Come Together

I have a couple of comments regarding "Come Together" (November/December 2010). I enjoyed the article overall, but found two sections to be erroneous. First, the third paragraph of the article states "I took my mom to a neurologist. After two days of tests, he said she had 'frontal lobe syndrome' but couldn't provide a definitive Alzheimer's diagnosis." In my opinion, it is inaccurate to describe Alzheimer's disease as a frontal lobe syndrome; AD is primarily a disease of the medial temporal lobes (i.e., memory). It does eventually affect the frontal lobes, but not until later in the disease process.

Secondly, the second to last paragraph in the section entitled "Treatments and Prevention" Tucker states "Since brain exercises have been shown to have some effect in warding off dementia..." I feel that readers are not being provided the most current National Institutes of Health consensus, which stated that there is no convincing evidence to support the claim that brain exercises are able to reduce risk or delay the onset of Alzheimer's disease. - Kara Dassel, PhD

THE EDITOR RESPONDS: Thank you, Dr. Dassel. The NIH panel stated that although there currently is little evidence these interventions lessen cognitive decline, some are not necessarily harmful and may confer other benefits. In addition, the panel's assessment is limited by inconsistent definitions of what constitutes cognitive decline. However, you are correct to point out that these proposed prevention strategies are currently, at best, only loosely associated with improved outcomes.

It was great to see how the Eikenberry-Tucker family rallied around Jill Eikenberry's mother Lora, who is suffering from Alzheimer's disease. I was disappointed, however, by Michael Tucker's insinuation that Americans put their ailing elders into nursing homes as a matter of convenience. Eikenberry and Tucker's solution—to move Lora into the apartment across the hall and hire round-the-clock nursing care—is an ideal situation that is unavailable to everyday Americans.

I would love to move my mother next door and provide her with personal attendants 24 hours a day. But in my world, that kind of personalized care is rarely available and certainly not affordable. I considered it a fantastic victory when I was finally able to move my mom to the same city I live in and find her a nursing home that suits her needs. My parents didn't financially prepare for retirement, let alone for a crippling disease like Alzheimer's. My mom may be in a nursing home, but I worked hard to find one that is experienced in caring for patients with dementia. The caregivers are loving, kind, and compassionate. They understand the needs of the Alzheimer's patient and they work closely with our family to help mom get the most out of her daily life. - Kate Erickson Salem, OR

THE EDITOR RESPONDS: Thank you for your letter, Kate. We certainly did not intend to dismiss nursing homes as a viable and compassionate option.

CORRECTIONS: In "Pictures of You" from the November/December 2010 issue, Steven Smith was mistakenly referred to as "Steven Spuds." In the cover story from that issue, we failed to mention that memantine is one of the FDA-approved medications for the symptoms of Alzheimer's disease.