1
00:00:00,920 --> 00:00:03,760
Speaker 1: Welcome to the Tutor Dixon Podcast. Today, we are going

2
00:00:03,800 --> 00:00:06,720
Speaker 1: to be talking about a startling new study that was

3
00:00:06,880 --> 00:00:11,280
Speaker 1: just released showing the rising risk of dementia. It projects

4
00:00:11,280 --> 00:00:14,000
Speaker 1: the number of dementia cases in the US will double

5
00:00:14,160 --> 00:00:17,440
Speaker 1: by twenty sixty. I think this is probably a fear

6
00:00:17,560 --> 00:00:21,239
Speaker 1: of most Americans, is the idea that you forget who

7
00:00:21,280 --> 00:00:23,640
Speaker 1: you are, that you're not capable of functioning. I mean,

8
00:00:24,040 --> 00:00:27,400
Speaker 1: we've been watching, you know, people questioning even the leader

9
00:00:27,440 --> 00:00:30,200
Speaker 1: of the country right now, and I think mostly because

10
00:00:30,400 --> 00:00:32,840
Speaker 1: the idea is just very terrifying to have this happen.

11
00:00:33,720 --> 00:00:34,000
Speaker 2: Now.

12
00:00:34,120 --> 00:00:37,440
Speaker 1: More than one million Americans are predicted to develop this

13
00:00:37,560 --> 00:00:41,080
Speaker 1: condition every year. It's estimated that there will be twelve

14
00:00:41,120 --> 00:00:45,320
Speaker 1: million Americans living with dementia by twenty sixty. So today

15
00:00:45,440 --> 00:00:48,159
Speaker 1: I am joined by one of the leaders of the study,

16
00:00:48,360 --> 00:00:51,800
Speaker 1: doctor Joseph Korish, who is the founding director of the

17
00:00:51,840 --> 00:00:56,400
Speaker 1: Optimal Aging Institute at New York University's Grossman School of Medicine,

18
00:00:56,760 --> 00:01:01,120
Speaker 1: and Argent Mazurker. He is a cognitive neurologist and dementia

19
00:01:01,240 --> 00:01:05,360
Speaker 1: specialist and leads a laboratory for early Alzheimer's disease symptoms

20
00:01:05,400 --> 00:01:08,720
Speaker 1: at NYU. Thank you both for joining me, Thank you

21
00:01:08,760 --> 00:01:09,319
Speaker 1: for having us.

22
00:01:09,680 --> 00:01:09,880
Speaker 3: Yeah.

23
00:01:09,920 --> 00:01:13,560
Speaker 1: Absolutely, So, Like I said, I think that the majority

24
00:01:13,560 --> 00:01:16,319
Speaker 1: of Americans hear this, and it's one of those things

25
00:01:16,319 --> 00:01:19,520
Speaker 1: that you're scared of all of us. I think everybody

26
00:01:19,520 --> 00:01:23,240
Speaker 1: has experienced one grandparent or a parent that has gone

27
00:01:23,240 --> 00:01:26,520
Speaker 1: through something like this, and I think it's hard. It's

28
00:01:26,520 --> 00:01:29,479
Speaker 1: really hard to be the person watching, and it's very

29
00:01:29,520 --> 00:01:32,160
Speaker 1: hard to be the person going through it. I remember

30
00:01:32,200 --> 00:01:36,040
Speaker 1: with my own grandparents. My grandfather started to struggle with this,

31
00:01:36,200 --> 00:01:40,200
Speaker 1: and for my grandmother it was so challenging to see

32
00:01:40,280 --> 00:01:43,520
Speaker 1: that decline. So when we see a study like this,

33
00:01:43,520 --> 00:01:45,959
Speaker 1: this is sort of scary. Doctor Korush tell us about

34
00:01:46,000 --> 00:01:46,600
Speaker 1: it a little bit.

35
00:01:47,400 --> 00:01:50,280
Speaker 2: Yeah, So we thought it was important to take a

36
00:01:50,440 --> 00:01:54,680
Speaker 2: life long respective because, as you say, we all kind

37
00:01:54,680 --> 00:01:57,640
Speaker 2: of know that we're in a very long game for this.

38
00:01:58,360 --> 00:02:00,440
Speaker 2: So we had the advantage of having a study that

39
00:02:00,520 --> 00:02:05,080
Speaker 2: followed fifteen thousand people since nineteen eighties, so for four decades.

40
00:02:05,440 --> 00:02:08,160
Speaker 2: We had the advantage that the study really went rigorously

41
00:02:08,200 --> 00:02:11,280
Speaker 2: and determining who got dementia, and we can talk about that.

42
00:02:12,000 --> 00:02:14,400
Speaker 2: And we asked the question for someone like myself or

43
00:02:14,440 --> 00:02:17,760
Speaker 2: someone who starts out at age fifty five over my lifetime,

44
00:02:18,520 --> 00:02:21,760
Speaker 2: will I reach dementia before I die? Or will I

45
00:02:21,840 --> 00:02:25,160
Speaker 2: die before I reach dementia? Right, only two options if

46
00:02:25,200 --> 00:02:28,560
Speaker 2: you go forever. And we found out that the old

47
00:02:28,800 --> 00:02:33,480
Speaker 2: estimates were off, and our estimates are that forty two

48
00:02:33,480 --> 00:02:37,600
Speaker 2: percent of us will reach dementia before that. Now, before

49
00:02:37,639 --> 00:02:41,040
Speaker 2: we all panic, I think it's very important that by

50
00:02:41,080 --> 00:02:44,280
Speaker 2: the age of seventy five this number is only four percent,

51
00:02:44,840 --> 00:02:47,080
Speaker 2: still a scary four percent, and we can talk about

52
00:02:47,080 --> 00:02:50,120
Speaker 2: who's at higher risk. By the age of eighty five,

53
00:02:50,240 --> 00:02:52,519
Speaker 2: it goes up to twenty percent, and as you say,

54
00:02:52,520 --> 00:02:54,840
Speaker 2: we know quite a few people who get dementia by

55
00:02:54,880 --> 00:02:57,480
Speaker 2: that eighty But then the part that's important is when

56
00:02:57,520 --> 00:02:59,840
Speaker 2: you go beyond eighty five. When we went to age

57
00:03:00,080 --> 00:03:03,320
Speaker 2: ninety five, that's more than half the risk, and that's

58
00:03:03,360 --> 00:03:06,160
Speaker 2: when things really pile up. And we can talk about

59
00:03:06,160 --> 00:03:08,320
Speaker 2: the idea of what do you do for prevention early,

60
00:03:08,480 --> 00:03:10,560
Speaker 2: what do you do for prevention medium, what do you

61
00:03:10,600 --> 00:03:13,720
Speaker 2: do for management later? And most people can still stay

62
00:03:13,720 --> 00:03:16,720
Speaker 2: at home. As doctor Mzerker, we'll talk about various options

63
00:03:16,760 --> 00:03:17,840
Speaker 2: and collaboration.

