February 11, 2025 • 46 mins
1 in 3 Older Adults DIE WITH ALZHEIMER’S or Another Dementia
What You Need to Know about Alzheimer’s
and Symptoms You May Not be Aware of!
Discover unknown symptoms of the disabling and deadly Alzheimer’s disease and how to combat them. Dr. Jim Polakof interviews – aging expert, Dr. Heather Whitson – leader of a collaborative Alzheimer's Disease initiative combining Duke University and the University of North Carolina (UNC) at Chapel Hill, with a bold vision to transform dementia research and care.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:07):
I'm Dr Jim Polakoff and welcome to another episode
of Live Healthy Longer.
Alzheimer's is currently rankedas the seventh leading cause of
death in the United States andit's the most common cause of
dementia among older adults.
It's the most common cause ofdementia among older adults.
(00:27):
But what makes Alzheimer'sreally challenging is the toll
these diseases take on lovedones and family.
Fortunately, my guest for thispodcast is a leading expert who
will provide insights and aclose look at solutions.
Speaker 2 (00:44):
Live Healthy Longer is sponsored by LHL Institute,
where aging presents a new stageof opportunity and the longer
we live, the more beautiful lifebecomes.
Our host, Dr Jim Polakoff,certified nutritionist, author
and health specialist dedicatedto enriching the lives of others
(01:05):
.
Now, here again is Dr JimPolakoff.
Speaker 1 (01:09):
While dementia is a medical condition involving the
decline of mental ability,alzheimer's disease actually
damages brain cells.
As a result, some signs ofAlzheimer's include memory loss,
poor judgment, leading to baddecisions, taking longer to
complete normal tasks, repeatingquestions and forgetfulness,
(01:34):
changes in mood and personality,losing or misplacing things,
even wandering or getting lost,and, as the disease progresses,
increased anxiety or depression.
Well over 6.5 million Americansare living in the clutches of
Alzheimer's, with more womenthan men suffering from this
(01:56):
deadly disease.
Fortunately, there's a leadingexpert who can shed light and
hope.
There's a leading expert whocan shed light and hope.
My guest is Dr Heather Whitson,director for the Study of Aging
and Human Development at DukeUniversity.
Dr Whitson also leads acollaborative initiative that
(02:18):
brings together investigatorsfrom Duke University and the
University of North Carolina,chapel Hill, with a bold vision
to transform the research andcare of Alzheimer's disease and
dementia.
Welcome, dr Whitson.
Speaker 3 (02:30):
Thank you, thanks for having me and thanks for
covering this topic.
Speaker 1 (02:33):
Well, it's our pleasure.
It's an important one, that'sfor sure.
Now, perhaps you can begin bydescribing how Alzheimer's
disease affects the brain.
Speaker 3 (02:42):
Yeah, sure.
So that's a good question.
We know a lot more about thatthan we did even five or 10
years ago.
So Alzheimer's disease andother types of pathology that
cause dementia are caused bymisfolded proteins in the brain
and whatever it is that causedthose proteins to misfold.
(03:03):
So it's important to realizethat when people are
experiencing the symptoms ofdementia, like memory loss and
confusion, what's happeninginside the brain, inside the
nerves of the brain, are thesemisfolded types of proteins and
then other changes to othertypes of cells that we think
either cause those proteins tobe there or are a reaction to
(03:26):
those proteins being there.
Speaker 1 (03:28):
So what are they doing?
Are they, these proteins?
Are they actually slowing downthe brain so that it's difficult
to remember something, forexample?
Speaker 3 (03:38):
So we don't entirely know, because it's possible to
have a lot of those proteins inyour brain and not have any
cognitive problems at all.
We call those peoplecognitively resilient.
So we can look at people'sbrain images, or we can look at
the protein levels in theirspinal fluid and see that there
are some people that carry a lotof those proteins and yet their
(04:00):
brains seem to function reallywell.
Their brains seem to functionreally well, and then sometimes
there are people that don't seemto have super high levels of
those proteins but havecognitive problems.
So there's not a perfectcorrelation, but some of the
proteins are actually inside thecells, some of the proteins are
outside the cells.
It certainly appears, though,increasingly, that the proteins
(04:25):
themselves are at least part ofthe problem.
So when the brain hasAlzheimer's disease, the, the,
the proteins are causing thebrain to not be able to do its
job as well.
Speaker 1 (04:37):
So how do you explain ?
I'm just curious.
You have some brilliant minds.
You know different people.
I mean, one of the great moviedirectors, you might say, of all
times won the academy award,clint eastwood.
He's 93 years of age.
Uh, carol burnett is 90 as a asa matter of fact.
I mean there are, and theirminds are very sharp and they're
(05:00):
very quick.
I mean clint eastwood can stillmemorize script, which is
amazing at 93 years of age, andyet there are others in their
70s who just quite can't getthere.
Is there any explanation as tothe difference?
Speaker 3 (05:14):
Yeah.
So I think you're bringing upone of my favorite things about
the field of geriatrics, whichis just that if you tell me a
person's age, all I really knowis their, their age.
Tell me a person's age, all Ireally know is their age.
It tells me very little abouthow healthy they are or what
they can do.
Because, you're absolutelyright, there are some of us
maintain mobility, cognition,other, you know eyesight,
(05:39):
hearing, other things that wereally care about you know for
all of our lives and othersdon't.
And it's very.
It was always interesting to mein medical school that in
pediatrics, you know, a babyacquires different functions at
one month and then two monthsand three months, and a
pediatrician can test variousthings and tell you, you know,
(06:01):
if the child is off the chart,not doing what it should be
doing, by, say, exactly 16months or 18 months, and when we
start to lose those samefunctions.
It doesn't happen in anystereotyped way at all.
It's anybody's guess sort ofhow they're going no explanation
.
Speaker 1 (06:19):
That's why the research goes on right.
Speaker 3 (06:21):
The research goes on.
I think the best thing that wecan probably say is that some of
it is luck, some of it is youknow what injuries, exposures
and things like that youencounter over your lifetime
that that cause variousimpairments or conditions to
develop.
Some of it is our genetics.
Speaker 1 (06:43):
I was going to ask you how you know basically what
you inherit from your parents,grandparents, how that plays
into effect.
Speaker 3 (06:51):
Yeah, and that's really interesting to me with
Alzheimer's disease, because oneof the things that we know is
that Alzheimer's disease is agenetic disease.
The gene that is most associatedwith Alzheimer's disease is
called the APOE gene.
The link between the APOE geneand Alzheimer's disease was
discovered here at Duke andsince then there have been
hundreds of other genes thatcontribute to smaller amounts to
(07:15):
a person's risk for Alzheimer'sdisease.
But what's fascinating to me isthat a person is born with
those genes and then in normalAlzheimer's disease, most people
don't get it until they're intheir 70s or 80s.
So we live decades with thosegenes.
And then in normal Alzheimer'sdisease, most people don't get
it until they're in their 70s or80s.
So we live decades with thosegenes and then something happens
around 60s, 70s, 80s that kindof opened the door to suddenly
(07:36):
this disease with the misfoldedproteins in the brain.
And one of the things that I'mmost interested about is what is
it that happens right beforethose proteins begin to appear
and we can see them in the brainand we see them start to cause
the problems that they do?
What happens in the body whenthe genetic risk has been there
(07:57):
for decades?
Speaker 1 (07:58):
Well, that leads me to my next question, and that is
we know that Alzheimer'sprimarily affects seniors who
are like 65 years and older, butwhat are the signs and symptoms
that my listeners should beaware of?
Speaker 3 (08:11):
Yeah, so one of the most telltale signs is a loss of
short-term memory and it'simportant for people to
understand sort of thedifference between short-term
memory and how those problemsmight manifest in long-term
memory.
So people, even into veryadvanced stages of Alzheimer's
disease, often have very intactlong-term memories so they can
(08:34):
remember things that happened 20years ago very well.
What they have difficulty withis storing and processing new
memories.
So the way that that canmanifest if you love somebody
who's developing Alzheimer'sdisease is they repeat questions
, they repeat stories kind of ona loop.
Speaker 1 (08:51):
Now all of us do those things sometimes and
that's I know, I repeat storiesmyself and I don't think I'm
there yet.
But I can't, sometimes I can'thelp it.
Speaker 3 (09:01):
But when that change happens and it's enough to be
worried about, it's usually notsubtle, it's you know, making it
through one sitting atbreakfast and the same question
gets asked multiple times, withthe person not really having a
memory that it's already beenasked and answered, and so that
that can be a real key sign.
The other kinds of things aredisorientation, so having more
(09:25):
difficulty either keeping trackof dates and times and calendar
appointments, or getting lost inwhat should be familiar places.
So sometimes that will manifestif someone is driving, they
feel very confident operatingthe car but they realize that
they start to get lost andturned around in what should
have been a familiar place to be.
(09:45):
Or maybe in a big store like aTarget or a Walmart Supercenter
that they go into and suddenlyfind themselves getting more
disoriented in a store like that.
Or maybe in a house that theyvisited sometimes but not all
the time, like going to staywith an adult kid or something
like that, and suddenly theyhave a hard time finding the
(10:06):
bathroom at night.
Speaker 1 (10:09):
And what about the idea of children worry if he
can't or she can't remember thename of someone after you know,
after shortly meeting them, orthat's something I was.
I would imagine that, god, Ithink from the time I was 20, I
was poor at remembering names,so I'm not sure that's a sign.
Speaker 3 (10:28):
Well, so the answer is it certainly can be.
Language difficulties are oftenone of the presenting symptoms
of certain kinds of dementia andcan be present in Alzheimer's
disease dementia too.
