July 23, 2023 • 26 mins
The Healthy Matters Podcast
S02_E16 - Dementia and Alzheimer's Disease
Dementia, and more particularly, Alzheimer's Disease is a condition that affects many people and their loved ones the world over. But what is it exactly? How is it detected and diagnosed? Is there anything that can be done to reduce the risk? And are there effective treatments for it?
There are a lot of questions when it comes to the topic of Dementia, and many we still don't have exact answers for. But as with anything in medicine - the more general awareness and knowledge we have around the subject, the better for all of us. In Episode 16 of The Healthy Matters Podcast, we'll be joined by a world-renowned expert on the subject, Dr. Anne Murray of Hennepin Healthcare, to help shed some light on this very important topic. She's a geriatrician and a researcher in the field of dementia, and will help guide us through the basics of the condition, what is known to be helpful and harmful to us as we age, and what the future looks like for those affected by this condition. Please join us.
To learn more about Alzheimer's Disease, or to find helpful resources, visit:
The Alzheimer's Association
Learn more about Healthy Aging through the Senior Years (HATS)
Got a question for the doc? Or an idea for a show? Contact us!
Email - healthymatters@hcmed.org
Call - 612-873-TALK (8255)
Twitter - @drdavidhilden
Find out more at www.healthymatters.org
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Speaker 2 (00:04):
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare
and what matters to you. Andnow here's our host, Dr. David
Hilden .
Speaker 3 (00:20):
Hey everybody, it's Dr. David Hilden , your host of
the Healthy Matters podcast.
And welcome to episode 16. Weare gonna tackle the subject of
Alzheimer's disease anddementia. Help me out. I've
invited Dr. Anne-Marie , she'sa colleague of mine here at
Hennepin Healthcare in downtownMinneapolis, and a researcher
into Alzheimer's disease , uh,and a geriatrician. And thanks
(00:42):
for being back on the show with
Speaker 4 (00:43):
Me. Great to be here. Thanks, Dave.
Speaker 3 (00:45):
I have worked with you before on other
broadcasting. We've talked overthe radio waves. Now we're
gonna do it in podcast form. Soyou have studied dementia your
whole career. Could you lay thebasics for our listeners? What
is Alzheimer's disease? Ormaybe what is dementia in
general? Yeah.
Speaker 4 (01:02):
Better to start with, what is dementia? So
dementia is the umbrella termto describe a chronic
progressive state of confusion.
That includes memory loss andloss of ability to make
decisions, to find the rightwords, to find things, and to
navigate and eventually to beindependent in your daily
(01:25):
functions. Dementia is thegeneral term, but there are
many types of dementia.
Alzheimer's is the most common,and it's important to
distinguish Alzheimer's as asubtype of dementia versus all
dementia. Many people thinkthat Alzheimer's is all
dementia, but it's the otherway around. Dementia is the
(01:46):
umbrella term, and Alzheimer'sis a type. Other types are Lewy
body dementia or frontaltemporal dementia, early onset
dementia. So that's kind of theoverview, the definition.
Speaker 3 (01:59):
How can you tell them apart?
Speaker 4 (01:59):
Right. So really difficult to tell 'em apart
initially. Usually, forexample, for Alzheimer's
disease, many of thecharacteristics seen in
Alzheimer's disease are alsoseen in other types of
dementia. But it's the timingand the association with other
symptoms that makes thedifference in the diagnosis. So
(02:20):
for Alzheimer's disease, it'susually memory loss for recent
events, recent memory lossversus remote or long distance
memory.
Speaker 3 (02:31):
So how is that different, or how do you know
if it's a pathological or anabnormal process from the
person who says, well, as I getolder, I sometimes forget where
I like put my checkbook. Right. How can you tell when is it a
problem versus a normalprocess? Or is it ever a normal
process? Um,
Speaker 4 (02:49):
That's up for argument, whether it's a normal
process, , there arepeople in their one hundreds
that are still withoutsignificant memory loss. So
generally, if it startsinterfering with your daily
function to the point whereit's making a big difference in
your daily life. So it's notthat you forgot where you put
(03:09):
your keys. Maybe you forgotthat you left your car in a
parking lot, or you can'tfigure out how to get home from
a neighborhood that's veryfamiliar to you, or how to find
your way home from say, anevent downtown. When you've
been doing that for 20 years,
Speaker 3 (03:26):
Suddenly you don't know where you are, how you ,
how do I get home?
Speaker 4 (03:28):
Right. Other things are forgetting something that
happened yesterday, forgettingconversations completely and
having family members startreminding you that we talked
about this or that appointmentwas yesterday and we need to
reschedule it. The frequencyand the persistence of those
(03:50):
episodes is what makes thedifference. When
Speaker 3 (03:52):
Does it begin in a person's life? Yeah.
Speaker 4 (03:55):
So it depends on whether you're talking about
when does it begin in the brainversus the symptoms in the
brain. It begins about 15 to 20years before the symptoms for
most types of dementia forAlzheimer's, and more of the
slowly progressive, what wecall degenerative dementias.
And we know that because there,there are brain autopsy studies
(04:16):
that show that those brainchanges. So amyloid and tau
begin 15 to 20 years before thesymptoms begin. Are
Speaker 3 (04:25):
These the proteins in the brain that people have
heard about? Right . Amyloidand tau, those are
Speaker 4 (04:29):
The two most prominent proteins that we've
been studying for many years.
Now. There are other proteinsthat are involved in other
types of dementia, but amyloidand tau are the biggest
players. And
Speaker 3 (04:41):
You said then about symptoms that those come on 10
to 15 years later after thesechanges begin in the brain.
Mm-hmm. , whatare the earliest symptoms? What
are the first things and howwould you know? How would a
family member know?
Speaker 4 (04:53):
Yeah . So short-term memory loss mm-hmm .
is the earliestsymptom word finding .
Recurrent word, findingproblems, persistent for
reasonably common words.
Mm-hmm. havingdifficulty planning your day
using that, what we callexecutive function and decision
making tools to plan your day.
And especially kind of a , alitmus test if you want, is
(05:16):
planning a trip. The ability toplan a trip with all the
different components. You know,the flights , uh, the hotels is
a very complex task thatrequires a lot of quote ,
executive function. Mm-hmm.
, and sometimespeople that have traveled
worldwide, that's when it firstshows up, is a very complex
task like that because they'realready extremely high
(05:37):
functioning people.
Speaker 3 (05:37):
Yeah. They've done this before. Yeah. They know
how to do that. Yeah . And nowthey can't. Right. That's
fascinating. So I'm gonna moveon to like, in the population,
how common is dementia and arethey on the rise, the decline
mm-hmm. in , inour country or
Speaker 4 (05:52):
Globally. So a recent study that was published
in the Lancet showed that it'sactually on the decline in
developed countries in mostlyWestern developed countries. So
the
Speaker 3 (06:03):
Lancet, one of the leading journals, medical
journals ,
Speaker 4 (06:05):
It's one of the leading medical journals in the
world. Right. And it's believedthat in part, that's due to
decreasing cardiovasculardisease and treating
cardiovascular risk factorslike high blood pressure and
high glucose. So treatingdiabetes, but also higher
levels of education acrosscountries. So having a higher
(06:25):
level of education is thestrongest protective factor. We
have to build up brain reserveto resist the changes of
dementia.
