers are studying whether intellectually stimulating jobs also offer protection. • Regular exercise can improve the physical and emotional health of people with moderate to severe Alzheimer's, according to research published last month. The study reported lower rates of depression and better physical function among patients who did simple exercises at home, especially when caregivers were trained in the approach. • Ongoing research on vitamin E, which slows the progress of some Alzheimer's symptoms, is focused on whether it can prevent or delay the disease, and scientists are testing ginkgo biloba, which may help treat Alzheimer's symptoms, to determine if it can delay or prevent dementia in older people. Reach the reporter at (602) 444-8998.