Q. Hello, Dr. C. My name is Frank and I live in Savannah. My father is seventy years old and has recently been diagnosed with Alzheimers Disease. He was very active in business until he retired five years ago, and at that time he stated that he had trouble remembering important things such as associates names, business meetings, and frequently called telephone numbers. I was happy to see him retire and leave the stress of his job. He had been a successful insurance agent. During the next five years, his memory became worse, and he began to lose interest in the things he had previously enjoyed such as baseball and reading. A widower, he lived alone for over a decade and had kept an orderly house on his own until this past year. I would visit and find the place a mess. He became unable to prepare his meals and began to lose weight. He had been going to the doctor but nothing specific was found. Eventually, his symptoms became more alarming. His personality began to change. He became distant, moody, and at times would cry for no real reason. Following a battery of tests, the diagnosis of Alzheimers Disease was made. The neurologist began some medication but told me that the disease would likely progress and that he will require total care. He is living with my family now and this is a very difficult situation. I have been told that the disease can be inherited, that there is no cure, and that it is fatal. Is all this true and what can we do to help my father?

A. Thank you for your story about your dad and for your question. Alzheimers Disease (AD) is the most common form of memory disorder. You are not alone in your situation as a caregiver for a family member with the disease. There are over four million patients in the US with AD and many of them are cared for at home. Twenty million Americans report that they have a family member with AD. Nearly half the patients in nursing homes today have AD. The problem is likely to become more serious as a national health issue in the coming decades. It is predicted that the number will rise to eighteen million in the next thirty to forty years as the American population ages. At the present time one in ten adults over age sixty-five has AD, and it is the fourth leading cause of mortality among adults affecting both males and females nearly equally. Unfortunately, there is no cure for the disease, but medications can slow the disease progress in up to half the patients treated. These medications include Aricept and Namenda.

Regarding the familial risk of developing AD, the risk is related to the age of onset in the family member. For example, if the parent develops AD at the relatively young age of fifty years, there may be a twenty-fold increase in the risk of AD developing in a son or daughter. The risk falls as the age of onset for the parent increases. The risk is increased by ten to thirty percent in your particular situation. There is probably no additional risk for children of a parent who develop AD very late in life, i.e. after age ninety. There are many things you can do as a caregiver. Giving the AD patient a structured environment, ensuring regular exercise, and monitoring for safety are central functions that improve the quality of life for the AD patient. The structured environment will reduce anxiety that is a common concern. Exercise, particularly walking, has been shown to be helpful not only for general fitness, but it also promotes energy expenditure that will assist in allowing a peaceful nights sleep. If the AD patient is particularly anxious or agitated at a given time of day, that is the time to take a long walk as it will help relax the patient. For yourself, it is very helpful to connect with groups such as the Alzheimers Association (www. Alz.org) for direction, support, and updates regarding medical advances in the treatment of AD.

I hope this answer helps you and your father.

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