Académique Documents
Professionnel Documents
Culture Documents
The Museum of
Modern Art
Offers Special
Programs for
r
Alzheimer’s Patients
ncle Junio
Tony and’sUThe Sopranos
from HBO
Is There a Link
What Does HBO’s Between Alzheimer’s
Disease and
Uncle Junior Have to Parkinson’s Disease?
Answers by Nobel Prize Winner
Do With Memory? Dr. Paul Greengard
TV Chef
Marvin Woods
Shares Healthy Cooking Tips
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12
Can Art Help Unlock Memory?
Alzheimer’s patients benefit from the Museum of
Modern Art’s special programs.
16
Music Is a Tool in Alzheimer’s Care
Research shows that music has power for people with
Alzheimer’s.
20
spring 2008 www.ALZinfo.org 3
Contents
5 From the Editor’s Desk
Welcome
6 News Briefs
Read the latest news on Alzheimer’s disease and
brain health.
8 Is There a Link Between West 46th Street & 12th Avenue, New York, NY 10036
Alzheimer’s Disease and 1-800-ALZ-INFO • www.ALZinfo.org
Parkinson’s Disease? Michael Stern, Publisher
Richard Shortway, Associate Publisher
10 Caregiver Voices Betsey Odell, Editor in Chief
Dorothy Pierce shares excerpts from her journal. Alan White, Managing Editor
William J. Netzer, PhD, Science Editor
12 The Power of a Song
Jerry Louis, Graphic Designer
15 Preserving Your Memory Update Toby Bilanow, Bernard A. Krooks, Contributing Writers
The movie we featured in our first issue has gone on
to achieve numerous awards and nominations.
Welcome
A
s this issue of Preserving Your Memory goes to press, spring is
almost here. This time of year, Mother Nature seems to have
music all her own, so what better time for us to bring you an
issue highlighting the many benefits of music—especially the role it
plays in preserving memory.
In this issue we’ll explore music as a phenomenal therapeutic tool for
Alzheimer’s patients and their caregivers. We’ll also learn how Emmy-
nominated actor Dominic Chianese of The Sopranos shares his musical
gifts with patients facing dementia.
Music isn’t the only cultural avenue for those with memory loss. The
Museum of Modern Art (MoMA) has launched a program that allows
Alzheimer’s patients and their caregivers to experience museum art in
a way that is sensitive to their needs. As you’ll read in “Can Art Help
Unlock Memory?,” this MoMA program will be extending across the
country.
As always, we want to provide you with important scientific Betsey Odell
information that will shed light on the work being done to help people
preserve memory. At our core, the Fisher Center Foundation is about scientific research. We’re excited to
share fascinating research on the link between Alzheimer’s and Parkinson’s diseases and how it may lead to
a new understanding of dementia.
I hope Preserving Your Memory magazine will show you ways you can enrich your life and the lives of those
you love. Take the time to enjoy this beautiful season and add music to your life!
Warm Regards,
T
he Fisher Center for Alzheimer’s Disease Research synuclein.” These folding problems are believed to be major
and The Michael Stern Parkinson’s Research contributors to the symptoms of each disease. Fisher and
laboratories are working together to find new Stern scientists are making progress in learning how to
treatments and ultimately cures for Alzheimer’s disease harness the body’s own defenses against “badly” folded
and Parkinson’s disease. They are the two most common proteins. This is one line of promising research aimed at
neurodegenerative disorders, and because they share discovering new and effective treatments for these diseases.
common connections, many researchers believe that
understanding one will create insights into the other. 25 percent of people with
That’s why the Fisher and Stern Centers have joined forces.
These researchers have long sought clues that may link Alzheimer’s disease will also
Alzheimer’s disease and Parkinson’s disease. Parkinson’s
disease is characterized by a decline in motor function,
develop Parkinson’s disease.
such as the ability to walk, move, and speak, and mood
and thinking disorders. Alzheimer’s disease and Parkinson’s Connecting the Proteins
disease affect different regions of the brain, but, in both, One of the strongest links between Alzheimer’s and
brain cells die and certain neurotransmitters (molecules Parkinson’s is that 25 percent of people with Alzheimer’s
that signal nerve impulses between brain cells) are depleted. disease will also develop Parkinson’s disease, and
Another link between Alzheimer’s and Parkinson’s involves many people with Parkinson’s will develop dementia.
the way proteins fold. In both diseases, specific proteins Understanding why this occurs is expected to provide
form the “wrong” fold or shape. In Alzheimer’s, one of important insights into both conditions. A clue came
the proteins that has a wrong fold is “beta-amyloid.” several years ago when scientists were investigating how
In Parkinson’s, the badly folded protein is “alpha- two proteins, beta-amyloid and alpha-synuclein were
8 Preserving Your Memory spring 2008
affecting the brain. In Alzheimer’s disease, beta-amyloid
forms the plaques that accumulate in the brain. In
Parkinson’s disease, the protein alpha-synuclein forms
clumps, called Lewy bodies, within brain cells. Although
Alzheimer’s plaques are composed mainly of beta-amyloid,
they also contain a lot of alpha-synuclein. The Lewy bodies
in Parkinson’s also contain a protein related to beta-
amyloid.
Several years ago, independent scientists developed
mice having human genes that resulted in a rare form of
Alzheimer’s, and other mice that had a human gene that
resulted in a rare form of Parkinson’s. These mice showed
symptoms of either disease depending on what genes
they had. When scientists bred the two kinds of mice,
the ones that contained both Alzheimer’s and Parkinson’s
genes showed symptoms of both diseases. However, the
presence of the Alzheimer’s genes caused a worsening of the
Parkinson’s symptoms, and the presence of the Parkinson’s 3-D fMRI Map of Regions in the Brain that
gene caused a worsening of the Alzheimer’s symptoms. Exhibit Blood Flow Changes in Response
to Visual Stimulation
Family Ties Scientists are using powerful MRI machines
In a recent study, researchers showed that first-degree
which allow, noninvasively, for the localization
relatives of patients with Parkinson’s disease have an
increased risk of developing dementia or memory problems. and visualization of active brain regions.
