Q. My mom is senile and it's getting worse. What's good for memory?

A. Alzheimer's disease is the most common cause, leading to memory loss, poor judgment, and inability to do tasks like shopping and bathing. The brain is like a damaged circuit board; sometimes the circuits connect, sometimes they don't. So it's not true that your mom could remember if she "really tried."

Personality changes like aggression and suspiciousness can occur. These can sometimes be caused by various drugs, or from sensory overload such as music during conversation or too many people around.

Try to determine what was going on just before an outburst. Was there too much noise?

Sometimes simply getting one's vision or hearing corrected will improve behavior. Sudden behavior changes like confusion could be because of a bladder infection, constipation, dehydration or something else, so tell the doctor.

Things like getting dressed or brushing teeth are actually very complex and may be overwhelming. Breaking down a task into smaller steps to be done one at a time may be needed. You may even have to do the first few steps of the task to get your mom started, and eventually may have to do most of the steps yourself.

People have trouble remembering to drive at the right speed, to stop when the lights change, or react quickly in emergencies. They are a danger both to themselves and others and must stop driving.

Call the Alzheimer's Association (591-2771) for hints on getting folks to stop driving, ideas on other issues (such as wandering) and for Alzheimer's support groups. And read "The 36-Hour Day," a wonderful book by Nancy Mace and Peter Rabins.

Drugs may help memory and function a bit, but will not cure Alzheimer's. The reference book "Clinical Evidence" considers donepezil and galantamine the best, though they may cause dizziness or drowsiness. Memantine may also help.

The highly regarded Cochrane Database looked at the most accurate (randomized) studies of Ginkgo biloba, and in April 2007 found that though it seemed safe, that there was no convincing evidence it improved senility or cognitive impairment. Selegiline, a Parkinson's drug, has been touted by some but there is likewise little evidence of benefit.

Lecithin and vitamin E don't work, and vitamin E may even worsen health. In 2002, Dr. David Waters and others studied 423 women with heart disease, putting half of them on 800 IU of vitamin E plus 1,000 mg of vitamin C a day. After four years, 16 of those on vitamins had died compared with six not on vitamins. Beta carotene (Vitamin A) is another antioxidant that does more harm than good. Folks should stop taking extra beta carotene.

Dr. Landis Lum is a family-practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i's John A. Burns School of Medicine. Send questions to Prescriptions, Island Life, The Advertiser, P.O. Box 3110, Honolulu, HI 96802; fax 535-8170; or islandlife@honoluluadvertiser.com. This column is not intended to provide medical advice.

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