Q:Dear Dr. Si, I’m 57 years old and am becoming increasingly forgetful. My mother developed Alzheimer’s disease in her late 60’s and I’m concerned that I may develop it too. How can I get a prescription for Aricept? Do you think I should start taking Aricept? Will that prevent me from developing Alzheimer’s disease? – VC, Williamsburg, VA
A:Dear VC,
I understand your concern because your mother was diagnosed with Alzheimer’s disease at a relatively young age and because children of parents with Alzheimer’s have a slightly increased risk of developing it compared to those who’s parents don’t have the condition. I’m not a medical doctor and can’t diagnose your condition but I can tell you that your forgetfulness might simply be a benign age-related change in memory or it might be related to something as simple as a vitamin deficiency. A thorough medical workup could possibly identify a reversible cause of your problem. Whether you should start taking Aricept, or one of the other available Alzheimer’s medications now, when your symptoms are very mild and maybe completely unrelated to Alzheimer’s is an interesting question. One of the sad facts about the currently available Alzheimer’s medicines is that they are not very effective and may only slightly improve a patient’s symptoms, or might only slow the patient’s ultimate decline. I know of one well-know geriatric psychiatrist who recommends that people start taking Alzheimer’s medicines like Aricept early, before any symptoms develop, with hope of delaying the onset or even preventing its development but he is in the minority and I’m unaware of any scientific studies that support his position. In my experience, most doctors who treat Alzheimer’s wait until the diagnosis is established, or at least highly suspected. The good news is that there is tremendous progress towards the discovery of the precise cause of Alzheimer’s disease on the molecular level. Once that is done it is only a matter of time before more effective medications will be developed. I believe that there is a good chance of one or more breakthrough therapies being developed within the next couple of years possibly even a vaccination that may actually prevent the development of Alzheimer’s!