Speaker 3 (06:36):
And those are more prevalent in developed
countries. So why do I hearthen that dementia and related
diseases are on the top list ofcauses of mortality death . Yep
. Yep . We keep hearing that.
And cardiovascular disease,heart disease is still number
one, but getting better strokesare still way up there, but
getting a little better. Right. But you hear about dementia
on the lists of reasons formortality. Why is that?
Speaker 4 (07:00):
Right ? Right.
Because the prevalence or howcommonly it occurs increases
almost doubles every 10 yearsafter the age of 65. So you
can't stop aging. Mm-hmm . Ourpopulation here and in many
countries has acceleratedaging. The aging population has
grown to the point where rightnow, close to a third of the
(07:24):
population in many parts of theUS and the western countries
are 65 and older, or it will beby 2050. Mm-hmm.
Speaker 3 (07:31):
, is
it similarly common in men
versus women?
Speaker 4 (07:34):
That's a good question. And still open for
debate. Prior studies havesuggested that it's more common
in women, but those studies hadsome potential flaws. And more
recent studies suggest that itdepends on many other factors
other than just being a woman.
Don't
Speaker 3 (07:52):
Women live longer?
Is that one of them ?
Speaker 4 (07:54):
Women live longer.
That is a potential factor.
Yeah. But that,
Speaker 3 (07:58):
So there's more women of a, of a certain age.
Yeah.
Speaker 4 (08:01):
But that, that study and others have adjusted for
that factor. Oh , they have.
What
Speaker 3 (08:05):
About, is it genetic? Is it hereditary?
Speaker 4 (08:07):
So there's definitely hereditary
component. Um, the a o e fourgenotype or type of genes that
you have,
Speaker 3 (08:15):
Do you know everybody's out there writing
down a o e four? Yeah . Andsaying, should I get this?
Yeah.
Speaker 4 (08:20):
APO E and then the number four. So that's just a
APO lipoprotein e And if youhave one of the two genes for
APO E four, you're at aboutthree times the risk of having
dementia, Alzheimer's disease,dementia. If you have both,
you're at about 15 times therisk. However, there's still
(08:43):
not enough clinical evidence ingeneral to say you should run
out and get that test because ,you
Speaker 3 (08:49):
Know, that's what I'm gonna ask you next. Yeah.
Who should run off and gettested for these two
Speaker 4 (08:52):
Kids ? 'cause there are so many other factors that
play a role, especiallyeducation and lifestyle,
nutrition, exercise,cardiovascular disease. If you
already have heart disease,you're at higher risk of
dementia. If you have highblood pressure, diabetes,
Speaker 3 (09:08):
Those are the things you should be focusing. That's
what you should not, whether orwhether you have one of these
two genes necessarily.
Speaker 4 (09:14):
There are, however, a couple of companies starting
to market a combination oftests with a o e four with one
of the amyloid tests, but theresults have to be in the right
hands to provide the patient'sguidance. Yeah. So it's not
ready for prime time unless ,for example, of patients being
seen by a neurologist or adementia expert.
Speaker 3 (09:34):
So we're talking to Dr. Anne Murray about dementia,
and we've, we've laid thegroundwork on what is it and
how common it is. So now I'mgonna ask you to shift a little
bit , uh, who should be testedand how do you test for it? How
do you diagnose it? So
Speaker 4 (09:47):
Most often it's family members or friends that
end up bringing a patient infor testing because the
affected person is oftentimesthe last to realize what's
going on or to admit it.
Mm-hmm. , itdepends on what level of
cognitive function they startedwith. If they were in a fairly
(10:07):
demanding executive position,academic position, where they
would've had , um, probably atleast a college education and
starting at a higherintellectual capacity, they're
going to have symptoms earlierperhaps than those that don't
start at such a high level. Butmost people aren't going to
notice 'em .
Speaker 3 (10:27):
They're able to hide it better. Are they
intentionally hiding it? Or isit
Speaker 4 (10:31):
They They often are, but not, not always that
there's no universal statementregarding that really.
Speaker 3 (10:37):
Right, right . Yeah . So higher education level,
previous very high cognitiveabilities might, might make it
so that it's harder to findthose symptoms.
Speaker 4 (10:45):
Absolutely. And so if they have cognitive testing
before they have more advancedsymptoms, it may not show
anything. So
Speaker 3 (10:51):
How is it diagnosed?
Speaker 4 (10:53):
It's diagnosed by cognitive tests and taking a
good history. Otherwise, whatis the story? When did the
symptoms begin? Uh, when didyour family or friends notice
changes? And how is itaffecting your daily function?
How long ago did it begin?
Usually by the time a persongoes to a clinic to get it
(11:13):
diagnosed, they've had symptomsfor at least two years. And
Speaker 3 (11:16):
Isn't that hard to pinpoint when it started? How
long have you been Right .
Getting this right . It's veryhard . Few years. It's
Speaker 4 (11:20):
Very hard.
Speaker 3 (11:21):
It's getting worse over time. Some days are better
than others. It's probablyhard. Yeah. Do they do actual
formal written cognitivetesting?
Speaker 4 (11:29):
They do. It varies by what specialists you go to
see. If you're starting withyour primary care clinic, there
are some cognitive tests thatcan be given. And depending on
the results and the extent thatthe provider has worked with
dementia patients, they candesign a plan in terms of,
(11:49):
well, are you ready formedications? Or is it time to
get some blood tests ? And, andmaybe we should refer you for
further evaluation. If you'regoing to a geriatrician or a
neurologist, they can usuallydo more of that workup right
away. Whereas primary carephysicians, as all physicians,
have limited time to see eachpatient. No ,
Speaker 3 (12:10):
We have nine minutes. You know? Yeah.
Speaker 4 (12:11):
I mean, it's absurd.
There's no way you can docognitive testing unless you
have an extended visit and billMedicare for that, which never
covers the costs .
Speaker 3 (12:20):
Never really does.
What about clinics that arespecifically designed to treat
older adults?
Speaker 4 (12:24):
Sure. So at Hennepin Healthcare, we have two senior
care clinics, one in BrooklynPark where we have several
geriatricians and our geriatricfellow. And then at the
Clinical Specialty Center hereon the Hennepin campus, Dr.
Emily Ssq also does memoryassessments.
Speaker 3 (12:43):
Our geriatrics division is simply top-notch.
