Speaker 1: Welcome to Stuff you Should Know from the house stuff
Speaker 1: Works dot Com. Hey, and welcome to the podcast. I'm
Speaker 1: Josh Clark with Charles W Chuck Bryant and Noel. The
Speaker 1: Stint of Noel continues. Everybody's like, stuff you should know. No, no,
Speaker 1: that's not what we're calling it. It's the stint of Noel,
Speaker 1: all right, stuff you should know? Well, that's too clever. Yeah,
Speaker 1: it's a little cutie. Yeah that's all. That's my only
Speaker 1: aversion to it. What do you are you with stuff
Speaker 1: you should know? Changing the name of our show after
Speaker 1: eight years? No, just the Noel stint the name of it.
Speaker 1: Remember the Summer of Sam? Oh? Yeah, yeah, sure, why not?
Speaker 1: I don't like it? All right? Should we come up
Speaker 1: with the third idea? Yeah? The Stint of Noel sounds
Speaker 1: too much like so something's wrong with nol. That's why
Speaker 1: I like it. It's hilarious. There's nothing wrong with Noel,
Speaker 1: by God, And if you think there is, you need
Speaker 1: to answer to me. There's something you should know. M
Speaker 1: And I see that's what I'm saying. It sounds like
Speaker 1: something Strickland would have come up with. Oh, you know,
Speaker 1: and we haven't been in a flame war with Strickland
Speaker 1: in a while. It's been too long, gotten soft, you
Speaker 1: just launched one across the bowl. So um, chuck, Yes,
Speaker 1: are you familiar with dementia? Uh? Yeah, sure, are you
Speaker 1: running your family? And doesn't run in the family. But
Speaker 1: my grandmother who lived to be a hundred, I had
Speaker 1: to mention at some point, which you know, when you
Speaker 1: live to be a hundred, that's I don't know about likely,
Speaker 1: but it's not surprising. It's probably pretty likely. It's Um,
Speaker 1: it's not from what I understand, it's not a uh
Speaker 1: just a natural consequence of age, but it's pretty prevalent um.
Speaker 1: And dementia is actually super misunderstood. Gets confused with Alzheimer's
Speaker 1: a lot or there's a lot of different kinds of dementia,
Speaker 1: but dementia is actually it's not a disease. It's a
Speaker 1: set of symptoms that's broad on. But disease. Yeah, I
Speaker 1: think that is widely misunderstood. But you are totally correct,
Speaker 1: a set of symptoms and um, it is not just
Speaker 1: your garden variety um forgetfulness that comes as you age, No,
Speaker 1: because that is age related and that is a totally
Speaker 1: age related things called age associated memory. Impairment, and that
Speaker 1: is uh, I think, I mean that happens to everyone, right,
Speaker 1: It's just like you forget your keys more often, that
Speaker 1: kind of stuff. But when you do forget your keys
Speaker 1: more often, you can snap your finger and go, I
Speaker 1: forgot my keys again, what is wrong with me? Yeah,
Speaker 1: that's normal. One of the big tales of true dementia
Speaker 1: is when you don't realize that you're forgetting right. So
Speaker 1: that's that's when it gets scary. And um we said
Speaker 1: that it's not a natural, real consequence of age. And
Speaker 1: one of the things that I turned up in researching
Speaker 1: this is we're not exactly sure what causes dementia. We
Speaker 1: don't even know if some of the tell tale signs
Speaker 1: of dementia are the cause of dementia in some cases
Speaker 1: or the result of dementia. Not entirely certain, but um,
Speaker 1: it is very widespread among the aged population in the
Speaker 1: United States. I think five point three million Americans have
Speaker 1: dementia right now. And as our population ages, because the
Speaker 1: baby boomers are starting to get older, um, I think
Speaker 1: they're expecting something like sixteen million Americans are going to
Speaker 1: have it. By sixteen million, is I think how many?
Speaker 1: About how many people have it around the world right now,
Speaker 1: and in America alone, we're gonna have that number in
Speaker 1: twenty fifty. And it's very expensive. Actually, Uh, how much
Speaker 1: money a lot? You're ready for this? In two thousand fifteen,
Speaker 1: we have spent two hundred and twenty six billion dollars
Speaker 1: on health care for dementia, while um, and they're expecting,
Speaker 1: by I believe, when we are caring for sixteen million
Speaker 1: in two thousand fifteen dollars not futuristic, much more inflated.
Speaker 1: In two thousand fifteen dollars will be spending about one
Speaker 1: point two trillion dollars on dementia. If somebody doesn't do something. Man, Yeah,
Speaker 1: it's it's very expensive. It's also extraordinarily sad as far
Speaker 1: as UM diseases or symptoms of diseases. Yeah, yeah, and uh.
Speaker 1: I also want to recommend our May eleven episode a
Speaker 1: podcast to remember our memory episode ties sevenly into this.
Speaker 1: So if you haven't listened to that one yet, go
Speaker 1: listen to that one, either before or after, or if
Speaker 1: you listen to it and forgot, go back and listen
Speaker 1: to it. That's right. So dementia itself is not UM diagnosed. Uh,
Speaker 1: it's not simply memory loss. It's memory loss UM along
Speaker 1: with one of the following at least one of the
Speaker 1: following one or more. Um aphasia, which is UH if
Speaker 1: you can't understand or produce language any longer. A praxia
Speaker 1: and all these are super sad if you've ever seen
Speaker 1: him up close. A praxia if you cannot make certain
Speaker 1: movements even though your body physically is healthy. UM agnosia,
Speaker 1: which is UH you don't recognize UM objects like the
Speaker 1: remote control or your grandkids stuff like that. UH. And
Speaker 1: then executive dysfunction UM when you have a lot of
Speaker 1: troubles planning and organizing and reasoning. So that, along with
Speaker 1: the memory loss, at least one of these you could
Speaker 1: be diagnosed with dementia. And so, like we said, dementia
Speaker 1: is a set of symptoms, right, yes, it's it's actually
Speaker 1: brought on by disease. And the most common cause of dementia.
Speaker 1: I think something like UM sixty or seventy or something
Speaker 1: like that of dementia UM cases is brought on by
Speaker 1: Alzheimer's disease. I could have sworn we did one in Alzheimer's,
Speaker 1: but we have not. Yeah, I don't think we have.
