January 22, 2025 • 32 mins
In this episode, Tudor discusses the alarming rise in dementia cases projected to double by 2060, with experts Dr. Joseph Coresh and Dr. Arjun Masurkar. They delve into the statistics surrounding dementia, the impact of lifestyle choices such as diet and alcohol consumption, the role of genetics, and the importance of preventative measures. The discussion also highlights the need for early detection and the evolving landscape of dementia research and treatment, emphasizing the significance of caregiving and support systems for those affected. The Tudor Dixon Podcast is part of the Clay Travis & Buck Sexton Podcast Network. For more visit TudorDixonPodcast.com
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Episode Transcript
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Speaker 1 (00:00):
Welcome to the Tutor Dixon Podcast. Today, we are going
to be talking about a startling new study that was
just released showing the rising risk of dementia. It projects
the number of dementia cases in the US will double
by twenty sixty. I think this is probably a fear
of most Americans, is the idea that you forget who
(00:21):
you are, that you're not capable of functioning. I mean,
we've been watching, you know, people questioning even the leader
of the country right now, and I think mostly because
the idea is just very terrifying to have this happen.
Speaker 2 (00:33):
Now.
Speaker 1 (00:34):
More than one million Americans are predicted to develop this
condition every year. It's estimated that there will be twelve
million Americans living with dementia by twenty sixty. So today
I am joined by one of the leaders of the study,
doctor Joseph Korish, who is the founding director of the
Optimal Aging Institute at New York University's Grossman School of Medicine,
(00:56):
and Argent Mazurker. He is a cognitive neurologist and dementia
specialist and leads a laboratory for early Alzheimer's disease symptoms
at NYU. Thank you both for joining me, Thank you
for having us.
Speaker 3 (01:09):
Yeah.
Speaker 1 (01:09):
Absolutely, So, Like I said, I think that the majority
of Americans hear this, and it's one of those things
that you're scared of all of us. I think everybody
has experienced one grandparent or a parent that has gone
through something like this, and I think it's hard. It's
really hard to be the person watching, and it's very
hard to be the person going through it. I remember
(01:32):
with my own grandparents. My grandfather started to struggle with this,
and for my grandmother it was so challenging to see
that decline. So when we see a study like this,
this is sort of scary. Doctor Korush tell us about
it a little bit.
Speaker 2 (01:47):
Yeah, So we thought it was important to take a
life long respective because, as you say, we all kind
of know that we're in a very long game for this.
So we had the advantage of having a study that
followed fifteen thousand people since nineteen eighties, so for four decades.
We had the advantage that the study really went rigorously
(02:08):
and determining who got dementia, and we can talk about that.
And we asked the question for someone like myself or
someone who starts out at age fifty five over my lifetime,
will I reach dementia before I die? Or will I
die before I reach dementia? Right, only two options if
you go forever. And we found out that the old
(02:28):
estimates were off, and our estimates are that forty two
percent of us will reach dementia before that. Now, before
we all panic, I think it's very important that by
the age of seventy five this number is only four percent,
still a scary four percent, and we can talk about
who's at higher risk. By the age of eighty five,
(02:50):
it goes up to twenty percent, and as you say,
we know quite a few people who get dementia by
that eighty But then the part that's important is when
you go beyond eighty five. When we went to age
ninety five, that's more than half the risk, and that's
when things really pile up. And we can talk about
the idea of what do you do for prevention early,
what do you do for prevention medium, what do you
(03:10):
do for management later? And most people can still stay
at home. As doctor Mzerker, we'll talk about various options
and collaboration.
Speaker 1 (03:18):
When I see fifty five being like that point where
you start to see it that is a few years away,
and that is very scary to me. So what are
the I mean, how do you even know that this
is happening. I think that's another part that's scary to
me is that the person who's experiencing it doesn't always
know what's happening.
Speaker 2 (03:36):
Yeah, So I think there are very good news in
the last decade. Right, So when people thought about dementia,
we still don't know all the causes. And again we
can talk about the different processes, but Alzheimer's dementia degeneration
of brain cells is a big process, and vascular dementia
(03:59):
is another huge process. The good thing is vascular risk
factors are treatable and that component of dementia is reducible. Right, So,
high blood pressure, diabetes is collectivity, no smoking, alcohol, sleep,
those are all among the fourteen factors that the Lancet
(04:20):
Commission has said can reduce the risk of dementia by
fifty percent. And we can talk about the fact that
even if you have hygienetic acceptability, you can still better.
Speaker 1 (04:31):
So it's interesting that you mentioned alcohol. So I'm a
cancer survivor. I was at my six month annual uphoor
or six month appointment a few weeks ago, and at
the appointment, the doctor really laid into like, you can't
have any alcohol, you can't drink it all. It's so important.
And I was sitting there thinking, like, does she think
(04:51):
I'm a total lush? Why does she saying We've never
in ten years, we've never had this conversation. And I
was like, I don't drink. I don't drink it all,
and she was not even but I'm saying, not even
a glass, and I said, I don't drink. Where is
this coming from? Well, then the story was published that
now they're saying that drinking alcohol is linked to cancer,
(05:11):
and I'm hearing, okay, alcohol is linked two dimensia now too.
I mean, how significant of a problem is it? Because
I do think that in the last I would say
my generation coming out of college in the nineties and
early two thousands, there was this really big push for
women to be in this wine culture, and it seems
(05:33):
like that has impacted health in a crazy way that
we really aren't paying attention to.
Speaker 2 (05:39):
Yeah, so I think I'll take a broader perspective and
then dig into the alcohol. I think it's important to
realize we're living a long time, right So if you
talk about a diet or meals alcohol, we have about
one hundred thousand meals to eat, right, And I think
it's important is I have so one meal you aid badly? Well,
(06:01):
you know, you can even smoke forty cigarettes in a
day and you're not gonna get cancer tomorrow. Right, If
you'll smoke forty cigarettes for thirty years, a couple of
people will get away with it, but a lot of
people are gonna have trouble. So I think it's important
to remember it's a marathon. We're all gonna fall down,
and we all should have things that we can enjoy.
(06:21):
I think related to that, I think with the alcohol,
you know, people are too tempted to go strong one
way or the other. Right, So you know, we're just
tempted to give strong answers when sometimes we have weaker answers, right,
And so it depends if you socialize and it helps you.
(06:42):
It's one thing, clearly, there's this thing among you know,
younger people in anxiety where people have bringe drinking and
a lot of drinks at a time. That's a problem.
Risk of injuries is a problem with dementia when you
get to older age and you reserve is smaller. It
could be that one or two drinks will push you
over an edge where you can't compensate. And I see
doctor Mzerker maybe ready to chime in with that, you know,
(07:06):
I think then we want to know if you want
optimal health, which is what we're looking for. We're trying
to develop all the best biomarkers to give you the
very best advice. Right So, I think doctors shouldn't be
pushing you to drink. In fact, now we're pushing you
to not drink. But I have a feeling if your
only vice is a couple of drinks a week, I
(07:27):
think you may have a lot of other things to
worry about. And in terms of dementia, one of the
proven risk factors for dementia is social isolation. Now, I
think we can socialize without alcohol. It's not a problem,
but you know what I mean. But socializlation is bad.
