Maybe it seems like nothing: you can't remember where you put your keys for what feels like the hundredth time. Your mother flounders for the occasional word in conversation. Your grandfather goes to the store and can't remember how he ended up four miles away.

But these and other lapses in normal brain function may in fact be indicators of a more serious problem-actual degeneration of the brain tissue that may fall under the heading of dementia, the most common form of which is Alzheimer's disease.

"We should not accept memory loss as part of aging," says Dr. Frederick Schaerf of Fort Myers' Neuropsychiatric Research Center of Southwest Florida. Most doctors and researchers believe that the human brain is capable of functioning properly well into old age, which means that changes in behavior or mental functioning may be early warning signs of Alzheimer's.

According to statistics provided by the National Institutes of Health, Alzheimer's affects four million people in the United States. That number is expected to more than triple by 2050. At $100 billion per year, it is the third-costliest disease in the country.

Though the specter of Alzheimer's can be a terrifying one for victims and their loved ones, the outlook for those diagnosed with the disease is becoming brighter.

Patient Care

Carolyn Conant first became concerned about her mother, whom she describes as "an efficient little German woman," when the older woman began to have trouble sleeping and balancing her checkbook, and became unusually upset by things like unexpected noises. She took her mother to a local doctor, who suspected Alzheimer's. "At that point I panicked," Conant says.

Her efforts to understand the diagnosis and their options led Conant to the Alvin A. Dubin Alzheimer's Resource Center in Fort Myers. The nonprofit organization offers education, a resource library of information, and support for patients, caregivers and families. The center referred Conant to doctors who specialize in the care and treatment of those with the disease, and a physician prescribed Reminyl, one of several cholinest-erase inhibitors (along with Aricept and Exelon) that have been shown to slow the progress of the disease when given early.

Carolyn also enrolled her mother in the center's ID bracelet program, offered in coordination with the Lee County Sheriff's Department, set up a timer system to remind her mo-ther when to take her medications, and wrote instructions for everyday tasks and posted them in her mother's house. These steps and others helped condition her mother to a routine that eased her path as the disease progressed.

Several other organizations in Lee and Collier counties offer help, hope and support to those affected by the disease. Lee Memory Care, part of the Lee Memorial Health System network, participates in studies to help diagnose, treat and combat the disease, and coordinates information from each of its 12 memory clinics across Florida to create what Lee Memorial's Sue Maxwell calls "the best database in the world on Alzheimer's." The organization also offers caregiver education classes, sensitivity training for professionals, free Alzheimer's screenings, support groups and other resources.

In Collier County, the Alzheimer's Support Network also offers support groups, including specialized ones for men. The center has a 24-hour help line, as well as education seminars and Ask the Expert panels.

Treatment Options

In addition to the currently available cholinesterase inhibitors prescribed to Alzheimer's sufferers, some 30 to 40 new drugs are under study, some right here in Southwest Florida at institutions like the Neuropsychiatric Research Center.

"Alzheimer's means your brain's neurons are dying," says the center's Schaerf. "It's cellular death." One new drug, Mementine, works by helping to delay nerve-cell degeneration. It has been shown to improve memory in middle to more advanced stages of Alzheimer's.

"Over the next several years, every year will result in another biochemical product coming on the market. It's not here today, but I think it'll be here," Schaerf predicts.

In fact, he adds, a drug cocktail will likely be coming for Alzheimer's patients. It will be a concoction similar in concept to that currently used for AIDS patients, designed to address a variety of symptoms.

Early Detection and Prevention

One reason some patients haven't been diagnosed in the early, more manageable stages of the disease has been a reluctance to address the problem. People may feel ashamed at symptoms like forgetfulness or confusion.

"They think, 'I'm stupid, I'm embarrassed'-they almost want to hide," says Carolyn Conant.

But increased awareness of Alzheimer's has led to a better-informed populace. "We're seeing people a lot earlier," says Dotty St. Amand, executive director of the Dubin Center. "People are coming in identifying it themselves."

That may be one of the most powerful tools in the battle to improve the quality and duration of life after diagnosis. And there is growing evidence that staying active, both physically and mentally, may help those who do develop Alzheimer's to function better, longer.

"This new idea of use it or lose it is true," says Schaerf. He recommends that people stay physically active as they age, always wear seat belts to avoid head injuries that can lead to dementia, and not leave depression untreated, as it can be a risk factor. "Keep your mind active, stay around people, challenge your brain," he advises. The fitter your brain is, the longer you may be able to maintain normal functioning even after a diagnosis of Alzheimer's.

The picture continues to brighten as scientists come to better understand the disease. "There's a lot of research being done, and I'm excited about that," says Barb Anderson, executive director of the Alzheimer's Support Network. "Down the line, I'm hopeful we'll be able to find a cause, because then we'll be able to find a cure."

RESOURCES

you can receive a free alzheimer's screening at Lee Memory Care by making an appointment. Or contact your doctor.

The proliferation of studies in the battle against Alzheimer's means that those who suffer from the disease may qualify as research subjects. Participation in such studies can provide free tests, drugs and doctor visits for patients in the programs, as well as access to cutting-edge treatment.

Support groups are available for patients, caregivers, families, health-care professionals and others. Contact any of the resource centers listed below.

Alvin A. Dubin Alzheimer's Resource Center: 437-3007

Alzheimer's Support Network (24-hour help line): 262-8388

Care Club: 353-1994

Lee Memory Care: 334-5634