64
00:03:18,200 --> 00:03:21,560
Speaker 1: When I see fifty five being like that point where

65
00:03:21,560 --> 00:03:24,320
Speaker 1: you start to see it that is a few years away,

66
00:03:24,480 --> 00:03:27,200
Speaker 1: and that is very scary to me. So what are

67
00:03:27,240 --> 00:03:28,960
Speaker 1: the I mean, how do you even know that this

68
00:03:29,040 --> 00:03:31,480
Speaker 1: is happening. I think that's another part that's scary to

69
00:03:31,520 --> 00:03:34,840
Speaker 1: me is that the person who's experiencing it doesn't always

70
00:03:34,880 --> 00:03:35,560
Speaker 1: know what's happening.

71
00:03:36,360 --> 00:03:41,360
Speaker 2: Yeah, So I think there are very good news in

72
00:03:41,400 --> 00:03:44,680
Speaker 2: the last decade. Right, So when people thought about dementia,

73
00:03:44,760 --> 00:03:48,880
Speaker 2: we still don't know all the causes. And again we

74
00:03:48,880 --> 00:03:54,600
Speaker 2: can talk about the different processes, but Alzheimer's dementia degeneration

75
00:03:54,720 --> 00:03:59,200
Speaker 2: of brain cells is a big process, and vascular dementia

76
00:03:59,320 --> 00:04:03,360
Speaker 2: is another huge process. The good thing is vascular risk

77
00:04:03,400 --> 00:04:09,800
Speaker 2: factors are treatable and that component of dementia is reducible. Right, So,

78
00:04:09,960 --> 00:04:16,000
Speaker 2: high blood pressure, diabetes is collectivity, no smoking, alcohol, sleep,

79
00:04:16,640 --> 00:04:20,160
Speaker 2: those are all among the fourteen factors that the Lancet

80
00:04:20,320 --> 00:04:24,200
Speaker 2: Commission has said can reduce the risk of dementia by

81
00:04:24,400 --> 00:04:26,919
Speaker 2: fifty percent. And we can talk about the fact that

82
00:04:27,000 --> 00:04:30,400
Speaker 2: even if you have hygienetic acceptability, you can still better.

83
00:04:31,279 --> 00:04:34,839
Speaker 1: So it's interesting that you mentioned alcohol. So I'm a

84
00:04:34,880 --> 00:04:39,799
Speaker 1: cancer survivor. I was at my six month annual uphoor

85
00:04:39,880 --> 00:04:42,640
Speaker 1: or six month appointment a few weeks ago, and at

86
00:04:42,640 --> 00:04:45,919
Speaker 1: the appointment, the doctor really laid into like, you can't

87
00:04:45,960 --> 00:04:49,479
Speaker 1: have any alcohol, you can't drink it all. It's so important.

88
00:04:49,520 --> 00:04:51,600
Speaker 1: And I was sitting there thinking, like, does she think

89
00:04:51,640 --> 00:04:54,000
Speaker 1: I'm a total lush? Why does she saying We've never

90
00:04:54,160 --> 00:04:56,680
Speaker 1: in ten years, we've never had this conversation. And I

91
00:04:56,760 --> 00:04:59,440
Speaker 1: was like, I don't drink. I don't drink it all,

92
00:04:59,480 --> 00:05:01,840
Speaker 1: and she was not even but I'm saying, not even

93
00:05:01,880 --> 00:05:04,800
Speaker 1: a glass, and I said, I don't drink. Where is

94
00:05:04,839 --> 00:05:07,440
Speaker 1: this coming from? Well, then the story was published that

95
00:05:07,560 --> 00:05:11,440
Speaker 1: now they're saying that drinking alcohol is linked to cancer,

96
00:05:11,839 --> 00:05:15,720
Speaker 1: and I'm hearing, okay, alcohol is linked two dimensia now too.

97
00:05:16,200 --> 00:05:19,680
Speaker 1: I mean, how significant of a problem is it? Because

98
00:05:19,760 --> 00:05:22,039
Speaker 1: I do think that in the last I would say

99
00:05:22,080 --> 00:05:26,479
Speaker 1: my generation coming out of college in the nineties and

100
00:05:26,560 --> 00:05:29,880
Speaker 1: early two thousands, there was this really big push for

101
00:05:29,960 --> 00:05:33,279
Speaker 1: women to be in this wine culture, and it seems

102
00:05:33,320 --> 00:05:37,320
Speaker 1: like that has impacted health in a crazy way that

103
00:05:37,400 --> 00:05:39,120
Speaker 1: we really aren't paying attention to.

104
00:05:39,680 --> 00:05:43,159
Speaker 2: Yeah, so I think I'll take a broader perspective and

105
00:05:43,160 --> 00:05:46,039
Speaker 2: then dig into the alcohol. I think it's important to

106
00:05:46,080 --> 00:05:50,640
Speaker 2: realize we're living a long time, right So if you

107
00:05:50,680 --> 00:05:54,119
Speaker 2: talk about a diet or meals alcohol, we have about

108
00:05:54,120 --> 00:05:58,520
Speaker 2: one hundred thousand meals to eat, right, And I think

109
00:05:58,520 --> 00:06:01,000
Speaker 2: it's important is I have so one meal you aid badly? Well,

110
00:06:01,320 --> 00:06:03,600
Speaker 2: you know, you can even smoke forty cigarettes in a

111
00:06:03,680 --> 00:06:06,120
Speaker 2: day and you're not gonna get cancer tomorrow. Right, If

112
00:06:06,120 --> 00:06:09,800
Speaker 2: you'll smoke forty cigarettes for thirty years, a couple of

113
00:06:09,839 --> 00:06:11,400
Speaker 2: people will get away with it, but a lot of

114
00:06:11,440 --> 00:06:14,400
Speaker 2: people are gonna have trouble. So I think it's important

115
00:06:14,440 --> 00:06:18,000
Speaker 2: to remember it's a marathon. We're all gonna fall down,

116
00:06:18,520 --> 00:06:20,559
Speaker 2: and we all should have things that we can enjoy.