Speaker 1 (07:43):
But it's like I can't focus on those few really
terrible sunburns I had in college for the rest of
my life.
Speaker 2 (07:50):
I think the dwelling and ruminating not a good thing.
Even though we're all victims of some worrying.
Speaker 1 (07:56):
Well, I think this is one of those things though
that you can. I mean, there's now well you can
have genetic testing, if you have relatives who had Alzheimer's,
people are getting that genetic testing. Then what happens once
you find out you have the gene? Then do you
just focus on that? How bad is that for your
health that you are constantly worried, Well, when's it coming?
(08:17):
When's it coming? When's it coming?
Speaker 2 (08:19):
Yeah, So it depends. And I've given a lecture to
the medical students in various places and to the students
of public health about genetics and epidemiology and screening and
april LIKEE protein E is always an example I raised
because we studied it for heart disease, where it's a
weak risk factors, whereas aplite protein E four was discovered
in the eighties to really be a pretty strong risk
(08:41):
factor for dementia. For a long time, I said, well,
we don't screen for it because there's nothing we can do.
It turns out now we've discovered that the vascular risk
factors interconnect with the amyloid deposition in the brain, and
our study and others have shown that people with more
vascular risk factors have even more amyloid deposition. And the
(09:04):
association was even stronger among genetically susceptible people. So in
some sense, your preventive measures could be more powerful if
you're at risk. Now, do you need to know or not?
A good question? Maybe? I mean I'd be interested in
doctor Zerka's opinion about particularly as you get to the
later stages, and how people deal with this. As you said,
(09:26):
they may not know. It's one thing to not know
about your genetic risk. What do you know about your
cognitive function? Do you want to get tested and what
do you do? Yeah?
Speaker 3 (09:35):
Absolutely, I think that.
Speaker 4 (09:36):
I think we're learning more about how to use genetic
testing as the years go by. I mean, right now,
I think it still stands that the genetic information like
an FOE test, can give some sense about general risk,
but it's not an absolute it's not that kind of gene.
That being said, there are ways that a person who's
(09:59):
concerned about their memory can more concretely assess their risk
by getting an evaluation by a geriatrician or neurologists, or
even talking to their primary doctor first. You know, a
lot of the memory concerns that are out there, if
they're not very consistent, if they're not affecting daily life,
it might just be part of what we call normal aging.
(10:21):
And I think that if you want to know if
it's more than normal aging, you might need some more
formal diagnostics in the form of what we call neuropsychological testing,
quantifying someone's memory and cognitive functions, doing some brain imaging
like an MRI, and doing some blood work to look
for maybe non neurological causes of memory loss.
Speaker 1 (10:46):
Interesting. So, if you are in this situation where you
start to see this decline, I mean, we're seeing that
one in three older Americans dies from Alzheimer's or dementia,
Obviously people are fearing that how are you dying? Are
you dying with it? Are you dying from it?
Speaker 2 (11:05):
I think, you know, back to the numbers. I think
you know, often when you develop a disease and you're ninety,
it's hard to know all the causes of it, right,
And at that point the number of years, which will
be one of our future topics, is an important topic, right,
So I think it's important to think about this opportunity
(11:27):
for prevention. And I think the other thing, you know
that I'm a big believer on avoiding the social isolation,
engaging other people, taking charge of your own health and
accepting that. I think we should try for the best health.
But we're gonna have setbacks, and there are ways to
work with them and have lots of meaningful things. As
(11:49):
you mentioned, right, you've had cancer, I wouldn't know. Seems
like you're doing great, which is wonderful. Congratulations, the same
things with a lot of things. So if somebody has
some limitations at older age, working together with their family members,
working together with their physicians, a lot can be done.
Speaker 1 (12:07):
So what is it that we should be doing. I
think we, especially in this country, we're very hot on
the quick fix. Just give me something that's going to
make all of these things happen. But I heard you
talk about exercise and diet, and those are things that
I think oftentimes feel like I don't really know what
that means, so I'm going to focus on something else.
(12:28):
I mean, exercise is pretty obvious. Diet is a challenge
in this country. I mean, just we're just seeing that now.
The FDA is saying that we can't have red food die.
I think it's red number four or three that they've
just eliminated. And people are talking about making America healthy
and all these things that we have in our food
that Europeans don't have in their food, and is this
(12:52):
contributing to that the health record that we see in
the United States as compared to other countries. So when
you talk about diet, it's it seems kind of like
an enigma. Nobody really knows what that means. How do
we break that down for people?
Speaker 2 (13:05):
Yeah, I think you know, we can each say something.
I would keep my eye on the big things right
in that exactly what we eat. It would be great
if we could figure it out. But for one hundred
thousand meals, maybe we don't even want a prescription for
every meal. But the biggest problem people have is too
many calories, right, too many calories and you know when
(13:26):
they add up because there's a scale and you know,
you step on it and you see what happens. The
good thing is if you lose even five pounds, it
reduces your risk of diabetes dramatically, right, really, and yes,
it turns out losing is better than gaining more powerful
for diabetes and connected to dementia. We've shown that diabetes
(13:48):
before the age of sixty five is a powerful risk factor.
And if you prevent it all together or delay it
on set at a later age is a much much
weaker risk factor for demension. So for diet, I'd watch
galleries and I'd watch total fruits and vegetables. The more
fruits and vegetables, the less you can eat other stuff.
Speaker 1 (14:07):
Let's take a quick commercial break. We'll continue next on
the Tutor Dixon podcast. So we see a lot of
people today taking drugs like ozebic or we go v
these drugs that are were for I guess, for diabetes.
Now people are finding out that maybe they prevent diabetes
(14:29):
by losing the weight. They take these drugs and they
lose the weight. Is that a sustainable way to take
care of your health.
Speaker 2 (14:36):
I'll start and have doctor Zerker continue. I'm in public health.
Ideally we should take care of things with behaviors, and
I think the good thing is we should study that,
we should know about it. But we're in medicine because
people aren't perfect. So when you fall, we don't just
blame you. We look for solutions. And in the US
we have incredible medications, an incredible healthcare system for people
(14:59):
who can act access it. And for high cholesterol, we
have wonderful drugs and statins for high blood pressure. We
have a range of wonderful drugs that are cheap and
very effective, and controlling blood pressure is one of the
best ways to prolong life, prevent dimension, and prevent stroke.
And obesity is an underlying cause for so much of
it that if it takes a pill, it turns out
(15:22):
science has now given us pills that seem to be
good for us. For decades, we only had weight loss
pills that were bad for us. Now they seem to
be protecting the weight, the diabetes, the kidneys, the heart,
and we're going to study them for the brain. So
the answer is still out as to whether it's a
huge benefit, but it's clearly a huge benefit for many
(15:44):
for many things. What will happen over decades, I don't know, what.
Speaker 3 (15:47):
Do you think.