But what you're describing is avery common thing that we all
(10:48):
experience, more of which, evenin the aging literature.
It's called TOT or tip of thetongue, where you know the thing
but you're just having a hardtime thinking of the word that
you want to say for it.
That happens a little bit moreas we age, to all of us.
Again, there's some point thatit starts happening so
frequently or to such degrees soyou might hear a person with
(11:13):
dementia substitute words veryfrequently.
So you know that the word thatthey're trying to say is shirt,
but they say jacket because theyjust couldn't find the word.
Speaker 1 (11:21):
They couldn't find the word shirt.
What about the slow on theuptake?
If someone you know seems toreact very slowly to questions,
you might ask them.
For example, is that anothersign?
Speaker 3 (11:34):
It could be a sign.
And there are again certainneurological conditions that we
maybe associate with that slowedreaction, which can happen in
Alzheimer's but also Parkinson'sdisease and other conditions
where that slowing is sort of areal feature.
But again, you know, is sort ofa real feature.
(11:56):
But again, you know,everybody's processing speed and
reaction time gets a little bitslower as we age.
It just does.
It starts about age 30 in thepopulation.
Speaker 1 (12:01):
Right, I'm just wondering.
I try to see if I can correlateour minds to a computer and
over time, as we age and as wegather more and more and more
information, does the computerbegin to be a little bit
congested and slow down.
Have there been any studiesthat correlate to that?
Speaker 3 (12:20):
I think that's a great analogy.
I think a lot of us realizethat the neural circuits of our
brain are not all that differentthan the electrical circuits of
the computer.
So I think thinking of it thatway is a great analogy.
Speaker 1 (12:34):
So why does Alzheimer's disease affect women
more than men?
Speaker 3 (12:40):
Oh, that's a great question and one that I'm also
really interested in, and nobodyknows for sure.
So, you know, one of thequestions that we've asked is is
it possible, you know, when Italked before about we've lived
with these genes our whole livesand then clearly something
happens in these later decadesof life that seem to sort of
(13:02):
open the door and the diseasemanifests For women, is there
something about menopause?
You know, women go through avery dramatic body change at
right about what would be theright time, that kind of late
40s or early 50s, and that seemsto be the time at which the
door opens.
So there are certainly peopleasking that question, addressing
that question, and there's someearly data to suggest that that
(13:24):
may have something to do withit, but the truth is we don't
know.
Speaker 1 (13:28):
So much more to research.
So once the signs or thesymptoms of Alzheimer's present
or manifest, what should aperson or a loved one do?
Speaker 3 (13:40):
Yeah.
So I think that it is important, and it's also important to
realize that one of the thingsthat is variable in Alzheimer's
disease is the degree to whichthe patient has insight about it
, and so that is for some people.
One of their kind of clinicalsymptoms is that they don't have
insight into the fact thatthey're having short-term memory
problems or getting turnedaround.
(14:01):
So, whereas some patients do,some patients are very aware
that this is happening.
So, if you're observing it insomeone or you're feeling that
it's happening yourself, eitherway, we really do encourage an
evaluation, and the reason thatI think that that's all the more
important now to do theevaluation is that we're
(14:21):
starting to get treatments, thatwe can actually do something
about it, and all the data sofar suggests that the treatments
are going to be more effectivethe earlier we start them.
Speaker 1 (14:35):
So early detection is obviously the key.
And then do you presentyourself.
I mean, obviously if you livein Raleigh or Durham, I mean you
certainly can come and visitDuke, but if you're in an
outlying area or in a differentstate or whatever, do you see
your primary care doctor?
Do you go straight to aneurologist?
What's your advice?
Speaker 3 (14:56):
I would talk first to the primary care doctor.
The other thing for people toknow is that they can get you
know.
With Medicare you can get anannual.
You should get as part of yourannual wellness check a
cognitive evaluation, just kindof a cognitive screener, that
any primary care provider canadminister.
(15:17):
So they should administer that.
Speaker 1 (15:20):
But should you ask for that, because I'm familiar
that some primary care doctorsdo not do that as part of the
Medicare screening.
Speaker 3 (15:27):
That's right, and I think if you're having any
concerns about it at all, or ifyou have a family history which
might be enough reason to beconcerned to ask for that as a
screen.
But also keeping in mind that,again, especially people who are
lifelong good test takers candefinitely be having true
(15:48):
cognitive changes that theyperceive and they still ace that
test.
They, you know, it's a screener,so it's the screeners that are
most often used in practice, areno more than 30 questions,
often less than that, and sopeople might make a perfect on
that and still, if you feel thatyou're having some kind of a
change, that is more than justyou know the occasional
(16:12):
sometimes we all forget a nameor sometimes we all ask the same
question twice If you reallythink that this is happening in
a sustained way, I think beingupfront and not letting someone
just reassure you and brush itoff- is well.
Speaker 1 (16:32):
And you're exactly right Because you know, if you
look at the typical average of aprimary care doctor, the
average national average isseven minutes for the patient.
So in seven minutes there's alot you can't do and that
obviously is concerning.
So is the next step?
If your primary care doctor isconcerned or you feel you're not
(16:53):
getting the proper concern,would you then go to a
neurologist?
Is that what you recommend?
I would.
Speaker 3 (17:00):
I would do one of two things.
It can be a neurologist orother memory disorder specialist
, which can be geriatricians,sometimes they're psychiatrists
tests, but looking for a memorycare specialty practice because
(17:22):
also there are increasinglyavailable tests that can be done
.
Now one of the tests that weuse most commonly is a lumbar
puncture.
So some people say you know, Idon't want to go in for a lumbar
puncture unless I really wantto know and I might do something
differently or it would help memake different plans if I knew.
But before long and when I saybefore long, we don't know
(17:42):
exactly how long it'll take forthese to get approval.
But in research now wefrequently use blood based tests
.
So I think it will.
I think it will be not too longbefore we've tested those
blood-based tests in enoughpeople and enough populations to
have more confidence in how tointerpret them, just in the
clinical population.
Speaker 1 (18:02):
And when we have that it suddenly becomes a lot
easier, I think, for providersaverage person, particularly as
they age past 55 or 60, it's anannual thing to have at least a
CBC, or perhaps it would be aninalungated type of blood test.
So that's a good suggestion, agood thought.
Hopefully that will happensooner than later in most
(18:23):
practices.
Now I know there are threestages of Alzheimer's and let's
just talk about the first two.
How do you treat or what formof treatment or what protocol is
there for mild and moderateAlzheimer's treatments?
Speaker 3 (18:39):
Yeah, so.
So for anyone with Alzheimer'sdisease I tell people or who are
worried about Alzheimer'sdisease there's all kinds of
things that we can do to protectour brain health that are not
adding a new medication.
So some of the things thatabsolutely do protect your brain
and protect your brain health.
You know, in some ways if it'sgood for the body, it's good for
(19:04):
the brain too.
So exercise, physical activity,social activity, reducing
stress, getting good sleep Ifsomeone is having issues like
depression or anxiety, gettingthose managed All of those
things help us think better andhelp our brain work better, and
people should be doing those.
(19:24):
In addition, one of the thingsthat we've definitely shown that
protects your brain iscontrolling your blood pressure.
So if you're a person who hashigh blood pressure, your blood
pressure has been kind ofborderline.
Controlling the blood pressureis something that also seems to
protect the brain going forwardand even in people over age 50.
And then, if we're at a pointwhere we think that this person
(19:47):
does have mild or moderateAlzheimer's disease and they
want to start a pill or amedication for it, there are
medications that have been onthe market for a long time.
It's important to realize thatthose that have been on the
market for a long time.
They're easy to take.
They're pretty well toleratedby people.
They don't cure the disease, sopeople shouldn't take them with
(20:09):
the false hope that this iscuring my Alzheimer's disease.
Speaker 1 (20:12):
It's not doing so what do they do?
Speaker 3 (20:14):
They seem to help the nerves in the brain function a
little bit better.
So the idea is to think of thebrain with Alzheimer's disease
is stressed and not functioningas efficiently as it should.
And your analogy of thecomputer it's sort of a computer
that's got some glitches, andwhat these do is it just kind of
gives a boost to the proteinsthat the nerves use to
(20:37):
communicate with each other.
So it's sort of more likeincreasing the power to the
computer or upping the juice,but not really fixing the
problem that's inside it.
Speaker 1 (20:47):
Well, now there's an FDA-approved medication on the
market.
Now I'm curious about it.
I'm not sure whether you go bythe pronunciation or by the
letters.
It's either Lequimbi or it'sL-E-Q-E-M-B-I, I understand.
The preliminary results arepromising.
Speaker 3 (21:07):
Yeah, so that's the one that I wanted to talk about
next.
So I'm glad that you broughtthat one up that I wanted to
talk about next.
So I'm glad that you broughtthat one up.
So, licanumab, or licanbee, asyou said, it just got its full
FDA approval in July, so it'snewly fully approved.
It had a partial approval inJanuary.
So you know, we in the DukeMemory Clinic have been
(21:30):
prescribing it since January, sowe already have some experience
and comfort level withprescribing it and it is
available.
The thing again that I like tosort of let people know is that
what it does is it veryeffectively clears out one of
those kinds of misfoldedproteins that we talked about,
(21:52):
so a protein called amyloid.
It's an antibody againstamyloid and it clears it out
really effectively and in thiskind of clearing out the cobwebs
.
Yeah.
So it sort of scrubbed, scrubsout the cobwebs of this amyloid.
What we've seen is that when,when you compare people who got
that drug versus people who lookthe same but didn't get that
(22:13):
drug, both of them continue todecline.
So it doesn't stop thecognitive decline and in both
groups of people they decline.
It's just how quickly do youdecline?
