11/24/04

LC041124

Val Zavala>> Tonight on Life and Times --

Beating Alzheimer's without any miracle cure. Do some seniors
in Orange County have the secret?

Philip Bruce>> You're 102. You're 102. Can you believe that?

Viola Kron>> Can you? (Laughter)

Philip Bruce>> (Laughter) No, I can't, actually. I really
can't believe that.

Val>> And then, what's more important to you? A long life or
the quality of your life? And can you help ensure either one?

These stories and more next on tonight's Life and Times.

Life and Times is made possible through the generous support of
the L.K. Whittier Foundation dedicated to improving the quality
of life by supporting innovative endeavors in the fields of
medicine, health, science and education.

And by a generous grant from Jim and Anne Rothenberg.

Val>> Unlocking the mysteries of Alzheimer's. It's a major
challenge as America grows older. In fact, people over one
hundred are one of the fastest growing segments of our
population. Well, we found a unique study on aging that's
happening right in our own back yard. Philip Bruce takes us to
the source in Orange County. It's the community of Leisure
World in Laguna Woods where doctors have a rare window into the
aging process.

>> Nice to meet you.

Viola Kron>> Why, thank you.

>> Would you like to come on back and get started?

Philip Bruce>> She was born two years before the Wright
Brothers took that first flight at Kitty Hawk, but after more
than a century on this earth, Viola Kron's body and, most of
all, her mind remains sound.

Viola Kron>> It looks like a mushroom?

>> Perfect.

Viola Kron>> A camel?

>> Good.

Philip Bruce>> And this is one of the ways we can tell just how
sound Viola really is. She's being tested on how well she can
identify familiar shapes and put them into words.

>> We have very few people who can do that.

Viola Kron>> Really?

>> Yes, and you did it in record time. Fantastic.

Philip Bruce>> The exam is being carried out by the folks at UC
Irvine's Institute for Brain Aging and Viola is an old friend
here. They've been tracking her and a few thousand other
seniors from Orange County for the past twenty years trying to
find out what makes them tick.

>> We're finished. You are terrific. Thank you very much.

Viola Kron>> And don't you forget it (laughter).

Philip Bruce>> Viola hasn't forgotten much and her memories are
enough to fill a movie. In the 1920's, she was a budding
Olympic diver after being discovered among a bevy of swimmers at
the old Los Angeles Athletic Club.

Viola Kron>> The coach, Fred Cady, started me diving and I
never went back to swimming. I became a diver and then I
married my coach, Fred Cady (laughter). Of course, after that,
then I simmered down and didn't compete any more.

Philip Bruce>> Her husband, Fred Cady, a legendary swim coach
at USC, went on to train four U.S. Olympic teams, but Viola
stayed home perhaps dreaming of the Gold, yet never getting a
chance to go for it. A lifelong friend says that was Fred's
fault.

Margery Voyer Cole>> He told her thirty years later, which just
bothered me no end, that he didn't submit her name to the
Olympics because he thought she'd fall in love with someone
else.

Philip Bruce>> But don't feel too sorry. Viola and Fred were
quite the popular couple and they had some famous friends like
legendary silent film star, Harold Lloyd. She remembers those
days and a lot more, including her early childhood in Arizona
before it was a state.

Viola Kron>> We came from Missouri to Arizona for my father's
health. He was supposed to have consumption and then years
later they said there was no sign of any lung trouble, but I
said, well, at least it got us out of St. Louis (laughter).

Philip Bruce>> Viola also remembers some of the stunts she
pulled as a young girl after she moved to Southern California.
Like the time back in 1918 when she swam out to a Navy
battleship anchored a mile off the coast of Long Beach.

Viola Kron>> And then, of course, when I got there, I said
aren't you going to invite me up?

Philip Bruce>> She never got to swim for a medal, but on her
one hundredth birthday, Viola did get to swim for Jay Leno on
NBC's Tonight Show. There on national TV, she redefined what it
means to be an active senior.

Jay Leno>> "Any time you want, baby, go ahead."

Philip Bruce>> Two years after that dive, Viola admits she
isn't always as able on dry land as she is in the pool, but as I
discovered, she hasn't lost her sense of humor. You're 102.
Can you believe that?