Speaker 4 (15:48):
I think that there are certain people who are, you know,
really struggling with their weight, struggling with their diabetes that
are going to really benefit medications, you know, like ozempic
et cetera. I just don't think that you know that
it can for the average person or someone who's slightly overweight,
whether diet and exercise. I think the diet and exercise
(16:14):
and the changes that can occur from those lifestyle changes
are probably going to be more efficacious long term, right
than taking a drug short term. I think you just
can't replace the effects of those kinds of lifestyle changes.
Speaker 2 (16:28):
Yeah, and importantly it's not either or I think actually
we're getting sort of the wrong message right in many
ways the GLP one receptor agonists, and they're gonna get better.
I've already seen presentations where you lose weight and you
lose muscle. Now they've got compounds to potentially protect and
increased muscle at the same time. So it's a changing game.
(16:50):
But they help you have better behaviors, and I think
there's no reason people should really try hard to then
when they're at the lower rate, establish good patterns of
behavior and test whether they can maintain them. I'm not
at all sure that it's not possible.
Speaker 1 (17:06):
So you've been working on the studies, like you said,
you've this has been going on since the eighties, and
you've come out with the fact that dementia risk for
folks over fifty five and older has doubled. Do you
think that that is because you've been watching it and
it I mean, has it really gone up over that timeframe?
Have you seen a change and seeing that change, what
(17:28):
were the contributing factors to that change?
Speaker 2 (17:30):
Yeah, So actually this is where being detailed on the
numbers is important. The risk will double in the next
forty years by twenty sixty because the population is aging.
Speaker 1 (17:42):
Because we're getting older than we used to be, or
because we yes.
Speaker 2 (17:46):
Because the whole baby boomers are when they're ninety, it's
going to be a lot of risk. So for the US,
the numbers will double for any one age. We're actually
doing a little better now than we did before, partly
just some better education and some better risk factors. The
problem is as a country we're going to have to
(18:06):
do much better because as a country and as a world,
we're aging rap.
Speaker 1 (18:12):
So when you say we're aging rapidly, what are the
details of aging rapidly? Because you know, in my mind,
I'm like, I mean the years come. That's the one
risk factor I can't do anything about because I'm going
to get older, no matter what I want that to be.
Are we as our body aging faster than what the
(18:32):
number is?
Speaker 2 (18:33):
Uh no, No, I think we keep doing better. So
as individuals, I agree you and I need to keep
watching it. And as we get older, we realize we've
got more risks, more complications, and the risk of dimension
becomes bigger, and we've talked about preventing about half the
risk as a country. Right, the number of babies that
are born drives the number of young people, And if
(18:55):
there were more people born in the baby boom, then
the percentage of the population that's over the age of
sixty five will double, the percentage of the population that's
over the age of eighty five will triple. And as
that happens over the coming decades, I think we need
to think about the fact that many people, if they're
in good health, can continue to be very productive, have
(19:15):
lots of wisdom, have lots to contribute for potentially decades
beyond age sixty five.
Speaker 1 (19:22):
It's really interesting though, that you say that it's how
you look at the numbers, because obviously the headline in
anything like this is going to be written so you
click right. So the headline was kind of terrifying. It's
like dementia has doubled why And so in my mind,
I'm like, oh, all of us are losing our minds
faster and quicker, and it's going to continue and it's
(19:42):
going to get worse. But it really hasn't changed. It's
not like more people are getting it's just that more
people are getting to that age. So that to me
is a major difference. But I just was having a
conversation with someone in their twenties last week and he
was saying, you know, we're not going to have kids
because look at healthcare is disaster. The world is falling apart.
(20:03):
And it just made me think when you said that,
it's how you are looking at the numbers. We aren't.
The younger population doesn't seem to want to have kids
because they're looking at numbers differently than what they actually
mean and to whether it's health numbers or financial numbers.
I think this younger generation is being scared away from
(20:25):
adding to the population, which is really sad to me.
Speaker 2 (20:30):
Yeah, lots of issues here. I think the press did
pretty well with this, but there really is an element
of this that's scary, which is if I go my
whole life, you know, the risk is forty two percent
I'll get the dementia before death. I try to emphasize
that it'll be late in life, right, so I have
many years and I can extend them. And I think
(20:51):
then this whole population pyramid is quite interesting as to
how we do that, and I think how we maintain
a vibrant society. I think that's both having young people
and realizing that many older people are young in so
many ways.
Speaker 3 (21:04):
I think this is also a changing landscape.
Speaker 4 (21:06):
I think in the course of the next decades, we're
going to come up with better and better ways to
detect the very beginnings of dementia, even before it's really dementia.
Speaker 3 (21:16):
We're going to be developing more.
Speaker 4 (21:18):
Drugs that are disease modifying to slow down or stop
the progression of memory loss. I mean, there's already two
amyloid lowering therapies approved in the last few years, and
so I think that's just the first step. I think
it's going to really change in the next thirty forty years.
Speaker 2 (21:36):
Yeah, we need talking about maybe the biology of dementia
at early ages versus late ages is important, you know,
and maybe doctor Zerker wants to expand on that and
sort of you know, the early Alzheimer's and late and
therapies and the important of an integrated approach like we
do it n Yu Lang.
Speaker 3 (21:55):
Go and help right.
Speaker 4 (21:57):
So I think, you know, one of the first steps
in the Alzheimer's cascade is the rise of amyloid, and
that's really been the focus of a lot of research
and clinical trials, and that's led to these two drugs
that are approved in the last few years that we're
giving at NYU, and they are helpful. They do slow
down the process. And then at later stages there's other
(22:19):
processes like TAW that's another toxic protein, and there are
ongoing clinical trials to target that. And then there is
at both early and late stages, inflammation and the immune
system clinic play a critical role. In early stages it
could be actually a good thing, and so there are
methods perhaps to boost the immune system to help clear
(22:40):
out amyloid INTAW that could be helpful. And then at
later stage anti inflammatory methodologies could actually be very helpful
as well. And so this is really a multi dimensional
pharmaceutical strategy that's really been built up after all the
science has been done over the last few decades.
Speaker 1 (22:58):
Let's take a quick commercial break. We'll continue next on
the Tutor Dixon podcast. I think we're so used to
looking for a problem once we feel something is off,
and what I am sort of hearing from you is
before there's warning signs. Eventually there will be checks, and
(23:19):
medicine has sort of been carrying in the past. Medicine
has been caring for a problem that's already there. And
it sounds like this is a lot of preventative medicine
to say, Okay, you're at the very beginnings of this.
But I don't think that we as a society have
been trained well for preventative medicine because we don't like
to go to the doctor unless we know something's wrong.
Is this something that you see like mammograms, where it's like, Okay,
(23:41):
at this age, you should be getting tested for this
so that you can prevent it.
Speaker 3 (23:45):
I think we're getting there.
Speaker 4 (23:46):
I think we have the methodology used to detect people.
Speaker 3 (23:49):
Who are.
Speaker 4 (23:52):
Don't have dementia but have impairment. And that's where we
stand now in today's science, and I think that we're
pushing that bar.
Speaker 3 (24:00):
To earlier and earlier stages.
Speaker 4 (24:02):
You know, does an amyloid reading mean something in a
normal person for their future cognitive parent.
