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HOUSE CALL WITH DR. SANJAY GUPTA

A look at Alzheimer's Disease

Aired June 12, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


BETTY NGUYEN, CNN ANCHOR: One of Iraq's deputy foreign ministers was killed this morning. Bassam Salih Kubba died in an ambush outside his Baghdad home. Kubba had just returned to Iraq from the United States.
Three people taken hostage earlier this week in Iraq, a Lebanese citizen and his two Iraqi co-workers, have been found shot to death. The bodies were found on a road near Ramadi. Meanwhile, their employer reports that seven Turkish civilian contractors being held hostage have been released. Three of the seven are shown in this video released earlier this week.

The FBI is telling 10 cities to be on alert for possibly ecoterrorism today. A security bulletin refers to a call for an international day of action and solidarity. San Francisco and Portland, Maine, are among the cities that are warned. Stay tuned for "HOUSE CALL" with Dr. Sanjay Gupta, which starts right now.

SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, and welcome to HOUSE CALL.

The death of former President Ronald Reagan has brought Alzheimer's disease back to the forefront this week. One in 10 Americans have a family member suffering from this memory-robbing disease. And according to the Alzheimer's Association, by 2050, as many as 16 million Americans may have Alzheimer's. Aaron Brown takes a look at where we stand in the research for a cure.

(BEGIN VIDEOTAPE)

AARON BROWN, CNN CORRESPONDENT (voice-over): Since he told the world a decade ago that he had Alzheimer's, scientists say there has been steady progress into detecting both the causes and identifying possible cures for the disease.

UNIDENTIFIED MALE: In 1994, we had just approved the very first drug treatment for Alzheimer's disease. There are now five that have been approved by the FDA. Funding by the federal government at that time was about $298 million a year. It's now almost $700 million a year. I think much of that can be attributed to President Reagan's statement, his willingness to come forward, and, really, the appreciation that the world has for his contributions.

BROWN: Alzheimer's is a steady, progressive brain disorder, usually affecting those over 65. It steals their memories, their speech, their perception of the world around them. Doctors who see Alzheimer's patients and their families say there was widespread awareness that it had afflicted someone as famous as Ronald Reagan.

UNIDENTIFIED MALE: The term Alzheimer's disease carries a stigma. It can be upsetting. To have President Reagan publicly announce that he had received this diagnosis 10 years ago, I think, was tremendously helpful for patients and their families, allowing them to much more comfortably deal with the symptoms and with the diagnosis, allowing more people to seek treatment.

BROWN: In Georgetown and other research centers around the country, scientists believe one of the keys to finding an Alzheimer's cure may lie in the use of stem cells.

Aaron Brown, CNN, New York.

(END VIDEOTAPE)

GUPTA: Embryonic stem cell research is still in its infancy and scientists caution there are many unknowns, but they also believe stem cells hold great promise. Something many patients suffering from Parkinson's, diabetes, heart disease and, yes Alzheimer's, hope will lead to a cure or maybe better treatments. It's also something former first lady Nancy Reagan believed as well. CNN medical correspondent Elizabeth Cohen explains.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): She came to the cause late in life.

NANCY REAGAN, FORMER FIRST LADY: Now, science has presented us with a hope called stem cell research, which may provide our scientists with many answers they've had for so long that have been beyond our grasp. I just don't see how we can turn our backs on this.

COHEN: Nancy Reagan watched her husband suffer...

N. REAGAN: Ronnie's long journey has finally taken him to a distant place where I can no longer reach him.

COHEN: ...and has become one of the most well-known advocates for this controversial research, along with Christopher Reeves, who suffered a spinal cord injury, which left him paralyzed, and Michael J. Fox, who suffers from Parkinson's disease.

MICHAEL J. FOX, ACTOR SUFFERING FROM PARKINSON'S DISEASE: Not only have you wonderfully taken care of the president for all these years, but in no small fashion, to your courage and conviction, you've taken care of us all.

COHEN: Mr. Reagan has faced a hurdle Reeve and Fox didn't. She's had to public disagree with a many of the leaders of her husband's only party, parting ways with the very constituencies that supported him and her. That's because the type of stem cell research she supports requires the destruction of embryos, such as the ones in fertility clinics. And that lead President Bush three years ago to authorize federal funding but with extensive limitations. GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: Embryonic stem cell research offers both great promise and great peril.