Speaker 1: I don't know. We've talked about it enough. I think, yeah,
Speaker 1: it's popped up plenty of times, but we've never just
Speaker 1: done a straight up Alzheimer's one. Alzheimer's brings on dementia
Speaker 1: through um something called neuro february fibrullary tangles also known
Speaker 1: as beta I'm sorry, TOW protein tangles and um beta
Speaker 1: amyloid plaques, right, yeah, and just a protein build up,
Speaker 1: a sticky protein build up, yeah, which is so when
Speaker 1: you when your neurons fire and you have a thought,
Speaker 1: it's an electrochemical process, and there's residual that is left behind,
Speaker 1: and these residuals can build up in your synapses and
Speaker 1: cause your synapses to not fire as well. And when
Speaker 1: your synapses don't fire as well, they start to die
Speaker 1: off in the neurons that are there that lead from
Speaker 1: these synapses or lead to these synapses die themselves, and
Speaker 1: you have neural loss. Like literally, the brain cells in
Speaker 1: your brain are dying off at a rapid rate. And
Speaker 1: when it's caused by beta proteins and TOW or beta
Speaker 1: amaloid plaques and TOW proteins in the cells, than what
Speaker 1: you have is Alzheimer's. Yeah, and they aren't sure the
Speaker 1: cause of Alzheimer's still UM. Genetics is uh. They think
Speaker 1: has a lot to do with it. UM. And you
Speaker 1: can live with Alzheimer's for a while up to a
Speaker 1: decade all they they sit in this article, Moley says
Speaker 1: three to five years is more common, so it definitely
Speaker 1: shortened your lifespan. And like you said, UM, genes are
Speaker 1: definitely part of the risk factors. UM. A polypo protein,
Speaker 1: a pop protein eka, I think, UM, which is weird.
Speaker 1: If you have a mutation on this gene, you have
Speaker 1: a higher risk of Alzheimer's, even though the gene just
Speaker 1: codes for a protein that carries cholesterol through your bloodstream. Yeah,
Speaker 1: it doesn't have anything to do with the tow protein
Speaker 1: tangles or anything like that as far as I know.
Speaker 1: That's weird. Um. Also, if you have a family history
Speaker 1: of dementia you're you have of Alzheimer's, you have a
Speaker 1: higher likelihood UM. And then if you have down syndrome,
Speaker 1: you are at a higher risk of developing Alzheimer's in
Speaker 1: middle age. Interesting. So UM, that's and we will do
Speaker 1: one in Alzheimer's. But that's how Alzheimer's can cause dementia. Uh,
Speaker 1: there's also vascular dementia, which is that was the case
Speaker 1: with my grandfather who he had a stroke, and it
Speaker 1: accounts for about twenty of dementia cases. And uh, you know,
Speaker 1: stroke is when you have a loss of blood supply
Speaker 1: to the to the brain or a hemorrhage and or
Speaker 1: blood clot and it can be either um, one big
Speaker 1: stroke event which causes a lot of damage and that's
Speaker 1: a single in farct dementia, or it can be a
Speaker 1: lot of the accumulation of symptoms because of a lot
Speaker 1: of little many strokes you have over the years, and
Speaker 1: then the damage just builds up and you finally once
Speaker 1: once that last one, that that is the straw that
Speaker 1: breaks the camel's back. Yeah, and you have dementia. Um,
Speaker 1: that happens pretty rapidly after that last that last one,
Speaker 1: that last stroke you had. Yeah, and that's a multi
Speaker 1: infarc when it's a bunch of them. Um, and little
Speaker 1: mini strokes are common a lot. Sometimes you have them
Speaker 1: and don't even realize you've had him. Uh. With my grandfather,
Speaker 1: he he had the big one. And yeah, we talked
Speaker 1: about this before and I think something about speech, but um, yeah,
Speaker 1: he lost his ability to speak you know English. Uh,
Speaker 1: so that would be a phasia. Yes, he couldn't produce language. Well,
Speaker 1: he produced Yes, he cannot produce language. He said things,
Speaker 1: but it you know, it didn't make any sense, but
Speaker 1: he had an understanding. You could see the frustration. Uh,
Speaker 1: you know, I know how to how I'm supposed to. Uh,
Speaker 1: my grandmother is driving us, let's say, and he she
Speaker 1: doesn't know how to get there. He does and he
Speaker 1: can't tell her, but he's telling her. Yeah, it's just
Speaker 1: coming out all mixed up. And that's that's a hallmark
Speaker 1: of dementia, is um. There's emotional changes in the person
Speaker 1: because they they're not communicating like they want to say,
Speaker 1: people aren't responding like they want the people to, and
Speaker 1: they'll get snippy and then ultimately say withdrawal. They'll just
Speaker 1: give up on communicating at all because it's too frustrating
Speaker 1: or just too sad, you know, um, which is it's
Speaker 1: one of the common results of dementia. It's a comorbidity.
Speaker 1: Now it's a complication. Yeah. And then and with the
Speaker 1: single stroke event um or actually or with the multi
Speaker 1: uh strokes, it's different for everyone. There isn't any single
Speaker 1: like well, this is going to happen because this person
Speaker 1: had a stroke. It could be a variety of different
Speaker 1: things from you know, paralysis on one side of the
Speaker 1: face or body bow and bladder control problems. He didn't
Speaker 1: have any of those. He looked totally the same physically,
Speaker 1: He walked and talked this same except for the fact
Speaker 1: that they weren't real words. That was like the most
Speaker 1: noticeable thing. I remember you telling me about your grandfather before.
Speaker 1: I don't remember what it was a long time. We
Speaker 1: were talking about speech, like we're Nikki's area or Broca's area, Yeah,
Speaker 1: something like that. So with Alzheimer's, it first attacks the hippocampus,
Speaker 1: which means that it's going to take away your um
Speaker 1: episodic memory, which is your memory of recent events, right. Uh.
