WEBVTT - Brain Expert: Why Dementia Is Australia's Number One Killer (Project 100)

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<v Speaker 1>Professor Matthew kindon Welcome to Project one hundred again made

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<v Speaker 1>and we probably run this on straight Talk as well,

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<v Speaker 1>if you don't mind, because I think there's a lot

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<v Speaker 1>of people who are in the straight talk audience who'd

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<v Speaker 1>like to hear what Project one hundred has got to

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<v Speaker 1>say about this, So appreciate your time.

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<v Speaker 2>No, thanks very much, Mark, and I really appreciate what

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<v Speaker 2>you're doing for the community to raise awareness of brain health.

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<v Speaker 1>Mental health. It's a huge topic and I was shocked

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<v Speaker 1>when I became aware that the broad umbrella of dementia

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<v Speaker 1>today is the number one cause of death in Australia

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<v Speaker 1>and so therefore it's overtaken heart or coronary attacks or

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<v Speaker 1>heart attacks or yeah, heart failure. First question to you

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<v Speaker 1>is is that just simply a result of us living

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<v Speaker 1>longer and therefore if we got through cancer and heart

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<v Speaker 1>problems that eventually our brain's going to get us. Is

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<v Speaker 1>that just that reason or you seeing younger people getting

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<v Speaker 1>it now?

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<v Speaker 2>Well, I think it's a combination of both of those factors.

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<v Speaker 2>But really, you know, as a doctor, when I was

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<v Speaker 2>a junior doctor, cardiovascular health was the key focus and

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<v Speaker 2>you know there was bypass surgery and people having heart attacks,

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<v Speaker 2>and it was the number one and so understandably, you know,

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<v Speaker 2>politicians in the community put a focus on trying to

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<v Speaker 2>understand the condition and treat it. And I think that's

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<v Speaker 2>really the gold standard to understand that, you know, heart

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<v Speaker 2>heart health and heart disease. You have to look after

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<v Speaker 2>vascular health, stop smoking, understand the risk factors cholesterol, blood pressure,

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<v Speaker 2>blood sugar levels. And it was with that understanding and

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<v Speaker 2>then some therapies coming through, and I think, you know,

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<v Speaker 2>everyone would accept that the statin evolution has changed cardiovascular health.

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<v Speaker 2>And then our buyer marker so understanding that we can

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<v Speaker 2>treat against cholesterol, and gradually you started to see cardiovascular

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<v Speaker 2>deaths going down. In my fields. In neurology, stroke was

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<v Speaker 2>always going up every single year, higher and higher and higher.

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<v Speaker 2>And then eventually they did an epidemiological study and they

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<v Speaker 2>saw that stroke was dropping. And the neurologists didn't actually

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<v Speaker 2>believe it, like, how could this be the case? They

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<v Speaker 2>repeated the study and sure enough, stroke was actually dropping.

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<v Speaker 2>And it's because we've learned from the vascular health approaches

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<v Speaker 2>from cardiologists and heart physicians and the same thing has happened.

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<v Speaker 2>So while that's been happening. And then obviously all the

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<v Speaker 2>great advances in cancer because of molecular biology, understanding genetics,

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<v Speaker 2>the human the whole human genome, all of these things

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<v Speaker 2>that are getting well understood, and no one has really

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<v Speaker 2>focused on inverticomus dementia. And I suppose as a community,

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<v Speaker 2>we've often thought that it's an elderly people's condition and

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<v Speaker 2>we didn't really care about it. And you know, okay,

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<v Speaker 2>if we end up a bit demented in a nursing hame,

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<v Speaker 2>that's the cost of living. But really what's happened alarmingly

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<v Speaker 2>is it's really come to the fore and we're seeing

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<v Speaker 2>there's a huge amounts of dementia and neuroady generation. And

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<v Speaker 2>in fact, this geographical region, the Western Pacific, carries three fifths,

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<v Speaker 2>so sixty percent of the world burden. What Yeah, and

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<v Speaker 2>it's going to be a massive cost, you.

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<v Speaker 1>Know about the budget. What is that?

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<v Speaker 2>Well, I think it's it's an unusual sort of racial mix.

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<v Speaker 2>But we've got you know, obviously a lot of Asian populations.

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<v Speaker 2>We've got South Pacific islanders, Obviously we've got the Anglos

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<v Speaker 2>from Western Europe. But it's a huge population. Firstly, and

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<v Speaker 2>they're prone to vascular, particularly related neuro problems, dementia, vascular

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<v Speaker 2>dementia in particular. And also I suppose there's a lot

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<v Speaker 2>of underdeveloped regions. So if we think about our neighboring countries,

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<v Speaker 2>you know, we've been very lucky, and Australia is lucky,

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<v Speaker 2>and there's Japan in Korea, but then it's mixed with

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<v Speaker 2>you know, great poverty. Thailand, Myanmar, Burma, Thaile, you know,

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<v Speaker 2>Indonesia all had huge populations. So the focus globally is

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<v Speaker 2>to try and fix up the Western Pacific and then

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<v Speaker 2>take some of the learnings from the Western Pacific and

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<v Speaker 2>do refinements, particularly in Western Europe and North America. So

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<v Speaker 2>as a neurologist, obviously I'm a bit prejudiced. I'm glad

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<v Speaker 2>there's a focus on brain health because it's really going

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<v Speaker 2>to be an evolution. And in fact, the reason I

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<v Speaker 2>did get into neurology was, you know, George bush Seni,

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<v Speaker 2>you're saying that the nineties were the decade of the brain,

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<v Speaker 2>and the brain has been left behind a little bit,

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<v Speaker 2>and now we're starting to understand these conditions and we're

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<v Speaker 2>going to be like the cardiologists of the nineties. We're

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<v Speaker 2>going to understand risk factors, we're going to be titrading

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<v Speaker 2>blood bier markers, We've got effective therapies and it's going

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<v Speaker 2>to be totally transformational. The joke about neurologists were they're

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<v Speaker 2>really good at making a diagnosis, but they don't do

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<v Speaker 2>any treatment. To go to the neurologists to get your

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<v Speaker 2>diagnosis and prepare you will, that was that's the prejudice

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<v Speaker 2>against us, poor old neurologists. But dare I say it.

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<v Speaker 2>We're going to a therapeutic era and it's really exciting.

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<v Speaker 1>And part of that, of course, is in your role

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<v Speaker 1>as Sea of Newer any Ura at UNSW or across

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<v Speaker 1>the road from the English horse Stable studying whatever it is.

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<v Speaker 1>But now Newer is as I understand it as, or

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<v Speaker 1>re Call is a joint venture between USW and the

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<v Speaker 1>Prince Well' Hospital. Is that right?

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<v Speaker 2>Yeah, so the Southeastern Sydney Local Health District and that

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<v Speaker 2>includes Prince of Wales, Saint George and Sutherlands. So and

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<v Speaker 2>it's a new initiative, but it's pretty big. I mean,

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<v Speaker 2>you've got a big premises of being any premises are

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<v Speaker 2>huge or brand new. How many people've got in your

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<v Speaker 2>ANEW about five hundred and fifty researchers focusing on brain

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<v Speaker 2>health and mental health. It's amazing and encourage everyone to

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<v Speaker 2>come out and visit like you've done, and we're very

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<v Speaker 2>keen to have, you know, really greater community involvement and connection.

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<v Speaker 1>Is that the biggest undertaking in the country. Yeah, I

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<v Speaker 1>would say it is.

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<v Speaker 2>The other sort of big centers around Australia will be

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<v Speaker 2>the Flory in Melbourne, there's the Queensland Brain Institute in Brisbane,

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<v Speaker 2>and there's the Parent Institute in Perth, but I think

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<v Speaker 2>they're the biggest entities, so only.

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<v Speaker 1>The biggest one in Sydney there, yeah, yeah. And does

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<v Speaker 1>government support it.

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<v Speaker 2>Well, of course the government does support it. But times

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<v Speaker 2>are tough and I suppose neuro was established on grand

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<v Speaker 2>funding so National Health and Medical Research Council, so NHMRC

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<v Speaker 2>and AARC Australian Research Council have been very very successful

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<v Speaker 2>in grants.

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<v Speaker 1>Do you have to apply for those grants?

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<v Speaker 2>And at present now the success rate for grants is

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<v Speaker 2>about eight to ten percent and the funding has really

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<v Speaker 2>taken a battering and I was actually pleased in the

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<v Speaker 2>budget to see an extra five hundred and eight million

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<v Speaker 2>coming towards medical research. And that had been driven by

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<v Speaker 2>a campaign through medical research institutes, but also great advocates

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<v Speaker 2>like Monique Ryan who'd been pushing for or to try

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<v Speaker 2>and get the MRFF amount fully released. But now with

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<v Speaker 2>you know, lowering government grants support, researchers have to reach

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<v Speaker 2>out more to the community and what are the best

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<v Speaker 2>what are the most successful ways? Well, the most successful

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<v Speaker 2>way to fund your research program is have an industry partner.

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<v Speaker 2>An industry you know they need to make money. For example, well,

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<v Speaker 2>I need any any farmer company, right. So examples that

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<v Speaker 2>we're working with very closely include Roach Diagnostics based in Switzerland,

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<v Speaker 2>ELI Lily or Lily Farmer the United States. They're they're

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<v Speaker 2>they're key tever are key partners for us to drive

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<v Speaker 2>our research programs. But the beauty about having an industry

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<v Speaker 2>partner is you're more likely to have what we call

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<v Speaker 2>impact and translations. In other words, your discoveries are going

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<v Speaker 2>to make it out to the patient, to the clinic.

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<v Speaker 2>And that's why the health district and the university are

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<v Speaker 2>engaged because they want to see better health outcomes. So

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<v Speaker 2>you're much more likely to get that if you have

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<v Speaker 2>an industry partner. Now, the other key way that Newer

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<v Speaker 2>has been surviving has been the support of the community.

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<v Speaker 2>And we've been very lucky to have fantastic philanthropic support

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<v Speaker 2>and the individuals who funded whole programs and developments of

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<v Speaker 2>the building. Margaret Ainsworth is responsible for the main building

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<v Speaker 2>at Nearer. But I think we're starting to see that

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<v Speaker 2>the community is investing in research with the desire to

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<v Speaker 2>have better health outcomes, and it's really it's great to see.

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<v Speaker 1>So let's just you measure vascular dementia and maybe you

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<v Speaker 1>could explain what is vascular dementia.

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<v Speaker 2>So vascular relates to the blood vessels, and dementia generally

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<v Speaker 2>means problems with memory and cognition. And the brain is

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<v Speaker 2>made up of nerves neurons that have has lining on it,

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<v Speaker 2>and the lining of the myeline is supplied the lining,

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<v Speaker 2>which is called myelin, is built through cholesterol and apo

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<v Speaker 2>lipoproteins and all of those sort of biochemical processes. But

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<v Speaker 2>it needs a vascular supply, It needs a blood. It

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<v Speaker 2>needs a blood.

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<v Speaker 1>So maybe we're just just for audience. Those things that

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<v Speaker 1>you just mentioned, Yeah, they're all fats, they're all flippers.

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<v Speaker 1>Fat's produced by our liver, so we're producing that.

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<v Speaker 2>We're endogenously so inside our body, yes, we are producing it.

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<v Speaker 2>And I think the other thing to say is the

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<v Speaker 2>brain is a network, so all of the brain is working,

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<v Speaker 2>communicating with itself all the time. We used to think that,

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<v Speaker 2>you know, one part of the brain might be memory,

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<v Speaker 2>one part of the brain might be vision. But that

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<v Speaker 2>was because we studied neurology on the basis of a

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<v Speaker 2>deficit like a stroke or an injury. In fact, okay,

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<v Speaker 2>a lot of the neurology understanding came from major wars,

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<v Speaker 2>so particularly World War One, bullet wounds in the back

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<v Speaker 2>of the head, people to understand that's the cerebellum, and

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<v Speaker 2>so it was looking at deficits. And one of the

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<v Speaker 2>great neurologists is a go called Charles Miller Fisher, and

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<v Speaker 2>he's said, you learn neurology stroke by stroke. So you

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<v Speaker 2>see a patient with a stroke, you see what part

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<v Speaker 2>of the brain is affected, and then you see what

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<v Speaker 2>the manifestation is that and then that's your understanding. But

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<v Speaker 2>now we see the brain more as a network. So

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<v Speaker 2>all of these parts of the brain are communicating through

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<v Speaker 2>these nerve fibers, and when the blood supply is affected,

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<v Speaker 2>they start not working as well as they should, so

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<v Speaker 2>the speed of the signal getting through is less. Sometimes

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<v Speaker 2>they die, so little parts of little holes start developing

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<v Speaker 2>small strokes, microstrokes at a very molecular level, So you

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<v Speaker 2>wouldn't see it if you had the brain in front

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<v Speaker 2>of you, but you put it under a microscope, you'd

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<v Speaker 2>see it.

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<v Speaker 1>And you probably can't detect it either while someone's alive.

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<v Speaker 2>Unless there's a certain amount happening, like a volume. It's

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<v Speaker 2>a volume effect, So we start to see it with

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<v Speaker 2>their MARI scans, but by that stage it's more often

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<v Speaker 2>than not more severe. So right at the beginning, and

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<v Speaker 2>that's the trouble, we don't know when this begins, so

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<v Speaker 2>it could be beginning twenty or thirty years before the

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<v Speaker 2>patient manifests any symptoms.

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<v Speaker 1>And what causes this blood supply problem? Like in other words,

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<v Speaker 1>I presume what we talk about is a reduction of

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<v Speaker 1>the blood to blow reduction of blood.

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<v Speaker 2>Supply, and it's really been driven the understanding through vascular researchers,

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<v Speaker 2>so cardiovascular hell, so understanding that the wall of the

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<v Speaker 2>blood vessel gets thicker, the sort of the lumen or

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<v Speaker 2>the hole in the middle gets smaller, less blood gets

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<v Speaker 2>out there. Sometimes the vessel actually breaks apart a little bit,

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<v Speaker 2>a bit of ooze, and you know, blood and proteins

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<v Speaker 2>escape into the brain. That's the process, and if that happens,

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<v Speaker 2>you know in general areas. Interestingly, one of the sort

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<v Speaker 2>of the key problems that you see is people start

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<v Speaker 2>falling over and everyone thinks, oh, falls are normal. No,

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<v Speaker 2>if you have a fall, that's abnormal. I mean, obviously

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<v Speaker 2>you have a fall you're running and your chip on

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<v Speaker 2>a gutter, that's understore. But if you're walking around the

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<v Speaker 2>house and you fall over, you're on the street, you

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<v Speaker 2>fall over, that's abnormal. You legs give away, Yeah, your

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<v Speaker 2>legs give away, or your balance is affected and you

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<v Speaker 2>fall over. That's often the beginning of understanding that someone

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<v Speaker 2>may be suffering from a vascular brain process. So falls

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<v Speaker 2>are very much characteristically linked. The other thing is obviously

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<v Speaker 2>your cognition. So family members notice that maybe you're not

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<v Speaker 2>as sharp as you were. You seem to be forgetting

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<v Speaker 2>things you might be I mean, sometimes, for instance, you

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<v Speaker 2>might drive the car home and you know, hit the

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<v Speaker 2>side of the car and the garage. You might not

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<v Speaker 2>even mention you've done it. You know, another family member

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<v Speaker 2>notices that there's a dent in the car.

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<v Speaker 1>How did that happen? So it's the.

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<v Speaker 2>Behavior and the fine tuning of motor function or brain

0:12:42.320 --> 0:12:47.160
<v Speaker 2>function is being affected. And it's usually often the family members,

0:12:47.200 --> 0:12:50.800
<v Speaker 2>people in the house, children, partners who notice and they

0:12:50.840 --> 0:12:53.760
<v Speaker 2>try and encourage a medical review because.

0:12:53.559 --> 0:12:57.000
<v Speaker 1>I remember when I come saw you just getting a

0:12:57.040 --> 0:13:02.480
<v Speaker 1>check up, and you may be do some physical moments

0:13:02.520 --> 0:13:06.760
<v Speaker 1>like walking and standing on one foot, and then you

0:13:06.960 --> 0:13:09.920
<v Speaker 1>sent me off to get an older center or adoptler.

0:13:09.960 --> 0:13:13.360
<v Speaker 1>I think you caught it on my crodod arteries. So

0:13:14.280 --> 0:13:17.920
<v Speaker 1>why would someone when would a doctor tell someone to

0:13:17.960 --> 0:13:19.960
<v Speaker 1>get that? And why would someone get that? What were those?

0:13:20.240 --> 0:13:23.000
<v Speaker 1>And those especially those tests we want to see my

0:13:23.880 --> 0:13:26.120
<v Speaker 1>old school physician tests. I remember I used to get that.

0:13:26.160 --> 0:13:27.800
<v Speaker 1>My doctor when I was a kid used to do that,

0:13:28.080 --> 0:13:30.800
<v Speaker 1>but doctor since then stopped doing it. What are you

0:13:30.880 --> 0:13:33.800
<v Speaker 1>looking for when you do those very fundamental tests?

0:13:34.840 --> 0:13:37.760
<v Speaker 2>So it's about motor function. So we're seeing how someone walks,

0:13:37.760 --> 0:13:40.200
<v Speaker 2>we're seeing their gate, we're seeing their gate length, and

0:13:40.240 --> 0:13:42.360
<v Speaker 2>then part of that is what we call tandem walking.

0:13:42.480 --> 0:13:45.080
<v Speaker 2>So the police stole our tests. This is a neurology test,

0:13:45.120 --> 0:13:47.240
<v Speaker 2>but doing heel in front of the toe in a

0:13:47.280 --> 0:13:51.479
<v Speaker 2>straight line, and these are markers for things like vascular dementia.

0:13:51.720 --> 0:13:54.200
<v Speaker 2>Also getting someone to stand on the spot and close

0:13:54.240 --> 0:13:57.160
<v Speaker 2>their eyes because if they're having problems with no function

0:13:57.280 --> 0:14:01.880
<v Speaker 2>in their legs in particular, other senses start to take off,

0:14:01.880 --> 0:14:04.760
<v Speaker 2>so they're relying on their eyes. But for instance, at nighttime,

0:14:04.760 --> 0:14:05.920
<v Speaker 2>when they get up in the middle of the night,

0:14:05.960 --> 0:14:06.560
<v Speaker 2>they fall over.

0:14:06.760 --> 0:14:07.480
<v Speaker 1>Yeah, so that's a.

0:14:07.400 --> 0:14:11.000
<v Speaker 2>Way to try and look at that, and coordination testing

0:14:11.080 --> 0:14:15.120
<v Speaker 2>in a general sense. Reflexes are used for us to

0:14:15.240 --> 0:14:17.640
<v Speaker 2>try to determine the level of We use a word

0:14:17.640 --> 0:14:19.920
<v Speaker 2>called lesion. Where is the lesions we're trying to work

0:14:19.960 --> 0:14:25.040
<v Speaker 2>out where the abnormality is, and by tradition we see

0:14:25.040 --> 0:14:28.040
<v Speaker 2>two two. We divide the nervous system up into central,

0:14:28.120 --> 0:14:30.080
<v Speaker 2>which is the brain and the spinal cord we call

0:14:30.120 --> 0:14:32.920
<v Speaker 2>it upper mode in urine or there's the peripheral and

0:14:32.960 --> 0:14:35.520
<v Speaker 2>that's the nerve and muscles in the arms and the legs,

0:14:36.080 --> 0:14:39.960
<v Speaker 2>and reflexes tell us where to go. So in other words,

0:14:40.040 --> 0:14:42.440
<v Speaker 2>if I test someone and they've got very brisk reflexes

0:14:42.480 --> 0:14:44.520
<v Speaker 2>in a territory, so I just tap them or I

0:14:44.520 --> 0:14:47.560
<v Speaker 2>don't even need a tendon hammer. That's suggesting upper mode

0:14:47.560 --> 0:14:50.840
<v Speaker 2>in urine or central problems. If I test their reflexes

0:14:50.840 --> 0:14:53.480
<v Speaker 2>and they've got no reflexes in a region, that would

0:14:53.480 --> 0:14:57.680
<v Speaker 2>suggest that the nerve supply is damage. So that's a

0:14:57.680 --> 0:14:59.760
<v Speaker 2>peripheral abnormality. So we're trying to see is this is

0:14:59.800 --> 0:15:03.240
<v Speaker 2>sense problem like vascular dementia or is it a peripheral

0:15:03.280 --> 0:15:05.520
<v Speaker 2>problem like a diabetic neuropathy.

