Web columnist answers some frequently asked questions about Pick's disease

• A. Pick's disease is a progressive dementia that is relatively rare.
• Pick described the first case as a 71-year-old man who presented with dementia, personality changes and loss of speech.
• At the autopsy, the patient's brain showed unusual shrinkage of the frontal cortex, which is the region involved in reasoning and other higher mental functions.
• The person may develop compulsory behaviors and obsessional overeating, changes in dietary preference, and obsessive cravings for certain types of food --- usually sweet foods.
• Speech problems are common, from a reduction in the patient's quality of speech to the amount of speech.
• In the later stages of the disease, the patient may compulsively put any available object in his/her mouth.
• Q. How is Pick's disease different from Alzheimer's disease?
• A. In contrast to Alzheimer's disease, in which early memory loss predominates, the first symptoms of Pick's disease are often personality change, followed by a decline in function at work and home.
• In the early stages of Pick's disease, the person usually remains aware of time and is able to recognize people and places, unlike the usual presentation of Alzheimer's disease.
• In Alzheimer's disease, spatial and mathematical skills are usually affected early, while in Pick's disease these skills are usually relatively well-preserved until later.
• A. Pick's disease usually presents after age 40 and is less common after age 60.
• A. Pick's disease is difficult to diagnose while the patient is alive, because its symptoms are so variable and they overlap so much with Alzheimer's disease.
• Q. Does anything slow the progression of the disease?
• A. We are not aware, at this time, of anything to slow the progression, but our best defense is to maintain a healthy lifestyle including sufficient sleep, routine exercise, healthy diet and regular check-ups with your physician.