DEAR DR. DONOHUE: My mother has become so forgetful, and she’s not thinking as clearly as she used to. I wonder about Alzheimer’s. What is the best way to detect it? – C.N.

ANSWER: At the moment, there is no single test that can prove Alzheimer’s beyond the shadow of a doubt. After death, microscopic examination of the brain reveals changes consistent with the disease.

There are signs and symptoms that are highly suggestive of the illness. Alzheimer’s patients can have trouble performing familiar household tasks, things they used to do without thinking. They often exhibit poor judgment. They might put on two pairs of pants or two dresses. They often put items in strange places, like putting keys in the refrigerator. Sometimes they can’t carry out mental tasks, such as balancing a checkbook, something they once did with ease. Frequently they have rapid mood changes, or they might sit mutely in a chair and not participate in discussions going on around them.

Memory loss is prominent. Normal people frequently forget things. When they are reminded of forgotten details, they say, “Oh, yes, now I remember.” Not so with Alzheimer’s patients. When they’re given the answer to a forgotten happening, they’re still puzzled.

A panel of tests confirms the suspicion of Alzheimer’s to a great degree. One of those tests is simply naming three different items, waiting three minutes and then asking what those items were. If a person cannot recall any of the items, that is definitely abnormal. Along with the recall test, patients are asked to draw a clock and set the hands at a specified time, like 10:30. Any mistake in drawing the clock and the time is considered abnormal.

Doctors often have Alzheimer’s patients get brain scans. The scans are done to exclude conditions that can mimic Alzheimer’s disease. A brain tumor is an example. Researchers are perfecting special scans that should be most useful for diagnosing this illness. Their day in medical practice is not far off.

The Alzheimer’s booklet describes this illness and outlines its current treatment. Readers can order a copy by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Is there any clinical proof that Proscar reduces the size of the prostate? I had been on Flomax for five years, and it increased the flow of urine. – G.W.

ANSWER: There’s lots of clinical proof that Proscar (finasteride) shrinks the prostate gland. The body changes testosterone into a more active form that stimulates prostate growth. Proscar interferes with the conversion of testosterone to the more active form. The prostate stops growing, and actually contracts. It takes three to six months before results begin to be appreciated, but the shrinkage continues for 12 to 18 more months.

Flomax (tamsulosin) acts differently. It relaxes muscles in the prostate so it doesn’t choke the urethra, the bladder’s emptying tube that runs through the gland. It also relaxes muscles at the bladder’s base. Both actions make it easier to empty the bladder. The effect takes place soon after beginning the medicine. The gland stays the same size, however.

DEAR DR. DONOHUE: Is chewing tobacco as unsafe for you as cigarettes are? Can chewing tobacco damage your lungs? – L.R.

ANSWER: Both are harmful. Chewing tobacco doesn’t get to the lungs, so it doesn’t damage them, but it damages many other things. It releases nicotine into the blood, and nicotine constricts arteries. That paves the wave for artery and heart disease. In the mouth, it’s a disaster. It can produce leukoplakia – white, leathery patches that can turn into cancers of the mouth, throat and tongue. It shrinks the gums and exposes the roots of the teeth to the erosive action of food, drinks and saliva. (The roots aren’t protected with enamel like the teeth themselves are.) It can also bring down blood levels of HDL cholesterol, the good kind of cholesterol, the kind that protects against heart attacks. Smoking and chewing tobacco are both villains with their own destructive agendas.

DEAR DR. DONOHUE: Is myopia inherited? Both my husband and I wear strong lenses for it, and we wonder if our children will also suffer from it. – K.D.

ANSWER: Myopia is nearsightedness – “sighted for near vision.” Myopic people cannot clearly see things in the distance.

Genetics figure heavily into myopia. The chances are your children will also have it. They live in an era when glasses and contacts are not the only answer. LASIK procedures can reconstruct the cornea to clear myopia.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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