0:15:05.960 --> 0:15:10.800
<v Speaker 1>Right, So, and then they're crottied Doppler.

0:15:10.960 --> 0:15:15.360
<v Speaker 2>Yeah, So it really depends on what the patient's presenting with.

0:15:15.480 --> 0:15:18.760
<v Speaker 2>But let's say the presentation might be a partners thinks

0:15:18.800 --> 0:15:20.920
<v Speaker 2>that they're not thinking as well as they were, or

0:15:21.480 --> 0:15:24.280
<v Speaker 2>as a family history, and with family history we use

0:15:24.400 --> 0:15:27.440
<v Speaker 2>typically under the age of fifty, so someone has had

0:15:27.640 --> 0:15:30.440
<v Speaker 2>a family members had either a heart attack or stroke

0:15:30.520 --> 0:15:33.920
<v Speaker 2>under fifty that's significant and so as part of my assessment,

0:15:33.960 --> 0:15:37.680
<v Speaker 2>we do investigations and the Doppler study is an ultrasound

0:15:37.680 --> 0:15:40.480
<v Speaker 2>looking at the carotid and vertebraladies. They're the main blood

0:15:40.520 --> 0:15:43.280
<v Speaker 2>vessels that go to the brain, supplying from the heart

0:15:43.440 --> 0:15:47.400
<v Speaker 2>from the heart directly, and if they start to get

0:15:48.280 --> 0:15:51.480
<v Speaker 2>closed off slightly, that can be the app that can

0:15:51.520 --> 0:15:54.120
<v Speaker 2>be the cause of the presentation. It was not a

0:15:54.120 --> 0:15:57.200
<v Speaker 2>blood flo enough blood flowing up and we use again

0:15:57.240 --> 0:15:59.680
<v Speaker 2>about a seventy percent market, so it's less than seventy

0:15:59.680 --> 0:16:04.520
<v Speaker 2>percent and flow. That's significant, right, But now with Doppler,

0:16:04.600 --> 0:16:06.840
<v Speaker 2>with technology, we can actually trace that up. When we

0:16:06.880 --> 0:16:09.520
<v Speaker 2>can go and now look at the blood vessels, the

0:16:09.520 --> 0:16:13.800
<v Speaker 2>middle cerebral artery, posterior cerebral artery, which form a sort

0:16:13.840 --> 0:16:16.520
<v Speaker 2>of circle inside the brain called the circle of Willis.

0:16:16.680 --> 0:16:20.200
<v Speaker 2>So we can study that now through ultrasound, and again

0:16:20.320 --> 0:16:23.760
<v Speaker 2>we can get some marker about blood flow.

0:16:23.960 --> 0:16:29.640
<v Speaker 1>Right, And so what would cause those arteries to do this?

0:16:29.720 --> 0:16:32.800
<v Speaker 1>I mean, obviously smoking is an issue, but yeah, is

0:16:32.840 --> 0:16:36.280
<v Speaker 1>it just high cholesterol, high low density cholesterol.

0:16:36.480 --> 0:16:39.160
<v Speaker 2>All of those factors, But definitely smoking would have been

0:16:39.240 --> 0:16:42.440
<v Speaker 2>probably the most common cause. And I've seen that evolution

0:16:42.600 --> 0:16:44.400
<v Speaker 2>now Like in the nineties we were seeing a lot

0:16:44.440 --> 0:16:47.560
<v Speaker 2>of credit artery. We use the words stenosis. It's less

0:16:47.560 --> 0:16:50.200
<v Speaker 2>common now. People don't smoke as much as they used to,

0:16:50.320 --> 0:16:54.080
<v Speaker 2>Like it's rare that you see smokers. Now you've mentioned

0:16:54.120 --> 0:16:58.360
<v Speaker 2>then cholesterol, so understanding like LDL in particular more than

0:16:58.400 --> 0:17:01.600
<v Speaker 2>about four point five or more more than two but

0:17:01.720 --> 0:17:04.280
<v Speaker 2>the total cholesterol of more than four point five is

0:17:04.320 --> 0:17:09.240
<v Speaker 2>significant blood sugar levels and obviously you know your body

0:17:09.280 --> 0:17:09.960
<v Speaker 2>mass index.

0:17:10.119 --> 0:17:13.399
<v Speaker 1>What about the so called apo b apolipo bread and B,

0:17:13.600 --> 0:17:16.880
<v Speaker 1>I mean, which is their carrier? So of the cholesterol

0:17:17.119 --> 0:17:20.320
<v Speaker 1>most people don't realize cholesterol doesn't get anywhere unless you've

0:17:20.320 --> 0:17:24.080
<v Speaker 1>got something we need to piggyback. Absolutely, And so that's

0:17:24.080 --> 0:17:25.440
<v Speaker 1>a new thing. Is there's a new test.

0:17:25.680 --> 0:17:29.760
<v Speaker 2>Yes, yeah, it's it's a new test. Yeah, And apper

0:17:29.800 --> 0:17:32.480
<v Speaker 2>LiPo protein is one of it. Turns out there's lots

0:17:32.480 --> 0:17:36.040
<v Speaker 2>of different types. There's lots of different forms. You know one, two, three, four, five,

0:17:36.560 --> 0:17:41.000
<v Speaker 2>four is the critical one. But these apper lipoproteins help

0:17:41.440 --> 0:17:46.119
<v Speaker 2>other processes, other nutrients come in and out of cells.

0:17:46.440 --> 0:17:50.160
<v Speaker 2>But the issue about appo LiPo protein E four is

0:17:50.520 --> 0:17:55.400
<v Speaker 2>that it is involved in the removal of amyloid and plaques.

0:17:56.200 --> 0:18:00.800
<v Speaker 2>So if you have higher numbers or manifestations of the

0:18:00.840 --> 0:18:05.280
<v Speaker 2>breakdown of amyloid in the brain is not as good.

0:18:05.760 --> 0:18:09.720
<v Speaker 2>So that makes you more prone to Alzheimer's disease. So

0:18:09.760 --> 0:18:12.800
<v Speaker 2>amyloid and tower proteins in the brain that are linked

0:18:12.960 --> 0:18:16.200
<v Speaker 2>to a specific form of dementia Alzheimer's.

0:18:15.600 --> 0:18:21.439
<v Speaker 1>Disease which forget forget from us basically can't remember stuff. Absolutely, yeah,

0:18:21.480 --> 0:18:24.400
<v Speaker 1>and that happens in one part of the brain more

0:18:24.400 --> 0:18:26.440
<v Speaker 1>prevalent in that hippocampus or the thing is that was

0:18:26.480 --> 0:18:26.880
<v Speaker 1>that right?

0:18:26.960 --> 0:18:28.959
<v Speaker 2>That's the most common and that that's the sort of

0:18:29.000 --> 0:18:31.840
<v Speaker 2>the center of memory function in our human brain. But

0:18:31.920 --> 0:18:33.600
<v Speaker 2>it doesn't have to be there, like it could also

0:18:33.640 --> 0:18:36.320
<v Speaker 2>be some people start losing their visions. It could be

0:18:36.320 --> 0:18:39.119
<v Speaker 2>in the occipital region. It can be lots of different

0:18:39.119 --> 0:18:41.880
<v Speaker 2>parts of the brain. But the more common part, yes,

0:18:42.080 --> 0:18:42.640
<v Speaker 2>is memory.

0:18:42.760 --> 0:18:46.639
<v Speaker 1>And is it fair to say that I don't know

0:18:46.640 --> 0:18:51.160
<v Speaker 1>where I read this, but vision and hearing are quite

0:18:51.160 --> 0:18:55.840
<v Speaker 1>important as early markers for that potentially you might be

0:18:55.840 --> 0:18:59.400
<v Speaker 1>getting dimension, might becoming your way down the track. Yeah,

0:18:59.600 --> 0:19:01.040
<v Speaker 1>why is that? Well?

0:19:01.040 --> 0:19:02.760
<v Speaker 2>I think this is really great work that came out

0:19:02.800 --> 0:19:06.879
<v Speaker 2>from the Lancet Commission, and they discovered fourteen factors which

0:19:07.160 --> 0:19:12.280
<v Speaker 2>could be modified to either prevent or treat dementia, modify

0:19:12.480 --> 0:19:16.359
<v Speaker 2>or prevent and one of those is hearing. And I

0:19:16.400 --> 0:19:19.679
<v Speaker 2>think that you know, I have a colleague as a neurologist,

0:19:19.760 --> 0:19:21.879
<v Speaker 2>and he started developing hearing problems and he noticed that

0:19:21.880 --> 0:19:23.600
<v Speaker 2>when he went to dinner party, he didn't really want

0:19:23.600 --> 0:19:25.600
<v Speaker 2>to engage because he couldn't hear what was going on.

0:19:25.960 --> 0:19:30.840
<v Speaker 2>So people start retreating and that then promotes the brain

0:19:30.920 --> 0:19:33.800
<v Speaker 2>not to function as well as it, you know, normally.

0:19:33.520 --> 0:19:35.560
<v Speaker 1>Retreating from what's social intrational.

0:19:35.160 --> 0:19:39.199
<v Speaker 2>Engagement, and so social engagement is another critical factor that

0:19:39.280 --> 0:19:42.119
<v Speaker 2>was identified by the Lancet Commission. So the more that

0:19:42.160 --> 0:19:47.639
<v Speaker 2>you're engaged in you know, a profession, a work, a environment,

0:19:47.680 --> 0:19:51.840
<v Speaker 2>a community, a sports environment, a rugby league club, the

0:19:51.880 --> 0:19:55.880
<v Speaker 2>better off people go. And if you're isolated the brain,

0:19:56.000 --> 0:20:00.199
<v Speaker 2>the brain doesn't like isolation. So this is all these

0:20:00.200 --> 0:20:03.199
<v Speaker 2>are all modifiable risk factors, and then how could you

0:20:03.240 --> 0:20:05.080
<v Speaker 2>sort of cut off a few of them? Well, firstly

0:20:05.160 --> 0:20:07.119
<v Speaker 2>like if you like exercise, are you involved in a

0:20:07.440 --> 0:20:10.760
<v Speaker 2>in a community approach or as a particular exercise that

0:20:10.800 --> 0:20:14.680
<v Speaker 2>you like doing aerobic type of exercise, but also resistance training,

0:20:14.960 --> 0:20:18.200
<v Speaker 2>and these again are all modifiable risk factors for dementia.

0:20:19.119 --> 0:20:21.680
<v Speaker 2>Another part of that that's only really come out in

0:20:21.720 --> 0:20:24.080
<v Speaker 2>the last few years is an understanding what we're called frailty.

0:20:24.560 --> 0:20:26.359
<v Speaker 2>So you might have said, O, someone looks a bit frail.

0:20:26.440 --> 0:20:29.840
<v Speaker 2>That doesn't really mean anything, but frailty is it's a

0:20:29.880 --> 0:20:32.600
<v Speaker 2>two way process between the body and all of the

0:20:32.600 --> 0:20:36.199
<v Speaker 2>body organs and the brain. So when the brain stops working,

0:20:36.480 --> 0:20:38.919
<v Speaker 2>the organs don't work as well. But if the organs

0:20:38.960 --> 0:20:43.000
<v Speaker 2>don't work as well, the brain stops working as in converse.

0:20:42.640 --> 0:20:44.040
<v Speaker 1>So your dale's you'll get frail.

0:20:45.480 --> 0:20:49.159
<v Speaker 2>How can you prevent yourself from becoming frail? Well, resistance training,

0:20:49.240 --> 0:20:53.199
<v Speaker 2>high protein diets, aerobic training, stay engaged with the community.

0:20:53.440 --> 0:20:55.320
<v Speaker 2>These are the things that are going to help brain health.

0:20:55.560 --> 0:20:57.920
<v Speaker 1>I remember Mark Penny, Professor Mark Pennie M's showing about

0:20:57.920 --> 0:21:00.000
<v Speaker 1>because I was talking about him about his dad, Ron, Yeah,

0:21:00.000 --> 0:21:02.800
<v Speaker 1>who died from dementia, and Ron was like a genius

0:21:04.160 --> 0:21:07.200
<v Speaker 1>skinny fit walked up the stairs to a level of

0:21:07.280 --> 0:21:10.919
<v Speaker 1>whatever it was every day at Sir Vincent's. And I

0:21:10.960 --> 0:21:17.040
<v Speaker 1>said to Mark, are you worried about your genetic predisposition perhaps,

0:21:17.400 --> 0:21:20.399
<v Speaker 1>and would you bother getting a genetic test for dementia?

0:21:20.720 --> 0:21:22.919
<v Speaker 1>And he said no? And I said why? And he

0:21:22.960 --> 0:21:25.080
<v Speaker 1>said to me The reason why, he said, is because

0:21:25.200 --> 0:21:28.960
<v Speaker 1>even if I find out the solution right now, I

0:21:28.960 --> 0:21:31.320
<v Speaker 1>don't have any symptoms. But the solution right now would

0:21:31.320 --> 0:21:35.240
<v Speaker 1>be to do high intensity exercise, he said, So I'm

0:21:35.240 --> 0:21:38.359
<v Speaker 1>mols do it. Anyway, whether I get a diagnosis or not,

0:21:38.359 --> 0:21:41.680
<v Speaker 1>they're only the diagnosis because getting the diagnosis can cause

0:21:41.720 --> 0:21:44.840
<v Speaker 1>a lot of anxiety, and people do retract socially and

0:21:44.880 --> 0:21:47.600
<v Speaker 1>all sorts of things. He said, I'm better probably not knowing,

0:21:48.680 --> 0:21:53.119
<v Speaker 1>but doing the very thing that they would recommend me

0:21:53.160 --> 0:21:59.400
<v Speaker 1>do anyway. And so how does high intensity exercise assist

0:21:59.800 --> 0:22:00.600
<v Speaker 1>in that regard?

0:22:01.000 --> 0:22:03.480
<v Speaker 2>Well, I think obviously he was a visionary, but yeah,

0:22:04.359 --> 0:22:07.280
<v Speaker 2>when you exercise, for instance, blood vessels dilate, so the

0:22:07.280 --> 0:22:10.080
<v Speaker 2>blood vessels dilate, more blood flow starts going through brain,

0:22:10.400 --> 0:22:12.080
<v Speaker 2>in your brain and all over your body, but in

0:22:12.080 --> 0:22:16.240
<v Speaker 2>your muscles. So it's just reflecting what's going on. But

0:22:16.320 --> 0:22:19.320
<v Speaker 2>a number of conditions are also associated with other metabolic

0:22:19.400 --> 0:22:22.200
<v Speaker 2>changes in the brain and the body in a general sense,

0:22:22.240 --> 0:22:27.919
<v Speaker 2>so insulin resistance, metabolic health, mitochondrial function, so all the

0:22:28.000 --> 0:22:32.399
<v Speaker 2>cellular approaches, inflammation, inflammation in the brain, inflammation in the

0:22:32.480 --> 0:22:33.400
<v Speaker 2>organs of the body.

0:22:33.880 --> 0:22:34.600
<v Speaker 1>So all of.

0:22:34.520 --> 0:22:38.640
<v Speaker 2>These are improved through exercise and high intensity exercises. As

0:22:39.040 --> 0:22:42.600
<v Speaker 2>Matt Penny suggested back then, I think the other thing is,

0:22:42.800 --> 0:22:44.720
<v Speaker 2>and I understand what he's saying as well, there's a

0:22:44.760 --> 0:22:47.720
<v Speaker 2>stigma and people don't necessarily want to be associated with

0:22:47.760 --> 0:22:50.760
<v Speaker 2>any of these conditions. But I think what we've got

0:22:50.840 --> 0:22:52.760
<v Speaker 2>to is try and turn that around as a community

0:22:52.800 --> 0:22:55.600
<v Speaker 2>and say, well, we're focusing on brain health. We want

0:22:55.640 --> 0:22:58.840
<v Speaker 2>optimal brain function, and we want to get into it early,

0:22:59.640 --> 0:23:01.520
<v Speaker 2>and we want to maintain it throughout the course of

0:23:01.560 --> 0:23:04.600
<v Speaker 2>your life. So wouldn't it be great if people started

0:23:04.600 --> 0:23:06.920
<v Speaker 2>going to their general practitioners at the age of thirty

0:23:06.960 --> 0:23:11.800
<v Speaker 2>and had a brain health check to prevent dementia and

0:23:11.840 --> 0:23:15.359
<v Speaker 2>erodegeneration in their sixty seventies, eighties, nineties. We don't know

0:23:15.359 --> 0:23:17.160
<v Speaker 2>how long we're going to live for, but it's still

0:23:17.200 --> 0:23:20.080
<v Speaker 2>going upwards. So I think that we can try and

0:23:20.240 --> 0:23:23.480
<v Speaker 2>encourage a more healthy approach to brain health.

0:23:24.160 --> 0:23:26.359
<v Speaker 1>It was funny, you know, today, knowing I was going

0:23:26.400 --> 0:23:28.119
<v Speaker 1>to talk to you, I actually had an appointment, just

0:23:28.359 --> 0:23:33.240
<v Speaker 1>a general point with my GP, who's actually fantastic. I've

0:23:33.240 --> 0:23:34.719
<v Speaker 1>got to give him, I've got to get shower him

0:23:34.720 --> 0:23:38.080
<v Speaker 1>out now. And he's new. He's new, he's a young

0:23:38.080 --> 0:23:40.920
<v Speaker 1>guy I knew, and he and I have all sorts

0:23:40.960 --> 0:23:43.040
<v Speaker 1>of conversations similar to you and I about all sorts

0:23:43.040 --> 0:23:45.800
<v Speaker 1>of things. And I said to him, I wonder whether

0:23:45.880 --> 0:23:50.240
<v Speaker 1>or not I should have say, two days off from

0:23:50.240 --> 0:23:53.320
<v Speaker 1>exercise and go and get a blood test for BDNF

0:23:53.880 --> 0:23:58.520
<v Speaker 1>brain revenue tropic factor. And he said, oh, he said, okay,

0:23:58.520 --> 0:24:00.520
<v Speaker 1>there's not a bad idea, but he can't find any

0:24:00.560 --> 0:24:04.160
<v Speaker 1>where who does that. He's still searching. He hasn't texted yet,

0:24:04.160 --> 0:24:06.399
<v Speaker 1>but he's still searching. And the only reason I was

0:24:06.440 --> 0:24:10.520
<v Speaker 1>saying that was because you know, I'm with things. You know,

0:24:10.680 --> 0:24:12.479
<v Speaker 1>as you know, my mother passed away from a new

0:24:12.560 --> 0:24:15.320
<v Speaker 1>disease or als and I've got a dimension on the

0:24:15.359 --> 0:24:17.320
<v Speaker 1>other side, So you know, I get nervous about these things,

0:24:17.600 --> 0:24:20.960
<v Speaker 1>but not so much that I'm over nervous. I'm not paranoid,

0:24:21.000 --> 0:24:24.280
<v Speaker 1>but but I take the view I'm a contra good

0:24:24.320 --> 0:24:26.320
<v Speaker 1>or something about it. I got to talk to people,

0:24:26.520 --> 0:24:29.840
<v Speaker 1>that's what this whole show's about. And and I thought, well,

0:24:30.920 --> 0:24:36.000
<v Speaker 1>I as I understand it, that particular MOLECULEAR gets produced

0:24:36.080 --> 0:24:40.400
<v Speaker 1>in your brain when you exercise is very good for

0:24:40.640 --> 0:24:44.239
<v Speaker 1>brain health, but no one knows what the level is.

0:24:44.840 --> 0:24:47.959
<v Speaker 1>No one's actually asked me to do a test. And

0:24:48.200 --> 0:24:50.280
<v Speaker 1>I'm assuming he can find he can find someone can

0:24:50.320 --> 0:24:52.560
<v Speaker 1>do it. You probably know the incident anyway, But what

0:24:52.600 --> 0:24:55.720
<v Speaker 1>are some of the things that you think Australians or

0:24:55.760 --> 0:24:59.159
<v Speaker 1>people listening to this show should be asking their doctor

0:24:59.240 --> 0:25:02.720
<v Speaker 1>to get tested, even if it's just baselining you now

0:25:02.800 --> 0:25:04.639
<v Speaker 1>in a relation to brain health, are there things that

0:25:04.680 --> 0:25:06.639
<v Speaker 1>you should be asking apart from the obvious ones, and

0:25:06.640 --> 0:25:09.879
<v Speaker 1>the obvious ones of the heart was good you want, Tommy,

0:25:10.320 --> 0:25:12.800
<v Speaker 1>if it's good for your heart's good for your brain exactly. Yeah,

0:25:12.880 --> 0:25:17.639
<v Speaker 1>But apart from those, you know, ApoB little A E

0:25:17.720 --> 0:25:19.879
<v Speaker 1>and all that stuff. Apart from those ones, are there

0:25:19.920 --> 0:25:22.680
<v Speaker 1>any specific things you should be getting tested when you

0:25:22.720 --> 0:25:24.480
<v Speaker 1>ask for a blood test from your doctor relative to

0:25:24.520 --> 0:25:25.440
<v Speaker 1>your brain health.

