On the program this week, host Phil Tower speaks with Dr. Kevin Foley, MD, Medical Director of Trinity Health Medical Group Alzheimer’s Disease and Memory Disorders Program in Grand Rapids. Dr. Foley is also a teaching Professor with the Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University.Dr. Foley is one of the preeminent experts on dementia and Alzheimer's disease in Michigan. We were fortunate to have him on the program, as June is recognized as Alzheimer's & Brain Awareness Month.
Currently, the Alzheimer’s Association estimates that 55 million people across the world are living with the disease.
Data shows that roughly 6.9 million Americans age 65 and older are living with Alzheimer's in 2024. Seventy-three percent are age 75 or older.
Dr. Foley reminded us that Alzheimer’s disease is the most common cause of dementia, but there are hundreds of other types of dementia as well. We learned that Trinity Health Grand Rapids now offers Lecanemab a new promising treatment for patients with early symptoms of Alzheimer’s.
Dr. Foley also recommends continuously educating and supporting caregivers to maintain their resolve and resilience.
ONLINE: Trinity Health’s Memory Disorders Program
Currently, the Alzheimer’s Association estimates that 55 million people across the world are living with the disease.
Data shows that roughly 6.9 million Americans age 65 and older are living with Alzheimer's in 2024. Seventy-three percent are age 75 or older.
Dr. Foley reminded us that Alzheimer’s disease is the most common cause of dementia, but there are hundreds of other types of dementia as well. We learned that Trinity Health Grand Rapids now offers Lecanemab a new promising treatment for patients with early symptoms of Alzheimer’s.
Dr. Foley also recommends continuously educating and supporting caregivers to maintain their resolve and resilience.
ONLINE: Trinity Health’s Memory Disorders Program
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
iHeartMedia West Michigan Weekend a public affairsprogram. It's West Michigan Weekend from iHeartRadio.
Thank you so very much for tuningin. I'm your host, Phil
Talmer. I'm glad you're tuned inacross all of our iHeartRadio brands here in
West Michigan. And don't forget,we'll have a podcast. This conversation you
hear on the radio will be availablelater on online at woodradio dot com in
(00:26):
our podcast section. In fact,we have nearly five hundred episodes of this
program available for you to peruse inthe podcast section at woodradio dot com.
It is my honor and pleasure inthis program to welcome I guess we have
never had on this program. Andthere are so many interesting people to speak
(00:47):
with here in West Michigan. Youknow we can't do them all, but
this one is no exception. DoctorKevin Foley, medical director of Trinity Health
Medical Group Alzheimer's Disease and Memory Disordersprogram in rapids, that is a mouthful,
but we're going to be perfectly practicedat saying that. By somewhat around
halfway through our conversation. Doctor fullyis also a professor with a Department of
(01:11):
Family and Community Medicine, College ofOsteopathic Medicine at Michigan State University. My
brother, the osteopathic medicine grad fromMSU's Osteopathic med School, will be glad
to know that as well. DoctorFully, Welcome to West Michigan Weekend.
Hey, thanks for having me.This is a real honor to have you
(01:32):
here. And I'm going to bepersonal and transparent for a moment. I
told Doctor Fully before we started talkingthis morning on the program that we just
lost a family member. We lostour oldest brother in our family to Alzheimer's.
He had had dimensioned and I guessfull blown Alzheimer's will unpack that in
(01:53):
a moment for several years and passedaway at the age of eighty. It
was almost eighty one. That wasin July, but it was a long
journey and this disease, doctor fully, impacts so many people, and we're
going to talk about that, butI want to get personal for a moment
with you. You're a doctor.You decided to go into the field of
(02:17):
medicine. Did you know you wantedto study the brain in neuroscience? Yeah?
I did when I was a medicalstudent. I really enjoyed the neurology
rotations that I took, and hadalways committed my career into going to geriatrics.
But I wanted to make sure thatI could emphasize in some way in
the neurological science, and I founda way to marry those two interests professionally
(02:40):
together over the last two decades.Was there a point in those rotations where
he said, Wow, this isreally cool. I think I want to
do this on a regular basis.Do you remember? There was no.
The brain is just an amazing organthe way that it structured, the way
that it seemlessly works to allow usto do all the things that need to
do in the course of the day. I was just fascinated by how it
(03:04):
worked and how much that we didn'tknow about it. So I decided to
dedicate my career into learning more aboutbrain functioning and especially how it can become
dysfunctional with conditions like dementia. Andwe still don't know all we need to
know about the brain. We're stilllearning. It's a vast horizon of knowledge
that we have to be able tocommand. We are making progress, and
(03:27):
that's the good news. You know, I should know this fact, but
that term Alzheimer's disease has actually beenwith us quite a long time. I'm
curious, does it go back hundredsof years, over a thousand years?
Do we know, like shortly aroundthe turn of the century or whenever it
was first classified. It was firstclassified in nineteen oh four. Alzheimer's disease
(03:53):
is named after a German neurologist andpsychiatrist whose name was Alois Alzheimer's who worked
in Germany and his first patient hadAlzheimer's disease. He was also a neuropathologist,
so upon her death he was ableto analyze her brain tissue and he
was the first to describe the characteristiccellular changes of Alzheimer's disease that remain the
(04:14):
same today. The Alzheimer's and BrainAwareness Month is recognized in the month of
June. This is a fast growingdisease. The Alzheimer's Association estimates that there
are about fifty five million people acrossthe world living with the disease. Just
shy of seven million Americans age sixtyfive and older living with Alzheimer's in twenty
(04:36):
twenty four, seventy three percent atage seventy five or older, so about
one in nine a person's age sixtyfive and older have Alzheimer's, and I
think a lot of people wonder intheir forties or fifties, how do I
know if I am prone to developingdimension in Alzheimer's disease ease? Is there
(05:00):
a genetic component? Do we knowthe factors? Doctor fully? There are
certain risk factors that have been identifiedover the years, and genes are an
important risk factor. However, certainsusceptibility genes do not necessarily mean that an
individual will develop Alzheimer's dementia in theirlifetime. The genetic tests are not perfect
(05:23):
in their ability to predict future risk, but we do use them from time
to time and in certain circumstances sothat patients can be fully aware of what
their risk may be as they age. If somebody were to come to you
at Trinity Health's Memory disorders program andsay, doctor fully, and forty five
degrees, I mean good, fortyfive years old. Rather, I'm in
(05:45):
good health, but I'd like tobe tested for Alzheimer's. They have no
family history. What would you tellthat person? I would first want to
understand what their motivation is for wantingto get tested, and how they might
react to knowing that they have specificrisk factors. I think it's important to
be able to prepare someone for understandingwhat those results mean and to be proactive.
