March 25, 2024 • 48 mins
Today on Feminine Roadmap we discuss understanding and preventing dementia with Dr. Mitch Clionsky. Dr. Clionsky and his wife have written a book called, “Dementia Prevention: Using Your Head to Save Your Brain”. Knowing that 80% of people over 55 are worried about getting Alzheimers or other dementias, they brought together the resources to help prevent that reality. The good news is that half of all dementias are preventable. Dr. Clionsky wants listeners to understand how to start the process of protecting their brains as they age. In this episode he shares many actionable strategies to start right away as well as free resources to utilize. Please grab a cuppa something wonderful and join us. Don’t forget to bring a friend along so you can learn together! https://braindoc.com/
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Episode Transcript
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(00:02):
Hi, him Gina for are welcometo the Feminine Roadmap Podcast, a global
community of women in midlife. Wegather here weekly over a cup of something
wonderful for real talk, life changingstrategies and a big dose of sisterhood.
Now, please sit back and enjoy. Hello, Feminine Roadmappers. Welcome back
(00:28):
to Feminine Roadmap Podcast, the podcastthat helps you navigate the challenges and the
changes of midlife and empowers you tolive a more vibrant second half. If
you find us today on YouTube,please don't forget to subscribe and ring that
bells you don't miss any more ofthese conversations. And if you're on a
podcast platform, please remember to subscribe, rate, and share. Today we're
(00:51):
having a new conversation, one aboutdementia. Eighty percent of people over fifty
five are worried about getting Alzheimer's diseaseor dementias. The good news is that
half of all dementias are preventable,and my guest today wants us to know
that we can start the process ofprotecting our brain as we age. My
(01:12):
guest today is doctor Mitch Kleonski.He's a BORED certified neuropsychologist. He's a
co author of a book with hiswife. The book is Dementia Prevention,
Using Your Head to Save Your Brain. Doctor Kleonski, thank you for being
with me today, Gina. It'sa real pleasure. I'm looking forward to
our conversation me too. As Ishared before we hit record, I just
(01:36):
lost a family member to early onsetdementia and Louis body last week, and
so it's on my mind. Andwhen I said yes to you, she
was the kind of the impetus forme to say yes. And I would
love to know why do you dothis? Why are you passionate about these
neuro issues like dementia and Alzheimer's.I think there's several threads to that answer,
(02:01):
so if you'll bear with me,I'll try to put them together because
I've given a lot of thought tothis. One of the reasons is that
I find that the brain is fascinatingand that more than just psychology. I
spent the first ten years of mycareer primarily doing clinical psychology, meet with
(02:21):
people, evaluate them, do psychotherapy, and during this time there was a
maturation in the field of clinical neuropsychology. As fat was really interesting. If
I'd go to a party and peoplewould say to me, so, what
do you do. I'd say,well, I'm a psychologist. They want
to either tell me all their problemsor they think I was reading their mind
(02:42):
and they try to run away.If I told them I was a clinical
neuropsychologist, they go oh, andso then we have a different start to
the conversation because I think, wow, that's a big word. It must
mean a lot of things. Basically, what it means is we use different
kinds of tests and interviews to findout how people are thinking, how they're
paying attention, how they're able tolearn and remember things, how they're able
(03:07):
to solve problems, and these kindsof questions, these kind of test results
reflect on what's going on in theirbrain and oftentimes leads us to be able
to make a really good diagnosis ofwhat's going on and then, even more
importantly, to lead to interventions thatcan stop something that's going bad from getting
(03:31):
worse, or in some cases,roll it back and make it better.
So back in the mid eighties,because I've been practicing for forty five years,
I know it looks to your viewerslike I'm maybe thirty, but I'm
really quite a bit older than thatI've been practicing now for forty five years,
(03:52):
and about ten years in my practice, I got really interested in this
and had taken a bunch of trainingsbackwards in graduate school, so it was
very natural I'd actually start first neuropsychologicallaboratory in Western Massachusetts, and I wanted
to do more of this. Ibegan to expand my practice to the point
(04:13):
where, over the course of theseyears, I've actually evaluated it says twenty
five thousand in my bio, it'sactually more like thirty thousand patients for different
kinds of cognitive problems. Each dayI go in and see people and have
new and exciting things to think about. So one of the reasons why I'm
(04:34):
passionate is because it's very fulfilling tome to understand how people tick and what
I can do to help them tobe better. It got really personal,
though, back when I was fiftyyears old and my mom was in her
early seventies, and I could puttogether the fact that some of the change
(05:00):
in who this very capable, competent, wonderful woman was that she was having
greater and greater difficulty and I realizedthat she was developing dementia. Took her
to a neurologist back where we grewup, where I grew up in Pennsylvania.
She got a diagnosis, got allthe various memory tests, the neurological
(05:23):
tests, and basically I was onthe other side of the table where my
patients and their family sit for thenext ten to twelve years of her life.
I conclude that it's much better tobe on the professional side than on
the patient side. But the onething that I thought at the time was
(05:45):
wasn't it wonderful that this gave mesome compassion and insight into what's happening with
these families that I might never havehad before. It was also real impetus
to try to do something that wouldhelp to spare other people from what my
(06:05):
mom went through and from what Iwent through as her son. So,
along with my wife Emily, whois a very brilliant psychiatrist who works mostly
in the field of neurology because theyget double borded in psychiatry and neurology,
and she'd already been an internal medicinedoctor, so she brought all this incredible
(06:28):
medical knowledge to bear, we decidedthat it made a lot of sense for
us to try to put this intoa book so that people could read this
book and make changes potentially in theirmedical conditions, in their habits and lifestyle
so they wouldn't have to go throughthis. And we were really bolstered by
the fact that the research was incrediblysupportive of the fact that half of these
(06:54):
cases could be avoided. Most peopledon't know that, So that's what gets
me here today. It's really encouragingto know that there is something we can
do because it's very frightening. Youknow, it's an unknown and losing your
mind is a scary thing. Andto the story of my cousin, what
(07:16):
it does to a person's personality andthe dynamics within a family, and if
it's a family caregiver, which inthis case it was, was very difficult,
very long and stressful journey for everyone. But you were sharing because I
was saying, my uncle had Alzheimer'sand then his daughter had this Louis body
dementia. You were saying, it'snot necessarily genetic. Is that correct?
(07:41):
In fact, few of the casesare actually genetic. Genes account for maybe
about five percent of your risk.Isn't that amazing because most people, I
say, oh, I had amother, I had a father, maybe
both of them who had Alzheimer's disease. I will sure have this and I
(08:01):
don't know what I'm going to doabout it. And we say, well,
yeah, there are some blood teststhat you can get that'll tell you
if you have some of the genesor some of the findings early on that
would predict this. On the otherhand, I'm not a big supporter of
these blood tests because you're going towant to do everything you can to prevent
(08:22):
dementia whether or not you have thegenes. It's not like you're going to
try harder if you have genetic background. You should be doing this anyway,
because while the genes are typically onespredicting Alzheimer's disease, Alzheimer's is only one
(08:43):
type of dementia. It's sort oflike Ford is only one type of automobile.
There's toyotas, there's chevrolets, there'slots of different types. Same thing
is true in the field of dementia. One question people ask is is it
Alzheimer's or is it dementia? Andthe answer is often well, it could
(09:05):
be both. Because Alzheimer's is atype of dementia, as is Lewis body
disease what you were talking about withyour cousin. One of the biggest types
of dementia, however, rivaling Alzheimer'sand often in combination with Alzheimer's, is
what we call vascular dementia. Andso here's where all the things that affect
(09:28):
your heart also affect your brain becauseit's all connected by circulatory systems. So
we see a lot of people havehistories of hypertension that they're not really controlling
well, diabetes that they're not payingattention to and not doing the things to
(09:50):
control that. We see that there'salso dementia's caused by repetitive brain injuries what
they call chronic traumatic encephalopathy, wherepeople get their heads hit a bunch of
times. It can be even justone time for that matter, but is
more often when it's a repetitive kindof pattern. Unfortunately, by the time
(10:13):
they're adults, a lot of thosekinds of damages have already been done,
so we're not going to undo thator prevent that. We're going to work
on everything else. Alcohol intoxication andexcess of alcohol use is also a very
common condition that leads to the lossof memory functioning and cognitive abilities, thinking
(10:37):
abilities as we age, and obesity, which is the huge epidemic in the
United States. Is underpins the highblood pressure, it underpins the diabetes,
It underpins the sedentary behavior of peoplewho don't move enough, making them susceptible
(11:01):
to dementia. So exercise is oneof those commonalities that we're going to be
talking about no matter what the diagnosisultimately ends up being. One of the
things that most people don't know.One of the preventable factors that's only been
discovered in the last several years isthat hearing loss actually causes memory decline.
