mother's friends. No one had noticed anything unusual leading up to the surgery. Within 24 hours she was fine, and though I worried about it, I chalked it up to trouble clearing the anesthesia.

All seemed well over the next six months. We visited monthly when I flew north to work and we enjoyed our lunches and browsing the floral and craft stores.

I first noticed she had trouble finding words, which gradually progressed to starting to describe things by their function, rather than calling them by name. Suddenly she seemed "blah" and didn't want to do much. She hadn't had her bathing suit out all season. Her primary care doctor started her on an antidepressant and within weeks she was cheery and more relaxed than she'd been in ages. I was happy that she was happy.

Then one day in December, I couldn't reach her. She didn't believe in answering machines. I knew she was busy, so it wasn't until 9 p.m. that I got really worried. I called her friend Marie to check on her and Marie reported the car was in the driveway, but there were no lights on. Moments later, friends entered the house to hear my mother crying out, "Help me, help me!" She was fully dressed, sitting in the bathtub, uninjured but unable to figure out how to stand up and get out of the tub.

The hospital certified her "fine" and ready to return home. I made frantic calls to her doctor, insisting she be admitted for evaluation. His response to me was, "Is it an old-fashioned tub with high sides?" I told him I thought we were dealing with Alzheimer's disease. He pooh-poohed me, as did her gynecologist and ophthalmologist, but I wouldn't back down. Her admission confirmed my fears. This bookkeeper and spelling bee champion was almost incapable of learning new information. But oh, did she hide it well! When the occupational therapist asked her to make a cup of tea, my mother said, "I don't drink tea." Then she tried saying, "The kettle is broken." Finally she simply huffed off, as if the request were beneath her; never admitting she couldn't make sense of the task.

Life changed dramatically then, but that's a story for another time. I share this very personal memory as my mother's birthday draws near and I recall again the awful slide into Alzheimer's we faced together. The problems with language, the change in mood, the loss of initiative, disorientation, difficulty performing familiar tasks -- all warning signs of Alzheimer's.

Many of us worry when we forget a name, or don't finish a task. Is it Alzheimer's? Not when it's an infrequent event. But when there is a pattern of real change from baseline, and a progression of difficulties, it is time to pay close attention. Treatments today can't cure Alzheimer's, but they can slow the progression of the disease and help keep life fuller, longer. www.alz.org is a great source of information. Be gentle, but be persistent if you think your loved one has a problem. You can make a difference.

Patricia Kincare, M.D., is a board-certified psychiatrist with Woodland Professional Associates of North Hampton. She treats adults who have mood and anxiety disorders and has a special interest in women's reproductive and childbearing issues.