(06:09):
After I have that conversation and I'mclear and ensure that they understand what
they are doing and why they aredoing it, we can go ahead and
get that testing set up. Butat the same time, I like to
tell them about other strategies that theycan use to maintain their brain health.
If the motivation for doing the testingis to try and determine what factors they
(06:30):
might need to change in their lifestyleso that they can ward off the symptoms
of memory loss for as long aspossible, then we have that discussion.
It's interesting to note two thirds ofAmericans living with Alzheimer's disease are women.
I found that to be a verycurious fact. Do we know why.
It's not so much that the femalegender is at higher risk because of being
(06:56):
female. It's more likely statistical aberrationbecause women outlive men, and the most
significant risk factor for dementia in thiscountry is age. In other words,
the longer you live, the morelikely that, over time, and especially
in older age, you'll begin todevelop symptoms of memory loss. Let's unpack
as we said we would. DoctorKevin Fuley is with us on West Michigan
Weekend here on iHeartRadio. Doctor Fully'smedical director of Trinity Health Medical Group Alzheimer's
(07:23):
Disease and Memory Disorders program here inGrand Rapids. By the way, you
can go to Trinityhealth Michigan dot organd all you need to do is type
in memory or memory disorders. You'llget right to that page. A lot
of great information there. Alzheimer's isthe most common cause. Alzheimer's disease is
(07:44):
the most common cause of dementia,which is a neurodegenerative disease that causes memory
loss. But there are different kindsof dementia. Let's kind of talk about
that. I remember one Robin Williams, when he tragically took his life,
it was said that he had Lewybody dementia, certain type of dementia.
Yes, that's correct, And forclarity, I think it's important to define
(08:07):
what dementia actually means. And that'svery often what's the difference between Alzheimer's and
dementia. Dementia is the outcome ofthe development of a nerd degenerative disease like
Alzheimer's, And what dementia means isthat because of memory loss that progresses over
time, that a person is notable to manage all of their usual responsibilities.
(08:30):
It's a measure of what's called functionality. So if someone can't manage their
finances or take their medications on time, or shop or keep their household in
order, or prepare meals or getaround because of memory loss, then that
is one of the factors that weuse in determining if somebody has dementia.
But the next question that should beasked is, well, what is the
(08:54):
cause of this. Alzheimer's disease,as you said, is the most common
cause, but there are other conditionsas well. And Williams had Louis body
disease, which is something like Parkinson's. Parkinson's disease in and of itself can
cause dementia. Strokes can cause dementia. And there's another condition called Pick's disease
or front of temper dementia that's alsoa common cause of And are we still
learning types of dementias we are.There have not been many new additions to
(09:18):
the list of causes of memory loss. A couple a few one is COVID.
I'm seeing quite a few people whohave brain fog as a result of
COVID, and even after their infectionwas cleared up, they continue to have
problems with their memory. And weare still learning as much as we possibly
can about why that happens and whattheir prognosis is. Hopefully that will be
(09:43):
the last addition to the list.We already have eighty different conditions that are
associated with memory loss. Eighty differentconditions, and I think people listening to
us have this conversation in the radio, especially if you are someone who is
over fifty. We've all had thosemoments where you forget something you think you
(10:05):
know, or something you have easilyrecalled for years, and suddenly you're just
blanking wondering is this cause of oldage or maybe I have something more serious
cognitively happening. And there is adifference between that senior moment or that forgetfulness.
In fact, I've run into alot of people in our thirties who
say they're having senior moment. Ithink that's an over messaged world. That's
(10:28):
my hypothesis on that overcommunicated world,especially in the digital revolution. We have
lived through knowing doctor. Fully,the difference between a senior moment or a
type of cognitive issue, physiological cognitiveissue or dementia. Let's talk about that
for a moment. I have seennew moments as well, and I guess
(10:52):
to be correct and accurate, Iam a senior now, I'm sixty five
years old, but I've been havingthem for all my life. And the
difference between a senior moment and somethingthat may be important to know about or
to have evaluated, is that seniormoments just happen every now and then.
They don't happen every day. Andwhen I have a senior moment, other
(11:13):
people don't pull me aside and sayare you all right? Are you having
some trouble with your memory? Thosewould be the warning signs of someone who
is having something other than just anormal lapse in memory. And everybody who
has progressive memory loss that is similarto what I just described really should have
an evaluation performed, and not somuch because they are going to receive bad
(11:35):
news that they may have dementia.They may have an underlying treatable condition that,
once managed successfully, will will leadto improvement in their memory. So
it's not something that somebody should necessarilyfear if they begin to have memory loss,
they should have it checked out.Fair enough, Doctor Kevin fully with
this medical director at Trinity Health's MedicalGroup and their Alzheimer's Disease and Memory disorders
(11:56):
program here in Grand Rapids, wherewe are going to be talking about some
medical treatments and some exciting new advancesfor treating people with Alzheimer's disease. But
I want to unpack a little bitmore of the risk factors for Alzheimer's.
Age is one. There are alot of risk factors that come with age.
(12:18):
People sixty five years and older ata higher risk for developing Alzheimer's genetic
predisposition. As we spoke about earlierDown syndrome, I did not know that.
So a person living with DOWNS isstatistically more likely to get Alzheimer's.