(11:24):
So when people are beginning to turnup the volume on the TV, when
they're not responding to what other peopleare saying as well as they used to,
when they're missing out on background noise, that's actually depriving their brain of
the stimulation it needs to be ableto make connections. So it affects two
parts. One is the surface ofthe brain and the other is a network
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that's internal to our brain called thesalience network. That's the connectivity of our
brain that says, oh, that'sinteresting or oh that it's important. The
good news is, in many cases, if you can get someone to have
a hearing test and then to usehearing aids, which these days are becoming
(12:11):
better and better and cheaper and cheaper. You can improve their ability to think
in the short term. Actually,their scores on testing will improve, and
you can help prevent decline as theyage. The hard part is getting people
to recognize it, to get pasttheir resistances and they say, oh,
(12:33):
you know, my husband's mumbling,or it's just that I wasn't thinking so
well. I was thinking about somethingelse. And the best advice is,
well, why don't you get yourhearing tested? Then we'll know for sure
and you can make good decisions goingforward. I have a question about so
one of my dearest friends, herfather went in for heart surgery. I
(12:56):
guess he'd been having some minor memoryissues, but when he came out of
surgery, something about the anesthesia justthrew him into full blown dementia and he
was also diagnosed with Louis body dementia. What was the correlation there? Is
that common? Is it kind ofan unusual situation? Yes, it is
(13:22):
common, but it's probably not somuch the anesthesia as it is the oxygen.
So we've known for a long timethat people who've had multi vessel surgeries
bypass surgeries have emerged from surgery withdifficulty thinking. Sometimes it's early on set
(13:46):
and it seems to get better,and the other group seems to get at
about five years later. They've usedto think that it was because people were
not on a heart lung machine gettingenough oxygen during that time. More recent
studies found those are probably equivalent whetherthey're on or off that pump, and
(14:07):
now think it may have to dopartially with little tiny pieces of plaque being
broken off when they reconnect the vessels. But there's another explanation for it that
I think is oftentimes the case,and it doesn't just occur with heart surgery.
It also occurs with knees and hipreplacement, which I'm sure many of
(14:33):
your listeners are either contemplating or havehad. And that is if you happen
to have obstructive sleep apnea. Inother words, if you are stopping breathing
or your oxygen level drops by fourpercent while you're sleeping. This occurs more
(14:56):
than on average five times per hour. That's what the definition of sleep apnea
is. If you have this andeither you don't know it or the surgeon
doesn't put you on a CPAP machine. When you come out of surgery and
they remove that breathing tube, theyexcubate you, you can have a sudden
(15:16):
loss of oxygen that will really messwith your brain, will cause you to
end up in some cases in intensivecare thinking there's spiders coming down from the
walls. Es suentially delirious, andif you already are having some problems with
your thinking abilities, if you're beginningto have some changes that are the precursors
(15:39):
for dementia, this is like throwingfuel on a fire. It can make
people much worse in a very shortperiod of time. So I guess the
takeaway is if you have symptoms ofsleep apnea or even are concerned about it,
you ought to get tested for it. Because we now know that the
most recent research is if you're midfifties or older, there's actually a fifty
(16:02):
percent chance you have this. Youdon't have to be fat, you don't
have to be male, you don'thave to snore loudly. You can still
have this and it's very very treatable, So you ought to get a treated
I ruled the world, everybody stargat age fifty would begin to get this
kind of a test in addition totheir colonoscopes and addition their mammograms every five
(16:26):
years, simply because if we identifyand treat this condition, we can avoid
a lot of problems heart attack,strokes, dementia down the road. But
anyway, if you're having a diagnosis, if you already know you've got sleep
apnea, you should treat it usingcontinuous positive airway pressure otherwise known as SEAPAP.
(16:48):
But even if you're one of thosepeople says, oh, I'm never
going to use that machine, Idon't want a SEEPAP, tell your surgeon
if you're going in for surgery thatyou have sleep apnea, so at least
they can put a CPAP on youwhen you're coming out of surgery. Okay,
fantastic. Now you talk about waysthat we can prevent or protect our
(17:14):
brains. What are some of theways that my audience can themselves protect their
brains or even help their parents,because a lot of us really are responsible
for our parents in this season oflife, myself included. So what are
some of the things that we cando for that preventative measure. So our
model that we build on in thebook takes about eight chapters to build this
(17:38):
entire model as a variety of differenttypes. So let me tackle a few
of these. For many people,the biggest ones are the cardiovascular conditions.
There's a cluster of them, andmost of them have lack of exercise and
obesity at their core. So yourbody was built to carry a certain weight.
(18:03):
I'm not trying to shame anybody.I'm not trying to talk about appearance.
I'm talking about what your body wasdesigned based on your height and your
bone structure. If you exceed that, you're going to have changes simply because
in your body and in your health, simply because your body is working too
(18:27):
hard for its structure. If youview it in that kind of a term,
you say, huh, it's reallyimportant. Then I do everything I
can so that it fits my bodyand what I'm made for. And that's
really, I think, a muchmore positive way of approaching this because it
gets away from the stigma. Itgets away from the you know, are
(18:49):
you being lazy? Are you nottaking care of yourself? And really says
okay, here I am at fifty, how do I want to be for
the next thirty years of my life? Well, part of me wants to
be more fit. So I gotto exercise on a regular basis number one,
because there really isn't an alternative tothat that works. The question is
(19:12):
how to get ourselves to start Thatfor most people is the issue. Yes,
And as I like to tell people, the first step in changing a
habit like exercise is you have toexamine your butt. And they look at
me like you're looking right now,saying what that's exactly what I mean,
(19:38):
not the one you're sitting on,but the butt that's in the sentence I
would exercise. But whatever comes afterthat is what you have to examine.
And oftentimes it's things like, well, I'm lazy. What does that mean?
That means I'm not doing it.That's just a rationalization. It means
I'm too busy. Really, itmeans I can't do it for this reason
(20:03):
or that reason. I'd have todo this first. But a lady you
told me that the reason she hadn'tdone much exercise in the past year was
she was still working on the apartmentshe moved into, and they were supposed
to replace the windows and they hadn'tdone it, and she needs to get
her drapes done first, I said, what does that have to do with
your exercise. So after we workon that, the question is, here's
(20:26):
here's a formula that I recommend peopleuse because this gets around most of everyone's
butt. The first thing is picka ten minute walk, do it three
times a day. Here's why thisten by three formula works. Number one,
walking is great exercise. Number two, you're unlikely to hurt yourself.
It's unlucky you're going to get lost. You can do it most everywhere,
(20:51):
you can do it in most everykind of weather. The exercise those ten
minute walks are cumulative. So thethree ten minute walk gives you two hundred
and ten minutes of exercise a week, right in the sweet spot for all
of the medical societies. And ifyou're walking briskly, which means you're getting
(21:14):
your heart rate up but you're stillable to talk, you're going to get
about nine to ten miles of exercise, which is great. The question then,
is what do you do while you'rewalking. Partly, you can listen
to a podcast like this always agood idea. Listen to music. You
can talk to a friend or relativethat you've been meaning to stay in touch
(21:36):
with. In fact, both ofyou can be walking at the same time,
which is a lot of fun,different places, same walk, and
you don't need special equipment. Youneed a nice pair of shoes and that's
about it. So if we getpeople to start at that point, for
many of them, that will beenough. But it also gives the springboard
for people who want to do more, who want to augment it with the
(22:00):
hike on the weekends when they havemore time. We want to also mix
in some bicycling or some other kindof exercise. So anyways, but you
have the exercise pieces I was talkingabout. That helps with the weight gain,
which helps to keep your blood pressuredown, which helps to keep your
blood sugars below the level of diabetes. And by the way, even pre
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diabetes is not good. That willelevate your risk of dementia, which means
that if you're a one C,you're a hemoglobin A one C is in
the sixes, but not at seven. That's still an increased risk. It's
like a fifty percent increased risk,whereas you have a twice as high increased
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risk if you actually have diagnosed diabeteswith an a one C of seven or
higher. Most people don't have aone CS below six but they should factors
into that as well. I haveone word to say about smoking, don't
(23:07):
It's involved with all kinds of differentvascular problems which ultimately go to affect your
brain. And also, all thesecardiovascular factors are very often involved with the
sleep apnea and sleep piece. Soif we take a look at all of
those things, you come to theconclusion, Wow, there's a lot of
them, but also that they're allintertwined and if you're not doing anything about
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them, they feed on each other. They actually create a vicious cycle of
decline. That's not good. Butthe good news is if you begin to
change one of those you now areturning the vicious cycle in reverse. So
if you're exercising, it's easier tolose weight, you're getting more oxygen to
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your You're oftentimes sleeping better because you'remore tired when you go to bed,
your blood pressure is more control.See, all these things work together in
your benefit. Not really what youwant to do is get that cycle going
in the positive direction. Yeah,I mean it was interesting that you brought
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up the say, the smoking forthe vascular My mom smoked for forty years
and we're going through the vascular issuesnow for her. But my uncle who
had the dementia and his daughter wereboth morbidly obese and he had diabetes.
