First, my thanks to Walter and Peggy Kline for their courage and willingness to share the pain and joy of their journey. Their experience will help open hearts and minds to the formidable challenges Alzheimer's disease poses to individuals and families, and siren the urgent need for society to address its staggering social and financial consequences.

Family caregivers deserve the utmost attention in waging this battle. They are the ones who largely determine when nursing home care is needed, due either to exhaustion of their physical, emotional, or financial resources, or need for ensuring the affected individual's safety. We also need to educate community physicians about early diagnosis, the risks and benefits of FDA-approved treatments and how to care for caregivers. Managing problem behaviors is a huge challenge -- educating caregivers about this will moderate caregiver distress and reduce or delay nursing home placement.

Currently available drug treatments have generally modest and variable effects, but can make a difference when optimized individually and combined with other types of interventions. More effective treatments for Alzheimer's disease will become available only through rigorous placebo-controlled trials of experimental agents.

Daniel Kaufer, M.D.

Chapel Hill

(The writer is president of the Society for Behavioral and Cognitive Neurology and director of the UNC Memory Disorders Program.)

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