And it's clear now in a coupleof trials that the people who
get the drug, they decline moreslowly and that's good news.
If you, you know, know thatyou've gotten, you have a
(22:35):
diagnosis of Alzheimer's diseaseand it is a progressive disease
and there is going to bedecline.
If you slow that decline, thatcan be worth a lot to people.
And then the question justbecomes is the is is slowing the
decline?
And our best estimates from thetrials are that over about an
18 month period, taking the drugputs you about five or six
(22:58):
months behind the group thatdidn't get the drug.
So it's over an 18 month period.
It'll sort of slow you down byabout five or six months worth
of time.
And for some people say, youknow, well, wow, that sounds
disappointing, I was hoping formore.
And other people say, hey, I'lltake it five to six months, you
(23:21):
know that could be.
Speaker 1 (23:22):
Those five or six months can be very precious.
Gives you time to prepare,gives your loved one, loved ones
, an opportunity to adjust.
So do you see any otheradvances in the horizon,
anything new that might becoming up?
Speaker 3 (23:37):
Yes, so.
So maybe before before we geton that, I just want to also
kind of share with yourlisteners the other things about
this drug that caused somepeople to say it's not for me.
Number one it is expensive.
Medicare is now covering it,but most Medicare plans cover
about 80% and it costs in thetens of thousands per year to
(23:58):
take.
Oh, my goodness, Even paying20% of that can be you know the
20% hope.
Speaker 1 (24:03):
Well, it could be $2,000 a year, roughly out of
pocket.
Speaker 3 (24:06):
Absolutely.
So that alone puts it.
You know some people are notgoing to go down that road.
Now there may be paymentprograms and things like that
through the drug company that wecould still get over that
hurdle.
The other thing is that youhave to take it by an infusion.
So every two weeks you go intoan infusion center and you get
the drug infused.
(24:27):
Some people tolerate theinfusions better than others.
Most people do fine with theinfusions.
But the real thing that we thinkabout with this drug is it
comes with a side effect andit's a side effect that it
depends on your genetics how atrisk you are for the side effect
.
There's three different kindsof of three different varieties.
(24:48):
You can either be somebody whodoesn't have the APOE4 gene at
all.
You can be a person who has onecopy of it, or you can be a
person who has two copies of it.
The two copies people are atmuch higher risk and what
they're at risk of is brainbleeding or swelling and so that
seems.
You know that's that that can bea pretty serious complication
(25:09):
if it occurs.
Fortunately, in the, in thestudies and in our experience so
far, when we stop the drug andfollow people, their brains
recover and there's there hasn'tbeen lasting damage, but in the
studies, particularly if peoplewere on any kind of blood
thinner, there were deathsassociated with the brain bleed.
So people need to go inunderstanding that.
(25:30):
You know, I really don'trecommend it for people that are
on blood thinners like Coumadinor Warfarin or Eliquis.
Speaker 1 (25:37):
Right, that makes a lot of sense.
You mentioned APO at late terms.
What does that mean?
Speaker 3 (25:43):
Yeah, so that's just the name of the gene.
That's the gene that we alreadyknew is a major risk factor for
getting Alzheimer's disease.
It turns out it's also a majorrisk factor for getting this
complication associated with thetreatment.
So it's important to know yourgenetic status If you're making
a decision whether or not I wantto go down this treatment road.
(26:04):
Most people say now I want toknow my genes because I know I'm
at higher risk or lower riskdepending on what my genes are.
So to monitor for that sideeffect, we have to do MRIs, and
several of them during the timethat people are getting treated.
So if you're a person who hatesbeing in the MRI machine, or
(26:25):
you can't be in the MRI machinefor some reason, like you have a
defibrillator or a pacemaker orsomething else, again this
isn't going to be the drug foryou.
So the thing that I tell peopleabout these drugs are it's so
exciting, it's an incrediblyexciting time to be practicing
an Alzheimer's disease whenthere are new drugs coming to
(26:47):
the market and it's the firsttime in two decades that that
that's been the case, where wehave something to offer people
that seems directly to behitting the pathology of the
disease that you know gets me upin the morning and very excited
it also.
The thing that really gets meup in the morning is that I
think that this is far from thebest drug that's going to
(27:08):
eventually be available to treatthis disease.
Speaker 1 (27:11):
So there are new.
There are new medications, newdrugs under development.
I'm assuming that's what you'resaying.
Speaker 3 (27:16):
That's yeah.
So there's a lot of other drugsunder development and it could
be that some of them, either incombination with this one or
instead of this one, begin toreally make a difference in the
fight against this disease.
And it's been a long fight, along and frustrating one for the
patients and families dealingwith the disease and also for
(27:37):
researchers like me that havebeen trying to crack the code
and get something out there topeople.
Speaker 1 (27:43):
Love your enthusiasm and excitement about what's
happening in this field.
I'd like to discuss somenatural methods of preventing or
at least reducing the risk ofAlzheimer's Like, for example
I'm going to throw some out.
I'd love to have your comments.
Diets including high proteinfoods and fruits.
Certain supplements Out thereis lion's mane, melatonin
(28:06):
supposedly there's a Japanesestudy that says that may have a
positive effect and, of courseyou mentioned it earlier getting
adequate sleep.
Any comments about those?
Speaker 3 (28:15):
Yeah.
So the diet one is a bigquestion and it's probably one
of the most common questions Iget in clinic is what should I
be eating to protect my brain?
There are so many studieshundreds that have looked at a
specific vitamin ormacronutrient or micronutrient.
My feeling on those is thatit's probably there.
(28:39):
I haven't seen any of them thatlook like a game changer.
To me, the best data for just ageneral type of diet that most
people feel like can be kind ofsustainable is a Mediterranean
type diet.
Speaker 1 (28:51):
And that's the one I recommend.
Speaker 3 (28:52):
Yeah, so I think, a Mediterranean diet, and people
can go online and see what theycan and can't eat on a
Mediterranean diet.
The other thing is that theevidence is pretty, pretty
strong that that there's a lotof things that we can eat and
drink that are bad for our brain.
So, whereas I never tell peoplethat they have to go total
teetotal and avoid all alcohol,I think people should know that
(29:16):
alcohol is a neurotoxin and ifyou're worried about protecting
your brain, not overdoing itwith alcohol is is a good thing
to do.
The other thing is avoidingreally processed foods.
There's, there's, you knowquite a bit of data that that
sort of processed foods andgeneral foods that are not
(29:39):
healthy, and by that I just meankind of your snack foods and
desserts and all the things thatwe know we shouldn't eat.
They're bad for other parts ofyour body there, but they seem
to be bad for your brain too.
Speaker 1 (29:50):
And that's a good correlation.
Are you familiar with?
It's called the MIND diet.
It's a combination of theMediterranean diet and the DASH
diet.
I don't like the word diet, I'drather use the word style,
Mediterranean style, whatever.
But are you familiar with thatand is there much difference
between that and just a straightMediterranean diet?
Speaker 3 (30:12):
So there is some difference.
And, yes, I do think that theMIND diet again a thing that
people can look up.
You know the DASH diet.
A lot of what it did was reducesodium and and it was initially
designed to control bloodpressure, and we sort of talked
before about how there is thiscorrelation between somebody's
blood pressure being out ofcontrol and maybe not even
(30:33):
terribly out of control, butjust higher than it needs to be
and that not being good forlong-term brain health.
So I do think that combiningthose two with the MIND diet is
a real promising diet orlifestyle.
I like that too.
Speaker 1 (30:51):
Well so, dr Whitson, why don't we turn to your, which
I find very interesting?
You lead a collaborativeAlzheimer's disease initiative
that brings togetherinvestigators from Duke and as
well as UNC, chapel Hill.
Tell us about the program.
Speaker 3 (31:09):
Yeah.
So we started this program afew years ago and got NIH
funding as a center ofexcellence in fall of 2021.
So this is a collaborationbetween Duke and UNC Chapel Hill
.
So normally, obviously, we'rebitter rivals on the basketball
court, but our tagline for thecenter is that when it comes to
(31:30):
fighting Alzheimer's disease,we're all on the same team.
So I think that thiscollaboration made a lot of
sense because in many ways theschools are.
They're so close in location,both, you know, national super
houses of superpowers of medicalresearch and very complimentary
(31:54):
in the kinds of Alzheimer'sdisease and dementia relevant
research that was going on atthe two different schools and so
coming together to form thiscenter.
And we have, you know, ourlong-term mission is to really
transform dementia care andearly diagnosis and care across
our whole catchment area, whichis Eastern North Carolina.
(32:15):
We also have what we refer toas our sister center, which is
Wake Forest, has an Alzheimer'sdisease center too.
So between these two centers wereally have the state of North
Carolina well covered.
And then at our center at Dukeand UNC, our focus is on these
changes across the lifespan thatalter people's presentation of
(32:40):
Alzheimer's disease or theirexperience of it.
So we're very focused on what'shappening in your 30s, 40s, 50s
.
That puts you at higher riskfor Alzheimer's disease and
that's a way that our center isa little different from what a
lot of the other centers aredoing.
We're one of the onlyAlzheimer's disease centers in
(33:02):
the country that mostly enrollspeople who do not have
Alzheimer's disease, becausewe're trying to get people
younger and when their brainsare still free of Alzheimer's
disease, because we want tocatch what's happening during
that critical transition periodright before they get the
disease.
Speaker 1 (33:18):
That's so important and obviously, with all these
institutions collaboratingtogether, you have a larger
study group than probably mostuniversities in the country do,
so that's laudatory, so I'm veryimpressed.
I understand you have aclinical trial.
Can you tell us a little bitabout that, exactly what the
trial is at the early detectionof Alzheimer's?