It's you know, it's one ofthose things when we think about our bodies,
(24:42):
it's all interconnected. I mean,I think we know that, but
when we go to what doctors say, we go for our eyes, we
go for our brain, we gofor our arm, we go for our
stomach, and everything segmented. AndI think that helps us forget that nothing
is nothing is an island in ourbody. Everything affects everything else. Does
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that make sense? Like I feellike we forget because when we go to
the doctor, they're like, Ican't talk about that because that's not my
specialty. And we tend to thinkof ourselves in pieces and parts. And
what I hear you saying is everythingleads to something in our body. So
we find that maybe the core thingthat stands out right now, whether it's
the breathing or the diabetes, anddo something to begin to impositively impact that,
(25:30):
and you will get a domino effect. It will begin to turn your
ship around. Maybe there's more youcan do, but it starts. Am
I right? You are absolutely right? Let me expand on that a little
bit, because you get a reallycentral point both to what's going on with
dementia and why we wrote our bookthe way we did. Typically people focus
(25:51):
on one thing. I always getasked, so, doctor, what's the
one thing you can do to reduceyour risk of dementia, to which,
tongue in cheek, I respond,read our book, Dementia Prevention, Using
your Head to save your brain.Because there isn't It isn't a particular food
or type of diet, it isn'ta particular brain game, it isn't a
(26:14):
particular thing. It's from all ofthese different areas. So when we decided
to write this book, the firstrole we had was it had to be
scientifically valid. We needed to useonly what has really been proven as rock
solid science. And then we thought, well that we can't do this from
(26:36):
just neurology. It has to alsoinvolve psychiatry and psychology, but also partyology,
endochronology, which is where the diabetesdoctors are. There's ophthalmological parts of
this. Your eyes are also involvedin this process curing doctors. We had
(26:57):
to really scour the literature for allof these different areas, and one of
the things that I realized was therearen't any dementiologists. Think about that.
We've got gastro enterologists, they dealwith our gut. We've got gynecologists,
we've got urologists, we've got neurologists, galithologists. We don't have any dementiologists
(27:23):
who pull all of this together.That was our goal, pull all of
it together, translate art science intounderstandable language, because if you don't understand
it, you can't use it.So I'm always really happy when people say
I read your book, Wow,it was really understandable. I didn't think
(27:45):
i'd be able to get it.And I tell them, well, the
book is written so it sounds likeyou're sitting in the same room with us
having a conversation like a podcast.And if it's understandable to you, then
you're going to be motivated to dosomething about it, including assessing your own
strengths and weaknesses and making changes thatmake a difference. So that's why this
(28:11):
whole idea about looking at this verywide net of information is really critical.
And you've identified the issue as wellas anyone I've seen so far in terms
of saying, yeah, it's nota dementia prevention is a thing, but
it's not one thing. It's allof this. It's a lifestyle shift,
(28:33):
it's what it sounds like. Yeah, and sort of recreating ourselves or adapting,
you know. One of the realchallenges at any point in life,
but particularly in midlife and beyond,is taking inventory and saying, Okay,
what do I want now? Becausechances are if I fit fifty, I'm
likely to be around for at leastthe next thirty years. When you turn
(28:57):
seventy, you're life span is noweighty five because you've now made it past
some of those things that will killyou in your fifties and sixties. But
at each point along that continuum,what you should be looking at is,
Okay, what do I want todo with this next period of time?
How do I want to keep myselfhealthy? How can I wake up dead
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one morning but that being sick ofthe day before. That's my goal?
How can I accomplish that? Andthe rule is if you pay attention to
your health, a lot of thesethings are very doable, including the keeping
your brain intact throughout that period ofyour life. Do you have a series
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of brain exercises that people can do, Like you said, to me in
my mind, it's like if yourhearing is bad, but you get your
hearing back up, then your braincan activate properly. Do you have things
that maybe you've gotten into habits ofdoing as a society, not even just
(30:02):
by age, that are kind ofsteering us toward less healthy futures as far
as dementia is concerned, things likescreen time or lack of activity, or
like you said, the sedentary whichis the lack of activity. Are there
things that the little shifts, likeyou said, a ten minute walk three
(30:23):
times a day, that's super fantastic. Does hydration come in to play?
Are there certain vitamins or minerals thatcan help us, you know, support
our systems so that they can dowhat they need to do. From your
standpoint, important questions. Number one, Vitamins and minerals are important if you
(30:45):
have a deficiency, okay, Butif you don't have a deficiency, you're
basically using your body as a wayof turning them from a pill into byproducts
from the toilet. Okay. Butif you want to pay a lot of
money and have it flow through yourbody to do that, it hopes that
it'll make a difference. Be myguest. But you know, I tell
(31:07):
people, if you can hear mein the next if you can hear someone
in the next state screaming at theTV, that may be me when I'm
watching commercials for some of the productsthat taut their advantages for brain health or
just for general vitality, and they'vecrammed vegetables and fruits into little, tiny
(31:30):
pills. Yeah, And people say, well, you know it's I don't
have the time to eat regularly.I'm sorry, make the time to do
that. This is a really stupidway of going about it. So no,
there really aren't any particular vitamins orminerals. Is recent research suggesting a
multivitamin would have some benefit. Theresearch was not really well designed. I
(31:53):
have to tell you. The evidencethat they use to make this statements relatively
weak. But it's not a badthing. You know, you want to
think a multi vitamin, go ahead. But I see people walk into my
office with bags of supplements and vitaminsthat they're spending a lot of money for
(32:14):
and getting nothing from. Number One. Oftentimes these are so poorly regulated that
you don't even know which brand haswhat in it. Number Two, In
most cases, it never can reacha blood level sufficient in your body to
even affect your brain, so it'sgetting digested along with food that you're eating.
(32:36):
So save your money on those kindsof things, and especially the one
with the jellyfish products that is worthless. The other issues have to do with
brain games. Really mixed data onthe efficacy of specific games for improving thinking
(33:00):
abilities. There's some research that saysfor certain people, certain games might help
with problem solving and other games mighthelp with the tension. The evidence is
not strong enough for me to evenput in a brain training office in my
(33:21):
suite of offices or hires someone toteach people how to use these. Believe
me, I've looked for this foryears because I thought, Wow, this
would be a great non pharmaceutical wayof helping out my patients and growing my
practice. And after're looking at theresearch, I keep coming up saying there's
(33:43):
nothing here. Now that doesn't meanyou shouldn't be active. I really want
people to be active in several ways. First of all the physical we talked
about, but second, I wantthem to be interpersonally active, because it
does show from the research that supportsystems, friendships, partnerships, doing things
(34:05):
with other people is really important inmaintaining our outlook but also our brain health.
So if you have a choice betweendoing a word search puzzle in your
house or going at someplace and playingbridge, pe knuckle majong board games with
friends, you the one that getsyou out, You're going to use much
(34:28):
more of your brain. We alsoknow that for a lot of people,
retirement isn't so wonderful from a cognitiveperspective. You know, they can't wait
to retire from their job, andthen they haven't made a plan about what
to do after retirement. So threeweeks into it and sleeping late, they're
(34:50):
looking around saying what now, Andwe say, okay, there's lots of
opportunities. You can try to geta part time job, you can take
up some new hobbies, you cando some volunteer work. But you got
to do something you don't want torust out. You could wear out,
that's not too bad, but youdon't want to rust out. So you
(35:14):
need to put some real hard energy. And frankly, what we should be
doing before we get to retirement ishave classes for retirement planning. All the
pre retirement planning is based on finances. Do you have enough to retire,
great, But what are you goingto do with that money once you retire
becomes the important question. Yeah,I'm really grateful for this conversation because you
(35:37):
know, the thing about fear isit overwhelms us, and then we were
not able to see possibility. We'renot able to see answers because the fear
becomes the all consuming thing. Andright now, at least what I'm seeing
is there's a lot of conversation arounddimension Alzheimer's, but it tends to come
(35:58):
from a scary place. It hasto feel scary, be couched scary,
and then you know, people startto go, well my dad had it,
I'm going to have it, oryou know, you know, sugar.
