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An attribute tom valenta once admired in his wife was the methodical way she went about things. "Say we were setting up a piece of kitchen equipment," he says. "She'd have read the instructions and made it work while I was still scratching my head trying to figure out step one." In her 30s, with the couple's three children all at school, Marie Valenta went to university to study primary school teaching, finishing each year in the top 1% of her class. More recently, she learned bookkeeping to make herself useful in the family's public relations business. She was clever? "Marie's a great believer in Edison's line that genius is 99% perspiration," says Valenta. "She was a super-organized person." Which is why he was quick to notice when she began behaving oddly a few years ago - leaving the front door open when she left the house, "vagueing out" during conversation, struggling with basic instructions. In January last year, at the age of 54, she was diagnosed with Alzheimer's disease, which doctors predict will end her life within six years unless there's a breakthrough in treatment.

It's only her relatively young age that makes Marie's case unusual: she's one of 170,000 Australians with dementia, of which Alzheimer's is the most common type. The incidence of dementia is set to soar in wealthy countries as their populations age. The number of Australians 65 and over is projected to more than double, to 5.7 million, by 2041. Within 20 years, over-85s - of whom roughly a quarter have dementia - are expected to comprise 2% of the population, twice the present figure. But the problem isn't simply that there'll be more oldies. A recent report by British researchers suggests that, compared to 30 years ago, brain diseases such as Alzheimer's strike a higher proportion of people in developed countries, a trend attributed to worsening pollution and greater exposure to harmful chemicals.

Australian authorities are counterattacking. A team of health experts, assembled by the national advocacy group Alzheimer's Australia and spearheaded by American dementia expert Zaven Khachaturian, will on Sept. 20 in Sydney present a "Vision Statement" that argues "there is no time to lose" and outlines a four-point plan for delaying the onset of dementia. If that goal sounds modest, there's cause to hope for more. "This is the best of times for Alzheimer's research," says group member Colin Masters, professor of pathology at the University of Melbourne, who says drugs that could stop or reverse the disease may not be far off. Alzheimer's inexorably strips people of their memory, personality and eventually all cognitive function. Characterized by the spread of sticky plaques and clumps of tangled fiber that disrupt communication between brain cells, Alzheimer's typically kills within 5 to 10 years of onset. Partly because the majority of patients spend the last stages of the illness in government-subsidized aged-care homes, Alzheimer's is extremely costly: an Access Economics report, also to be released next week, estimates that in 2004 the disease will drain more than $A3 billion from the public purse. The thrust of the report is that any measures that can delay the onset of dementia by a few years - or at least delay the need for institutionalized care - will save billions of dollars over coming decades. The expert group wants the Australian government to fund a dementia research program that tackles the disease from all angles, including drug development. Like remedies for colds and 'flu, the four drugs being marketed for the treatment of Alzheimer's do no more than ameliorate the symptoms. Researchers like Melbourne University's Masters are involved in developing drugs that they hope will break down the plaques and tangles in patients' brains. "We've learned in the last five years that there's a handful of major therapeutic targets - enzymes that make the protein that accumulates in the brain - that if addressed properly might have a major effect on the disease," says Masters, a director of Melbourne biotech firm Prana, whose Alzheimer's drug, clioquinol, showed encouraging results last year in a small-scale human trial. "The best-case scenario" for clioquinol and other similar drugs being developed elsewhere, says Masters, "is that they could stop the disease in its tracks." Then, perhaps, the body's repair mechanism would kick in and clean up some of the damage.

Through a public awareness campaign, the group wants to ram home the message that some people may be able to reduce their risk of dementia. Researchers believe vascular disease increases vulnerability not only to vascular dementia - the second most common type of dementia - but also to Alzheimer's, presumably because it decreases blood flow to the brain. Doctors want word to spread that things known to be good for the heart - eating well, not smoking, exercising regularly - may also give some protection from dementia. As for the value of mental exercise, the jury is still out.

Masters says there's no evidence from "solid" trials that doing crosswords and the like does a spot of good. Alzheimer's Australia leans toward a different position: "Mental stimulation," says national executive director Glenn Rees, "may do some good and certainly does no harm."

The expert group also wants to stress the importance of early diagnosis. Prompt clinical intervention can delay the need for institutionalization and give families extra time to plan for that stage. The same logic applies to the group's final point: the need for better care of people with Alzheimer's, and more support for the family members who look after them.

In that area things are moving. On the second Monday of every month, Bob Clarke lunches with up to 14 other men at the Southern Cross Yacht Club on the shores of Canberra's Lake Burley Griffin. Mostly in their 60s, they form one of Australia's few all-male Alzheimer's support groups - the husbands of women in various stages of decline. "You can talk or you can listen, but I'm sure the lunches help," says Clarke, whose wife, Bonnie, 74, was diagnosed in the early 1990s and entered a nursing home two years ago after Clarke had a heart attack. Those who know describe caring for a loved one with Alzheimer's as one of the most exhausting and distressing jobs, and say governments must do more to help those who take it on. Citing international research, a soon-to-be-released Alzheimer's Australia paper says "psychosocial interventions for carers have been shown to delay . . . the person with dementia's admission to a nursing home."

Tom Valenta wants to keep his wife at home "for as long as humanly possible." His feeling is that clioquinol is still three or four years away from the market (others say it could be much longer) - too late to help Marie. So he's trying to enroll her in the drug's next trial. Since there's evidence that Alzheimer's runs in families, it's also with thoughts of his children that Valenta longs for speedy progress toward preventing and treating this awful disease.

• Daniel Williams
• Doctors exlpore new tactics in the fight against Alzheimer's