Also, the younger the age at which Parkinson’s appears, the Image courtesy of Dr. Noam Harel, University of Minnesota
greater the likelihood that family members will develop
dementia. The findings appeared in the October 2007 issue risk of developing dementia or cognitive impairment. In
of the Archives of Neurology, one of the journals from the other words, relatives of people who developed Parkinson’s
American Medical Association. disease at an earlier age, have a greater risk of dementia
In this study, researchers at the Mayo Clinic in compared to relatives of people who were older at the onset
Rochester, Minn., looked at various groups of patients with of Parkinson’s.
and without Parkinson’s, as well as their close relatives. The
study included 1,019 first-degree relatives of 162 patients First-degree relatives of
with Parkinson’s disease who were living near the Mayo
Clinic. As controls, they included 858 relatives of 147 patients with Parkinson’s
people in the same geographic area who were approximately
the same age and sex makeup as people in the Parkinson’s
disease have an increased
disease group but who did not have the condition. In risk of developing dementia or
addition, the researchers evaluated 2,716 relatives of 411
patients with Parkinson’s disease who were referred to the memory problems.
Mayo Clinic from a wider geographic area.
The study group surveyed the participants with a Although this study did not determine whether
telephone questionnaire as well as cognitive tests and cognitively impaired or demented participants had
a review of medical histories to assess the occurrence Alzheimer’s rather than some other condition, it is likely
of memory problems. These would include conditions that at least some of the study participants had Alzheimer’s.
like mild cognitive impairment, as well as more serious This study shows there may be genetic links between
conditions like Alzheimer’s and other forms of dementia. Parkinson’s and dementia. It is possible that Parkinson’s
They found that relatives of patients with Parkinson’s and certain forms of dementia share common genes that
disease were at increased risk of cognitive impairment or predispose family members to one or both conditions.
dementia. There may also be undiscovered environmental factors that
Relatives of patients who experienced the onset of lie at the root of these diseases.
Parkinson’s disease at age 66 or younger were at higher (continued on page 26)
spring 2008 www.ALZinfo.org 9
Caregiver Voices
A Caregiver’s Journal
While caring for her husband who had Alzheimer’s, Dorothy Pierce decided to keep a written record of her
experiences. Here are her thoughts on caregiving along with an excerpt from her journal.
A
lzheimer’s dementia seems to van and could see Ed’s figure sitting tall
sneak up on a person in the for probably his last ride.
disguise of “forgetfulness.” It A hoist was needed to transfer him from
is irreversible; drugs do nothing but the van to a wheelchair and another to lift
postpone the inevitable. Caregivers him into the bed. His clothes were removed
suffer through watching the slow and a hospital gown and diapers were put
regression, physical and mental. Some on. I wondered if I was being unrealistic
Alzheimer’s patients live 20 years in having bought some new PJs and shirts …
this forgetting state, and it’s very hard Visiting him at the new facility I found
to witness these changes in a person him dressed and in a wheelchair in the
whom we have known and loved. It has sunroom, and on another day he was in
been called the “long good-bye.” the activities room listening to a woman
As a caregiver/wife, I want to play old tunes on the piano. I pushed his
suggest a way to witness and to cope. chair around the small courtyard and up
After the initial months of denial, and down the halls.
grief, impatience, anger, frustration, He was coughing a little. His neck was
and prolonged sadness (not necessarily rigid and he seemed unable to turn his
in that order), I started a journal as a head. His lower jaw was slack. I rubbed
way of releasing my thoughts—and of his chest and patted his shoulder. He slept
Dorothy Pierce expresses her
feeling not so alone. And, of course, I again. The nurse and I agreed we needed
sought caregivers who could help with feelings through art as well as to talk about how much treatment would
my husband’s care. writing. She created this mixed- be given for some of his health conditions
As I sat at the computer at the media painting to represent When I asked him, “How’re you doing?”
end of a day, describing changes in her husband’s slow fade. he answered, “Very want,” which I think
my husband, the pressure inside my meant “Very well.” Another time he replied,
head seemed slowly to diminish, and no longer stand alone or walk. His limbs “Wonderful!” Toward the end of July he
the heavy feelings of sorrow in my seemed to be freezing, becoming useless. asked someone else, “How are you?”
midsection were channeled into words He smiled a little when he saw me, and The nurses liked him and agreed he
that sometimes overflowed into tears. I wheeled him backward around the hall was a “sweet gentleman.” …
Marital misunderstandings I had because his footrests had been removed I had gone to Dallas for the birth of
hoped to resolve were tucked away and his rubber soles were braking forward our daughter’s twins and received a call
forever. Hopes for communication motion. I gave him several kisses, told him that Ed was having trouble breathing
through words surrendered to a kiss on how many people loved him, and rubbed and was unable to swallow. The nurse
the cheek, a holding of hands. that spot between his eyebrows, a touch said there was gurgling in his throat and
I think this time of resignation he used to enjoy. When I asked if he was oxygen had been prescribed. He was also
happens when anyone we love is dying sleepy, he said, “yes,” so I knew he still being given morphine under his tongue to
slowly before us. heard me. keep him comfortable. The doctor wanted
I watched as he was hoisted into the to know if I wanted an antibiotic to be
Final Journal Entries— van to carry him to the nursing home. I given. My mind whirled, and all the
July - August 2001 tried to pat his hand and reassure him, weight of what I was about to say was on
Arrangements were made to move Ed to but he seemed puzzled and extra tense my heart. I said “no” and that I would be
a skilled nursing facility because he could and made no sound. I drove behind the back the next day.
10 Preserving Your Memory spring 2008
When I saw Ed he had a tube in his Dr. Ford had been to see him the The nurse called at 2:15 a.m. to say Ed
nose and there was gurgling every time night before and said he probably had had died at 2:00 a.m.
he took a breath. A spray, which was not pneumonia and his body was very tired When I arrived at the hospital in the
an antibiotic, was added to the oxygen from fighting the infection. I remembered early morning, his bed was empty except
periodically to help him breathe. The night seeing him one day in the lounge area for two boxes containing his clothes. ■
nurse gave him a few drops of morphine shivering after a shower and wondered if
under his tongue. His eyelids flickered this had happened again while I was gone. Dorothy Pierce, Santa Rosa, California
a little when she told him his wife was I thought of all the months and years of
with him. I held his hand and told him sadness and inability to communicate. Join Dorothy, and share your caregiving
how much people loved him, especially his I stayed by his bed until 1:45 a.m., holding story with other readers. Contact The
children and sister. I knew at the same his hand, telling him about all the people who Fisher Center for Alzheimer’s Research
time that my decision to withhold the loved him, saying the Lord’s Prayer several Foundation, West 46th Street & 12th
antibiotic might end his life. Was that times, and telling him how sorry I was. Avenue, New York, NY 10036, or e-mail
what he would have wanted? I would never see him again. them to betsey@alzinfo.org
Every 72 seconds, someone in the United States is diagnosed with Alzheimer’s disease. There are
now more than 5 million Americans living with the disease. What is not widely known—even by some
physicians—is that there are products available that are made especially to help make Alzheimer’s patients’
lives better with the disease, and, in some cases, to help them remain living at home longer and safer.
