DEAR DR. GOTT:

I understand Aricept is not intended to reverse the process of brain degeneration in Alzheimer's patients but is expected to slow the process down. I am a retired physician and have been on it for about two years, and at age 88, I feel that I am probably having the normal expected results. I am slowly getting worse, primarily because of memory loss, etc.

Do you know of any recent research that has led to any improvement in the actual treatment of Alzheimer's? I appreciate your response.

DEAR READER:

While I am confident you know all the ins and outs of Alzheimer's, I will briefly explain it for other readers. This disease is one of several forms of dementia that worsen over time, affecting memory, thinking and behavior. Risk factors for developing the disease include aging, a family history of the disorder, and having a specific combination of genes for proteins that appear as abnormal in the disease. Other factors that are not as well proven include a history of head trauma, being female and a long-standing history of hypertension.

There are two types of the disorder: early- and late-onset. Early-onset is less common, with symptoms that progress rapidly appearing before the age of 65. It has been known to run in families.

The late-onset form is more common and appears after the age of 65. Symptoms include difficulty with cognitive skills, memory, forgetting names and events, taking more time to perform routine activities, misplacing items, losing interest in things that were once enjoyed, becoming lost while driving down a familiar street, an inability to multitask, depression, using poor judgment, losing keys or personal items, dressing inappropriately at different times of the year and hallucinating.

Some medical conditions can cause dementia or worsen its symptoms, such as anemia, medication intoxication, thyroid disease and a vitamin deficiency. Unfortunately at this stage, there is no cure for Alzheimer's, but progression of the disease can be slowed with medication.

The first drug approved by the FDA was tacrine (Cognex) in 1993, followed by donepezil (Aricept) in 1996, rivastigmine (Exelon) in 2000, galantamine (Razadyne) in 2001 and memantine (Namenda) in 2003 for all stages of the disease. On average, the five drugs approved by the FDA are effective for about six to 12 months for 50 percent of those individuals who take them.

It is possible for a person to suffer ill effects and intoxication from these medications that can appear to worsen a condition and leave family members and caregivers with little hope. I am personally aware of a friend on a different medication whose symptoms exacerbated rapidly, leaving him with hallucinations every waking hour and an inability to speak so anyone could understand, to get out of a chair without help or even to recognize family members. Fortunately, his specialist switched him from the medication he was on to Aricept, with fewer side effects, and his turnaround was rather phenomenal.

Recent treatment trials are in progress, while others have been completed. Some were reported to have negative results; however, even when those treatments failed to be as effective as hoped, knowledge was gained that will help researchers in the future. Because the trials are in various stages of completion, I recommend you visit the Alzheimer's Association website for details. Numerous trials do reveal hope for victims of the disorder.

According to the chief medical and scientific officer of the Alzheimer's Association, there are two main obstacles to overcome. First is the need for volunteers for clinical trials, followed by an increase in federal research funding. If you are interested in participating in a current clinical trial, you can contact the Alzheimer's Association at www.alz.org/research.

Readers who would like related information can order my Health Report "Alzheimer's Disease" by sending a self-addressed, stamped No. 10 envelope and a $2 U.S. check or money order to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039. Be sure to mention the title, or print an order form from my website's direct link: www.AskDrGottMD.com/order_form.pdf.

Dr. Peter H. Gott is a retired physician and the author of several books, including "Live Longer, Live Better," "Dr. Gott's No Flour, No Sugar Diet" and "Dr. Gott's No Flour, No Sugar Cookbook," which are available at most bookstores or online. His website is www.AskDrGottMD.com.

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