117
00:06:21,440 --> 00:06:24,640
Speaker 2: I think related to that, I think with the alcohol,

118
00:06:25,880 --> 00:06:28,719
Speaker 2: you know, people are too tempted to go strong one

119
00:06:28,800 --> 00:06:32,840
Speaker 2: way or the other. Right, So you know, we're just

120
00:06:32,880 --> 00:06:36,800
Speaker 2: tempted to give strong answers when sometimes we have weaker answers, right,

121
00:06:38,320 --> 00:06:42,200
Speaker 2: And so it depends if you socialize and it helps you.

122
00:06:42,279 --> 00:06:45,680
Speaker 2: It's one thing, clearly, there's this thing among you know,

123
00:06:45,760 --> 00:06:48,400
Speaker 2: younger people in anxiety where people have bringe drinking and

124
00:06:48,480 --> 00:06:51,400
Speaker 2: a lot of drinks at a time. That's a problem.

125
00:06:51,520 --> 00:06:54,880
Speaker 2: Risk of injuries is a problem with dementia when you

126
00:06:54,880 --> 00:06:58,040
Speaker 2: get to older age and you reserve is smaller. It

127
00:06:58,120 --> 00:06:59,919
Speaker 2: could be that one or two drinks will push you

128
00:07:00,080 --> 00:07:02,159
Speaker 2: over an edge where you can't compensate. And I see

129
00:07:02,200 --> 00:07:06,520
Speaker 2: doctor Mzerker maybe ready to chime in with that, you know,

130
00:07:06,680 --> 00:07:08,440
Speaker 2: I think then we want to know if you want

131
00:07:08,480 --> 00:07:11,040
Speaker 2: optimal health, which is what we're looking for. We're trying

132
00:07:11,040 --> 00:07:13,720
Speaker 2: to develop all the best biomarkers to give you the

133
00:07:13,880 --> 00:07:17,840
Speaker 2: very best advice. Right So, I think doctors shouldn't be

134
00:07:17,880 --> 00:07:21,120
Speaker 2: pushing you to drink. In fact, now we're pushing you

135
00:07:21,200 --> 00:07:23,880
Speaker 2: to not drink. But I have a feeling if your

136
00:07:23,960 --> 00:07:27,480
Speaker 2: only vice is a couple of drinks a week, I

137
00:07:27,520 --> 00:07:29,320
Speaker 2: think you may have a lot of other things to

138
00:07:29,360 --> 00:07:32,000
Speaker 2: worry about. And in terms of dementia, one of the

139
00:07:32,160 --> 00:07:35,720
Speaker 2: proven risk factors for dementia is social isolation. Now, I

140
00:07:35,720 --> 00:07:39,040
Speaker 2: think we can socialize without alcohol. It's not a problem,

141
00:07:39,520 --> 00:07:43,200
Speaker 2: but you know what I mean. But socializlation is bad.

142
00:07:43,560 --> 00:07:46,080
Speaker 1: But it's like I can't focus on those few really

143
00:07:46,160 --> 00:07:48,720
Speaker 1: terrible sunburns I had in college for the rest of

144
00:07:48,720 --> 00:07:49,360
Speaker 1: my life.

145
00:07:50,120 --> 00:07:52,800
Speaker 2: I think the dwelling and ruminating not a good thing.

146
00:07:53,160 --> 00:07:55,600
Speaker 2: Even though we're all victims of some worrying.

147
00:07:56,760 --> 00:07:58,800
Speaker 1: Well, I think this is one of those things though

148
00:07:58,800 --> 00:08:00,640
Speaker 1: that you can. I mean, there's now well you can

149
00:08:00,680 --> 00:08:05,720
Speaker 1: have genetic testing, if you have relatives who had Alzheimer's,

150
00:08:05,720 --> 00:08:08,960
Speaker 1: people are getting that genetic testing. Then what happens once

151
00:08:09,000 --> 00:08:11,280
Speaker 1: you find out you have the gene? Then do you

152
00:08:11,480 --> 00:08:14,240
Speaker 1: just focus on that? How bad is that for your

153
00:08:14,280 --> 00:08:17,239
Speaker 1: health that you are constantly worried, Well, when's it coming?

154
00:08:17,280 --> 00:08:18,480
Speaker 1: When's it coming? When's it coming?

155
00:08:19,520 --> 00:08:22,560
Speaker 2: Yeah, So it depends. And I've given a lecture to

156
00:08:22,600 --> 00:08:25,440
Speaker 2: the medical students in various places and to the students

157
00:08:25,480 --> 00:08:29,080
Speaker 2: of public health about genetics and epidemiology and screening and

158
00:08:29,200 --> 00:08:31,679
Speaker 2: april LIKEE protein E is always an example I raised

159
00:08:31,680 --> 00:08:33,920
Speaker 2: because we studied it for heart disease, where it's a

160
00:08:33,960 --> 00:08:38,360
Speaker 2: weak risk factors, whereas aplite protein E four was discovered

161
00:08:38,400 --> 00:08:41,960
Speaker 2: in the eighties to really be a pretty strong risk

162
00:08:41,960 --> 00:08:45,280
Speaker 2: factor for dementia. For a long time, I said, well,

163
00:08:45,280 --> 00:08:47,440
Speaker 2: we don't screen for it because there's nothing we can do.

164
00:08:48,480 --> 00:08:52,280
Speaker 2: It turns out now we've discovered that the vascular risk

165
00:08:52,320 --> 00:08:56,920
Speaker 2: factors interconnect with the amyloid deposition in the brain, and

166
00:08:57,400 --> 00:09:00,560
Speaker 2: our study and others have shown that people with more

167
00:09:00,640 --> 00:09:04,280
Speaker 2: vascular risk factors have even more amyloid deposition. And the

168
00:09:04,320 --> 00:09:08,120
Speaker 2: association was even stronger among genetically susceptible people. So in

169
00:09:08,160 --> 00:09:13,520
Speaker 2: some sense, your preventive measures could be more powerful if

170
00:09:13,559 --> 00:09:15,760
Speaker 2: you're at risk. Now, do you need to know or not?