Speaker 1: And then it starts to move its way into other
Speaker 1: areas of the brain where your judgment is affected, your
Speaker 1: speech patterns are going to be affected, your personality is
Speaker 1: very much affected in changes with Alzheimer's. With Alzheimer's, but
Speaker 1: not as much with the stroke. Yeah, with vascular dementia,
Speaker 1: you know, there might be some other things um where
Speaker 1: like part of the faces sagging, or or the patient
Speaker 1: can't move their arm or something like that. But yeah,
Speaker 1: the personality will remain intact because those regions of the
Speaker 1: brain aren't affected like they are in Alzheimer's. And then
Speaker 1: in about five of dementia cases, Uh, it stems from
Speaker 1: something called Louis body dementia UM, which we were just
Speaker 1: talking about. They think Robin Williams might have suffered from
Speaker 1: He definitely did. He definitely did. They found in his
Speaker 1: autopsy he had. I think he was diagnosed with it
Speaker 1: before he died. That was one of the reasons why
Speaker 1: he took his life. Yeah, because that can cause severe
Speaker 1: intense hallucinations. Uh, big time. Did you look those up? Oh? Yeah,
Speaker 1: many scary stuff like very apparently a typical one is
Speaker 1: very brightly colored animal or person. Yeah, that you see
Speaker 1: in great detail for many minutes on daily daily basis,
Speaker 1: Like just intense hallucinations. I'm sure you think you're you know,
Speaker 1: losing it, right. And that's one of the first symptoms
Speaker 1: of a Louis body dementia. And it was discovered by
Speaker 1: Frederick Louis and nineteen twelve and has has nothing to
Speaker 1: do with your body. A Louis body is Uh, there
Speaker 1: are are deposits again, protein deposits of the alpha uh
Speaker 1: sinucleon that appear on the brain. So don't think of
Speaker 1: body in the terms of like your physical body. Uh.
Speaker 1: And this is also president Louis bodies and Parkinson's. So
Speaker 1: as a result, not only are you going to have
Speaker 1: some them similar to Alzheimer's with Louis body dementia, but
Speaker 1: also some of the tremors and balance issues of Parkinson's,
Speaker 1: which is uh, super sad as well. Is that what
Speaker 1: Michael J. Fox, Yes, Parkinson's. Yeah, and that's what the
Speaker 1: movie Awakenings was about. When they wasn't it like a
Speaker 1: group of Parkinson's patients that like L. Dobo worked on,
Speaker 1: is that Parkinson's I can't remember. I think they didn't.
Speaker 1: They didn't realize what they thought they were locked in
Speaker 1: or something, and then realized their Parkinson's trummers were so
Speaker 1: acute that they were like they were not even shaking,
Speaker 1: they were just yeah, interesting, They're just their muscles were
Speaker 1: totally contracted rather than contracting and relaxing again and again.
Speaker 1: And Robert Williams, Yeah, how about that? Yeah. Uh. Then
Speaker 1: we have something that used to be well it's called
Speaker 1: now front o temporal dementia, used to be called picks disease,
Speaker 1: but now Picks disease is a uh specific version which
Speaker 1: I couldn't really sus out what the difference is, could
Speaker 1: you know? I couldn't as long as it wasn't just me,
Speaker 1: I feel better. But f t D is it's really
Speaker 1: an umbrella term. Um. It's about five percent of dementia
Speaker 1: cases and it's going to affect personality and behavior and
Speaker 1: language time, big time. And it's where your frontal and
Speaker 1: temporal lobes are actually atrophying and shrinking, right, And the
Speaker 1: reason why is um. You remember, with Alzheimer's you have
Speaker 1: beta amyloid plaques and tow protein tangles. Well, with the
Speaker 1: frontal temporal dementia, you don't have the beta amaloid plaques.
Speaker 1: You just have the tow protein t angles. But it's
Speaker 1: enough to cause massive neuronal loss. Yeah, and this is
Speaker 1: like I think a lot of people at first think
Speaker 1: they might have UM tourette. Yeah, because you can yell
Speaker 1: things out inappropriate behaviors. Uh. Yeah, Like if your grandfather
Speaker 1: suddenly becomes hyper interested in sex and like likes to
Speaker 1: talk about it in public or exposes himself to people
Speaker 1: in public, there's a pretty good chance that he has
Speaker 1: developed front o temporal um dementia or if I did,
Speaker 1: because um, it's unusual in that it attacks younger people. Um,
Speaker 1: it's gonna on set between forty and seventy years old,
Speaker 1: which distinguishes it from other types of dementia. And if
Speaker 1: your grandfather used to do that stuff already, then that's
Speaker 1: not the case. The key here is that like this
Speaker 1: has come out of the blue, somebody has really just
Speaker 1: completely changed in their personality. They might get into really
Speaker 1: risky behavior like gambling all of a sudden, shop lifting,
Speaker 1: and like risky investments are like pulling all their money
Speaker 1: out of the bank and with picks disease too. Um,
Speaker 1: the apparently apathy is a big indicator of this. There's
Speaker 1: a big personality change and the person is no longer
Speaker 1: they have no empathy, they have blunted emotions, and then
Speaker 1: they may also be engaging in risky behavior. So basically,
Speaker 1: your grandpa or your grandma has just turned into like
Speaker 1: the trans border you know, or me or you, well, yeah,
Speaker 1: you lack empathy. No no, no, I'm just saying it's
Speaker 1: because it affects you. Something turned into you. Oh no, no, no,
Speaker 1: you have blunted emotions and you gamble. Uh, there's also
Speaker 1: Huntington's disease. Uh. This is uh, it seems like much
Speaker 1: more physical in nature, uncontrollable movements, although there are changes
Speaker 1: in in personality. But um real fidgety, herky jerky. Uh.
Speaker 1: Your brain loses the ability to control coordination essentially, right,
Speaker 1: which is I think, uh fifty chance of inheriting the gene.
Speaker 1: But you can live with it for up to twenty years. Yeah,
Speaker 1: which seems like as far as dementiao is one of
Speaker 1: the longer life expectancies. But again, I mean, like I
Speaker 1: would guess this has kind of become clear. The hallmark
Speaker 1: of dementia is memory loss paired with some other problem
Speaker 1: like not being able to create speech any longer recognized speech,
Speaker 1: or not being able to move that kind of thing,
Speaker 1: or not being able to plan um. And like we said,
Speaker 1: well we should probably take a break. Huh. Yeah, we
Speaker 1: got a couple of more types that we'll talk about
Speaker 1: and then some other good stuff. Okay, right after this,
Speaker 1: the last two, actually the last three we're gonna talk
Speaker 1: about because there are many, many other kinds of dementia.