0:25:25.800 --> 0:25:29.280
<v Speaker 2>Well, you've already articulated the main ones currently, but this

0:25:29.359 --> 0:25:33.240
<v Speaker 2>is a rapidly evolving landscape. So, for instance, at Neuroscience

0:25:33.280 --> 0:25:37.200
<v Speaker 2>Research Australia have formed a partnership with Roast Diagnostics platform

0:25:37.680 --> 0:25:39.680
<v Speaker 2>and part of the reason for that is to get

0:25:39.720 --> 0:25:43.679
<v Speaker 2>blood bio markers as a Medicare item number, so that

0:25:43.720 --> 0:25:46.080
<v Speaker 2>people can go to their GP and have all of these.

0:25:46.000 --> 0:25:46.720
<v Speaker 1>Get numb for free.

0:25:46.920 --> 0:25:49.480
<v Speaker 2>Yeah, and that's where it's going to be. That's going

0:25:49.520 --> 0:25:51.199
<v Speaker 2>to be in the next five to ten years, right,

0:25:51.840 --> 0:25:57.679
<v Speaker 2>And some of those markers are specifically, you know, identified

0:25:57.760 --> 0:26:00.560
<v Speaker 2>with particular conditions. But there are things called neurofilement, so

0:26:00.800 --> 0:26:04.080
<v Speaker 2>the neurofilament goes up in your blood when there's been

0:26:04.359 --> 0:26:08.639
<v Speaker 2>some nerve damage. There are other markers we call GFAPP.

0:26:09.760 --> 0:26:16.280
<v Speaker 2>These are blood tests that can suggest a particular diagnosis.

0:26:17.480 --> 0:26:20.119
<v Speaker 2>There's been a huge study in the UK and they've

0:26:20.640 --> 0:26:25.520
<v Speaker 2>taken blood and clinical examinations from fifty thousand people and

0:26:25.520 --> 0:26:27.480
<v Speaker 2>they've gone back to the blood bio markers and they're

0:26:27.480 --> 0:26:30.200
<v Speaker 2>show them that if five particular proteins in the blood

0:26:30.240 --> 0:26:35.040
<v Speaker 2>go up about ten years before Alzheimer's disease develops, and

0:26:35.080 --> 0:26:36.959
<v Speaker 2>that's where we're going to be going. So we're going

0:26:37.000 --> 0:26:40.359
<v Speaker 2>to be testing these in healthy individuals and then we

0:26:40.400 --> 0:26:44.280
<v Speaker 2>can start to treat against these blood bio markers to

0:26:44.400 --> 0:26:47.600
<v Speaker 2>try and maximize brain health. It's not here at the present,

0:26:47.920 --> 0:26:49.199
<v Speaker 2>but there's a lot of work going on in your

0:26:49.280 --> 0:26:50.359
<v Speaker 2>hurry right now.

0:26:50.520 --> 0:26:54.399
<v Speaker 1>I can't wait forever. Yeah no, because one of these

0:26:54.440 --> 0:26:56.720
<v Speaker 1>I want to ask you is can you test? Can

0:26:56.800 --> 0:27:01.040
<v Speaker 1>I do a blood test today for amyloids in tower?

0:27:02.640 --> 0:27:05.040
<v Speaker 2>At the moment you can't. But that's exactly so this

0:27:05.160 --> 0:27:08.360
<v Speaker 2>sort of diagnostic pathway is to bittering amyloid and tau

0:27:08.920 --> 0:27:13.000
<v Speaker 2>for Alzheimer's disease, TDP forty three for motor neurone disease,

0:27:13.000 --> 0:27:16.399
<v Speaker 2>in front of temperal dementia, alpha si nucleon for leuis

0:27:16.440 --> 0:27:19.399
<v Speaker 2>body dementia, Parkinson's disease. That's where it's going to be

0:27:19.720 --> 0:27:21.680
<v Speaker 2>and we're going to see what are those levels, but

0:27:21.760 --> 0:27:24.280
<v Speaker 2>we can't really at the moment. We haven't done large

0:27:24.320 --> 0:27:26.880
<v Speaker 2>population studies to know what that range should be.

0:27:27.640 --> 0:27:30.880
<v Speaker 1>It's just people. You don't have a range, So that's

0:27:30.920 --> 0:27:34.000
<v Speaker 1>cutting in. Yeah, So do you think in the next

0:27:34.000 --> 0:27:38.720
<v Speaker 1>five years these are some of these are realistically able

0:27:38.760 --> 0:27:39.120
<v Speaker 1>to be done?

0:27:39.240 --> 0:27:42.320
<v Speaker 2>I'd say with absolute guarantee they will be. And you'll

0:27:42.359 --> 0:27:44.000
<v Speaker 2>be going to the doctor with a blood result like

0:27:44.000 --> 0:27:46.439
<v Speaker 2>you do now with a full blood count hemoglobin and

0:27:46.480 --> 0:27:49.840
<v Speaker 2>they'll say, oh, your neurofilm and is slightly high. This

0:27:49.880 --> 0:27:52.639
<v Speaker 2>is the treatment to bring it down towards roughly normal

0:27:52.680 --> 0:27:55.000
<v Speaker 2>levels or that's really high. We need to do some

0:27:55.040 --> 0:27:57.240
<v Speaker 2>more investigations on that one. We need to lumber Puncher

0:27:57.280 --> 0:27:59.359
<v Speaker 2>and MRIs again. So I think it's going to start

0:27:59.560 --> 0:28:03.080
<v Speaker 2>to deter and the way forward. But then also linked

0:28:03.080 --> 0:28:05.600
<v Speaker 2>to that, we're going to start having treatments and we

0:28:05.680 --> 0:28:10.119
<v Speaker 2>have now two treatments for Alzheimer's, these monoclonal antibodies, and

0:28:10.160 --> 0:28:12.440
<v Speaker 2>there's a lot more on the horizon coming through, so

0:28:12.560 --> 0:28:14.760
<v Speaker 2>it's a very much a therapeutic era.

0:28:15.240 --> 0:28:18.080
<v Speaker 1>Well, so I do want to talk about those monoclone

0:28:18.240 --> 0:28:22.200
<v Speaker 1>antibody treatments in a moment, because I have one. As

0:28:22.200 --> 0:28:24.440
<v Speaker 1>you know, I text you. But I have one friend

0:28:24.440 --> 0:28:27.840
<v Speaker 1>of mine who's in his eighties, and I don't know

0:28:27.880 --> 0:28:29.880
<v Speaker 1>whether it's him or his wife showed him this thing

0:28:29.920 --> 0:28:32.320
<v Speaker 1>and he knows I have this show, and he sent

0:28:32.359 --> 0:28:34.000
<v Speaker 1>me the text, and I said, don't worry. I'm going

0:28:34.080 --> 0:28:35.639
<v Speaker 1>to get Matthew Kin and I'm going to ask him

0:28:35.640 --> 0:28:39.080
<v Speaker 1>the question because he actually is worried at his age

0:28:39.600 --> 0:28:43.960
<v Speaker 1>about dementia. I'm genuinely worried by the way he's in

0:28:44.000 --> 0:28:47.920
<v Speaker 1>great shape. But people do get nervous about the stuff, mate,

0:28:47.920 --> 0:28:50.760
<v Speaker 1>They get really anxious. I mean, I think there's more anxiety.

0:28:51.560 --> 0:28:54.680
<v Speaker 1>Of all the guys I know around my age. The

0:28:54.760 --> 0:28:57.520
<v Speaker 1>one thing that is, particularly the ones who played footy

0:28:57.600 --> 0:29:00.480
<v Speaker 1>or boxed or did anything like that. Had we're in

0:29:00.520 --> 0:29:05.080
<v Speaker 1>contact spoorts, they are all worried about dementia. It's like

0:29:05.200 --> 0:29:08.280
<v Speaker 1>it's a big deal. You'd be seeing as in your religis.

0:29:08.320 --> 0:29:09.120
<v Speaker 1>But it's a big deal.

0:29:09.360 --> 0:29:12.720
<v Speaker 2>Yeah, and I think again industry has taken that on

0:29:12.760 --> 0:29:15.320
<v Speaker 2>board as well. There was recently a superannuation conference and

0:29:15.360 --> 0:29:19.040
<v Speaker 2>all of the key superproviders. You know, imagine you've done

0:29:19.080 --> 0:29:22.320
<v Speaker 2>your whole life, you've worked, you set yourself up, and

0:29:22.360 --> 0:29:26.480
<v Speaker 2>then your cognition goes down. So it's it's incredibly important

0:29:26.520 --> 0:29:28.720
<v Speaker 2>and I can see why people are worried. I'm worried,

0:29:29.000 --> 0:29:31.400
<v Speaker 2>but we don't have a way to identify who is

0:29:31.440 --> 0:29:34.840
<v Speaker 2>at the greatest risk at the moment. And that's why

0:29:35.440 --> 0:29:38.280
<v Speaker 2>the focus on making brain health, you know, the key

0:29:38.960 --> 0:29:43.160
<v Speaker 2>treatment area for our community is critical and that's why

0:29:43.160 --> 0:29:45.040
<v Speaker 2>it's happening. Everyone's worried about it.

0:29:45.880 --> 0:29:48.200
<v Speaker 1>Well, government should be worried about too, because some mean

0:29:48.280 --> 0:29:51.600
<v Speaker 1>their job, is my view, their job is to increase

0:29:51.600 --> 0:29:54.080
<v Speaker 1>their standard of living. Our stand living. That the ultimate

0:29:54.120 --> 0:29:56.360
<v Speaker 1>it's about stand living. And there are lots of measurements

0:29:56.400 --> 0:29:58.240
<v Speaker 1>for that. One measurement that should be how long you

0:29:58.280 --> 0:30:01.040
<v Speaker 1>can live on this planet, how well you live during

0:30:01.040 --> 0:30:05.600
<v Speaker 1>that period. And living with dementia, like when it's full

0:30:05.600 --> 0:30:08.960
<v Speaker 1>blown at least, is not living, you know, like it's

0:30:09.000 --> 0:30:11.760
<v Speaker 1>pretty dreadful on everyone. Else around you, Like if you

0:30:12.080 --> 0:30:14.800
<v Speaker 1>someone said to me today, ail to you or anybody, Look,

0:30:14.920 --> 0:30:16.920
<v Speaker 1>you know, how would you see yourself when you're eighty

0:30:16.960 --> 0:30:19.440
<v Speaker 1>five or ninety. And by the way, medical technology you'll

0:30:19.440 --> 0:30:22.280
<v Speaker 1>get us there now because they can fix the hard thing,

0:30:22.280 --> 0:30:23.840
<v Speaker 1>and replace the hard thing, and fix the guineas and

0:30:23.880 --> 0:30:28.760
<v Speaker 1>fix just better really accept this thing. And if they said,

0:30:29.000 --> 0:30:31.640
<v Speaker 1>if you were to rate your standard living, one thing

0:30:31.680 --> 0:30:34.720
<v Speaker 1>is you probably don't want to be confronted with is

0:30:35.320 --> 0:30:40.360
<v Speaker 1>your kids having to bathe you and not be recognized

0:30:40.360 --> 0:30:42.360
<v Speaker 1>by you, or your kids have having to put you

0:30:42.440 --> 0:30:44.760
<v Speaker 1>in a nursing home because you turn a little bit

0:30:44.880 --> 0:30:48.560
<v Speaker 1>violent because you've got dementia. That would be probably the

0:30:48.880 --> 0:30:51.920
<v Speaker 1>lowest stand of living I can imagine for me. I'd

0:30:51.920 --> 0:30:53.560
<v Speaker 1>tell a lot of people to agree with that. Yeah,

0:30:53.600 --> 0:30:56.040
<v Speaker 1>that's the fear. Absolutely, it's a massive fear.

0:30:56.440 --> 0:31:00.160
<v Speaker 2>Yeah, and it's well founded. I think that the the

0:31:00.360 --> 0:31:03.880
<v Speaker 2>essence of being a human is our brain function, our

0:31:03.920 --> 0:31:06.840
<v Speaker 2>executive function, the fact that we're having this conversation now.

0:31:07.280 --> 0:31:10.440
<v Speaker 2>So when that is affected in any way, it has

0:31:10.600 --> 0:31:15.400
<v Speaker 2>massive implications and it's very hard for individuals and families

0:31:15.480 --> 0:31:16.080
<v Speaker 2>to cope with that.

0:31:16.880 --> 0:31:19.880
<v Speaker 1>So I just had to thought then if Matthew just

0:31:19.920 --> 0:31:23.080
<v Speaker 1>go back to something. When we're talking about high intensity exercise,

0:31:24.120 --> 0:31:27.960
<v Speaker 1>you can do that when you're forty, fifty, sixty, some

0:31:28.000 --> 0:31:32.920
<v Speaker 1>people maybe seventy, but it largely depends on your mobility

0:31:32.960 --> 0:31:35.960
<v Speaker 1>and a lot of other stuff, you know, energy levels,

0:31:36.320 --> 0:31:40.360
<v Speaker 1>et cetera. But when you're eighty does high intensity then? Mean?

0:31:40.840 --> 0:31:42.640
<v Speaker 1>I mean, how do we measure high intensity? Is it

0:31:42.680 --> 0:31:46.320
<v Speaker 1>about my heart as a percentage of maximum heart rate?

0:31:47.000 --> 0:31:49.719
<v Speaker 1>Or is it? And therefore you take one hundred and

0:31:49.760 --> 0:31:52.840
<v Speaker 1>two twenty multiply minus eighty and it gives me one

0:31:52.880 --> 0:31:54.960
<v Speaker 1>forty and I go, try you at eighty five percent

0:31:55.000 --> 0:31:57.520
<v Speaker 1>of that? Or is it? What is it? What is

0:31:57.600 --> 0:32:00.200
<v Speaker 1>high intensity? Well? That is exactly it.

0:32:00.240 --> 0:32:02.480
<v Speaker 2>But I suppose when you're eighty or ninety, are you

0:32:02.480 --> 0:32:04.760
<v Speaker 2>going to suddenly do a high intensity exer's for the

0:32:04.760 --> 0:32:06.200
<v Speaker 2>first time and do it as well as a twenty

0:32:06.240 --> 0:32:08.000
<v Speaker 2>year old. No, so you're going to be doing it

0:32:08.000 --> 0:32:11.240
<v Speaker 2>in your twenties, thirties, forties, fifties, sixty, seventies and eighties.

0:32:11.520 --> 0:32:13.400
<v Speaker 2>And in fact, by doing that, it makes it more

0:32:13.480 --> 0:32:14.600
<v Speaker 2>likely that you are going to be able to do

0:32:14.640 --> 0:32:18.000
<v Speaker 2>it in your eighties, nineties and one hundred. I see

0:32:18.000 --> 0:32:19.960
<v Speaker 2>a lot of people who come in who were in

0:32:20.240 --> 0:32:23.800
<v Speaker 2>fantastic health in their eighties and nineties. So that's the message.

0:32:23.880 --> 0:32:25.320
<v Speaker 2>You don't have to be in bad health, you don't

0:32:25.320 --> 0:32:29.840
<v Speaker 2>have to have you know, disability. But that hasn't come

0:32:29.880 --> 0:32:35.040
<v Speaker 2>out of nowhere. Yeah, So it's like doing homework all day,

0:32:35.080 --> 0:32:37.160
<v Speaker 2>every day for the course of your life.

0:32:37.680 --> 0:32:41.440
<v Speaker 1>Yes, and to that extent. And that's what this shows

0:32:41.440 --> 0:32:43.080
<v Speaker 1>a lot about this is that they you've got to

0:32:43.080 --> 0:32:46.520
<v Speaker 1>take control individuals. We might, but they're not going to

0:32:46.560 --> 0:32:50.040
<v Speaker 1>take control as someone makes them aware and sort of

0:32:50.040 --> 0:32:52.040
<v Speaker 1>give them a bit of an indication of the type

0:32:52.080 --> 0:32:55.520
<v Speaker 1>of life. There's life style of stuff. Yeah, change your life. No,

0:32:55.680 --> 0:32:58.480
<v Speaker 1>don't drink as much, don't drink it all if you

0:32:58.520 --> 0:33:02.840
<v Speaker 1>can help it, garettes at all, eat the right foods,

0:33:02.840 --> 0:33:07.120
<v Speaker 1>don't put on too much weight, exercise properly. Sleep is

0:33:07.160 --> 0:33:11.080
<v Speaker 1>really important. I do want to talk to you about

0:33:11.520 --> 0:33:18.080
<v Speaker 1>something this this APO like APO E. Chris Hemsworth did

0:33:18.080 --> 0:33:23.320
<v Speaker 1>he show on whatever whatever the streaming platform was. He

0:33:23.360 --> 0:33:27.480
<v Speaker 1>talked to Peter a teer Peter Tree blood test on

0:33:26.440 --> 0:33:29.200
<v Speaker 1>you know, one of the most athletic looking people and

0:33:29.400 --> 0:33:32.920
<v Speaker 1>I've ever seen on television. And I say, therefore, is

0:33:32.960 --> 0:33:37.200
<v Speaker 1>it athletic? He's young, And the bad news, as delivered

0:33:37.200 --> 0:33:42.479
<v Speaker 1>by Peter Tear to Hemsworth, was that he had two

0:33:42.560 --> 0:33:45.160
<v Speaker 1>alleles of E four one month from dad. I presume

0:33:45.280 --> 0:33:46.720
<v Speaker 1>he must have been my month for dad and he

0:33:46.800 --> 0:33:52.920
<v Speaker 1>was four E four. One could you comment on is

0:33:53.800 --> 0:33:57.320
<v Speaker 1>are we now testing for this stuff more more more often?

0:33:58.120 --> 0:33:59.720
<v Speaker 1>And two what does it mean?

0:34:02.600 --> 0:34:05.400
<v Speaker 2>Both excellent questions. We are testing for it more often,

0:34:05.400 --> 0:34:08.239
<v Speaker 2>but it's not routine and people often need to ask

0:34:08.280 --> 0:34:10.160
<v Speaker 2>for it. So I think it's important, and that's why

0:34:10.200 --> 0:34:13.200
<v Speaker 2>this show is important to understand that this is part

0:34:13.440 --> 0:34:18.920
<v Speaker 2>of a risk factor for conditions such as dementia. And

0:34:19.239 --> 0:34:22.440
<v Speaker 2>if you have alleles of APO E four, as you mentioned,

0:34:22.880 --> 0:34:25.600
<v Speaker 2>that means that you're less likely to break down the

0:34:25.640 --> 0:34:28.319
<v Speaker 2>proteins that cause dementia in the brain.

0:34:28.360 --> 0:34:33.239
<v Speaker 1>Because if that protein E four ye, or if it's

0:34:33.280 --> 0:34:37.680
<v Speaker 1>E two E three operates more efficiently than ethol. Absolutely,

0:34:37.840 --> 0:34:39.920
<v Speaker 1>that is that the issue. Yeah, And if you've got

0:34:39.960 --> 0:34:42.160
<v Speaker 1>A four, you don't have E two or three or

0:34:42.200 --> 0:34:46.319
<v Speaker 1>two in particular, you're not as likely to break down those,

0:34:46.560 --> 0:34:48.319
<v Speaker 1>so it's not that efficient in getting rid of all

0:34:48.320 --> 0:34:49.799
<v Speaker 1>the debris that's hanging around your brain.

0:34:50.200 --> 0:34:52.719
<v Speaker 2>Yeah, and it's still working, but it's not working as

0:34:52.800 --> 0:34:56.080
<v Speaker 2>well as I suppose the comparison of you know, nineteen seventies,

0:34:56.360 --> 0:34:59.359
<v Speaker 2>you know, Mini with a Tesla or something like that.

0:34:59.360 --> 0:35:03.600
<v Speaker 2>Like it's total different, but it is working to an extent.