COHEN: Researchers hope embryonic stem cells can be turned into neurons and then used to replace the type of neurons that are damaged by Alzheimer's, or turned into virtually any type of human tissue to help people with a wide variety of diseases. Mrs. Reagan's inspiration to take this bold stance came from watching her husband toward the end of his life.

N. REAGAN: We can't share the wonderful memories of our 52 years together. And I think that's probably the hardest part. And because of this, I'm determined to do what I can to save other families from this pain.

COHEN: To help ease that pain, she vows to continue the fight.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: There are many myths surrounding the causes of Alzheimer's. When we come back, could a fall from his horse have contributed to President Reagan's Alzheimer's? The answer may surprise you. Stay with us.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. Well, no one knows exactly what causes Alzheimer's disease, but we do know that age is the biggest risk factor. As many as 10 percent of all people over the age of 65 have the disease and that number climbs to 50 percent when you get over 85 years of age. Paula Zahn talked earlier this week with Dr. Gary Small. He's director of the UCLA Center on Aging. He's also author of the book, "The Memory Prescription." She started by asking him about a recent conversation with Nancy Reagan.

(BEGIN VIDEOTAPE)

DR. GARY SMALL, DIRECTOR, UCLA CENTER ON AGING: I can tell you that she remained fiercely dedicated to her husband, even when he was at the end stages of Alzheimer's and out of reach to her. And what she said it me and the rest of the world that evening was that we should stop wasting time. We need to do whatever we can to prevent more families from feeling the pain of Alzheimer's and other age- related illnesses. She actually agreed with me that the best medicine for Alzheimer's, diabetes, Parkinson's and these devastating illnesses was through research and prevention.

PAULA ZAHN, CNN CORRESPONDENT: Could you tell in the conversation that you had if there was a general acceptance that the end was near?

SMALL: I definitely sensed an acceptance, that she had come to terms with the long, devastating, emotionally tiring experience of being with a loved one who is suffering from this illness, and this is typical of family members who have to deal with Alzheimer's disease, that they go through a long process where he literally mourn the loss of the person. The human being is no longer emotionally there. The physical person is there. And it isn't until they die that they do the final mourning process. It can be very confusing emotionally.

ZAHN: Of course, it can. And you could just see the wear and tear on Mrs. Reagan's face, particularly, as he put her face on her husband's casket. This has been a 10-year fight for her family. Is that an unusual length of time from diagnosis to death?

SMALL: Ten years today is fairly typical. With better day-to- day care, we find that Alzheimer's victims are living longer, and that just prolongs the suffering of the family members. It's true that we do have treatments or medications that help with the symptoms, but as yet, we have no cure. However, there is a lot of hope for new treatments. Research is very active. I'm convinced that over the next 10 years we're going to see some major breakthroughs in prevention research.

ZAHN: It was Mrs. Reagan's belief that maybe one of the things that sped up the progression of President Reagan's Alzheimer's was a fall that he had taken on his horse. Might that have contributed?

SMALL: It very well may have...

ZAHN: (UNINTELLIGIBLE) Alzheimer's becoming more active?

SMALL: It very well may have contributed. We know from many studies that if somebody hits their head and they lose consciousness for an hour or more, they will double their risk for Alzheimer's disease. Genetics are important as well. For example, if you have a genetic risk for Alzheimer's in your head, that might increase your risk tenfold. But for the average person, the risk for Alzheimer's, only one-third of that risk comes from genetics, what you inherit from your parents. That means that two-thirds has to do with non-genetic factors and lifestyle choices are tremendously important.

ZAHN: A final thought on a number of published reports that are suggesting that the Reagan family took great comfort in believing that the president actually might have recognized Mrs. Reagan before he took his last breath. Is that possible?

SMALL: It's certainly possible. We often see that even at the end stage of the disease, there can be moments where there is, at least, a sense of recognition. The brain is a very complicated organ. What happens in the disease is that the neurons or the brain cells are misfiring and not communicating well. But there can be moments where at least there is that sense that there is recognition and the person is there.

ZAHN: Dr. Small, thank you.

(END VIDEOTAPE)

GUPTA: When HOUSE CALL continues, we'll talk with a man living with Alzheimer's, plus, take a firsthand look at caring for a loved one with this debilitating disease. Stay with us.