Yes, And unfortunately, by thetime an adult withood Down syndrome reaches the
(12:41):
age of thirty five, Alzheimer's diseasebecomes ubiquitous. Really, yes, And
is there anything that has slowed that, I mean, have we seen it
happen much later in someone with downs? Or is it very common in middle
age? There? It's very common. It's difficult to know, though,
so exactly when the symptoms of Alzheimer'sdisease begin to emerge. Because the disease
(13:05):
is present at age thirty five doesn'tnecessarily mean that that is the age in
which the symptoms will become apparent.They may not emerge until the adult is
between say, forty to sixty yearsold, but it's important to know that
they are at much higher risk andtheir cognitive or their memory abilities need to
be followed very carefully to see whetheror not they are beginning to decline,
(13:26):
and then to receive advice about whatthe appropriate next steps would be. We
know that had injury, especially thosewho have played contact sports, that can
be another risk factor and certainly canlead to some serious cognitive issues. For
years, we heard coming out ofthe NFL players dealing with CTE. Yeah,
(13:48):
that's a different type of dementia unrelatedto Alzheimer's disease, and we are
still learning about what that condition isand why it arises. If you can
imagine for a moment how many athletesthere are in the world and have been
that play contact sports, not allof them will develop CTE or chronic traumatic
(14:09):
encephalopothy. Some do and we're tryingto understand why those individuals are at higher
risk. But at the same time, the safety issues need to be extended
beyond where they are right now,so that those who are in contact sports
can remain as safe as possible whilethey are playing their sport. And when
we say head injury is a riskfactor, do we know how many head
(14:30):
injuries? Is it more than oneor is it too hard to determine?
It's very hard to determine it.If you think about it. There are
many ways in which a person caninjure their head. In general, though
we describe the injuries that are mostlikely to lead to consequences as concussive head
injuries or concussions where there's loss ofconsciousness. We're speaking with doctor Kevin Foley
(14:50):
about Alzheimer's and dementia the month ofJune as we are closing out the month
of June is Alzheimer's in Brain AwarenessMonth. I want to mention as well.
In addition to Trinity Health's Memories DisordersProgram Trinity Healthsmichigan dot org, you
can check out the Alzheimer's Association MichiganGreat Lakes Chapter alz dot org and just
(15:13):
search for the Great Lakes chapter.There is a big walk that happens in
the fall here in Grand Rapids.It's a great event if you have a
loved one with Alzheimer's in your family, or maybe a friend or somebody you
would like to walk in honor of. I know that our family will certainly
be doing that as well. Nowwhen it comes to a diagnosis, and
(15:35):
I'm kind of jumping ahead of myselfand I want to back up though,
to preventative measures, I think anyone, as much as we hear about dementia
and Alzheimer's and cognitive challenges as weage, I think anyone would would want
to try to avoid a cognitive decline. It's one thing to have physical discline,
but let's face it, doctor,fully, I know you've heard this
(15:58):
from patients. I certainly would expressthis. The fear of losing control of
your thoughts in your mind. It'sa very scary thing, and it's something
a lot of people probably fear morethan anything else, maybe even more than
death. But there are some thingsyou can do to keep your brain sharp.
It doesn't mean it's going to necessarilyward off dementia or Alzheimer's disease.
(16:23):
I've read a lot about brain teasersand things that will force you to use
your mind, crossword puzzles, wordsearches. I'm a fan of wordle I'm
almost addicted to wordle am I playingbrain games doing something like that. It
doesn't hurt. But there is somenew messaging about ways in which we can
(16:44):
possibly prevent memory loss, some interventionsthat are much different than what the public
has heard about before. One isto make sure that if you're hearing impaired,
that you be evaluated, have ahearing test done, and if you
need hearing aids, do you usethem, because hearing loss is now considered
to be a risk factor for dimensionsome people. I've heard that that's one
(17:06):
factor. The second is that somepeople who have sleep apnea that don't have
it treated will also have a higherlikelihood of developing dementia in their lifetime.
Now, this is not all peoplewith sleep atna, but a certain subset.
And what is also important to understandis that sleep apnea this is sometimes
misunderstood. It has nothing to dowith the quality of your sleep. It
(17:27):
has to do with what's going onwith your breathing while you're asleep. People
have sleep atnea, stop breathing andas a result, that puts stresses on
the brain and can lead to memoryloss. And then the third intervention,
which we're finding may be significant inreducing the risk of dementia is to avoid
medications that have certain side effects,which are called anticholinergic side effects. And
(17:51):
those kinds of side effects arise fromthe use of antihistamines and other types of
medications that might be used save forbladder control or even for treatment of mood
disorders. Doctor Kevin fully Woo,us medical director at Trinity Health Medical Group
Alzheimer's Disease and Memory Disorders program.As we talk about Alzheimer's disease and dementia
(18:12):
and ways that you can well atleast try to do some preventative things to
delay or maybe avoid having dementia orAlzheimer's. Research is in complete in this
area. I've read about supplements.I've read a lot about exercise being certainly
(18:33):
helpful for a lot of things,including memory and cognitive issues. Yeah,
memory can be impacted favorably by exercise. Exercise research has been going on for
decades and we still don't know exactlywhat is the best type of exercise or
how long one needs to exercise inorder for it to have a benefit from
memory. I recommend it all thetime to my patients, and not so
(18:57):
much because of them that it willkeep their memory strong, but it also
will do good things for their heartand lungs. And if your heart and
lungs begin to decline in their abilityto function well, then it's going to
have a toll on your memory aswell. Indeed, and something as simple
as walking is a great way tostart. Absolutely, thirty minutes of walking,
(19:18):
four times a week is the minimumamount of exercise that's now recommended.
We're speaking with doctor Kevin Fully fromTrinity Health Medical Group Alzheimer's Disease and Memory
Disorders Program. If someone suspects theymight have a dementia and they would like
to get tested, You've got awonderful facility within your memory disorders program.
(19:44):
Walk us through the steps. IfI reach out to Trinity, he'll say,
my husband or my wife, ormaybe you just want to call and
be tested or at least evaluated.I'm assuming there's evaluations test ones would do.