0:35:04.440 --> 0:35:09.239
<v Speaker 2>So obviously, if you do have at BOI four like

0:35:10.040 --> 0:35:13.640
<v Speaker 2>Hemsworth's show on his show, that would put you at

0:35:13.640 --> 0:35:16.319
<v Speaker 2>a higher risk. So that would put more emphasis on

0:35:16.480 --> 0:35:19.800
<v Speaker 2>you to focus on all the other modifiable risk factors

0:35:19.800 --> 0:35:22.360
<v Speaker 2>that you can control, the ones that we've already talked about.

0:35:23.200 --> 0:35:24.560
<v Speaker 2>A statistical higher risk.

0:35:24.880 --> 0:35:25.640
<v Speaker 1>Yeah, it doesn't.

0:35:27.200 --> 0:35:28.879
<v Speaker 2>And these are based on and that's a good point.

0:35:28.960 --> 0:35:32.640
<v Speaker 2>These are based on populations. This is population health. However,

0:35:32.680 --> 0:35:36.319
<v Speaker 2>you can extrapulate the population to the best for you.

0:35:37.200 --> 0:35:39.600
<v Speaker 2>But of course an an equals one I e.

0:35:39.680 --> 0:35:40.200
<v Speaker 1>Yourself.

0:35:40.560 --> 0:35:42.920
<v Speaker 2>It's like it's not it's not an exact science.

0:35:43.600 --> 0:35:46.760
<v Speaker 1>Yeah. So, and as I understand it, there is something

0:35:46.840 --> 0:35:52.239
<v Speaker 1>like people who pass away with perhaps Alzheimer's disease or

0:35:52.600 --> 0:35:57.160
<v Speaker 1>some form of dementia, probably heart attacks two, but have

0:35:57.320 --> 0:36:03.400
<v Speaker 1>a ten times more of those people have the genotype

0:36:03.400 --> 0:36:06.839
<v Speaker 1>B four were both they've got both parents. It's a

0:36:06.840 --> 0:36:10.719
<v Speaker 1>ten time factor. So otherwise it's correlation it's not a causation.

0:36:11.320 --> 0:36:14.279
<v Speaker 1>But lets say, look, he looks great, I mean, and

0:36:14.360 --> 0:36:16.880
<v Speaker 1>obviously he's adjusted his lifestyle. And by the way, I

0:36:16.880 --> 0:36:18.920
<v Speaker 1>don't mind telling everyone, I'm me three E four. So

0:36:18.960 --> 0:36:21.800
<v Speaker 1>I got E four from one of my parents. I

0:36:21.920 --> 0:36:25.040
<v Speaker 1>don't know which one, but one of them, And I

0:36:25.040 --> 0:36:27.160
<v Speaker 1>don't know who to blame, so one mum or dad.

0:36:27.640 --> 0:36:29.560
<v Speaker 1>It doesn't really matter because they both passed away. But

0:36:31.000 --> 0:36:35.319
<v Speaker 1>point being is that there's a I don't know, six

0:36:35.400 --> 0:36:38.000
<v Speaker 1>times I don't have ten times chance like some other

0:36:38.239 --> 0:36:43.160
<v Speaker 1>statistical greater chance of having a brain disorder or even

0:36:43.160 --> 0:36:45.040
<v Speaker 1>a hard disorder, because the four actually fixed your heart too,

0:36:45.080 --> 0:36:46.200
<v Speaker 1>like it's a bad for your heart, and as you

0:36:46.200 --> 0:36:48.319
<v Speaker 1>always say, if it's not good for you with your brain,

0:36:48.800 --> 0:36:50.600
<v Speaker 1>E four does that too, and also has effect on

0:36:50.640 --> 0:36:52.799
<v Speaker 1>the kidneys. It's a kidney issue too, by the way,

0:36:52.840 --> 0:36:54.680
<v Speaker 1>because there's the same deal.

0:36:54.680 --> 0:36:56.600
<v Speaker 2>Absolutely the same deal, because as.

0:36:56.480 --> 0:37:01.279
<v Speaker 1>Your kidneys can get the archer can get, the ones

0:37:01.320 --> 0:37:06.360
<v Speaker 1>coming out of the kidney can get damaged because you're hardened,

0:37:06.400 --> 0:37:08.840
<v Speaker 1>and then they don't filter as well, and so you know,

0:37:08.880 --> 0:37:12.080
<v Speaker 1>you start getting early kidney disease. That's exactly. So it's

0:37:12.120 --> 0:37:14.680
<v Speaker 1>a big deal and we should be getting tests of

0:37:14.719 --> 0:37:18.960
<v Speaker 1>this sort of stuff more often. So E. Four just

0:37:19.280 --> 0:37:21.520
<v Speaker 1>explained a little bit more if you don't mind, because

0:37:21.640 --> 0:37:24.760
<v Speaker 1>one of the things that as I understand it, Matthew,

0:37:24.800 --> 0:37:32.279
<v Speaker 1>is that how comes after amyloid accumulation and TAO come

0:37:32.320 --> 0:37:37.880
<v Speaker 1>about as a result of other processes that happened before

0:37:37.960 --> 0:37:43.480
<v Speaker 1>that way before those things start getting produced. And there

0:37:43.600 --> 0:37:49.000
<v Speaker 1>is you know they're talking about, you know, the Crisper

0:37:49.080 --> 0:37:54.120
<v Speaker 1>process projects whereby they can turn some genes off that

0:37:54.360 --> 0:37:57.279
<v Speaker 1>some people have in their brain, whether they've got EPO

0:37:57.440 --> 0:38:01.120
<v Speaker 1>or not, that you can turn off these processes where

0:38:01.239 --> 0:38:04.160
<v Speaker 1>certain molecules are not going to get produced, which ultimately

0:38:04.239 --> 0:38:07.759
<v Speaker 1>end up in producing more amloids in tow Can you

0:38:07.800 --> 0:38:11.120
<v Speaker 1>just talk about your advances in crisper and what crisper is.

0:38:11.600 --> 0:38:15.800
<v Speaker 2>Well, first, I'd say that focusing on a particular gene

0:38:16.320 --> 0:38:20.800
<v Speaker 2>that might do one part of a function, that's great research,

0:38:21.239 --> 0:38:24.560
<v Speaker 2>but it might not necessarily have any impact or translation

0:38:24.760 --> 0:38:27.120
<v Speaker 2>into the humans that we are. So I think that's

0:38:27.160 --> 0:38:29.279
<v Speaker 2>the first thing. You often see these great discoveries, and

0:38:29.600 --> 0:38:32.200
<v Speaker 2>we've been able to model mice. Yeah, it did it on mice,

0:38:32.920 --> 0:38:34.920
<v Speaker 2>and you know, in a lot of the conditions we're

0:38:34.960 --> 0:38:37.440
<v Speaker 2>talking about. All of my studies have been negative because

0:38:37.600 --> 0:38:40.320
<v Speaker 2>how good is that model for the human disease?

0:38:40.640 --> 0:38:40.879
<v Speaker 1>Right?

0:38:41.480 --> 0:38:45.000
<v Speaker 2>And the other thing is we've obviously mentioned amyloid and

0:38:45.080 --> 0:38:47.600
<v Speaker 2>TAW and they're important parts, but they're not the whole

0:38:47.600 --> 0:38:50.560
<v Speaker 2>story either, and so there's a discussion. I remember when

0:38:50.560 --> 0:38:52.880
<v Speaker 2>people we talking about ammeloid they said, well, it's like

0:38:52.960 --> 0:38:55.279
<v Speaker 2>saying if you remove smoke, is at the end of

0:38:55.360 --> 0:38:55.760
<v Speaker 2>the fire.

0:38:56.120 --> 0:38:56.560
<v Speaker 1>No way.

0:38:57.040 --> 0:39:00.600
<v Speaker 2>So there's a whole process going on here. Emoloid and

0:39:00.680 --> 0:39:04.000
<v Speaker 2>TOW are critical parts, and the genes modifying them are

0:39:04.040 --> 0:39:07.560
<v Speaker 2>critical parts. But if we remove all of the amyloid

0:39:07.600 --> 0:39:10.360
<v Speaker 2>out of someone's brain, will they be back to normal? Well, no,

0:39:10.400 --> 0:39:12.760
<v Speaker 2>they're not, because we're doing that now. So we can

0:39:13.040 --> 0:39:17.120
<v Speaker 2>remove the amyloid with the monoclonal antibodies and they don't

0:39:17.120 --> 0:39:19.799
<v Speaker 2>get back to normal, they might either plateau or they

0:39:19.880 --> 0:39:23.000
<v Speaker 2>might might slow down the progression. But then the question

0:39:23.239 --> 0:39:25.839
<v Speaker 2>is can we find tune that when do we start it?

0:39:26.160 --> 0:39:28.880
<v Speaker 2>Do we start these medications at the age of thirty

0:39:28.920 --> 0:39:32.399
<v Speaker 2>when we see four is up and monitoring some other

0:39:32.440 --> 0:39:34.719
<v Speaker 2>parts of the biomus, and that's where we're going. We're

0:39:34.760 --> 0:39:37.319
<v Speaker 2>going to go earlier and earlier and earlier. And it

0:39:37.400 --> 0:39:40.360
<v Speaker 2>might be that one of the medications is related to

0:39:40.440 --> 0:39:44.360
<v Speaker 2>a gene modification in amyloid in a few years time,

0:39:44.520 --> 0:39:47.359
<v Speaker 2>but that's not available at the moment. The other thing

0:39:47.440 --> 0:39:50.239
<v Speaker 2>is when you start knocking out certain genes, you don't

0:39:50.239 --> 0:39:51.719
<v Speaker 2>know what the downstream effects of.

0:39:51.640 --> 0:39:55.040
<v Speaker 1>That effect is. Yeah, exactly. That might be good for

0:39:55.080 --> 0:39:56.359
<v Speaker 1>something else, yeah, and.

0:39:56.320 --> 0:39:59.640
<v Speaker 2>It might be a catastrophe, you know, were there were trials,

0:39:59.640 --> 0:40:03.120
<v Speaker 2>for instance, in Parkinson's disease, putting in stem cells into

0:40:03.160 --> 0:40:05.120
<v Speaker 2>the brain and all sounding great, It was looking good,

0:40:05.360 --> 0:40:08.960
<v Speaker 2>but then the stem cell started to overgrow and cause cancer,

0:40:08.960 --> 0:40:12.000
<v Speaker 2>and so people coming in with you know, overgrowth and

0:40:12.080 --> 0:40:14.520
<v Speaker 2>cancer cells in the brain. So it was a catastrophe.

0:40:14.760 --> 0:40:16.799
<v Speaker 2>So you've got to be able to understand. And that's

0:40:16.800 --> 0:40:20.920
<v Speaker 2>really why human trials are so critical. So a model

0:40:21.000 --> 0:40:23.960
<v Speaker 2>is only as good as a disease. It models, but

0:40:24.040 --> 0:40:25.880
<v Speaker 2>I think we have to get more and more into

0:40:26.280 --> 0:40:31.200
<v Speaker 2>patients and patients with neurological conditions. Of course we need

0:40:31.239 --> 0:40:34.160
<v Speaker 2>basic science and discovery, but we've got to focus on

0:40:34.600 --> 0:40:35.400
<v Speaker 2>the human.

0:40:37.640 --> 0:40:40.080
<v Speaker 1>We are talking. I mean, dementia covers a lot of

0:40:40.120 --> 0:40:42.719
<v Speaker 1>stuff and we've been talking about and Alzheimer is the

0:40:42.719 --> 0:40:46.440
<v Speaker 1>one probably everybody tends to focus on. But loss of memory,

0:40:46.480 --> 0:40:50.360
<v Speaker 1>I guess is probably of describing it. What is the

0:40:50.480 --> 0:40:55.120
<v Speaker 1>general progression? Though? From the moment you and I remember

0:40:55.120 --> 0:41:00.080
<v Speaker 1>asking you this question, I said to you, sometimes I

0:41:00.120 --> 0:41:02.920
<v Speaker 1>just can forget a word, and I just can't remember

0:41:02.960 --> 0:41:06.040
<v Speaker 1>the word, and about two or three minutes that comes

0:41:06.040 --> 0:41:07.920
<v Speaker 1>to me. Or I forget a person's name. I know

0:41:07.960 --> 0:41:10.279
<v Speaker 1>them so well, but I haven't said it maybe for

0:41:10.320 --> 0:41:13.520
<v Speaker 1>a while. And you said to me something like that

0:41:13.680 --> 0:41:17.600
<v Speaker 1>sort of anxiety memory because some of you are said

0:41:17.600 --> 0:41:19.440
<v Speaker 1>to me, oh my god, I can't remember that word.

0:41:19.480 --> 0:41:21.319
<v Speaker 1>And they're older people and they're going and they're just

0:41:21.360 --> 0:41:26.000
<v Speaker 1>marking around, go bloody, early dementia. But what what other

0:41:26.040 --> 0:41:29.040
<v Speaker 1>things could be causing us not to remember that the

0:41:29.160 --> 0:41:33.600
<v Speaker 1>name or the word. What is this anxiety about memory?

0:41:34.200 --> 0:41:35.799
<v Speaker 2>Well, I think once we start focusing on it, we

0:41:35.840 --> 0:41:37.640
<v Speaker 2>all become anxious. Like hearing a story there, I was

0:41:37.640 --> 0:41:41.759
<v Speaker 2>feeling a bit anxious, So that's something natural. But I

0:41:41.800 --> 0:41:45.080
<v Speaker 2>suppose you're worried that you can't recall a name or

0:41:45.120 --> 0:41:47.399
<v Speaker 2>a process, and then a little bit later you do,

0:41:47.600 --> 0:41:51.399
<v Speaker 2>so the function is there, so you haven't lost the function.

0:41:51.320 --> 0:41:53.360
<v Speaker 1>Right, ourzeime's major lost the function.

0:41:53.239 --> 0:41:55.920
<v Speaker 2>It doesn't doesn't come back right. And it's like I

0:41:55.920 --> 0:41:59.760
<v Speaker 2>suppose an onion starts stripping away the very core parts

0:41:59.800 --> 0:42:02.200
<v Speaker 2>of and remain and you might, you know, have memories

0:42:02.239 --> 0:42:05.279
<v Speaker 2>from long standing memories about you know, growing up and

0:42:05.360 --> 0:42:07.840
<v Speaker 2>your parents and so on, but you don't remember that

0:42:07.880 --> 0:42:09.560
<v Speaker 2>you need to go down and get you know, to

0:42:09.680 --> 0:42:12.240
<v Speaker 2>Col's and get dinner for tonight, those sort of things.

0:42:12.360 --> 0:42:15.960
<v Speaker 2>It's so there's a level of what is intrinsic in

0:42:16.000 --> 0:42:18.839
<v Speaker 2>your brain function that's laid down and these these are

0:42:18.880 --> 0:42:22.560
<v Speaker 2>memories that are laid down and reinforced. But it's the

0:42:22.600 --> 0:42:25.719
<v Speaker 2>short term issues that tend to be more problematic. And

0:42:25.760 --> 0:42:29.520
<v Speaker 2>that also means your daily function in your job, in

0:42:29.560 --> 0:42:31.440
<v Speaker 2>your family, in your environment.

0:42:31.600 --> 0:42:35.600
<v Speaker 1>So what is the usual progression? So people start having

0:42:37.040 --> 0:42:39.400
<v Speaker 1>maybe what's something that someone might come to you? And

0:42:39.640 --> 0:42:42.440
<v Speaker 1>obviously I don't want to breach any professional situation here,

0:42:42.480 --> 0:42:47.680
<v Speaker 1>but like maybe someone comes to you and like very

0:42:47.680 --> 0:42:51.720
<v Speaker 1>early stage Alzheimer's, like what would you what would you see?

0:42:52.200 --> 0:42:55.759
<v Speaker 2>Well, part of it can be prolonged word finding difficulties,

0:42:55.800 --> 0:42:58.440
<v Speaker 2>and we might test for it, like you might show

0:42:58.880 --> 0:43:00.960
<v Speaker 2>them a picture of say the Eiffel Tower and anyone.

0:43:00.960 --> 0:43:03.440
<v Speaker 2>So that's the Eiffel Tower, So what's that. That's that

0:43:03.600 --> 0:43:08.000
<v Speaker 2>place that's sort of not here, but it's and it's

0:43:08.600 --> 0:43:10.920
<v Speaker 2>it's made of metal, and they're sort of talking around,

0:43:10.920 --> 0:43:14.000
<v Speaker 2>so it's fluent, it's fluent speech, but they can't say

0:43:14.080 --> 0:43:16.720
<v Speaker 2>Eiffel Tower. They can't say that's a structure in powers

0:43:16.719 --> 0:43:19.479
<v Speaker 2>and Powers is in France. So the connections are all gone.

0:43:19.800 --> 0:43:23.560
<v Speaker 1>There are tests, specific tests later, Yeah, you'll.

0:43:23.360 --> 0:43:26.760
<v Speaker 2>Have them, and so either the neurologists will be involved

0:43:26.760 --> 0:43:29.239
<v Speaker 2>in those tests or there's a neuropsychologist. It's usually a

0:43:29.320 --> 0:43:34.200
<v Speaker 2>multidisciplinary approach and there's testing for word finding difficulties, but

0:43:34.280 --> 0:43:38.160
<v Speaker 2>also then trails, so for instance, doing networks of you know,

0:43:38.520 --> 0:43:44.160
<v Speaker 2>shapes and sizes, doing images of clocks, understanding times. Another

0:43:44.480 --> 0:43:47.920
<v Speaker 2>you know, test is verbal fluency. That's the frontal lobe function.

0:43:48.080 --> 0:43:50.560
<v Speaker 2>So for instance, I don't know if you want to

0:43:50.560 --> 0:43:52.800
<v Speaker 2>do it on the spot, but tell me all the letters,

0:43:52.880 --> 0:43:54.880
<v Speaker 2>all the words that you can think of with the letter.

0:43:54.880 --> 0:44:04.120
<v Speaker 1>M words real, masterclock, I can't even think he got

0:44:04.200 --> 0:44:09.319
<v Speaker 1>me nervous? Can I think of names? No? No, I

0:44:09.320 --> 0:44:28.120
<v Speaker 1>can't think of it. In addiction, money, metal, motor, car Modikaid, Mammoth, Milestone, mightiness, Michaelangelo.

0:44:31.080 --> 0:44:32.520
<v Speaker 1>How's my time going? Perfect?

0:44:32.640 --> 0:44:35.280
<v Speaker 2>You still got abut another ten or twenty seconds, But

0:44:35.320 --> 0:44:38.360
<v Speaker 2>more than more than double figures in a minute is normal?

0:44:38.480 --> 0:44:40.280
<v Speaker 1>Normal? Yeah? And also you're.

0:44:40.120 --> 0:44:42.160
<v Speaker 2>Looking at the words you use there, like like some

0:44:42.239 --> 0:44:44.319
<v Speaker 2>of those were three or four syllables, so they're very

0:44:44.320 --> 0:44:46.400
<v Speaker 2>complex words. So it's totally normal.

0:44:46.480 --> 0:44:48.400
<v Speaker 1>Yeah, but these are this is part of the So

0:44:49.320 --> 0:44:51.880
<v Speaker 1>how would someone know THATTT that they should go and

0:44:51.920 --> 0:44:54.840
<v Speaker 1>see someone? So because you know, like let's say I

0:44:54.880 --> 0:44:57.759
<v Speaker 1>could get to two out like for example, then I'm

0:44:57.920 --> 0:45:00.440
<v Speaker 1>sort of a bit late to the game. Talk to

0:45:00.480 --> 0:45:04.920
<v Speaker 1>a neurologist. Is there some sort of self testing? Is

0:45:04.920 --> 0:45:07.400
<v Speaker 1>there something like can they go to the new website

0:45:07.400 --> 0:45:10.520
<v Speaker 1>and your Your neuro website sort of explains a few

0:45:10.560 --> 0:45:12.360
<v Speaker 1>things to me and maybe it gets me starting to

0:45:12.400 --> 0:45:13.719
<v Speaker 1>think about it. Or I might be talking to my

0:45:13.760 --> 0:45:16.280
<v Speaker 1>brother who's younger than me, but I might have noticed

0:45:16.280 --> 0:45:18.400
<v Speaker 1>something I can say, maybe you just should go and

0:45:18.440 --> 0:45:20.560
<v Speaker 1>see a doctor about this. I mean, how far back

0:45:20.600 --> 0:45:21.000
<v Speaker 1>can we go?

