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Dementia Fight
Moves Slowly
Haverhill Gazette (MA) - October 02, 2009

HAVERHILL, Mass. -- About two years ago, Tippy Heffernan-Missick noticed that her father, lifelong Haverhill resident John Heffernan, was becoming withdrawn and had given up activities he had previously enjoyed, such as working crossword puzzles.

Last January, doctors diagnosed Heffernan with Alzheimer's disease.

His intellectual abilities went from genius standing to that of a 5-year-old child in a matter of months. A man who previously could converse easily began speaking incoherently.

His doctors prescribed a new drug called Namenda, and within a week his condition began to improve.

Heffernan-Missick said her father now speaks more clearly and his social nature is returning. He is doing crossword puzzles again.

Her dad continues to be sweet, loving and caring, especially toward his wife of 60 years, who is legally blind and deaf, and they both still work out at the gym every morning, Heffernan-Missick said.

Alzheimer's is a devastating disease, the most common cause of dementia in the elderly. It affects approximately 18 million people worldwide -- 5 million in the U.S. alone.

Dr. Buck Woo, director of Neuropsychology and Behavioral Medicine at the Memory Disorders Clinic at Merrimack Medical Center and Merrimack Valley Hospital in Haverhill, said health professionals are getting better at diagnosing and treating Alzheimer's.

Alzheimer's is a type of abnormal aging; not everyone will be diagnosed with or affected by it, Woo said.

For those who are affected, Alzheimer's touches the patient as well as family, friends and caregivers. In its early stages, a person with Alzheimer's might become withdrawn or agitated, may forget the names of common household items or the names of close family and friends.

As the disease progresses, the person with Alzheimer's might begin dressing inappropriately, such as wearing coats on hot days or putting on pajamas on top of daytime clothes. The patient becomes lost, even in familiar places.

In the final stages, Alzheimer's patients often lose the ability to walk without assistance. Some cannot sit upright and problems with swallowing can lead to choking. Many Alzheimer's patients stop eating in the disease's advanced stages.

For anyone who has a family history of early Alzheimer's, Woo advises performing regular screening with a primary care physician at the age of 55, otherwise the optimal age for beginning screenings is between 60 and 65.

"Many people put off being tested for Alzheimer's or other types of memory diseases because they are afraid. It's a simple screening that takes about five minutes at your doctor's office and can make a significant impact on someone's future," Woo said.

The earlier Alzheimer's disease is diagnosed, the sooner a patient can begin using medications to delay the onset of its most debilitating symptoms, Woo said.

Medications such as the often-advertised Aricept are used to treat Alzheimer's disease while still in its early, mild stages.

Namenda, the medication given to John Heffernan of Haverhill, was the first to be approved by the Federal Drug Administration for moderate Alzheimer's -- disease activity that has advanced to the point where the patient may not be able to think clearly or be able to follow directions.

For some patients, the drugs can reverse some symptoms. For others, the medications simply slow the progression of the disease.

Both types of medication, while successful for many patients at treating the symptoms of Alzheimer's disease, do not treat the disease itself, Woo said.

Woo is involved in a study called the Investigational Clinical Amyloid Research in Alzheimer's, which is evaluating the safety and effectiveness of an investigational drug, called bapineuzumab, aimed at slowing the disease progression.

Doctors and researchers have long believed that Alzheimer's is caused by amyloid plaques forming in the brain, causing it to cease normal functioning.

New drugs that attack the molecular structure of the disease are giving doctors hope of better treatments, if not an outright cure.

Haverhill is one of the North American locations of the bapineuzumab study, in which more than 2,000 people diagnosed with Alzheimer's will be put either on the new drug or a placebo and its effects monitored over time.

"We still have a lot of work to go, but the energy generated toward the research to fight this disease is great," Woo said.

Woo said physicians now know that high blood pressure, high cholesterol and hypertension -- commonly referred to as high blood pressure -- contribute to Alzheimer's.

"The more people hear about the disease and learn about the disease and how a healthy lifestyle can greatly reduce your risk the better," Woo said. "People really need to stay in the best shape possible for their mental and physical well-being. Everything is linked in some way. I'm more convinced now then ever that maintaining a healthy lifestyle is one of the keys to fighting this disease."

Woo has more than 20 years of clinical and research experience in neuropsychology. After receiving his doctorate, Woo performed a two-year fellowship from 1987 to 1989 at the Alzheimer's Disease Research Center in California. He was an assistant professor of Clinical Psychiatry at Dartmouth Medical School from 1989 to 1991 and director of neuropsychology, stroke and brain injury programs at Whittier Rehabilitation Hospital from 1991 to 1994. Woo spent the next 14 years as an assistant professor of Rehabilitation Medicine at Boston University School of Medicine before becoming the director of Neuropsychology and Behavioral Medicine at Merrimack Valley Hospital a little more than a year ago.

As someone who comes into contact on a daily basis with the effects of Alzheimer's disease, Woo is dedicated to doing what he can to bring awareness to the disease.

This year, Woo will participate for the first time in the annual Memory Walk to benefit the Alzheimer's Association, serving as the clinical chairman for the event.

"I really hope to help generate a general awareness of the bigger studies in diagnosing and treating this disease and to spread the message that we are moving closer and closer to a way to stop this disease and possibly even cure it in the future," Woo said.

Memory Walk 2009 is the nation's largest event to raise awareness and money for Alzheimer's care, support and research.