Let's walk through that process if youwould, doctor Fully, But first
step is to contact the primary carephysician, they should be aware of what
(20:04):
the concern is and they can actuallystart a work up in the office and
then discuss what the appropriateness would beof a referral to the specialists. Say,
like myself, I'm very happy tosee anyone who has concerns that are
not well addressed in the primary carephysician's office. The very first appointment,
we listen to the patient and understandwhat their story is in regard to what
(20:27):
changes they and their family members mayhave noticed in their memory abilities, and
also how those changes have impacted theirfunctioning. As I mentioned before, functional
impairment due to memory loss may suggestthat the person has dementia. We obtain
a health screen, we look atthe medications that they're taking, their personal
(20:48):
habits, and then we perform aneurological exam and a memory test right in
the office that will give us someidea whether or not there is a need
for the testing, which may includebrain imaging, a longer set of memory
tests, or even some very highlyspecialized tests that will allow us to arrive
at a final diagnosis. And thenwith that diagnosis, we sit down and
(21:11):
talk about what the likelihood is overtime of further change and what to do
about it, how to prepare forit, and we also talk about medication
options too. I'm fascinated by thatperson who's in your office. You see
them, they have a diagnosis ofearly onset of Alzheimer's disease. Maybe they're
sixty three to sixty three years ofage. You fast forward three or four
(21:36):
years. Every patient's different in termsof the progress and the cognitive decline.
Fair enough to say absolutely. Itell my colleagues, because they asked me
to predict a person's trajectory, Itell them, if you've seen one person
with Alzheimer's disease, then you haveseen one person with Alzheimer's. Their trajectories
(21:56):
may be very, very different.So for some people it may be a
much longer delay before it really kicksin. Absolutely. I have met many
patients who have had very slow andalmost imperceptible decline over a period of years,
and I wish I knew why thathappened. I'd like to put that
in a capsule and give it topatients. But I have had others that
(22:17):
have not fared so well and haveprogressed more rapidly. We have researchers across
the world trying to come up witha pharmaceutical solution to this terrible disease.
A lot of news I think inthe last year or so about this lacanamab,
this new drug treatment. It's calleda disease modifying drug. I'd like
you to talk about that. We'vegot about three or four minutes left in
(22:40):
this conversation. I'm so grateful foryour time and we By the way,
if you have just tuned in,we have one of the pre eminent experts
here in West Michigan, doctor KevinFoley, Medical director Fraternity Health Medical Groups
Alzheimer's Disease and Memory Disorders program hereright in Grand Rapids, Michigan. You
can learn more at Trinity Health Michigandorg Trinity Health Michigan dot org. I
(23:08):
want to talk about lacanamab. Ipractice saying that for about three or four
hours. By the way, thecommercial name for that drug is lacmbie.
It's very new, it's been aroundabout a year. Yes, let's talk
about that and who should be prescribedthat drug. It's an exciting development and
(23:29):
research. I think that it doesoffer real hope. The research is still
very preliminary, but is showing thatthere could be a potential benefit with long
term treatment. It is indicated forpatients who have pre dementia, which is
called mild cognitive impairment, and alsoearlier mild dementia due to Alzheimer's disease.
(23:51):
The treatment is given over a periodof eighteen months. It is given by
intravenous infusion every two weeks, andover that eighteen month period of time time,
what would be anticipated is a modestslowing of the rate of further decline
that would be expected, and itmay be working better than the early reports
will suggest, because some of theresearch is showing that it may have a
(24:14):
prolonged effect once that eighteen months oftreatment is completed. So we're very excited
about the prospects of this drug.As you said, it is still new,
and new means that we don't knoweverything that we need to know about
it, but it really offers anew hope for patients who have Alzheimer's disease
in this world. I know youhave probably been asked this more than any
other question, but I'm going toask it on the radio. Are you
(24:37):
hopeful for a cure? You're arelatively young guy. I did say that
sixty five is the new forty five? Doctor, fully, are you hopeful
for a cure? Maybe ten yearsfrom now, fifteen years from now.
I am hopeful the work goes on. It's a very difficult disease to understand
personally. It would give me agreat feeling of gratitude for the commitment that
(25:03):
I've made in my career, becausewhen I first started as a very young
doctor, we did not have treatments, and it would be very fulfilling for
me if at the end of mycareer that was actually here. Yeah,
or at least something that could greatlydelay it greatly slow, like that one
patient you described with a very slowprogression of the disease. You know,
we haven't talked about caregivers real quickly. I've got a couple of minutes left.
(25:27):
Do you have any recommendations for thosecaring for the family member loved going
with Alzheimer's. Yes. The firstcouple of visits that I spent with patients
is all directed to the patient,but subsequent visits, almost all the time
that I spend is with the caregiversbecause the outcome of the patient will be
directly related to how well the caregiverprovides care and it can be very,
(25:48):
very difficult. Caregiving is not somethingthat is innately learned. It's not innately
learned. It takes time to learnhow to be a caregiver and how to
balance the needs of the caregiver withthe person that they're taking care of.
It can be a great deal ofstress in some circumstances related to caregiving.
So our team helps the caregiver tounderstand what they need to do to build
(26:11):
skills as a caregiver and to maintaintheir resilience so the outcome will be as
best as possible. And one ofthe best places for support for people to
lean on, for people to haveconversations with is the Alzheimer's Association of Michigan
Great Lakes Chapter. They can certainlytalk with you and your experts at Trinity
Health Memory Disorders Program, but theyare a great resource as well. And
(26:33):
this is not that whispered disease anymore, thankfully. Now. It's very similar
now to the way that cancer usedto be viewed in the fifties. No
one ever told anyone that they hadcancer because they were so embarrassed. But
now we wear ribbons to identify thisdisease and the people who support means to
try and find better ways to treatit and cure it. I can't tell
(26:59):
you how grateful I am that wehave people like you here in our hometown
in West Michigan. I know thepeople all over Michigan, all over the
country that we'll hear this conversation.We all, but we're so grateful that
you and the Memory disorders program teamhave been on a leading edge of this.
I can tell you're very good,and I'm just going to say,
(27:21):
now i've had you on the radio, I get first ibbs. If I
have cognitive decline, absolutely I wantyou as my doctor. You bet any
final thoughts, Doctor fully Well,it's been a privilege for me to serve
this community for the last twenty twoyears. I have had opportunities to build
a program that's been supported by ourhospital system for the last two decades.
