When Kenneth Hardy enrolled in a clinical trial of a new drug to combat Alzheimer's disease, he answered 23 questions correctly in a memory test that had 30 questions.
Now, nearly three months later, his score is 29."It's considered perfect. Everyone misses one," explained Dr. Jim Ferguson, president of Pharmacology Research Corp.
"Yes, this gives us great hope," said Hardy, a retired building contractor who seems to be coping remarkably well with Alzheimer's, a debilitating and ultimately deadly disease that kills brain cells.
"There is hope on the horizon, and he has done well," said his wife, Betty, 72.
In fact, Hardy still takes on occasional jobs, like a recent one in which he erected a handrailing. He also regularly sets up chairs and loudspeakers for meetings at a local residential care center.
The center can depress him, because there he can see people whose vitality has been robbed by Alzheimer's. To make the situation even grimmer, the disorder is known to sometimes have a genetic component - and the disease took the lives of three of his close family members.
Still, said Betty Hardy, the couple feel "very upbeat" about the situation.
According to Danielle Post, a research-coordinator at Pharmacology Research, Hardy has always been among the better-functioning of people with the disorder.
That's just how the doctors would like to keep Hardy and others like him. And if new treatments - such as the latest crop of experimental drugs - prove useful, early diagnosis might help a patient stay healthy for years.
Four experimental drugs are presently under clinical trial in Utah, and two will be added in the fall, said Ferguson, a psychiatrist who heads a team of three physicians and two psychologists. Pharmacology Research is carrying out the only tests of Alzheimer's drugs in Utah, he said.
Ferguson is not yet at liberty to publicize the name of the drug that Hardy takes every morning. But he says the medicine is similar to, but possibly better than, Cognex. That is the only Alzheimer's drug on the market today; available through prescription, it was approved by the U.S. Food and Drug Administration last summer.
Cognex has shown some success in treating Alzheimer's disease, though it may pose some difficulties; for example, it is slightly toxic to the liver.
The problem with Alzheimer's, said Ferguson, is that nobody knows what causes the disorder. It could be early exposure to toxins; it could be a disease whose effects show up in later years, such as shingles, which strike older people decades after they had chicken pox.
Maybe Alzheimer's is caused by "a virus we don't know about," he said. Without a doubt, genetics plays a role in some cases. But many patients have no family history of the disorder.
Regardless of the cause, the devastating results are all too well-known. The brain loses cells and shrinks, and the patient suffers.
"You're working with dying neurons. You don't know what's killing them, but you know they are dying," Ferguson said.
Researchers studying Alzheimer's disease have two goals: to find ways to make the remaining brain cells work harder, so memory is improved, and to delay the death of any more neurons.
Over the past five years, 250 to 300 people have been included in Utah trials of drugs to combat the disease. That is only a small fraction of people involved in tests internationally.
A new test should enlist 1,200 volunteers nationally by December, many of them in Utah. Altogether, researchers would like to find another 200 people in this state to test drugs.
Those who join the effort get free physicals, CT scans, neurologic tests, complete medical work-ups and all the medication needed for the trial. The test could take several years.
"We like to get copies of all that testing back to that regular doctor," said Ferguson. "Since the drug company's paying for it, we might as well get that information to the patient's physician."
Some participants must come in from distant areas, and the companies will pay their transportation.
Of course, the best benefit of participating in a drug trial might turn out to be damping down the ravages of Alzheimer's.
"Some of the drugs look very promising," Ferguson said. Several may have the potential of prolonging the patient's health for years.
Besides the improvement in quality of life, he said, "if you can keep people at home functioning better for a year or two, you can save the family tremendous amounts of money."
Through his battle with Alzheimer's, Hardy has kept his wry sense of humor. Asked what the point of the study is, he said, "to find out what part of my brain's gone."
Has the drug resulted in any changes in his life? "Well, I haven't noticed it as much as my wife does," he said.
"Oh, he's more relaxed. He hasn't wanted to argue quite as bad," said Betty Hardy.
Before the clinical trial began, she added, he would ask her questions about things that he might have forgotten. Now, he still sometimes asks questions, but there's a difference.
"I have him think about it, and it only takes him a minute," and he comes up with the answer himself, she said.
The differences are apparent to others, too. When Hardy plays cards with his sister and his wife, "Every time she (his sister) goofs, she says, `Hey, can you get me in that program?"' he said.
Betty Hardy said he seems to be playing cards better too. The three play partly to keep him alert, she said.
"I thought it was to take my money," he said.
Alzheimer's disease: How it affects the brain
Alzheimer's disease causes the brain to shrink. Ventricles and sulci (furrows of the brain) widen and fill with fluid.