Alzheimer's In The Family

Anne Nagel seems determined to greet every last one of her guests personally. "I'm so happy to see you! I'm so glad you could make it," she says, flashing her infectious smile over and over. Some five dozen family members--brothers, sisters, children, nieces, nephews, grandchildren--have crowded into Maguire's, an old-fashioned wood-paneled Irish bar and restaurant in the Bayside section of Queens, N.Y., festooned on this chilly, bright November Saturday with pink and purple balloons for her 90th-birthday party.

To an outsider, Anne appears perfectly normal. She is impeccably dressed, her white hair is immaculate, and she wears a corsage of pink baby roses on her lapel. She engages in conversation, cracks jokes and seems thrilled to be surrounded by so many loved ones. But talk to her daughter Barbara Reiter, and it's clear that Anne isn't normal at all. She insists that she didn't know about the party, even though, Barbara says, "I told her about it every day for at least a week." Barbara got her mother dressed that morning and took her to the beauty parlor as well. "I could have taken her Friday," says Barbara, "but she has a tendency to put Vaseline in her hair."

Anne Nagel, ne Weiss, is almost certainly in the early stages of Alzheimer's disease ("almost," because a definitive diagnosis can be made only after death). The disease probably also afflicts her sister Helen, 88, and her brother David, 94. Her brother Nathan and sister Sylvia, both now dead, also had Alzheimer's. That's half the 10 Weiss siblings suffering the memory loss and cognitive impairment of this terrifying disease.

Why are the Weisses so vulnerable to Alzheimer's? One reason is that they tend to live long lives; advanced age is a major risk factor for late-onset Alzheimer's. But scientists are convinced that defective genes are also involved. Four have already been located--one known as ApoE has been linked to late-onset Alzheimer's--and last week several new mutations on a gene associated with the much rarer early-onset Alzheimer's were tentatively identified, but it's clear that there are more genes to be found. That's why the National Institute on Aging (NIA) began last fall to recruit families with multiple Alzheimer's victims, scanning their DNA to see how the genes of the healthy differ from those of the sick.

The Weisses are one such family, which is why Brenda Goldfine, 64, Helen's daughter and Anne's niece, was in Dr. Richard Mayeux's office two weeks ago. The Columbia University neurologist, executive coordinator of the NIA's Alzheimer's Disease Genetics Initiative, quizzed her about her family history. Then he asked whether she had noticed any problems with memory. "I'm not the girl I used to be, that's for certain," she said. "It isn't terrible, but I think I make more mistakes than I used to." She got the day and month wrong when Mayeux asked, but she passed the rest of the cognition and memory tests "with flying colors," he says. "She did spectacularly well."