We're gonna take a quick breaknow, and when we come back, I
want to talk a little bit moreabout some preventive things
you might be able to do. Alsogonna talk about current
treatments and importantly,what is down the road for
future treatments in researchinto dementia. We're talking
with Dr. Anne Murray from thedivision of Geriatrics and a
dementia researcher here atHennepin Healthcare in downtown
(13:04):
Minneapolis. Stay tuned. We'llbe right back after a quick
break.
Speaker 2 (13:09):
You are listening to the Healthy Matters podcast
with Dr. David Hilden . Got aquestion or comment for the
doc, email us at Healthymatters@hcme.org or give us a
call at six one two eight seventhree talk. That's 6 1 2 8 7 3
8 2 5 5. And now let's get backto more healthy conversation.
Speaker 3 (13:32):
And we're back talking about dementia with Dr.
Anne Murray from HennepinHealthcare. And you mentioned a
little bit in our first segmentthat there are some things that
people can do to lower theirrisk. I don't know if you would
call those preventive, but youcan lower your risk.
Absolutely. And you talkedabout heart disease, diabetes,
exercise. Can you say moreabout that please?
Speaker 4 (13:49):
Absolutely. There have been several studies that
shown that you can reduce yourrisk of dementia by about 40%
or more just by maintaining ahealthy lifestyle. Foremost is
exercise. Just taking a 20minute walk a day is enough to
reduce your risk of dementia.
Doing more is better, but 20minutes a day of exercise that
(14:11):
gets your heart rate up. Andother things like weightlifting
yoga. What about
Speaker 3 (14:17):
Doing crossword puzzles or exercising your
brain? Is that Yeah. So
Speaker 4 (14:21):
Physical, physical exercise is actually more
important. It's
Speaker 3 (14:23):
More important
Speaker 4 (14:24):
Comparatively.
That's
Speaker 3 (14:26):
Fascinating. Is that because of increased blood flow
to the
Speaker 4 (14:28):
Brain? Yes. It's because of increased blood flow
from the heart to the brain.
And there are hormones in thebrain that are triggered by
exercise that increase bloodflow and decrease some nerve
damage.
Speaker 3 (14:41):
One more reason to get out and walk.
Speaker 4 (14:44):
Right.
Speaker 3 (14:44):
Right . What about what I've just said though, is
that a myth or does isexercising your brain help? I
meanly your brain doing wordleevery day or something like
that?
Speaker 4 (14:51):
Yes. Exercise in your brain does help. The key
is to keep your brain as activeas it has been in whatever ways
you have been doing and add newchallenges. Even picking up an
instrument or maybe trying tolearn a new language, picking
up some kind of new skill is abenefit. But do not watch tv.
Speaker 3 (15:13):
for crying
out loud. There's a new show I
found on Netflix. It's gonnamake my brain literally
atrophy.
Speaker 4 (15:19):
I should not say that.
Speaker 3 (15:20):
No, that's probably right. You're not active. Okay.
There , lots of us like to sitdown and binge Netflix
sometimes. Is that actuallyharmful?
Speaker 4 (15:28):
Only if it's prolonged sitting time and not
using your brain. Well,
Speaker 3 (15:33):
It totally is prolonged sitting time. Well,
for many people, for
Speaker 4 (15:36):
For many people two hours to watch a Netflix movie
is okay. But you have tocounterbalance it with
exercise. Yeah. Right.
Speaker 3 (15:44):
And I of course am on a treadmill when I'm
watching TV continuously.
Speaker 4 (15:47):
Right, right.
as aren't we all,aren't
Speaker 3 (15:50):
We all okay. What . Okay. So TV is maybe
not quite so good. Physicalexercise is good. What about
the disease processes? Youmentioned earlier treating
heart disease and diabetes andthe like. Why would those be
helpful?
Speaker 4 (16:02):
Because the same risk factors that increase your
risk of heart disease andstroke, increase your risk of
dementia. So the things thatincrease heart disease are high
blood pressure, high bloodsugar, diabetes, high blood
lipids,
Speaker 3 (16:18):
Cholesterol,
Speaker 4 (16:19):
Cholesterol, a poor diet and unhealthy diet. And
maintaining a normal bodyweight is really important.
More important even than thebody weight is your waist
circumference. And when I saywaist , it's not your belt
measurement, it's the biggestpart of your abdomen is the
waist circumference.
Speaker 3 (16:39):
So I will , I will , uh, uh, alert listeners. We did
a show on weight managementwith Dr. Aisha Galloway Gilliam
, and just a few weeks ago herein season two. Go back in here
that we talked about that theapple shape of a body. Right?
Not in your hips, that big gutthat you have
Speaker 4 (16:53):
Having abdominal fat. So for example, having a
pot belly doubles your risk ofdementia because there's enough
fat breakdown, fat metabolism,the energy that goes into
trying to break down the fatincreases inflammation and that
inflammation is bad for yourbrain. Wow.
Speaker 3 (17:12):
Let's shift to treatments. Now you've studied
treatments and for some yearsmm-hmm. are the
ones, first of all, that havebeen around for a while .
Effective. There are somemedications, for instance,
Speaker 4 (17:22):
Right? Yeah. There are two primary medications.
Um, Aricept or Donepezil andMemantine or naa , they work on
different nerve chemicals. Sothe Aricept works on the
acetylcholine neurologicsystem. And in doing that, it
prolongs how long acetylcholinestays around to transmit nerve
(17:43):
signals. The EDA slows down adifferent system. It's called
the glutamine or theglutaminergic system, and it
decreases the production ofglutamine, which is bad for the
brain. So
Speaker 3 (17:57):
Are these medicines clinically significant? Yeah.
Can people tell that theyworked?
Speaker 4 (18:01):
Some can. Yeah. Um, overall, probably 60 to 70% of
people will see a benefit ifthey have dementia due to
Alzheimer's disease,potentially less effective in
Lewy body disease. Um , may beeffective in parental temporal
dementia, but in some, there'sno effect in others. There
(18:23):
seems to be a little bit of ajump of an improvement right
away. And then they stabilizeand decline slower or more
slowly than they would've ifthey hadn't been on the
medication for about up toabout two years. And
Speaker 3 (18:35):
These have been around a long time. They've
been around 10, 20 yearsprobably, right?
Speaker 4 (18:38):
Yeah , about 20 years. What
Speaker 3 (18:39):
About aspirin? Is that doing anything?
Speaker 4 (18:41):
So funny. You should ask .
Speaker 3 (18:43):
Dr . Murray knows more than any living human
being I know about aspirin. II'm planting that question.
Speaker 4 (18:49):
Yeah . So there was a large, an ongoing study
called the aspirin and reducingevents in the elderly study
Speaker 3 (18:56):
Ri
Speaker 4 (18:57):
RI conducted in Australia in the us and we here
at the Berman Center, at theHennepin Health Research
Institute are still thecoordinating center. And we
found that after about fiveyears of taking low dose , a
hundred milligrams of dailyaspirin to see if it would
reduce the risk of dementia ordisability or death, it did not
do any of those things. It alsodid not reduce the risk of
(19:19):
cardiovascular disease. So for,
Speaker 3 (19:21):
It was based on that trial that you were leading in
this country and with yourworldwide partners, a daily
aspirin of roughly a babyaspirin dose . Yeah . That was
roughly a baby aspir .