(BEGIN VIDEO CLIP, "THE BOD SQUAD")

GUPTA (voice-over): It only takes as few simple items, a stability ball, rubber tubing, a few mats, and you get yourself a home gym. Personal trainer, Sabrina Newton, says resist the urge to buy expensive machines.

SABRINA NEWTON, PERSONAL TRAINER: Go about the most inexpensive way first.

GUPTA: Start off purchasing a stability ball for crunches and lower body work.

NEWTON: Basically for resistance.

GUPTA: Rubber tubing also provided resistance and it's good for squats.

NEWTON: It doesn't look like it weighs much, but it does.

GUPTA: Medicine balls work out the upper body.

NEWTON: Stepping, basically, up and off the step.

GUPTA: While a step bench works the legs, and a few small hand weights round out your home gym. The price tag for this home gym around $100. Of course, prior to starting any exercise regimen, pay a visit to your physician.

Dr. Sanjay Gupta, CNN, New York.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. According to the Alzheimer's Association, the majority of people living with this disease live at home and almost 75 percent of care is provided by family and by friends. Holly Firfer has one of their stories.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: There we go.

HOLLY FIRFER, CNN CORRESPONDENT (voice-over): Amy and Mack were high school sweethearts. Sixty-one years ago, they promised to love each other in sickness and health. Amy stood by him as he fought in three wars. Two children and nine grandchildren later, they wrote a book together on how to have a successful marriage. Mack says Amy was his world. Then a diagnosis of Alzheimer's tore that world apart.

UNIDENTIFIED MALE: We traveled five continents, 100 countries and we stay home. We tell people, you know where I live. And I started to set up a routine, because I decided I wanted to be the caregiver. FIRFER: As long as he's able, Mack says he will care for Amy.

UNIDENTIFIED MALE: Now, don't misunderstand me. I kick a chair once in a while and say words that my wife wouldn't like.

FIRFER: Amid his frustrations, Mack learned how to grocery shop and do housework. He makes Amy breakfast and dinner and gives her her medications.

UNIDENTIFIED MALE: Here you go, darling, (UNINTELLIGIBLE).

FIRFER: Healthcare professionals say most caregivers suffer from depression and anxiety. So it's crucial that people who care for Alzheimer's patients care for themselves, too. They suggest joining a support group and some basic tips, like being calm and understanding, patient and flexible, don't argue with the patient, and most importantly, don't take any unusual behavior personally. Mack enrolled Amy in an adult daycare at his church for $30 a day so he gets a break. Right now, Amy's physical demands aren't too tough, but the emotional toll, he says, is the hardest.

UNIDENTIFIED MALE: I miss her as being part of me. I -- see, I believe that marriage, you become one. I try to look at it this way, I'll face, as we get old, eternity together.

FIRFER: Holly Firfer, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: We turn to another man who gives us a unique view of this disease. He's 57-year-old Thomas Debaggio and five years ago he was diagnosed with Alzheimer's disease. Since then, he's written books about his struggle, including one titled, "Losing My Mind." Paula Zahn spoke with him and his wife, Joyce, earlier this week. And she started by reading a poignant quote from his book.

(BEGIN VIDEOTAPE)

ZAHN: I awake in the dark morning without awareness of what day of the week it is. I wait for the newspaper or the radio to locate me in time. The day of the week, the hour of the day has little meaning for me even when I remember. I float in my own chaotic world, grateful to know I am still alive."

Thomas Debaggio joins us from Washington along with his wife, Joyce.

Good to see both of you. Welcome.

THOMAS DEBAGGIO, SUFFERS FROM ALZHEIMER'S: Good morning.

JOYCE DEBAGGIO, WIFE: Nice to be here.

ZAHN: So we are all very moved by that little passage I just read, Thomas. Describe to us what it is like to realize that you're not only losing grasp of distant memories but things as simple as the day of the week?

T. DEBAGGIO: Well, it's something that's kind of hard to explain, because everybody else knows, and sometimes I have to wait. Sometimes I have to wait for something to come, or just kind of -- it's hard to explain this, but it's something that I recognize now. I didn't when it first happened to me. But it's something that -- that's hard to describe, because it's something that I'd never seen before. And...

ZAHN: Of course.

T. DEBAGGIO: ...all of a sudden, there was this thing before me. The way it got started...

ZAHN: Sure.