All of these things come up andall of it figures in. But
I'm grateful for this conversation because tome, the fear is being pulled back
(36:22):
and the truth and the reality andthe possibility of us being able to contribute
to the outcome instead of it justbeing like, well, there's nothing we
can do, do you know whatI mean? And I appreciate that because
it is a it's a real concernI'm interested in. It seems like there's
(36:45):
an uptick or is it just becauseit hasn't been focused on before, Like,
is it really something that's becoming epidemicwith hand quotes or is it just
something that's becoming a conversation. It'sI think a couple different reasons. Number
one is the conversation. People arebeing willing to talk about this a lot
(37:09):
more than they used to. It'sreally we've shined a light on it,
especially Alzheimer's disease and also fronto temporaldementia, which is what Bruce Willis has
is that a phasia a phasia canbe a part of it. Also,
behavioral changes are a big part formany people in front of temporal dementia.
(37:29):
That actually is the type of demensiathat occurs usually at an earlier age,
usually in someone's fifties. So peopleare coming out of the closet the you
know, they talk about celebrities whohave Alzheimer's disease, who have vascular dementia,
et cetera, et cetera. Sothat's great. The other thing that
(37:51):
is important to know is that dementiais usually a disease of aging. So
when we're in our sixties, therisk is it's about ten percent. Get
into our mid seventies, it doublesto about twenty percent. Get into our
mid eighties, and it doubles again. So if you're eighty five years old,
(38:12):
you have about a forty percent chance. People are living longer. And
therefore, and we're and the peoplewho are living longer are also very much
baby boomers. We're moving into thatera. And so there's this big hump
in the population because baby boomers werethe largest segment of the population and I
(38:35):
think it still may be so nowthey're in their retirement years. So there's
a lot more evidence and a lotof the baby boomers, including myself,
are saying, Hey, no,we won't go we won't go into this
dark night. We're going to pushback. We're going to fight this thing.
We're going to use what we canto make a difference in our lives,
because you know, being older isn'twhat it used to be when our
(38:59):
parents older or our grandparents were older. Yeah, and I think that's encouraging
too. If you had to givethree key takeaways to my audience, I'm
going to assume and take this onefrom you that one of your key takeaways
would be to get a hold ofthe book Dementia Prevention using your head to
(39:20):
save your brain. I know,I know that that was one of yours,
so I would like three other onesfrom you in addition to getting a
copy of the book. Well.Alide with that, if you go to
our website called brain dot dot com, there is a free downloadable Dementia Risk
(39:43):
Inventory Dementia prevention checklist that everyone canfill out that'll show them where they are
in relation to where they should bein terms of being on target. And
the beauty of this is it allowsyou to develop a plan. So we
like to give that away because weYou can look at other things on the
(40:06):
website, for sure, but ifyou simply take this questionnaire, which is
the only one that I know ofthat actually is out there, you'll be
able to assess your own risk andmore importantly, say, oh, I
didn't realize I was off target onthis. I didn't realize that was an
important factor. I can work onthat. So that's more important than any
(40:27):
one particular piece of information. Sothat would be number one. Number two.
There's also linked to that a what'scalled a col ergic or anti polar
ergic risk or a tychol energic burdenexcuse me anti cool energic burden calculator.
(40:50):
The reason for this, So wedidn't develop this calculator. It's a couple
of doctors in England who developed thiscalculator. But many of us take medications,
both prescription and over the counter thatcontain chemicals, including one very common
one called benadrill or diphenhydromene, thatdepletes our brain of acetylcholine. Now,
(41:15):
all of the memory chemical, thememory medications we've had out, we're actually
most of three out of the fourthat we've had out since the nineteen nineties
are aimed at trying to preserve acetylcholine. So we may be inadvertently depleting our
brains of a chemical that we need. Very common in over the counter sleep
(41:39):
aids, all the ones with thePM at the end of it, very
common in medications we take for allergiesand flu symptoms. They you also find
these in medications for urinary control.The ditropans, the trolls brand names for
(42:01):
things like oxybutant can contain these aswell as some prescription medications for your heart
or for your mood. So thebeauty of this calculator is you get to
put in each of the things justfrom your medicine cabinet, and it will
calculate whether or not your levels aretoo high or not, and then you
(42:24):
can begin to make some changes inwhat you buy over the counter. But
if you're concerned about the prescriptions,do not stop them on your own.
Go to your doctor and talk aboutthem. Probably. The other thing is
that when your if you drink alcohol, measure what you're drinking. I see
people all the time and they say, oh, I only have two drinks
(42:45):
a day, and I ask them, well, how do you pour them?
I said, what do you mean? I just pour them into the
glass. I said, ah,you pour like your neuropsychologists poors. What
you should be doing here is usinga shot glass, because I want you
to do an experiment and go andfor using a shot class, see if
that's the amount you're actually drinking,because it isn't. But they tell themselves,
(43:09):
well, just three fingers, Wellwhat does that mean. I don't
go buy fingers, I go buyounces. There's also and people say,
well I only drink beer. Fine, but one beer equals a glass of
wine equals a shot of bourbon.So it's not just beer. It's an
alcoholic beverage. That's diluted with water. So those twelve ounces at four percent
(43:35):
alcohol are about the same as fiftypercent alcohol of a shot of whiskey.
So you have to do the calculationsand what's what you drink, watch what
you're taking that appears to be benignbecause after all, it's sold without a
prescription, And those are things wehaven't touched on, but they really are
important. Well, obviously I thinkthis conversation could continue because this is really
(44:05):
a deep and wide conversation. Butthat's the benefit of having a resource like
your book and your website. Thisis to I think peak the interest and
the information kind of ears of peopleto say, ah, he said that
thing, or oh that sounds interestingto me, and you have the resources.
So where can people find your resourcesagain, so that we can direct
(44:28):
them there. Well, the bookis available on Amazon, Barnes and Noble.
Johns Hopkins is the publisher, soit's available through them. It's on
Kindle, it's on Apple, it'son audiobook, which is really wonderful for
people who like to listen to somethingin the car while they're taking a walk.
(44:50):
The website is brain doc br ain dooc, brain doc dot com.
And it'll link you with all kindsof different resources, including the book
and including other articles we've written theother podcasts as a wealth of knowledge which
we just want to give away.I just want people to have this and
probably our books also in a bunchof libraries. So if you're saying I
(45:14):
can't afford the book, great,borrow it from your library and you can
request it from your library. Forthose of you who don't know. If
it's not in your library, speakto the library and see if you can
get a copy that way. Sothat's a library hack and it works.
Yes, it totally works well,Doctor Kleoncek. I want to thank you
(45:35):
so much for being on the showtoday and for sharing your wisdom and your
knowledge. I realized it was justa drop in the bucket, but I'm
so grateful to have the opportunity toopen up this conversation and to lift the
fear a little bit. I appreciatethe direct way that you communicated, the
clarity with which you communicated, thepractical ways that you communicated this issue,
(45:55):
because it is something that is comingto the surface more and more, and
fear comes with lack of knowledge,So thank you for bringing that knowledge to
the plate today so that we canhelp call the fear and take control of
our health and our brain health andour life, so that we can go
into our future not fearful, butin control of potentially our brain health and
(46:19):
our you know, just the outcomesbeing more in our hands and less feeling
like we're just going to be avictim of whatever it is that happens to
us. So I appreciate you,you know, your wealth of knowledge and
the confidence and clarity that you deliveredit. Thank you so very much.
Thank you for inviting me. It'sbeen great, it has been fantastic.
And today, friends, if thisis a conversation that really rings a bell
(46:44):
for you or you know someone whoneeds this information, I would like you
ahead to www dot Feminine, roadmapdot com, Forward Slash episode three sixty
three, or if you're on YouTube, just look down below. I will
have the links for him, thedoctor there and his book. Everything will
be easily accessible for you. Wedon't have to be afraid. That's the
(47:06):
key part of this conversation. Feardoes not have to drive us into our
future of aging. We do nothave to air quote decline. We can
choose to pursue life along our agetimeline, with an empowerment, with an
education, with the choices that wemake. To doctor Mitch's point, retirement,
(47:30):
what does retirement look like for us? We can really curate the life
we want to live. We arenot victims of the timeline. We can
choose the way we live our lives, the way we think, the way
we feed our bodies, the waywe move our bodies, the way we
communicate in and around us with thepeople in our lives. There's so many
(47:50):
elements. I want to go downa buddy trail right now, But what
I'm going to say is, don'tbe afraid of aging. Take the resources
like Dot or Mitch and his wifeand learn what you need to learn,
change what you need to change,and live a healthy, vibrant life.