(33:39):
I think you alluded to part ofit there in your statement.
Speaker 3 (33:43):
Yeah, yeah, so we do have some trials going on.
So when I hear trial, what Ithink of is that we're offering
somebody an intervention andcomparing it to placebo.
So the study that I thinkyou're talking about is not
really a trial, and that we'renot giving people a treatment
Although if we hear about anopportunity for a treatment
(34:07):
trial that would benefit them,we send them over there and they
can get the treatment.
But in this study that you'retalking about, what we're doing
is enrolling people.
We're enrolling people who havea family history or a known
genetic risk factor, and we'restarting there's studies for
people as young as age 25.
So a 25-year-old who has agrandparent first you know, a
(34:31):
relative with Alzheimer'sdisease can come and be in the
study.
We collect samples from them.
So some of the samples that wecollect are bloods and spinal
fluid, images of their brain,images of their eyes, and then,
when people turn 45, we caninclude them in the study where
(34:52):
we can follow them every year.
So we follow them every year,and both so that we can give
them information aboutthemselves and connect them to
new data and findings about howthey can protect their brain and
reduce their risk, but also sothat the data we get from them
can get into the hands of ourresearchers and investigators,
(35:14):
who are trying to develop newtreatments and learn new things.
Speaker 1 (35:17):
I think that's a great program.
Now, do you study like forsomebody who's in their 30s or
40s?
Do you study them over a periodof time as opposed to just, you
know, gaining some initialinformation and evidence from
them?
Speaker 3 (35:31):
Yeah.
So starting at age 45 is when webring them back every year, the
people in our very young cohort.
What they're doing is kind ofdoing us the favor, so that if
we start to see something in 50and 60-year-olds that looks like
it might be preceding thisonset of Alzheimer's disease,
the question then becomes iswhat we're seeing just an
(35:52):
age-related change, justsomething that happens with
people as they get older, or isthis really disease-related?
And having that younger cohort,their data, is a good touch
point for us to be able to goback and compare and say no, is
this just a change that we'reseeing that's mostly an age
thing, or does it look like thisis more disease related?
So the young folks we only seethem one time when they're young
(36:13):
, just because we don't expect alot to change until they start
to get about 45.
Then if those young folks whocontributed some data to us in
the past, if they're stillliving in North Carolina and
want to come back and join thecohort at age 45 and get
followed every year, we're happyto have them.
It's even more valuable, infact, because we have
(36:34):
information from when they werevery young.
Speaker 1 (36:36):
Sounds like an excellent study.
Now I know you have abackground in ophthalmology.
How does the eye fit into allof this, into Alzheimer's?
Any correlation?
Well, obviously there's acorrelation there.
Speaker 3 (36:48):
Yeah, so that's really interesting.
So I guess I'll clarify.
I'm not a trainedophthalmologist.
My training is in internalmedicine and geriatrics, but my
research has been inophthalmology and I've
collaborated with a lot ofophthalmologists.
Because one of the things thatI've always been very interested
in is, you know, when we have,when a person has a brain that
has started to experience eitherthese misfolded proteins of
(37:10):
diseases like Alzheimer'sdisease or other issues, strokes
, other vascular problems thathappened with age, what are all
the other things that we can doto try to help and protect that
brain?
And one of the obvious thingsis to provide it with the best
sensory information that it canget.
So you know, we all don't, wedon't, we kind of take it for
(37:31):
granted, but the but for most ofus, the information that our
brain uses relies on what we seeand hear or taste and smell,
and those are other functionsthat often decline with age.
So if we can do everything thatwe can to sort of protect
vision and hearing or helppeople accommodate vision or
(37:53):
hearing problems that they maybe having, my question has
always been is that importantsort of a treatment approach
that we haven't fully leveragedin being able to protect aging
brains?
Speaker 1 (38:09):
And you're exploring that further obviously, which is
good.
Speaker 3 (38:11):
Sorry.
Speaker 1 (38:13):
I said, you're exploring that in greater depth,
obviously, which is good.
Speaker 3 (38:17):
Yes, we are, and you know it certainly looks like
there's real opportunities there, and that is another thing that
we tell people when they'rejust getting an early diagnosis
is that you know, if they needhearing aids, to go ahead and
see about getting hearing aids.
If they have issues with theirvision, it's a good time to see
(38:38):
an eye doctor.
Again, you just want to givethe brain the clearest signals
that it can possibly get,especially if it's starting to
struggle with information.
Speaker 1 (38:48):
Right Now, as we conclude, I think we want to get
to what I call the bad news,because we haven't talked about
it yet.
We get to stage three and youknow, basically, I know I guess
the typical life expectancy issomewhere once you've been
diagnosed with Alzheimer's.
(39:09):
It's a wide variance, but threeto 11 years, if I'm correct.
But when you get to that finalstage, what is someone to expect
and what can someone do, andparticularly in regards to the
loved ones who at that point arereached almost a stage of panic
?
That's what I've seen happen insomeone's lives.
Speaker 3 (39:30):
Yeah.
So I think that you know,importantly at that stage, it is
when people reach a stage thatthey can't take care of
themselves.
It really is a disease that thefamily is experiencing with
them because they're having tomake choices for how do I keep
(39:51):
my loved ones safe?
How do I give them the bestquality of life that I can?
How do I deal with some of thethings that arise with the
disease?
That can be anxiety,fearfulness, and there are
really great strategies for kindof dealing with all those
things.
I definitely think that peopleshould reach out to clinics, and
(40:13):
oftentimes it's not thephysician in the clinic that
will be the best source of thisinformation, but the social
worker, either in the clinic orassociated in people's counties
with the agency on aging.
And then in North Carolina, foryour listeners who are in North
Carolina, there's somethingcalled the Duke Dementia Family
Support Program, which is a freeservice to anybody in North
(40:35):
Carolina.
That is a group of socialworkers that, through funding
from the state and philanthropy,have made this service
available to people and can givepeople just really practical
tips, everything from how tonavigate all of the payment
systems for, if we're needing tothink about assisted living or
(40:58):
memory units.
How do we make that change?
How do we deal with things liketaking away somebody's car, if
a person is not safe to be onthe road and yet that
independence is really importantto people?
How do we have thoseconversations?
What are our legalresponsibilities?
How do we get things set uplike wills and power of attorney
documents?
Practical questions of what doI do if it's two o'clock in the
(41:30):
morning and mom is wandering andwon't settle down and go to bed
.
What are my options?
What can I do?
And so I think those becomevery real, very important
questions.
Speaker 1 (41:37):
Very important considerations.
I'm glad we covered this andagain I want to advise my
listeners who are outside of thestate of North Carolina.
I mean, it's great that NorthCarolina has these programs
available, but check with yourstate and see what's available.
If you have a loved one who'sgetting near that stage stage
(41:57):
three you definitely want toexplore every opportunity
available to you to get as muchassistance and support as you
possibly can.
Speaker 3 (42:05):
Yep and I would say look at their counties and also
look at the Alzheimer'sAssociation, which is national
and a great advocacy group thathas lots of information, also
through the National Instituteon Aging.
But I think the thing forlisteners to know is that if
they're going through this,they're not alone.
Often we feel very alone whenwe're caring for somebody with
(42:26):
Alzheimer's disease, but almostany conundrum that they're
facing is something that otherpeople caring for a person with
with Alzheimer's disease havefaced too.
So just reaching out to thosenetworks to get suggestions,
tips, solutions You're not alone.
Speaker 1 (42:45):
Well, dr Woodson, you've been a wealth of
excellent information.
I'm so glad you've been able tojoin us.
How does someone who suspectsthey might have Alzheimer's, you
know, or really their primarycare doctor, might be concerned
as well.
How do they get to you, or howdid they get to your department
at Duke?
Speaker 3 (43:05):
Yeah, so I think the Internet is always one great way
to do it.
So if you you know Google Duke,unc Alzheimer's Disease
Research Center, then you'llfind a website and you can go
from there.
Speaker 1 (43:18):
Well, also your links , whatever links you wish to
send to us, will be published onour website.
So if any of our listeners arecurious or want to go to the
website, they'll be able to findthose links.
So I want to thank you so much.
You've been extremely graciousand your knowledge, I think, is
important to all of ourlisteners, either for themselves
(43:39):
or for their loved ones,because if it's not happening
now, it may soon.
We want to be prepared.
Speaker 3 (43:45):
Yeah, well, thank you , and again thanks for covering
the important topic.
Speaker 1 (43:49):
You're welcome.
Speaker 2 (43:55):
Live Healthy Longer is sponsored by LHL Institute,
where aging presents a new stageof opportunity, and the longer
we live, the more beautiful lifebecomes.
Our website, jamespolakoffcom,contains links to excellent
Alzheimer's programs offered byDuke University.
But, as important, the sitealso has a great selection of
(44:17):
outstanding, informativepodcasts, as well as
health-oriented blogs written byDr Polakoff.
Again, please visitjamespolakoffcom.
That's jamespolakoffcom.
Now back to Dr Jim Polakoff forour conclusion.
Speaker 1 (44:34):
Again, I wish to thank Dr Whitson for joining us,
and please check out ourwebsite for links to Duke's
Alzheimer's resources.
I also want to alert myaudience to a relatively new
Alzheimer's blood test that isavailable to consumers.
One of the advantages of takingthis test is that it lets you
know, potentially, that you areat risk for Alzheimer's.
(44:57):
More information about this AADdetect test for Alzheimer's
disease is available on ourwebsite, jamespolikoffcom.
I once again want to thank mylisteners for making Live
Healthy Longer a fast-growing,popular podcast.