I think that we've really made adifference in this community and help people with
(27:45):
problems that oftentimes they feel are dreaded. And we hope to continue to be
able to provide these services for theindefinite future until we find those better treatments
and cures. Yeah, well,said doctor Kevin Fully, medical director of
Trinity Health Medical Grow Alzheimer's Disease andMemory disorders program right here in Grand Rapids.
He's been our guest on this fullprogram of West Michigan Weekend. Thank
(28:08):
you so much and thank you forhaving me. That's our program for this
week. Be sure to catch usas a podcast as well at woodradio dot
com. Until next time. ForiHeartRadio West Michigan Weekend, I'm Phil Tower.
Thank you for listening. iHeartMedia WestMichigan Weekend a public affairs program
iHeartMedia West Michigan Weekend a public affairsprogram. It's West Michigan Weekend from iHeartRadio.
Thank you so very much for tuningin. I'm your host, Phil
Talmer. I'm glad you're tuned inacross all of our iHeartRadio brands here in
West Michigan. And don't forget,we'll have a podcast. This conversation you
hear on the radio will be availablelater on online at woodradio dot com in
(00:26):
our podcast section. In fact,we have nearly five hundred episodes of this
program available for you to peruse inthe podcast section at woodradio dot com.
It is my honor and pleasure inthis program to welcome I guess we have
never had on this program. Andthere are so many interesting people to speak
(00:47):
with here in West Michigan. Youknow we can't do them all, but
this one is no exception. DoctorKevin Foley, medical director of Trinity Health
Medical Group Alzheimer's Disease and Memory Disordersprogram in rapids, that is a mouthful,
but we're going to be perfectly practicedat saying that. By somewhat around
halfway through our conversation. Doctor fullyis also a professor with a Department of
(01:11):
Family and Community Medicine, College ofOsteopathic Medicine at Michigan State University. My
brother, the osteopathic medicine grad fromMSU's Osteopathic med School, will be glad
to know that as well. DoctorFully, Welcome to West Michigan Weekend.
Hey, thanks for having me.This is a real honor to have you
(01:32):
here. And I'm going to bepersonal and transparent for a moment. I
told Doctor Fully before we started talkingthis morning on the program that we just
lost a family member. We lostour oldest brother in our family to Alzheimer's.
He had had dimensioned and I guessfull blown Alzheimer's will unpack that in
(01:53):
a moment for several years and passedaway at the age of eighty. It
was almost eighty one. That wasin July, but it was a long
journey and this disease, doctor fully, impacts so many people, and we're
going to talk about that, butI want to get personal for a moment
with you. You're a doctor.You decided to go into the field of
(02:17):
medicine. Did you know you wantedto study the brain in neuroscience? Yeah?
I did when I was a medicalstudent. I really enjoyed the neurology
rotations that I took, and hadalways committed my career into going to geriatrics.
But I wanted to make sure thatI could emphasize in some way in
the neurological science, and I founda way to marry those two interests professionally
(02:40):
together over the last two decades.Was there a point in those rotations where
he said, Wow, this isreally cool. I think I want to
do this on a regular basis.Do you remember? There was no.
The brain is just an amazing organthe way that it structured, the way
that it seemlessly works to allow usto do all the things that need to
do in the course of the day. I was just fascinated by how it
(03:04):
worked and how much that we didn'tknow about it. So I decided to
dedicate my career into learning more aboutbrain functioning and especially how it can become
dysfunctional with conditions like dementia. Andwe still don't know all we need to
know about the brain. We're stilllearning. It's a vast horizon of knowledge
that we have to be able tocommand. We are making progress, and
(03:27):
that's the good news. You know, I should know this fact, but
that term Alzheimer's disease has actually beenwith us quite a long time. I'm
curious, does it go back hundredsof years, over a thousand years?
Do we know, like shortly aroundthe turn of the century or whenever it
was first classified. It was firstclassified in nineteen oh four. Alzheimer's disease
(03:53):
is named after a German neurologist andpsychiatrist whose name was Alois Alzheimer's who worked
in Germany and his first patient hadAlzheimer's disease. He was also a neuropathologist,
so upon her death he was ableto analyze her brain tissue and he
was the first to describe the characteristiccellular changes of Alzheimer's disease that remain the
(04:14):
same today. The Alzheimer's and BrainAwareness Month is recognized in the month of
June. This is a fast growingdisease. The Alzheimer's Association estimates that there
are about fifty five million people acrossthe world living with the disease. Just
shy of seven million Americans age sixtyfive and older living with Alzheimer's in twenty
(04:36):
twenty four, seventy three percent atage seventy five or older, so about
one in nine a person's age sixtyfive and older have Alzheimer's, and I
think a lot of people wonder intheir forties or fifties, how do I
know if I am prone to developingdimension in Alzheimer's disease ease? Is there
(05:00):
a genetic component? Do we knowthe factors? Doctor fully? There are
certain risk factors that have been identifiedover the years, and genes are an
important risk factor. However, certainsusceptibility genes do not necessarily mean that an
individual will develop Alzheimer's dementia in theirlifetime. The genetic tests are not perfect
(05:23):
in their ability to predict future risk, but we do use them from time
to time and in certain circumstances sothat patients can be fully aware of what
their risk may be as they age. If somebody were to come to you
at Trinity Health's Memory disorders program andsay, doctor fully, and forty five
degrees, I mean good, fortyfive years old. Rather, I'm in
(05:45):
good health, but I'd like tobe tested for Alzheimer's. They have no
family history. What would you tellthat person? I would first want to
understand what their motivation is for wantingto get tested, and how they might
react to knowing that they have specificrisk factors. I think it's important to
be able to prepare someone for understandingwhat those results mean and to be proactive.
(06:09):
After I have that conversation and I'mclear and ensure that they understand what
they are doing and why they aredoing it, we can go ahead and
get that testing set up. Butat the same time, I like to
tell them about other strategies that theycan use to maintain their brain health.