And share these resources with those inyour world. I want to thank you
(48:12):
so much for being with us today. I look forward to sharing more inspirational
people, conversations and resources with youin the weeks to come. Take care
of my friends. Bye bye,
Hi, him Gina for are welcometo the Feminine Roadmap Podcast, a global
community of women in midlife. Wegather here weekly over a cup of something
wonderful for real talk, life changingstrategies and a big dose of sisterhood.
Now, please sit back and enjoy. Hello, Feminine Roadmappers. Welcome back
(00:28):
to Feminine Roadmap Podcast, the podcastthat helps you navigate the challenges and the
changes of midlife and empowers you tolive a more vibrant second half. If
you find us today on YouTube,please don't forget to subscribe and ring that
bells you don't miss any more ofthese conversations. And if you're on a
podcast platform, please remember to subscribe, rate, and share. Today we're
(00:51):
having a new conversation, one aboutdementia. Eighty percent of people over fifty
five are worried about getting Alzheimer's diseaseor dementias. The good news is that
half of all dementias are preventable,and my guest today wants us to know
that we can start the process ofprotecting our brain as we age. My
(01:12):
guest today is doctor Mitch Kleonski.He's a BORED certified neuropsychologist. He's a
co author of a book with hiswife. The book is Dementia Prevention,
Using Your Head to Save Your Brain. Doctor Kleonski, thank you for being
with me today, Gina. It'sa real pleasure. I'm looking forward to
our conversation me too. As Ishared before we hit record, I just
(01:36):
lost a family member to early onsetdementia and Louis body last week, and
so it's on my mind. Andwhen I said yes to you, she
was the kind of the impetus forme to say yes. And I would
love to know why do you dothis? Why are you passionate about these
neuro issues like dementia and Alzheimer's.I think there's several threads to that answer,
(02:01):
so if you'll bear with me,I'll try to put them together because
I've given a lot of thought tothis. One of the reasons is that
I find that the brain is fascinatingand that more than just psychology. I
spent the first ten years of mycareer primarily doing clinical psychology, meet with
(02:21):
people, evaluate them, do psychotherapy, and during this time there was a
maturation in the field of clinical neuropsychology. As fat was really interesting. If
I'd go to a party and peoplewould say to me, so, what
do you do. I'd say,well, I'm a psychologist. They want
to either tell me all their problemsor they think I was reading their mind
(02:42):
and they try to run away.If I told them I was a clinical
neuropsychologist, they go oh, andso then we have a different start to
the conversation because I think, wow, that's a big word. It must
mean a lot of things. Basically, what it means is we use different
kinds of tests and interviews to findout how people are thinking, how they're
paying attention, how they're able tolearn and remember things, how they're able
(03:07):
to solve problems, and these kindsof questions, these kind of test results
reflect on what's going on in theirbrain and oftentimes leads us to be able
to make a really good diagnosis ofwhat's going on and then, even more
importantly, to lead to interventions thatcan stop something that's going bad from getting
(03:31):
worse, or in some cases,roll it back and make it better.
So back in the mid eighties,because I've been practicing for forty five years,
I know it looks to your viewerslike I'm maybe thirty, but I'm
really quite a bit older than thatI've been practicing now for forty five years,
(03:52):
and about ten years in my practice, I got really interested in this
and had taken a bunch of trainingsbackwards in graduate school, so it was
very natural I'd actually start first neuropsychologicallaboratory in Western Massachusetts, and I wanted
to do more of this. Ibegan to expand my practice to the point
(04:13):
where, over the course of theseyears, I've actually evaluated it says twenty
five thousand in my bio, it'sactually more like thirty thousand patients for different
kinds of cognitive problems. Each dayI go in and see people and have
new and exciting things to think about. So one of the reasons why I'm
(04:34):
passionate is because it's very fulfilling tome to understand how people tick and what
I can do to help them tobe better. It got really personal,
though, back when I was fiftyyears old and my mom was in her
early seventies, and I could puttogether the fact that some of the change
(05:00):
in who this very capable, competent, wonderful woman was that she was having
greater and greater difficulty and I realizedthat she was developing dementia. Took her
to a neurologist back where we grewup, where I grew up in Pennsylvania.
She got a diagnosis, got allthe various memory tests, the neurological
(05:23):
tests, and basically I was onthe other side of the table where my
patients and their family sit for thenext ten to twelve years of her life.
I conclude that it's much better tobe on the professional side than on
the patient side. But the onething that I thought at the time was
(05:45):
wasn't it wonderful that this gave mesome compassion and insight into what's happening with
these families that I might never havehad before. It was also real impetus
to try to do something that wouldhelp to spare other people from what my
(06:05):
mom went through and from what Iwent through as her son. So,
along with my wife Emily, whois a very brilliant psychiatrist who works mostly
in the field of neurology because theyget double borded in psychiatry and neurology,
and she'd already been an internal medicinedoctor, so she brought all this incredible
(06:28):
medical knowledge to bear, we decidedthat it made a lot of sense for
us to try to put this intoa book so that people could read this
book and make changes potentially in theirmedical conditions, in their habits and lifestyle
so they wouldn't have to go throughthis. And we were really bolstered by
the fact that the research was incrediblysupportive of the fact that half of these
(06:54):
cases could be avoided. Most peopledon't know that, So that's what gets
me here today. It's really encouragingto know that there is something we can
do because it's very frightening. Youknow, it's an unknown and losing your
mind is a scary thing. Andto the story of my cousin, what
(07:16):
it does to a person's personality andthe dynamics within a family, and if
it's a family caregiver, which inthis case it was, was very difficult,
very long and stressful journey for everyone. But you were sharing because I
was saying, my uncle had Alzheimer'sand then his daughter had this Louis body
dementia. You were saying, it'snot necessarily genetic. Is that correct?
(07:41):
In fact, few of the casesare actually genetic. Genes account for maybe
about five percent of your risk.Isn't that amazing because most people, I
say, oh, I had amother, I had a father, maybe
both of them who had Alzheimer's disease. I will sure have this and I
(08:01):
don't know what I'm going to doabout it. And we say, well,
yeah, there are some blood teststhat you can get that'll tell you
if you have some of the genesor some of the findings early on that
would predict this. On the otherhand, I'm not a big supporter of
these blood tests because you're going towant to do everything you can to prevent
(08:22):
dementia whether or not you have thegenes. It's not like you're going to
try harder if you have genetic background. You should be doing this anyway,
because while the genes are typically onespredicting Alzheimer's disease, Alzheimer's is only one
(08:43):
type of dementia. It's sort oflike Ford is only one type of automobile.
There's toyotas, there's chevrolets, there'slots of different types. Same thing
is true in the field of dementia. One question people ask is is it
Alzheimer's or is it dementia? Andthe answer is often well, it could
(09:05):
be both. Because Alzheimer's is atype of dementia, as is Lewis body
disease what you were talking about withyour cousin. One of the biggest types
of dementia, however, rivaling Alzheimer'sand often in combination with Alzheimer's, is
what we call vascular dementia. Andso here's where all the things that affect
(09:28):
your heart also affect your brain becauseit's all connected by circulatory systems. So
we see a lot of people havehistories of hypertension that they're not really controlling
well, diabetes that they're not payingattention to and not doing the things to
(09:50):
control that. We see that there'salso dementia's caused by repetitive brain injuries what
they call chronic traumatic encephalopathy, wherepeople get their heads hit a bunch of
times. It can be even justone time for that matter, but is
more often when it's a repetitive kindof pattern. Unfortunately, by the time
(10:13):
they're adults, a lot of thosekinds of damages have already been done,
so we're not going to undo thator prevent that. We're going to work
on everything else. Alcohol intoxication andexcess of alcohol use is also a very
common condition that leads to the lossof memory functioning and cognitive abilities, thinking
(10:37):
abilities as we age, and obesity, which is the huge epidemic in the
United States. Is underpins the highblood pressure, it underpins the diabetes,
It underpins the sedentary behavior of peoplewho don't move enough, making them susceptible
(11:01):
to dementia. So exercise is oneof those commonalities that we're going to be
talking about no matter what the diagnosisultimately ends up being. One of the
things that most people don't know.One of the preventable factors that's only been
discovered in the last several years isthat hearing loss actually causes memory decline.