Viola Kron>> Can you? (Laughter)

Philip Bruce>> Remember we told you that UC Irvine's doctors
have been tracking Viola for the past twenty years? Well, it's
not because of her adventurous past. It's because of where she
lives. You see, Viola is a resident of Leisure World, a
retirement community of some eighteen thousand souls near Laguna
Beach. Ever since 1981, thousands of seniors there have been
taking part in a yearly voluntary survey.

They answer questions about what they eat, what they drink, how
much they exercise, even what they think. And as Leisure
World's population gets older, researchers compare the answers
to how each individual is aging. It's especially valuable in
studying how the brain ages and determining if such things as
lifestyle, diet and mental outlook have anything to do with who
gets Alzheimer's.

Dr. Claudia Kawas>> What we want to learn are the secrets of
those who age the most successfully in different ways so that we
can apply those and make all of us age successfully now that
we're more and more frequently moving to age ninety and well
beyond.

Philip Bruce>> Dr. Claudia Kawas, one of UCI's top
neurologists, has taken the study a step further. She's
bringing in survey responders such as Viola for regular tests
that measure both physical and mental well-being. The doctor
says, with each step, researchers here are learning more about
how the brain ages and why some people like Viola are faring so
well.

Dr. Claudia Kawas>> We're looking at their neurological
function in terms of their thinking, memory, language, but also
their neurological function in terms of their ability to walk
and get around and do things that they need to do. When we're
able to put that information with the information that we got
from them twenty years ago, that's when the real value will
happen.

Philip Bruce>> Whatever it is that keeps a person's mind sharp,
Roscoe Maguire has got it.

Roscoe Maguire>> Shirt. Brown. Honesty.

Philip Bruce>> At age ninety-seven, he's another Leisure World
resident who's beating the odds of old age and, in these memory
drills at the UCI lab, he sometimes beats the clock.

Roscoe Maguire>> Remember, I told you. I don't want any
arithmetic (laughter).

Philip Bruce>> Roscoe wasn't a championship swimmer or a great
athlete. He'll also tell you that his diet wasn't especially
healthy and that he often enjoyed a good drink or two up until a
few years ago. In fact, no one is more surprised at his
longevity than he is. What do you think -- this is a trick
question that people always ask at your age -- how do you think
you've made it this far in this good a shape?

Roscoe Maguire>> I have no idea. I truly don't. I've never
done anything because I didn't expect to live this long. My
father was fifty-five when he died and all his siblings were
either that old or younger. My mother, I don't know what
happened to her sister, but I say my mother lived to be eighty-
two or almost eighty-two.

Philip Bruce>> Is Roscoe's sharp mind a product of his cheery
demeanor? Well, he thinks not, since he describes himself as a
lifelong worry-wart prone to depression. He wanted to be a
movie actor and even got a screen test back in 1927, but his
dream never worked out. And even now, Roscoe is not always Mr.
Optimism. You look at the future now. What do you think the
future holds?

Roscoe Maguire>> I don't have any future. That's the thing
that pisses me off (laughter). I have no future. That's
another thing that's depressing. Everybody I know, they're all
younger and they have futures, but I don't have a future except
to die.

Philip Bruce>> But Roscoe knows that, for whatever reason, he's
been lucky, much luckier than many of his friends who've lost
their memories and much more to Alzheimer's, so why not him?
Who knows? But he hopes that being part of this study will help
unlock the mysteries at how minds like his survive the march of
time without getting trampled. Do you ever imagine what might
have been?

Roscoe Maguire>> Oh, yes. Of course, you know, I've lived my
whole life in fantasy. I've done that all my life, you know.
That's the only thing maybe that's kept me going. For things I
didn't like, I'd fantasize something better, so I was always a
movie star (laughter).

Val>> The Leisure World survey didn't start out as a study in
Alzheimer's. In fact, the questions were aimed at women who had
taken estrogen in middle age. But after the survey was
broadened, thousands of women and men responded and scientists
realized that they had tapped into a mother lode of data on
aging.

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Val>> One of the challenges of Alzheimer's is diagnosing it
correctly. Is it Alzheimer's or is it some other form of
dementia? And there are many. Well, here at UCLA, scientists
are doing some cutting edge research. They're now able not only
to see Alzheimer's in the human brain, but to track its
progress.