The Alzheimer’s Store is dedicated to providing unique products and information for those caring for someone
with Alzheimer’s disease. Every product in the store has been carefully selected to make living with Alzheimer’s
disease as easy as possible. The store also provides a rating system for products that tells potential buyers
whether a particular product is for the early, middle, or late stages of the disease. For example:
❖ A clock that will automatically remind an Alzheimer’s sufferer of the day and date.
This easy-to-read, battery-operated wall clock displays the day of the week and
date, and automatically changes at midnight.
❖ A telephone that allows the user to push the picture of the person they want
to call. For those who may be a little forgetful or who have difficulty seeing the
numbers, this phone is a blessing.
With over 200 products that address various activities of daily living and caregiver challenges, the
Alzheimer’s Store is dedicated to finding and providing products for people with Alzheimer’s disease
and those caring for them.
The Power
of a Song
Photo: Josh Wolff
Dominic Chianese,
star of HBO’s award-
winning series
The Sopranos,
uses the healing
“Core ‘ngrato …”
power of music in his
own life and in the
lives of others.
In a moving, mellow voice, a baritone sings a haunting
Italian ballad of unrequited love. Everyone in the room sits ‘My First Love’
silently, drifting away into their own bittersweet memories. Bronx-born Chianese has been a singer even longer than
The tragic beauty of the performance causes many to shed he’s been an actor. The 77-year-old has been performing
a tear. music since his teenage years. “I eventually got into theater,
This describes a popular scene from the season three but music has always been my first love,” he says. “I grew
finale of The Sopranos—perhaps one of the most memorable up with role models like Bing Crosby and Frank Sinatra,
scenes in the series’ entirety. “Core ‘ngrato,” translated and I loved listening to some of the opera greats of the
into English as “The Ungrateful Heart,” was performed ’30s,” he says. As a second-generation Italian American,
by the character of Corrado “Uncle Junior” Soprano, Chianese also learned many traditional Italian songs from
played masterfully by actor Dominic Chianese. But this his father and grandfather—songs he still sings to this day.
same scene could just as easily describe performances by When Chianese says he loves music, he doesn’t just mean
Chianese at any number of senior centers and communities the music he grew up listening to; he means “all types of
in the New York City area. music.” It might surprise many to know that Chianese, a
Long before Chianese’s musical talent was broadcast native New Yorker, has a special appreciation for Country
across America, he brought it to New York’s elderly citizens. music. In fact, he has even performed at the Grand Ole
12 Preserving Your Memory spring 2008
Opry in Nashville. “I’m probably the only person who has Chianese primarily visits senior facilities in the New York
ever sung in Italian at the Grand Ole Opry,” jokes Chianese. City and Westchester County areas. While his singing has
While he did perform in Italian, he also sung the classic always been popular among the senior citizens he visits, his
Country standard “A Fool Such As I.” “I love Country Sopranos stardom has added an element of excitement to
music,” says Chianese. “I guess his performances for many of
you could just say that I love them. “To them, I was always
music—all of it.” ‘just Dominic,’” he says. “Now,
While music has always been I’m ‘Dominic from TV.’
an important part of his life, “But it has always just been
Chianese is better known to me and an acoustic guitar,”
the general public as an actor. he continues. “The songs I
For decades, he has acted sing are the songs these people
in theater, and on the big grew up with. You can see in
and small screens. He even their eyes the happiness—and
had a role in Francis Ford sadness—this music can bring.
Coppola’s Oscar-winning The It brings memories.”
Godfather: Part II. It was The Chianese says that music
Sopranos, however, that made has the same effect on him,
him a recognizable face. But bringing up memories of his
even as his success in acting parents and grandparents.
continued, Chianese never “Performing for senior citizens
abandoned his first love. is important to me now,” he
He continued to perform says. “I’m a senior citizen, too.”
regularly with his band, the
New York Sidewalkers, and Remembering
recorded two albums: Hits “Stardust”
and Ungrateful Heart. Throughout his years of
Chianese’s real-life musical volunteering his musical
talents were also incorporated talents, Chianese has noticed
Photo: Anthony Neste/HBO
or y
g yo
I
n the premiere issue of Preserving Your Memory, we ur
highlighted the film Away From Her, starring Oscar® Sum
mer
2007
T he M
winner Julie Christie. At the time, the movie was just ag a z
ine o
debuting. Since then, this touching love story has gone on f He a
lth an
d Hope
to win praise from critics and moviegoers alike. The film
has garnered numerous awards and nominations. Christie’s
performance as a wife with Alzheimer’s was particularly Osca ®
Julie r winner Rese
powerful, and it ultimately won her Critic’s Choice, Golden Gord Christie s
Mak
ing S
a rch
:
on P ta trid
Globe, and Screen Actors Guild awards for Best Actress, Awa
insen rs with
t in Alzh Toward es
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and a nomination for Best Performance by an Actress in a Fro y Wha
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mH t Am
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Leading Role at the 80th Academy Awards. a
n Alz er Th ica
Alzh inks :
of co heimer’s The
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to let nding the passion
y
er
Sur v ’s
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Alzheimer’s makes it a special movie to the staff of go stren
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Brainr y These
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Preserving Your Memory and the Fisher Center for M
Keep ers !
emo Y
r y Sh our
Alzheimer’s Research Foundation. We would like to ar p
www.ALZinfo.org/Julie.
A
Can
RT
Help Unlock Memory?
Alzheimer’s patients benefit
from the Museum of Modern
Art’s special programs.
Anyone who has provided care for someone with a debilitating disease such as Alzheimer’s
can recognize the challenges of correctly interpreting and applying a doctor’s instructions. The
American Medical Association (AMA) Foundation understands these challenges. That’s why it
provides physicians with the resources to help caregivers, patients and physicians communicate
effectively with one another to ensure that patients receive the best care possible.