Speaker 3 (24:08):
We don't know the answer to that.
Speaker 1 (24:10):
How do we How invasive is that?
Speaker 3 (24:12):
What even is that you can do it through a
brain scan?
Speaker 4 (24:15):
Right now, we don't do it on people who are
normal because we don't know how to use that information.
But people who have memory loss, the amyloid brain scan
can be very helpful to see if they have risk
for Alzheimer's dimension in the future and start treatments before
they have dementia.
Speaker 2 (24:31):
And in terms of the research domain, right, you can
image amyloid in the brain, you can measure amyloid and
it turns out phosphorylated TAW, which is even more powerful
in the CSF right. And then it turns out they
leak into your blood and you can measure them in
the blood, and there are measures of neurodegeneration in the blood.
So what we're working on with neurologists and other researchers,
(24:53):
including in this study, is how to develop markers that
are like the cholesterol and troponent for the heart for
the brain, so we can measure brain how decades beforehand,
and we already have these measures. What we need to
do is validate them so we know how to use them.
Speaker 1 (25:11):
And then ultimately, I mean, the costs associated with caregiving
and all that, they're pretty extreme when you're talking about dementia.
I mean it's not just an actual financial cost, but
the emotional cost to the people around you. Too, is significant,
and I think that is when you talk about dementia,
that's the fear that hits people first. It's not just
(25:34):
the idea of well I might not remember, it's what
would happened to my family, how would they afford this?
What would they go through? So I do think that
as these studies are coming out there, that we should
be putting more focus and more attention on this because
we are very naive about how to take care of
ourselves and prevent illness.
Speaker 2 (25:55):
Yeah, so our biggest push, both in the research and
in the clinical arena we've recruited another expert here and
we're working with other experts, is on caregiving and both
paid and unpaid, and too often it's just knowing how
to get it, knowing where services are and maybe maybe
doctor m Zerker will expand. And then the other thing
(26:16):
we've spent a lot of time on is uncensory losses vision.
We want to study and we've done a lot with
hearing and hearing aids are getting better and better, and
there's a national campaign to know your hearing number, and
on any given cell phone you can download an app
and test yourself and if you have a.
Speaker 1 (26:34):
Prole go yes, that's so interesting. I have no idea.
Speaker 2 (26:39):
Look up the Know Your Hearing Number campaign and a
friend Frank Linn and his colleague Nick Read are very
much trying to get everybody as another number love pressure, cholesterol,
but also hearing. And we've published last year that among
the people are at high risk for cognitive decline in
the first three years, you can reduce the decline by
(27:00):
one half in those people randomized to hearing it. We
also had it was complicated because some people with hearing
loss were sort of the worried well and didn't have
cognitive decline in the first three years, in which case
you couldn't improve it. But probably getting it early is
good for later, and it's good for sort of addressing
issues of social isolation and other issues like that. But
(27:22):
hearing adidas are making dramatic leaps. They do take patients,
they're getting cheaper. There's more over the counter, but you
have to get the fittings right and when you don't
like it, you have to work with ideologists. And while
you has a whole program with also co clear implants
for those who need much more advanced care.
Speaker 1 (27:37):
It's interesting how much more patient we are with doing
things for our vision than we are for doing things
for our hearing. If you can't see something, you totally
freak out and you'll sit for hours with somebody to
help you. We're a stubborn group. Okay, So I want
to get into a few of really quick before we go. Hypertension, diabetes,
(27:58):
high high cholesterol, all of these things that we are
testing for. We do know. I know that people are
there's this pushback against medicine in some cases, especially when
it's like I don't want to take a stat and
I don't want to take this. So explain to us
when you see that number and that number goes down,
how much is that protecting you from something else that
(28:21):
you're not recognizing, like dementia.
Speaker 3 (28:26):
Well, I think that.
Speaker 4 (28:30):
The way I look at it is when you're talking
about brain health. You know, the brain is connected to
all the organs in our body, and you can't treat
someone's memory loss without optimizing the health of their heart,
the health of their kidney, the health of their blood
vesters or lungs, et cetera. And so I really stressed
with my patients how important it is to, you know,
(28:53):
optimize their vascular risk factors through both medicine and both lifestyle,
even in middle a. I think that this is a
critical inroads to optimizing your brain help for the future.
And you know, it is sometimes a tough conversation to
get people to control their diabetes better, to change their diet,
(29:16):
but it really pays enormous dividends. And I also highlight
that it's not just about vascular dementia. Vascular risk factors
also play a role in Alzheimer's dementia as well, so
they can also prevent multiple types of dementia as well
by controlling these factors.
Speaker 1 (29:35):
And so ultimately is the goal of what you're doing
a cure or preventative or both.
Speaker 3 (29:42):
I think it's both, always both.
Speaker 2 (29:44):
There's a quote from the Lancet Commission It's never too
early or too late to address dementia risks, right, And
I think the important thing is different things at different stages.
And the wonderful thing is you start early, even education
for children, better education, better cognit development gets you resilience
and lower dementiists And that's working and helping us as
a society. As we've gotten more education in midlife, the
(30:08):
vascar risk factors are incredibly important. And then I think
once you get past age seventy five, you're going to
need to deal with some issues. And past eighty five,
I think these you know, maybe you know the sensory
deficits and the teamwork in terms of care, people can
do amazing things together.
Speaker 1 (30:27):
Well, I mean, I'm very impressed. This has been completely
enlightening because I do I think that probably once you've
gone through something like cancer, you think about your health
in a different way and you try to be more proactive.
But I mean even the hearing thing and the testing
of your plaques and brain and all of that, that's
(30:49):
something I don't think about on a regular basis. So
it's nice when you see a study that you can
have the doctors actually come on and talk about it
and get into a little bit more death depth. So
I thank you so much, doctor Korsh and doctor Mazerker,
thank you so much for being here.
Speaker 3 (31:04):
Thanks for having us you.
Speaker 1 (31:06):
Absolutely And just a question, doctor Korish, is there's some
place where people can find you guys, that they can
follow this and find out where what you what else
you're doing on the stuff.
Speaker 2 (31:17):
I mean, Google is great, right, you just Google my
name is pretty unique, so you really fast we're mostly
doing research and the neurology department and YU is number
one in the world, so they've got I think now,
three hundred physicians. So I think the idea of you know,
the NYU Liane going search will do very well. Okay,
awesomes name looks pretty unique too.
Speaker 1 (31:38):
Yeah, I was gonna say doctor Masserker's name is pretty unique.
Speaker 3 (31:41):
Also, yes, might be the only one.
Speaker 1 (31:45):
Well then I guess people will definitely be able to
find you as well. Thank you so much.
Speaker 2 (31:48):
Thanks for joinering number the app that you can look
up as Mimi.
Speaker 1 (31:52):
Okay, perfect, how do you what was that again?
Speaker 2 (31:55):
Spell it? It's am I am I am.
Speaker 1 (31:57):
I am I. Okay, we should be able to find that.
Speaker 2 (31:59):
Yeah, and I'm you know, we have a colleague here
who is doing tons of great research.
Speaker 1 (32:02):
With that wonderful Thank you both for joining me today.
