DEAR DR. DONOHUE: On TV, a commentator said Alzheimer’s disease is known as the disease of the four A’s. What are those four A’s? – M.C.

I don’t know. I’m pretty sure they were devised either by that commentator or by someone whom he heard speak. They’re not a universally used way to identify this illness. I can give you a list of the more common Alzheimer’s symptoms, and, by stretching things, I can come up with three A’s.

Loss of memory is a prominent symptom, and most Alzheimer’s patients don’t realize how bad their memory is. The “A” word here would be “amnesia.” In addition, people with this condition have trouble with abstract thinking – a second “A” word. An example of abstract thinking is maneuvering numbers as you’d do in balancing your checkbook. Difficulty with language is another sign. Such difficulties include constantly using the wrong words or forgetting the meaning of simple words. By really stretching things, this could be called “aphasia,” a third “A.”

Another sign of Alzheimer’s is the inability to do routine tasks, things that people do without giving them a second thought, like dressing. Poor judgment is yet another sign. On a cold day, an Alzheimer’s patient might go out with only a T-shirt. Alzheimer’s makes it hard for people to get their bearings; they become lost even in surroundings that should be familiar. On misplacing something like their keys, Alzheimer’s patients often look for them in outlandish places, like the refrigerator. They have rapid swings in their mood. Frequently, they suffer an about-face in their personality. A pleasant, friendly person becomes suspicious of everyone and acts in a gruff, abrasive manner.

If any reader knows M.C.’s four A’s, please write. I’ll be sure to put them in the paper.

Readers who would like a more comprehensive discussion of this common and distressing illness can order the Alzheimer’s booklet. Write to: 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: I’ve been told that if you ingest more salt than your body requires, the body can slough off the excess if you increase your water intake. Is that true? – G.S.

That’s false. In fact, the extra salt holds onto fluid. The kidneys are excellent chemists, but they can do only so much. If a person overwhelms them with too much salt, they can’t get rid of it all. Much of it stays in the body and holds onto fluid.

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