Speaker 1: Like we could spend hours and hours talking about all
Speaker 1: the different kinds hours, but we have talked about kreitz
Speaker 1: Felt yakup disease, and I can't remember which one. And
Speaker 1: is there a disease that kills by preventing sleep? Oh?
Speaker 1: Is that the one which we should have rightly called
Speaker 1: how prion diseases worked? Yeah, because it is is a
Speaker 1: prion infection. It's very rare, about one um out of
Speaker 1: a million people will be affected in any given year,
Speaker 1: like mad cow disease. Yeah, exactly. Um, it's a sponge
Speaker 1: of form disease. So crazy it is. It's very interesting.
Speaker 1: It could be genetic. Um. But and I thought we
Speaker 1: also talked about it an organ transplant. We I think so,
Speaker 1: because it can occur because of infected tissue that you
Speaker 1: are implanted with or from an organ. Yeah. And this
Speaker 1: is neuronal loss due to the like holes literally being
Speaker 1: eaten into your brain by this disease. Yeah. Um. And
Speaker 1: then you can also get dementia UM from from when
Speaker 1: you have HIV. If you are a boxer or say
Speaker 1: a football player in the NFL, you may have dementia
Speaker 1: from a traumatic brain injury, a concussion or repeated concussions. Um.
Speaker 1: And there are plenty of diseases. There's also um reversible
Speaker 1: dementia too. If you have a vitamin deficiency, if you
Speaker 1: um uh take certain medications, um, you can develop dementia.
Speaker 1: But this is reversible for the most part. Though age
Speaker 1: associated dementia is not reversible. And like we said, it's
Speaker 1: kind of tricky to diagnose this stuff because it is
Speaker 1: normal for people to become more forgetful as you age,
Speaker 1: and then to make it even more confounding if you're
Speaker 1: a diagnostician, not only are do people get more forgetful.
Speaker 1: There's an intermediate stage between dementia, a dementia diagnosis, and
Speaker 1: just normal age related forgetfulness, and that is um called
Speaker 1: mild cognitive impairment. So if you can catch this from
Speaker 1: what I understand, and we'll talk about treat and said
Speaker 1: everything later. But if you can catch things like Alzheimer's
Speaker 1: and other um other diseases that lead to dementia early,
Speaker 1: although there's no cure for any of them, you can
Speaker 1: you can manage them a lot better and delay say
Speaker 1: death or like the real devastation associated with it by
Speaker 1: a significant amount of time. But it's catching is the
Speaker 1: tricky part. And especially if you have dementia, you don't
Speaker 1: really realize that there's any kind of problem. Um, So
Speaker 1: you're probably not going to take yourself to the doctor. No,
Speaker 1: but you what you should do is listen to your
Speaker 1: loved ones because they are going to be looking at
Speaker 1: you a little more closely uh than you can. You
Speaker 1: know that that they're more perspective. Yeah, exactly, that's what
Speaker 1: you're looking for. Um, So don't get you know, don't
Speaker 1: get offended if if a loved one says, let's go
Speaker 1: get you checked out, because you can do something if
Speaker 1: you catch it early on. Unless you're very wealthy and
Speaker 1: it's you're no good nephew that you've never trusted anyone,
Speaker 1: you know, then maybe bring a lawyer in on it. Uh.
Speaker 1: So if you do go get checked out. Um, from
Speaker 1: the second you walk in the door, your doctor is
Speaker 1: gonna be eyeball on you and looking for any signs,
Speaker 1: um just from their their trained eye, like you know,
Speaker 1: from how you walk to the way you answer questions,
Speaker 1: to how they interact with you. Uh, they want to
Speaker 1: know you're They're gonna have to know your history, um
Speaker 1: because they need to have some context to compare it to. Right,
Speaker 1: like were you always a compulsive gambler? Is just like
Speaker 1: new behavior yeah, and it helps to bring you know
Speaker 1: if if um, if you're older, maybe bring your grown
Speaker 1: son or daughter with you or whoever has a lot
Speaker 1: of contact, although your spouse you never know what, I
Speaker 1: don't know, maybe trying to get ready you. Oh yeah
Speaker 1: like that, No good, nephew, Yeah exactly. Um, I'm just kidding,
Speaker 1: of course, although I'm sure that happens. Then there are
Speaker 1: a couple of tests that they usually do in conjunction
Speaker 1: with one another, um, the Mini Mental State Examination the
Speaker 1: m m s E UM just a lot of basic
Speaker 1: questions there um for mental tasks, but they're coded. The
Speaker 1: tasks are yeah, and they're scored individually. Yeah. Um. And
Speaker 1: when you when you M say question three, this person
Speaker 1: got an eid on, you can go over and be like, yeah, dementia.
Speaker 1: It's actually pretty effective actually. And there's another test that
Speaker 1: ties into the mm SC that um. There they both
Speaker 1: indicate one another, which apparently they're both really good at
Speaker 1: indicating dementia. But there's other tests called the clock drawing test.
Speaker 1: Did you look this thing up? Yeah? I thought that's
Speaker 1: pretty fascinating. It really is. It seems really like, why
Speaker 1: would someone tell someone to draw a clock at a
Speaker 1: certain time of the day. Yeah. Usually they say draw
Speaker 1: a clock showing that it's ten after eleven. And it
Speaker 1: makes a lot of sense in a lot of way
Speaker 1: because it draws on all these different kinds or different
Speaker 1: regions of the brain, different um skills. Right, So, like,
Speaker 1: first of all, you have to remember what a clock
Speaker 1: is and what it signifies. That's a big one. What
Speaker 1: it looks like. Uh, yeah, as clock isn't made of
Speaker 1: like squiggly lines or anything like that. Um, you have
Speaker 1: to remember how a clock is laid out, the order
Speaker 1: that the numbers go in that it doesn't keep going
Speaker 1: after twelve to thirteen, fourteen, fifteen. And then once you
Speaker 1: got all this, you have to show the hands showing
Speaker 1: that it's ten after eleven. So the hands won't be
Speaker 1: pointing at ten and eleven, it should be uh, the
Speaker 1: longer hand should be pointing at the two, and the
Speaker 1: shorter hand should be just past the eleven. Right. This
Speaker 1: requires a tremendous amount of brain power, even though it's
Speaker 1: very simple and straightforward, and you can tell a lot
Speaker 1: about a person's mental faculties just by having them draw this. Yeah,
Speaker 1: the four specific things that requires their verbal understanding memory
Speaker 1: spatially coded knowledge and constructive skills, and if any of
Speaker 1: those are off in conjunction with the MMS, then they're
Speaker 1: gonna have a pretty good idea where you fall on
Speaker 1: the dementia scale. If you don't have the constructive skills
Speaker 1: to pay the bills, you may have dementia. That's right.