It's nice to know that more andmore listeners are following my
(45:18):
podcast and finding theminteresting, informative, even
helpful, so please continue totune in each week.
I appreciate it.
This is Dr Jim Polakoff.
Thank you for listening andplease remember the words of
Gandhi it is health that is realwealth, not pieces of gold or
silver.
Thank you.
I'm Dr Jim Polakoff and welcome to another episode
of Live Healthy Longer.
Alzheimer's is currently rankedas the seventh leading cause of
death in the United States andit's the most common cause of
dementia among older adults.
It's the most common cause ofdementia among older adults.
(00:27):
But what makes Alzheimer'sreally challenging is the toll
these diseases take on lovedones and family.
Fortunately, my guest for thispodcast is a leading expert who
will provide insights and aclose look at solutions.
Speaker 2 (00:44):
Live Healthy Longer is sponsored by LHL Institute,
where aging presents a new stageof opportunity and the longer
we live, the more beautiful lifebecomes.
Our host, Dr Jim Polakoff,certified nutritionist, author
and health specialist dedicatedto enriching the lives of others
(01:05):
.
Now, here again is Dr JimPolakoff.
Speaker 1 (01:09):
While dementia is a medical condition involving the
decline of mental ability,alzheimer's disease actually
damages brain cells.
As a result, some signs ofAlzheimer's include memory loss,
poor judgment, leading to baddecisions, taking longer to
complete normal tasks, repeatingquestions and forgetfulness,
(01:34):
changes in mood and personality,losing or misplacing things,
even wandering or getting lost,and, as the disease progresses,
increased anxiety or depression.
Well over 6.5 million Americansare living in the clutches of
Alzheimer's, with more womenthan men suffering from this
(01:56):
deadly disease.
Fortunately, there's a leadingexpert who can shed light and
hope.
There's a leading expert whocan shed light and hope.
My guest is Dr Heather Whitson,director for the Study of Aging
and Human Development at DukeUniversity.
Dr Whitson also leads acollaborative initiative that
(02:18):
brings together investigatorsfrom Duke University and the
University of North Carolina,chapel Hill, with a bold vision
to transform the research andcare of Alzheimer's disease and
dementia.
Welcome, dr Whitson.
Speaker 3 (02:30):
Thank you, thanks for having me and thanks for
covering this topic.
Speaker 1 (02:33):
Well, it's our pleasure.
It's an important one, that'sfor sure.
Now, perhaps you can begin bydescribing how Alzheimer's
disease affects the brain.
Speaker 3 (02:42):
Yeah, sure.
So that's a good question.
We know a lot more about thatthan we did even five or 10
years ago.
So Alzheimer's disease andother types of pathology that
cause dementia are caused bymisfolded proteins in the brain
and whatever it is that causedthose proteins to misfold.
(03:03):
So it's important to realizethat when people are
experiencing the symptoms ofdementia, like memory loss and
confusion, what's happeninginside the brain, inside the
nerves of the brain, are thesemisfolded types of proteins and
then other changes to othertypes of cells that we think
either cause those proteins tobe there or are a reaction to
(03:26):
those proteins being there.
Speaker 1 (03:28):
So what are they doing?
Are they, these proteins?
Are they actually slowing downthe brain so that it's difficult
to remember something, forexample?
Speaker 3 (03:38):
So we don't entirely know, because it's possible to
have a lot of those proteins inyour brain and not have any
cognitive problems at all.
We call those peoplecognitively resilient.
So we can look at people'sbrain images, or we can look at
the protein levels in theirspinal fluid and see that there
are some people that carry a lotof those proteins and yet their
(04:00):
brains seem to function reallywell.
Their brains seem to functionreally well, and then sometimes
there are people that don't seemto have super high levels of
those proteins but havecognitive problems.
So there's not a perfectcorrelation, but some of the
proteins are actually inside thecells, some of the proteins are
outside the cells.
It certainly appears, though,increasingly, that the proteins
(04:25):
themselves are at least part ofthe problem.
So when the brain hasAlzheimer's disease, the, the,
the proteins are causing thebrain to not be able to do its
job as well.
Speaker 1 (04:37):
So how do you explain ?
I'm just curious.
You have some brilliant minds.
You know different people.
I mean, one of the great moviedirectors, you might say, of all
times won the academy award,clint eastwood.
He's 93 years of age.
Uh, carol burnett is 90 as a asa matter of fact.
I mean there are, and theirminds are very sharp and they're
(05:00):
very quick.
I mean clint eastwood can stillmemorize script, which is
amazing at 93 years of age, andyet there are others in their
70s who just quite can't getthere.
Is there any explanation as tothe difference?
Speaker 3 (05:14):
Yeah.
So I think you're bringing upone of my favorite things about
the field of geriatrics, whichis just that if you tell me a
person's age, all I really knowis their, their age.
Tell me a person's age, all Ireally know is their age.
It tells me very little abouthow healthy they are or what
they can do.
Because, you're absolutelyright, there are some of us
maintain mobility, cognition,other, you know eyesight,
(05:39):
hearing, other things that wereally care about you know for
all of our lives and othersdon't.
And it's very.
It was always interesting to mein medical school that in
pediatrics, you know, a babyacquires different functions at
one month and then two monthsand three months, and a
pediatrician can test variousthings and tell you, you know,
(06:01):
if the child is off the chart,not doing what it should be
doing, by, say, exactly 16months or 18 months, and when we
start to lose those samefunctions.
It doesn't happen in anystereotyped way at all.
It's anybody's guess sort ofhow they're going no explanation
.
Speaker 1 (06:19):
That's why the research goes on right.
Speaker 3 (06:21):
The research goes on.
I think the best thing that wecan probably say is that some of
it is luck, some of it is youknow what injuries, exposures
and things like that youencounter over your lifetime
that that cause variousimpairments or conditions to
develop.
Some of it is our genetics.
Speaker 1 (06:43):
I was going to ask you how you know basically what
you inherit from your parents,grandparents, how that plays
into effect.
Speaker 3 (06:51):
Yeah, and that's really interesting to me with
Alzheimer's disease, because oneof the things that we know is
that Alzheimer's disease is agenetic disease.
The gene that is most associatedwith Alzheimer's disease is
called the APOE gene.
The link between the APOE geneand Alzheimer's disease was
discovered here at Duke andsince then there have been
hundreds of other genes thatcontribute to smaller amounts to
(07:15):
a person's risk for Alzheimer'sdisease.
But what's fascinating to me isthat a person is born with
those genes and then in normalAlzheimer's disease, most people
don't get it until they're intheir 70s or 80s.
So we live decades with thosegenes.
And then in normal Alzheimer'sdisease, most people don't get
it until they're in their 70s or80s.
So we live decades with thosegenes and then something happens
around 60s, 70s, 80s that kindof opened the door to suddenly
(07:36):
this disease with the misfoldedproteins in the brain.
And one of the things that I'mmost interested about is what is
it that happens right beforethose proteins begin to appear
and we can see them in the brainand we see them start to cause
the problems that they do?
What happens in the body whenthe genetic risk has been there
(07:57):
for decades?
Speaker 1 (07:58):
Well, that leads me to my next question, and that is
we know that Alzheimer'sprimarily affects seniors who
are like 65 years and older, butwhat are the signs and symptoms
that my listeners should beaware of?
Speaker 3 (08:11):
Yeah, so one of the most telltale signs is a loss of
short-term memory and it'simportant for people to
understand sort of thedifference between short-term
memory and how those problemsmight manifest in long-term
memory.
So people, even into veryadvanced stages of Alzheimer's
disease, often have very intactlong-term memories so they can
(08:34):
remember things that happened 20years ago very well.
What they have difficulty withis storing and processing new
memories.
So the way that that canmanifest if you love somebody
who's developing Alzheimer'sdisease is they repeat questions
, they repeat stories kind of ona loop.
Speaker 1 (08:51):
Now all of us do those things sometimes and
that's I know, I repeat storiesmyself and I don't think I'm
there yet.
But I can't, sometimes I can'thelp it.
Speaker 3 (09:01):
But when that change happens and it's enough to be
worried about, it's usually notsubtle, it's you know, making it
through one sitting atbreakfast and the same question
gets asked multiple times, withthe person not really having a
memory that it's already beenasked and answered, and so that
that can be a real key sign.
The other kinds of things aredisorientation, so having more
(09:25):
difficulty either keeping trackof dates and times and calendar
appointments, or getting lost inwhat should be familiar places.
So sometimes that will manifestif someone is driving, they
feel very confident operatingthe car but they realize that
they start to get lost andturned around in what should
have been a familiar place to be.
(09:45):
Or maybe in a big store like aTarget or a Walmart Supercenter
that they go into and suddenlyfind themselves getting more
disoriented in a store like that.
Or maybe in a house that theyvisited sometimes but not all
the time, like going to staywith an adult kid or something
like that, and suddenly theyhave a hard time finding the
(10:06):
bathroom at night.
Speaker 1 (10:09):
And what about the idea of children worry if he
can't or she can't remember thename of someone after you know,
after shortly meeting them, orthat's something I was.
I would imagine that, god, Ithink from the time I was 20, I
was poor at remembering names,so I'm not sure that's a sign.
Speaker 3 (10:28):
Well, so the answer is it certainly can be.
Language difficulties are oftenone of the presenting symptoms
of certain kinds of dementia andcan be present in Alzheimer's
disease dementia too.
But what you're describing is avery common thing that we all
(10:48):
experience, more of which, evenin the aging literature.
It's called TOT or tip of thetongue, where you know the thing
but you're just having a hardtime thinking of the word that
you want to say for it.
That happens a little bit moreas we age, to all of us.
