Remember, if you've heard this old joke once before, raise one finger, ever so discretely, but that won't stop me. However, if you've read this "three fingers worth," it means that you've read too many outdated editions of Readers Digest-type recycled magazines and/or have spent too much time being bored in the waiting rooms of miserly dentists or doctors, and that too can't stop me. So here goes.

A 96-year-old women ran her bathtub full of water, but just as she was struggling to get into the tub, she shouted, "Was I getting in the tub or out?" Her 94-year-old sister bellows back, "I don't know, I'll come and see." She stops halfway up the stairs, and shouts, "Was I going up or coming down?" Their 92-year-old sister booms from the kitchen table, "I sure hope I never get that forgetful," and knocks on wood for luck. Then she yells, "I'll come up and help both of you as soon as I see who's at the door."

I've summarized that particular version from an old Reader's Digest joke page to illustrate "normal" forgetfulness at age 90-plus, and to make what I did this past Friday at Wal Mart seem a bit more normal for me, a seventy-year-old. The lady at Wal Mart's register nine is an extremely efficient and friendly veteran cashier- trainer, and a speedy cashier herself. She had asked me about a relative, with whom she usually sees me, and I just stood there socializing with her, without placing a single item on the checkout conveyer belt. She looked at me, smiled, and then looked knowingly at my cart full of groceries, as if to say, "Well, wouldn't you like to start emptying your cart, so that we can get on with?" We both had a little nervous laugh, and then I worried to myself, "Well, now it starts, my decline into dementia."

I've been researching "Dementia and Alzheimer's Disease" in hopes of writing an informative column about Alzheimer's disease. And, like the well-known anxiety reaction of many second year medical students, I get to thinking that I have all the symptoms of any disease that I earnestly research.

I've been studying abstracts, complete articles, and my old "psyche" textbooks for information on the mental health problems of the elderly (me?) I've also been a fairly regular visitor to www.alz.org, and my computer desk overflows with printouts and references. By the way, the "Alzheimer's Association International Conference on Prevention of Dementia" will be held in Washington, D.C., June 18-21, so I've reasoned that there won't be a better time than today to write about what I've learned these past weeks.

Dementia means: "A cognitive disorder, characterized by impaired memory, language, thinking, and perception." Cognitive means: "The mental processes of thinking, understanding, perceiving, judging, remembering, and reasoning, in contrast to emotional processes."

About 15 out of a hundred of us older folks lose previous mental capabilities and develop an organic (physical brain tissue) brain disorder called dementia. Of that 15 percent of seasoned citizens with dementia, 60 percent (of those already diagnosed with dementia) will suffer from a particular type of dementia called Alzheimer's disease, a progressive deterioration of brain cells and mental capacity. It's important to remember that Alzheimer's patients (even though current publicity is high) make up only a small part of the total sufferers of "dementia in the elderly." And for that reason, it is often misdiagnosed until it reaches its middle stages. About 20 percent of all Alzheimer's patients have vascular dementia, which means the person suffers a series of small strokes that damage or destroy tissue in the affected areas of the brain. Parkinson's disease (a slowly progressive disease of the central nervous system, characterized by tremor at rest, and the third most common neurological disease, affecting about 500,000 persons in our country) can also cause dementia in us older folks. But our subject today is Alzheimer's.

Alzheimer's can rob people just like us, and our friends and neighbors, of their memories, their intellects, their personalities, and eventually their lives. The illness progresses slowly, stealing bits of a person's mind and memory a little at a time. Individuals who realize that "something is going wrong" may make initial efforts to cope by establishing a rigid schedule for daily life and avoiding any changes in that schedule. As the disease progresses, those who have periods of awareness of their condition can become upset and depressed. In time, these lucid periods become less frequent, memory is severely impaired, and eventually the ability to recall words or form sentences is lost. Personalities of Alzheimer's patients, and patients with all forms of severe dementia, not just Alzheimer's, change. Victims of the disease may withdraw into a world of their own, become quarrelsome or irritable, and say or do inappropriate things. Some may become stubborn or impulsive, and others may become apathetic. Alzheimer's and sufferers of other types of dementia may become increasingly suspicious, and may accuse others of thefts, betrayal, or plotting against them. As their impairment worsens, inhibitions worsen, and some may become aggressive or violent. Sadly, dementia sufferers may eventually forget the names of their close friends and relatives, their former jobs or occupations, even their own names. They may wander away from home and get lost. Caregivers must be extraordinary in order to help their loved ones. They must be patient, and they must understand that the behavior of their loved ones will often appear to them as stubborn and full of ill will, but those are simply symptoms of the victim's terrible ordeal. Doctors can prescribe medications to help moderate the worst behavioral symptoms of their loved ones, but there is no cure, and there is nothing that the families or their doctors could have done to have prevented the heartbreaking disease of Alzheimer's.

Finally, let me recommend "Dr. Koop's Self-Care Advisor," Time-Life's Health Publishing Group, January 1996, pages 50-53, for a layman's concise overview of Alzheimer's, along with its commendable list of sources for support. The friendly and helpful staff of our Dunklin County Library and its branches can also help you find more information about Alzheimer's disease.

Kenneth Kinchen is an independent writer with a background in international business and foreign service contracting.