T. DEBAGGIO: ...I went out to the...

J. DEBAGGIO: Greenhouse.

T. DEBAGGIO: ...greenhouse and all of a sudden I realized I didn't really know what this was. And it was strange to me, because it was -- you know, the day before, it wasn't that way. And it was kind of scary.

ZAHN: Not only scary for you, but scary for Joyce.

T. DEBAGGIO: Of course, yes.

ZAHN: And, Joyce, besides the day-to-day challenge of living with those gaps in memory, you also have to live with the knowledge that so much of the life that you two led together has now been erased from Tom's memory. Joyce, what is that like for you?

J. DEBAGGIO: It's disorienting. And sometimes I get agitated that he's -- he needs me to repeat things, and he was so bright before. And simple things, he needs me to explain to him and that wasn't that way before. And he's gotten to the point now where one of his gravest pleasures, reading, is not really available to him anymore, because he stumbles over words, and it makes it more difficult for him. And he's always anxious and scared, really.

ZAHN: Sure. And it requires patience all the way around in your household. I wanted to share with our audience another piece that Tom wrote, another passage from the book. And this one is particularly blunt. He writes, "At first, I viewed the diagnosis as a death sentence. Tears welled up in my eyes uncontrollably. Spasms of depression grabbed me by the throat. I was nearer to death than anticipated. A few days later, I realized good might come of this. After 40 years of pussyfooting around with words, I finally had a story of hell to tell."

Is it hell, Tom?

T. DEBAGGIO: Yes. It's awful. I -- it's difficult to describe it, because you don't know it. But if you got up one day and didn't know where you were, that would be, sometimes, what happens to me.

J. DEBAGGIO: Or in the middle of the night, he'll wake up and...

T. DEBAGGIO: Yes.

J. DEBAGGIO: ...not know where he is.

ZAHN: And Joyce, one of the things that you learned from family members -- and I just heard this from Maria Shriver, who was in the studio a couple of weeks ago, whose father has Alzheimer's, and she said the hardest part of all of this is learning to accept that a loved one has it. I imagine you've gone through a whole host of emotions. Haven't you?

J. DEBAGGIO: Oh, yes. I've been -- my psychiatrist told me two weeks ago she thought I was in denial still. So -- and in some ways I think denial works, because it keeps you going. I think without denial, I don't think I could make it.

ZAHN: And, Joyce, just a quick final thought on what it has meant to be to be able to read some of what Tom has written that has been so honest and so candid?

J. DEBAGGIO: He's always been that way, and to have it on paper -- he's always been a writer. And I'm just immensely grateful that the drugs he's been taking have -- I'm sure, have helped him. And to be able to read it and to go back and read it again, I'm sure will be very helpful. It will keep me in a way knowing him.

(END VIDEOTAPE)

GUPTA: There's more HOUSE CALL when we come back, including news about the biggest breakthrough in brain cancer in 30 years. Stay tuned.

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

FIRFER: There's new hope for patients with one of the most common and deadly forms of brain cancer. Studies show that giving patients with glioblastoma low doses of the chemotherapy drug, Temodar before and after radiation doubles the chance of survival for at least two years.

Traditionally, radiation and surgery have been first line treatments for glioblastoma. But the disease usually kills within a year or less. Experts say the study released at the annual meeting of the American Society of Clinical Oncology is the first positive news in brain cancer in 30 years and predict the new results will change the standard of care for patients.

In other news, a new study says teens who watch too much TV are more likely to develop sleeping problems as young adults. The study published in the archives of pediatrics and adolescent medicine found that adolescents who watch three or more hours of television a day were at a significantly elevated risk for sleep problems by early adulthood. Sleeping habits improved when viewing time was cut to an hour or less per day by age 16.

Holly Firfer, CNN.

(END VIDEOTAPE)

GUPTA: To find out more about Alzheimer's disease, go to www.alz.org. There you're going to find information ranging from risk factors to treatments to the latest research. And if you're a caregiver, try calling their help line. That's at 1-800-272-3900. Someone's available 24 hours a day to help you find the resources you need.

Well, we're out of time for today. Tune in next week when we're going to be talking about men's health, everything from low testosterone to some surprising health issues like breast cancer. Make sure to e-mail us your questions at Housecall@cnn.com. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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