171
00:09:16,720 --> 00:09:19,640
Speaker 2: A good question? Maybe? I mean I'd be interested in

172
00:09:19,640 --> 00:09:22,360
Speaker 2: doctor Zerka's opinion about particularly as you get to the

173
00:09:22,480 --> 00:09:26,400
Speaker 2: later stages, and how people deal with this. As you said,

174
00:09:26,640 --> 00:09:29,200
Speaker 2: they may not know. It's one thing to not know

175
00:09:29,240 --> 00:09:31,480
Speaker 2: about your genetic risk. What do you know about your

176
00:09:31,480 --> 00:09:33,920
Speaker 2: cognitive function? Do you want to get tested and what

177
00:09:33,960 --> 00:09:35,440
Speaker 2: do you do? Yeah?

178
00:09:35,440 --> 00:09:36,600
Speaker 3: Absolutely, I think that.

179
00:09:36,760 --> 00:09:39,520
Speaker 4: I think we're learning more about how to use genetic

180
00:09:39,559 --> 00:09:42,319
Speaker 4: testing as the years go by. I mean, right now,

181
00:09:42,360 --> 00:09:45,880
Speaker 4: I think it still stands that the genetic information like

182
00:09:45,920 --> 00:09:50,320
Speaker 4: an FOE test, can give some sense about general risk,

183
00:09:50,679 --> 00:09:54,520
Speaker 4: but it's not an absolute it's not that kind of gene.

184
00:09:54,679 --> 00:09:59,640
Speaker 4: That being said, there are ways that a person who's

185
00:09:59,640 --> 00:10:03,560
Speaker 4: concerned about their memory can more concretely assess their risk

186
00:10:04,040 --> 00:10:08,720
Speaker 4: by getting an evaluation by a geriatrician or neurologists, or

187
00:10:08,840 --> 00:10:11,600
Speaker 4: even talking to their primary doctor first. You know, a

188
00:10:11,600 --> 00:10:15,120
Speaker 4: lot of the memory concerns that are out there, if

189
00:10:15,120 --> 00:10:18,000
Speaker 4: they're not very consistent, if they're not affecting daily life,

190
00:10:18,000 --> 00:10:20,400
Speaker 4: it might just be part of what we call normal aging.

191
00:10:21,040 --> 00:10:23,480
Speaker 4: And I think that if you want to know if

192
00:10:23,520 --> 00:10:26,319
Speaker 4: it's more than normal aging, you might need some more

193
00:10:26,360 --> 00:10:31,280
Speaker 4: formal diagnostics in the form of what we call neuropsychological testing,

194
00:10:31,360 --> 00:10:37,080
Speaker 4: quantifying someone's memory and cognitive functions, doing some brain imaging

195
00:10:37,160 --> 00:10:40,040
Speaker 4: like an MRI, and doing some blood work to look

196
00:10:40,080 --> 00:10:44,480
Speaker 4: for maybe non neurological causes of memory loss.

197
00:10:46,320 --> 00:10:51,280
Speaker 1: Interesting. So, if you are in this situation where you

198
00:10:51,360 --> 00:10:53,840
Speaker 1: start to see this decline, I mean, we're seeing that

199
00:10:54,600 --> 00:10:58,280
Speaker 1: one in three older Americans dies from Alzheimer's or dementia,

200
00:10:58,760 --> 00:11:03,440
Speaker 1: Obviously people are fearing that how are you dying? Are

201
00:11:03,480 --> 00:11:05,600
Speaker 1: you dying with it? Are you dying from it?

202
00:11:05,880 --> 00:11:09,120
Speaker 2: I think, you know, back to the numbers. I think

203
00:11:10,600 --> 00:11:14,320
Speaker 2: you know, often when you develop a disease and you're ninety,

204
00:11:14,880 --> 00:11:17,800
Speaker 2: it's hard to know all the causes of it, right,

205
00:11:18,000 --> 00:11:20,319
Speaker 2: And at that point the number of years, which will

206
00:11:20,320 --> 00:11:24,040
Speaker 2: be one of our future topics, is an important topic, right,

207
00:11:24,360 --> 00:11:27,199
Speaker 2: So I think it's important to think about this opportunity

208
00:11:27,240 --> 00:11:29,920
Speaker 2: for prevention. And I think the other thing, you know

209
00:11:30,120 --> 00:11:33,400
Speaker 2: that I'm a big believer on avoiding the social isolation,

210
00:11:33,720 --> 00:11:38,480
Speaker 2: engaging other people, taking charge of your own health and

211
00:11:38,640 --> 00:11:42,160
Speaker 2: accepting that. I think we should try for the best health.

212
00:11:42,559 --> 00:11:45,520
Speaker 2: But we're gonna have setbacks, and there are ways to

213
00:11:45,640 --> 00:11:49,360
Speaker 2: work with them and have lots of meaningful things. As

214
00:11:49,400 --> 00:11:54,000
Speaker 2: you mentioned, right, you've had cancer, I wouldn't know. Seems

215
00:11:54,040 --> 00:11:57,920
Speaker 2: like you're doing great, which is wonderful. Congratulations, the same

216
00:11:57,920 --> 00:11:59,760
Speaker 2: things with a lot of things. So if somebody has

217
00:11:59,760 --> 00:12:03,440
Speaker 2: some limitations at older age, working together with their family members,

218
00:12:03,440 --> 00:12:06,800
Speaker 2: working together with their physicians, a lot can be done.

219
00:12:07,760 --> 00:12:09,600
Speaker 1: So what is it that we should be doing. I

220
00:12:09,600 --> 00:12:13,920
Speaker 1: think we, especially in this country, we're very hot on

221
00:12:13,960 --> 00:12:16,280
Speaker 1: the quick fix. Just give me something that's going to

222
00:12:16,520 --> 00:12:18,680
Speaker 1: make all of these things happen. But I heard you

223
00:12:18,720 --> 00:12:22,200
Speaker 1: talk about exercise and diet, and those are things that

224
00:12:22,760 --> 00:12:26,199
Speaker 1: I think oftentimes feel like I don't really know what

225
00:12:26,240 --> 00:12:28,880
Speaker 1: that means, so I'm going to focus on something else.

226
00:12:28,920 --> 00:12:32,240
Speaker 1: I mean, exercise is pretty obvious. Diet is a challenge

227
00:12:32,320 --> 00:12:36,000
Speaker 1: in this country. I mean, just we're just seeing that now.

228
00:12:36,160 --> 00:12:39,600
Speaker 1: The FDA is saying that we can't have red food die.