Speaker 1: And they actually, um, I looked at one study about
Speaker 1: the clock drawing tests. Basically I think it was just
Speaker 1: a more recent like, hey, let's go in and really
Speaker 1: look at this thing again and it checks out. Yeah.
Speaker 1: They stood behind and said, yeah, it's actually a really
Speaker 1: good indicator. Yeah, like it really holds up. And they
Speaker 1: think they developed it in the sixties, but it didn't
Speaker 1: take off until the eighties. And then they do you know,
Speaker 1: but it's something you can do anywhere. And now they're
Speaker 1: starting to gather these um different clocks that people with
Speaker 1: different types of dementia drawing and basically compiling them into
Speaker 1: a database so you know what to look for. Even
Speaker 1: more like, oh, somebody draws a clock that has like
Speaker 1: a thirteen fourteen on it, they may have this type
Speaker 1: of dimension, right, and this one looks like Sabod or
Speaker 1: Dali drew it. Uh, then they might have this kind
Speaker 1: of dementia, or they might just be super talented creative.
Speaker 1: You never know. Um, all right, let's uh should we
Speaker 1: take another break? Why not? Is it time? Sure? All right,
Speaker 1: we'll be back after this talk about treatment and some
Speaker 1: of the other pitfalls of dementia. So Chuck, we've kind
Speaker 1: of um, I think it's almost goes without saying, like
Speaker 1: the problems associated with with dementia, like you lose your
Speaker 1: ability to um reason in a lot of cases, you
Speaker 1: lose your ability to to move and take care of yourself.
Speaker 1: You lose your memories, you have trouble forming new memories,
Speaker 1: you have trouble recognizing people. Um. So living life is
Speaker 1: extremely difficult. Um. But there's also like other complications that
Speaker 1: you may or may not think of. Right. So, let's
Speaker 1: say you're an elderly person and you have a battery
Speaker 1: of medications that you need to take for unrelated heart disease.
Speaker 1: Do you think you're going to remember to take those medications?
Speaker 1: Probably not. Even if you have like a time or
Speaker 1: set or some sort of calendar or something like that,
Speaker 1: you may have trouble even remembering that you have a
Speaker 1: calendar that you need to go check out to see
Speaker 1: what's on there. Let alone to take the medication that's
Speaker 1: indicated that's on that calendar. Yeah, that's a big problem. Uh,
Speaker 1: nutrition itself is a big problem. Either you forget to
Speaker 1: eat altogether, or you think you've already eaten, or you
Speaker 1: physically have deteriorated so that you can't control the muscles,
Speaker 1: the true and to chew and swallow. A good joke.
Speaker 1: It's a real danger. So when people die from Alzheimer's
Speaker 1: it sounds kind of strange if you think about it.
Speaker 1: It's like, well, no, they forgot they lost their memory
Speaker 1: or whatever. No, the brain is actually being slowly destroyed
Speaker 1: period aodically, and eventually it's going to reach the parts
Speaker 1: of the brain where like you can't swallow any longer.
Speaker 1: Then you die from that kind of thing. Um, you
Speaker 1: also can lose your sense of hunger, like you just
Speaker 1: aren't hungry anymore. Kind of tough to eat, especially when
Speaker 1: you're not thinking or remembering that you should eat, um,
Speaker 1: when you're just not hungry. Ever. Yeah, this to one. Hygiene.
Speaker 1: Reduced hygiene is a big one. UM. A lot of
Speaker 1: times in severe dementia cases, you either are unable to
Speaker 1: bathe and dress yourself and brush your teeth or you
Speaker 1: forget to. Uh, it just falls by the wayside um.
Speaker 1: I know that was the case with my grandmother. She needed,
Speaker 1: you know, she needed to be bathed by my dad
Speaker 1: because she lost interest in it or because she just
Speaker 1: couldn't do it anymore. Uh, I think both. Yeah, yeah, um,
Speaker 1: that's another indicator. You said that when you go in
Speaker 1: for a diagnosis, the doctor is going to be watching
Speaker 1: you and just kind of sizing you up. One of
Speaker 1: the things you'll look for is whether you look disheveled.
Speaker 1: That's a big one. And especially if your son or
Speaker 1: daughter is saying, like, this is really bizarre behavior because
Speaker 1: mom always like dressed to the nines. She just wears
Speaker 1: this dirty old bathrobe all the time and doesn't ever
Speaker 1: want to take a shower. That's that's usually an indicator
Speaker 1: of dementia. Yeah, it's not like she just gave up
Speaker 1: and doesn't care anymore. It's it's part of the symptoms. Hold. Although,
Speaker 1: another problem with dementia, and one of the confounding factors,
Speaker 1: is that depression can be a byproduct or come morbidity
Speaker 1: of dementia because you recognize that your life is changing
Speaker 1: in ways that you're not happy about you can't communicate anymore,
Speaker 1: you forget stuff all the time. You can become depressed. Um.
Speaker 1: So then that could lead to you giving up on
Speaker 1: taking showers and dressing as well. Yeah. And not only depressed,
Speaker 1: but um agitated and aggressive um riddle with anxiety. A
Speaker 1: lot of your emotional well being and emotional health will
Speaker 1: be uh slipping away from you. Yeah. And again this
Speaker 1: can be a direct result of chemical changes in your
Speaker 1: brain due to dementia, or it can be like your
Speaker 1: this is the result of you recognizing these changes and
Speaker 1: and just be coming upset about them. We talked about communication, UM,
Speaker 1: and the hallucinations. You're gonna have trouble sleeping as well
Speaker 1: in a lot of cases. Uh. And then personal safety UM.