Speaker 4 (19:30):
Yeah .
Speaker 3 (19:30):
Um , uh, didn't do anything to, to reduce the risk
of getting dementia. Didn'tmake people live longer, didn't
help their heart. That was agroundbreaking study. Were you
disappointed? We,
Speaker 4 (19:40):
Everybody was disappointed. Not completely
surprised, because the bottomline was that the bleeding risk
far outweighed any potentialbenefits . So 40% increased
risk of severe bleeding onaspirin compared to those who
are on, not on aspirin. So
Speaker 3 (19:54):
That's aspirin.
We've talked about the two, thetwo biggies that are out there.
What about what people arereading about in the newspapers
all the time, hearing on thenews, there's a new drug for
Alzheimer's disease, or there'sa new drug for dementia in
general. What's the latest ,uh,
Speaker 4 (20:07):
On that ? So the , the latest that is being given
out in selected centers underclinical observation is Lecan
Map , which is an anti amyloidmedication that is believed to
decrease plaques. Sopre-existing plaques,
Speaker 3 (20:23):
Amyloid plaques in the brain, it actually reduces
their presence
Speaker 4 (20:27):
A little bit. It may, in some patients also
improve their memory ordecrease their dementia
symptoms because
Speaker 3 (20:34):
Isn't that what you're after? That's what
you're after. Does someonereally care if I have fewer
plaques in my brain, if itdidn't result in any
improvement in my life?
Speaker 4 (20:41):
They don't, especially if the plaques have
been there for so long, they'reprobably not making a
difference anymore. Right.
They're more, more of a scarthan anything.
Speaker 3 (20:48):
Are you encouraged by these? Are you , uh, do , is
there a promise in these newWell,
Speaker 4 (20:51):
There are
Speaker 3 (20:52):
Biologic treatments is what they are
Speaker 4 (20:54):
Somewhat. I think that we have to be aware that
there are many different waysto get dementia, many different
types of nerve damage toproduce dementia, Alzheimer's.
So amyloid and tau are not byany means, the only ways to get
it. And so we have to deviseways to address all those other
different types of cells, todevise medications, to treat
(21:16):
those. And that's why notreatment has been a panacea.
Nothing has really worked well.
Speaker 3 (21:20):
Right. What about non-medication resources , uh,
that are out there? Yes. I knowpeople in my own life that use
the Alzheimer's organization
Speaker 4 (21:28):
Services . The Alzheimer's Association is
wonderful. And we in Minnesota,North Dakota, have a wonderful
chapter. They have , uh,tremendous amount of
information for caregivers aswell as for those experiencing
memory loss. That includesresources for finding in-home
health caregivers, supportgroups, daycare centers, what's
(21:50):
available for daycare centers,for those who are already along
the path with moderatedementia. A lot of good ideas
on what steps to take next,because
Speaker 3 (21:58):
It's really about the caregivers as well. Oh ,
this is not a disease thatpeople do on their own. Right .
They , it's a , it's a, there's, it takes caregivers and loved
ones and support systems andprofessionals.
Speaker 4 (22:09):
Yes. And the caregivers know that better
than anybody. It tra makes ,takes a tremendous toll on the
caregiver. And oftentimes it'shard to remind them because
they're so dedicated that youhave got to take care of
yourself, because if you don't,who's gonna take care of your
family member? So there've beenactually a lot more research
studies in the past 10 yearssupported by National Institute
(22:31):
of Aging to look at caregiverresearch and how to support
them. So I
Speaker 3 (22:34):
Happen to know that you do have done a lot of this
research over your career andyou continue to be actively
doing internationally basedresearch and right out, right
out of here in downtownMinneapolis. What are you
working on right now? Sure.
Speaker 4 (22:46):
So there's a new study that just began enrolling
called The Healthy Agingthrough the senior years, or
the hats study. You
Speaker 3 (22:55):
Guys always come up with acronyms.
Speaker 4 (22:57):
have to be
able to remember them. Um, and
this is a , a very excitingstudy that we're doing here at
the Berman Center at HennepinHealth, together with the Mayo
Clinic. This is a collaborationwith Mayo where we are adapting
the study design that Mayocreated for their , um, Mayo
Clinic study of aging, to studydementia and other diseases
(23:19):
over the long term , but nowenrolling black participants.
Mm-hmm . And we've been veryfortunate to work with two
community engagement partners,Clarence Jones with his Humane
Group and Monisha Washingtonwith her link group that have
been great in helping us engagewith community and begin
enrollment.
Speaker 3 (23:38):
Much research over the years has not included
people of color. That's right.
And so this one specificallydoes,
Speaker 4 (23:44):
This is specifically targeted to that. And we're ,
um, hoping to enroll about 300participants over the next two
and a half years. We have somefunding through Mayo
philanthropic funding. We areapplying for more both through
N I H and through the MinnesotaResearch Partnership with the
University of Minnesota throughthe state. So , so
Speaker 3 (24:03):
I'm hearing a lot , uh, although it's a big burden
for our community, it affectsso many of us, our families. Um
, dementia does, I'm hearingsome positive things. I'm
hearing some new treatmentsdown the road. I am hearing
about the Alzheimer'sAssociation as an incredible
resource for people. And I'mhearing about the research that
you're doing that sounds likethere are some promising things
down the road.
Speaker 4 (24:23):
Absolutely. I think there will be in the next 10
years or so, successfultreatments, not to cure, but to
slow it. And in the future toprevent it. We will
Speaker 3 (24:34):
Put a link to the hats trial on the show notes.
So, great. Fantastic,fantastic.
Speaker 4 (24:38):
Listeners,
Speaker 3 (24:38):
Fantastic . Um , go there. Please look at it and
see if , uh, that might besomething you or a loved one or
someone you know, might beinterested in and be part of
the solution to dementia. Ihave been talking with my
colleague, Dr. Anne Murray, whois a researcher, a
geriatrician, and a colleagueof mine here at Hennepin
Healthcare in downtownMinneapolis. Thank you so much.
(24:59):
Not only for being here today,but for helping me out to learn
about these topics over thelast couple of decades since
we've been working together andfor all the work you're doing
for our, our communities.
Speaker 4 (25:09):
My pleasure. It's been fun.
Speaker 3 (25:10):
It's great to have you here. We've been talking
about dementia with Dr. AnnMurray . I hope you have picked
something up. I have learned aton in this episode. And if you
liked what you heard, give us areview , uh, wherever you get
your podcasts and share thesepodcasts with your friends and
neighbors. That's all we havefor today. And thank you for
tuning in listeners, and I hopeyou'll join us for our next
episode. In the meantime, behealthy and be well.
