By Rita Watson

August 9, 2011:  Leading physicians at the recent Paris International Conference on Alzheimer’s Disease “offered suggestions, but no definitive answers.”  While physicians talked about prevention, research is ongoing for early detection.  The by-words in Paris were diet, exercise, socialization, and stimulating activities, according to physicians interviewed about prevention.

Dr. James Ellison, Harvard, on evidence to date

Many wonder about the usefulness of recommendations once the disease is manifest: James M. Ellison, M.D., is clinical director of geriatric psychiatry at McLean Hospital in Belmont, Mass., and an associate professor of psychiatry at Harvard Medical School. He told me: “The most authoritative evidence to date suggests that receiving training in cognitive skills such as processing speed, problem solving, and memory can produce persistent improvements in cognitively intact older adults.

“Even in the presence of mild cognitive impairment, training in reasoning and processing speed may have value,” he said.

Dr. Ellison added: “Keep in mind that the activities one chooses to boost memory should be enjoyable and pursed in moderation. Ultimately, I would put more faith in physical activity than cognitive stimulation. It seems to me that the evidence is stronger at this point for exercise and activity than for cognitive stimulation, but I believe both can help.”

Physicians from UC San Francisco and Mayo Clinic

J. Craig Nelson, M.D., is professor in residence and Leon J. Epstein, M.D., Endowed Chair in Geriatric Psychiatry at the University of California, San Francisco.  He tells me: “Puzzles are fine. I’m not sure it’s clear how much they help once one has dementia versus staying sharp before. The other thing I would add is physical exercise. It may be more helpful and have more general cognitive effects than specific mental exercises.”

The Arizona Mayo Clinic’s Joseph I. Sirven, M.D., is professor of neurology and professor and chairman of the department of neurology.  With regard to early dementia, he says: “I always tell patients to exercise, keep active and to learn new things.”

One woman’s determination — Berna Huebner, Hilgos Foundation

Dr. Ellison’s words regarding activities struck a chord when he noted “activities one chooses to boost memory should be enjoyable.”

Can those with dementia make their own choices? Physicians seem to agree that this must be balanced by “perceived” choice as well as “in the best interest of.” And oftentimes even the best of us need a little push.

One woman who was also at the Paris conference took a leap of faith when Alzheimer’s hit home by embracing painting for her mother. In Paris, Berna Huebner, directs the Center for the Study of International Communications, and founded the Chicago-based Hilgos Foundation, which fosters artistic creativity for those with Alzheimer’s and other dementias.  She also serves on the Alzheimer’s Board at the Boston University School of Medicine.

Taking a chance on hope: When everyone at the nursing home was giving up on the worsening dementia of Huebner’s mother, painter Hilda Goldblatt Gorenstein, called “Hilgos,” she was given hope by her mother’s psychiatrist. “He suggested I contact her former art school, the Art Institute of Chicago. When I asked my mother if she would like to paint again, her eyes suddenly sparkled, and she answered, ‘Yes, I remember better when I paint.’ ”

Huebner hired trained art students, brought them into the nursing home, and later created a documentary, “I Remember Better When I Paint – Narrated by Olivia de Havilland .” The film depicted the dramatic way her mother reclaimed some of her identity as an artist and as a person.

When her mother became discouraged at first with painting and balked, Huebner said, “The art student-teacher persisted for three months. Finally, one day, my mother started up again and began creating hundreds of designs.”

Through Huebner’s devotion, and those of the student-teachers — who sometimes had to pick up a brush and put it in the artist’s hand when she resisted — mother and daughter found ways to express love and art.

Copyright 2011 Rita Watson/ All Rights Reserved