Dr. Gary Small is Professor of Psychiatry and Director of the
Memory Clinic at UCLA. He's a nationally renowned expert and
author of "Aging and Dementia". There are a lot of things that
can cause memory loss. A stroke, a tumor, even vitamin
deficiency. So to be able to pinpoint the problem as
Alzheimer's and to do so early would be extremely valuable to
doctors and patients.

Dr. Gary Small>> Right now we have drugs like Namenda and like
the other medicines, Aricept, Reminyl and Exelon, that are
available and approved for patients once they're diagnosed with
Alzheimer's disease.

Val>> But how easy and how early can we diagnose it?

Dr. Gary Small>> That's another area that we're working on.

Val>> And their work is paying off. Dr. Small was part of the
team who discovered a way to actually see brain deterioration
with the use of PET scans.

Dr. Andrew Gustavson>> We've been working with brain imaging
technologies like Positron Emission Tomography, or PET scanning,
and we've been finding that tool helps make a diagnosis earlier.

Val>> They developed a chemical with a radioactive molecule.
When it's injected into a patient and the patient is given a PET
scan, the chemical reveals which parts of the brain are most
active and least active. Dr. Andrew Gustavson is a Post-
Doctorate Fellow at UCLA funded by the French Foundation. He is
doing the very technical nitty-gritty work of analyzing hundreds
of PET scans and MRIs.

Dr. Andrew Gustavson>> In Alzheimer's disease, the most
important part is to look for the periotal lobe lack of brain
activity.

Val>> This scan is from a seventy-seven year old woman.

Dr. Andrew Gustavson>> And what we can see is, in the periotal
lobe, it's turned to blue.

Val>> Blue means?

Dr. Andrew Gustavson>> Blue means that there is very little or
less than expected amount of brain activity in the cells.

Val>> And red means?

Dr. Andrew Gustavson>> Red means a fair amount, and white means
the most. In a normal person, this would be red and yellow all
the way around this outside ring which is the cerebral cortex.
In Alzheimer's disease, this part of the brain called the
periotal lobe which is right here shows a characteristically
diminished amount of activity on both sides.

Val>> And that's Alzheimer's versus some other --

Dr. Andrew Gustavson>> -- versus other types of dementia.

Val>> Now Dr. Gustavson is going one step further. He's trying
to zero in on the origin of one symptom that is unique to
Alzheimer's. That symptom is hallucinations.

Dr. Gary Small>> One of the reasons it's important is these are
very common, very disturbing, symptoms for patients. They are
frequently what lead to patients needing to be placed into a
nursing home. If we could effectively treat those symptoms, it
may allow people to stay at home with their relatives and be
much more comfortable. That's particularly important because,
Alzheimer's disease patients don't adapt well to change and the
change to a nursing home frequently is accompanied by a
deterioration in their condition. So if we can learn what part
of the brain it is, it gives us a real head start in knowing how
to develop those medications.

Val>> With the PET scans as a measuring tool, neurochemists can
see almost immediately if a drug is working. Most drugs
currently used for Alzheimer's like Aricept or Exelon are
borrowed in a sense from psychiatry's medicine chest, but
recently there was good news. In October 2003, the FDA approved
a new drug called Namenda, or Memantine generically. It is the
first drug designed specifically for Alzheimer's and the first
one to be aimed at treating the later stages of the disease.

Dr. Gary Small>> This new drug, Namenda, has been found to be
useful in patients with moderate to severe Alzheimer's disease.
That's helpful because earlier people thought that it's only in
the early stage of the disease that you can treat it. Now we
know that there is a benefit throughout the disease course and
many families do want help as the disease progresses. In
addition, we have studies showing that Namenda will help people
who are already on one of the older medications, so families can
get an additional six months to a year of benefit where
previously they didn't have that.

Val>> Namenda is a different class of drug, meaning it works on
a different set of brain cells.

Dr. Gary Small>> I think this is an important step because I
think families today don't have a lot of tools to deal with this
devastating problem. So now we have an additional drug that
affects a different group of brain messengers and families can
get some additional help for months or sometimes years.

Val>> Can this be introduced late in the game and still make a
difference?

