Sometimes a reader's letter is like a punch in the face. I've received one from a 59-year old Bradford schoolteacher who has just been given the diagnosis of Alzheimer's disease.

She had recently been getting forgetful and finding it difficult to control her class, and went to her doctor for what she had thought to be a minor problem. Devastated by the news she has early Alzheimer's, she wants to understand her illness - as she writes "while I can" - and how to face the future.

So I'm directing this whole column to your letter, Miss G. And I hope it helps. I will try not to be entirely pessimistic. In the last few years a new optimism has arisen among researchers, as knowledge of the origins of dementia has grown, and new ideas on drugs to treat it and even reverse its progress are about to be brought to fruition.

It is probably no real comfort that you are not alone. Today there are 700,000 people in the United Kingdom with dementia. It affects one in 20 people over 60 and one in five people over 80. These figures mean that there is huge pressure on keeping people at home for as long as possible (there will never be enough nursing home or hospital beds). Britain is organising itself to do just that, with much better systems being planned for home care. But you must recognise early on that you will need help. Dementia is usually a slow process, so that you can probably look forward to many years in a similar state of physical and mental health to the one you enjoy now.

Today's anti-Alzheimer's drugs aim to prolong this early phase, so that you should not notice much deterioration and may even see some improvement over the next few years.

Alzheimer's disease is a primary disorder of brain nerve cells. Many of the chemical and physical changes that it causes in the brain are now known, and the newer drugs are designed to reverse or at least stabilise them. So your doctor will surely prescribe one of them, after ruling out illnesses mimicking dementia in a woman of your age, such as low thyroid function or depression, which can be easily reversed.

To begin with, what you are most likely to notice are forgetfulness and absent-mindedness, tiredness, difficulty in recalling familiar words and in learning new skills.

You may have to prepare for the years ahead, when things aren't so good. In the middle years of dementia, you may become irritable, find you are losing your logical abilities, be restless and aggressive, and even become suspicious of your nearest and dearest. That's when you may have to accept mood-altering drugs, to help you feel a little less anxious and/or depressed. This is the time when you will be more of a burden to your carers, and relatives and friends are not enough. They will need a break from constantly looking after you, and that can be provided by professional carers.

This is where the health services, societies and voluntary organisations come into their own. Your GP will want to organise care in the home. GPs and social welfare services are now combining their efforts for dementia sufferers and their carers, with day centres, respite services and sheltered housing. The Alzheimer's Disease Society, which it is essential to join, provides information and helps organise services for carers and for early Alzheimer's sufferers like yourself. Phone their Helpline at 0845 300 0336 for more information.

Among other organisations that can help are Age Concern, Crossroads Care, the Carers National Association, Cruse - Bereavement Care, the Disabled Living Foundation, Elderly Accommodation Counsel, MIND, the National Association of Citizens Advice Bureaux, and the Registered Nursing Home Association.

Converted for the new archive on 30 June 2000. Some images and formatting may have been lost in the conversion.