Speaker 1: A lot of people die every day because of accidents
Speaker 1: that happened as a result of dementia, people who shouldn't
Speaker 1: be driving it into cars. Um. And there's this there's
Speaker 1: a push that's going on now, I think in the
Speaker 1: last year or so UM as part of the Council
Speaker 1: on Aging, like the United States Council and Aging, there's
Speaker 1: a new initiative called the Dementia Friendly America Initiative. Really
Speaker 1: neat Yeah, it's basically saying, look, we've got about one
Speaker 1: in eight people over sixty five and the US have dementia.
Speaker 1: We're about to have way more than that in the
Speaker 1: next couple of decades. We need to be prepared for
Speaker 1: this kind of thing. So let's start training America how
Speaker 1: to recognize the signs of dementia and then how to
Speaker 1: react to it in a friendly and helpful manner so
Speaker 1: that people who are wandering around with dementia don't withdraw
Speaker 1: eighty thousand dollars from their bank account and and walk
Speaker 1: around with it in their pockets outside. Yeah, and how
Speaker 1: do you do that? You you get some money uh
Speaker 1: from the government as a grant to go out and
Speaker 1: hire people to literally go to businesses and go to
Speaker 1: restaurants and talk to waiters and waitresses or should I
Speaker 1: just say waitron's uh. Go to banks and talk to tellers,
Speaker 1: go to uh anywhere where there's interaction with another human,
Speaker 1: grocery store checkout people, and literally train them on, like
Speaker 1: you said, how to recognize it and how to kindly
Speaker 1: deal with these people, right exactly. Um. Apparently one of
Speaker 1: the things you teach people in service industries is not
Speaker 1: take it personally. That if somebody's behaving around clear or
Speaker 1: they're using incorrect words, and they're of a certain age,
Speaker 1: the chances are they probably have dementia. And there's ways
Speaker 1: of dealing with it. Um. Apparently, responding to it in
Speaker 1: a soft, friendly manner tends to get results from the
Speaker 1: dementia patient. Um, especially if you are not being an
Speaker 1: aggressive jerking right exactly. It just being nice will will
Speaker 1: frequently get good results. Um. And Yeah, it is a
Speaker 1: pretty neat initiative absolute um and and necessary. Yeah, you know,
Speaker 1: but it's it's I'm stricken by the idea that people
Speaker 1: are planning out this far ahead for this kind of thing.
Speaker 1: It's exceptional, it is and scary. Uh So if you
Speaker 1: do have a family member, one thing that's I'm important
Speaker 1: to remember. There's something called the caregiver burden that my
Speaker 1: dad and his wife definitely experienced. It is really really
Speaker 1: on you, on your family. Uh and it can actually
Speaker 1: take a physical toll. Um. They have some stats here
Speaker 1: if you your risk of death as a woman if
Speaker 1: your husband has dementia increases in the first year after
Speaker 1: they're diagnosed, and only for a husband whose wife is diagnosed.
Speaker 1: Um and then a little pretty significant inco just from
Speaker 1: the dementia diagnosis. Yeah, and um, what they recommend in
Speaker 1: this article is to take care of yourself first, because
Speaker 1: they found that if you are not going into this
Speaker 1: with the right attitude and you are upset or have anxiety,
Speaker 1: you're just gonna do more harm anyway. So get yourself right,
Speaker 1: take care of yourself, and go into it in the
Speaker 1: right frame of mind, and you'll actually be able to
Speaker 1: help better. Yeah, and this, this caregiver burden or caregiver
Speaker 1: burnout is a very real thing physically too. Like you,
Speaker 1: um have low energy, you'r you have low productivity, You
Speaker 1: become snippy, resentful, angry, and you can end up basically
Speaker 1: mistreating your own parents or spouse because you're so upset
Speaker 1: with this horrific disease. One of the hallmarks of dementia
Speaker 1: is that that that there's no two days that are alike,
Speaker 1: and when you're dealing with the dementia patient, what worked
Speaker 1: yesterday isn't gonna necessarily work today. Well, if you can
Speaker 1: no longer predict what your life is going to be
Speaker 1: like from day to day and you're spending I think
Speaker 1: I saw this one study that found an average of
Speaker 1: twenty two hours a week of unpaid care by spouses, wives, daughters,
Speaker 1: that kind of thing. Um, your you can very easily
Speaker 1: get stressed out. The main thing you have to do
Speaker 1: is ask for a respect care. Like. You can't do
Speaker 1: it by yourself. You have to have other family members,
Speaker 1: members of your church, your community come and give you
Speaker 1: a break so you can go do other stuff for
Speaker 1: a while. Absolutely, And I mean you could totally see
Speaker 1: how you could just very easily evolve a really unhealthy
Speaker 1: dynamic if you're just trying to do it yourself. Because
Speaker 1: you lose perspective. This becomes your norm, even though it's
Speaker 1: totally abnormal. Yeah, and boy you talk about it's a
Speaker 1: really sad way to damage what previously was a good
Speaker 1: relationship with a parent or something. It is devastating, you know. Um.
Speaker 1: So there are drugs that they use to help stave
Speaker 1: off dementia. Um, mainly right now. They are colon estras inhibitors,
Speaker 1: uh and they suppress colonestras, which is an enzyme that
Speaker 1: breaks down uh uh cta CEO lathing which we talked
Speaker 1: about before. That's what helps transmit messages between neurons. So
Speaker 1: that will help. Yeah, because if you're not commu indicating
Speaker 1: as much as you were before. At least the communication
Speaker 1: that is going on can stick around longer. You know.
Speaker 1: It's seems primitive as far as like brain drugs go,
Speaker 1: but it makes sense, you know. Yeah. And then there's
Speaker 1: another one. Are they still using this believes momanten uh,
Speaker 1: And it inhibitates inhibits glutamate, which we talked about before,
Speaker 1: which causes neuron death when over stimulated. Yeah. I can't
Speaker 1: remember where we talked about that one either. I just
Speaker 1: remember glutamate from the Umami episode. Yeah, I was definitely
Speaker 1: that one. Um. And then there's also stuff you can
Speaker 1: so these drugs will help some. That's for non vascular dementia, right.