If the motivation for doing the testingis to try and determine what factors they
(06:30):
might need to change in their lifestyleso that they can ward off the symptoms
of memory loss for as long aspossible, then we have that discussion.
It's interesting to note two thirds ofAmericans living with Alzheimer's disease are women.
I found that to be a verycurious fact. Do we know why.
It's not so much that the femalegender is at higher risk because of being
(06:56):
female. It's more likely statistical aberrationbecause women outlive men, and the most
significant risk factor for dementia in thiscountry is age. In other words,
the longer you live, the morelikely that, over time, and especially
in older age, you'll begin todevelop symptoms of memory loss. Let's unpack
as we said we would. DoctorKevin Fuley is with us on West Michigan
Weekend here on iHeartRadio. Doctor Fully'smedical director of Trinity Health Medical Group Alzheimer's
(07:23):
Disease and Memory Disorders program here inGrand Rapids. By the way, you
can go to Trinityhealth Michigan dot organd all you need to do is type
in memory or memory disorders. You'llget right to that page. A lot
of great information there. Alzheimer's isthe most common cause. Alzheimer's disease is
(07:44):
the most common cause of dementia,which is a neurodegenerative disease that causes memory
loss. But there are different kindsof dementia. Let's kind of talk about
that. I remember one Robin Williams, when he tragically took his life,
it was said that he had Lewybody dementia, certain type of dementia.
Yes, that's correct, And forclarity, I think it's important to define
(08:07):
what dementia actually means. And that'svery often what's the difference between Alzheimer's and
dementia. Dementia is the outcome ofthe development of a nerd degenerative disease like
Alzheimer's, And what dementia means isthat because of memory loss that progresses over
time, that a person is notable to manage all of their usual responsibilities.
(08:30):
It's a measure of what's called functionality. So if someone can't manage their
finances or take their medications on time, or shop or keep their household in
order, or prepare meals or getaround because of memory loss, then that
is one of the factors that weuse in determining if somebody has dementia.
But the next question that should beasked is, well, what is the
(08:54):
cause of this. Alzheimer's disease,as you said, is the most common
cause, but there are other conditionsas well. And Williams had Louis body
disease, which is something like Parkinson's. Parkinson's disease in and of itself can
cause dementia. Strokes can cause dementia. And there's another condition called Pick's disease
or front of temper dementia that's alsoa common cause of And are we still
learning types of dementias we are.There have not been many new additions to
(09:18):
the list of causes of memory loss. A couple a few one is COVID.
I'm seeing quite a few people whohave brain fog as a result of
COVID, and even after their infectionwas cleared up, they continue to have
problems with their memory. And weare still learning as much as we possibly
can about why that happens and whattheir prognosis is. Hopefully that will be
(09:43):
the last addition to the list.We already have eighty different conditions that are
associated with memory loss. Eighty differentconditions, and I think people listening to
us have this conversation in the radio, especially if you are someone who is
over fifty. We've all had thosemoments where you forget something you think you
(10:05):
know, or something you have easilyrecalled for years, and suddenly you're just
blanking wondering is this cause of oldage or maybe I have something more serious
cognitively happening. And there is adifference between that senior moment or that forgetfulness.
In fact, I've run into alot of people in our thirties who
say they're having senior moment. Ithink that's an over messaged world. That's
(10:28):
my hypothesis on that overcommunicated world,especially in the digital revolution. We have
lived through knowing doctor. Fully,the difference between a senior moment or a
type of cognitive issue, physiological cognitiveissue or dementia. Let's talk about that
for a moment. I have seennew moments as well, and I guess
(10:52):
to be correct and accurate, Iam a senior now, I'm sixty five
years old, but I've been havingthem for all my life. And the
difference between a senior moment and somethingthat may be important to know about or
to have evaluated, is that seniormoments just happen every now and then.
They don't happen every day. Andwhen I have a senior moment, other
(11:13):
people don't pull me aside and sayare you all right? Are you having
some trouble with your memory? Thosewould be the warning signs of someone who
is having something other than just anormal lapse in memory. And everybody who
has progressive memory loss that is similarto what I just described really should have
an evaluation performed, and not somuch because they are going to receive bad
(11:35):
news that they may have dementia.They may have an underlying treatable condition that,
once managed successfully, will will leadto improvement in their memory. So
it's not something that somebody should necessarilyfear if they begin to have memory loss,
they should have it checked out.Fair enough, Doctor Kevin fully with
this medical director at Trinity Health's MedicalGroup and their Alzheimer's Disease and Memory disorders
(11:56):
program here in Grand Rapids, wherewe are going to be talking about some
medical treatments and some exciting new advancesfor treating people with Alzheimer's disease. But
I want to unpack a little bitmore of the risk factors for Alzheimer's.
Age is one. There are alot of risk factors that come with age.
(12:18):
People sixty five years and older ata higher risk for developing Alzheimer's genetic
predisposition. As we spoke about earlierDown syndrome, I did not know that.
So a person living with DOWNS isstatistically more likely to get Alzheimer's.
Yes, And unfortunately, by thetime an adult withood Down syndrome reaches the
(12:41):
age of thirty five, Alzheimer's diseasebecomes ubiquitous. Really, yes, And
is there anything that has slowed that, I mean, have we seen it
happen much later in someone with downs? Or is it very common in middle
age? There? It's very common. It's difficult to know, though,
so exactly when the symptoms of Alzheimer'sdisease begin to emerge. Because the disease
(13:05):
is present at age thirty five doesn'tnecessarily mean that that is the age in
which the symptoms will become apparent.They may not emerge until the adult is
between say, forty to sixty yearsold, but it's important to know that
they are at much higher risk andtheir cognitive or their memory abilities need to
be followed very carefully to see whetheror not they are beginning to decline,
(13:26):
and then to receive advice about whatthe appropriate next steps would be. We
know that had injury, especially thosewho have played contact sports, that can
be another risk factor and certainly canlead to some serious cognitive issues. For
years, we heard coming out ofthe NFL players dealing with CTE. Yeah,
(13:48):
that's a different type of dementia unrelatedto Alzheimer's disease, and we are
still learning about what that condition isand why it arises. If you can
imagine for a moment how many athletesthere are in the world and have been
that play contact sports, not allof them will develop CTE or chronic traumatic
(14:09):
encephalopothy. Some do and we're tryingto understand why those individuals are at higher
risk. But at the same time, the safety issues need to be extended
beyond where they are right now,so that those who are in contact sports
can remain as safe as possible whilethey are playing their sport. And when
we say head injury is a riskfactor, do we know how many head
(14:30):
injuries? Is it more than oneor is it too hard to determine?