Dr. Gary Small>> We can introduce this drug late in the game
and see if it will make a difference. Now certainly there is a
point where patients become so impaired that families are not
sure whether they want to continue treatment. There's the
question about quality of life. We don't have good measures to
tell us when to stop treatment and I think that becomes a
difficult decision to discuss with the doctor and other family
members.

Val>> A month's supply of Namenda costs between $75 and $120.
The side effects are headache, dizziness, confusion and
constipation, but Dr. Small says his patients have tolerated it
very well. And now scientists are testing drugs on younger
people with only minor memory loss to see if they can stave off
or even prevent Alzheimer's.

Dr. Gary Small>> Now we know medicines for Alzheimer's disease
can keep patients out of the nursing home for a year or two.
What we'd like to do is keep people on the job for a year or two
by diagnosing them earlier. A strategy that our group and many
groups are focusing on has to do with identifying the problem
very early, even before there is dementia, and to delay the
onset of that problem. We think it's going to be easier to
protect the brain before there is damage rather than try to
repair it once the damage is present.

Val>> In fact, one of the interesting things I heard is that --
and maybe you can comment on this -- do we really have to find a
cure if we actually find the successful delay?

Dr. Gary Small>> Well, to me, that is a cure. If we can live
long enough disease-free, that is cure.

Val>> Despite the medical advances, Dr. Small has found that
people experiencing brain failures and memory loss tend to deny
they have a problem.

Dr. Gary Small>> The big problem with Alzheimer's disease is
denial. Studies have found that many people who even have
moderately severe disease are not getting help and not getting
treated.

Val>> They don't want to face it.

Dr. Gary Small>> They don't want to face it. They want to
avoid the problem. But there is help out there and, if you have
a concern, see your doctor and get some help.

Val>> And these days, the earlier the better.

Dr. Gary Small>> The earlier you start, the more you're going
to benefit.

Val>> Scientists in all sorts of disciplines are working on
Alzheimer's, in psychology, psychiatry, neurology, chemistry and
imaging, and they say that once the advances from all these
disciplines begin to converge, that's when the real breakthrough
in Alzheimer's will happen.

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Val>> Some doctors say if you live long enough, you'll
eventually get dementia. But as you've seen, there's a lot we
can do in terms of lifestyle to stave off the symptoms of aging.
Gay Yee found one woman who has Alzheimer's in the family and
was determined to avoid the disease herself.

Gay Yee>> About the time John Glenn launched into space to
become the first man to circumnavigate the earth, the country
was also launching Medicare, the government's insurance program
for the elderly and disabled. Medicare hasn't changed much
since the 1960's. It's one of the reasons why the system
continues to finance full-time institutional care like this --
not this.

[Film Clip]

Gay Yee>> The Wise Adult Day Care Center in Santa Monica is a
drop-off center. It allows sixty-nine year old Alzheimer
patient, Francine Bessey, to have rec time and a hot meal during
the day and still live with her daughter, Michele, at night.

Michele Bessey>> Now this has become more of a place for her to
really enjoy and be with people like it has been before and it
has been a place for me that I can pursue my career.

Maria Arrechaederra>> The desire of anyone at any age is to
remain in their community with the things they love, with their
family, with their friends, and that is the way it should be.
That is where you are going to remain and have the dignity that
you really require if you are going to grow old well.

Gay Yee>> Wise Senior Services is committed to doing whatever
it takes to keep seniors independent, providing a safety net of
services. Take Francine, for instance. At this point, all she
needs is simple custodial care, someone to make sure she's safe,
takes her medication and gets a hot meal. But Medicare doesn't
pay for it, even though Michele is convinced it's keeping her
mother happy and healthy.

Michele Bessey>> She might not remember it that night, but
during the day you can see there's a big difference. She's
happy. You know, she's really joyful and I think that you would
lose, you would become a vegetable, if you didn't keep that
stimuli going.

Gay Yee>> But everyone would agree the best way to keep people
out of the healthcare system is to keep them healthy and self-
reliant. The same would apply for the elderly, only the system
was never set up that way.

Mary Lou Martin>> What is the big problem? The big problem is
that Medicare was established in 1965 and it isn't set up in a
way that allows people to really focus on preventative type
care.