(11:24):
So when people are beginning to turnup the volume on the TV, when
they're not responding to what other peopleare saying as well as they used to,
when they're missing out on background noise, that's actually depriving their brain of
the stimulation it needs to be ableto make connections. So it affects two
parts. One is the surface ofthe brain and the other is a network
(11:50):
that's internal to our brain called thesalience network. That's the connectivity of our
brain that says, oh, that'sinteresting or oh that it's important. The
good news is, in many cases, if you can get someone to have
a hearing test and then to usehearing aids, which these days are becoming
(12:11):
better and better and cheaper and cheaper. You can improve their ability to think
in the short term. Actually,their scores on testing will improve, and
you can help prevent decline as theyage. The hard part is getting people
to recognize it, to get pasttheir resistances and they say, oh,
(12:33):
you know, my husband's mumbling,or it's just that I wasn't thinking so
well. I was thinking about somethingelse. And the best advice is,
well, why don't you get yourhearing tested? Then we'll know for sure
and you can make good decisions goingforward. I have a question about so
one of my dearest friends, herfather went in for heart surgery. I
(12:56):
guess he'd been having some minor memoryissues, but when he came out of
surgery, something about the anesthesia justthrew him into full blown dementia and he
was also diagnosed with Louis body dementia. What was the correlation there? Is
that common? Is it kind ofan unusual situation? Yes, it is
(13:22):
common, but it's probably not somuch the anesthesia as it is the oxygen.
So we've known for a long timethat people who've had multi vessel surgeries
bypass surgeries have emerged from surgery withdifficulty thinking. Sometimes it's early on set
(13:46):
and it seems to get better,and the other group seems to get at
about five years later. They've usedto think that it was because people were
not on a heart lung machine gettingenough oxygen during that time. More recent
studies found those are probably equivalent whetherthey're on or off that pump, and
(14:07):
now think it may have to dopartially with little tiny pieces of plaque being
broken off when they reconnect the vessels. But there's another explanation for it that
I think is oftentimes the case,and it doesn't just occur with heart surgery.
It also occurs with knees and hipreplacement, which I'm sure many of
(14:33):
your listeners are either contemplating or havehad. And that is if you happen
to have obstructive sleep apnea. Inother words, if you are stopping breathing
or your oxygen level drops by fourpercent while you're sleeping. This occurs more
(14:56):
than on average five times per hour. That's what the definition of sleep apnea
is. If you have this andeither you don't know it or the surgeon
doesn't put you on a CPAP machine. When you come out of surgery and
they remove that breathing tube, theyexcubate you, you can have a sudden
(15:16):
loss of oxygen that will really messwith your brain, will cause you to
end up in some cases in intensivecare thinking there's spiders coming down from the
walls. Es suentially delirious, andif you already are having some problems with
your thinking abilities, if you're beginningto have some changes that are the precursors
(15:39):
for dementia, this is like throwingfuel on a fire. It can make
people much worse in a very shortperiod of time. So I guess the
takeaway is if you have symptoms ofsleep apnea or even are concerned about it,
you ought to get tested for it. Because we now know that the
most recent research is if you're midfifties or older, there's actually a fifty
(16:02):
percent chance you have this. Youdon't have to be fat, you don't
have to be male, you don'thave to snore loudly. You can still
have this and it's very very treatable, So you ought to get a treated
I ruled the world, everybody stargat age fifty would begin to get this
kind of a test in addition totheir colonoscopes and addition their mammograms every five
(16:26):
years, simply because if we identifyand treat this condition, we can avoid
a lot of problems heart attack,strokes, dementia down the road. But
anyway, if you're having a diagnosis, if you already know you've got sleep
apnea, you should treat it usingcontinuous positive airway pressure otherwise known as SEAPAP.
(16:48):
But even if you're one of thosepeople says, oh, I'm never
going to use that machine, Idon't want a SEEPAP, tell your surgeon
if you're going in for surgery thatyou have sleep apnea, so at least
they can put a CPAP on youwhen you're coming out of surgery. Okay,
fantastic. Now you talk about waysthat we can prevent or protect our
(17:14):
brains. What are some of theways that my audience can themselves protect their
brains or even help their parents,because a lot of us really are responsible
for our parents in this season oflife, myself included. So what are
some of the things that we cando for that preventative measure. So our
model that we build on in thebook takes about eight chapters to build this
(17:38):
entire model as a variety of differenttypes. So let me tackle a few
of these. For many people,the biggest ones are the cardiovascular conditions.
There's a cluster of them, andmost of them have lack of exercise and
obesity at their core. So yourbody was built to carry a certain weight.
(18:03):
I'm not trying to shame anybody.I'm not trying to talk about appearance.
I'm talking about what your body wasdesigned based on your height and your
bone structure. If you exceed that, you're going to have changes simply because
in your body and in your health, simply because your body is working too
(18:27):
hard for its structure. If youview it in that kind of a term,
you say, huh, it's reallyimportant. Then I do everything I
can so that it fits my bodyand what I'm made for. And that's
really, I think, a muchmore positive way of approaching this because it
gets away from the stigma. Itgets away from the you know, are
(18:49):
you being lazy? Are you nottaking care of yourself? And really says
okay, here I am at fifty, how do I want to be for
the next thirty years of my life? Well, part of me wants to
be more fit. So I gotto exercise on a regular basis number one,
because there really isn't an alternative tothat that works. The question is
(19:12):
how to get ourselves to start Thatfor most people is the issue. Yes,
And as I like to tell people, the first step in changing a
habit like exercise is you have toexamine your butt. And they look at
me like you're looking right now,saying what that's exactly what I mean,
(19:38):
not the one you're sitting on,but the butt that's in the sentence I
would exercise. But whatever comes afterthat is what you have to examine.
And oftentimes it's things like, well, I'm lazy. What does that mean?
That means I'm not doing it.That's just a rationalization. It means
I'm too busy. Really, itmeans I can't do it for this reason
(20:03):
or that reason. I'd have todo this first. But a lady you
told me that the reason she hadn'tdone much exercise in the past year was
she was still working on the apartmentshe moved into, and they were supposed
to replace the windows and they hadn'tdone it, and she needs to get
her drapes done first, I said, what does that have to do with
your exercise. So after we workon that, the question is, here's
(20:26):
here's a formula that I recommend peopleuse because this gets around most of everyone's
butt. The first thing is picka ten minute walk, do it three
times a day. Here's why thisten by three formula works. Number one,
walking is great exercise. Number two, you're unlikely to hurt yourself.
It's unlucky you're going to get lost. You can do it most everywhere,
(20:51):
you can do it in most everykind of weather. The exercise those ten
minute walks are cumulative. So thethree ten minute walk gives you two hundred
and ten minutes of exercise a week, right in the sweet spot for all
of the medical societies. And ifyou're walking briskly, which means you're getting
(21:14):
your heart rate up but you're stillable to talk, you're going to get
about nine to ten miles of exercise, which is great. The question then,
is what do you do while you'rewalking. Partly, you can listen
to a podcast like this always agood idea. Listen to music. You
can talk to a friend or relativethat you've been meaning to stay in touch
(21:36):
with. In fact, both ofyou can be walking at the same time,
which is a lot of fun,different places, same walk, and
you don't need special equipment. Youneed a nice pair of shoes and that's
about it. So if we getpeople to start at that point, for
many of them, that will beenough. But it also gives the springboard
for people who want to do more, who want to augment it with the
(22:00):
hike on the weekends when they havemore time. We want to also mix
in some bicycling or some other kindof exercise. So anyways, but you
have the exercise pieces I was talkingabout. That helps with the weight gain,
which helps to keep your blood pressuredown, which helps to keep your
blood sugars below the level of diabetes. And by the way, even pre
(22:26):
diabetes is not good. That willelevate your risk of dementia, which means
that if you're a one C,you're a hemoglobin A one C is in
the sixes, but not at seven. That's still an increased risk. It's
like a fifty percent increased risk,whereas you have a twice as high increased
(22:47):
risk if you actually have diagnosed diabeteswith an a one C of seven or
higher. Most people don't have aone CS below six but they should factors
into that as well. I haveone word to say about smoking, don't
(23:07):
It's involved with all kinds of differentvascular problems which ultimately go to affect your
brain. And also, all thesecardiovascular factors are very often involved with the
sleep apnea and sleep piece. Soif we take a look at all of
those things, you come to theconclusion, Wow, there's a lot of
them, but also that they're allintertwined and if you're not doing anything about
(23:33):
them, they feed on each other. They actually create a vicious cycle of
decline. That's not good. Butthe good news is if you begin to
change one of those you now areturning the vicious cycle in reverse. So
if you're exercising, it's easier tolose weight, you're getting more oxygen to
(23:59):
your You're oftentimes sleeping better because you'remore tired when you go to bed,
your blood pressure is more control.See, all these things work together in
your benefit. Not really what youwant to do is get that cycle going
in the positive direction. Yeah,I mean it was interesting that you brought
(24:21):
up the say, the smoking forthe vascular My mom smoked for forty years
and we're going through the vascular issuesnow for her. But my uncle who
had the dementia and his daughter wereboth morbidly obese and he had diabetes.
