Story of early-onset dementia was sad, dramatic - and lucrative.
On the Internet, James W. Smith of Hermantown, Minn., is described as one of the Faces of Alzheimer's.
In interviews, essays and speeches, Smith tells how early-onset dementia derailed his career as an information technology supervisor for American Express Financial Advisors in his mid-40s and left him disabled and facing death just as his twin daughters were setting off to college.
Smith beat the drum from Minnesota to Washington, D.C., raising money and awareness about the devastating toll that Alzheimer's Disease takes on some 5 million Americans and their loved ones.
In the Twin Cities, he led a support group, lobbied the Legislature and spoke at conferences sponsored by the state Alzheimer's Association. KARE-11 TV named him one of its "Health Care Heroes."
As it turns out, though, Smith didn't have dementia at all. He faked it to qualify for disability insurance and will soon be sentenced by U.S. District Judge John Tunheim for defrauding the government.
Prosecutors contend that between 2006 and August 2010, Smith defrauded taxpayers out of $144,293.40. The government also says he collected more than $300,000 from Met Life for disability insurance.
A federal grand jury in Minneapolis indicted Smith in April on one count of theft of government funds, and three counts of concealing information from the Social Security Administration. He pleaded guilty in August to the theft charge.
"It's an amazing case," said Dr. David S. Knopman, a Mayo Clinic neurologist who diagnosed Smith as having Alzheimer's in 2005. "I have some strong feelings about this," he said. He declined to say more, citing patient confidentiality. Smith's attorney declined to comment before the sentencing.
The Star Tribune pieced together Smith's story from court records, interviews with law enforcement, family members and former neighbors, as well as Smith's own writings and videotaped interviews.
In an article posted on the Alzheimer's Reading Room website, Smith wrote that he had been director of information technology for American Express and was up for a promotion in the fall of 2004 when he began noticing memory lapses. He was initially diagnosed with depression, but the symptoms worsened.
Dr. Paul Tuite at the University of Minnesota referred him to the Mayo Clinic in Rochester in November 2005.
According to an affidavit filed by John Dillon, a special agent with the Inspector General's office, Smith went through extensive testing at Mayo. Brain scans were inconclusive and a spinal tap was normal, but memory tests showed impairments.
Smith wrote that he and his wife at the time, Juanita, learned of the diagnosis in December 2005.
"Both of us knew what was left unsaid that day. We had seen my wife's mother succumb to Alzheimer's. It was like watching death in slow motion."
Smith filed a claim on his Met Life disability insurance in January 2006, and he applied for Social Security disability payments three months later. Together, they would pay him about $81,275 a year.
Unencumbered by work, Smith volunteered with the Minnesota-North Dakota Chapter of the Alzheimer's Association and offered insights to the disease. His activism led to an invitation to speak at the 2008 Alzheimer's Public Policy Forum and Candlelight Vigil in Washington, D.C.
"We were looking forward to so many things as a couple, as a family -- and it all shattered in an instant with just five little words -- 'You have probable Alzheimer's Disease,' " Smith told the crowd around the Capitol reflecting pool.
The Alzheimer's Association declined to comment, noting that Smith had been a client.
Most family members contacted declined to speak about Smith, who grew up in Bloomington as the oldest of six children.
"James can be very vindictive," said a relative who asked not to be identified.
The relative cited Smith's 1999 conviction in Dakota County for pointing a gun at a driver in a road rage incident. He denied having a weapon, but police found two loaded handguns and a shotgun in his trunk and loaded magazines and pistol ammo in the glove box and door pockets. Under a seat were two nightsticks and night vision goggles.
Several family members had doubts about Smith's diagnosis, including his children. Alzheimer's is a degenerative disease, yet his symptoms didn't get worse over time, his relative said.
His mother, Wan Smith, said she finds the situation hard to understand.
"He went to the University of Minnesota for testing. Then he went to the Mayo Clinic," she said. "I just find it hard to believe that a doctor can diagnose him and then, because an agent says something, [the doctor] decides that he's made a mistake. Who's got the medical degree?"
Smith, representing himself, filed for divorce in April 2008. His mother said he told her that a financial adviser suggested divorce to protect his family's finances as his health declined.
In June, he bought an 80-acre hobby farm in Floodwood, Minn. He closed his bank and retirement accounts, sticking his ex-wife with the house payments and their daughters' college bills, his relative said. She earned about $55,000 a year at the time as a massage therapist, according to divorce records.
It's unclear what prompted the investigation.
The Inspector General's office told Knopman, the Mayo neurologist, that Smith adroitly handled the farm purchase. Smith's neighbors -- including the town's police chief -- reported that he showed no signs of dementia. Knopman concluded that Smith's "cognitive functioning level is incompatible with the prior diagnosis," Dillon wrote.
Ajit K. Das, a retired psychology professor in Duluth, reevaluated Smith in November 2009. His report to Social Security said that Smith was living with a girlfriend, didn't drive, and didn't go anywhere alone. He was unshaven, struggled with simple questions and spoke haltingly, Das wrote.
But in two undercover visits in 2010, Dillon found Smith articulate and sociable. He said Smith told him that the farm was just what he was looking for: "a place at the end of a dead-end road."
Smith said he had security cameras on his property and talked in detail about farm machinery, area real estate, setting up Internet access and Skype video conferences with his daughters, Dillon said.
Asked in general if it's easy to fake dementia, Knopman said, "Let's just say it's extremely uncommon. And it's difficult, but it can be done."
The most celebrated case of phony dementia involved Vincent "The Chin" Gigante, a New York mafia boss who strolled around Greenwich Village in his bathrobe babbling nonsense. He was found incompetent to stand trial until federal investigators caught him on wiretaps speaking coherently, which led to his conviction on racketeering charges in 1973.
While Smith admitted to the theft, in the plea agreement he maintains that he believed he had the disease from 2006 until February 2008. That's when he claims he realized that he did not have Alzheimer's, yet continued the ruse to keep receiving $6,773 a month in disability payments.
The distinction could affect the length of his prison term. Tunheim will resolve the question at a yet-to-be-scheduled sentencing hearing.
Dan Browning • 612-673-4493