Speaker 1: With with vascular dementia, you're gonna want to take blood thinners, yeah,
Speaker 1: to keep more strokes from coming along and making the
Speaker 1: whole thing worse. Um. And then with like Louis body disease,
Speaker 1: to deal with things like the hallucinations and stuff, you'll
Speaker 1: probably also be given anti psychotics as well. Um. And
Speaker 1: one thing that they're starting to realize more and more,
Speaker 1: it's very difficult to really figure out what kind of
Speaker 1: dementia people have just from um uh, what's the scan. Yeah,
Speaker 1: MRI I scan UM, and you can really go back
Speaker 1: and accurately identify types of UM dementia from autopsies, right,
Speaker 1: And so for more and more autosies, they're finding that
Speaker 1: there's a lot of what's called mixed dementia, where you
Speaker 1: have Alzheimer's and vascular dementia, or where you have Alzheimer's
Speaker 1: and Louis Bodies disease UM. And so it can be
Speaker 1: really tough to suss out all the different kinds of
Speaker 1: dementia person might have. But if you can do that,
Speaker 1: then you can you can put them on a drug
Speaker 1: regimen that could really kind of help more than just
Speaker 1: treating the Alzheimer's and letting the Louis body go unrecognized
Speaker 1: and rampant or unchecked. There's also preventative stuff you can
Speaker 1: do too. Oh yeah, yeah, like what cross or puzzles. Yeah,
Speaker 1: I told you. Emily's grandmother, Mary is ninety five and
Speaker 1: very sharp. Uh, and she does word puzzles all the
Speaker 1: live long day and uh this is sodoku. Yeah, she does.
Speaker 1: She does all kinds of word puzzles. Yeah, things that
Speaker 1: I have never even heard of. It supposedly that helps
Speaker 1: stave it off apparently, Um, this one's great. Alcohol. Moderate
Speaker 1: alcohol consumption, which is two a day or for men
Speaker 1: or one a day for women. Okay, Uh, has a
Speaker 1: protective effect. It staves off all stays off dementia. They're
Speaker 1: not sure why, they're not sure what kind of alcohol
Speaker 1: is the best. They just know that for some reason,
Speaker 1: alcohol has a protective effect. Uh. Probably up to that
Speaker 1: to drinks, and then it's probably bad after that. Then
Speaker 1: it becomes very bad after that. So you want to
Speaker 1: just moderate amount, right in all things, people, moderation, moderation. Uh.
Speaker 1: And then uh, there are some things that you can do.
Speaker 1: Here's the thing. There's a a debate on whether or not, um,
Speaker 1: you're tricking your loved one by doing things like, um,
Speaker 1: giving them an appliance that doesn't work, so they can
Speaker 1: pretend that they're ironing or something because they used to
Speaker 1: love to take care of their laundry themselves. So here,
Speaker 1: let me remove the cord from this iron. And uh.
Speaker 1: And is that tricking someone? Is it not? Uh? And
Speaker 1: a lot of people think, no, that's what you should
Speaker 1: do because it makes them feel like they're being useful.
Speaker 1: They're not gonna get hurt with a hot iron. So
Speaker 1: it's all good. Other people say no, that means that
Speaker 1: they're not hanging onto that last bit of reality they
Speaker 1: may have. I think it's fine. I think it's fine too.
Speaker 1: And there's actually, um, there's a an entire village set
Speaker 1: up in I think like just outside of Amsterdam. Yeah,
Speaker 1: this is awesome, right, Yeah, how would you say that?
Speaker 1: I have because Dutch is the weirdest, the weirdest language,
Speaker 1: we'll say that, okay, Um, And uh, it's a it
Speaker 1: is a it's an what's called the Dementia village. Basically
Speaker 1: where everyone who lives in this village, I think a
Speaker 1: hundred and fifty people all have dementia and they live
Speaker 1: in group houses there. Well there's caretakers that live there too,
Speaker 1: but okay, yes, you're right, um, And they live in
Speaker 1: the group houses with them, and a lot of the
Speaker 1: people realize that this is their nurse or just think
Speaker 1: it's a good friend of theirs. They don't really remember
Speaker 1: where when they became friends. Yeah, exactly. Um. And the
Speaker 1: houses they live in have different themes according to how
Speaker 1: the people lived, depending on whether they are blue collar,
Speaker 1: whether they their memories go back to the seventies. This
Speaker 1: whole place is basically set up so that it's a very, um,
Speaker 1: non threatening safe place because people just kind of live
Speaker 1: and um move about within safely. Yeah, safely. Um. And
Speaker 1: so they can go to the grocery store, they can
Speaker 1: go to the movies, they can go ride a bike,
Speaker 1: and everyone, the people at the movie theater, I know
Speaker 1: that the people there have dementia, right like every They're
Speaker 1: real movie theater workers and reil waiters in the restaurant
Speaker 1: especially trained exactly. So it's a less clinical setting than
Speaker 1: say a nursing home. And a lot of people say
Speaker 1: this is awesome because it's as close to real normal
Speaker 1: life that they were used to as they're gonna get.
Speaker 1: Yeah exactly. Uh. Then of course there's other people that
Speaker 1: poople would say, no, you're tricking these people. But but
Speaker 1: you can say, hey, okay, here's here's the big difference
Speaker 1: with this place. If this if this dementia patient gets
Speaker 1: lost in Manhattan and they run across the city worker
Speaker 1: who's collecting garbage, that city worker may do absolutely nothing
Speaker 1: to help them. In Hovey Village, that city worker especially
Speaker 1: trained to get that person back to their house or
Speaker 1: alert their caretaker that this person is having a crisis.
Speaker 1: Or something like that. That's what we're trying to train
Speaker 1: people to do in the future. Yes, they've just isolated
Speaker 1: it to a community. Yeah, so there's I mean, when
Speaker 1: you break it down to that distinction, I don't really
Speaker 1: see anything wrong with it, especially when you are protecting
Speaker 1: the patients themselves. It's not like you're doing it to
Speaker 1: experiment on them, you know, or because they'll they'll produce
Speaker 1: gold in their urine or something like that. You know,
Speaker 1: like this is strictly for their protection, but also allowing
Speaker 1: them to to live a free life outside of a
Speaker 1: clinical setting. I don't see much wrong with that. I
Speaker 1: do get what the bioethicists are saying, like, yes, you're
Speaker 1: robbing someone of their dignity by lying to them, by
Speaker 1: deluding them, or playing into their fantasies. Strictly speaking, Yes,
Speaker 1: in the real practical world, I think this is great.