It's very hard to determine it.If you think about it. There are
many ways in which a person caninjure their head. In general, though
we describe the injuries that are mostlikely to lead to consequences as concussive head
injuries or concussions where there's loss ofconsciousness. We're speaking with doctor Kevin Foley
(14:50):
about Alzheimer's and dementia the month ofJune as we are closing out the month
of June is Alzheimer's in Brain AwarenessMonth. I want to mention as well.
In addition to Trinity Health's Memories DisordersProgram Trinity Healthsmichigan dot org, you
can check out the Alzheimer's Association MichiganGreat Lakes Chapter alz dot org and just
(15:13):
search for the Great Lakes chapter.There is a big walk that happens in
the fall here in Grand Rapids.It's a great event if you have a
loved one with Alzheimer's in your family, or maybe a friend or somebody you
would like to walk in honor of. I know that our family will certainly
be doing that as well. Nowwhen it comes to a diagnosis, and
(15:35):
I'm kind of jumping ahead of myselfand I want to back up though,
to preventative measures, I think anyone, as much as we hear about dementia
and Alzheimer's and cognitive challenges as weage, I think anyone would would want
to try to avoid a cognitive decline. It's one thing to have physical discline,
but let's face it, doctor,fully, I know you've heard this
(15:58):
from patients. I certainly would expressthis. The fear of losing control of
your thoughts in your mind. It'sa very scary thing, and it's something
a lot of people probably fear morethan anything else, maybe even more than
death. But there are some thingsyou can do to keep your brain sharp.
It doesn't mean it's going to necessarilyward off dementia or Alzheimer's disease.
(16:23):
I've read a lot about brain teasersand things that will force you to use
your mind, crossword puzzles, wordsearches. I'm a fan of wordle I'm
almost addicted to wordle am I playingbrain games doing something like that. It
doesn't hurt. But there is somenew messaging about ways in which we can
(16:44):
possibly prevent memory loss, some interventionsthat are much different than what the public
has heard about before. One isto make sure that if you're hearing impaired,
that you be evaluated, have ahearing test done, and if you
need hearing aids, do you usethem, because hearing loss is now considered
to be a risk factor for dimensionsome people. I've heard that that's one
(17:06):
factor. The second is that somepeople who have sleep apnea that don't have
it treated will also have a higherlikelihood of developing dementia in their lifetime.
Now, this is not all peoplewith sleep atna, but a certain subset.
And what is also important to understandis that sleep apnea this is sometimes
misunderstood. It has nothing to dowith the quality of your sleep. It
(17:27):
has to do with what's going onwith your breathing while you're asleep. People
have sleep atnea, stop breathing andas a result, that puts stresses on
the brain and can lead to memoryloss. And then the third intervention,
which we're finding may be significant inreducing the risk of dementia is to avoid
medications that have certain side effects,which are called anticholinergic side effects. And
(17:51):
those kinds of side effects arise fromthe use of antihistamines and other types of
medications that might be used save forbladder control or even for treatment of mood
disorders. Doctor Kevin fully Woo,us medical director at Trinity Health Medical Group
Alzheimer's Disease and Memory Disorders program.As we talk about Alzheimer's disease and dementia
(18:12):
and ways that you can well atleast try to do some preventative things to
delay or maybe avoid having dementia orAlzheimer's. Research is in complete in this
area. I've read about supplements.I've read a lot about exercise being certainly
(18:33):
helpful for a lot of things,including memory and cognitive issues. Yeah,
memory can be impacted favorably by exercise. Exercise research has been going on for
decades and we still don't know exactlywhat is the best type of exercise or
how long one needs to exercise inorder for it to have a benefit from
memory. I recommend it all thetime to my patients, and not so
(18:57):
much because of them that it willkeep their memory strong, but it also
will do good things for their heartand lungs. And if your heart and
lungs begin to decline in their abilityto function well, then it's going to
have a toll on your memory aswell. Indeed, and something as simple
as walking is a great way tostart. Absolutely, thirty minutes of walking,
(19:18):
four times a week is the minimumamount of exercise that's now recommended.
We're speaking with doctor Kevin Fully fromTrinity Health Medical Group Alzheimer's Disease and Memory
Disorders Program. If someone suspects theymight have a dementia and they would like
to get tested, You've got awonderful facility within your memory disorders program.
(19:44):
Walk us through the steps. IfI reach out to Trinity, he'll say,
my husband or my wife, ormaybe you just want to call and
be tested or at least evaluated.I'm assuming there's evaluations test ones would do.
Let's walk through that process if youwould, doctor Fully, But first
step is to contact the primary carephysician, they should be aware of what
(20:04):
the concern is and they can actuallystart a work up in the office and
then discuss what the appropriateness would beof a referral to the specialists. Say,
like myself, I'm very happy tosee anyone who has concerns that are
not well addressed in the primary carephysician's office. The very first appointment,
we listen to the patient and understandwhat their story is in regard to what
(20:27):
changes they and their family members mayhave noticed in their memory abilities, and
also how those changes have impacted theirfunctioning. As I mentioned before, functional
impairment due to memory loss may suggestthat the person has dementia. We obtain
a health screen, we look atthe medications that they're taking, their personal
(20:48):
habits, and then we perform aneurological exam and a memory test right in
the office that will give us someidea whether or not there is a need
for the testing, which may includebrain imaging, a longer set of memory
tests, or even some very highlyspecialized tests that will allow us to arrive
at a final diagnosis. And thenwith that diagnosis, we sit down and
(21:11):
talk about what the likelihood is overtime of further change and what to do
about it, how to prepare forit, and we also talk about medication
options too. I'm fascinated by thatperson who's in your office. You see
them, they have a diagnosis ofearly onset of Alzheimer's disease. Maybe they're
sixty three to sixty three years ofage. You fast forward three or four
(21:36):
years. Every patient's different in termsof the progress and the cognitive decline.
