Forget me not

A man and woman, married for decades, recently walked into Dr. Vincent Fortanasce’s office in Arcadia. Immediately, the neurologist detected something was amiss. The man — who usually held his wife’s hand, tenderly caressing her wrinkled skin — now dragged her almost violently through the doorway.

“I don’t know what to do, doctor,” the man said, turning abruptly to Fortanasce. “This woman follows me everywhere. She insists that she’s my wife.”

After a series of neurological exams, Fortanasce — author of the widely-acclaimed book “The Anti-Alzheimer’s Prescription,” in which he advocates diet and mind exercises to help prevent the incurable disease — confirmed that his patient had Alzheimer’s.

Recognizing the need to raise public awareness of this ubiquitous and debilitating illness, Alzheimer’s Disease International (ADI), a worldwide nonprofit organization based in London, has declared Sunday World Alzheimer’s Day.

From a memory walk in Armenia to organized breathing exercise training in Nepal and an Alzheimer’s awareness tea party in Zimbabwe, ADI has organized events to galvanize the international health community behind the imminent need for increased Alzheimer’s research funding and additional support for families already affected by the disease.

Both USC and UCLA’s medical centers have research facilities dedicated specifically to work on Alzheimer’s, but despite the billions of dollars spent on research in Southern California alone, there are currently no cures on the horizon. 

“Younger people often believe that they do not need to worry about Alzheimer’s disease because they strongly trust that modern medical science will have discovered a cure by the time it might affect them. But that just isn’t the case,” Fortanasce said.

Joshua Grill, recruitment and education core director of UCLA’s Mary S. Easton Center for Alzheimer’s Research, concurred.

“Ten million baby boomers will be diagnosed with Alzheimer’s disease,” he said. “Caring for all these people will cost the country more then $1 trillion. Considering the federal deficit we face already, when this happens it will cause a national crisis.”

When Fortanasce first opened his neurology practice he made an average of one Alzheimer’s diagnosis per month. “Now, I make between three and six per week,” he said.

Perhaps most frightening, though, is that 30 percent of Alzheimer’s patients are committed to residential nursing homes within one year of being diagnosed and 70 percent are institutionalized within three years.

“Even the most high-class nursing homes tend to be horrible places,” Fortanasce said. “I can’t even imagine what’s going to happen in the next few years when so many people need full-time care.”

Alzheimer’s patients can generally function on their own during the first stages of the illness because short-term memory is the first faculty to be affected. The preliminary symptoms of the illness often go undetected because victims may only experience difficulty with word and name retrieval. Soon, though, people diagnosed with Alzheimer’s disease may lose one or more senses — often smell and taste.

“One of my patients inadvertently left a bag of pork chops in the car for over a week and didn’t smell it at all when they began to rot,” Fortanasce recalled.

In the final stages, Alzheimer’s sufferers undergo extreme behavioral changes — sometimes becoming paranoid and delusional. At this point, everyday life functions become hazardous for the patient.

When Don Lorenzini recognized that his brother’s dementia had progressed to this level, Lorenzini and his wife, Carole, made the difficult decision to commit their loved one to a residential nursing home.

But in the eight years since Lorenzini’s brother has lived in a local home, the couple has engaged in constant battles with the administration and nursing staff to protect the rights of a relative who can no longer fight for himself.

“Most of the staff is totally unqualified,” Carole Lorenzini said.

Added her husband, “God help those patients who don’t have a relative to check in on them. I watched my brother transform from a forgetful but vibrant and lively human being into a vegetable from all the drugs they give him. And the drugs don’t even do anything to stop the progression of the disease. They are just sedatives to make the nurses’ lives easier.”

Don Lorenzini’s suspicion that the drugs constantly pumped into his brother have not improved the man’s condition is irrefutably accurate.

Although there are four Food and Drug Administration-approved medications for the treatment of Alzheimer’s disease — the most widely prescribed of which is Pfizer’s Aricept — not one is effective in curing the physiological causes of brain degeneration.

“Like prescribing aspirin for a headache, these drugs all provide a symptomatic benefit,” Fortanasce said. “Of course, I prescribe them to my patients because they do undoubtedly improve quality of life, but I make sure that patients understand that taking these medications will not slow down the process of the disease.”

UCLA’s Grill supported Fortanasce’s bleak assessment of the potential for a pharmaceutical cure, adding that because of FDA laws on drug testing and development, “I can almost definitively say that there will be no effective drugs available either to prevent or stop the progress of Alzheimer’s within the next 10 to 15 years.”

Given the present inability of modern medicine to treat Alzheimer’s disease despite the pervasive American reliance on pharmaceuticals, Fortanasce embarked on writing his book, “The Anti-Alzheimer’s Prescription,” with a revolutionary attitude in mind — prevention.

“I wrote this book so that people could take proactive measures not to get Alzheimer’s,” Fortanasce said.

“The Anti-Alzheimer’s Prescription: The Science-Proven Plan to Start at Any Age” delineates specific lifestyle changes that average Americans can make to improve their chances of staying free of Alzheimer’s.

“Although there is almost definitely a genetic component to the disease, I have found that the unhealthy American way of life is also a hugely contributing factor,” Fortanasce said.

“I watched my father deteriorate from the disease and my mother is now suffering from age-related memory loss. So studying the controllable measures one can take against getting Alzheimer’s is of profound importance to me.”

In assessing the American way of life, Fortanasce discovered that some of the most important risk factors for Alzheimer’s disease were alliterative — sleeplessness, stress and a sedentary life.

“Research shows that the United States has higher rates of Alzheimer’s disease than those countries — often less affluent countries — where people sleep more and experience less stress,” Fortanasce said.

Next, Fortanasce prescribes an anti-Alzheimer’s diet — which is remarkably similar to other healthy eating plans that supposedly aid in the prevention of diabetes and heart disease.

“In my book I call it a harmonic diet because it requires that one eat equal proportions of protein, fat and carbohydrates. The main difference between the diet I promote and others is that I emphasize the order in which you eat these macronutrients. I recommend eating the carbs last,” Fortanasce said. “But really, I’ve found that what’s good for your heart is also good for your brain. So my diet plan shouldn’t be shocking to anyone striving to live a healthier life.”

Where “The Anti-Alzheimer’s Prescription” diverges from other self-help guides is in the concept of “neurobics,” or the act of exercising one’s mind.

“So many accountants and engineers tell me that they aren’t worried about getting Alzheimer’s because they’re constantly crunching numbers,” Fortanasce said. “But that just isn’t true. Because they are always performing the same functions, they aren’t truly challenging their minds.”

Fortanasce suggests that people concerned about getting Alzheimer’s try to challenge themselves creatively so that they develop new neurological pathways. Some of his proposals: eating with the non-dominant hand, trying a Sudoku puzzle if you’re generally an avid crossword puzzler or closing your eyes and tapping into your sense of smell before eating a meal.

“I have actually found that taxi drivers experience some of the lowest incidences of Alzheimer’s disease,” Fortanasce said. “They constantly need to remember new routes, but the stress level isn’t too high because they generally aren’t concerned with how long it takes them to get there.”