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Early detection remains best treatment of Alzheimer's

Frederick News-Post - 5/8/2021

May 8—As soon as Carolyn Perrygo noticed small signs that her husband John's memory was slipping back in 2010, they were sitting in a doctor's office, charting a path forward.

Four years later, through a clinical trial, John Perrygo was diagnosed with Alzheimer's disease thanks to a positron emission tomography scan (PET) that wasn't yet available to the general public.

The Perrygos are both retired and longtime residents of Hagerstown. Carolyn previously worked as a counselor and has an extensive background in the social sciences. So, she may have recognized some of the smaller warning signs with her husband faster than others.

"We weren't going to put our head in the sand on this," Carolyn Perrygo said. "There is no cure."

More than a century after it was first discovered, early detection remains the best defense against Alzheimer's and dementia. There is no cure, and the four drugs to treat it that have survived the Food and Drug Administration's stringent approval process are only moderately effective against it, according to Dr. Marilyn Albert, a professor of neurology at Johns Hopkins and director of the Division of Cognitive Neuroscience.

However, with early detection, the disease can be treated sooner, and the chances for a better outcome increase.

Alzheimer's is a neurodegenrative disease that is both the most common type of and the leading cause of dementia.

It often takes decades to develop and, thus, is a disease inextricably linked with age. By age 85, you are five times more likely to develop Alzheimer's than you were at 65, according Albert.

"The population is getting older. More and more people are living to that age," she said. "So, more people are at risk."

Alzheimer's is believed to occur when an abnormal buildup of proteins called amyloid and tau forms in and around brain cells, Albert said.

While a lot is known about the disease, treating is is very complicated because, as Albert put it, it's very difficult to get things in and out of the brain since it has such a strong protective layer around it. It requires high doses of strong medication that come with a lot of side effects that Albert said "are not good."

The last drug to receive FDA approval to treat Alzheimer's was Namenda in 2003.

"Since then, there have been hundreds of clinical trials looking for medication. So far, none of the trials have been successful," Albert said.

There is a lot of funding behind finding that elusive cure. The federal government directed an additional $300 million to the National Institutes of Health in the last fiscal year to combat Alzheimer's, bringing the overall federal price tag of the effort to $3.1 billion, U.S. Sen. Chris Van Hollen (D-Md), recently told a community forum the Alzheimer's Association conducted virtually for residents of Frederick and Washington counties.

"I am optimistic," Albert said. "We have learned so much about the disease. Now, we are finally getting the resources to learn more."

When John Perrygo, 76, would get to the end of the driveway and not know which way to go to the grocery store or other familiar locations, Carolyn knew that something was wrong, and something needed to be done.

Since his diagnosis, the Perrygos have tried to live as normally as possible, and they plan to resume their ambitious traveling schedule as soon as coronavirus restrictions allow for it.

"We don't slow down," Carolyn said. "We are not going to let this thing change us, unless it requires us to change."

John has had to give up driving, which was very difficult for him. But he maintains an active social life and has not lost his sense of humor. He beat bladder cancer 55 years ago, and feels he can defeat this as well.

"I have Alzheimer's. I didn't do anything wrong to get it. And I don't hide it," he said. "Instead, I tell everyone I know or meet. And then they are aware that I may not remember things we have discussed. Being open also helps counteract the stigma about it and may help someone else get the help that they need."

He continued, "What is living with Alzheimer's like? It's challenging. There is a lot of frustration with not remembering, mostly the little things. And occasionally it makes me sad because it doesn't allow me to do all that I would want to do ... Those realities make me sad. But it passes ... Things can only get so bad, and I realize how grateful I am to be here."

Follow Greg Swatek on Twitter: @greg_swatek

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