Fair enough to say absolutely. Itell my colleagues, because they asked me
to predict a person's trajectory, Itell them, if you've seen one person
with Alzheimer's disease, then you haveseen one person with Alzheimer's. Their trajectories
(21:56):
may be very, very different.So for some people it may be a
much longer delay before it really kicksin. Absolutely. I have met many
patients who have had very slow andalmost imperceptible decline over a period of years,
and I wish I knew why thathappened. I'd like to put that
in a capsule and give it topatients. But I have had others that
(22:17):
have not fared so well and haveprogressed more rapidly. We have researchers across
the world trying to come up witha pharmaceutical solution to this terrible disease.
A lot of news I think inthe last year or so about this lacanamab,
this new drug treatment. It's calleda disease modifying drug. I'd like
you to talk about that. We'vegot about three or four minutes left in
(22:40):
this conversation. I'm so grateful foryour time and we By the way,
if you have just tuned in,we have one of the pre eminent experts
here in West Michigan, doctor KevinFoley, Medical director Fraternity Health Medical Groups
Alzheimer's Disease and Memory Disorders program hereright in Grand Rapids, Michigan. You
can learn more at Trinity Health Michigandorg Trinity Health Michigan dot org. I
(23:08):
want to talk about lacanamab. Ipractice saying that for about three or four
hours. By the way, thecommercial name for that drug is lacmbie.
It's very new, it's been aroundabout a year. Yes, let's talk
about that and who should be prescribedthat drug. It's an exciting development and
(23:29):
research. I think that it doesoffer real hope. The research is still
very preliminary, but is showing thatthere could be a potential benefit with long
term treatment. It is indicated forpatients who have pre dementia, which is
called mild cognitive impairment, and alsoearlier mild dementia due to Alzheimer's disease.
(23:51):
The treatment is given over a periodof eighteen months. It is given by
intravenous infusion every two weeks, andover that eighteen month period of time time,
what would be anticipated is a modestslowing of the rate of further decline
that would be expected, and itmay be working better than the early reports
will suggest, because some of theresearch is showing that it may have a
(24:14):
prolonged effect once that eighteen months oftreatment is completed. So we're very excited
about the prospects of this drug.As you said, it is still new,
and new means that we don't knoweverything that we need to know about
it, but it really offers anew hope for patients who have Alzheimer's disease
in this world. I know youhave probably been asked this more than any
other question, but I'm going toask it on the radio. Are you
(24:37):
hopeful for a cure? You're arelatively young guy. I did say that
sixty five is the new forty five? Doctor, fully, are you hopeful
for a cure? Maybe ten yearsfrom now, fifteen years from now.
I am hopeful the work goes on. It's a very difficult disease to understand
personally. It would give me agreat feeling of gratitude for the commitment that
(25:03):
I've made in my career, becausewhen I first started as a very young
doctor, we did not have treatments, and it would be very fulfilling for
me if at the end of mycareer that was actually here. Yeah,
or at least something that could greatlydelay it greatly slow, like that one
patient you described with a very slowprogression of the disease. You know,
we haven't talked about caregivers real quickly. I've got a couple of minutes left.
(25:27):
Do you have any recommendations for thosecaring for the family member loved going
with Alzheimer's. Yes. The firstcouple of visits that I spent with patients
is all directed to the patient,but subsequent visits, almost all the time
that I spend is with the caregiversbecause the outcome of the patient will be
directly related to how well the caregiverprovides care and it can be very,
(25:48):
very difficult. Caregiving is not somethingthat is innately learned. It's not innately
learned. It takes time to learnhow to be a caregiver and how to
balance the needs of the caregiver withthe person that they're taking care of.
It can be a great deal ofstress in some circumstances related to caregiving.
So our team helps the caregiver tounderstand what they need to do to build
(26:11):
skills as a caregiver and to maintaintheir resilience so the outcome will be as
best as possible. And one ofthe best places for support for people to
lean on, for people to haveconversations with is the Alzheimer's Association of Michigan
Great Lakes Chapter. They can certainlytalk with you and your experts at Trinity
Health Memory Disorders Program, but theyare a great resource as well. And
(26:33):
this is not that whispered disease anymore, thankfully. Now. It's very similar
now to the way that cancer usedto be viewed in the fifties. No
one ever told anyone that they hadcancer because they were so embarrassed. But
now we wear ribbons to identify thisdisease and the people who support means to
try and find better ways to treatit and cure it. I can't tell
(26:59):
you how grateful I am that wehave people like you here in our hometown
in West Michigan. I know thepeople all over Michigan, all over the
country that we'll hear this conversation.We all, but we're so grateful that
you and the Memory disorders program teamhave been on a leading edge of this.
I can tell you're very good,and I'm just going to say,
(27:21):
now i've had you on the radio, I get first ibbs. If I
have cognitive decline, absolutely I wantyou as my doctor. You bet any
final thoughts, Doctor fully Well,it's been a privilege for me to serve
this community for the last twenty twoyears. I have had opportunities to build
a program that's been supported by ourhospital system for the last two decades.
I think that we've really made adifference in this community and help people with
(27:45):
problems that oftentimes they feel are dreaded. And we hope to continue to be
able to provide these services for theindefinite future until we find those better treatments
and cures. Yeah, well,said doctor Kevin Fully, medical director of
Trinity Health Medical Grow Alzheimer's Disease andMemory disorders program right here in Grand Rapids.
He's been our guest on this fullprogram of West Michigan Weekend. Thank
(28:08):
you so much and thank you forhaving me. That's our program for this
week. Be sure to catch usas a podcast as well at woodradio dot
com. Until next time. ForiHeartRadio West Michigan Weekend, I'm Phil Tower.
Thank you for listening. iHeartMedia WestMichigan Weekend a public affairs program
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