Excerpt from Live Now, Age Later by Isadore Rosenfeld M.D., plus links to reviews, author biography & more

• Other underlying diseases, acute or chronic, can produce behavioral changes at any age, especially in the elderly. Is it any wonder that a mind doesn't function normally in someone with emphysema in whom the effort of just breathing wears them out? Or if the heart isn't pumping enough blood and oxygen to the brain? Or if the kidneys have stopped working and toxins are accumulating in the body? Behavior mimicking Alzheimer's can also develop when the brain is physically injured in an accident, directly infected by some virus or fungus, or exposed to poisons such as carbon monoxide or methyl alcohol.

Diagnosing Alzheimer's

There is no reliable marker that identifies Alzheimer's with certainty during life. Even the most sophisticated scans cannot reveal the neurofibrillary tangles or the amyloid plaques in someone who's still alive. An abnormal protein called Alzheimer's Disease Associated Protein (ADAP) has recently been found only in the brains of persons who have died with Alzheimer's. Hopefully, scientists will one day develop a test that can identify this protein in the spinal fluid or blood during life and so diagnose Alzheimer's clinically. At the present time, however, doctors make the diagnosis only after all other possible causes of dementia have been eliminated.

Because of these limitations, Alzheimer's is the most overdiagnosed and misdiagnosed mental ailment in older people. Whenever this disorder is suspected, a thorough examination must be done to eliminate all other possibilities. This should include, in addition to the physical itself, a careful and detailed history to identify any family predisposition. It's important also to investigate the possibility of poor nutrition, a head injury, the use or abuse of medication, or the presence of other medical problems.

An evaluation of mental status and neuropsychological testing are also in order. Most family doctors are not trained to do so, and even if they are they would usually recommend a specialist, such as a neurologist, psychologist, or psychiatrist. No screening for Alzheimer's is complete without an electroencephalogram (EEG) to analyze the brain waves, and a CT scan of the brain to visualize its physical structure. Magnetic resonance imagining (MRI) and positron emission tomography (PET), which provide data concerning the metabolic activity of the brain and cerebral function, are expensive and rarely necessary. Ask a good neurologist to decide what special procedures, if any, are necessary.

How to Reduce Your Chances of Getting Alzheimer's

Despite the absence of a cure for Alzheimer's, there are some proven ways to help your brain stay young and lessen your chances of developing this disease.

• Ongoing mental and physical exercise keep the brain healthy. Either "use it or lose it." Regular physical activity increases blood flow to the brain and provides the nutrients necessary to render its tissues resistant to Alzheimer's. Exercise also increases the number of connections (synapses) among the millions of brain cells (neurons) needed for normal mental function. In a recent experiment on laboratory rats, performance was compared in two groups: controls, given no opportunity to play or exercise; and a "treated" group, provided with toys and made to exercise vigorously. After a few weeks, the brains of the treated animals were found to have 25 percent more connections (synapses) than the couch potatoes. Get into the habit of walking for thirty to sixty minutes a day as briskly as possible. Stair climbing is particularly effective, so take the steps when going up or down one or two flights and leave the elevators and escalators to the kids.

• Education: Several population studies have shown that the more schooling you have, the greater are your chances against Alzheimer's. That may be because the educated are more likely to eat more nutritiously and receive better medical care throughout their lives. However, like physical exercise, ongoing intellectual challenges stimulate the formation of nerve connections. Even if you're destined to develop Alzheimer's, the more neurons you develop when you're young, the more you can afford to lose before symptoms set in. This theory is supported by the observation that symptoms of Alzheimer's disease in persons whose head circumference is greater than twenty-four inches---and who therefore have a greater brain mass---progress more slowly than they do in "pinheads." So calling someone a "fathead" may actually be a compliment!

From Live Now Age Later: Proven Ways to Slow Down the Clock,by Isadore Rosenfeld. © June 1999, Isadore Rosenfeld. Used with permission.