NEW YORK (AP) — The words "musical" and "Alzheimer's disease" aren't often used together. Yet Sara Cooper's new work, "The Memory Show," turns out to be a poignant, sophisticated and often humorous musical about dealing with Alzheimer's disease.

Cooper has written an emotionally layered story about the frustrating effects of the disease on both patient and caregiver, which opened Tuesday night off-Broadway, in a well-done Transport Group production at the Duke on 42nd Street.

Joe Calarco's direction keeps the two actors moving naturally around the stage, and helps the audience figure out what year the Alzheimer's patient may think it is. Calarco also connects the audience to the dark humor that Cooper finds even in despairing moments.

The book and lyrics by Cooper are enveloped in moodily dissonant music by Zach Redler that reflects the mental confusion of dementia. That dissonance, combined with the way the lyrics are often spoken rather than sung, also mirrors how frequently upset the pair of characters can become with each other. Vadim Feichtner, who conducts a trio of musicians while playing the piano, provides subtle and effective musical direction.

The patient known only as Mother, (a brave performance by Catherine Cox) opens with a comical number about how annoying doctors can be, constantly asking her who the president is. Then Daughter (Leslie Kritzer) lists the contents of her suitcase for the audience — mostly clothing — but concludes with, "and a sense of impending doom." At age 31, she's put her life on hold to move back home to care for her mother, and soon they're arguing about who's made the greater sacrifice.

The characters are contentious, and both try to persuade the audience to take their side, when they're not arguing and getting on each other's nerves in the way that only family can. Cox is slightly manic as Mother, who knows she's forgetting things and often confused, but attributes it to "a calcium deficiency." Yet Cox wears a hint of melancholy behind her gleeful smile, creating a complex portrayal of a woman who's always been emotionally "difficult" and now finds her past disappearing during a very confusing present.

Kritzer is grounded and wry as the Daughter who patiently — at first — navigates the difficulties of caring for her confused yet combative mother. Kritzer becomes more openly irritable as her character wearies of her mother's impaired thought processes and prickly barbs.

Aside from a humorous but unnecessary number that Kritzer sings to the toilet she's cleaning, Cooper is strikingly accurate and sensitive in her depiction of words and actions that will be familiar to anyone who's seen the effects of Alzheimer's disease in a friend or relative. In the affecting song, "Memory Like an Elephant,"Cox sings "I can't remember half the things I know I used to know." At another time, Mother says reflectively, "It's full of emptiness, this place."

Brian Prather's scenic design and Chris Lee's lighting work harmoniously, especially when family photos lining a hallway light up, then fade away like Mother's disappearing memories. In the metaphor-laden number "Apple and Tree," Cooper provides a wrenching examination of how even a loving mother and daughter can remain embattled, with lines like, "The closer two are/The more unforgiving/So we fight and we spar/That's the cost of living."

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Online: http://transportgroup.org