To help you get the most from doctor visits, follow these tips:
• Write down questions. Prepare a list of questions • Report changes. Tell the doctor about any
to ask the doctor before your visit. new or different symptoms your care
• Bring your care recipient’s medicines. Bring all recipient is having.
prescription and over-the-counter medicines • Ask questions. Before you leave the doctor’s
your care recipient is taking. office, make sure you understand what the
doctor has told you. Remember, the doctor
is there to help.
The AMA Foundation serves as the philanthropic arm of the AMA, developing programs to
support medical education, public health and research.
Visit www.amafoundation.org to learn more.
A
Mozart concerto, Tchaikovsky’s
“Nutcracker” suite, even a
round of “Row, Row, Row
Your Boat,” may all provide benefits
for a person with Alzheimer’s disease.
A growing body of research suggests
that music, like art and other creative
forms of therapy, can stir emotions and
memories, enhance enjoyment and self-
esteem, and enrich the lives of people
with dementia.
A Soothing Sound
“Relaxation with the type of music
W
hen you were a kid, Mom’s Low-Country Cooking, both of which tools that I would always utilize in life.”
oven always held the prom- he authored. You may have even dined Talk about an understatement!
ise of something Woods’ parents, noting their
warm and satisfying. Would it Marvin Woods, son’s growing passion, sub-
be meatloaf, mac and cheese, scribed him to Betty Crocker’s
author of
or pot roast? She knew all recipe cards. “By the time I was
your favorite comfort foods.
Home Plate Cooking 13,” says Woods, “I was cook-
Now that you’re the caregiver, ing meals on the weekends for
you want to nurture her with the family.” And he was among
those same cherished dishes— only a handful of guys taking
only lighter. Experts maintain Home Economics at his New
that a healthy diet may actu- Jersey high school.
ally reduce the symptoms of But young Marvin’s real
Alzheimer’s and help preserve “epiphany” came one morning
memory. So, while comfort at age 14 in his Aunt Tiny’s
foods can be soothing, the ex- North Carolina kitchen. “For
tra fat and calories are anything breakfast it was pork chops,
but. eggs, and grits—the first time
Is there a recipe for trans- I ever had pork chops for
forming tradition? Absolutely. breakfast—and she served it
Just take a few fresh ingre- with sweet tea. And it just blew
dients and healthy strategies my doors off!” says Woods. “I
and add a pinch of creativ- never knew really how much
ity. But don’t forget Mom’s effect that had on me until I
secret ingredient. Says Chef became a professional.”
Marvin Woods, “Whether
you’re cooking professionally or at home, at one of the many restaurants from Southern Comfort Lite
the number one ingredient with cooking New York to London where Woods While attending the Academy of Cu-
is your heart.” has contributed his unique talents over linary Arts in Atlantic City in 1983,
the past two decades. Or perhaps you Woods was tapped to help open Har-
Pork Chops and Sweet Tea saw him preparing food on CBS This rah’s at Trump Plaza. He went on to
Meet Chef Marvin Woods—that Morning, or read one of his recipes in build an impressive resume in such New
is, if you haven’t already. Perhaps you O Magazine. York establishments as The Sea Grill at
were among the 7 million regular view- Chef Woods’ love of food and cook- Rockefeller Center, Windows on the
ers of Home Plate, the top-rated Turner ing came early. “My dad was the first World, and Helmsley Palace before
South cooking show that, from 2002 person that took me in the kitchen heading abroad to fine-tune his skills.
to 2006, featured Woods’ lighter take when I was seven,” says Woods, “and it It was during a mid-’90s stint at Café
on traditional Southern cooking. Or was just to make some scrambled eggs. Beulah, New York’s “low-country” cui-
maybe your cookbook collection con- My dad wanted me to be independent sine hot spot, that Woods started devel-
tains Home Plate Cooking or The New so, in his mind, he was giving me some (continued on page 24)
22 Preserving Your Memory spring 2008
Healthy Recipes
Turkey Meatloaf
Makes 6 servings
Balance, variety, and moderation are the keys to a healthful diet. You don’t have to sacrifice good taste for good
health. Modifying recipes by substituting low-fat foods for higher-fat ones is the best way to skim the fat. Here we
turn traditional meatloaf into a more healthful entrée by switching from ground beef to ground turkey.
Adding mushrooms to the mix adds flavor and texture without adding fat. Cremini mushrooms are simply
baby Portobello mushrooms. They are dark brown and slightly firmer and more full-flavored than white button
mushrooms. Look for mushrooms with no bruises, closed gills, and a rounded cap that ranges from one-half to
two inches in diameter. If you cannot find cremini, plain white button mushrooms may be substituted.
Ingredients
2 tablespoons olive oil, Coarse salt and freshly ground 1 cup fresh white breadcrumbs
plus more for pan black pepper 1/3 cup milk
1 large onion, finely chopped 2 garlic cloves, finely chopped 2 large eggs, lightly beaten
1 medium carrot, finely diced 2 teaspoons Worcestershire sauce 1 ¼ pounds ground turkey meat
12 ounces cremini mushrooms, ½ cup chopped fresh parsley (mix of dark and light)
finely diced ¼ cup ketchup
Directions
• Preheat the oven to 400 degrees F. Oil a 13 x 9 x 2-inch loaf pan.
• Heat the oil in a large sauté pan over medium heat. Add the onion and cook, stirring, just until softened, about
2 minutes. Add the carrot and cook, stirring, until softened, about 3 minutes. Add the mushrooms, season
with salt and pepper to taste, and cook, stirring occasionally, until the liquid mushrooms give off is evaporated,
10 to 12 minutes. Add the garlic and cook until fragrant, 45 to 60 seconds. Remove from the heat and add
Worcestershire sauce, parsley, and ketchup. Transfer the vegetables to a large bowl to cool.
• In a small bowl combine the breadcrumbs and milk, and let stand 5 minutes. Add the eggs and stir to combine.
Add the breadcrumb mixture to the cooled vegetables. Add the turkey, season with salt and pepper, and mix
well with your hands. Mixture will be very moist.
• Form into a 9 x 5-inch oval loaf and place in the prepared pan. Transfer to the oven, and bake until an instant-
read thermometer inserted into the center registers 170 degrees F, about 50 minutes. Remove to a rack to cool
and tent loosely with foil. Let the meatloaf stand 5 minutes before serving.
