Alzheimer's patients not going without a fight

Experts suggest another lifestyle change that may help stave off symptoms: physical exercise. Both mouse and human studies show that physical exercise may slow the disease, says Brian Christie, an associate professor in the division of medical sciences at the University of British Columbia in Victoria.

Christie’s research on Alzheimer’s mice has shown that regular workouts on an exercise wheel block the buildup of plaques and tangles. He and others suspect that exercise works by increasing the flow of blood, nutrients and other substances that improve brain-cell survival. “So exercising is like keeping the garden watered,” Christie says.

The mouse research has been backed up by studies that followed healthy seniors.

“There is a very powerful dataset on exercise,” says Cummings. “One large study showed that exercising 30 minutes three times a week diminished the risk of developing Alzheimer’s by 50 percent.”

This still isn’t proof. There’s a difference, experts say, between showing that people who exercise are less likely to develop Alzheimer’s and showing that exercise actually slowed mental decline in those who already have the disease.

Patients like Rothenberg aren’t waiting for the definitive studies, though.

“I’m doing whatever I can do, medication-wise, doctor-wise, health-wise,” she says. “I walk because I know it’s good for you. I do my exercises in the morning. I try to stay fit.”

Byways in the brain
Other researchers are looking for strategies that might allow people with Alzheimer’s to live independently for longer by rewiring the brain to circumvent areas damaged by the disease. It’s like choosing a side road when a major freeway is blocked.

As it turns out, there are different types of memory, explains David Loewenstein, a professor of psychiatry and behavioral sciences at the University of Miami School of Medicine.

Information stored in episodic memory is like the narrative of a short story. This kind of memory depends on the hippocampus, a part of the brain hit hardest by Alzheimer’s. The brain regions involved in another kind of memory — procedural memory — are less affected by the disease. Procedural memory is what allows us to learn a foreign language or to ride a bicycle.

“You don’t have to think about it. It becomes automatic,” explains Loewenstein, who is also director of research and neuropsychology at the Wein Center at the Mount Sinai Medical Center in Miami.

In a pilot study, Loewenstein and his colleagues showed that you could teach Alzheimer’s patients skills that capitalize on procedural memory, bypassing brain regions affected by the disease. The Miami researchers are now working on a larger study funded by the National Institutes of Health.

One example of a way to use procedural memory is by adding up the change received from a store clerk, Loewenstein explains. Normally a person would try to do the math in her head, but that can be difficult for someone with Alzheimer’s. There’s an easier way, Loewenstein says. If you get change from a $20 bill and count the bills you receive back to yourself, making sure it adds up to the original $20, you only have to remember how much money you gave the clerk.

Loewenstein points to another example of using a side road in the brain to access information. People with Alzheimer’s often have problems remembering names, he says. You teach them to associate the name with a facial feature that begins with the same first letter as the name, and it can make a huge difference. “So, if you met me you might say to yourself, this is David and he has dimples,” Loewenstein explains. “Then the next time you met me you’d say, ‘There’s the guy with the dimples. That’s David.’”

Loewenstein also encourages patients to keep a “memory notebook” in which they write down names of people and places and review the events of the day.

Exercise your mind Getty Images Wordy brain workouts: Think of the "S" word Words with double meanings

If this kind of training kept patients functional a year longer, the impact on people and the health-care system would be tremendous, Loewenstein says.

The effects of mental stimulation are obvious to Phyllis Blais — and her family.

Blais is happy and alert when she comes back home, says her daughter, Susan Cuoccio. “She always looks forward to going there,” says Cuoccio, 49. “And when she comes back, there’s a real excitement, a spark.”

Blais will bring home word puzzles and sometimes mentions a particularly engaging speaker. “I’ll ask her about it to see how much she retains,” Cuoccio says. “I’m often surprised. She remembers a lot.”

Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in The New York Times, Newsday, Health magazine and SmartMoney.

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