0:45:21.600 --> 0:45:25.080
<v Speaker 2>Well, we have got risk assessment profiles through the neuro website,

0:45:25.120 --> 0:45:27.080
<v Speaker 2>and people can they're they're all free? Is that neuro

0:45:27.080 --> 0:45:29.520
<v Speaker 2>dot com dot you.

0:45:28.600 --> 0:45:29.879
<v Speaker 1>You, and.

0:45:31.239 --> 0:45:33.920
<v Speaker 2>I think it's also just your engagement in life, like

0:45:33.920 --> 0:45:37.040
<v Speaker 2>people like Sudoku's or reading the newspapers or you know,

0:45:37.600 --> 0:45:41.440
<v Speaker 2>looking at the stock market, talking about the the budget.

0:45:41.840 --> 0:45:43.680
<v Speaker 2>All of those sort of things are sort of that

0:45:43.600 --> 0:45:46.239
<v Speaker 2>that they're markers that things are going okay. The tests

0:45:46.239 --> 0:45:49.520
<v Speaker 2>that we're talking about are more buyer markers. Following a

0:45:49.600 --> 0:45:52.840
<v Speaker 2>clinical presentation, so someone has been brought in either on

0:45:52.840 --> 0:45:55.520
<v Speaker 2>their own volition or by by a family member or

0:45:55.560 --> 0:45:59.319
<v Speaker 2>a friend, like you know, Matthew's not not Matthew's not

0:45:59.320 --> 0:46:00.960
<v Speaker 2>the same person that he seemed to be, or there

0:46:00.960 --> 0:46:03.560
<v Speaker 2>seems to be some minor, like high level stuff, and

0:46:03.600 --> 0:46:06.080
<v Speaker 2>then we would go into this sort of cognitive assessment,

0:46:06.480 --> 0:46:09.560
<v Speaker 2>and then that cognitive assessment would suggest what we need

0:46:09.600 --> 0:46:11.880
<v Speaker 2>to do, Like it might say that actually part of

0:46:11.920 --> 0:46:15.719
<v Speaker 2>it as well is assessment of anxiety and mood. So

0:46:15.840 --> 0:46:18.520
<v Speaker 2>I might score badly, but it might be like really

0:46:18.560 --> 0:46:22.640
<v Speaker 2>really down in my in my mood score, and then

0:46:22.680 --> 0:46:25.360
<v Speaker 2>if I can improve my mood score, does the cognitive

0:46:25.600 --> 0:46:28.800
<v Speaker 2>process come out. And that's people use these word pseudo dementia,

0:46:28.840 --> 0:46:31.640
<v Speaker 2>so in other words, it's not really dementia, it's something

0:46:31.680 --> 0:46:35.120
<v Speaker 2>else that's triggering the process. We'd also then you know,

0:46:35.200 --> 0:46:38.920
<v Speaker 2>look at you know, blood test results, vitamin levels, thyroid function,

0:46:39.080 --> 0:46:42.279
<v Speaker 2>these are all markers that will help brain function and

0:46:42.320 --> 0:46:44.720
<v Speaker 2>they could account for the presentation wow.

0:46:45.280 --> 0:46:53.200
<v Speaker 1>And so like this whole an ecosystem around the outcome

0:46:54.239 --> 0:46:56.360
<v Speaker 1>is pretty important. It's not just one thing. It's not

0:46:56.400 --> 0:46:57.759
<v Speaker 1>just going to sit in front of your Olgers and

0:46:57.800 --> 0:46:59.880
<v Speaker 1>he goes, oh, you've got it or you got to

0:47:00.160 --> 0:47:03.279
<v Speaker 1>stage and what's the progress there? So, I mean, where

0:47:03.280 --> 0:47:06.120
<v Speaker 1>would someone end up. Let's say someone starts at seventy

0:47:06.160 --> 0:47:11.600
<v Speaker 1>either got early dementia and you know diagnosed, is it

0:47:11.640 --> 0:47:15.279
<v Speaker 1>ten years or fifteen years? A minute? And then how

0:47:15.320 --> 0:47:16.200
<v Speaker 1>are they at the end of it?

0:47:16.520 --> 0:47:19.680
<v Speaker 2>Well, the beauty is back to the autonomy issue. People

0:47:19.719 --> 0:47:22.200
<v Speaker 2>can have some control of the modifiable risk factor. So

0:47:22.280 --> 0:47:24.120
<v Speaker 2>let's say I was not scoring as well as I

0:47:24.160 --> 0:47:26.279
<v Speaker 2>should be, or I'd been measuring it over the last

0:47:26.320 --> 0:47:28.120
<v Speaker 2>ten years and I'm starting.

0:47:27.760 --> 0:47:28.439
<v Speaker 1>To drop off.

0:47:28.760 --> 0:47:32.640
<v Speaker 2>If I start to adjust some of my lifestyle factors

0:47:32.880 --> 0:47:35.160
<v Speaker 2>and some of the blood results I've got, can I

0:47:35.160 --> 0:47:37.920
<v Speaker 2>either plateau out or start to raise it again. And

0:47:38.239 --> 0:47:40.239
<v Speaker 2>these are things that yes, we can do. So when

0:47:40.280 --> 0:47:42.799
<v Speaker 2>you say is it ten years is at fifteen years. Well, no,

0:47:43.000 --> 0:47:47.800
<v Speaker 2>it's all modifiable. So forty five percent is modifiable. So

0:47:47.840 --> 0:47:51.480
<v Speaker 2>you've got control, right, So as long as you know that, yeah,

0:47:51.520 --> 0:47:52.920
<v Speaker 2>as long as you know so long as you've been

0:47:52.960 --> 0:47:54.799
<v Speaker 2>tested and as well, and part of that as well

0:47:54.840 --> 0:47:56.879
<v Speaker 2>blood pressure. So how often you get blood pressure checked

0:47:56.880 --> 0:47:58.919
<v Speaker 2>by a general practitioner if you're not seeing a general

0:47:58.920 --> 0:48:01.560
<v Speaker 2>practition again see practition to get your blood pressure.

0:48:01.440 --> 0:48:03.120
<v Speaker 1>Gown by one of those omor on things what they're

0:48:03.120 --> 0:48:04.600
<v Speaker 1>called from the chemist. So I go one a home

0:48:05.080 --> 0:48:08.720
<v Speaker 1>just every day. Probably it would be great if because

0:48:08.719 --> 0:48:10.839
<v Speaker 1>somehow I talked to my phone there could be some

0:48:10.880 --> 0:48:13.239
<v Speaker 1>sort of app to it that I could actually you

0:48:13.239 --> 0:48:15.319
<v Speaker 1>probably can get it minds old, but actually I can

0:48:15.360 --> 0:48:17.080
<v Speaker 1>have a record of I can actually see the changes.

0:48:17.120 --> 0:48:20.759
<v Speaker 1>But that's happening. It's a hundred bucks because a hundred

0:48:20.800 --> 0:48:23.000
<v Speaker 1>bucks and the whole family can use it and you

0:48:23.040 --> 0:48:27.960
<v Speaker 1>can use it forever and so but in the end,

0:48:28.840 --> 0:48:32.840
<v Speaker 1>what is a person from dementia die from? Very good question.

0:48:33.719 --> 0:48:36.440
<v Speaker 2>It doesn't kill them, does it? Well, it does, but

0:48:36.520 --> 0:48:40.759
<v Speaker 2>it's back to the brain is the sort of executive

0:48:40.760 --> 0:48:44.040
<v Speaker 2>function controlling all other organs. So usually part of that

0:48:44.200 --> 0:48:47.800
<v Speaker 2>is you're breathing, so you don't necessarily, you know, breathe

0:48:47.840 --> 0:48:51.200
<v Speaker 2>as as quickly and as deeply as normal, so that

0:48:51.440 --> 0:48:53.640
<v Speaker 2>you know the base of the lungs don't fill up

0:48:53.760 --> 0:48:56.719
<v Speaker 2>with air as they normally do. Some fluid might stay

0:48:56.760 --> 0:48:59.160
<v Speaker 2>down there. You might aspirate, so you might swallow your

0:48:59.160 --> 0:49:02.440
<v Speaker 2>food incorrectly. There'll be a chest infection. You die for pneumonia,

0:49:02.520 --> 0:49:05.279
<v Speaker 2>So you die for pneumonia. That's the most common. But alternatively,

0:49:05.360 --> 0:49:08.000
<v Speaker 2>it also does control you know, your heart, your heart rhythm.

0:49:08.239 --> 0:49:11.120
<v Speaker 2>People have heart attacks that they just die in their sleep.

0:49:11.680 --> 0:49:14.560
<v Speaker 2>So the brain is controlling all of these functions. But yeah,

0:49:14.880 --> 0:49:15.839
<v Speaker 2>that's how you die.

0:49:16.480 --> 0:49:20.680
<v Speaker 1>As you know, my mother was went to the other

0:49:20.719 --> 0:49:22.880
<v Speaker 1>place you used to be at Brandon Mind Center when

0:49:22.880 --> 0:49:25.000
<v Speaker 1>she had motor neurone disease, and she died of motor

0:49:25.080 --> 0:49:29.120
<v Speaker 1>neurone disease. And it's a it's a crappy way to die,

0:49:29.239 --> 0:49:31.839
<v Speaker 1>to be honest, it's one of the worst. I've seen

0:49:31.880 --> 0:49:33.839
<v Speaker 1>lots of people pass away and that's the worst thing

0:49:33.880 --> 0:49:41.000
<v Speaker 1>I've ever seen. Motor neurone disease is different to dementia.

0:49:41.200 --> 0:49:45.839
<v Speaker 1>And say, someone like me, who's you know, I've had

0:49:45.880 --> 0:49:50.719
<v Speaker 1>lots of concussions, mini concussions, and major concussions. Is there

0:49:51.120 --> 0:49:58.319
<v Speaker 1>any scientific evidence or statistical evidence about and that correlates

0:49:59.080 --> 0:50:02.200
<v Speaker 1>concussions to als or motori disease.

0:50:03.280 --> 0:50:06.799
<v Speaker 2>Yeah, Well, just to put it into a bit of perspective, So,

0:50:07.040 --> 0:50:12.400
<v Speaker 2>motor neurone disease is a neurodegenerative condition. A neurodegeneration incorporates dimension.

0:50:12.480 --> 0:50:16.720
<v Speaker 2>Dementia is due to say Alzheimer's disease or vascular dimension

0:50:16.800 --> 0:50:19.560
<v Speaker 2>that we've talked about. Modeor neurine disease is due to

0:50:19.560 --> 0:50:22.000
<v Speaker 2>a protein abnormality in the brain as well, called TDP

0:50:22.160 --> 0:50:26.840
<v Speaker 2>forty three. It tends to affect particularly the motor pathway,

0:50:26.920 --> 0:50:29.440
<v Speaker 2>so the cordico spinal tract, which is a tract that

0:50:29.520 --> 0:50:33.080
<v Speaker 2>goes through the brain and spinal col cord and controls

0:50:33.080 --> 0:50:36.840
<v Speaker 2>all of our voluntary muscles. So the motor neurine itself

0:50:36.920 --> 0:50:39.280
<v Speaker 2>is one of the biggest cells in the body. Sometimes

0:50:39.280 --> 0:50:41.600
<v Speaker 2>it's up to one point four meters long and has

0:50:41.719 --> 0:50:45.880
<v Speaker 2>huge metabodys one point one point four meters. It's huge,

0:50:46.320 --> 0:50:50.080
<v Speaker 2>that's massive, massive, but it has high metabolic needs and

0:50:50.160 --> 0:50:54.200
<v Speaker 2>it means what it requires a lot of, you know, protein.

0:50:55.040 --> 0:50:57.480
<v Speaker 2>It's very sensitive to not having things, you know, waste

0:50:57.560 --> 0:51:00.680
<v Speaker 2>cleared out properly, so it needs you know, all the

0:51:00.719 --> 0:51:04.520
<v Speaker 2>things we've talked about healthy sleeping habits are good protein,

0:51:04.640 --> 0:51:09.960
<v Speaker 2>good nutrition, and exercise. But for what for some individuals

0:51:09.960 --> 0:51:14.360
<v Speaker 2>in the community, they're prone to having a disease whereby

0:51:14.680 --> 0:51:18.160
<v Speaker 2>the degeneration occurs in the mode and urine itself, and

0:51:18.239 --> 0:51:22.120
<v Speaker 2>so people start to develop weakness. It's usually focal. So

0:51:22.520 --> 0:51:25.279
<v Speaker 2>in our clinics, I think we give a picture of

0:51:25.280 --> 0:51:27.200
<v Speaker 2>a human and we so where did the disease begin?

0:51:27.520 --> 0:51:29.640
<v Speaker 2>And they can always pinpoint whether it began in my

0:51:29.719 --> 0:51:32.279
<v Speaker 2>right hand, whether it began in my mouth, where it

0:51:32.280 --> 0:51:32.879
<v Speaker 2>began in my.

0:51:32.880 --> 0:51:34.800
<v Speaker 1>Left legatis the patient.

0:51:34.840 --> 0:51:37.040
<v Speaker 2>So it always begins, it seems to begin in one

0:51:37.200 --> 0:51:40.040
<v Speaker 2>area and then it starts to spread and become a

0:51:40.040 --> 0:51:41.120
<v Speaker 2>bit more generalized.

0:51:41.200 --> 0:51:44.840
<v Speaker 1>So just explain where that cell is that one point

0:51:44.920 --> 0:51:45.600
<v Speaker 1>four meter.

0:51:46.239 --> 0:51:49.080
<v Speaker 2>So it starts in the brain and goes all the

0:51:49.080 --> 0:51:51.719
<v Speaker 2>way down through the spinal cord, and then there's what

0:51:51.760 --> 0:51:54.400
<v Speaker 2>we call a sign apse to what we call the

0:51:54.440 --> 0:51:57.279
<v Speaker 2>lower mode in urine, which comes out and goes into

0:51:57.320 --> 0:51:59.160
<v Speaker 2>the nerve for instance, of your arm or your leg,

0:51:59.280 --> 0:52:00.360
<v Speaker 2>or into the tongue.

0:52:00.520 --> 0:52:03.600
<v Speaker 1>So long skinny cellars that must be quite skinny if

0:52:03.600 --> 0:52:06.920
<v Speaker 1>it's going down. Yeah, we'll talk about microscopic. Yeah, microscope,

0:52:06.960 --> 0:52:09.799
<v Speaker 1>but it's always get one point four meters in length

0:52:10.040 --> 0:52:12.320
<v Speaker 1>up to one point four death. Wow.

0:52:12.520 --> 0:52:15.320
<v Speaker 2>But it controls everything you're doing now, like talking, moving

0:52:15.320 --> 0:52:16.040
<v Speaker 2>your hands.

0:52:15.760 --> 0:52:17.839
<v Speaker 1>Your leg. So it's not your brain that does it,

0:52:17.840 --> 0:52:18.919
<v Speaker 1>it's the well.

0:52:18.840 --> 0:52:21.840
<v Speaker 2>The control is through the brain and central the central

0:52:21.880 --> 0:52:23.920
<v Speaker 2>mode of neurine is there in the brain.

0:52:23.760 --> 0:52:26.160
<v Speaker 1>Right, and and that's the thing that controls all your

0:52:26.200 --> 0:52:28.520
<v Speaker 1>motor motor skills what are you want to call it?

0:52:28.760 --> 0:52:33.920
<v Speaker 1>And and so just going back a step on that,

0:52:34.680 --> 0:52:37.120
<v Speaker 1>I remember one of the things they did to my

0:52:37.200 --> 0:52:39.800
<v Speaker 1>mother's they were they did it on the hands. They're

0:52:39.800 --> 0:52:42.520
<v Speaker 1>putting pins in it like I don't know, stimulating her

0:52:42.600 --> 0:52:44.920
<v Speaker 1>hand Yep, that's how she got diagnosed.

0:52:45.360 --> 0:52:49.919
<v Speaker 2>Yeah, So neurophysiology is the critical part of a diagnosis.

0:52:49.960 --> 0:52:55.120
<v Speaker 2>That's that's the investigation. And nerves and muscles are electrically active,

0:52:55.640 --> 0:52:58.520
<v Speaker 2>so the signals going down through the nerve that go

0:52:58.600 --> 0:53:01.640
<v Speaker 2>to the muscle that keeps the muscle live. If the muscle,

0:53:01.680 --> 0:53:04.879
<v Speaker 2>if the nerve is damaged, the muscle starts firing off

0:53:04.880 --> 0:53:08.680
<v Speaker 2>by itself, and a manifestation of that might be muscle twitching.

0:53:08.960 --> 0:53:11.640
<v Speaker 2>But if we put a needle into the muscle and

0:53:11.719 --> 0:53:14.600
<v Speaker 2>it's firing off by itself, so in other words, the

0:53:14.680 --> 0:53:17.719
<v Speaker 2>patient isn't controlling it's going. It's just firing units going

0:53:17.719 --> 0:53:21.239
<v Speaker 2>bang bang bang bang bang. That's a feature of nerve

0:53:21.320 --> 0:53:22.960
<v Speaker 2>damage to that particular muscle.

0:53:23.400 --> 0:53:24.000
<v Speaker 1>Now, if, for.

0:53:23.920 --> 0:53:26.200
<v Speaker 2>Instance, you know you're working as a butcher and you

0:53:26.280 --> 0:53:29.920
<v Speaker 2>accidentally cut the nerve and that muscle was affected, that

0:53:29.960 --> 0:53:32.239
<v Speaker 2>makes sense. But if I start putting needles into lots

0:53:32.239 --> 0:53:35.320
<v Speaker 2>of different areas and getting the same results, it suggesting

0:53:35.400 --> 0:53:39.160
<v Speaker 2>there's a more widespread abnormality of nerve and muscle function,

0:53:39.320 --> 0:53:42.920
<v Speaker 2>and that's what is typically the picture of modeer neurine disease.

0:53:43.000 --> 0:53:45.920
<v Speaker 2>So with your mother, it'll be testing muscles in the

0:53:46.040 --> 0:53:48.879
<v Speaker 2>arms and the legs and the speech muscles, and if

0:53:48.880 --> 0:53:52.480
<v Speaker 2>they're all affected, that's, you know, that's the sign of

0:53:52.560 --> 0:53:53.600
<v Speaker 2>modern neurine disease.

0:53:53.800 --> 0:53:58.520
<v Speaker 1>So her first sign of there being a problem was

0:53:58.600 --> 0:54:02.040
<v Speaker 1>that I used to ring her every night, so I'll

0:54:02.040 --> 0:54:04.279
<v Speaker 1>be going home and my way home from work on

0:54:04.400 --> 0:54:06.640
<v Speaker 1>ring her. My mother loves to speak talk a lot,

0:54:06.680 --> 0:54:10.440
<v Speaker 1>and she's a Orish descent, so Irish people love to

0:54:10.480 --> 0:54:12.920
<v Speaker 1>have a chat, so I would recall the moment I

0:54:12.960 --> 0:54:14.399
<v Speaker 1>got my car, because I knew it was twenty five

0:54:14.440 --> 0:54:16.000
<v Speaker 1>minutes to get home, so I could sort of limit

0:54:16.040 --> 0:54:17.239
<v Speaker 1>the time and say, mom my home, Now I'm going

0:54:17.280 --> 0:54:20.839
<v Speaker 1>to have a dinner. So but I noticed she didn't drink.

0:54:21.120 --> 0:54:25.800
<v Speaker 1>I noticed that she started to sound like she was drunk,

0:54:25.920 --> 0:54:28.239
<v Speaker 1>not drunk, but slurring her words, like a person who

0:54:28.239 --> 0:54:30.320
<v Speaker 1>has been drinking would sound not bad, but just a

0:54:30.400 --> 0:54:34.279
<v Speaker 1>little bit slurring. And she was always very articular. And

0:54:34.360 --> 0:54:36.560
<v Speaker 1>I said to her, are you drinking, like having a

0:54:36.560 --> 0:54:40.040
<v Speaker 1>whisky with dad or something like that, and she said no, no, no,

0:54:40.120 --> 0:54:45.160
<v Speaker 1>And then that's when we decided to get her checked out.

0:54:45.719 --> 0:54:49.640
<v Speaker 1>Does it normally start off in the speech, So.

