Is it dementia, or just aging?

Ronald Reisner was a respected physician, a professor and chief of dermatology at UCLA who at 73 was still going strong in a career he loved. But secretly, he suspected something was amiss. He had always been one of the smartest, most hard-charging among his contemporaries. “But in some part of me, I knew I was not at the top of my game,” he says.

“It wasn’t that I was making mistakes or couldn’t stand up and talk for an hour,” he adds. “But I think somehow I knew that things that used to take 10% of my energy to master now took me 20%.”

His wife of 37 years noticed her husband’s facility for multitasking had slipped a bit, but thought the distractions of a surgery he’d undergone and a new home were probably to blame. At work, Reisner says, “no one ever said anything.”

Reisner’s mother had developed dementia in her late 60s, but Reisner had always assumed that -- given his intensity -- his health trajectory would more likely mimic that of his father, who died at age 42 after four heart attacks.

Instead, at 73, he was strong and healthy, but concerned about his memory. A neurologist ordered a preliminary test of mental function and found him fit. But a year later, he was diagnosed with mild cognitive impairment, and soon after, with Alzheimer’s disease.

Extremely articulate and active in the Alzheimer’s Assn.’s California Southland chapter, Reisner today finds his problems with forgetfulness the most troublesome of his Alzheimer’s symptoms. He takes medication that he believes has helped slow his decline, and uses a small dictating machine and notepad to scribble notes that help him stay on track throughout the day.

But he still finds it frustrating to go upstairs for something and find he has forgotten what he went for. Without a note to remind him, the memory of his intended mission will not come back. And after a lifetime of keeping control over his emotions, Reisner says he has, several times, let himself scream and rage at his fate. “It’s very important for me to get those feelings out.”

Reisner says that knowing his diagnosis early on is the only way he would want it. Knowing what to expect, he has found new pleasures in a life now lived much more in the moment.

“I was always very goal-oriented, did not take much time to stop and smell the roses,” he says. Now he enjoys his garden and has come to appreciate his wife’s strength in the face of his cognitive changes. “Together, we’ve laughed and cried a lot,” he says. “I could cry and know that was not going to destroy her.”

-- Melissa Healy