Speaker 3 (32:06):
I appreciate it, pleasure, Thanks for doing.
Speaker 1 (32:08):
Absolutely Thank you all for joining us on this podcast.
For more episodes, go to the iHeartRadio app, Apple Podcasts,
or wherever you get your podcasts and join us next time.
Have a blessed ey
Welcome to the Tutor Dixon Podcast. Today, we are going
to be talking about a startling new study that was
just released showing the rising risk of dementia. It projects
the number of dementia cases in the US will double
by twenty sixty. I think this is probably a fear
of most Americans, is the idea that you forget who
(00:21):
you are, that you're not capable of functioning. I mean,
we've been watching, you know, people questioning even the leader
of the country right now, and I think mostly because
the idea is just very terrifying to have this happen.
Speaker 2 (00:33):
Now.
Speaker 1 (00:34):
More than one million Americans are predicted to develop this
condition every year. It's estimated that there will be twelve
million Americans living with dementia by twenty sixty. So today
I am joined by one of the leaders of the study,
doctor Joseph Korish, who is the founding director of the
Optimal Aging Institute at New York University's Grossman School of Medicine,
(00:56):
and Argent Mazurker. He is a cognitive neurologist and dementia
specialist and leads a laboratory for early Alzheimer's disease symptoms
at NYU. Thank you both for joining me, Thank you
for having us.
Speaker 3 (01:09):
Yeah.
Speaker 1 (01:09):
Absolutely, So, Like I said, I think that the majority
of Americans hear this, and it's one of those things
that you're scared of all of us. I think everybody
has experienced one grandparent or a parent that has gone
through something like this, and I think it's hard. It's
really hard to be the person watching, and it's very
hard to be the person going through it. I remember
(01:32):
with my own grandparents. My grandfather started to struggle with this,
and for my grandmother it was so challenging to see
that decline. So when we see a study like this,
this is sort of scary. Doctor Korush tell us about
it a little bit.
Speaker 2 (01:47):
Yeah, So we thought it was important to take a
life long respective because, as you say, we all kind
of know that we're in a very long game for this.
So we had the advantage of having a study that
followed fifteen thousand people since nineteen eighties, so for four decades.
We had the advantage that the study really went rigorously
(02:08):
and determining who got dementia, and we can talk about that.
And we asked the question for someone like myself or
someone who starts out at age fifty five over my lifetime,
will I reach dementia before I die? Or will I
die before I reach dementia? Right, only two options if
you go forever. And we found out that the old
(02:28):
estimates were off, and our estimates are that forty two
percent of us will reach dementia before that. Now, before
we all panic, I think it's very important that by
the age of seventy five this number is only four percent,
still a scary four percent, and we can talk about
who's at higher risk. By the age of eighty five,
(02:50):
it goes up to twenty percent, and as you say,
we know quite a few people who get dementia by
that eighty But then the part that's important is when
you go beyond eighty five. When we went to age
ninety five, that's more than half the risk, and that's
when things really pile up. And we can talk about
the idea of what do you do for prevention early,
what do you do for prevention medium, what do you
(03:10):
do for management later? And most people can still stay
at home. As doctor Mzerker, we'll talk about various options
and collaboration.
Speaker 1 (03:18):
When I see fifty five being like that point where
you start to see it that is a few years away,
and that is very scary to me. So what are
the I mean, how do you even know that this
is happening. I think that's another part that's scary to
me is that the person who's experiencing it doesn't always
know what's happening.
Speaker 2 (03:36):
Yeah, So I think there are very good news in
the last decade. Right, So when people thought about dementia,
we still don't know all the causes. And again we
can talk about the different processes, but Alzheimer's dementia degeneration
of brain cells is a big process, and vascular dementia
(03:59):
is another huge process. The good thing is vascular risk
factors are treatable and that component of dementia is reducible. Right, So,
high blood pressure, diabetes is collectivity, no smoking, alcohol, sleep,
those are all among the fourteen factors that the Lancet
(04:20):
Commission has said can reduce the risk of dementia by
fifty percent. And we can talk about the fact that
even if you have hygienetic acceptability, you can still better.
Speaker 1 (04:31):
So it's interesting that you mentioned alcohol. So I'm a
cancer survivor. I was at my six month annual uphoor
or six month appointment a few weeks ago, and at
the appointment, the doctor really laid into like, you can't
have any alcohol, you can't drink it all. It's so important.
And I was sitting there thinking, like, does she think
(04:51):
I'm a total lush? Why does she saying We've never
in ten years, we've never had this conversation. And I
was like, I don't drink. I don't drink it all,
and she was not even but I'm saying, not even
a glass, and I said, I don't drink. Where is
this coming from? Well, then the story was published that
now they're saying that drinking alcohol is linked to cancer,
(05:11):
and I'm hearing, okay, alcohol is linked two dimensia now too.
I mean, how significant of a problem is it? Because
I do think that in the last I would say
my generation coming out of college in the nineties and
early two thousands, there was this really big push for
women to be in this wine culture, and it seems
(05:33):
like that has impacted health in a crazy way that
we really aren't paying attention to.
Speaker 2 (05:39):
Yeah, so I think I'll take a broader perspective and
then dig into the alcohol. I think it's important to
realize we're living a long time, right So if you
talk about a diet or meals alcohol, we have about
one hundred thousand meals to eat, right, And I think
it's important is I have so one meal you aid badly? Well,
(06:01):
you know, you can even smoke forty cigarettes in a
day and you're not gonna get cancer tomorrow. Right, If
you'll smoke forty cigarettes for thirty years, a couple of
people will get away with it, but a lot of
people are gonna have trouble. So I think it's important
to remember it's a marathon. We're all gonna fall down,
and we all should have things that we can enjoy.
(06:21):
I think related to that, I think with the alcohol,
you know, people are too tempted to go strong one
way or the other. Right, So you know, we're just
tempted to give strong answers when sometimes we have weaker answers, right,
And so it depends if you socialize and it helps you.
(06:42):
It's one thing, clearly, there's this thing among you know,
younger people in anxiety where people have bringe drinking and
a lot of drinks at a time. That's a problem.
Risk of injuries is a problem with dementia when you
get to older age and you reserve is smaller. It
could be that one or two drinks will push you
over an edge where you can't compensate. And I see
doctor Mzerker maybe ready to chime in with that, you know,
(07:06):
I think then we want to know if you want
optimal health, which is what we're looking for. We're trying
to develop all the best biomarkers to give you the
very best advice. Right So, I think doctors shouldn't be
pushing you to drink. In fact, now we're pushing you
to not drink. But I have a feeling if your
only vice is a couple of drinks a week, I
(07:27):
think you may have a lot of other things to
worry about. And in terms of dementia, one of the
proven risk factors for dementia is social isolation. Now, I
think we can socialize without alcohol. It's not a problem,
but you know what I mean. But socializlation is bad.
Speaker 1 (07:43):
But it's like I can't focus on those few really
terrible sunburns I had in college for the rest of
my life.
Speaker 2 (07:50):
I think the dwelling and ruminating not a good thing.