229
00:12:39,720 --> 00:12:42,640
Speaker 1: I think it's red number four or three that they've

230
00:12:42,720 --> 00:12:46,319
Speaker 1: just eliminated. And people are talking about making America healthy

231
00:12:46,400 --> 00:12:48,720
Speaker 1: and all these things that we have in our food

232
00:12:48,800 --> 00:12:52,200
Speaker 1: that Europeans don't have in their food, and is this

233
00:12:52,320 --> 00:12:55,840
Speaker 1: contributing to that the health record that we see in

234
00:12:55,840 --> 00:12:58,720
Speaker 1: the United States as compared to other countries. So when

235
00:12:58,720 --> 00:13:00,679
Speaker 1: you talk about diet, it's it seems kind of like

236
00:13:00,760 --> 00:13:03,360
Speaker 1: an enigma. Nobody really knows what that means. How do

237
00:13:03,400 --> 00:13:04,880
Speaker 1: we break that down for people?

238
00:13:05,640 --> 00:13:07,840
Speaker 2: Yeah, I think you know, we can each say something.

239
00:13:08,320 --> 00:13:12,520
Speaker 2: I would keep my eye on the big things right

240
00:13:12,840 --> 00:13:14,920
Speaker 2: in that exactly what we eat. It would be great

241
00:13:14,920 --> 00:13:16,640
Speaker 2: if we could figure it out. But for one hundred

242
00:13:16,640 --> 00:13:18,880
Speaker 2: thousand meals, maybe we don't even want a prescription for

243
00:13:18,920 --> 00:13:21,880
Speaker 2: every meal. But the biggest problem people have is too

244
00:13:21,880 --> 00:13:26,079
Speaker 2: many calories, right, too many calories and you know when

245
00:13:26,120 --> 00:13:29,240
Speaker 2: they add up because there's a scale and you know,

246
00:13:29,320 --> 00:13:31,280
Speaker 2: you step on it and you see what happens. The

247
00:13:31,360 --> 00:13:34,960
Speaker 2: good thing is if you lose even five pounds, it

248
00:13:35,040 --> 00:13:39,520
Speaker 2: reduces your risk of diabetes dramatically, right, really, and yes,

249
00:13:40,200 --> 00:13:43,360
Speaker 2: it turns out losing is better than gaining more powerful

250
00:13:43,360 --> 00:13:48,319
Speaker 2: for diabetes and connected to dementia. We've shown that diabetes

251
00:13:48,360 --> 00:13:51,040
Speaker 2: before the age of sixty five is a powerful risk factor.

252
00:13:51,360 --> 00:13:53,800
Speaker 2: And if you prevent it all together or delay it

253
00:13:54,160 --> 00:13:56,319
Speaker 2: on set at a later age is a much much

254
00:13:56,360 --> 00:13:59,520
Speaker 2: weaker risk factor for demension. So for diet, I'd watch

255
00:14:00,000 --> 00:14:05,000
Speaker 2: galleries and I'd watch total fruits and vegetables. The more

256
00:14:05,040 --> 00:14:07,600
Speaker 2: fruits and vegetables, the less you can eat other stuff.

257
00:14:07,800 --> 00:14:10,480
Speaker 1: Let's take a quick commercial break. We'll continue next on

258
00:14:10,559 --> 00:14:16,560
Speaker 1: the Tutor Dixon podcast. So we see a lot of

259
00:14:16,600 --> 00:14:21,000
Speaker 1: people today taking drugs like ozebic or we go v

260
00:14:21,240 --> 00:14:25,880
Speaker 1: these drugs that are were for I guess, for diabetes.

261
00:14:26,000 --> 00:14:29,280
Speaker 1: Now people are finding out that maybe they prevent diabetes

262
00:14:29,320 --> 00:14:31,600
Speaker 1: by losing the weight. They take these drugs and they

263
00:14:31,640 --> 00:14:34,520
Speaker 1: lose the weight. Is that a sustainable way to take

264
00:14:34,560 --> 00:14:35,360
Speaker 1: care of your health.

265
00:14:36,800 --> 00:14:40,560
Speaker 2: I'll start and have doctor Zerker continue. I'm in public health.

266
00:14:40,920 --> 00:14:44,600
Speaker 2: Ideally we should take care of things with behaviors, and

267
00:14:44,680 --> 00:14:46,520
Speaker 2: I think the good thing is we should study that,

268
00:14:46,600 --> 00:14:49,160
Speaker 2: we should know about it. But we're in medicine because

269
00:14:49,160 --> 00:14:52,160
Speaker 2: people aren't perfect. So when you fall, we don't just

270
00:14:52,200 --> 00:14:55,680
Speaker 2: blame you. We look for solutions. And in the US

271
00:14:56,040 --> 00:14:59,520
Speaker 2: we have incredible medications, an incredible healthcare system for people

272
00:14:59,520 --> 00:15:02,360
Speaker 2: who can act access it. And for high cholesterol, we

273
00:15:02,440 --> 00:15:05,480
Speaker 2: have wonderful drugs and statins for high blood pressure. We

274
00:15:05,520 --> 00:15:08,360
Speaker 2: have a range of wonderful drugs that are cheap and

275
00:15:08,480 --> 00:15:10,720
Speaker 2: very effective, and controlling blood pressure is one of the

276
00:15:10,720 --> 00:15:14,160
Speaker 2: best ways to prolong life, prevent dimension, and prevent stroke.

277
00:15:14,920 --> 00:15:18,200
Speaker 2: And obesity is an underlying cause for so much of

278
00:15:18,240 --> 00:15:21,720
Speaker 2: it that if it takes a pill, it turns out

279
00:15:22,760 --> 00:15:25,920
Speaker 2: science has now given us pills that seem to be

280
00:15:26,000 --> 00:15:28,600
Speaker 2: good for us. For decades, we only had weight loss

281
00:15:28,640 --> 00:15:31,120
Speaker 2: pills that were bad for us. Now they seem to

282
00:15:31,160 --> 00:15:34,920
Speaker 2: be protecting the weight, the diabetes, the kidneys, the heart,

283
00:15:35,120 --> 00:15:36,960
Speaker 2: and we're going to study them for the brain. So

284
00:15:37,000 --> 00:15:39,840
Speaker 2: the answer is still out as to whether it's a

285
00:15:40,200 --> 00:15:44,280
Speaker 2: huge benefit, but it's clearly a huge benefit for many

286
00:15:44,360 --> 00:15:47,760
Speaker 2: for many things. What will happen over decades, I don't know, what.

287
00:15:47,680 --> 00:15:49,000
Speaker 3: Do you think.