Speaker 2 (25:33):
Thanks for listening to the Healthy Matters podcast
with Dr . David Hilden . Tofind out more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. You got a questionor a comment for the show?
Email us at Healthymatters@hcmed.org or call 6 1 2
8 7 3 talk. There's also a linkin the show notes. And finally,
(25:56):
if you enjoy the show, pleaseleave us a review and share the
show with others. The HealthyMatters Podcast is made
possible by Hennepin Healthcarein Minneapolis, Minnesota, and
engineered and produced by JohnLucas At Highball Executive
Producers are Jonathan, CTO andChristine Hill . Please
remember, we can only givegeneral medical advice during
this program, and every case isunique. We urge you to consult
(26:17):
with your physician if you havea more serious or pressing
health concern. Until nexttime, be healthy and be well.
Speaker 2 (00:04):
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare
and what matters to you. Andnow here's our host, Dr. David
Hilden .
Speaker 3 (00:20):
Hey everybody, it's Dr. David Hilden , your host of
the Healthy Matters podcast.
And welcome to episode 16. Weare gonna tackle the subject of
Alzheimer's disease anddementia. Help me out. I've
invited Dr. Anne-Marie , she'sa colleague of mine here at
Hennepin Healthcare in downtownMinneapolis, and a researcher
into Alzheimer's disease , uh,and a geriatrician. And thanks
(00:42):
for being back on the show with
Speaker 4 (00:43):
Me. Great to be here. Thanks, Dave.
Speaker 3 (00:45):
I have worked with you before on other
broadcasting. We've talked overthe radio waves. Now we're
gonna do it in podcast form. Soyou have studied dementia your
whole career. Could you lay thebasics for our listeners? What
is Alzheimer's disease? Ormaybe what is dementia in
general? Yeah.
Speaker 4 (01:02):
Better to start with, what is dementia? So
dementia is the umbrella termto describe a chronic
progressive state of confusion.
That includes memory loss andloss of ability to make
decisions, to find the rightwords, to find things, and to
navigate and eventually to beindependent in your daily
(01:25):
functions. Dementia is thegeneral term, but there are
many types of dementia.
Alzheimer's is the most common,and it's important to
distinguish Alzheimer's as asubtype of dementia versus all
dementia. Many people thinkthat Alzheimer's is all
dementia, but it's the otherway around. Dementia is the
(01:46):
umbrella term, and Alzheimer'sis a type. Other types are Lewy
body dementia or frontaltemporal dementia, early onset
dementia. So that's kind of theoverview, the definition.
Speaker 3 (01:59):
How can you tell them apart?
Speaker 4 (01:59):
Right. So really difficult to tell 'em apart
initially. Usually, forexample, for Alzheimer's
disease, many of thecharacteristics seen in
Alzheimer's disease are alsoseen in other types of
dementia. But it's the timingand the association with other
symptoms that makes thedifference in the diagnosis. So
(02:20):
for Alzheimer's disease, it'susually memory loss for recent
events, recent memory lossversus remote or long distance
memory.
Speaker 3 (02:31):
So how is that different, or how do you know
if it's a pathological or anabnormal process from the
person who says, well, as I getolder, I sometimes forget where
I like put my checkbook. Right. How can you tell when is it a
problem versus a normalprocess? Or is it ever a normal
process? Um,
Speaker 4 (02:49):
That's up for argument, whether it's a normal
process,
that are still withoutsignificant memory loss. So
generally, if it startsinterfering with your daily
function to the point whereit's making a big difference in
your daily life. So it's notthat you forgot where you put
(03:09):
your keys. Maybe you forgotthat you left your car in a
parking lot, or you can'tfigure out how to get home from
a neighborhood that's veryfamiliar to you, or how to find
your way home from say, anevent downtown. When you've
been doing that for 20 years,
Speaker 3 (03:26):
Suddenly you don't know where you are, how you ,
how do I get home?
Speaker 4 (03:28):
Right. Other things are forgetting something that
happened yesterday, forgettingconversations completely and
having family members startreminding you that we talked
about this or that appointmentwas yesterday and we need to
reschedule it. The frequencyand the persistence of those
(03:50):
episodes is what makes thedifference. When
Speaker 3 (03:52):
Does it begin in a person's life? Yeah.
Speaker 4 (03:55):
So it depends on whether you're talking about
when does it begin in the brainversus the symptoms in the
brain. It begins about 15 to 20years before the symptoms for
most types of dementia forAlzheimer's, and more of the
slowly progressive, what wecall degenerative dementias.
And we know that because there,there are brain autopsy studies
(04:16):
that show that those brainchanges. So amyloid and tau
begin 15 to 20 years before thesymptoms begin. Are
Speaker 3 (04:25):
These the proteins in the brain that people have
heard about? Right . Amyloidand tau, those are
Speaker 4 (04:29):
The two most prominent proteins that we've
been studying for many years.
Now. There are other proteinsthat are involved in other
types of dementia, but amyloidand tau are the biggest
players. And
Speaker 3 (04:41):
You said then about symptoms that those come on 10
to 15 years later after thesechanges begin in the brain.
Mm-hmm.
are the first things and howwould you know? How would a
family member know?
Speaker 4 (04:53):
Yeah . So short-term memory loss mm-hmm .
Recurrent word, findingproblems, persistent for
reasonably common words.
Mm-hmm.
using that, what we callexecutive function and decision
making tools to plan your day.
And especially kind of a , alitmus test if you want, is
(05:16):
planning a trip. The ability toplan a trip with all the
different components. You know,the flights , uh, the hotels is
a very complex task thatrequires a lot of quote ,
executive function. Mm-hmm.
worldwide, that's when it firstshows up, is a very complex
task like that because they'realready extremely high
(05:37):
functioning people.
Speaker 3 (05:37):
Yeah. They've done this before. Yeah. They know
how to do that. Yeah . And nowthey can't. Right. That's
fascinating. So I'm gonna moveon to like, in the population,
how common is dementia and arethey on the rise, the decline
mm-hmm.
Speaker 4 (05:52):
Globally. So a recent study that was published
in the Lancet showed that it'sactually on the decline in
developed countries in mostlyWestern developed countries. So
the
Speaker 3 (06:03):
Lancet, one of the leading journals, medical
journals ,
Speaker 4 (06:05):
It's one of the leading medical journals in the
world. Right. And it's believedthat in part, that's due to
decreasing cardiovasculardisease and treating
cardiovascular risk factorslike high blood pressure and
high glucose. So treatingdiabetes, but also higher
levels of education acrosscountries. So having a higher
(06:25):
level of education is thestrongest protective factor. We
have to build up brain reserveto resist the changes of
dementia.
Speaker 3 (06:36):
And those are more prevalent in developed
countries. So why do I hearthen that dementia and related
diseases are on the top list ofcauses of mortality death . Yep
. Yep . We keep hearing that.