It's you know, it's one ofthose things when we think about our bodies,
(24:42):
it's all interconnected. I mean,I think we know that, but
when we go to what doctors say, we go for our eyes, we
go for our brain, we gofor our arm, we go for our
stomach, and everything segmented. AndI think that helps us forget that nothing
is nothing is an island in ourbody. Everything affects everything else. Does
(25:03):
that make sense? Like I feellike we forget because when we go to
the doctor, they're like, Ican't talk about that because that's not my
specialty. And we tend to thinkof ourselves in pieces and parts. And
what I hear you saying is everythingleads to something in our body. So
we find that maybe the core thingthat stands out right now, whether it's
the breathing or the diabetes, anddo something to begin to impositively impact that,
(25:30):
and you will get a domino effect. It will begin to turn your
ship around. Maybe there's more youcan do, but it starts. Am
I right? You are absolutely right? Let me expand on that a little
bit, because you get a reallycentral point both to what's going on with
dementia and why we wrote our bookthe way we did. Typically people focus
(25:51):
on one thing. I always getasked, so, doctor, what's the
one thing you can do to reduceyour risk of dementia, to which,
tongue in cheek, I respond,read our book, Dementia Prevention, Using
your Head to save your brain.Because there isn't It isn't a particular food
or type of diet, it isn'ta particular brain game, it isn't a
(26:14):
particular thing. It's from all ofthese different areas. So when we decided
to write this book, the firstrole we had was it had to be
scientifically valid. We needed to useonly what has really been proven as rock
solid science. And then we thought, well that we can't do this from
(26:36):
just neurology. It has to alsoinvolve psychiatry and psychology, but also partyology,
endochronology, which is where the diabetesdoctors are. There's ophthalmological parts of
this. Your eyes are also involvedin this process curing doctors. We had
(26:57):
to really scour the literature for allof these different areas, and one of
the things that I realized was therearen't any dementiologists. Think about that.
We've got gastro enterologists, they dealwith our gut. We've got gynecologists,
we've got urologists, we've got neurologists, galithologists. We don't have any dementiologists
(27:23):
who pull all of this together.That was our goal, pull all of
it together, translate art science intounderstandable language, because if you don't understand
it, you can't use it.So I'm always really happy when people say
I read your book, Wow,it was really understandable. I didn't think
(27:45):
i'd be able to get it.And I tell them, well, the
book is written so it sounds likeyou're sitting in the same room with us
having a conversation like a podcast.And if it's understandable to you, then
you're going to be motivated to dosomething about it, including assessing your own
strengths and weaknesses and making changes thatmake a difference. So that's why this
(28:11):
whole idea about looking at this verywide net of information is really critical.
And you've identified the issue as wellas anyone I've seen so far in terms
of saying, yeah, it's nota dementia prevention is a thing, but
it's not one thing. It's allof this. It's a lifestyle shift,
(28:33):
it's what it sounds like. Yeah, and sort of recreating ourselves or adapting,
you know. One of the realchallenges at any point in life,
but particularly in midlife and beyond,is taking inventory and saying, Okay,
what do I want now? Becausechances are if I fit fifty, I'm
likely to be around for at leastthe next thirty years. When you turn
(28:57):
seventy, you're life span is noweighty five because you've now made it past
some of those things that will killyou in your fifties and sixties. But
at each point along that continuum,what you should be looking at is,
Okay, what do I want todo with this next period of time?
How do I want to keep myselfhealthy? How can I wake up dead
(29:21):
one morning but that being sick ofthe day before. That's my goal?
How can I accomplish that? Andthe rule is if you pay attention to
your health, a lot of thesethings are very doable, including the keeping
your brain intact throughout that period ofyour life. Do you have a series
(29:42):
of brain exercises that people can do, Like you said, to me in
my mind, it's like if yourhearing is bad, but you get your
hearing back up, then your braincan activate properly. Do you have things
that maybe you've gotten into habits ofdoing as a society, not even just
(30:02):
by age, that are kind ofsteering us toward less healthy futures as far
as dementia is concerned, things likescreen time or lack of activity, or
like you said, the sedentary whichis the lack of activity. Are there
things that the little shifts, likeyou said, a ten minute walk three
(30:23):
times a day, that's super fantastic. Does hydration come in to play?
Are there certain vitamins or minerals thatcan help us, you know, support
our systems so that they can dowhat they need to do. From your
standpoint, important questions. Number one, Vitamins and minerals are important if you
(30:45):
have a deficiency, okay, Butif you don't have a deficiency, you're
basically using your body as a wayof turning them from a pill into byproducts
from the toilet. Okay. Butif you want to pay a lot of
money and have it flow through yourbody to do that, it hopes that
it'll make a difference. Be myguest. But you know, I tell
(31:07):
people, if you can hear mein the next if you can hear someone
in the next state screaming at theTV, that may be me when I'm
watching commercials for some of the productsthat taut their advantages for brain health or
just for general vitality, and they'vecrammed vegetables and fruits into little, tiny
(31:30):
pills. Yeah, And people say, well, you know it's I don't
have the time to eat regularly.I'm sorry, make the time to do
that. This is a really stupidway of going about it. So no,
there really aren't any particular vitamins orminerals. Is recent research suggesting a
multivitamin would have some benefit. Theresearch was not really well designed. I
(31:53):
have to tell you. The evidencethat they use to make this statements relatively
weak. But it's not a badthing. You know, you want to
think a multi vitamin, go ahead. But I see people walk into my
office with bags of supplements and vitaminsthat they're spending a lot of money for
(32:14):
and getting nothing from. Number One. Oftentimes these are so poorly regulated that
you don't even know which brand haswhat in it. Number Two, In
most cases, it never can reacha blood level sufficient in your body to
even affect your brain, so it'sgetting digested along with food that you're eating.
(32:36):
So save your money on those kindsof things, and especially the one
with the jellyfish products that is worthless. The other issues have to do with
brain games. Really mixed data onthe efficacy of specific games for improving thinking
(33:00):
abilities. There's some research that saysfor certain people, certain games might help
with problem solving and other games mighthelp with the tension. The evidence is
not strong enough for me to evenput in a brain training office in my
(33:21):
suite of offices or hires someone toteach people how to use these. Believe
me, I've looked for this foryears because I thought, Wow, this
would be a great non pharmaceutical wayof helping out my patients and growing my
practice. And after're looking at theresearch, I keep coming up saying there's
(33:43):
nothing here. Now that doesn't meanyou shouldn't be active. I really want
people to be active in several ways. First of all the physical we talked
about, but second, I wantthem to be interpersonally active, because it
does show from the research that supportsystems, friendships, partnerships, doing things
(34:05):
with other people is really important inmaintaining our outlook but also our brain health.
So if you have a choice betweendoing a word search puzzle in your
house or going at someplace and playingbridge, pe knuckle majong board games with
friends, you the one that getsyou out, You're going to use much
(34:28):
more of your brain. We alsoknow that for a lot of people,
retirement isn't so wonderful from a cognitiveperspective. You know, they can't wait
to retire from their job, andthen they haven't made a plan about what
to do after retirement. So threeweeks into it and sleeping late, they're
(34:50):
looking around saying what now, Andwe say, okay, there's lots of
opportunities. You can try to geta part time job, you can take
up some new hobbies, you cando some volunteer work. But you got
to do something you don't want torust out. You could wear out,
that's not too bad, but youdon't want to rust out. So you
(35:14):
need to put some real hard energy. And frankly, what we should be
doing before we get to retirement ishave classes for retirement planning. All the
pre retirement planning is based on finances. Do you have enough to retire,
great, But what are you goingto do with that money once you retire
becomes the important question. Yeah,I'm really grateful for this conversation because you
(35:37):
know, the thing about fear isit overwhelms us, and then we were
not able to see possibility. We'renot able to see answers because the fear
becomes the all consuming thing. Andright now, at least what I'm seeing
is there's a lot of conversation arounddimension Alzheimer's, but it tends to come
(35:58):
from a scary place. It hasto feel scary, be couched scary,
and then you know, people startto go, well my dad had it,
I'm going to have it, oryou know, you know, sugar.