288
00:15:48,680 --> 00:15:51,840
Speaker 4: I think that there are certain people who are, you know,

289
00:15:51,920 --> 00:15:54,680
Speaker 4: really struggling with their weight, struggling with their diabetes that

290
00:15:54,720 --> 00:15:58,800
Speaker 4: are going to really benefit medications, you know, like ozempic

291
00:15:58,800 --> 00:16:02,480
Speaker 4: et cetera. I just don't think that you know that

292
00:16:02,600 --> 00:16:07,800
Speaker 4: it can for the average person or someone who's slightly overweight,

293
00:16:08,360 --> 00:16:14,040
Speaker 4: whether diet and exercise. I think the diet and exercise

294
00:16:14,080 --> 00:16:17,600
Speaker 4: and the changes that can occur from those lifestyle changes

295
00:16:17,640 --> 00:16:20,960
Speaker 4: are probably going to be more efficacious long term, right

296
00:16:21,080 --> 00:16:24,760
Speaker 4: than taking a drug short term. I think you just

297
00:16:24,800 --> 00:16:28,560
Speaker 4: can't replace the effects of those kinds of lifestyle changes.

298
00:16:28,640 --> 00:16:32,240
Speaker 2: Yeah, and importantly it's not either or I think actually

299
00:16:32,240 --> 00:16:35,000
Speaker 2: we're getting sort of the wrong message right in many

300
00:16:35,040 --> 00:16:39,680
Speaker 2: ways the GLP one receptor agonists, and they're gonna get better.

301
00:16:39,880 --> 00:16:43,000
Speaker 2: I've already seen presentations where you lose weight and you

302
00:16:43,040 --> 00:16:45,840
Speaker 2: lose muscle. Now they've got compounds to potentially protect and

303
00:16:45,920 --> 00:16:49,840
Speaker 2: increased muscle at the same time. So it's a changing game.

304
00:16:50,120 --> 00:16:53,320
Speaker 2: But they help you have better behaviors, and I think

305
00:16:53,360 --> 00:16:57,440
Speaker 2: there's no reason people should really try hard to then

306
00:16:57,520 --> 00:17:00,640
Speaker 2: when they're at the lower rate, establish good patterns of

307
00:17:00,680 --> 00:17:03,840
Speaker 2: behavior and test whether they can maintain them. I'm not

308
00:17:03,920 --> 00:17:05,680
Speaker 2: at all sure that it's not possible.

309
00:17:06,160 --> 00:17:08,280
Speaker 1: So you've been working on the studies, like you said,

310
00:17:08,320 --> 00:17:10,720
Speaker 1: you've this has been going on since the eighties, and

311
00:17:10,880 --> 00:17:14,600
Speaker 1: you've come out with the fact that dementia risk for

312
00:17:14,760 --> 00:17:18,199
Speaker 1: folks over fifty five and older has doubled. Do you

313
00:17:18,240 --> 00:17:21,119
Speaker 1: think that that is because you've been watching it and

314
00:17:21,200 --> 00:17:24,200
Speaker 1: it I mean, has it really gone up over that timeframe?

315
00:17:24,280 --> 00:17:28,119
Speaker 1: Have you seen a change and seeing that change, what

316
00:17:28,440 --> 00:17:30,720
Speaker 1: were the contributing factors to that change?

317
00:17:30,920 --> 00:17:33,840
Speaker 2: Yeah, So actually this is where being detailed on the

318
00:17:33,920 --> 00:17:36,880
Speaker 2: numbers is important. The risk will double in the next

319
00:17:36,920 --> 00:17:41,320
Speaker 2: forty years by twenty sixty because the population is aging.

320
00:17:42,320 --> 00:17:44,600
Speaker 1: Because we're getting older than we used to be, or

321
00:17:44,720 --> 00:17:46,640
Speaker 1: because we yes.

322
00:17:46,440 --> 00:17:50,360
Speaker 2: Because the whole baby boomers are when they're ninety, it's

323
00:17:50,440 --> 00:17:52,800
Speaker 2: going to be a lot of risk. So for the US,

324
00:17:52,840 --> 00:17:58,920
Speaker 2: the numbers will double for any one age. We're actually

325
00:17:58,920 --> 00:18:01,639
Speaker 2: doing a little better now than we did before, partly

326
00:18:01,720 --> 00:18:04,600
Speaker 2: just some better education and some better risk factors. The

327
00:18:04,720 --> 00:18:06,760
Speaker 2: problem is as a country we're going to have to

328
00:18:06,800 --> 00:18:10,600
Speaker 2: do much better because as a country and as a world,

329
00:18:10,680 --> 00:18:12,160
Speaker 2: we're aging rap.

330
00:18:12,160 --> 00:18:15,439
Speaker 1: So when you say we're aging rapidly, what are the

331
00:18:15,480 --> 00:18:19,000
Speaker 1: details of aging rapidly? Because you know, in my mind,

332
00:18:19,040 --> 00:18:22,200
Speaker 1: I'm like, I mean the years come. That's the one

333
00:18:22,320 --> 00:18:24,800
Speaker 1: risk factor I can't do anything about because I'm going

334
00:18:24,840 --> 00:18:27,359
Speaker 1: to get older, no matter what I want that to be.

335
00:18:28,600 --> 00:18:32,080
Speaker 1: Are we as our body aging faster than what the

336
00:18:32,200 --> 00:18:32,679
Speaker 1: number is?

337
00:18:33,480 --> 00:18:36,199
Speaker 2: Uh no, No, I think we keep doing better. So

338
00:18:36,280 --> 00:18:38,920
Speaker 2: as individuals, I agree you and I need to keep

339
00:18:38,960 --> 00:18:41,360
Speaker 2: watching it. And as we get older, we realize we've

340
00:18:41,400 --> 00:18:44,240
Speaker 2: got more risks, more complications, and the risk of dimension

341
00:18:44,280 --> 00:18:48,000
Speaker 2: becomes bigger, and we've talked about preventing about half the

342
00:18:48,119 --> 00:18:52,359
Speaker 2: risk as a country. Right, the number of babies that

343
00:18:52,400 --> 00:18:55,000
Speaker 2: are born drives the number of young people, And if

344
00:18:55,000 --> 00:18:57,639
Speaker 2: there were more people born in the baby boom, then

345
00:18:57,680 --> 00:19:00,119
Speaker 2: the percentage of the population that's over the age of

346
00:19:00,160 --> 00:19:03,120
Speaker 2: sixty five will double, the percentage of the population that's

347
00:19:03,119 --> 00:19:06,600
Speaker 2: over the age of eighty five will triple. And as

348
00:19:06,680 --> 00:19:09,520
Speaker 2: that happens over the coming decades, I think we need

349
00:19:09,560 --> 00:19:12,400
Speaker 2: to think about the fact that many people, if they're

350
00:19:12,440 --> 00:19:15,800
Speaker 2: in good health, can continue to be very productive, have

351
00:19:15,880 --> 00:19:20,240
Speaker 2: lots of wisdom, have lots to contribute for potentially decades

352
00:19:20,320 --> 00:19:21,560
Speaker 2: beyond age sixty five.