Spiced Carrots
Makes 6 servings
This dish is crunchy, colorful, and delicious. Carrots will keep in the refrigerator in a plastic bag up to 10 days.
Remove the green tops before storing, since they will shorten the carrots’ shelf life.
Paprika is dried, ground, sweet red pepper. It is mildly flavored and prized in the kitchen for its brilliant red color.
Make sure to keep paprika and other ground spices no longer than three to six months.
Ingredients
¼ teaspoon ground cumin Coarse salt and freshly ground 1 ½ tablespoons chopped, fresh
¼ teaspoon paprika black pepper flat-leaf parsley
Pinch of cayenne (or to taste) 1 ½ pounds carrots, cut into
2 teaspoons olive oil julienne or matchsticks
1 tablespoon honey 1 teaspoon white wine vinegar
Directions
• Using a small, nonstick sauté pan over low heat, combine the cumin, paprika, cayenne, and oil. Cook, stirring,
until fragrant, about 2 minutes. Remove from the heat and cool slightly.
Add the honey and season with the salt and pepper to taste.
• Using a 4-quart saucepan, cook the carrots in boiling salted water until
tender, 2 to 3 minutes. Transfer to a colander and drain thoroughly.
• Place the warm carrots in a medium bowl. Add the spiced oil, vinegar, and
parsley. Toss to coat and combine. Taste and adjust for seasoning with
salt and pepper. Serve immediately.
T
he two major hallmarks of fighting drug developed by scientists
Alzheimer’s disease are plaques at Memorial Sloan-Kettering Cancer
made out of the protein called Center. The Fisher scientists reasoned
“beta-amyloid” and tangles of the protein that this drug might also help Alzheimer’s
called “tau.” Plaques accumulate outside because the drug was designed to block
of cells throughout parts of the brain the chaperone, Hsp90. Remember,
used for thinking, memory, language, Hsp90 is needed for p25, and p25 is
and other aspects of behavior. Tangles needed to make tau into tangles. The
accumulate inside cells in these same Fisher scientists reasoned that if they used
brain regions. Both beta-amyloid and tau a very small amount of this drug, only
proteins exist normally in the brain—not enough to block Hsp90 from keeping
in the form of plaques or tangles but some but not all of the p25 properly
rather as well-ordered parts of brain cells folded, they might be able to prevent tau
or as in the case of beta-amyloid, bits of from tangling and do so without hurting
protein that are secreted by brain cells. Fisher scientist Wenjie Luo the rest of the cell. To test this, they used
The plaques and tangles are actually hopes to find a drug to fight a type of mouse that was bred to have
sticky clumps of beta-amyloid or tau “folding” of tau proteins. badly folded tau protein. Dr. Luo fed
that have taken on abnormal shapes. In the mice the Hsp90-blocking drug for
other words, proteins have specific shapes chaperones stick to such proteins and several months. Then she examined the
that allow them to function normally. either try to re-fold them into the brains of the mice and found that the
Sometimes they take on abnormal forms proper shape or send them to the cell’s drug had prevented tau from tangling,
as a consequence of physical stress. This recycling facility—to be chopped up while producing no ill effects.
may be what is happening in the brains and in some cases re-used for parts. Even though most scientists think
of people with Alzheimer’s disease. These Cells also contain proteins that have that tangled tau is an indirect result of
mistakes in protein shape, or “folding,” a hard time keeping the right fold, even beta-amyloid accumulation, many still
as scientists call it, prevent proteins from when there is no stress. Such unstable believe that the tangles do the brain
functioning normally and may also cause proteins are still very useful to the cell. harm. By preventing their formation or
direct damage to brain cells. That is what They just need pampering and certain by ridding the brain of these tangles,
Fisher scientists think is happening inside kinds of chaperones do this job. One Fisher scientists hope to prevent some of
the Alzheimer’s brain; beta-amyloid and of these unstable proteins is called p25. the memory loss and other devastating
tau proteins have taken on the wrong fold It gets its pampering from a chaperone effects of Alzheimer’s. Right now,
and are damaging the brain. called Hsp90 (that stands for “heat Fisher scientists are planning to test
Bad folding is not restricted to the shock protein weighing 90,000 Daltons). whether the mice that have been
proteins believed to cause Alzheimer’s Without Hsp90, p25 would be quickly treated with the tangle-reducing drug
disease; it can happen to just about chopped up by the cell and discarded. are smarter and have better memory
any protein. Fortunately, our body’s Although p25 is needed by the cell, it can than the mice with tangles that have
cells, including our brain cells, can also cause trouble. In fact, it is one of the not been treated. If the drug helps the
defend themselves against badly folded proteins that cause tau to form tangles. tangled mice, it would be a candidate
proteins most of the time. The cell’s Drs. Wenjie Luo and Paul Greengard for clinical trials in humans, and not
defender is another type of protein at the Fisher Center for Alzheimer’s just to treat Alzheimer’s disease but
called a “chaperone,” which recognizes Research may have found a way to correct other neurological diseases that are
proteins that are badly folded. In fact, this. They experimented with a cancer- caused by badly folded tau. ■
spring 2008 www.ALZinfo.org 27
Ask the Experts Do you have a question you would like to ask the experts at the Fisher Center
for Alzheimer’s Research Foundation? If so, please call 1-800-ALZINFO, visit
ALZinfo.org, send surface mail to Fisher Center for Alzheimer’s Research
Foundation, West 46th Street & 12th Avenue, New York, NY 10036, or e-mail
info@ALZinfo.org.
Home-Modification Tips
Many readers have written to • Helpful safety products can be
our experts asking about home found here: www.alzstore.com
adaptations that can ease the
burden on the caregiver and Fire Safety
increase the independence, • Install smoke detectors and check
safety, and dignity of the per- and replace batteries regularly.
son with dementia. • Keep fire extinguishers accessible
If you decide to have your Alzheimer’s- in every room.
afflicted loved one live at home in a fa- • Eliminate poor wiring and over-
miliar environment, it is important to loaded sockets.
consider certain safety modifications, • Install radiator covers and insulate
such as the ones below. hot water pipes to prevent burns.