All of these things come up andall of it figures in. But
I'm grateful for this conversation because tome, the fear is being pulled back
(36:22):
and the truth and the reality andthe possibility of us being able to contribute
to the outcome instead of it justbeing like, well, there's nothing we
can do, do you know whatI mean? And I appreciate that because
it is a it's a real concernI'm interested in. It seems like there's
(36:45):
an uptick or is it just becauseit hasn't been focused on before, Like,
is it really something that's becoming epidemicwith hand quotes or is it just
something that's becoming a conversation. It'sI think a couple different reasons. Number
one is the conversation. People arebeing willing to talk about this a lot
(37:09):
more than they used to. It'sreally we've shined a light on it,
especially Alzheimer's disease and also fronto temporaldementia, which is what Bruce Willis has
is that a phasia a phasia canbe a part of it. Also,
behavioral changes are a big part formany people in front of temporal dementia.
(37:29):
That actually is the type of demensiathat occurs usually at an earlier age,
usually in someone's fifties. So peopleare coming out of the closet the you
know, they talk about celebrities whohave Alzheimer's disease, who have vascular dementia,
et cetera, et cetera. Sothat's great. The other thing that
(37:51):
is important to know is that dementiais usually a disease of aging. So
when we're in our sixties, therisk is it's about ten percent. Get
into our mid seventies, it doublesto about twenty percent. Get into our
mid eighties, and it doubles again. So if you're eighty five years old,
(38:12):
you have about a forty percent chance. People are living longer. And
therefore, and we're and the peoplewho are living longer are also very much
baby boomers. We're moving into thatera. And so there's this big hump
in the population because baby boomers werethe largest segment of the population and I
(38:35):
think it still may be so nowthey're in their retirement years. So there's
a lot more evidence and a lotof the baby boomers, including myself,
are saying, Hey, no,we won't go we won't go into this
dark night. We're going to pushback. We're going to fight this thing.
We're going to use what we canto make a difference in our lives,
because you know, being older isn'twhat it used to be when our
(38:59):
parents older or our grandparents were older. Yeah, and I think that's encouraging
too. If you had to givethree key takeaways to my audience, I'm
going to assume and take this onefrom you that one of your key takeaways
would be to get a hold ofthe book Dementia Prevention using your head to
(39:20):
save your brain. I know,I know that that was one of yours,
so I would like three other onesfrom you in addition to getting a
copy of the book. Well.Alide with that, if you go to
our website called brain dot dot com, there is a free downloadable Dementia Risk
(39:43):
Inventory Dementia prevention checklist that everyone canfill out that'll show them where they are
in relation to where they should bein terms of being on target. And
the beauty of this is it allowsyou to develop a plan. So we
like to give that away because weYou can look at other things on the
(40:06):
website, for sure, but ifyou simply take this questionnaire, which is
the only one that I know ofthat actually is out there, you'll be
able to assess your own risk andmore importantly, say, oh, I
didn't realize I was off target onthis. I didn't realize that was an
important factor. I can work onthat. So that's more important than any
(40:27):
one particular piece of information. Sothat would be number one. Number two.
There's also linked to that a what'scalled a col ergic or anti polar
ergic risk or a tychol energic burdenexcuse me anti cool energic burden calculator.
(40:50):
The reason for this, So wedidn't develop this calculator. It's a couple
of doctors in England who developed thiscalculator. But many of us take medications,
both prescription and over the counter thatcontain chemicals, including one very common
one called benadrill or diphenhydromene, thatdepletes our brain of acetylcholine. Now,
(41:15):
all of the memory chemical, thememory medications we've had out, we're actually
most of three out of the fourthat we've had out since the nineteen nineties
are aimed at trying to preserve acetylcholine. So we may be inadvertently depleting our
brains of a chemical that we need. Very common in over the counter sleep
(41:39):
aids, all the ones with thePM at the end of it, very
common in medications we take for allergiesand flu symptoms. They you also find
these in medications for urinary control.The ditropans, the trolls brand names for
(42:01):
things like oxybutant can contain these aswell as some prescription medications for your heart
or for your mood. So thebeauty of this calculator is you get to
put in each of the things justfrom your medicine cabinet, and it will
calculate whether or not your levels aretoo high or not, and then you
(42:24):
can begin to make some changes inwhat you buy over the counter. But
if you're concerned about the prescriptions,do not stop them on your own.
Go to your doctor and talk aboutthem. Probably. The other thing is
that when your if you drink alcohol, measure what you're drinking. I see
people all the time and they say, oh, I only have two drinks
(42:45):
a day, and I ask them, well, how do you pour them?
I said, what do you mean? I just pour them into the
glass. I said, ah,you pour like your neuropsychologists poors. What
you should be doing here is usinga shot glass, because I want you
to do an experiment and go andfor using a shot class, see if
that's the amount you're actually drinking,because it isn't. But they tell themselves,
(43:09):
well, just three fingers, Wellwhat does that mean. I don't
go buy fingers, I go buyounces. There's also and people say,
well I only drink beer. Fine, but one beer equals a glass of
wine equals a shot of bourbon.So it's not just beer. It's an
alcoholic beverage. That's diluted with water. So those twelve ounces at four percent
(43:35):
alcohol are about the same as fiftypercent alcohol of a shot of whiskey.
So you have to do the calculationsand what's what you drink, watch what
you're taking that appears to be benignbecause after all, it's sold without a
prescription, And those are things wehaven't touched on, but they really are
important. Well, obviously I thinkthis conversation could continue because this is really
(44:05):
a deep and wide conversation. Butthat's the benefit of having a resource like
your book and your website. Thisis to I think peak the interest and
the information kind of ears of peopleto say, ah, he said that
thing, or oh that sounds interestingto me, and you have the resources.
So where can people find your resourcesagain, so that we can direct
(44:28):
them there. Well, the bookis available on Amazon, Barnes and Noble.
Johns Hopkins is the publisher, soit's available through them. It's on
Kindle, it's on Apple, it'son audiobook, which is really wonderful for
people who like to listen to somethingin the car while they're taking a walk.
(44:50):
The website is brain doc br ain dooc, brain doc dot com.
And it'll link you with all kindsof different resources, including the book
and including other articles we've written theother podcasts as a wealth of knowledge which
we just want to give away.I just want people to have this and
probably our books also in a bunchof libraries. So if you're saying I
(45:14):
can't afford the book, great,borrow it from your library and you can
request it from your library. Forthose of you who don't know. If
it's not in your library, speakto the library and see if you can
get a copy that way. Sothat's a library hack and it works.
Yes, it totally works well,Doctor Kleoncek. I want to thank you
(45:35):
so much for being on the showtoday and for sharing your wisdom and your
knowledge. I realized it was justa drop in the bucket, but I'm
so grateful to have the opportunity toopen up this conversation and to lift the
fear a little bit. I appreciatethe direct way that you communicated, the
clarity with which you communicated, thepractical ways that you communicated this issue,
(45:55):
because it is something that is comingto the surface more and more, and
fear comes with lack of knowledge,So thank you for bringing that knowledge to
the plate today so that we canhelp call the fear and take control of
our health and our brain health andour life, so that we can go
into our future not fearful, butin control of potentially our brain health and
(46:19):
our you know, just the outcomesbeing more in our hands and less feeling
like we're just going to be avictim of whatever it is that happens to
us. So I appreciate you,you know, your wealth of knowledge and
the confidence and clarity that you deliveredit. Thank you so very much.
Thank you for inviting me. It'sbeen great, it has been fantastic.
And today, friends, if thisis a conversation that really rings a bell
(46:44):
for you or you know someone whoneeds this information, I would like you
ahead to www dot Feminine, roadmapdot com, Forward Slash episode three sixty
three, or if you're on YouTube, just look down below. I will
have the links for him, thedoctor there and his book. Everything will
be easily accessible for you. Wedon't have to be afraid. That's the
(47:06):
key part of this conversation. Feardoes not have to drive us into our
future of aging. We do nothave to air quote decline. We can
choose to pursue life along our agetimeline, with an empowerment, with an
education, with the choices that wemake. To doctor Mitch's point, retirement,
(47:30):
what does retirement look like for us? We can really curate the life
we want to live. We arenot victims of the timeline. We can
choose the way we live our lives, the way we think, the way
we feed our bodies, the waywe move our bodies, the way we
communicate in and around us with thepeople in our lives. There's so many
(47:50):
elements. I want to go downa buddy trail right now, But what
I'm going to say is, don'tbe afraid of aging. Take the resources
like Dot or Mitch and his wifeand learn what you need to learn,
change what you need to change,and live a healthy, vibrant life.
And share these resources with those inyour world. I want to thank you
(48:12):
so much for being with us today. I look forward to sharing more inspirational
people, conversations and resources with youin the weeks to come. Take care
of my friends. Bye bye,
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