0:54:49.680 --> 0:54:52.280
<v Speaker 2>There's three areas really were a beginning, So it's usually

0:54:52.480 --> 0:54:55.000
<v Speaker 2>upper limonset is the most common, so in your arms,

0:54:55.560 --> 0:55:00.160
<v Speaker 2>then lower leg so leg weakness is the second, and

0:55:00.200 --> 0:55:02.880
<v Speaker 2>speech is the third, so you call it bulbar onset.

0:55:03.000 --> 0:55:05.520
<v Speaker 2>So it's the tongue muscle, so the tongue has become weak.

0:55:05.520 --> 0:55:07.719
<v Speaker 1>So she would have had those other things before.

0:55:08.000 --> 0:55:11.880
<v Speaker 2>Necessarily, so it can begin in the mouth. And I

0:55:11.920 --> 0:55:15.400
<v Speaker 2>suppose it's interesting that humans are the only ones who

0:55:15.440 --> 0:55:18.680
<v Speaker 2>have a form of communication like speech, and that's also

0:55:18.880 --> 0:55:22.080
<v Speaker 2>an are that that's where mode neurone disease begins. Another

0:55:22.120 --> 0:55:24.440
<v Speaker 2>area where it begins is the pincer grip in the hand,

0:55:24.800 --> 0:55:27.360
<v Speaker 2>and we're the only mammalian species who can do a

0:55:27.400 --> 0:55:29.480
<v Speaker 2>pincer grip. But then when you look at the motors

0:55:29.480 --> 0:55:31.960
<v Speaker 2>strip in the brain, the two biggest areas they have

0:55:32.080 --> 0:55:36.160
<v Speaker 2>massive representation are the bulbar region and the thumb and

0:55:36.160 --> 0:55:40.840
<v Speaker 2>the index finger the bulbarth Yeah, so that's been evolution.

0:55:41.080 --> 0:55:43.400
<v Speaker 2>Our brains have grown in those regions so that we

0:55:43.440 --> 0:55:47.600
<v Speaker 2>can speak, we can do this pincer grip. But as

0:55:47.600 --> 0:55:50.640
<v Speaker 2>a result, it's got huge metabolic demand. And when there's

0:55:50.680 --> 0:55:53.880
<v Speaker 2>a failure of that network, how does it manifest? Speech

0:55:53.960 --> 0:55:57.840
<v Speaker 2>goes off or upper limb function, particularly pincer grip is diminished.

0:55:58.000 --> 0:56:01.680
<v Speaker 1>So has the disease has got something to do with

0:56:01.760 --> 0:56:07.680
<v Speaker 1>the metabolic demand not being satisfied? Yeah, or is it?

0:56:08.120 --> 0:56:12.960
<v Speaker 1>Let's rule genetics out. Is it because the metabolic demand

0:56:13.560 --> 0:56:15.640
<v Speaker 1>is not being met In other words, I'm neither not

0:56:16.400 --> 0:56:18.879
<v Speaker 1>a blood flying there, but no of nutrients getting in there?

0:56:19.840 --> 0:56:20.319
<v Speaker 1>What is it?

0:56:20.360 --> 0:56:23.560
<v Speaker 2>Most likely that is the case, and there's a probably

0:56:23.560 --> 0:56:27.480
<v Speaker 2>a threshold what gets something over a threshold for an abnormality,

0:56:27.520 --> 0:56:30.960
<v Speaker 2>and it's probably cellular failure and that leads to a

0:56:31.040 --> 0:56:35.200
<v Speaker 2>protein abnormality, a folding protein abnormality in this case TDP

0:56:35.400 --> 0:56:39.399
<v Speaker 2>forty three. And that's then that we use the word

0:56:39.520 --> 0:56:42.000
<v Speaker 2>notice it's the origin, and then the origin starts to

0:56:42.040 --> 0:56:45.040
<v Speaker 2>spread out like a fire spreading through the brain or

0:56:45.040 --> 0:56:47.040
<v Speaker 2>through the motor pathways.

0:56:48.080 --> 0:56:51.000
<v Speaker 1>And are there any treatments yet.

0:56:52.000 --> 0:56:56.560
<v Speaker 2>Well, in terms of why individuals get it, we know

0:56:56.600 --> 0:57:00.279
<v Speaker 2>that there's genetic abnormalities and there's been large study has

0:57:00.320 --> 0:57:02.879
<v Speaker 2>been one study that was done here in Australia and

0:57:03.239 --> 0:57:07.680
<v Speaker 2>in Japan and Korea showing that they needed to be

0:57:07.760 --> 0:57:10.200
<v Speaker 2>six things to happen for someone to develop mode of

0:57:10.280 --> 0:57:14.920
<v Speaker 2>neurone disease, six hits and if there is a gene

0:57:14.960 --> 0:57:17.040
<v Speaker 2>in the family that accounts for three of the hits,

0:57:17.040 --> 0:57:20.040
<v Speaker 2>then the other three are at this stage unknown.

0:57:21.240 --> 0:57:22.400
<v Speaker 1>But if there is.

0:57:22.360 --> 0:57:25.560
<v Speaker 2>A genetic abnormality, there is now genetic treatment so to

0:57:25.640 --> 0:57:28.000
<v Speaker 2>first one was approved in May of this year twenty

0:57:28.040 --> 0:57:32.360
<v Speaker 2>twenty six, that's now available to treat superoxide dismutes one

0:57:32.440 --> 0:57:37.040
<v Speaker 2>SOD one genetic forms of als. Then we have neuroprotective therapy.

0:57:37.120 --> 0:57:40.240
<v Speaker 2>So really zola is available and that was through clinical

0:57:40.280 --> 0:57:42.040
<v Speaker 2>trials that we were actually part of in the mid

0:57:42.080 --> 0:57:45.440
<v Speaker 2>nineteen nineties and that was approved in Australia in twenty

0:57:45.480 --> 0:57:49.000
<v Speaker 2>twenty five, two thousand and five. And the second medication

0:57:49.320 --> 0:57:52.440
<v Speaker 2>is a darovone already kava, which is an intravenous infusion,

0:57:53.080 --> 0:57:55.040
<v Speaker 2>and that was approved in twenty twenty five. So the

0:57:55.080 --> 0:57:57.680
<v Speaker 2>other three approved the medications in a space you've got it.

0:57:58.000 --> 0:58:01.920
<v Speaker 1>Yeah, So it's and what's and what's its success rate

0:58:01.960 --> 0:58:03.360
<v Speaker 1>like efficacy in terms.

0:58:03.160 --> 0:58:05.400
<v Speaker 2>Of well, the idea is to keep people in the

0:58:05.440 --> 0:58:08.320
<v Speaker 2>mildiforms for longer and so the patients are living with

0:58:08.400 --> 0:58:11.640
<v Speaker 2>the disease for a longer period of time, less affected.

0:58:12.360 --> 0:58:17.320
<v Speaker 1>Right. So, but you mentioned with some forms of dementia

0:58:17.440 --> 0:58:20.680
<v Speaker 1>that there are lifestyle actors that can improve dementia. Other

0:58:20.760 --> 0:58:23.920
<v Speaker 1>lifestyle actors can improve.

0:58:23.640 --> 0:58:25.800
<v Speaker 2>Well some of the factors that are still relevant. But

0:58:25.880 --> 0:58:29.640
<v Speaker 2>you know, in physical exercise but not too much. And

0:58:29.800 --> 0:58:34.680
<v Speaker 2>there has been, I suppose an understanding that sports people

0:58:34.680 --> 0:58:37.400
<v Speaker 2>are more commonly affected. So for instance, in America, it's

0:58:37.400 --> 0:58:42.400
<v Speaker 2>called Lugerrig's disease. Lugeeric developed als in his thirties and

0:58:42.720 --> 0:58:47.560
<v Speaker 2>obviously we've seen a lot of tennis players, Brad Drewett,

0:58:47.600 --> 0:58:53.040
<v Speaker 2>Peter Dowen, We've seen rugby players have been affected. So

0:58:53.160 --> 0:58:58.440
<v Speaker 2>this AFL Neil Danaher, who's totally Neil Danaher and Fighter

0:58:58.560 --> 0:59:01.120
<v Speaker 2>and D are the third largest unders of modern neurone

0:59:01.120 --> 0:59:06.240
<v Speaker 2>disease research globally, Like, isn't that amazing from Australia And

0:59:06.240 --> 0:59:08.360
<v Speaker 2>who's the other fight M and D which is what

0:59:08.440 --> 0:59:09.240
<v Speaker 2>he established.

0:59:09.760 --> 0:59:12.439
<v Speaker 1>Wow, third biggest in the world. In the world. Yeah,

0:59:13.200 --> 0:59:16.040
<v Speaker 1>it's amazing. That's fantastic. It's fantastic.

0:59:16.320 --> 0:59:19.680
<v Speaker 2>So what are the some of the lifestyle things though,

0:59:19.680 --> 0:59:24.840
<v Speaker 2>Matthew like, well, these are complicated discussions, but certainly we

0:59:24.960 --> 0:59:29.840
<v Speaker 2>know that head injuries form part of that discussion. And

0:59:29.880 --> 0:59:31.280
<v Speaker 2>there was a study that came out a couple of

0:59:31.360 --> 0:59:35.280
<v Speaker 2>years ago showing higher incidences of neurodegenerative diseases, including mode

0:59:35.360 --> 0:59:40.920
<v Speaker 2>neurone disease in contact athletes, particularly professional high level contact.

0:59:40.480 --> 0:59:42.120
<v Speaker 1>Athletes like NFL and stuff like that.

0:59:42.200 --> 0:59:44.840
<v Speaker 2>Yeah, yeah, yeah, And I think that the study came

0:59:44.920 --> 0:59:47.640
<v Speaker 2>I think from the Scottish brain banks, so they've had

0:59:47.640 --> 0:59:50.960
<v Speaker 2>a lot of Scottish rugby union players and they made

0:59:51.000 --> 0:59:54.840
<v Speaker 2>that connection. It's similar here. And I know that the

0:59:54.920 --> 0:59:57.880
<v Speaker 2>Rugby codes are very interested and they're very concerned about it,

0:59:57.880 --> 0:59:59.600
<v Speaker 2>and they're putting a lot of focus on it in

1:00:00.160 --> 1:00:02.919
<v Speaker 2>the AFL and the NRL to try and understand these

1:00:02.920 --> 1:00:07.200
<v Speaker 2>conditions better. But it's a form of research, so we

1:00:07.280 --> 1:00:10.640
<v Speaker 2>still don't have, you know, one hundred percent diagnostic approach

1:00:10.680 --> 1:00:14.880
<v Speaker 2>for chronic traumatic and caphilopathy CTE, and part of that

1:00:15.480 --> 1:00:18.840
<v Speaker 2>is really diagnosed by doing the post mortem examination.

1:00:19.160 --> 1:00:20.880
<v Speaker 1>Maybe you could explain it because a lot of people

1:00:20.920 --> 1:00:24.400
<v Speaker 1>come and say I've been I've heard them, I know them,

1:00:24.600 --> 1:00:27.720
<v Speaker 1>I've been diagnosed with the CTE, And as I understand it,

1:00:27.760 --> 1:00:29.920
<v Speaker 1>you can't do that until you actually get hold of

1:00:29.920 --> 1:00:32.600
<v Speaker 1>their brain once they passed away to do the actual diagnosis.

1:00:32.680 --> 1:00:35.640
<v Speaker 2>That's exactly it, and every approach that's been used up

1:00:35.720 --> 1:00:39.080
<v Speaker 2>till now has been unsuccessful. And in whole groups where

1:00:39.080 --> 1:00:41.080
<v Speaker 2>people said, oh there's a ct and they go and

1:00:41.120 --> 1:00:45.720
<v Speaker 2>to the postmodern examination, there's no neuropathological evidence of ct.

1:00:45.800 --> 1:00:47.640
<v Speaker 1>Maybe you could explain what it looks like. I've seen

1:00:47.640 --> 1:00:49.080
<v Speaker 1>it because I've been to the brain bang at it

1:00:50.680 --> 1:00:53.920
<v Speaker 1>a Brain of Mind center, and in fact I made

1:00:53.920 --> 1:00:55.520
<v Speaker 1>a big donation and then said to them they can

1:00:55.560 --> 1:00:58.160
<v Speaker 1>have my brain when I pass away if they want

1:00:58.200 --> 1:01:01.200
<v Speaker 1>to do evenuevary. But they showed me when it was

1:01:01.240 --> 1:01:04.840
<v Speaker 1>actually like a so here's your brain, like you know,

1:01:05.000 --> 1:01:07.960
<v Speaker 1>that's sort of wrinkly sorting and there was a big

1:01:08.280 --> 1:01:11.760
<v Speaker 1>sort of dent like that is that is that? Am I? Right? So?

1:01:11.880 --> 1:01:15.360
<v Speaker 2>Look there are holes in the brain where fluid passes

1:01:15.400 --> 1:01:18.840
<v Speaker 2>through and they become bigger, and the cell the cell

1:01:18.920 --> 1:01:21.160
<v Speaker 2>processes of the brain becomes smaller, so they shrink, so

1:01:21.160 --> 1:01:23.840
<v Speaker 2>you get shrinkage of different areas. You can also get

1:01:23.920 --> 1:01:26.560
<v Speaker 2>then it's like scar tissue building up in the brain

1:01:27.600 --> 1:01:29.880
<v Speaker 2>and the space has become bigger. That's and then there's

1:01:29.920 --> 1:01:30.760
<v Speaker 2>certain patterns.

1:01:31.320 --> 1:01:33.120
<v Speaker 1>But but why can't you look at that under an

1:01:33.200 --> 1:01:35.160
<v Speaker 1>MRI or a machine.

1:01:35.280 --> 1:01:36.800
<v Speaker 2>Well, there are so many other things that could also

1:01:36.840 --> 1:01:40.480
<v Speaker 2>be affecting the brain, right, I think though that it's

1:01:40.520 --> 1:01:43.000
<v Speaker 2>really interesting that I think we're going to get better

1:01:43.360 --> 1:01:46.400
<v Speaker 2>by using the technology of the day. So AI with

1:01:46.960 --> 1:01:50.400
<v Speaker 2>hundreds of thousands of scans is much better than you

1:01:50.560 --> 1:01:52.360
<v Speaker 2>or I looking at a scan and saying it looks

1:01:52.360 --> 1:01:55.080
<v Speaker 2>normal or it doesn't look normal like that. That's that's

1:01:55.120 --> 1:01:57.440
<v Speaker 2>where're at today. That's all going to be a thing

1:01:57.440 --> 1:01:58.360
<v Speaker 2>of the past.

1:01:58.280 --> 1:02:01.040
<v Speaker 1>Like the guys from Harris and AI, those guys who

1:02:01.120 --> 1:02:06.360
<v Speaker 1>are producing all these AI models to assist the radiologist, yes,

1:02:06.560 --> 1:02:11.280
<v Speaker 1>and the neurologists in your case, in his or her diagnosis.

1:02:11.640 --> 1:02:14.800
<v Speaker 2>And that's a global approach. And at neuro we're hopeful

1:02:14.840 --> 1:02:18.360
<v Speaker 2>of signing up a partnership with IMAD and using the

1:02:18.400 --> 1:02:20.800
<v Speaker 2>sort of the volume of practices they have to use

1:02:20.840 --> 1:02:24.120
<v Speaker 2>AI technology to better diagnose all of the conditions we've

1:02:24.160 --> 1:02:26.720
<v Speaker 2>been talking about, you know, today, and that's going to

1:02:26.760 --> 1:02:30.360
<v Speaker 2>be the reality. But then also can we go earlier

1:02:31.640 --> 1:02:34.320
<v Speaker 2>and at the moment we can't. But let's say we

1:02:34.360 --> 1:02:36.240
<v Speaker 2>did a brain health check of a thirty year old.

1:02:36.400 --> 1:02:39.720
<v Speaker 2>We wouldn't do an MRI scan because what are we

1:02:39.760 --> 1:02:41.160
<v Speaker 2>going to find And what we don't want to do

1:02:41.240 --> 1:02:43.479
<v Speaker 2>is find an incidental finding. Let's say there's a little

1:02:43.520 --> 1:02:45.640
<v Speaker 2>cyst in the brain, what should we do about that?

1:02:46.280 --> 1:02:50.280
<v Speaker 2>And the current understanding of incidental findings is leave them alone?

1:02:50.360 --> 1:02:52.560
<v Speaker 2>Like that just leads to a whole you know, you

1:02:52.720 --> 1:02:55.400
<v Speaker 2>mentioned anxiety, and you imagine the anxiety of the patient,

1:02:55.440 --> 1:02:58.080
<v Speaker 2>of the treating doctor of the family. Do you intervene

1:02:58.160 --> 1:03:01.960
<v Speaker 2>or nind is to not intervene, leave it alone. You

1:03:02.000 --> 1:03:05.480
<v Speaker 2>didn't do the scan to find that that's an incidental finding.

1:03:05.200 --> 1:03:07.200
<v Speaker 1>But maybe you do go back in five years time

1:03:07.720 --> 1:03:10.240
<v Speaker 1>to see if there's been in delta any change. Exactly

1:03:10.360 --> 1:03:13.240
<v Speaker 1>that's your delta. That's good, I don't you said, well,

1:03:13.280 --> 1:03:15.680
<v Speaker 1>but yes, that's exactly it. Yeah, yeah, because as you

1:03:15.720 --> 1:03:18.320
<v Speaker 1>know how to preneuvo. And the only reason I had

1:03:18.320 --> 1:03:21.120
<v Speaker 1>it was not to get well. I did take it

1:03:21.160 --> 1:03:22.720
<v Speaker 1>to you, and I took it to live specially took

1:03:22.760 --> 1:03:26.400
<v Speaker 1>with everybody, but everybody was fine. But the point being

1:03:26.440 --> 1:03:28.680
<v Speaker 1>here is now Prinivas or Australia, I mean I can

1:03:28.680 --> 1:03:31.360
<v Speaker 1>go and get another one, and I presume they've got

1:03:31.400 --> 1:03:33.880
<v Speaker 1>own their own AI systems. Now they could probably look

1:03:33.880 --> 1:03:36.800
<v Speaker 1>at both of them, but I can someone can They

1:03:36.800 --> 1:03:40.520
<v Speaker 1>can say well that has grown. So like one of

1:03:40.520 --> 1:03:42.600
<v Speaker 1>the things you pointed out to me in relation to

1:03:42.640 --> 1:03:44.560
<v Speaker 1>the scan of my brain when I had my whole

1:03:44.600 --> 1:03:47.600
<v Speaker 1>body was I think you said, I think you use

1:03:47.640 --> 1:03:52.520
<v Speaker 1>the word plak be used as normal because for my age,

1:03:52.680 --> 1:03:55.720
<v Speaker 1>but if that was like double in a year or two,

1:03:55.720 --> 1:03:57.320
<v Speaker 1>then you said, well, hang on, let's have a little.

1:03:57.080 --> 1:03:59.520
<v Speaker 2>Bit of that. It's the yeah, and that could be

1:03:59.560 --> 1:04:01.920
<v Speaker 2>getting part the threshold to intervene.

1:04:02.080 --> 1:04:04.000
<v Speaker 1>Yeah, yeah, so I'm actually going to go and get

1:04:04.000 --> 1:04:07.680
<v Speaker 1>another one. But I think down in Melbourne, it's what

1:04:07.720 --> 1:04:10.600
<v Speaker 1>do you think about I mean, I know it's expensive,

1:04:10.640 --> 1:04:14.200
<v Speaker 1>and you know it's easy for me to say, but

1:04:14.240 --> 1:04:17.360
<v Speaker 1>what do you think about those sorts of processes as

1:04:17.400 --> 1:04:22.800
<v Speaker 1>a brain doctor us getting and you can get it

1:04:22.840 --> 1:04:26.200
<v Speaker 1>an your brain much cheaper than a whole reneuvo? But

1:04:26.240 --> 1:04:27.840
<v Speaker 1>what about what do you think about people doing that?

1:04:27.880 --> 1:04:31.680
<v Speaker 1>As a market say at six years of age? Should

1:04:31.720 --> 1:04:33.320
<v Speaker 1>they think about that sort of stuff?

1:04:33.560 --> 1:04:36.960
<v Speaker 2>Well, look, I'm a scientist and I love the brain. Yeah,

1:04:36.960 --> 1:04:38.000
<v Speaker 2>I love all of this sort of stuff.

1:04:38.040 --> 1:04:41.040
<v Speaker 1>You a scientists first or a clinician?

