I got the deluxe edition running with vista, and I can fly around with the speed patch, but I can't do anything with the ALT key. I just hear Vista dinging in the background. I've tried running as admin but it hasn't helped.
You could downgrade the windows edition to the dos edition and run it in dosbox. I've gotten that working pretty decently before. (it's how I run it on linux) sounds like windows wants to grab that key from the game. Dosbox might let you take control of it.
Mine always freezes with the windows version... even to the point of actually locking up Vista and XP. In dosbox the fix was basically downgrading what I picked for a sound card. It would freeze with anything higher than Soundblaster 16, and general midi was out of the question, even though theoretically dosbox *should* be able to handle that.