Since each person with Alzheim- • Remove dials on stoves and ovens
er’s is different, both in the stage of to prevent your loved one from
the disease and its manifestations, Keep fire extinguishers mistakenly turning them on.
not all of the modifications sug- Also remove space heaters and hot
accessible in every room.
gested will apply in your situation. plates.
Use this list as a guide and adapt • Prevent fires by moving furniture
the suggestions accordingly. The home- appliances, cutlery and other sharp so that it is not in contact with ra-
owner can do some changes, whereas kitchen objects, hand and power diators.
others may need to be done by a handy- tools, firearms, and razor blades to • Lower the hot water temperature
man or contractor, which may involve a prevent accidents. to 120 degrees to prevent scalding.
significant investment. Visit us at www. • Use an electric razor while shav- • If your loved one smokes, restrict
ALZinfo.org for more information. ing. it to a non-carpeted area with a
• Store medications, household non-upholstered chair to minimize
General Safety cleansers, and insecticides in a risk.
locked cabinet to prevent acciden- • Provide large, deep ashtrays to pre-
• Post emergency numbers for doc- tal ingestion. vent falling embers.
tor, police, fire, ambulance, and • Install outlet covers to prevent
readily available family members electrocution. Preventing Falls/Improving
near a centrally located telephone. • Use sturdy chairs that do not tip. Mobility
• Disable automatic locks on storm • Remove or pad furniture with
and screen doors as to not get sharp corners. • Build a ramp to the front and back
locked out, and hide an extra key • Remove fake fruit and other “look- doors of your house.
in case it happens. alike” decorations such as refrig- • Install a stair/elevator chair to help
• Put decals on glass doors to pre- erator magnets to prevent choking your loved one get up and down
vent your loved one from walking or injury to teeth. stairs.
into them. • Use sturdy plastic plates to prevent • Install handrails in hallways and
• Lock up objects that might present breakage. stairways, put a gate on the stair-
a danger, such as matches, kitchen • Hide car keys if necessary. way and grab bars in the bath-
28 Preserving Your Memory spring 2008
room. Make sure all lighting one has accidentally discarded
in these areas is maintained. something of value.
• Install locks on the doors to • Have consistent background
the cellar/basement and attic. noise such as music they chose or
• Add non-skid strips and re- nature sounds.
pair or remove carpeting on
steps. Managing Wandering
• Tape or paint stair edges to
increase their visibility. • Fence in your yard to reduce
• Remove clutter that may the chance of your loved one wan-
contribute to slips and falls, dering too far. Install a lock. This
including area rugs. applies to swimming pools, too.
• Use assistive devices as neces- • Install additional locks, a mo-
sary, whether a cane, walker, tion detector, or an alarm or
or wheelchair, which can help buzzer on exit doors to prevent
your loved one maintain his/ your loved one from trying to
her independence by remain- leave without you knowing.
ing mobile. • Install safety locks on win-
• Remove low furniture like Use a shower chair dows, and safety bars on ones
coffee tables that might be a or tub seat for bathing. above the first floor.
tripping hazard. Use a handheld shower wand. • Provide your loved one with
• Keep a clear path in the cen- an identification bracelet, and a
ter of rooms so that your card in their wallet along with a
loved one can walk around safely. • Keep furniture arrangements con- note in case of wandering.
• Post pictures or signs as cues to sistent in all rooms because people
help your loved one find his or her who are disoriented may use these
way and use objects appropriately. objects to remember. Do this also
• Avoid placing electrical cords with personal belongings. If not,
across walkways, or tape them anxiety may occur.
down. Make sure lighting in these • Use a shower chair or tub seat for
areas is maintained. bathing. Use a handheld shower
• Use non-skid mats in bathrooms, wand.
bathtubs, and showers. • Simplify clothing to enable easy
• Use nightlights in hallways and dressing.
bathrooms. • Use grooming tools specifically de-
signed for people with motor skill
Improving Daily Activities deficiencies (e.g., curved hairbrush • Enroll individuals with Alzheim-
handles and toothbrushes) er’s or dementia into the Safe Re-
• If more than one person is a care- • Add an additional bathroom or turn program available through
giver, post a list of specific respon- have a portable toilet available to your local Alzheimer’s Association
sibilities that each one should aid a person with incontinence. chapter.
perform to prevent misunderstand- • Put plastic covering on furniture to • Have several photos of your loved
ings and forgetfulness. (Use: www. protect it. one available should they get lost.
lotsahelpinghands.com for an on- • Prepare food that is easily eaten • Notify the police who patrol the
line caregiving tool.) with fingers and provide straws for neighborhood that your loved one
• Post a calendar on an obvious wall drinks. has dementia and may wander.
and mark each day. Also record • Use a vinyl tablecloth that can be Provide a photo.
appointments and list activities to easily cleaned. • Notify neighbors of your loved one’s
help them regain a sense of time • Store valuable items in a locked or condition, and caregivers’ schedules;
passing. Also place clocks promi- inaccessible area. ask them to call you if they see your
nently for this effect. • Check the trash in case your loved loved one unattended. ■
spring 2008 www.ALZinfo.org 29
Fitness By Jason Schneider
Graceful Exercise
The ancient practice of tai chi is a low-impact way to stay healthy.
E
xercise is important for people flow freely, and integrate many of them.” a good range of motion at the joints,
of all ages, but can be especially As a low-impact and aerobic exercise, Comana adds. “Coupled with the slow
beneficial to people with memo- tai chi can help improve physical condi- movements, [tai chi] helps with many
ry problems, as well as their caregivers. tion, muscle strength, coordination, and age-related conditions such as arthritis,”
Low-impact exercises, such as wa- flexibility; ease pain and stiffness; and he says.
ter aerobics, yoga—and even simply improve sleep.
walking—are often suggested for older “[The various forms of tai chi] em- Staying Active
adults. To improve balance and coordi- phasize movement through three planes Because inactivity can lead to muscle
nation, as well as combat joint stiffness (breathing, relaxation, and meditation), weakness and other problems, it’s im-
and increase calmness and awareness, and thus help maintain functional mo- portant for people with Alzheimer’s to
tai chi is an ideal choice. bility at joints and integrate multiple joint continue physical activity as long as pos-
movements, which helps older adults sible, says The Cleveland Clinic.