Even though we're all victims of some worrying.
Speaker 1 (07:56):
Well, I think this is one of those things though
that you can. I mean, there's now well you can
have genetic testing, if you have relatives who had Alzheimer's,
people are getting that genetic testing. Then what happens once
you find out you have the gene? Then do you
just focus on that? How bad is that for your
health that you are constantly worried, Well, when's it coming?
(08:17):
When's it coming? When's it coming?
Speaker 2 (08:19):
Yeah, So it depends. And I've given a lecture to
the medical students in various places and to the students
of public health about genetics and epidemiology and screening and
april LIKEE protein E is always an example I raised
because we studied it for heart disease, where it's a
weak risk factors, whereas aplite protein E four was discovered
in the eighties to really be a pretty strong risk
(08:41):
factor for dementia. For a long time, I said, well,
we don't screen for it because there's nothing we can do.
It turns out now we've discovered that the vascular risk
factors interconnect with the amyloid deposition in the brain, and
our study and others have shown that people with more
vascular risk factors have even more amyloid deposition. And the
(09:04):
association was even stronger among genetically susceptible people. So in
some sense, your preventive measures could be more powerful if
you're at risk. Now, do you need to know or not?
A good question? Maybe? I mean I'd be interested in
doctor Zerka's opinion about particularly as you get to the
later stages, and how people deal with this. As you said,
(09:26):
they may not know. It's one thing to not know
about your genetic risk. What do you know about your
cognitive function? Do you want to get tested and what
do you do? Yeah?
Speaker 3 (09:35):
Absolutely, I think that.
Speaker 4 (09:36):
I think we're learning more about how to use genetic
testing as the years go by. I mean, right now,
I think it still stands that the genetic information like
an FOE test, can give some sense about general risk,
but it's not an absolute it's not that kind of gene.
That being said, there are ways that a person who's
(09:59):
concerned about their memory can more concretely assess their risk
by getting an evaluation by a geriatrician or neurologists, or
even talking to their primary doctor first. You know, a
lot of the memory concerns that are out there, if
they're not very consistent, if they're not affecting daily life,
it might just be part of what we call normal aging.
(10:21):
And I think that if you want to know if
it's more than normal aging, you might need some more
formal diagnostics in the form of what we call neuropsychological testing,
quantifying someone's memory and cognitive functions, doing some brain imaging
like an MRI, and doing some blood work to look
for maybe non neurological causes of memory loss.
Speaker 1 (10:46):
Interesting. So, if you are in this situation where you
start to see this decline, I mean, we're seeing that
one in three older Americans dies from Alzheimer's or dementia,
Obviously people are fearing that how are you dying? Are
you dying with it? Are you dying from it?
Speaker 2 (11:05):
I think, you know, back to the numbers. I think
you know, often when you develop a disease and you're ninety,
it's hard to know all the causes of it, right,
And at that point the number of years, which will
be one of our future topics, is an important topic, right,
So I think it's important to think about this opportunity
(11:27):
for prevention. And I think the other thing, you know
that I'm a big believer on avoiding the social isolation,
engaging other people, taking charge of your own health and
accepting that. I think we should try for the best health.
But we're gonna have setbacks, and there are ways to
work with them and have lots of meaningful things. As
(11:49):
you mentioned, right, you've had cancer, I wouldn't know. Seems
like you're doing great, which is wonderful. Congratulations, the same
things with a lot of things. So if somebody has
some limitations at older age, working together with their family members,
working together with their physicians, a lot can be done.
Speaker 1 (12:07):
So what is it that we should be doing. I
think we, especially in this country, we're very hot on
the quick fix. Just give me something that's going to
make all of these things happen. But I heard you
talk about exercise and diet, and those are things that
I think oftentimes feel like I don't really know what
that means, so I'm going to focus on something else.
(12:28):
I mean, exercise is pretty obvious. Diet is a challenge
in this country. I mean, just we're just seeing that now.
The FDA is saying that we can't have red food die.
I think it's red number four or three that they've
just eliminated. And people are talking about making America healthy
and all these things that we have in our food
that Europeans don't have in their food, and is this
(12:52):
contributing to that the health record that we see in
the United States as compared to other countries. So when
you talk about diet, it's it seems kind of like
an enigma. Nobody really knows what that means. How do
we break that down for people?
Speaker 2 (13:05):
Yeah, I think you know, we can each say something.
I would keep my eye on the big things right
in that exactly what we eat. It would be great
if we could figure it out. But for one hundred
thousand meals, maybe we don't even want a prescription for
every meal. But the biggest problem people have is too
many calories, right, too many calories and you know when
(13:26):
they add up because there's a scale and you know,
you step on it and you see what happens. The
good thing is if you lose even five pounds, it
reduces your risk of diabetes dramatically, right, really, and yes,
it turns out losing is better than gaining more powerful
for diabetes and connected to dementia. We've shown that diabetes
(13:48):
before the age of sixty five is a powerful risk factor.
And if you prevent it all together or delay it
on set at a later age is a much much
weaker risk factor for demension. So for diet, I'd watch
galleries and I'd watch total fruits and vegetables. The more
fruits and vegetables, the less you can eat other stuff.
Speaker 1 (14:07):
Let's take a quick commercial break. We'll continue next on
the Tutor Dixon podcast. So we see a lot of
people today taking drugs like ozebic or we go v
these drugs that are were for I guess, for diabetes.
Now people are finding out that maybe they prevent diabetes
(14:29):
by losing the weight. They take these drugs and they
lose the weight. Is that a sustainable way to take
care of your health.
Speaker 2 (14:36):
I'll start and have doctor Zerker continue. I'm in public health.
Ideally we should take care of things with behaviors, and
I think the good thing is we should study that,
we should know about it. But we're in medicine because
people aren't perfect. So when you fall, we don't just
blame you. We look for solutions. And in the US
we have incredible medications, an incredible healthcare system for people
(14:59):
who can act access it. And for high cholesterol, we
have wonderful drugs and statins for high blood pressure. We
have a range of wonderful drugs that are cheap and
very effective, and controlling blood pressure is one of the
best ways to prolong life, prevent dimension, and prevent stroke.
And obesity is an underlying cause for so much of
it that if it takes a pill, it turns out
(15:22):
science has now given us pills that seem to be
good for us. For decades, we only had weight loss
pills that were bad for us. Now they seem to
be protecting the weight, the diabetes, the kidneys, the heart,
and we're going to study them for the brain. So
the answer is still out as to whether it's a
huge benefit, but it's clearly a huge benefit for many
(15:44):
for many things. What will happen over decades, I don't know, what.
Speaker 3 (15:47):
Do you think.
Speaker 4 (15:48):
I think that there are certain people who are, you know,
really struggling with their weight, struggling with their diabetes that
are going to really benefit medications, you know, like ozempic
et cetera. I just don't think that you know that
it can for the average person or someone who's slightly overweight,
whether diet and exercise. I think the diet and exercise
(16:14):
and the changes that can occur from those lifestyle changes
are probably going to be more efficacious long term, right
than taking a drug short term. I think you just
can't replace the effects of those kinds of lifestyle changes.