Again, there's some point thatit starts happening so
frequently or to such degrees soyou might hear a person with
(11:13):
dementia substitute words veryfrequently.
So you know that the word thatthey're trying to say is shirt,
but they say jacket because theyjust couldn't find the word.
Speaker 1 (11:21):
They couldn't find the word shirt.
What about the slow on theuptake?
If someone you know seems toreact very slowly to questions,
you might ask them.
For example, is that anothersign?
Speaker 3 (11:34):
It could be a sign.
And there are again certainneurological conditions that we
maybe associate with that slowedreaction, which can happen in
Alzheimer's but also Parkinson'sdisease and other conditions
where that slowing is sort of areal feature.
But again, you know, is sort ofa real feature.
(11:56):
But again, you know,everybody's processing speed and
reaction time gets a little bitslower as we age.
It just does.
It starts about age 30 in thepopulation.
Speaker 1 (12:01):
Right, I'm just wondering.
I try to see if I can correlateour minds to a computer and
over time, as we age and as wegather more and more and more
information, does the computerbegin to be a little bit
congested and slow down.
Have there been any studiesthat correlate to that?
Speaker 3 (12:20):
I think that's a great analogy.
I think a lot of us realizethat the neural circuits of our
brain are not all that differentthan the electrical circuits of
the computer.
So I think thinking of it thatway is a great analogy.
Speaker 1 (12:34):
So why does Alzheimer's disease affect women
more than men?
Speaker 3 (12:40):
Oh, that's a great question and one that I'm also
really interested in, and nobodyknows for sure.
So, you know, one of thequestions that we've asked is is
it possible, you know, when Italked before about we've lived
with these genes our whole livesand then clearly something
happens in these later decadesof life that seem to sort of
(13:02):
open the door and the diseasemanifests For women, is there
something about menopause?
You know, women go through avery dramatic body change at
right about what would be theright time, that kind of late
40s or early 50s, and that seemsto be the time at which the
door opens.
So there are certainly peopleasking that question, addressing
that question, and there's someearly data to suggest that that
(13:24):
may have something to do withit, but the truth is we don't
know.
Speaker 1 (13:28):
So much more to research.
So once the signs or thesymptoms of Alzheimer's present
or manifest, what should aperson or a loved one do?
Speaker 3 (13:40):
Yeah.
So I think that it is important, and it's also important to
realize that one of the thingsthat is variable in Alzheimer's
disease is the degree to whichthe patient has insight about it
, and so that is for some people.
One of their kind of clinicalsymptoms is that they don't have
insight into the fact thatthey're having short-term memory
problems or getting turnedaround.
(14:01):
So, whereas some patients do,some patients are very aware
that this is happening.
So, if you're observing it insomeone or you're feeling that
it's happening yourself, eitherway, we really do encourage an
evaluation, and the reason thatI think that that's all the more
important now to do theevaluation is that we're
(14:21):
starting to get treatments, thatwe can actually do something
about it, and all the data sofar suggests that the treatments
are going to be more effectivethe earlier we start them.
Speaker 1 (14:35):
So early detection is obviously the key.
And then do you presentyourself.
I mean, obviously if you livein Raleigh or Durham, I mean you
certainly can come and visitDuke, but if you're in an
outlying area or in a differentstate or whatever, do you see
your primary care doctor?
Do you go straight to aneurologist?
What's your advice?
Speaker 3 (14:56):
I would talk first to the primary care doctor.
The other thing for people toknow is that they can get you
know.
With Medicare you can get anannual.
You should get as part of yourannual wellness check a
cognitive evaluation, just kindof a cognitive screener, that
any primary care provider canadminister.
(15:17):
So they should administer that.
Speaker 1 (15:20):
But should you ask for that, because I'm familiar
that some primary care doctorsdo not do that as part of the
Medicare screening.
Speaker 3 (15:27):
That's right, and I think if you're having any
concerns about it at all, or ifyou have a family history which
might be enough reason to beconcerned to ask for that as a
screen.
But also keeping in mind that,again, especially people who are
lifelong good test takers candefinitely be having true
(15:48):
cognitive changes that theyperceive and they still ace that
test.
They, you know, it's a screener,so it's the screeners that are
most often used in practice, areno more than 30 questions,
often less than that, and sopeople might make a perfect on
that and still, if you feel thatyou're having some kind of a
change, that is more than justyou know the occasional
(16:12):
sometimes we all forget a nameor sometimes we all ask the same
question twice If you reallythink that this is happening in
a sustained way, I think beingupfront and not letting someone
just reassure you and brush itoff- is well.
Speaker 1 (16:32):
And you're exactly right Because you know, if you
look at the typical average of aprimary care doctor, the
average national average isseven minutes for the patient.
So in seven minutes there's alot you can't do and that
obviously is concerning.
So is the next step?
If your primary care doctor isconcerned or you feel you're not
(16:53):
getting the proper concern,would you then go to a
neurologist?
Is that what you recommend?
I would.
Speaker 3 (17:00):
I would do one of two things.
It can be a neurologist orother memory disorder specialist
, which can be geriatricians,sometimes they're psychiatrists
tests, but looking for a memorycare specialty practice because
(17:22):
also there are increasinglyavailable tests that can be done
.
Now one of the tests that weuse most commonly is a lumbar
puncture.
So some people say you know, Idon't want to go in for a lumbar
puncture unless I really wantto know and I might do something
differently or it would help memake different plans if I knew.
But before long and when I saybefore long, we don't know
(17:42):
exactly how long it'll take forthese to get approval.
But in research now wefrequently use blood based tests
.
So I think it will.
I think it will be not too longbefore we've tested those
blood-based tests in enoughpeople and enough populations to
have more confidence in how tointerpret them, just in the
clinical population.
Speaker 1 (18:02):
And when we have that it suddenly becomes a lot
easier, I think, for providersaverage person, particularly as
they age past 55 or 60, it's anannual thing to have at least a
CBC, or perhaps it would be aninalungated type of blood test.
So that's a good suggestion, agood thought.
Hopefully that will happensooner than later in most
(18:23):
practices.
Now I know there are threestages of Alzheimer's and let's
just talk about the first two.
How do you treat or what formof treatment or what protocol is
there for mild and moderateAlzheimer's treatments?
Speaker 3 (18:39):
Yeah, so.
So for anyone with Alzheimer'sdisease I tell people or who are
worried about Alzheimer'sdisease there's all kinds of
things that we can do to protectour brain health that are not
adding a new medication.
So some of the things thatabsolutely do protect your brain
and protect your brain health.
You know, in some ways if it'sgood for the body, it's good for
(19:04):
the brain too.
So exercise, physical activity,social activity, reducing
stress, getting good sleep Ifsomeone is having issues like
depression or anxiety, gettingthose managed All of those
things help us think better andhelp our brain work better, and
people should be doing those.
(19:24):
In addition, one of the thingsthat we've definitely shown that
protects your brain iscontrolling your blood pressure.
So if you're a person who hashigh blood pressure, your blood
pressure has been kind ofborderline.
Controlling the blood pressureis something that also seems to
protect the brain going forwardand even in people over age 50.
And then, if we're at a pointwhere we think that this person
(19:47):
does have mild or moderateAlzheimer's disease and they
want to start a pill or amedication for it, there are
medications that have been onthe market for a long time.
It's important to realize thatthose that have been on the
market for a long time.
They're easy to take.
They're pretty well toleratedby people.
They don't cure the disease, sopeople shouldn't take them with
(20:09):
the false hope that this iscuring my Alzheimer's disease.
Speaker 1 (20:12):
It's not doing so what do they do?
Speaker 3 (20:14):
They seem to help the nerves in the brain function a
little bit better.
So the idea is to think of thebrain with Alzheimer's disease
is stressed and not functioningas efficiently as it should.
And your analogy of thecomputer it's sort of a computer
that's got some glitches, andwhat these do is it just kind of
gives a boost to the proteinsthat the nerves use to
(20:37):
communicate with each other.
So it's sort of more likeincreasing the power to the
computer or upping the juice,but not really fixing the
problem that's inside it.
Speaker 1 (20:47):
Well, now there's an FDA-approved medication on the
market.
Now I'm curious about it.
I'm not sure whether you go bythe pronunciation or by the
letters.
It's either Lequimbi or it'sL-E-Q-E-M-B-I, I understand.
The preliminary results arepromising.
Speaker 3 (21:07):
Yeah, so that's the one that I wanted to talk about
next.
So I'm glad that you broughtthat one up that I wanted to
talk about next.
So I'm glad that you broughtthat one up.
So, licanumab, or licanbee, asyou said, it just got its full
FDA approval in July, so it'snewly fully approved.
It had a partial approval inJanuary.
So you know, we in the DukeMemory Clinic have been
(21:30):
prescribing it since January, sowe already have some experience
and comfort level withprescribing it and it is
available.
The thing again that I like tosort of let people know is that
what it does is it veryeffectively clears out one of
those kinds of misfoldedproteins that we talked about,
(21:52):
so a protein called amyloid.
It's an antibody againstamyloid and it clears it out
really effectively and in thiskind of clearing out the cobwebs
.
Yeah.
So it sort of scrubbed, scrubsout the cobwebs of this amyloid.
What we've seen is that when,when you compare people who got
that drug versus people who lookthe same but didn't get that
(22:13):
drug, both of them continue todecline.
So it doesn't stop thecognitive decline and in both
groups of people they decline.
It's just how quickly do youdecline?
And it's clear now in a coupleof trials that the people who
get the drug, they decline moreslowly and that's good news.
If you, you know, know thatyou've gotten, you have a
(22:35):
diagnosis of Alzheimer's diseaseand it is a progressive disease
and there is going to bedecline.