And cardiovascular disease,heart disease is still number
one, but getting better strokesare still way up there, but
getting a little better. Right. But you hear about dementia
on the lists of reasons formortality. Why is that?
Speaker 4 (07:00):
Right ? Right.
Because the prevalence or howcommonly it occurs increases
almost doubles every 10 yearsafter the age of 65. So you
can't stop aging. Mm-hmm . Ourpopulation here and in many
countries has acceleratedaging. The aging population has
grown to the point where rightnow, close to a third of the
(07:24):
population in many parts of theUS and the western countries
are 65 and older, or it will beby 2050. Mm-hmm.
Speaker 3 (07:31):
versus women?
Speaker 4 (07:34):
That's a good question. And still open for
debate. Prior studies havesuggested that it's more common
in women, but those studies hadsome potential flaws. And more
recent studies suggest that itdepends on many other factors
other than just being a woman.
Don't
Speaker 3 (07:52):
Women live longer?
Is that one of them ?
Speaker 4 (07:54):
Women live longer.
That is a potential factor.
Yeah. But that,
Speaker 3 (07:58):
So there's more women of a, of a certain age.
Yeah.
Speaker 4 (08:01):
But that, that study and others have adjusted for
that factor. Oh , they have.
What
Speaker 3 (08:05):
About, is it genetic? Is it hereditary?
Speaker 4 (08:07):
So there's definitely hereditary
component. Um, the a o e fourgenotype or type of genes that
you have,
Speaker 3 (08:15):
Do you know everybody's out there writing
down a o e four? Yeah . Andsaying, should I get this?
Yeah.
Speaker 4 (08:20):
APO E and then the number four. So that's just a
APO lipoprotein e And if youhave one of the two genes for
APO E four, you're at aboutthree times the risk of having
dementia, Alzheimer's disease,dementia. If you have both,
you're at about 15 times therisk. However, there's still
(08:43):
not enough clinical evidence ingeneral to say you should run
out and get that test because ,you
Speaker 3 (08:49):
Know, that's what I'm gonna ask you next. Yeah.
Who should run off and gettested for these two
Speaker 4 (08:52):
Kids ? 'cause there are so many other factors that
play a role, especiallyeducation and lifestyle,
nutrition, exercise,cardiovascular disease. If you
already have heart disease,you're at higher risk of
dementia. If you have highblood pressure, diabetes,
Speaker 3 (09:08):
Those are the things you should be focusing. That's
what you should not, whether orwhether you have one of these
two genes necessarily.
Speaker 4 (09:14):
There are, however, a couple of companies starting
to market a combination oftests with a o e four with one
of the amyloid tests, but theresults have to be in the right
hands to provide the patient'sguidance. Yeah. So it's not
ready for prime time unless ,for example, of patients being
seen by a neurologist or adementia expert.
Speaker 3 (09:34):
So we're talking to Dr. Anne Murray about dementia,
and we've, we've laid thegroundwork on what is it and
how common it is. So now I'mgonna ask you to shift a little
bit , uh, who should be testedand how do you test for it? How
do you diagnose it? So
Speaker 4 (09:47):
Most often it's family members or friends that
end up bringing a patient infor testing because the
affected person is oftentimesthe last to realize what's
going on or to admit it.
Mm-hmm.
cognitive function they startedwith. If they were in a fairly
(10:07):
demanding executive position,academic position, where they
would've had , um, probably atleast a college education and
starting at a higherintellectual capacity, they're
going to have symptoms earlierperhaps than those that don't
start at such a high level. Butmost people aren't going to
notice 'em .
Speaker 3 (10:27):
They're able to hide it better. Are they
intentionally hiding it? Or isit
Speaker 4 (10:31):
They They often are, but not, not always that
there's no universal statementregarding that really.
Speaker 3 (10:37):
Right, right . Yeah . So higher education level,
previous very high cognitiveabilities might, might make it
so that it's harder to findthose symptoms.
Speaker 4 (10:45):
Absolutely. And so if they have cognitive testing
before they have more advancedsymptoms, it may not show
anything. So
Speaker 3 (10:51):
How is it diagnosed?
Speaker 4 (10:53):
It's diagnosed by cognitive tests and taking a
good history. Otherwise, whatis the story? When did the
symptoms begin? Uh, when didyour family or friends notice
changes? And how is itaffecting your daily function?
How long ago did it begin?
Usually by the time a persongoes to a clinic to get it
(11:13):
diagnosed, they've had symptomsfor at least two years. And
Speaker 3 (11:16):
Isn't that hard to pinpoint when it started? How
long have you been Right .
Getting this right . It's veryhard . Few years. It's
Speaker 4 (11:20):
Very hard.
Speaker 3 (11:21):
It's getting worse over time. Some days are better
than others. It's probablyhard. Yeah. Do they do actual
formal written cognitivetesting?
Speaker 4 (11:29):
They do. It varies by what specialists you go to
see. If you're starting withyour primary care clinic, there
are some cognitive tests thatcan be given. And depending on
the results and the extent thatthe provider has worked with
dementia patients, they candesign a plan in terms of,
(11:49):
well, are you ready formedications? Or is it time to
get some blood tests ? And, andmaybe we should refer you for
further evaluation. If you'regoing to a geriatrician or a
neurologist, they can usuallydo more of that workup right
away. Whereas primary carephysicians, as all physicians,
have limited time to see eachpatient. No ,
Speaker 3 (12:10):
We have nine minutes. You know? Yeah.
Speaker 4 (12:11):
I mean, it's absurd.
There's no way you can docognitive testing unless you
have an extended visit and billMedicare for that, which never
covers the costs .
Speaker 3 (12:20):
Never really does.
What about clinics that arespecifically designed to treat
older adults?
Speaker 4 (12:24):
Sure. So at Hennepin Healthcare, we have two senior
care clinics, one in BrooklynPark where we have several
geriatricians and our geriatricfellow. And then at the
Clinical Specialty Center hereon the Hennepin campus, Dr.
Emily Ssq also does memoryassessments.
Speaker 3 (12:43):
Our geriatrics division is simply top-notch.
We're gonna take a quick breaknow, and when we come back, I
want to talk a little bit moreabout some preventive things
you might be able to do. Alsogonna talk about current
treatments and importantly,what is down the road for
future treatments in researchinto dementia. We're talking
with Dr. Anne Murray from thedivision of Geriatrics and a
dementia researcher here atHennepin Healthcare in downtown
(13:04):
Minneapolis. Stay tuned. We'llbe right back after a quick
break.
Speaker 2 (13:09):
You are listening to the Healthy Matters podcast
with Dr. David Hilden . Got aquestion or comment for the
doc, email us at Healthymatters@hcme.org or give us a
call at six one two eight seventhree talk. That's 6 1 2 8 7 3
8 2 5 5. And now let's get backto more healthy conversation.
Speaker 3 (13:32):
And we're back talking about dementia with Dr.