An Ancient Practice maintain their functional capacity,” says And although exercise doesn’t stop
Tai chi, a mind-body practice that Comana. “In many of the movements, the disease from progressing, it gives pa-
originated in China around the 12th the eyes are closed, challenging the bal- tients a feeling of accomplishment.
century A.D. as a martial art, focuses ance centers of the body. This certainly is “In general, exercise improves cerebral
on moving the body blood flow, bringing
slowly and gently more oxygen to the
while breathing Persons with brain to help main-
deeply and medi- dementia tain neural and cog-
tating. Studies have benefit from nitive function,” says
suggested that tai these basic, Comana. “Tai chi
chi can help boost simple movements might be
older adults’ immu- movements. difficult to recall or
nity to viruses and perform with these
improve their bal- [dementia] patients;
ance, thereby help- basic, simple move-
ing to prevent falls. ments would have to
“The premise is be employed.”
to coordinate the The Mayo Clinic
movements with reports that up to
breathing, and 70 percent of people
many of them are with Alzheimer’s
simple movements also have symptoms
or can be modified of depression. They
to fit the needs of may eventually with-
older adults,” says draw from all ac-
Fabio Comana, MA, MS, ACE-CPT & key to functional capacity, given the risk tivities because, over time, they lose the
LWMC, ACSM HFI, CSCS, CISSN, of falls with older adults. It’s great train- ability to take part in the activities they
exercise physiologist and research scien- ing for balance and coordinated move- once enjoyed. Exercise, such as tai chi,
tist with the American Council on Ex- ments, parameters lost as we age.” might help reduce depression in patients
ercise in San Diego, Calif. “It teaches the Movements in tai chi use the person’s able to do the exercise and may alleviate
participant to evolve the movements, to own body as resistance and maintains boredom or loneliness.
30 Preserving Your Memory spring 2008
Precautions
As with any exercise, there are some
precautions to take into consideration
before practicing tai chi. Although rela-
tively safe, like any exercise, it should be
done with care. The National Center for
Complementary and Alternative Medi-
cine, part of the National Institutes of
Health, offers these tips:
• Tell your healthcare provider if you
are considering learning tai chi for
health purposes, especially if you
have a health condition for which
you are being treated, if you have
not exercised in a while, or if you
are an older person.
• If you do not position your body
properly in tai chi or if you overdo
practice, you may get sore muscles
or sprains.
• Tai chi instructors often recom-
mend that people not practice tai
chi right after they eat, when they
are very tired, or when they have an
active infection.
• Use caution if you have any of the
conditions listed below, as your Tai chi originated in
health care provider should advise China around the
you whether to modify or avoid cer- 12th century A.D.
tain postures in tai chi:
- Pregnancy
- Hernia
- Joint problems, back pain, sprains,
a fracture, or severe osteoporosis helping to control many of the health No matter what form of exercise you
• A complementary/alternative medi- problems found in older adults, such as choose to do, you can help improve your
cine approach should not be used to diabetes, high blood pressure, and high loved one’s quality of live—as well as
replace conventional medical care cholesterol. your own. ■
or to delay seeking that care.
I
f I asked you for a defi- This care can be received at
nition of estate plan- home or in an assisted living
ning, you might say facility, adult day care center,
that it means making or a nursing home.
sure that your loved ones Most people think that
receive what you have these costs affect only the life
worked so hard for during savings of the seniors receiv-
your life when you pass ing the care. However, a sig-
away. Some of you might nificant number of adult chil-
even say it means making dren take care of their aging
sure that the government parents, including paying the
does not get any more costs of housing, health care,
than necessary in taxes and incidental expenses. Costs
from your estate when of clothing, home repair, and
you die. Nevertheless, fo- cell phones can be unnoticed
cusing on estate planning and often come out of the
is about as desirable as go- pockets of the adult children.
ing to the dentist for root Most children are not aban-
canal work for many of us. doning their elderly parents
Although it may weigh on but shouldering the signifi-
our minds, there always cant time and financial bur-
seems to be something Once you understand the facts, planning for den required to help them.
more important to do like long-term care becomes much less daunting. This burden is compounded
buying a new car or plan- by the fact that most people
ning a family vacation. simply do not have any idea
Surprisingly, there is something we nursing home before we die. Moreover, how much long-term care costs, and
like thinking about even less than es- more than 50 percent of the people sur- they believe that Medicare pays this cost,
tate planning and that is planning for veyed said that going to a nursing home which it does not. However, if we haven’t
the rest of our lives and, in particular, is worse than becoming bankrupt and planned in advance, our life savings can
planning for the possibility that we even worse than dying. be depleted since Medicare coverage of
may get sick and no longer be able to This is unfortunate since annual long-term care is extremely limited. In
take care of ourselves. According to long-term care costs nationwide aver- fact, even if you qualify, Medicare pays
a recent survey by a major insurance age approximately $75,000; and in for only a couple of months of care if
company, more than half of all people some major metropolitan areas, the you’re lucky. It will pay only 20 days
would rather meet with an advisor to costs can exceed $150,000 per year. for “skilled nursing home care,” which
discuss their will and estate planning Generally speaking, long-term care is occur after a hospital stay. Thereafter,
than discuss planning for long-term the assistance needed by someone who there are significant co-payments. In
care needs. This is true despite the fact can no longer independently perform some special cases, and these are lim-
that approximately 50% of us over the daily activities such as eating, bath- ited, Medicare will provide home care
age of 65 will spend some time in a ing, toileting, transferring, or dressing. services without a prior hospital stay. In
32 Preserving Your Memory spring 2008
these cases, the person must be home- 3. Understand Medicaid and Spou- Medicaid within five years of pay-
bound due to their condition, require sal Protections: Generally, indi- ing for a grandchild’s education,
intermittent (not full-time) skilled nurs- viduals become eligible for Med- then the grandparent may not be
ing care, and the person applies directly icaid assistance once their assets eligible for Medicaid, and there
through a Medicare Certified Home are below a certain level; (approxi- may be no funds available to pay
Health Agency (CHHA). mately $2,000-$4,000). There for the grandparent’s care.