If you slow that decline, thatcan be worth a lot to people.
And then the question justbecomes is the is is slowing the
decline?
And our best estimates from thetrials are that over about an
18 month period, taking the drugputs you about five or six
(22:58):
months behind the group thatdidn't get the drug.
So it's over an 18 month period.
It'll sort of slow you down byabout five or six months worth
of time.
And for some people say, youknow, well, wow, that sounds
disappointing, I was hoping formore.
And other people say, hey, I'lltake it five to six months, you
(23:21):
know that could be.
Speaker 1 (23:22):
Those five or six months can be very precious.
Gives you time to prepare,gives your loved one, loved ones
, an opportunity to adjust.
So do you see any otheradvances in the horizon,
anything new that might becoming up?
Speaker 3 (23:37):
Yes, so.
So maybe before before we geton that, I just want to also
kind of share with yourlisteners the other things about
this drug that caused somepeople to say it's not for me.
Number one it is expensive.
Medicare is now covering it,but most Medicare plans cover
about 80% and it costs in thetens of thousands per year to
(23:58):
take.
Oh, my goodness, Even paying20% of that can be you know the
20% hope.
Speaker 1 (24:03):
Well, it could be $2,000 a year, roughly out of
pocket.
Speaker 3 (24:06):
Absolutely.
So that alone puts it.
You know some people are notgoing to go down that road.
Now there may be paymentprograms and things like that
through the drug company that wecould still get over that
hurdle.
The other thing is that youhave to take it by an infusion.
So every two weeks you go intoan infusion center and you get
the drug infused.
(24:27):
Some people tolerate theinfusions better than others.
Most people do fine with theinfusions.
But the real thing that we thinkabout with this drug is it
comes with a side effect andit's a side effect that it
depends on your genetics how atrisk you are for the side effect
.
There's three different kindsof of three different varieties.
(24:48):
You can either be somebody whodoesn't have the APOE4 gene at
all.
You can be a person who has onecopy of it, or you can be a
person who has two copies of it.
The two copies people are atmuch higher risk and what
they're at risk of is brainbleeding or swelling and so that
seems.
You know that's that that can bea pretty serious complication
(25:09):
if it occurs.
Fortunately, in the, in thestudies and in our experience so
far, when we stop the drug andfollow people, their brains
recover and there's there hasn'tbeen lasting damage, but in the
studies, particularly if peoplewere on any kind of blood
thinner, there were deathsassociated with the brain bleed.
So people need to go inunderstanding that.
(25:30):
You know, I really don'trecommend it for people that are
on blood thinners like Coumadinor Warfarin or Eliquis.
Speaker 1 (25:37):
Right, that makes a lot of sense.
You mentioned APO at late terms.
What does that mean?
Speaker 3 (25:43):
Yeah, so that's just the name of the gene.
That's the gene that we alreadyknew is a major risk factor for
getting Alzheimer's disease.
It turns out it's also a majorrisk factor for getting this
complication associated with thetreatment.
So it's important to know yourgenetic status If you're making
a decision whether or not I wantto go down this treatment road.
(26:04):
Most people say now I want toknow my genes because I know I'm
at higher risk or lower riskdepending on what my genes are.
So to monitor for that sideeffect, we have to do MRIs, and
several of them during the timethat people are getting treated.
So if you're a person who hatesbeing in the MRI machine, or
(26:25):
you can't be in the MRI machinefor some reason, like you have a
defibrillator or a pacemaker orsomething else, again this
isn't going to be the drug foryou.
So the thing that I tell peopleabout these drugs are it's so
exciting, it's an incrediblyexciting time to be practicing
an Alzheimer's disease whenthere are new drugs coming to
(26:47):
the market and it's the firsttime in two decades that that
that's been the case, where wehave something to offer people
that seems directly to behitting the pathology of the
disease that you know gets me upin the morning and very excited
it also.
The thing that really gets meup in the morning is that I
think that this is far from thebest drug that's going to
(27:08):
eventually be available to treatthis disease.
Speaker 1 (27:11):
So there are new.
There are new medications, newdrugs under development.
I'm assuming that's what you'resaying.
Speaker 3 (27:16):
That's yeah.
So there's a lot of other drugsunder development and it could
be that some of them, either incombination with this one or
instead of this one, begin toreally make a difference in the
fight against this disease.
And it's been a long fight, along and frustrating one for the
patients and families dealingwith the disease and also for
(27:37):
researchers like me that havebeen trying to crack the code
and get something out there topeople.
Speaker 1 (27:43):
Love your enthusiasm and excitement about what's
happening in this field.
I'd like to discuss somenatural methods of preventing or
at least reducing the risk ofAlzheimer's Like, for example
I'm going to throw some out.
I'd love to have your comments.
Diets including high proteinfoods and fruits.
Certain supplements Out thereis lion's mane, melatonin
(28:06):
supposedly there's a Japanesestudy that says that may have a
positive effect and, of courseyou mentioned it earlier getting
adequate sleep.
Any comments about those?
Speaker 3 (28:15):
Yeah.
So the diet one is a bigquestion and it's probably one
of the most common questions Iget in clinic is what should I
be eating to protect my brain?
There are so many studieshundreds that have looked at a
specific vitamin ormacronutrient or micronutrient.
My feeling on those is thatit's probably there.
(28:39):
I haven't seen any of them thatlook like a game changer.
To me, the best data for just ageneral type of diet that most
people feel like can be kind ofsustainable is a Mediterranean
type diet.
Speaker 1 (28:51):
And that's the one I recommend.
Speaker 3 (28:52):
Yeah, so I think, a Mediterranean diet, and people
can go online and see what theycan and can't eat on a
Mediterranean diet.
The other thing is that theevidence is pretty, pretty
strong that that there's a lotof things that we can eat and
drink that are bad for our brain.
So, whereas I never tell peoplethat they have to go total
teetotal and avoid all alcohol,I think people should know that
(29:16):
alcohol is a neurotoxin and ifyou're worried about protecting
your brain, not overdoing itwith alcohol is is a good thing
to do.
The other thing is avoidingreally processed foods.
There's, there's, you knowquite a bit of data that that
sort of processed foods andgeneral foods that are not
(29:39):
healthy, and by that I just meankind of your snack foods and
desserts and all the things thatwe know we shouldn't eat.
They're bad for other parts ofyour body there, but they seem
to be bad for your brain too.
Speaker 1 (29:50):
And that's a good correlation.
Are you familiar with?
It's called the MIND diet.
It's a combination of theMediterranean diet and the DASH
diet.
I don't like the word diet, I'drather use the word style,
Mediterranean style, whatever.
But are you familiar with thatand is there much difference
between that and just a straightMediterranean diet?
Speaker 3 (30:12):
So there is some difference.
And, yes, I do think that theMIND diet again a thing that
people can look up.
You know the DASH diet.
A lot of what it did was reducesodium and and it was initially
designed to control bloodpressure, and we sort of talked
before about how there is thiscorrelation between somebody's
blood pressure being out ofcontrol and maybe not even
(30:33):
terribly out of control, butjust higher than it needs to be
and that not being good forlong-term brain health.
So I do think that combiningthose two with the MIND diet is
a real promising diet orlifestyle.
I like that too.
Speaker 1 (30:51):
Well so, dr Whitson, why don't we turn to your, which
I find very interesting?
You lead a collaborativeAlzheimer's disease initiative
that brings togetherinvestigators from Duke and as
well as UNC, chapel Hill.
Tell us about the program.
Speaker 3 (31:09):
Yeah.
So we started this program afew years ago and got NIH
funding as a center ofexcellence in fall of 2021.
So this is a collaborationbetween Duke and UNC Chapel Hill
.
So normally, obviously, we'rebitter rivals on the basketball
court, but our tagline for thecenter is that when it comes to
(31:30):
fighting Alzheimer's disease,we're all on the same team.
So I think that thiscollaboration made a lot of
sense because in many ways theschools are.
They're so close in location,both, you know, national super
houses of superpowers of medicalresearch and very complimentary
(31:54):
in the kinds of Alzheimer'sdisease and dementia relevant
research that was going on atthe two different schools and so
coming together to form thiscenter.
And we have, you know, ourlong-term mission is to really
transform dementia care andearly diagnosis and care across
our whole catchment area, whichis Eastern North Carolina.
(32:15):
We also have what we refer toas our sister center, which is
Wake Forest, has an Alzheimer'sdisease center too.
So between these two centers wereally have the state of North
Carolina well covered.
And then at our center at Dukeand UNC, our focus is on these
changes across the lifespan thatalter people's presentation of
(32:40):
Alzheimer's disease or theirexperience of it.
So we're very focused on what'shappening in your 30s, 40s, 50s
.
That puts you at higher riskfor Alzheimer's disease and
that's a way that our center isa little different from what a
lot of the other centers aredoing.
We're one of the onlyAlzheimer's disease centers in
(33:02):
the country that mostly enrollspeople who do not have
Alzheimer's disease, becausewe're trying to get people
younger and when their brainsare still free of Alzheimer's
disease, because we want tocatch what's happening during
that critical transition periodright before they get the
disease.
Speaker 1 (33:18):
That's so important and obviously, with all these
institutions collaboratingtogether, you have a larger
study group than probably mostuniversities in the country do,
so that's laudatory, so I'm veryimpressed.
I understand you have aclinical trial.
Can you tell us a little bitabout that, exactly what the
trial is at the early detectionof Alzheimer's?
(33:39):
I think you alluded to part ofit there in your statement.
Speaker 3 (33:43):
Yeah, yeah, so we do have some trials going on.
So when I hear trial, what Ithink of is that we're offering
somebody an intervention andcomparing it to placebo.