353
00:19:22,240 --> 00:19:24,760
Speaker 1: It's really interesting though, that you say that it's how

354
00:19:24,800 --> 00:19:27,560
Speaker 1: you look at the numbers, because obviously the headline in

355
00:19:27,640 --> 00:19:30,080
Speaker 1: anything like this is going to be written so you

356
00:19:30,160 --> 00:19:33,400
Speaker 1: click right. So the headline was kind of terrifying. It's

357
00:19:33,440 --> 00:19:36,440
Speaker 1: like dementia has doubled why And so in my mind,

358
00:19:36,480 --> 00:19:39,320
Speaker 1: I'm like, oh, all of us are losing our minds

359
00:19:39,359 --> 00:19:42,480
Speaker 1: faster and quicker, and it's going to continue and it's

360
00:19:42,480 --> 00:19:46,360
Speaker 1: going to get worse. But it really hasn't changed. It's

361
00:19:46,400 --> 00:19:48,960
Speaker 1: not like more people are getting it's just that more

362
00:19:49,000 --> 00:19:51,679
Speaker 1: people are getting to that age. So that to me

363
00:19:51,760 --> 00:19:53,439
Speaker 1: is a major difference. But I just was having a

364
00:19:53,440 --> 00:19:56,800
Speaker 1: conversation with someone in their twenties last week and he

365
00:19:56,960 --> 00:19:59,119
Speaker 1: was saying, you know, we're not going to have kids

366
00:19:59,240 --> 00:20:03,320
Speaker 1: because look at healthcare is disaster. The world is falling apart.

367
00:20:03,560 --> 00:20:05,719
Speaker 1: And it just made me think when you said that,

368
00:20:05,760 --> 00:20:09,480
Speaker 1: it's how you are looking at the numbers. We aren't.

369
00:20:09,880 --> 00:20:13,119
Speaker 1: The younger population doesn't seem to want to have kids

370
00:20:13,240 --> 00:20:17,240
Speaker 1: because they're looking at numbers differently than what they actually

371
00:20:17,359 --> 00:20:21,639
Speaker 1: mean and to whether it's health numbers or financial numbers.

372
00:20:21,680 --> 00:20:25,760
Speaker 1: I think this younger generation is being scared away from

373
00:20:25,920 --> 00:20:28,520
Speaker 1: adding to the population, which is really sad to me.

374
00:20:30,880 --> 00:20:33,480
Speaker 2: Yeah, lots of issues here. I think the press did

375
00:20:33,520 --> 00:20:36,639
Speaker 2: pretty well with this, but there really is an element

376
00:20:36,680 --> 00:20:39,280
Speaker 2: of this that's scary, which is if I go my

377
00:20:39,359 --> 00:20:42,520
Speaker 2: whole life, you know, the risk is forty two percent

378
00:20:42,600 --> 00:20:45,880
Speaker 2: I'll get the dementia before death. I try to emphasize

379
00:20:45,880 --> 00:20:48,240
Speaker 2: that it'll be late in life, right, so I have

380
00:20:48,359 --> 00:20:51,760
Speaker 2: many years and I can extend them. And I think

381
00:20:51,800 --> 00:20:55,040
Speaker 2: then this whole population pyramid is quite interesting as to

382
00:20:55,119 --> 00:20:57,200
Speaker 2: how we do that, and I think how we maintain

383
00:20:57,280 --> 00:21:00,439
Speaker 2: a vibrant society. I think that's both having young people

384
00:21:00,800 --> 00:21:03,520
Speaker 2: and realizing that many older people are young in so

385
00:21:03,520 --> 00:21:04,280
Speaker 2: many ways.

386
00:21:04,720 --> 00:21:06,760
Speaker 3: I think this is also a changing landscape.

387
00:21:06,800 --> 00:21:08,800
Speaker 4: I think in the course of the next decades, we're

388
00:21:08,800 --> 00:21:11,399
Speaker 4: going to come up with better and better ways to

389
00:21:11,520 --> 00:21:16,159
Speaker 4: detect the very beginnings of dementia, even before it's really dementia.

390
00:21:16,680 --> 00:21:18,880
Speaker 3: We're going to be developing more.

391
00:21:18,800 --> 00:21:23,160
Speaker 4: Drugs that are disease modifying to slow down or stop

392
00:21:23,880 --> 00:21:27,119
Speaker 4: the progression of memory loss. I mean, there's already two

393
00:21:27,640 --> 00:21:30,600
Speaker 4: amyloid lowering therapies approved in the last few years, and

394
00:21:30,640 --> 00:21:33,040
Speaker 4: so I think that's just the first step. I think

395
00:21:33,080 --> 00:21:36,600
Speaker 4: it's going to really change in the next thirty forty years.

396
00:21:36,920 --> 00:21:39,960
Speaker 2: Yeah, we need talking about maybe the biology of dementia

397
00:21:39,960 --> 00:21:45,359
Speaker 2: at early ages versus late ages is important, you know,

398
00:21:45,480 --> 00:21:48,239
Speaker 2: and maybe doctor Zerker wants to expand on that and

399
00:21:48,280 --> 00:21:51,679
Speaker 2: sort of you know, the early Alzheimer's and late and

400
00:21:51,920 --> 00:21:54,560
Speaker 2: therapies and the important of an integrated approach like we

401
00:21:54,640 --> 00:21:55,600
Speaker 2: do it n Yu Lang.

402
00:21:55,480 --> 00:21:57,200
Speaker 3: Go and help right.