Anne Murray from HennepinHealthcare. And you mentioned a
little bit in our first segmentthat there are some things that
people can do to lower theirrisk. I don't know if you would
call those preventive, but youcan lower your risk.
Absolutely. And you talkedabout heart disease, diabetes,
exercise. Can you say moreabout that please?
Speaker 4 (13:49):
Absolutely. There have been several studies that
shown that you can reduce yourrisk of dementia by about 40%
or more just by maintaining ahealthy lifestyle. Foremost is
exercise. Just taking a 20minute walk a day is enough to
reduce your risk of dementia.
Doing more is better, but 20minutes a day of exercise that
(14:11):
gets your heart rate up. Andother things like weightlifting
yoga. What about
Speaker 3 (14:17):
Doing crossword puzzles or exercising your
brain? Is that Yeah. So
Speaker 4 (14:21):
Physical, physical exercise is actually more
important. It's
Speaker 3 (14:23):
More important
Speaker 4 (14:24):
Comparatively.
That's
Speaker 3 (14:26):
Fascinating. Is that because of increased blood flow
to the
Speaker 4 (14:28):
Brain? Yes. It's because of increased blood flow
from the heart to the brain.
And there are hormones in thebrain that are triggered by
exercise that increase bloodflow and decrease some nerve
damage.
Speaker 3 (14:41):
One more reason to get out and walk.
Speaker 4 (14:44):
Right.
Speaker 3 (14:44):
Right . What about what I've just said though, is
that a myth or does isexercising your brain help? I
meanly your brain doing wordleevery day or something like
that?
Speaker 4 (14:51):
Yes. Exercise in your brain does help. The key
is to keep your brain as activeas it has been in whatever ways
you have been doing and add newchallenges. Even picking up an
instrument or maybe trying tolearn a new language, picking
up some kind of new skill is abenefit. But do not watch tv.
Speaker 3 (15:13):
found on Netflix. It's gonnamake my brain literally
atrophy.
Speaker 4 (15:19):
I should not say that.
Speaker 3 (15:20):
No, that's probably right. You're not active. Okay.
There , lots of us like to sitdown and binge Netflix
sometimes. Is that actuallyharmful?
Speaker 4 (15:28):
Only if it's prolonged sitting time and not
using your brain. Well,
Speaker 3 (15:33):
It totally is prolonged sitting time. Well,
for many people, for
Speaker 4 (15:36):
For many people two hours to watch a Netflix movie
is okay. But you have tocounterbalance it with
exercise. Yeah. Right.
Speaker 3 (15:44):
And I of course am on a treadmill when I'm
watching TV continuously.
Speaker 4 (15:47):
Right, right.
Speaker 3 (15:50):
We all okay. What
not quite so good. Physicalexercise is good. What about
the disease processes? Youmentioned earlier treating
heart disease and diabetes andthe like. Why would those be
helpful?
Speaker 4 (16:02):
Because the same risk factors that increase your
risk of heart disease andstroke, increase your risk of
dementia. So the things thatincrease heart disease are high
blood pressure, high bloodsugar, diabetes, high blood
lipids,
Speaker 3 (16:18):
Cholesterol,
Speaker 4 (16:19):
Cholesterol, a poor diet and unhealthy diet. And
maintaining a normal bodyweight is really important.
More important even than thebody weight is your waist
circumference. And when I saywaist , it's not your belt
measurement, it's the biggestpart of your abdomen is the
waist circumference.
Speaker 3 (16:39):
So I will , I will , uh, uh, alert listeners. We did
a show on weight managementwith Dr. Aisha Galloway Gilliam
, and just a few weeks ago herein season two. Go back in here
that we talked about that theapple shape of a body. Right?
Not in your hips, that big gutthat you have
Speaker 4 (16:53):
Having abdominal fat. So for example, having a
pot belly doubles your risk ofdementia because there's enough
fat breakdown, fat metabolism,the energy that goes into
trying to break down the fatincreases inflammation and that
inflammation is bad for yourbrain. Wow.
Speaker 3 (17:12):
Let's shift to treatments. Now you've studied
treatments and for some yearsmm-hmm.
ones, first of all, that havebeen around for a while .
Effective. There are somemedications, for instance,
Speaker 4 (17:22):
Right? Yeah. There are two primary medications.
Um, Aricept or Donepezil andMemantine or naa , they work on
different nerve chemicals. Sothe Aricept works on the
acetylcholine neurologicsystem. And in doing that, it
prolongs how long acetylcholinestays around to transmit nerve
(17:43):
signals. The EDA slows down adifferent system. It's called
the glutamine or theglutaminergic system, and it
decreases the production ofglutamine, which is bad for the
brain. So
Speaker 3 (17:57):
Are these medicines clinically significant? Yeah.
Can people tell that theyworked?
Speaker 4 (18:01):
Some can. Yeah. Um, overall, probably 60 to 70% of
people will see a benefit ifthey have dementia due to
Alzheimer's disease,potentially less effective in
Lewy body disease. Um , may beeffective in parental temporal
dementia, but in some, there'sno effect in others. There
(18:23):
seems to be a little bit of ajump of an improvement right
away. And then they stabilizeand decline slower or more
slowly than they would've ifthey hadn't been on the
medication for about up toabout two years. And
Speaker 3 (18:35):
These have been around a long time. They've
been around 10, 20 yearsprobably, right?
Speaker 4 (18:38):
Yeah , about 20 years. What
Speaker 3 (18:39):
About aspirin? Is that doing anything?
Speaker 4 (18:41):
So funny. You should ask
Speaker 3 (18:43):
Dr . Murray knows more than any living human
being I know about aspirin. II'm planting that question.
Speaker 4 (18:49):
Yeah . So there was a large, an ongoing study
called the aspirin and reducingevents in the elderly study
Speaker 3 (18:56):
Ri
Speaker 4 (18:57):
RI conducted in Australia in the us and we here
at the Berman Center, at theHennepin Health Research
Institute are still thecoordinating center. And we
found that after about fiveyears of taking low dose , a
hundred milligrams of dailyaspirin to see if it would
reduce the risk of dementia ordisability or death, it did not
do any of those things. It alsodid not reduce the risk of
(19:19):
cardiovascular disease. So for,
Speaker 3 (19:21):
It was based on that trial that you were leading in
this country and with yourworldwide partners, a daily
aspirin of roughly a babyaspirin dose . Yeah . That was
roughly a baby aspir .
Speaker 4 (19:30):
Yeah .
Speaker 3 (19:30):
Um , uh, didn't do anything to, to reduce the risk
of getting dementia. Didn'tmake people live longer, didn't
help their heart. That was agroundbreaking study. Were you
disappointed? We,
Speaker 4 (19:40):
Everybody was disappointed. Not completely
surprised, because the bottomline was that the bleeding risk
far outweighed any potentialbenefits . So 40% increased
risk of severe bleeding onaspirin compared to those who
are on, not on aspirin. So
Speaker 3 (19:54):
That's aspirin.