Many theories abound attempting to are, however, special protections
explain our apprehension about plan- for married couples, so that the 5. Discuss Different Planning Op-
ning for long-term care and the rest of spouse living at home (the commu- portunities: Elder law attorneys
our lives. While most Americans rec- nity spouse) has sufficient funds to are using strategies like irrevocable
ognize the importance of planning for meet his or her needs. Generally income-only trusts to assist clients
their possible long-term care needs, the speaking, the community spouse with long-term care planning. Prior
emotions that surround the thought is entitled to keep non-exempt to the DRA, transfers to trusts were
of losing our independence, as well as assets of up to $104,400. This is subject to a five-year, look-back pe-
the misconceptions we may have about called the Community Spouse riod, while transfers to individuals
care options, make it uncomfortable Resource Allowance (CSRA). In were subject to a three-year look-back
for us to confront these issues. addition, the community spouse period. Now that the five-year look-
Here are 5 steps to help explain the is entitled to monthly income of back period applies to all transfers,
facts about long term care, so that up to $2,610. This is called the trusts should be given careful con-
planning for the possibility of needing Minimum Monthly Maintenance sideration as a planning tool. Trusts
it becomes much less daunting. Needs Allowance (MMMNA). provide more flexibility and more se-
These amounts vary depending on curity for the senior than an outright
1. Define Long Term Health Care: which state we are talking about transfer to a child. In addition, trusts
Long term care does not necessarily and may be increased through a offer tax advantages when compared
have to mean nursing home care. fair hearing or court order. to an outright gift. Another plan-
In fact, most care today is received ning technique might be to purchase
at home. By planning in advance, 4. Be Familiar with Medicaid Look long-term care insurance to cover the
you can keep more options avail- Back Rules: Prior to the passage of look-back period, in case you need
able to you and make things easier the DRA, there were rules in effect nursing home assistance within five
for you and your family. to limit asset transfers to children years after the transfer to the trust.
and other persons. The DRA tight-
2. Know Your State’s Rules: Long- ened those rules. Previously, a per- Although the landscape has signifi-
term care planning has always been son could transfer assets, and if the cantly changed since the enactment of
a complex area of the law, and it has person applied for Medicaid within the DRA, planning opportunities re-
become even more complex since the three years of making the transfer main to protect your assets. The earlier
enactment of the Deficit Reduction (the look-back period), then the you plan ahead, the more assets that
Act of 2005 (the “DRA”) on Febru- person would be assessed a pen- can be protected for you and your fam-
ary 8, 2006. The federal government alty period based on the amount ily. Do yourself a favor; take the time
oversees the Medicaid program, but of the transfer, with the penalty today to plan for the rest of your life.
the program is administered by the period starting in the month after Although the process might involve a
states. Rules can vary from state to the date of the transfer. Now, any significant amount of time and effort,
state, and all states have not yet com- transfers made within five years and force you to confront some dif-
pleted modifying their guidelines of applying for Medicaid will be ficult issues, you’re worth it. You and
and regulations as a result of the assessed a penalty period, but the your family will be glad you did. ■
DRA. Although about three-quar- penalty period will not start un-
ters of the states have implemented til the Medicaid applicant is in a Bernard A. Krooks, JD, CPA, LLM (in
DRA, there remain many issues that nursing home, is otherwise eligible taxation), CELA, is president and founding
still require further clarification. In for Medicaid, and applies for as- member of the NY Chapter of the National
fact, we may not know the answers sistance. These rules could poten- Academy of Elder Law Attorneys and a na-
to some questions until the courts tially cover gifts to grandchildren tionally known and widely quoted expert on
have had a chance to review and to help pay for their education. If elder law. For more information, visit www.
consider these issues. the grandparent needs to apply for littmankrooks.com.
spring 2008 www.ALZinfo.org 33
Keeping Your Mind Sharp
Brain-Boosting Puzzles
“Use it or lose it.” The message is simple. If you don’t use your
muscles, they will no longer be as effective as they should be. Of
course the brain is not a muscle; however, it has recently come
to light that “mental workouts” might help preserve memory and
other mental skills. In these pages, we offer a variety of different
types of puzzles that will give your various skills involving mem-
ory, deduction, and letter manipulation a work out, and, we hope,
also provide you with a ton of fun!
(Answers on page 37)
M AT C H T H E S E DROPLINE
LEAPFROG
•VISIT US AT KAPPAPUZZLES.COM•
SUDOKU
•VISIT US AT KAPPAPUZZLES.COM•
BLUE RIBBON SUDOKU PUZZLES (JBRS) � $28.30 (12 ISSUES) � $53.80 (24 ISSUES)
NAME ________________________________________________________________
TOTAL PAYMENT
ENCLOSED
ADDRESS ____________________________________________________________
$__________
CITY ________________________________________________________ STATE ____ ZIP ________________
CANADIAN FUNDS ACCEPTED
E-MAIL ADDRESS: ____________________________________________________________________________
� VISA � MASTERCARD #_ _ _ _ __ _ _ __ _ _ __ _ _
Expiration date: ____ / ____ Signature _______________________________________________
MO YR
� Check or Money order (Payable to KAPPA PUBLISHING GROUP, INC.)
GIF
T � THIS IS A GIFT FROM: (complete below if this is a gift subscription)
NAME __________________________________________________________________
ADDRESS ______________________________________________________________
CITY __________________________________________ STATE ________ ZIP __________________ 8FCAR3
PLEASE ALLOW 8 WEEKS FOR SUBSCRIPTION TO BEGIN. *CANADIAN FUNDS ACCEPTED; HOWEVER, OUTSIDE THE U.S. ADD POSTAGE: $22.20-12 ISSUES; $44.40-24 ISSUES. OUTSIDE U.S. AND CANADA, PAY WITH
CHECK DRAWN ON A U.S. BANK OR A MONEY ORDER ISSUED IN U.S. FUNDS. OFFER EXPIRES 12/31/08.
Agnes
T: 7 in
T: 4.875 in
the doctor will
hear you now
want better health care? start asking more questions. to your doctor. to your pharmacist.
to your nurse. what are the test results? what about side effects? don’t fully understand your
prescriptions? don’t leave confused. because the most important question is the one you should
have asked. go to www.ahrq.gov/questionsaretheanswer or call 1-800-931-AHRQ (2477)
for the 10 questions every patient should ask. questions are the answer.
But there is hope. At the Fisher Center for Alzheimer's Research, our team
of international scientists, led by Nobel laureate Dr. Paul Greengard,
is rapidly closing in on the cure. And you can help.
For more information or to donate (94¢ of every dollar we raise goes directly
to our research labs), please visit ALZinfo.org or call 1-800-ALZ-INFO.
Because the devastation of Alzheimer’s doesn’t stop with the person afflicted.