1:04:41.080 --> 1:04:43.960
<v Speaker 2>What do you I'd say clinician your clinician, as in

1:04:44.040 --> 1:04:47.760
<v Speaker 2>you diagnose and examine and prescribe. But we all want

1:04:47.800 --> 1:04:49.959
<v Speaker 2>we all want better outcomes and where's that going to come.

1:04:50.120 --> 1:04:51.840
<v Speaker 2>That's going to come from the science.

1:04:51.520 --> 1:04:53.040
<v Speaker 1>And I think you need to explain that though. I

1:04:53.400 --> 1:04:56.000
<v Speaker 1>think most people don't know the difference between a brain scientist,

1:04:56.880 --> 1:05:00.320
<v Speaker 1>a neuroscientist, and a neurologist. I mean, what are the

1:05:00.360 --> 1:05:04.280
<v Speaker 1>different roles and they know different things? True?

1:05:04.640 --> 1:05:09.120
<v Speaker 2>Well, look I suppose in you're a neurologist is a

1:05:09.160 --> 1:05:12.200
<v Speaker 2>doctor so you do you do medical training. A scientist

1:05:12.440 --> 1:05:16.760
<v Speaker 2>does a science degree and they might focus on neurosciences

1:05:16.840 --> 1:05:19.120
<v Speaker 2>and they might focus on a part of neuroscience, could

1:05:19.160 --> 1:05:22.320
<v Speaker 2>be synapses, it could be on the pure mathematics, it

1:05:22.360 --> 1:05:23.280
<v Speaker 2>could be unstructural.

1:05:23.680 --> 1:05:24.480
<v Speaker 1>But I think.

1:05:25.880 --> 1:05:29.680
<v Speaker 2>It's science unlocks the understanding. And at the beginning we

1:05:29.760 --> 1:05:32.960
<v Speaker 2>talked about brain, you know, being their number one. We're

1:05:32.960 --> 1:05:35.680
<v Speaker 2>careful about saying, you know, you know, cause of death

1:05:35.680 --> 1:05:38.200
<v Speaker 2>in Australia. But to try and turn that around, we

1:05:38.240 --> 1:05:41.000
<v Speaker 2>need people focusing on the science and why has that happened,

1:05:41.280 --> 1:05:45.120
<v Speaker 2>and that could be anything from epidemiology, population studies, what's

1:05:45.120 --> 1:05:49.800
<v Speaker 2>happening in you know, Sydney compared to Perth versus rural Australia.

1:05:50.800 --> 1:05:53.320
<v Speaker 2>That's all science, and then by trying to take that

1:05:53.480 --> 1:05:56.160
<v Speaker 2>forward to try and have a message to try and

1:05:56.160 --> 1:06:01.600
<v Speaker 2>improve outcomes, ideally outcomes for a pop but then also

1:06:01.840 --> 1:06:03.240
<v Speaker 2>outcomes for an individual.

1:06:03.600 --> 1:06:08.360
<v Speaker 1>And they're any exciting maybe a tablet or whatever it

1:06:08.400 --> 1:06:12.880
<v Speaker 1>is exciting things on the you know out there in

1:06:12.880 --> 1:06:16.080
<v Speaker 1>the future that you know of that you guys might

1:06:16.080 --> 1:06:19.160
<v Speaker 1>be looking at, like testing or whatever the case may be,

1:06:19.800 --> 1:06:23.440
<v Speaker 1>for things like dementia. And we'll just leave manual disease

1:06:23.640 --> 1:06:25.240
<v Speaker 1>leave aside, but what about dementia.

1:06:25.280 --> 1:06:27.680
<v Speaker 2>Well, look, I think one of the most exciting things

1:06:27.720 --> 1:06:31.160
<v Speaker 2>that's happened in medicine over the last few years has

1:06:31.240 --> 1:06:36.040
<v Speaker 2>been the GLP one so glucagan like peptides, and these

1:06:36.080 --> 1:06:39.600
<v Speaker 2>have come out of particularly the realm of sugar controlled

1:06:39.600 --> 1:06:45.200
<v Speaker 2>blood sugar diabetes, and they're just so incredibly effective.

1:06:45.360 --> 1:06:48.920
<v Speaker 1>Being ozembic for example, yeah, or mandura or whatever it's called,

1:06:49.000 --> 1:06:49.760
<v Speaker 1>those those things.

1:06:50.080 --> 1:06:52.720
<v Speaker 2>So it actually came from very interesting research showing that

1:06:52.920 --> 1:06:55.520
<v Speaker 2>if you put if you had glucose, either you ingested

1:06:55.560 --> 1:06:58.960
<v Speaker 2>it or injected it, they had different levels in the body.

1:06:59.240 --> 1:07:02.480
<v Speaker 2>So it turns out if you ingested that something was

1:07:02.560 --> 1:07:05.960
<v Speaker 2>released that actually brings the blood sugar levels down much

1:07:05.960 --> 1:07:09.440
<v Speaker 2>better than if you had sugar injected. And it took

1:07:09.480 --> 1:07:13.440
<v Speaker 2>a while that that was called gligan like peptide, so

1:07:13.560 --> 1:07:17.600
<v Speaker 2>GLP GLP one, But GOLP one only survives in the

1:07:17.600 --> 1:07:20.919
<v Speaker 2>body for a few minutes after you eat a meal. Really, yeah,

1:07:21.240 --> 1:07:25.200
<v Speaker 2>so it's not really the stuff you produce. Yeah, it

1:07:25.280 --> 1:07:28.280
<v Speaker 2>turns out there was this endocrinologist and he's working for

1:07:28.280 --> 1:07:30.840
<v Speaker 2>the Veterans Affairs and they said, look, go and you know,

1:07:30.880 --> 1:07:33.600
<v Speaker 2>try and work on this area in general, as they

1:07:33.680 --> 1:07:36.480
<v Speaker 2>just went through virtually like encyclopedias. And he found this

1:07:36.520 --> 1:07:39.640
<v Speaker 2>thing called a Gila monster, and a Gila monster had

1:07:39.680 --> 1:07:44.840
<v Speaker 2>pancreatic overgrowth but also could slow their metabolism down and

1:07:45.320 --> 1:07:49.320
<v Speaker 2>manage blood sugar control. And so he off line. He

1:07:49.400 --> 1:07:51.880
<v Speaker 2>went and found some of the venom of this Gila monster,

1:07:51.920 --> 1:07:52.640
<v Speaker 2>and then he animals it.

1:07:52.640 --> 1:07:54.840
<v Speaker 1>Was a national animal, yeah, g LA.

1:07:55.640 --> 1:08:00.720
<v Speaker 2>And he found a new substance called extendon, and extendon

1:08:00.800 --> 1:08:05.200
<v Speaker 2>looked like glucagan like peptide, and he thought this could

1:08:05.280 --> 1:08:07.880
<v Speaker 2>be the key. So he went back to his bosses

1:08:07.920 --> 1:08:09.840
<v Speaker 2>at Veterans' Affairs and he said, look, I think I

1:08:09.880 --> 1:08:11.880
<v Speaker 2>found something. And I said, look, it's not relevant for us,

1:08:11.880 --> 1:08:14.440
<v Speaker 2>because we're only interested in veterans, more interested in you know,

1:08:14.520 --> 1:08:17.000
<v Speaker 2>blast Day's spinal cord injury. We're not interested in this

1:08:17.040 --> 1:08:19.040
<v Speaker 2>sort of stuff. But he thought he's onto something, so

1:08:19.120 --> 1:08:23.200
<v Speaker 2>he patented himself. He had to put a take a

1:08:23.320 --> 1:08:27.000
<v Speaker 2>loan out on the house, and then basically it was

1:08:27.000 --> 1:08:29.679
<v Speaker 2>becoming very, very expensive. So he then went and presented

1:08:29.680 --> 1:08:34.360
<v Speaker 2>at the American Diabetes Association, and a person from a

1:08:34.400 --> 1:08:38.120
<v Speaker 2>small therapeutics company, Ammelon came along and thought this is fascinating,

1:08:38.240 --> 1:08:42.000
<v Speaker 2>called up his bosses that straight away and they came

1:08:42.080 --> 1:08:45.679
<v Speaker 2>up to a licensing agreement that was eventually then taken

1:08:45.760 --> 1:08:49.320
<v Speaker 2>on with Lily. And that is the whole GLP one.

1:08:49.600 --> 1:08:53.800
<v Speaker 2>So extendon would turn GLP one instead of disappearing within

1:08:54.000 --> 1:08:56.360
<v Speaker 2>a few minutes, could make it last in the body

1:08:56.400 --> 1:08:58.720
<v Speaker 2>for hours four to twenty four hours. And this all

1:08:58.760 --> 1:09:01.800
<v Speaker 2>came from the skill was that a lizard. So I

1:09:01.840 --> 1:09:04.599
<v Speaker 2>suppose that also shows discoveries come from anywhere. But you've

1:09:04.600 --> 1:09:08.720
<v Speaker 2>got to have curiosity, the curiosity like this guy thought, oh,

1:09:08.720 --> 1:09:11.120
<v Speaker 2>this is interesting. There's a lizard that has a big

1:09:11.160 --> 1:09:13.759
<v Speaker 2>pancreas that must be doing something about, you know, blood

1:09:13.760 --> 1:09:16.360
<v Speaker 2>sugar control. And that's where it's all come from.

1:09:16.760 --> 1:09:20.680
<v Speaker 1>And where is GOLP one fit into Brainhill? Now got

1:09:20.680 --> 1:09:22.040
<v Speaker 1>distracted there for a lot now, but it was a

1:09:22.040 --> 1:09:23.000
<v Speaker 1>great story. I love it.

1:09:23.160 --> 1:09:26.599
<v Speaker 2>But what's very interesting is that GP one was used

1:09:26.640 --> 1:09:29.360
<v Speaker 2>for blood sugar control and in the studies that and

1:09:29.360 --> 1:09:31.400
<v Speaker 2>this is all you know. Publishing the best journals of

1:09:31.400 --> 1:09:33.880
<v Speaker 2>the world, New England Journal of Medicine, landst et cetera.

1:09:34.720 --> 1:09:38.200
<v Speaker 2>They're also now seeing that cognitive function is improved in

1:09:38.760 --> 1:09:42.040
<v Speaker 2>diabetics treated with this family of medications.

1:09:42.320 --> 1:09:43.200
<v Speaker 1>So that's established.

1:09:43.240 --> 1:09:46.040
<v Speaker 2>So if you have altered blood sugar control and you

1:09:46.080 --> 1:09:50.960
<v Speaker 2>get treated with these medications, you preserve brain health as

1:09:50.960 --> 1:09:54.000
<v Speaker 2>opposed to not having the treatment. Now the next question is, Okay,

1:09:54.040 --> 1:09:57.959
<v Speaker 2>they're in diabetic patients. What about patients with anonymer disease. Yeah,

1:09:58.280 --> 1:10:00.200
<v Speaker 2>and so that's cutting ENGINEW. So the t I was

1:10:00.280 --> 1:10:04.519
<v Speaker 2>underway in Alzum's disease with GLP one, and I think

1:10:04.520 --> 1:10:06.840
<v Speaker 2>this is where it's really going to start breaking open.

1:10:07.120 --> 1:10:09.559
<v Speaker 2>And again we're going to see the importance of metabolic health,

1:10:09.720 --> 1:10:13.440
<v Speaker 2>brain health, frailty all coming together. But then the individual

1:10:13.520 --> 1:10:15.880
<v Speaker 2>GP is going to be able to unlock all of

1:10:15.920 --> 1:10:18.559
<v Speaker 2>this with the markets coming from the patient. So it's

1:10:18.600 --> 1:10:21.040
<v Speaker 2>going to be fascinating, but I think it's going to

1:10:21.439 --> 1:10:23.720
<v Speaker 2>really improve our outcomes as a community.

1:10:24.120 --> 1:10:30.120
<v Speaker 1>So and GLP one like originally was marketed or is

1:10:30.120 --> 1:10:32.080
<v Speaker 1>that because originally marketed for a bit like a lot

1:10:32.080 --> 1:10:34.240
<v Speaker 1>of people us lose weight and not originally but like

1:10:34.320 --> 1:10:37.040
<v Speaker 1>after that, but when it got into the consumer world,

1:10:37.080 --> 1:10:40.880
<v Speaker 1>the retail world, and how does it stop you from

1:10:41.160 --> 1:10:43.960
<v Speaker 1>putting weight on? What's it make? I thought it'd stop

1:10:44.000 --> 1:10:44.880
<v Speaker 1>your appetitis something.

1:10:45.280 --> 1:10:47.720
<v Speaker 2>It does work on appetite, but it also works on

1:10:48.520 --> 1:10:52.840
<v Speaker 2>emptying of the of your stomach of food. But the

1:10:52.880 --> 1:10:55.639
<v Speaker 2>effects through brain health are also linked to the effects

1:10:55.680 --> 1:11:01.640
<v Speaker 2>on obesity, reducing inflammation, reducing sleep, and when you have

1:11:01.720 --> 1:11:04.439
<v Speaker 2>less sleep, aap near the glymphatic system is working. It's

1:11:04.479 --> 1:11:07.240
<v Speaker 2>clearing up the proteins at night time. So it's all

1:11:07.320 --> 1:11:09.440
<v Speaker 2>We're all a huge ecosystem.

1:11:10.240 --> 1:11:13.840
<v Speaker 1>And that's my final question or my final sort of

1:11:13.840 --> 1:11:20.960
<v Speaker 1>subtopic I wanted to talk about. With sleep. Everyone sleeps,

1:11:21.560 --> 1:11:24.040
<v Speaker 1>we all need different levels of sleep, and of course

1:11:24.040 --> 1:11:26.080
<v Speaker 1>everyone keeps saying you got to sleep from seven eight hours,

1:11:26.080 --> 1:11:28.920
<v Speaker 1>but I mean it's rare that I ever ever do that.

1:11:29.840 --> 1:11:31.240
<v Speaker 1>I might be bed for that long, but I might

1:11:31.280 --> 1:11:35.360
<v Speaker 1>not sleep that whole period. What is the difference between, Well,

1:11:35.360 --> 1:11:37.519
<v Speaker 1>why is it important from a brain health point of

1:11:37.560 --> 1:11:43.480
<v Speaker 1>view to a get overall enough sleep but be consistently

1:11:44.560 --> 1:11:49.559
<v Speaker 1>to do it and c also to have slow wave

1:11:49.640 --> 1:11:52.400
<v Speaker 1>sleep or what they call deep sleep or restored sleep

1:11:52.600 --> 1:11:55.160
<v Speaker 1>not so much round but the other one. What is

1:11:55.160 --> 1:11:56.320
<v Speaker 1>that doing for our brain?

1:11:58.040 --> 1:12:00.320
<v Speaker 2>So this is again an evolving era of side. But

1:12:00.439 --> 1:12:03.080
<v Speaker 2>understanding that there are systems in the brain that switch

1:12:03.120 --> 1:12:06.000
<v Speaker 2>on when we're in sleep and deep sleep, and we

1:12:06.080 --> 1:12:10.280
<v Speaker 2>need that every day to clean out the abnormalities, the

1:12:10.360 --> 1:12:13.760
<v Speaker 2>protein abnormalities. In particular, we've talked about amyloid TAO, but

1:12:13.840 --> 1:12:17.559
<v Speaker 2>presumably TDP forty three ouphas on newclin they've been pushed

1:12:17.640 --> 1:12:21.599
<v Speaker 2>through this sort of cleansing process during us sleep. Now,

1:12:21.640 --> 1:12:23.479
<v Speaker 2>the question I suppose when someone does have a sleep

1:12:23.479 --> 1:12:27.280
<v Speaker 2>abnormality is is it a sleep abnormatic abnormality that's been

1:12:27.360 --> 1:12:30.519
<v Speaker 2>driven by brain function or is it just a lifestyle problem.

1:12:30.920 --> 1:12:33.439
<v Speaker 2>And it's much better to try and address that early on.

1:12:33.880 --> 1:12:36.559
<v Speaker 2>And we all need proper sleep and whatever that hour

1:12:36.960 --> 1:12:40.120
<v Speaker 2>those hours are is everyone's different. Like you said, you know,

1:12:40.200 --> 1:12:42.439
<v Speaker 2>you don't need eight hours, and that's true. Some people

1:12:42.520 --> 1:12:45.959
<v Speaker 2>need five, six, seven. But we all need a certain quality,

1:12:46.280 --> 1:12:49.160
<v Speaker 2>a certain amount of sleep, but also than a deep sleep,

1:12:49.560 --> 1:12:52.320
<v Speaker 2>and this is for preserving brain function.

1:12:52.280 --> 1:12:54.519
<v Speaker 1>And deep sleep. During that deep sleep period or the

1:12:54.640 --> 1:12:56.320
<v Speaker 1>slow wage sleep, the deep sleep, when you're sort of

1:12:56.320 --> 1:12:58.920
<v Speaker 1>basically paralyzed. Yeah, you know, you're not moving, you know

1:12:59.000 --> 1:13:02.360
<v Speaker 1>nothing's going on. Posted when you have your sleep during

1:13:02.360 --> 1:13:08.400
<v Speaker 1>that period, something opens up in your brain and sends

1:13:08.439 --> 1:13:10.439
<v Speaker 1>something out there to flush it. And unless you get

1:13:10.439 --> 1:13:14.640
<v Speaker 1>into that state you don't flush out your brain. Is

1:13:14.680 --> 1:13:17.679
<v Speaker 1>there a general rule as to how many hours per

1:13:17.800 --> 1:13:20.120
<v Speaker 1>night or how much of it as a total percentage

1:13:20.120 --> 1:13:21.639
<v Speaker 1>of your total sleep you should be getting.

1:13:21.960 --> 1:13:24.599
<v Speaker 2>So a rough sleep hours is slight cycle is about

1:13:24.640 --> 1:13:27.000
<v Speaker 2>three hours to two of those, so about six hours

1:13:27.400 --> 1:13:29.960
<v Speaker 2>and probably maybe some break in between. So in and

1:13:30.000 --> 1:13:34.360
<v Speaker 2>around six hours is the perfect. But obviously we're talking

1:13:34.360 --> 1:13:36.800
<v Speaker 2>about adults. The younger you are, the more you need,

1:13:36.880 --> 1:13:39.559
<v Speaker 2>and you know children need more eight ten, et cetera.

1:13:39.720 --> 1:13:41.960
<v Speaker 2>So I think part of it is to try and

1:13:42.040 --> 1:13:47.040
<v Speaker 2>ensure that people are used to looking after themselves, to

1:13:47.080 --> 1:13:49.920
<v Speaker 2>go to sleep, to sleep hygiene.

1:13:50.040 --> 1:13:52.920
<v Speaker 1>Yeah, it's just so easily. Yeah, and whilst you're leaping too.

1:13:53.080 --> 1:13:55.720
<v Speaker 2>Yeah, and that's why again exercise, making sure you get

1:13:55.720 --> 1:13:58.840
<v Speaker 2>a bed when you're fatigued. No booze, no booze, don't

1:13:58.880 --> 1:14:02.040
<v Speaker 2>drink you know, teaen coffe just before beforehand.

1:14:01.680 --> 1:14:03.920
<v Speaker 1>You know, try to stay on down, keep your excitement

1:14:04.040 --> 1:14:04.519
<v Speaker 1>levels down.

1:14:04.960 --> 1:14:06.280
<v Speaker 2>I think you should write a book on all of this,

1:14:06.320 --> 1:14:07.680
<v Speaker 2>because you've got all of the keys.

1:14:07.600 --> 1:14:09.639
<v Speaker 1>Can I can I just ask you one more question?

1:14:10.479 --> 1:14:14.040
<v Speaker 1>Hopefully it's a comment on a lot of people, on

1:14:14.400 --> 1:14:18.559
<v Speaker 1>a lot of guys I know older more, my age more,

1:14:18.600 --> 1:14:21.559
<v Speaker 1>my age category. For many many years have been taking

1:14:21.720 --> 1:14:26.280
<v Speaker 1>enormous and all sorts of those old school of sleeping tablets.

1:14:27.040 --> 1:14:31.200
<v Speaker 1>And some people I know, and one of them are,

1:14:33.520 --> 1:14:36.920
<v Speaker 1>are quite aware and alert when they're sleeping, so they

1:14:36.920 --> 1:14:39.240
<v Speaker 1>don't get into the deep sleep for as long as

1:14:39.240 --> 1:14:42.519
<v Speaker 1>other people do because maybe because they're listening, or they're

1:14:42.520 --> 1:14:45.559
<v Speaker 1>not listening, but sort of instinctively they're listening that any

1:14:45.560 --> 1:14:49.040
<v Speaker 1>little norms wake, come up, any movement, awakem up. They're aware,

1:14:49.360 --> 1:14:51.200
<v Speaker 1>but they're asleep sort of thing. And I'm one of

1:14:51.200 --> 1:14:57.400
<v Speaker 1>those people, and recently I come across these sleeping tables.