We've talked about the two, thetwo biggies that are out there.
What about what people arereading about in the newspapers
all the time, hearing on thenews, there's a new drug for
Alzheimer's disease, or there'sa new drug for dementia in
general. What's the latest ,uh,
Speaker 4 (20:07):
On that ? So the , the latest that is being given
out in selected centers underclinical observation is Lecan
Map , which is an anti amyloidmedication that is believed to
decrease plaques. Sopre-existing plaques,
Speaker 3 (20:23):
Amyloid plaques in the brain, it actually reduces
their presence
Speaker 4 (20:27):
A little bit. It may, in some patients also
improve their memory ordecrease their dementia
symptoms because
Speaker 3 (20:34):
Isn't that what you're after? That's what
you're after. Does someonereally care if I have fewer
plaques in my brain, if itdidn't result in any
improvement in my life?
Speaker 4 (20:41):
They don't, especially if the plaques have
been there for so long, they'reprobably not making a
difference anymore. Right.
They're more, more of a scarthan anything.
Speaker 3 (20:48):
Are you encouraged by these? Are you , uh, do , is
there a promise in these newWell,
Speaker 4 (20:51):
There are
Speaker 3 (20:52):
Biologic treatments is what they are
Speaker 4 (20:54):
Somewhat. I think that we have to be aware that
there are many different waysto get dementia, many different
types of nerve damage toproduce dementia, Alzheimer's.
So amyloid and tau are not byany means, the only ways to get
it. And so we have to deviseways to address all those other
different types of cells, todevise medications, to treat
(21:16):
those. And that's why notreatment has been a panacea.
Nothing has really worked well.
Speaker 3 (21:20):
Right. What about non-medication resources , uh,
that are out there? Yes. I knowpeople in my own life that use
the Alzheimer's organization
Speaker 4 (21:28):
Services . The Alzheimer's Association is
wonderful. And we in Minnesota,North Dakota, have a wonderful
chapter. They have , uh,tremendous amount of
information for caregivers aswell as for those experiencing
memory loss. That includesresources for finding in-home
health caregivers, supportgroups, daycare centers, what's
(21:50):
available for daycare centers,for those who are already along
the path with moderatedementia. A lot of good ideas
on what steps to take next,because
Speaker 3 (21:58):
It's really about the caregivers as well. Oh ,
this is not a disease thatpeople do on their own. Right .
They , it's a , it's a, there's, it takes caregivers and loved
ones and support systems andprofessionals.
Speaker 4 (22:09):
Yes. And the caregivers know that better
than anybody. It tra makes ,takes a tremendous toll on the
caregiver. And oftentimes it'shard to remind them because
they're so dedicated that youhave got to take care of
yourself, because if you don't,who's gonna take care of your
family member? So there've beenactually a lot more research
studies in the past 10 yearssupported by National Institute
(22:31):
of Aging to look at caregiverresearch and how to support
them. So I
Speaker 3 (22:34):
Happen to know that you do have done a lot of this
research over your career andyou continue to be actively
doing internationally basedresearch and right out, right
out of here in downtownMinneapolis. What are you
working on right now? Sure.
Speaker 4 (22:46):
So there's a new study that just began enrolling
called The Healthy Agingthrough the senior years, or
the hats study. You
Speaker 3 (22:55):
Guys always come up with acronyms.
Speaker 4 (22:57):
this is a , a very excitingstudy that we're doing here at
the Berman Center at HennepinHealth, together with the Mayo
Clinic. This is a collaborationwith Mayo where we are adapting
the study design that Mayocreated for their , um, Mayo
Clinic study of aging, to studydementia and other diseases
(23:19):
over the long term , but nowenrolling black participants.
Mm-hmm . And we've been veryfortunate to work with two
community engagement partners,Clarence Jones with his Humane
Group and Monisha Washingtonwith her link group that have
been great in helping us engagewith community and begin
enrollment.
Speaker 3 (23:38):
Much research over the years has not included
people of color. That's right.
And so this one specificallydoes,
Speaker 4 (23:44):
This is specifically targeted to that. And we're ,
um, hoping to enroll about 300participants over the next two
and a half years. We have somefunding through Mayo
philanthropic funding. We areapplying for more both through
N I H and through the MinnesotaResearch Partnership with the
University of Minnesota throughthe state. So , so
Speaker 3 (24:03):
I'm hearing a lot , uh, although it's a big burden
for our community, it affectsso many of us, our families. Um
, dementia does, I'm hearingsome positive things. I'm
hearing some new treatmentsdown the road. I am hearing
about the Alzheimer'sAssociation as an incredible
resource for people. And I'mhearing about the research that
you're doing that sounds likethere are some promising things
down the road.
Speaker 4 (24:23):
Absolutely. I think there will be in the next 10
years or so, successfultreatments, not to cure, but to
slow it. And in the future toprevent it. We will
Speaker 3 (24:34):
Put a link to the hats trial on the show notes.
So, great. Fantastic,fantastic.
Speaker 4 (24:38):
Listeners,
Speaker 3 (24:38):
Fantastic . Um , go there. Please look at it and
see if , uh, that might besomething you or a loved one or
someone you know, might beinterested in and be part of
the solution to dementia. Ihave been talking with my
colleague, Dr. Anne Murray, whois a researcher, a
geriatrician, and a colleagueof mine here at Hennepin
Healthcare in downtownMinneapolis. Thank you so much.
(24:59):
Not only for being here today,but for helping me out to learn
about these topics over thelast couple of decades since
we've been working together andfor all the work you're doing
for our, our communities.
Speaker 4 (25:09):
My pleasure. It's been fun.
Speaker 3 (25:10):
It's great to have you here. We've been talking
about dementia with Dr. AnnMurray . I hope you have picked
something up. I have learned aton in this episode. And if you
liked what you heard, give us areview , uh, wherever you get
your podcasts and share thesepodcasts with your friends and
neighbors. That's all we havefor today. And thank you for
tuning in listeners, and I hopeyou'll join us for our next
episode. In the meantime, behealthy and be well.
Speaker 2 (25:33):
Thanks for listening to the Healthy Matters podcast
with Dr . David Hilden . Tofind out more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. You got a questionor a comment for the show?
Email us at Healthymatters@hcmed.org or call 6 1 2
8 7 3 talk. There's also a linkin the show notes. And finally,
(25:56):
if you enjoy the show, pleaseleave us a review and share the
show with others. The HealthyMatters Podcast is made
possible by Hennepin Healthcarein Minneapolis, Minnesota, and
engineered and produced by JohnLucas At Highball Executive
Producers are Jonathan, CTO andChristine Hill . Please
remember, we can only givegeneral medical advice during
this program, and every case isunique. We urge you to consult
(26:17):
with your physician if you havea more serious or pressing
health concern. Until nexttime, be healthy and be well.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!