Speaker 2 (16:28):
Yeah, and importantly it's not either or I think actually
we're getting sort of the wrong message right in many
ways the GLP one receptor agonists, and they're gonna get better.
I've already seen presentations where you lose weight and you
lose muscle. Now they've got compounds to potentially protect and
increased muscle at the same time. So it's a changing game.
(16:50):
But they help you have better behaviors, and I think
there's no reason people should really try hard to then
when they're at the lower rate, establish good patterns of
behavior and test whether they can maintain them. I'm not
at all sure that it's not possible.
Speaker 1 (17:06):
So you've been working on the studies, like you said,
you've this has been going on since the eighties, and
you've come out with the fact that dementia risk for
folks over fifty five and older has doubled. Do you
think that that is because you've been watching it and
it I mean, has it really gone up over that timeframe?
Have you seen a change and seeing that change, what
(17:28):
were the contributing factors to that change?
Speaker 2 (17:30):
Yeah, So actually this is where being detailed on the
numbers is important. The risk will double in the next
forty years by twenty sixty because the population is aging.
Speaker 1 (17:42):
Because we're getting older than we used to be, or
because we yes.
Speaker 2 (17:46):
Because the whole baby boomers are when they're ninety, it's
going to be a lot of risk. So for the US,
the numbers will double for any one age. We're actually
doing a little better now than we did before, partly
just some better education and some better risk factors. The
problem is as a country we're going to have to
(18:06):
do much better because as a country and as a world,
we're aging rap.
Speaker 1 (18:12):
So when you say we're aging rapidly, what are the
details of aging rapidly? Because you know, in my mind,
I'm like, I mean the years come. That's the one
risk factor I can't do anything about because I'm going
to get older, no matter what I want that to be.
Are we as our body aging faster than what the
(18:32):
number is?
Speaker 2 (18:33):
Uh no, No, I think we keep doing better. So
as individuals, I agree you and I need to keep
watching it. And as we get older, we realize we've
got more risks, more complications, and the risk of dimension
becomes bigger, and we've talked about preventing about half the
risk as a country. Right, the number of babies that
are born drives the number of young people, And if
(18:55):
there were more people born in the baby boom, then
the percentage of the population that's over the age of
sixty five will double, the percentage of the population that's
over the age of eighty five will triple. And as
that happens over the coming decades, I think we need
to think about the fact that many people, if they're
in good health, can continue to be very productive, have
(19:15):
lots of wisdom, have lots to contribute for potentially decades
beyond age sixty five.
Speaker 1 (19:22):
It's really interesting though, that you say that it's how
you look at the numbers, because obviously the headline in
anything like this is going to be written so you
click right. So the headline was kind of terrifying. It's
like dementia has doubled why And so in my mind,
I'm like, oh, all of us are losing our minds
faster and quicker, and it's going to continue and it's
(19:42):
going to get worse. But it really hasn't changed. It's
not like more people are getting it's just that more
people are getting to that age. So that to me
is a major difference. But I just was having a
conversation with someone in their twenties last week and he
was saying, you know, we're not going to have kids
because look at healthcare is disaster. The world is falling apart.
(20:03):
And it just made me think when you said that,
it's how you are looking at the numbers. We aren't.
The younger population doesn't seem to want to have kids
because they're looking at numbers differently than what they actually
mean and to whether it's health numbers or financial numbers.
I think this younger generation is being scared away from
(20:25):
adding to the population, which is really sad to me.
Speaker 2 (20:30):
Yeah, lots of issues here. I think the press did
pretty well with this, but there really is an element
of this that's scary, which is if I go my
whole life, you know, the risk is forty two percent
I'll get the dementia before death. I try to emphasize
that it'll be late in life, right, so I have
many years and I can extend them. And I think
(20:51):
then this whole population pyramid is quite interesting as to
how we do that, and I think how we maintain
a vibrant society. I think that's both having young people
and realizing that many older people are young in so
many ways.
Speaker 3 (21:04):
I think this is also a changing landscape.
Speaker 4 (21:06):
I think in the course of the next decades, we're
going to come up with better and better ways to
detect the very beginnings of dementia, even before it's really dementia.
Speaker 3 (21:16):
We're going to be developing more.
Speaker 4 (21:18):
Drugs that are disease modifying to slow down or stop
the progression of memory loss. I mean, there's already two
amyloid lowering therapies approved in the last few years, and
so I think that's just the first step. I think
it's going to really change in the next thirty forty years.
Speaker 2 (21:36):
Yeah, we need talking about maybe the biology of dementia
at early ages versus late ages is important, you know,
and maybe doctor Zerker wants to expand on that and
sort of you know, the early Alzheimer's and late and
therapies and the important of an integrated approach like we
do it n Yu Lang.
Speaker 3 (21:55):
Go and help right.
Speaker 4 (21:57):
So I think, you know, one of the first steps
in the Alzheimer's cascade is the rise of amyloid, and
that's really been the focus of a lot of research
and clinical trials, and that's led to these two drugs
that are approved in the last few years that we're
giving at NYU, and they are helpful. They do slow
down the process. And then at later stages there's other
(22:19):
processes like TAW that's another toxic protein, and there are
ongoing clinical trials to target that. And then there is
at both early and late stages, inflammation and the immune
system clinic play a critical role. In early stages it
could be actually a good thing, and so there are
methods perhaps to boost the immune system to help clear
(22:40):
out amyloid INTAW that could be helpful. And then at
later stage anti inflammatory methodologies could actually be very helpful
as well. And so this is really a multi dimensional
pharmaceutical strategy that's really been built up after all the
science has been done over the last few decades.
Speaker 1 (22:58):
Let's take a quick commercial break. We'll continue next on
the Tutor Dixon podcast. I think we're so used to
looking for a problem once we feel something is off,
and what I am sort of hearing from you is
before there's warning signs. Eventually there will be checks, and
(23:19):
medicine has sort of been carrying in the past. Medicine
has been caring for a problem that's already there. And
it sounds like this is a lot of preventative medicine
to say, Okay, you're at the very beginnings of this.
But I don't think that we as a society have
been trained well for preventative medicine because we don't like
to go to the doctor unless we know something's wrong.
Is this something that you see like mammograms, where it's like, Okay,
(23:41):
at this age, you should be getting tested for this
so that you can prevent it.
Speaker 3 (23:45):
I think we're getting there.
Speaker 4 (23:46):
I think we have the methodology used to detect people.
Speaker 3 (23:49):
Who are.
Speaker 4 (23:52):
Don't have dementia but have impairment. And that's where we
stand now in today's science, and I think that we're
pushing that bar.
Speaker 3 (24:00):
To earlier and earlier stages.
Speaker 4 (24:02):
You know, does an amyloid reading mean something in a
normal person for their future cognitive parent.
Speaker 3 (24:08):
We don't know the answer to that.
Speaker 1 (24:10):
How do we How invasive is that?
Speaker 3 (24:12):
What even is that you can do it through a
brain scan?
Speaker 4 (24:15):
Right now, we don't do it on people who are
normal because we don't know how to use that information.