Maria Arrechaederra>> This health care system is wonderful, but
for older people, they are in the business of saving lives. I
have been at this agency for twenty-five years and I hear from
the seniors all the time that it's not that important for them
to live forever. It's to live well. It's to live with dignity
and the independence that they deserve and want.

Gay Yee>> It's one of the disconnects we often hear about when
talking about our healthcare system, and USC Policy Planning
Professor, Glenn Melnick, says don't expect a solution any time
soon.

Dr. Glenn Melnick>> Ultimately, it's going to have to be solved
through some national policy. Individual states or individual
jurisdictions are not going to be able to solve that problem
because it's a national problem.

Gay Yee>> Here's a further complication. Every forty seconds,
another baby boomer turns fifty. In fifty years, the number of
Americans aged over sixty-five will triple in number. The Pepsi
Generation is fast becoming the Medicare Generation. But the
baby boomers aren't about to take the situation lying down.

Dr. Gary Small>> We're at a time right now where we can become
proactive. We have a whole generation of baby boomers who want
answers, who want to do something about their health as they
age.

Gay Yee>> Dr. Gary Small of UCLA's Center on Aging says baby
boomers can do something. Proof is in the MacArthur Study
profiled in successful aging.

Dr. Gary Small>> In studies of successful aging, it shows that
it isn't all genetics, that only about a third of it is genetic,
but two-thirds has to do with the way we live our lives. Are we
remaining engaged in an active lifestyle? Are we working with
other people? Are we remaining social? Are we remaining active
both physically and mentally? Those kinds of approaches are
going to help us live longer better.

Gay Yee>> Taking charge of her aging is something Joan Chassey
Bennett takes quite seriously.

Joan Chassey Bennett>> One-third you have no control over, but
two-thirds you do. Well, to me, that's, you know, that's a
major part. Maybe I can't help getting hit by a car, but I can
help looking when I walk out the door to make sure there's no
car coming.

Gay Yee>> Joan is proactive with good reason. Joan's mother
and aunt died of Alzheimer's. She suspects her grandmother and
uncle were victims as well. She's enrolled in several projects
with UCLA's Center on Aging, working with Dr. Small on his
Alzheimer's studies, participating in the Center's memory
training. Joan is learning to enhance her memory with rhyme
association. Will this prevent Alzheimer's? Dr. Small says
there's no definitive answer, but studies suggest it helps.

Dr. Gary Small>> We know that people who go to college have a
lower risk for getting Alzheimer's disease. We know that there
are studies showing that people who have more mentally active
jobs actually have a lower risk for Alzheimer's disease. Even
if memory training doesn't ultimately prevent Alzheimer's
disease, it's not going to hurt us and it's going to help us
now.

Gay Yee>> In the meantime, Joan has her own strategy. A few
years ago, she took up painting to exercise the creative side of
her brain and also took up a job as a temp to exercise her
logical side.

Joan Chassey Bennett>> When I went for one of my tests as
follow-up a couple of years ago, the psychologist said she had
noticed there really was a difference, that there was an
increase in my ability to remember better.

Gay Yee>> A survivor of ovarian cancer, Joan is convinced
living better can make a difference.

Joan Chassey Bennett>> When you have a disease where you're
probably going to die, that if you don't take action, you will
die, you know? You're the one because nobody else can do that
for you, so you really have to work at that. I did and I've
just followed it through with everything else in my life.

Val>> Dr. Gary Small has written a book called "The Memory
Bible". It has all sorts of practical information on diet and
lifestyle to help you maintain a healthy brain. If you'd like
to get more information on Alzheimer's, you can go to PBS.org
and click on "The Forgetting". That's our program. I'm Val
Zavala. For everyone at Life and Times, thanks for watching.

Life and Times was made possible through the generous support of
the L.K. Whittier Foundation dedicated to improving the quality
of life by supporting innovative endeavors in the fields of
medicine, health, science and education.

And by a generous grant from Jim and Anne Rothenberg.

Val>> Next time on Life and Times --

Something to ponder while you enjoy your next cup of coffee, the
faces and politics behind the beans.

>> If I don't sell my coffee at a good price, then my workers
will be unemployed. They wouldn't be able to feed their
children, so is it fair? Is that a fair trade really? No.

Val>> That's next time on Life and Times.