1:14:57.439 --> 1:15:01.240
<v Speaker 1>They're not sleeping tablets, the tubblets which actually blocked the

1:15:01.280 --> 1:15:07.920
<v Speaker 1>receptors for arecsen in your brain. And I just wonder

1:15:07.920 --> 1:15:11.320
<v Speaker 1>if there's you might wouldn't get to make comment on

1:15:11.360 --> 1:15:14.879
<v Speaker 1>it enough as area you even looked at. But rection's

1:15:14.920 --> 1:15:17.240
<v Speaker 1>the mullog and ee brain there sort of just for

1:15:17.320 --> 1:15:19.840
<v Speaker 1>the audience that keeps us sort of aware and awakes

1:15:20.320 --> 1:15:24.080
<v Speaker 1>sort of awaking. It's normal. Seemed tables sort of sedate you,

1:15:24.200 --> 1:15:26.840
<v Speaker 1>they said, your whole brain, and you basically feel like

1:15:26.840 --> 1:15:28.679
<v Speaker 1>shit when you wake up because you didn't really sleep.

1:15:28.920 --> 1:15:32.599
<v Speaker 1>They knocked you out. Whereas these things blocked the receptors

1:15:32.600 --> 1:15:36.080
<v Speaker 1>on you on your brain cells that actually look grab

1:15:36.120 --> 1:15:39.360
<v Speaker 1>this RECs and stuff that keep that actually trying to

1:15:39.400 --> 1:15:42.120
<v Speaker 1>keep you awake, So it sort of blocks that that process.

1:15:42.760 --> 1:15:45.200
<v Speaker 1>What do you think about those sorts of tablets and

1:15:45.600 --> 1:15:47.800
<v Speaker 1>you have you have you had much experience with it?

1:15:48.000 --> 1:15:50.120
<v Speaker 2>Well, what I would say is, again we're talking about

1:15:50.200 --> 1:15:52.640
<v Speaker 2>upstream and downstream and lots of other things that happened. So,

1:15:52.840 --> 1:15:56.639
<v Speaker 2>like we've been very interested in erecs and producing cells

1:15:56.680 --> 1:16:00.759
<v Speaker 2>in the hippocampus because they also control our eating behavior

1:16:01.200 --> 1:16:04.120
<v Speaker 2>and they're affected in front of temporal dementia and modeor

1:16:04.160 --> 1:16:06.719
<v Speaker 2>neurine disease. The work that's been done here in Sydney,

1:16:06.720 --> 1:16:10.519
<v Speaker 2>particularly Rebecca are Mad to show on that those cells

1:16:10.640 --> 1:16:13.880
<v Speaker 2>are affected early in front of temporal dementia and modeor

1:16:13.920 --> 1:16:17.080
<v Speaker 2>neurine disease. So although you've taken the approach from the

1:16:17.120 --> 1:16:20.479
<v Speaker 2>erecs and to sleep, it's also important for your eating

1:16:20.560 --> 1:16:21.759
<v Speaker 2>behavior and.

1:16:21.840 --> 1:16:25.160
<v Speaker 1>To have to control the amount of recent or yeah, yeah,

1:16:25.200 --> 1:16:25.839
<v Speaker 1>that's interesting.

1:16:25.960 --> 1:16:29.639
<v Speaker 2>Yeah, and they can degenerate and when they degenerate, that's

1:16:29.680 --> 1:16:32.800
<v Speaker 2>why people start having altered eating behavior. So there's a

1:16:32.880 --> 1:16:38.400
<v Speaker 2>propensity with certain dementias to like sweet foods, and you know,

1:16:38.439 --> 1:16:42.760
<v Speaker 2>to eat chocolates, and patients typically become put on weight

1:16:43.040 --> 1:16:46.040
<v Speaker 2>and become a beast, and to exercise, and that's markers

1:16:46.080 --> 1:16:48.320
<v Speaker 2>that this could be fronto temporal dementias. What I'm saying

1:16:48.360 --> 1:16:51.000
<v Speaker 2>is you focus on erection for sleep, but those erections

1:16:51.000 --> 1:16:53.400
<v Speaker 2>and cells also have other functions. So that's why I'd

1:16:53.439 --> 1:16:56.879
<v Speaker 2>be always careful in doing thing that might alter function

1:16:57.000 --> 1:16:58.200
<v Speaker 2>of cells in the brain.

1:16:58.400 --> 1:17:01.719
<v Speaker 1>Because erection is from the gregwood or rexy, which means

1:17:01.960 --> 1:17:07.599
<v Speaker 1>we say, when we're saying to someone in Greek, it's

1:17:07.640 --> 1:17:11.640
<v Speaker 1>a calix, which means good appetite. And it's funny. So

1:17:12.320 --> 1:17:14.720
<v Speaker 1>now I know why it was fascinating. Now I know

1:17:14.760 --> 1:17:17.439
<v Speaker 1>why they call it a recitent has something to do

1:17:17.439 --> 1:17:21.680
<v Speaker 1>with your appetite, it does and eating behavior. Oh right, yeah,

1:17:21.720 --> 1:17:25.000
<v Speaker 1>So would you expect then if you know, let's say

1:17:25.000 --> 1:17:28.439
<v Speaker 1>the half life of rex and pill was twenty four hours,

1:17:28.479 --> 1:17:32.320
<v Speaker 1>for I say it's probably not the case, but that

1:17:32.520 --> 1:17:35.400
<v Speaker 1>you might lose your hunger, I would say, so, yeah.

1:17:35.439 --> 1:17:37.360
<v Speaker 1>And the other thing is, though I presume that it

1:17:37.400 --> 1:17:40.600
<v Speaker 1>bounces back, because it does have a bounce. There's a

1:17:40.600 --> 1:17:43.799
<v Speaker 1>mad bounce because I've measured it. Uh huh, so I measured.

1:17:43.840 --> 1:17:48.240
<v Speaker 1>I measured a heart rate and HIV. So and I've

1:17:48.280 --> 1:17:50.800
<v Speaker 1>watched it go through my So I look at my

1:17:51.479 --> 1:17:55.320
<v Speaker 1>I go through and I look at my my movements

1:17:55.360 --> 1:17:58.120
<v Speaker 1>of my heart, my art movements. Because it records everything,

1:17:58.560 --> 1:18:01.880
<v Speaker 1>and you sleep deep in the beginning, but there's a

1:18:01.920 --> 1:18:04.160
<v Speaker 1>bounce because the half life actually is five hours. So

1:18:04.760 --> 1:18:08.040
<v Speaker 1>right towards the end of the sleep period, yeah, your

1:18:08.040 --> 1:18:11.000
<v Speaker 1>heart rate shoots up big time and your HIV drops

1:18:11.040 --> 1:18:12.200
<v Speaker 1>big time. Yeah.

1:18:12.320 --> 1:18:15.599
<v Speaker 2>Yeah, well it's right at the core of functions in

1:18:15.640 --> 1:18:17.280
<v Speaker 2>the hypothalamus and then.

1:18:17.439 --> 1:18:21.559
<v Speaker 1>You actually wake up really bright. So to some extent,

1:18:21.600 --> 1:18:23.880
<v Speaker 1>it's a bit of a trap because you think this

1:18:23.920 --> 1:18:26.040
<v Speaker 1>is a sleeping tablet. And when I take the Sleepma tableau,

1:18:26.080 --> 1:18:28.439
<v Speaker 1>wake up and feel really good. I feel really awake,

1:18:28.880 --> 1:18:32.160
<v Speaker 1>Whereas if I take enormous and normal that the usual

1:18:32.200 --> 1:18:34.080
<v Speaker 1>types of sleeping tablets, I wake up and feel like

1:18:34.120 --> 1:18:38.599
<v Speaker 1>shit so immediately that my brain says me, well that's better,

1:18:38.680 --> 1:18:41.599
<v Speaker 1>that's good. But the reason is is because my recxs

1:18:41.600 --> 1:18:43.599
<v Speaker 1>and bounce is back the other direction, and I'm actually

1:18:43.720 --> 1:18:47.639
<v Speaker 1>wide awake and I can actually get away less sleep

1:18:47.960 --> 1:18:50.920
<v Speaker 1>and feel quite away. But it's just a bounce because

1:18:50.920 --> 1:18:54.360
<v Speaker 1>all of a sudden you the receptors are now released

1:18:54.600 --> 1:18:57.360
<v Speaker 1>from they're not blocked, and they grab and everything.

1:18:57.800 --> 1:19:00.360
<v Speaker 2>What's fascinating. So I presume the ancient Greek must have

1:19:00.400 --> 1:19:01.280
<v Speaker 2>known a bit about this.

1:19:01.800 --> 1:19:07.160
<v Speaker 1>They probably did this. Ancient Greek does well. I really

1:19:07.240 --> 1:19:09.320
<v Speaker 1>enjoyed today. I'm got to ask you this one question

1:19:09.360 --> 1:19:09.760
<v Speaker 1>from my friend.

1:19:09.800 --> 1:19:13.360
<v Speaker 2>If you don't monoclonal antibodies, that's what this is.

1:19:13.960 --> 1:19:14.160
<v Speaker 1>Right.

1:19:14.520 --> 1:19:19.320
<v Speaker 2>So monoclonal antibodies are now approved in Australia l kenomabed

1:19:19.320 --> 1:19:23.800
<v Speaker 2>and aanamab, and they're very effective at stripping amyloid from

1:19:23.800 --> 1:19:26.479
<v Speaker 2>the brain. And we know that so when we do

1:19:26.520 --> 1:19:28.599
<v Speaker 2>a PET scan, if we do an amyloid PET scan

1:19:28.760 --> 1:19:30.920
<v Speaker 2>before and after, we can see that the amyloid is

1:19:30.960 --> 1:19:35.000
<v Speaker 2>either cleared or that the volume is right.

1:19:34.880 --> 1:19:38.720
<v Speaker 1>Down post taking the monoclonal. Yeah, anybody.

1:19:39.080 --> 1:19:41.679
<v Speaker 2>But then you may say to me, Okay, that's the case,

1:19:42.080 --> 1:19:45.599
<v Speaker 2>and that protein is the critical driver of Alzheimer's disease.

1:19:46.000 --> 1:19:48.320
<v Speaker 2>The patient should be completely back to normal, but they're

1:19:48.320 --> 1:19:52.439
<v Speaker 2>not so, and that's where research is at. So we're

1:19:52.479 --> 1:19:56.760
<v Speaker 2>clearing amyloid, but the patients aren't necessarily getting better, But

1:19:56.800 --> 1:19:59.439
<v Speaker 2>what's happening is you're slow in the decline. You're turning

1:19:59.439 --> 1:20:03.559
<v Speaker 2>the disease process back perps up to three years, right, okay,

1:20:04.080 --> 1:20:06.600
<v Speaker 2>but cutting edge eries and these are patients who have

1:20:06.680 --> 1:20:11.280
<v Speaker 2>had already manifestations and memory problems, but they're not too

1:20:11.320 --> 1:20:14.120
<v Speaker 2>far affected because it's too late, so they have to

1:20:14.200 --> 1:20:18.439
<v Speaker 2>have a mild effect in their brain function. But the

1:20:18.439 --> 1:20:21.760
<v Speaker 2>cutting edge then is what if we treated people, you know,

1:20:22.120 --> 1:20:24.840
<v Speaker 2>before they developed the condition. So we're looking at now,

1:20:24.840 --> 1:20:28.080
<v Speaker 2>this is research that's being underway at at Neuroscience Research

1:20:28.120 --> 1:20:30.800
<v Speaker 2>Australia and Emma Devenue I think he spoke to as

1:20:30.840 --> 1:20:33.360
<v Speaker 2>one of the key drivers of that. So she's she's

1:20:33.400 --> 1:20:38.240
<v Speaker 2>treating patients who have genetic malformations linked to Alzheimer's disease

1:20:38.360 --> 1:20:41.320
<v Speaker 2>with these monoclonal antibodies in the hope they'll never develop

1:20:41.360 --> 1:20:44.439
<v Speaker 2>the condition. And already we're seeing that if the families

1:20:44.439 --> 1:20:47.920
<v Speaker 2>were developing, say Alzheimer's disease at forty five point fifty,

1:20:48.280 --> 1:20:51.920
<v Speaker 2>they're passing those ages without developing the condition. Oh wow, yeah,

1:20:51.960 --> 1:20:54.639
<v Speaker 2>so it's having an effect. But also these are early

1:20:54.760 --> 1:20:58.799
<v Speaker 2>generation therapies. In other words, that's the first type of approach,

1:20:58.920 --> 1:21:02.320
<v Speaker 2>there'd be more ederations, and there's so many coming through

1:21:03.080 --> 1:21:04.080
<v Speaker 2>right now as we speak.

1:21:04.160 --> 1:21:07.880
<v Speaker 1>So one of those two monoclinal antibodies called it's.

1:21:07.800 --> 1:21:11.480
<v Speaker 2>A nanomab and look Canama, there may be means monoclonal

1:21:11.520 --> 1:21:13.640
<v Speaker 2>antibodies and they're two different companies.

1:21:13.280 --> 1:21:16.320
<v Speaker 1>And they're both are both basically available through neurologies. If

1:21:16.360 --> 1:21:17.599
<v Speaker 1>you're a person in this category.

1:21:17.640 --> 1:21:20.160
<v Speaker 2>There are people being treated here in Sydney now, so

1:21:20.200 --> 1:21:23.559
<v Speaker 2>it's approved by the TGA. It hasn't yet been approved

1:21:23.560 --> 1:21:26.599
<v Speaker 2>by the Pharmaceutical Benefits Advisory Committee, so you get paid

1:21:26.720 --> 1:21:30.680
<v Speaker 2>for it. So yeah, so standard and don't quote me

1:21:30.720 --> 1:21:33.439
<v Speaker 2>on this, but a standard treatment course would be about

1:21:33.439 --> 1:21:36.080
<v Speaker 2>one hundred thousand dollars. But if you if you want

1:21:36.160 --> 1:21:38.839
<v Speaker 2>to preserve your brain function, it's worth it. It's absolutely

1:21:38.880 --> 1:21:41.360
<v Speaker 2>if you afford it, absolutely worth it if you can

1:21:41.439 --> 1:21:43.720
<v Speaker 2>tap into your super and use it.

1:21:43.840 --> 1:21:46.880
<v Speaker 1>And I had one final question for you, just in

1:21:46.960 --> 1:21:49.400
<v Speaker 1>terms of and if I could just go back to

1:21:49.960 --> 1:21:52.600
<v Speaker 1>cholesterol and to these stads, that that's a problem for

1:21:52.640 --> 1:21:57.479
<v Speaker 1>your brain too. And let's say you're and I'd like

1:21:57.520 --> 1:22:01.720
<v Speaker 1>you to comment on this. Let's say yours statin you're

1:22:01.760 --> 1:22:04.200
<v Speaker 1>not able to take saturns. You know, for some reason

1:22:04.280 --> 1:22:06.360
<v Speaker 1>the statins affecture sleep, but whatever the case may be,

1:22:08.680 --> 1:22:13.800
<v Speaker 1>and sleeps critical. So there are now injections you can

1:22:13.840 --> 1:22:19.320
<v Speaker 1>get which actually don't cross the blood brain barrier and

1:22:19.680 --> 1:22:25.040
<v Speaker 1>lake statins do, and it will reduce significantly reduce your LDAL.

1:22:27.200 --> 1:22:28.479
<v Speaker 1>Would you just like to comment on.

1:22:28.439 --> 1:22:32.280
<v Speaker 2>That, Well, we're just talking about monoclonal antibodies. So monoclinal

1:22:32.320 --> 1:22:36.760
<v Speaker 2>antibodies actually came from hematology for cancers. They're very effective

1:22:36.800 --> 1:22:39.559
<v Speaker 2>in melanoma. We're now putting them into the brain for

1:22:39.680 --> 1:22:43.679
<v Speaker 2>Alzheimer's disease. They're also very very effective for cholesterol control.

1:22:43.880 --> 1:22:49.160
<v Speaker 2>So monoclonal antibodies are available for lowering cholesterol. But obviously

1:22:49.320 --> 1:22:52.240
<v Speaker 2>that needs to be under pharmaceutical benefit scheme. There are

1:22:52.240 --> 1:22:54.400
<v Speaker 2>certain people who are entitled to it, are not, and

1:22:54.520 --> 1:22:58.880
<v Speaker 2>there are markers. It's not really my area, but there

1:22:58.880 --> 1:23:01.360
<v Speaker 2>are people who focus on. But if it works, it

1:23:01.400 --> 1:23:02.799
<v Speaker 2>does work. It's very effective.

1:23:02.840 --> 1:23:05.240
<v Speaker 1>And if it's effective, if you can get your cholesterol

1:23:05.280 --> 1:23:08.920
<v Speaker 1>down to the levels where it's like in the right territory, yeah,

1:23:09.280 --> 1:23:10.240
<v Speaker 1>then it's good for your brain.

1:23:10.320 --> 1:23:13.040
<v Speaker 2>It's fantastic for the brain. And again that's going to

1:23:13.080 --> 1:23:17.360
<v Speaker 2>be transformational for our community. That's that's that's an amazing development.

1:23:17.479 --> 1:23:20.080
<v Speaker 1>You know, I'm about to try it, but I'm not

1:23:20.120 --> 1:23:24.040
<v Speaker 1>someone to qualifies under the pharmaceutical benefit scheme. I paid

1:23:24.120 --> 1:23:26.880
<v Speaker 1>for it. Yeah, it's not cheap, but you have to

1:23:26.880 --> 1:23:28.439
<v Speaker 1>go I think two injections a year, and you do

1:23:28.479 --> 1:23:30.200
<v Speaker 1>one where you just do it every week or whatever is.

1:23:30.240 --> 1:23:32.280
<v Speaker 1>But there's another one. We get two injections a year,

1:23:32.840 --> 1:23:36.080
<v Speaker 1>but allegedly at Regicial audio by fifty percent.

1:23:36.439 --> 1:23:38.080
<v Speaker 2>Quite quickly, incredibly effective.

1:23:38.160 --> 1:23:40.880
<v Speaker 1>Yeah, it activates more receptors to grab hold of more

1:23:40.920 --> 1:23:45.360
<v Speaker 1>older right, because there's something in your that turns out

1:23:45.720 --> 1:23:49.360
<v Speaker 1>that blocks these receptors. What they do is they stop that.

1:23:49.720 --> 1:23:53.680
<v Speaker 1>I think it's PCSK or nineteen is the name of

1:23:53.760 --> 1:23:57.160
<v Speaker 1>the you know, the molecule, and that turns it stops that.

1:23:57.320 --> 1:23:59.840
<v Speaker 1>It turns that off and then your receptors are grabbing

1:23:59.840 --> 1:24:03.880
<v Speaker 1>all the elder that can on yourselves and that and

1:24:03.920 --> 1:24:06.280
<v Speaker 1>that's this ingestion just fixes that part, so it goes

1:24:06.280 --> 1:24:08.080
<v Speaker 1>nowhere else just go straight there and sorts it out.

1:24:08.240 --> 1:24:12.479
<v Speaker 1>It's pretty amazing and great science. And again some scientists

1:24:12.520 --> 1:24:14.479
<v Speaker 1>has worked this stuff out. They probably were doing it

1:24:14.479 --> 1:24:16.840
<v Speaker 1>with something using it for something else at some stage,

1:24:17.160 --> 1:24:19.519
<v Speaker 1>and all these things, as you say, you always say,

1:24:20.080 --> 1:24:22.559
<v Speaker 1>and I want everyone to remember this, that what's good

1:24:22.560 --> 1:24:26.479
<v Speaker 1>for your heart is good for your brain. Fantastic going

1:24:26.520 --> 1:24:29.000
<v Speaker 1>to that, Matthew. Thanks very much, Thanks.

1:24:28.720 --> 1:24:31.439
<v Speaker 2>Mark, and and thanks for your support for brain health,

1:24:31.520 --> 1:24:34.479
<v Speaker 2>mental health and and also for neuroscience research Australia. We're

1:24:34.520 --> 1:24:36.400
<v Speaker 2>really grateful, so thank you for most of them.