But people who have memory loss, the amyloid brain scan
can be very helpful to see if they have risk
for Alzheimer's dimension in the future and start treatments before
they have dementia.
Speaker 2 (24:31):
And in terms of the research domain, right, you can
image amyloid in the brain, you can measure amyloid and
it turns out phosphorylated TAW, which is even more powerful
in the CSF right. And then it turns out they
leak into your blood and you can measure them in
the blood, and there are measures of neurodegeneration in the blood.
So what we're working on with neurologists and other researchers,
(24:53):
including in this study, is how to develop markers that
are like the cholesterol and troponent for the heart for
the brain, so we can measure brain how decades beforehand,
and we already have these measures. What we need to
do is validate them so we know how to use them.
Speaker 1 (25:11):
And then ultimately, I mean, the costs associated with caregiving
and all that, they're pretty extreme when you're talking about dementia.
I mean it's not just an actual financial cost, but
the emotional cost to the people around you. Too, is significant,
and I think that is when you talk about dementia,
that's the fear that hits people first. It's not just
(25:34):
the idea of well I might not remember, it's what
would happened to my family, how would they afford this?
What would they go through? So I do think that
as these studies are coming out there, that we should
be putting more focus and more attention on this because
we are very naive about how to take care of
ourselves and prevent illness.
Speaker 2 (25:55):
Yeah, so our biggest push, both in the research and
in the clinical arena we've recruited another expert here and
we're working with other experts, is on caregiving and both
paid and unpaid, and too often it's just knowing how
to get it, knowing where services are and maybe maybe
doctor m Zerker will expand. And then the other thing
(26:16):
we've spent a lot of time on is uncensory losses vision.
We want to study and we've done a lot with
hearing and hearing aids are getting better and better, and
there's a national campaign to know your hearing number, and
on any given cell phone you can download an app
and test yourself and if you have a.
Speaker 1 (26:34):
Prole go yes, that's so interesting. I have no idea.
Speaker 2 (26:39):
Look up the Know Your Hearing Number campaign and a
friend Frank Linn and his colleague Nick Read are very
much trying to get everybody as another number love pressure, cholesterol,
but also hearing. And we've published last year that among
the people are at high risk for cognitive decline in
the first three years, you can reduce the decline by
(27:00):
one half in those people randomized to hearing it. We
also had it was complicated because some people with hearing
loss were sort of the worried well and didn't have
cognitive decline in the first three years, in which case
you couldn't improve it. But probably getting it early is
good for later, and it's good for sort of addressing
issues of social isolation and other issues like that. But
(27:22):
hearing adidas are making dramatic leaps. They do take patients,
they're getting cheaper. There's more over the counter, but you
have to get the fittings right and when you don't
like it, you have to work with ideologists. And while
you has a whole program with also co clear implants
for those who need much more advanced care.
Speaker 1 (27:37):
It's interesting how much more patient we are with doing
things for our vision than we are for doing things
for our hearing. If you can't see something, you totally
freak out and you'll sit for hours with somebody to
help you. We're a stubborn group. Okay, So I want
to get into a few of really quick before we go. Hypertension, diabetes,
(27:58):
high high cholesterol, all of these things that we are
testing for. We do know. I know that people are
there's this pushback against medicine in some cases, especially when
it's like I don't want to take a stat and
I don't want to take this. So explain to us
when you see that number and that number goes down,
how much is that protecting you from something else that
(28:21):
you're not recognizing, like dementia.
Speaker 3 (28:26):
Well, I think that.
Speaker 4 (28:30):
The way I look at it is when you're talking
about brain health. You know, the brain is connected to
all the organs in our body, and you can't treat
someone's memory loss without optimizing the health of their heart,
the health of their kidney, the health of their blood
vesters or lungs, et cetera. And so I really stressed
with my patients how important it is to, you know,
(28:53):
optimize their vascular risk factors through both medicine and both lifestyle,
even in middle a. I think that this is a
critical inroads to optimizing your brain help for the future.
And you know, it is sometimes a tough conversation to
get people to control their diabetes better, to change their diet,
(29:16):
but it really pays enormous dividends. And I also highlight
that it's not just about vascular dementia. Vascular risk factors
also play a role in Alzheimer's dementia as well, so
they can also prevent multiple types of dementia as well
by controlling these factors.
Speaker 1 (29:35):
And so ultimately is the goal of what you're doing
a cure or preventative or both.
Speaker 3 (29:42):
I think it's both, always both.
Speaker 2 (29:44):
There's a quote from the Lancet Commission It's never too
early or too late to address dementia risks, right, And
I think the important thing is different things at different stages.
And the wonderful thing is you start early, even education
for children, better education, better cognit development gets you resilience
and lower dementiists And that's working and helping us as
a society. As we've gotten more education in midlife, the
(30:08):
vascar risk factors are incredibly important. And then I think
once you get past age seventy five, you're going to
need to deal with some issues. And past eighty five,
I think these you know, maybe you know the sensory
deficits and the teamwork in terms of care, people can
do amazing things together.
Speaker 1 (30:27):
Well, I mean, I'm very impressed. This has been completely
enlightening because I do I think that probably once you've
gone through something like cancer, you think about your health
in a different way and you try to be more proactive.
But I mean even the hearing thing and the testing
of your plaques and brain and all of that, that's
(30:49):
something I don't think about on a regular basis. So
it's nice when you see a study that you can
have the doctors actually come on and talk about it
and get into a little bit more death depth. So
I thank you so much, doctor Korsh and doctor Mazerker,
thank you so much for being here.
Speaker 3 (31:04):
Thanks for having us you.
Speaker 1 (31:06):
Absolutely And just a question, doctor Korish, is there's some
place where people can find you guys, that they can
follow this and find out where what you what else
you're doing on the stuff.
Speaker 2 (31:17):
I mean, Google is great, right, you just Google my
name is pretty unique, so you really fast we're mostly
doing research and the neurology department and YU is number
one in the world, so they've got I think now,
three hundred physicians. So I think the idea of you know,
the NYU Liane going search will do very well. Okay,
awesomes name looks pretty unique too.
Speaker 1 (31:38):
Yeah, I was gonna say doctor Masserker's name is pretty unique.
Speaker 3 (31:41):
Also, yes, might be the only one.
Speaker 1 (31:45):
Well then I guess people will definitely be able to
find you as well. Thank you so much.
Speaker 2 (31:48):
Thanks for joinering number the app that you can look
up as Mimi.
Speaker 1 (31:52):
Okay, perfect, how do you what was that again?
Speaker 2 (31:55):
Spell it? It's am I am I am.
Speaker 1 (31:57):
I am I. Okay, we should be able to find that.
Speaker 2 (31:59):
Yeah, and I'm you know, we have a colleague here
who is doing tons of great research.
Speaker 1 (32:02):
With that wonderful Thank you both for joining me today.
Speaker 3 (32:06):
I appreciate it, pleasure, Thanks for doing.
Speaker 1 (32:08):
Absolutely Thank you all for joining us on this podcast.
For more episodes, go to the iHeartRadio app, Apple Podcasts,
or wherever you get your podcasts and join us next time.
Have a blessed ey
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