Alzheimer’s is a thief, and it doesn’t stop until it takes everything from its victims. Imagine your mother patting you on the hand and, without a familiar look, calling you “young man” or your husband of many years trying to remember why he knows your face. We’d like to believe that of all our possessions, our mind is inviolable. But, it too can be stolen, and there’s no safe in which to lock it away. About five million Americans suffer from Alzheimer’s disease, and about 65,000 South Carolinians. The most common form of dementia, it is a progressive, degenerative brain disease, and there is no known cure. It usually strikes older adults, with about 13 percent of those over the age of 65 and about half of those over 85 affected. It is the seventh leading cause of death in the country and the fifth for people over 65. But the numbers could be underreported, since death certificates usually list complications such as pneumonia as the cause. Unless researchers find a way to prevent or cure the disease, in 20 years there could be 14 million people affected. The disease is named after a German physician, Alois Alzheimer. In 1906, at a scientific meeting, he presented the case of a 51-year-old woman named Auguste whose family brought her to him in 1901. She had developed problems with memory, unfounded suspicions that her husband was unfaithful, and difficulty speaking and understanding what was said to her. Her symptoms worsened, and within a few years she was bedridden. She died in spring 1906, of overwhelming infections from bedsores and pneumonia. Alzheimer had never seen such a case, and the family allowed him to perform an autopsy. He found dramatic shrinkage of the brain, especially of the cortex—the outer layer involved in memory, thinking, judgment and speech. Under the microscope, he also saw widespread fatty deposits in small blood vessels, dead and dying brain cells, and abnormal deposits in and around cells. The condition became a subject of medical literature, and it was named after Alzheimer in 1910. Stealing Memories, Stealing Life Joyce Finkle, program director of the Spartanburg area Alzheimer’s Association said that it is easy to dismiss the disease at first and that the “denial factor” is large. The process is gradual, but eventually it can’t be ignored. It is not the simple forgetfulness or slowing down that comes with age. “It erases current memories,” Finkle said, “and the long-lasting embedded memories may linger. They may confuse their children with their siblings or think they’re back on the farm. It moves gradually until they’re able to do fewer and fewer of the activities of daily living.” The disease is characterized by “plaques” and “tangles,” which are proteins in the brain that interfere with nerve cells. It may take years for symptoms to show themselves, and a person may live ten years or more after the diagnosis. In the early stages, a person may lose his “zest for life.” He may also have difficulty learning and making new memories, organizing and thinking logically. Many withdraw, lose interest in others, or become irritable. Some may take longer to perform routine chores or get upset because of an unexpected event. Some may also forget how to handle money, lose things or forget where they go, forget to eat or eat constantly, or hoard things of no value. As the disease progresses, the affected person may begin to show poor judgment; have trouble recognizing familiar people; become unable to organize thoughts, follow logical explanations, or formulate responses to written requests; accuse, threaten, fidget or behave inappropriately; experience hallucinations and lose a grip on reality. The problems continue to worsen until the person loses control of his body and can no longer care for themselves. Doctors can administer a number of tests to determine if a patient may be in the early stages of Alzheimer’s, such as the “clock test” or the Mini-Mental Status Exam. In the first, patients are asked to draw a clock face and draw in the hands to indicate a particular time. Finkle said that even such a simple task could be difficult for someone with dementia. Some patients can draw the circle and write in the numbers but cannot draw in the hands to the right time. Others can barely draw the circle. The MMSE is a set of 30 questions aimed at testing a patient’s awareness, memory, and other mental functions. A score of below 23 usually correlates to some form of dementia. Doctors are diagnosing the disease earlier and earlier with about 90 percent accuracy. Unfortunately, said Jill Smith, who works with the Alzheimer’s Association, “an autopsy of the brain is the only guaranteed way to know.” This disease may be a killer, but scientists are making advances everyday. Recently, it was announced that the arthritis drug Enbrel may be useful in the fight against Alzheimer’s, but scientific research is a difficult process, and a cure may be years, decades, or longer away. The Alzheimer’s Association exists today to promote research and to support those who suffer from the disease. In the coming weeks, we will look at how this organization supports those in need, what advances medicine is making, and how local families have coped with the disease.