Speaker 1: If I'm at that point, then play into my fantasy exactly. Um,
Speaker 1: it is not four all the time. Uh. In fact,
Speaker 1: one of the people that work there say that people
Speaker 1: that do criticize it at a very good point. He's like,
Speaker 1: they don't understand what we're doing here. These aren't actors,
Speaker 1: they're like real employees of these places. They're just helping out,
Speaker 1: you know, And so jog Ve Village. I hope I'm
Speaker 1: staying that right because I'm really putting myself out there. Oh,
Speaker 1: I'm sure you're not. It's become this kind of ideal
Speaker 1: standard of care, but it's also really expensive. So in
Speaker 1: a country where there's a lot of socialized medicine, it
Speaker 1: could do pretty well, like in the Netherlands or in Canada,
Speaker 1: when they take care of people even though they don't
Speaker 1: have money, right exactly. There's there's one called UM in Canada.
Speaker 1: It's called UM Pentanginguish pentanguishin Ontario they have one. It's
Speaker 1: a little smaller than the one in in Amsterdam. They're
Speaker 1: also building one in Miami as well. So it is
Speaker 1: starting to take hold. People do believe in it, and
Speaker 1: apparently the patients families are very happy with this kind
Speaker 1: of thing too well. And hopefully with the initiative of
Speaker 1: what's it called America d f A. Uh yeah, hopefully
Speaker 1: with those efforts, UM, more and more people will because
Speaker 1: it's coming. Oh yeah, it's coming. A lot more folks
Speaker 1: are going to be out there that we need to
Speaker 1: take care of. Yeah, we don't know. How do you
Speaker 1: cure dementia? We just know it's coming. I'm gonna be
Speaker 1: one of them, do you think so? Sure at some
Speaker 1: point if I if I make it that long. But
Speaker 1: you know, not everybody gets dementia no matter how long
Speaker 1: you live. I don't know. I got a feeling really Yeah.
Speaker 1: It does run in my family a little bit. Yeah,
Speaker 1: and I have the my father's family genes more than
Speaker 1: my mother's. I feel like, uh so, if if I
Speaker 1: had my mother's jeans, they all died from heart attacks
Speaker 1: and strokes and heart disease. Young, not a lot of cancer, yeah,
Speaker 1: pretty young. Yeah. Um so if you make it past yeah,
Speaker 1: you you beat the heart stuff. Then the Bryant genes,
Speaker 1: the dimension, well we're all going down one, you know.
Speaker 1: Um Man, I thought it's something. Oh yeah, I wonder, Chuck,
Speaker 1: if like our specific like us, you and me specifically,
Speaker 1: creaming all this information in every week is actually beneficial,
Speaker 1: or if we're just setting ourselves up for massive cases
Speaker 1: of dementia because we're just pushing stuff in and getting
Speaker 1: it out, pushing a new stuff and getting it out,
Speaker 1: Like are we are we abusing our brains? Or are
Speaker 1: we exercising it. I question that. Sometimes I bet someone
Speaker 1: out there. I bet there's a neurologist who has a
Speaker 1: good gut instincts let us know. I want to know
Speaker 1: good news are bad? Okay, neurologists. There's gonna be a
Speaker 1: subject a line that just says neurologists, guys, you're screwed. Yeah,
Speaker 1: I have news. If you want to know more about dementia,
Speaker 1: you can type that word into your favorite search engine
Speaker 1: and it will bring up tons of information and great resources.
Speaker 1: You can also type it into the search part how
Speaker 1: stiff works and it'll bring up a great article. Since
Speaker 1: I said search parts, time for listener mail. I'm gonna
Speaker 1: call this one. Hecky Krasnall lives okay, although I don't
Speaker 1: think he is with us. Hey, guys, only just started
Speaker 1: recently listening to the show. It's been a fantastic way
Speaker 1: to pass time and learn something interesting. I'm a home
Speaker 1: taught high schooler, so every time I listen to an
Speaker 1: episode of your show, I get a history or science credit.
Speaker 1: How about that? That is pretty great. But as great
Speaker 1: as that is, that's not why I'm emailing. Actually have
Speaker 1: a fun fact for you guys from your Plato episode
Speaker 1: and once you mentioned Captain Kangaroo. Well, my great grandfather
Speaker 1: worked on that show. He produced the songs for it,
Speaker 1: as well as several several Christmas carols, including Frosty the
Speaker 1: Snowman and his biggest claim to fame, Rudolph the Red
Speaker 1: Nose Reindeer. That is awesome. I've always thought it was
Speaker 1: very funny that a Jewish guy was responsible for the
Speaker 1: popularity of Christmas carols. My family all still Jewish watches
Speaker 1: the Claimation Rudolph movie every year because of that, our
Speaker 1: own little taste of that irony. I don't want to
Speaker 1: tell you what to do, because I'm sure you have
Speaker 1: a lot of episodes on your plate already, But I'm
Speaker 1: just saying, Hecky Krasnaw was a pretty interesting person. Uh,
Speaker 1: there might just be enough material for an episode on him.
Speaker 1: Up to you. Thanks for helping with my school work.
Speaker 1: That is from Aiden in Maryland. Awesome. Thank you very much. Aiden.
Speaker 1: And when I say Hecky Krasnow lives, I mean lives
Speaker 1: on like Viva La Hecky. Yeah. Uh, if you want
Speaker 1: to tell us about someone interesting in your family, we
Speaker 1: love that kind of stuff. Also, if you're caring for
Speaker 1: them into patient we want to hear the highs and
Speaker 1: the lows of that. UM just kind of bring it
Speaker 1: on home for us, will you? You can tweet too,
Speaker 1: said s y esk podcast. You can join us on Facebook,
Speaker 1: dot com, slash stuff you Should Know. You can send
Speaker 1: us an email to Stuff Podcast at how stuff works
Speaker 1: dot com, and as always, joined us at our home
Speaker 1: on the web, Stuff you Should Know dot com. For
Speaker 1: more on this and thousands of other topics, is it
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