So the study that I thinkyou're talking about is not
really a trial, and that we'renot giving people a treatment
Although if we hear about anopportunity for a treatment
(34:07):
trial that would benefit them,we send them over there and they
can get the treatment.
But in this study that you'retalking about, what we're doing
is enrolling people.
We're enrolling people who havea family history or a known
genetic risk factor, and we'restarting there's studies for
people as young as age 25.
So a 25-year-old who has agrandparent first you know, a
(34:31):
relative with Alzheimer'sdisease can come and be in the
study.
We collect samples from them.
So some of the samples that wecollect are bloods and spinal
fluid, images of their brain,images of their eyes, and then,
when people turn 45, we caninclude them in the study where
(34:52):
we can follow them every year.
So we follow them every year,and both so that we can give
them information aboutthemselves and connect them to
new data and findings about howthey can protect their brain and
reduce their risk, but also sothat the data we get from them
can get into the hands of ourresearchers and investigators,
(35:14):
who are trying to develop newtreatments and learn new things.
Speaker 1 (35:17):
I think that's a great program.
Now, do you study like forsomebody who's in their 30s or
40s?
Do you study them over a periodof time as opposed to just, you
know, gaining some initialinformation and evidence from
them?
Speaker 3 (35:31):
Yeah.
So starting at age 45 is when webring them back every year, the
people in our very young cohort.
What they're doing is kind ofdoing us the favor, so that if
we start to see something in 50and 60-year-olds that looks like
it might be preceding thisonset of Alzheimer's disease,
the question then becomes iswhat we're seeing just an
(35:52):
age-related change, justsomething that happens with
people as they get older, or isthis really disease-related?
And having that younger cohort,their data, is a good touch
point for us to be able to goback and compare and say no, is
this just a change that we'reseeing that's mostly an age
thing, or does it look like thisis more disease related?
So the young folks we only seethem one time when they're young
(36:13):
, just because we don't expect alot to change until they start
to get about 45.
Then if those young folks whocontributed some data to us in
the past, if they're stillliving in North Carolina and
want to come back and join thecohort at age 45 and get
followed every year, we're happyto have them.
It's even more valuable, infact, because we have
(36:34):
information from when they werevery young.
Speaker 1 (36:36):
Sounds like an excellent study.
Now I know you have abackground in ophthalmology.
How does the eye fit into allof this, into Alzheimer's?
Any correlation?
Well, obviously there's acorrelation there.
Speaker 3 (36:48):
Yeah, so that's really interesting.
So I guess I'll clarify.
I'm not a trainedophthalmologist.
My training is in internalmedicine and geriatrics, but my
research has been inophthalmology and I've
collaborated with a lot ofophthalmologists.
Because one of the things thatI've always been very interested
in is, you know, when we have,when a person has a brain that
has started to experience eitherthese misfolded proteins of
(37:10):
diseases like Alzheimer'sdisease or other issues, strokes
, other vascular problems thathappened with age, what are all
the other things that we can doto try to help and protect that
brain?
And one of the obvious thingsis to provide it with the best
sensory information that it canget.
So you know, we all don't, wedon't, we kind of take it for
(37:31):
granted, but the but for most ofus, the information that our
brain uses relies on what we seeand hear or taste and smell,
and those are other functionsthat often decline with age.
So if we can do everything thatwe can to sort of protect
vision and hearing or helppeople accommodate vision or
(37:53):
hearing problems that they maybe having, my question has
always been is that importantsort of a treatment approach
that we haven't fully leveragedin being able to protect aging
brains?
Speaker 1 (38:09):
And you're exploring that further obviously, which is
good.
Speaker 3 (38:11):
Sorry.
Speaker 1 (38:13):
I said, you're exploring that in greater depth,
obviously, which is good.
Speaker 3 (38:17):
Yes, we are, and you know it certainly looks like
there's real opportunities there, and that is another thing that
we tell people when they'rejust getting an early diagnosis
is that you know, if they needhearing aids, to go ahead and
see about getting hearing aids.
If they have issues with theirvision, it's a good time to see
(38:38):
an eye doctor.
Again, you just want to givethe brain the clearest signals
that it can possibly get,especially if it's starting to
struggle with information.
Speaker 1 (38:48):
Right Now, as we conclude, I think we want to get
to what I call the bad news,because we haven't talked about
it yet.
We get to stage three and youknow, basically, I know I guess
the typical life expectancy issomewhere once you've been
diagnosed with Alzheimer's.
(39:09):
It's a wide variance, but threeto 11 years, if I'm correct.
But when you get to that finalstage, what is someone to expect
and what can someone do, andparticularly in regards to the
loved ones who at that point arereached almost a stage of panic
?
That's what I've seen happen insomeone's lives.
Speaker 3 (39:30):
Yeah.
So I think that you know,importantly at that stage, it is
when people reach a stage thatthey can't take care of
themselves.
It really is a disease that thefamily is experiencing with
them because they're having tomake choices for how do I keep
(39:51):
my loved ones safe?
How do I give them the bestquality of life that I can?
How do I deal with some of thethings that arise with the
disease?
That can be anxiety,fearfulness, and there are
really great strategies for kindof dealing with all those
things.
I definitely think that peopleshould reach out to clinics, and
(40:13):
oftentimes it's not thephysician in the clinic that
will be the best source of thisinformation, but the social
worker, either in the clinic orassociated in people's counties
with the agency on aging.
And then in North Carolina, foryour listeners who are in North
Carolina, there's somethingcalled the Duke Dementia Family
Support Program, which is a freeservice to anybody in North
(40:35):
Carolina.
That is a group of socialworkers that, through funding
from the state and philanthropy,have made this service
available to people and can givepeople just really practical
tips, everything from how tonavigate all of the payment
systems for, if we're needing tothink about assisted living or
(40:58):
memory units.
How do we make that change?
How do we deal with things liketaking away somebody's car, if
a person is not safe to be onthe road and yet that
independence is really importantto people?
How do we have thoseconversations?
What are our legalresponsibilities?
How do we get things set uplike wills and power of attorney
documents?
Practical questions of what doI do if it's two o'clock in the
(41:30):
morning and mom is wandering andwon't settle down and go to bed
.
What are my options?
What can I do?
And so I think those becomevery real, very important
questions.
Speaker 1 (41:37):
Very important considerations.
I'm glad we covered this andagain I want to advise my
listeners who are outside of thestate of North Carolina.
I mean, it's great that NorthCarolina has these programs
available, but check with yourstate and see what's available.
If you have a loved one who'sgetting near that stage stage
(41:57):
three you definitely want toexplore every opportunity
available to you to get as muchassistance and support as you
possibly can.
Speaker 3 (42:05):
Yep and I would say look at their counties and also
look at the Alzheimer'sAssociation, which is national
and a great advocacy group thathas lots of information, also
through the National Instituteon Aging.
But I think the thing forlisteners to know is that if
they're going through this,they're not alone.
Often we feel very alone whenwe're caring for somebody with
(42:26):
Alzheimer's disease, but almostany conundrum that they're
facing is something that otherpeople caring for a person with
with Alzheimer's disease havefaced too.
So just reaching out to thosenetworks to get suggestions,
tips, solutions You're not alone.
Speaker 1 (42:45):
Well, dr Woodson, you've been a wealth of
excellent information.
I'm so glad you've been able tojoin us.
How does someone who suspectsthey might have Alzheimer's, you
know, or really their primarycare doctor, might be concerned
as well.
How do they get to you, or howdid they get to your department
at Duke?
Speaker 3 (43:05):
Yeah, so I think the Internet is always one great way
to do it.
So if you you know Google Duke,unc Alzheimer's Disease
Research Center, then you'llfind a website and you can go
from there.
Speaker 1 (43:18):
Well, also your links , whatever links you wish to
send to us, will be published onour website.
So if any of our listeners arecurious or want to go to the
website, they'll be able to findthose links.
So I want to thank you so much.
You've been extremely graciousand your knowledge, I think, is
important to all of ourlisteners, either for themselves
(43:39):
or for their loved ones,because if it's not happening
now, it may soon.
We want to be prepared.
Speaker 3 (43:45):
Yeah, well, thank you , and again thanks for covering
the important topic.
Speaker 1 (43:49):
You're welcome.
Speaker 2 (43:55):
Live Healthy Longer is sponsored by LHL Institute,
where aging presents a new stageof opportunity, and the longer
we live, the more beautiful lifebecomes.
Our website, jamespolakoffcom,contains links to excellent
Alzheimer's programs offered byDuke University.
But, as important, the sitealso has a great selection of
(44:17):
outstanding, informativepodcasts, as well as
health-oriented blogs written byDr Polakoff.
Again, please visitjamespolakoffcom.
That's jamespolakoffcom.
Now back to Dr Jim Polakoff forour conclusion.
Speaker 1 (44:34):
Again, I wish to thank Dr Whitson for joining us,
and please check out ourwebsite for links to Duke's
Alzheimer's resources.
I also want to alert myaudience to a relatively new
Alzheimer's blood test that isavailable to consumers.
One of the advantages of takingthis test is that it lets you
know, potentially, that you areat risk for Alzheimer's.
(44:57):
More information about this AADdetect test for Alzheimer's
disease is available on ourwebsite, jamespolikoffcom.
I once again want to thank mylisteners for making Live
Healthy Longer a fast-growing,popular podcast.
It's nice to know that more andmore listeners are following my
(45:18):
podcast and finding theminteresting, informative, even
helpful, so please continue totune in each week.
I appreciate it.
This is Dr Jim Polakoff.
Thank you for listening andplease remember the words of
Gandhi it is health that is realwealth, not pieces of gold or
silver.
Thank you.
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