403
00:21:57,320 --> 00:21:59,840
Speaker 4: So I think, you know, one of the first steps

404
00:21:59,880 --> 00:22:04,000
Speaker 4: in the Alzheimer's cascade is the rise of amyloid, and

405
00:22:04,040 --> 00:22:05,880
Speaker 4: that's really been the focus of a lot of research

406
00:22:05,920 --> 00:22:09,639
Speaker 4: and clinical trials, and that's led to these two drugs

407
00:22:09,640 --> 00:22:11,520
Speaker 4: that are approved in the last few years that we're

408
00:22:11,560 --> 00:22:15,119
Speaker 4: giving at NYU, and they are helpful. They do slow

409
00:22:15,160 --> 00:22:18,600
Speaker 4: down the process. And then at later stages there's other

410
00:22:19,520 --> 00:22:23,240
Speaker 4: processes like TAW that's another toxic protein, and there are

411
00:22:23,359 --> 00:22:26,879
Speaker 4: ongoing clinical trials to target that. And then there is

412
00:22:27,600 --> 00:22:31,359
Speaker 4: at both early and late stages, inflammation and the immune

413
00:22:31,400 --> 00:22:34,639
Speaker 4: system clinic play a critical role. In early stages it

414
00:22:34,680 --> 00:22:37,000
Speaker 4: could be actually a good thing, and so there are

415
00:22:37,040 --> 00:22:40,920
Speaker 4: methods perhaps to boost the immune system to help clear

416
00:22:40,960 --> 00:22:44,040
Speaker 4: out amyloid INTAW that could be helpful. And then at

417
00:22:44,119 --> 00:22:48,159
Speaker 4: later stage anti inflammatory methodologies could actually be very helpful

418
00:22:48,200 --> 00:22:52,080
Speaker 4: as well. And so this is really a multi dimensional

419
00:22:52,760 --> 00:22:56,439
Speaker 4: pharmaceutical strategy that's really been built up after all the

420
00:22:56,480 --> 00:22:58,480
Speaker 4: science has been done over the last few decades.

421
00:22:58,640 --> 00:23:01,359
Speaker 1: Let's take a quick commercial break. We'll continue next on

422
00:23:01,359 --> 00:23:07,159
Speaker 1: the Tutor Dixon podcast. I think we're so used to

423
00:23:07,520 --> 00:23:10,920
Speaker 1: looking for a problem once we feel something is off,

424
00:23:11,040 --> 00:23:13,919
Speaker 1: and what I am sort of hearing from you is

425
00:23:14,440 --> 00:23:18,000
Speaker 1: before there's warning signs. Eventually there will be checks, and

426
00:23:19,000 --> 00:23:22,600
Speaker 1: medicine has sort of been carrying in the past. Medicine

427
00:23:22,600 --> 00:23:24,639
Speaker 1: has been caring for a problem that's already there. And

428
00:23:24,680 --> 00:23:27,320
Speaker 1: it sounds like this is a lot of preventative medicine

429
00:23:27,480 --> 00:23:29,560
Speaker 1: to say, Okay, you're at the very beginnings of this.

430
00:23:30,119 --> 00:23:32,600
Speaker 1: But I don't think that we as a society have

431
00:23:32,760 --> 00:23:36,119
Speaker 1: been trained well for preventative medicine because we don't like

432
00:23:36,200 --> 00:23:38,280
Speaker 1: to go to the doctor unless we know something's wrong.

433
00:23:38,720 --> 00:23:41,920
Speaker 1: Is this something that you see like mammograms, where it's like, Okay,

434
00:23:41,920 --> 00:23:43,879
Speaker 1: at this age, you should be getting tested for this

435
00:23:43,960 --> 00:23:45,040
Speaker 1: so that you can prevent it.

436
00:23:45,600 --> 00:23:46,680
Speaker 3: I think we're getting there.

437
00:23:46,840 --> 00:23:50,000
Speaker 4: I think we have the methodology used to detect people.

438
00:23:49,800 --> 00:23:50,399
Speaker 3: Who are.

439
00:23:52,240 --> 00:23:55,679
Speaker 4: Don't have dementia but have impairment. And that's where we

440
00:23:55,720 --> 00:23:58,560
Speaker 4: stand now in today's science, and I think that we're

441
00:23:58,600 --> 00:24:00,040
Speaker 4: pushing that bar.

442
00:24:00,160 --> 00:24:01,760
Speaker 3: To earlier and earlier stages.

443
00:24:02,800 --> 00:24:06,359
Speaker 4: You know, does an amyloid reading mean something in a

444
00:24:06,440 --> 00:24:08,720
Speaker 4: normal person for their future cognitive parent.

445
00:24:08,800 --> 00:24:10,040
Speaker 3: We don't know the answer to that.

446
00:24:10,400 --> 00:24:11,960
Speaker 1: How do we How invasive is that?

447
00:24:12,000 --> 00:24:14,359
Speaker 3: What even is that you can do it through a

448
00:24:14,359 --> 00:24:14,960
Speaker 3: brain scan?

449
00:24:15,960 --> 00:24:17,760
Speaker 4: Right now, we don't do it on people who are

450
00:24:17,800 --> 00:24:19,760
Speaker 4: normal because we don't know how to use that information.

451
00:24:19,880 --> 00:24:23,520
Speaker 4: But people who have memory loss, the amyloid brain scan

452
00:24:23,640 --> 00:24:26,920
Speaker 4: can be very helpful to see if they have risk

453
00:24:26,960 --> 00:24:29,600
Speaker 4: for Alzheimer's dimension in the future and start treatments before

454
00:24:29,640 --> 00:24:30,679
Speaker 4: they have dementia.

455
00:24:31,119 --> 00:24:34,040
Speaker 2: And in terms of the research domain, right, you can

456
00:24:34,160 --> 00:24:38,239
Speaker 2: image amyloid in the brain, you can measure amyloid and

457
00:24:38,320 --> 00:24:41,240
Speaker 2: it turns out phosphorylated TAW, which is even more powerful

458
00:24:41,280 --> 00:24:43,920
Speaker 2: in the CSF right. And then it turns out they

459
00:24:44,000 --> 00:24:46,159
Speaker 2: leak into your blood and you can measure them in

460
00:24:46,160 --> 00:24:49,480
Speaker 2: the blood, and there are measures of neurodegeneration in the blood.

461
00:24:49,840 --> 00:24:53,160
Speaker 2: So what we're working on with neurologists and other researchers,

462
00:24:53,160 --> 00:24:57,119
Speaker 2: including in this study, is how to develop markers that

463
00:24:57,160 --> 00:25:00,199
Speaker 2: are like the cholesterol and troponent for the heart for

464
00:25:00,280 --> 00:25:04,560
Speaker 2: the brain, so we can measure brain how decades beforehand,

465
00:25:04,880 --> 00:25:07,480
Speaker 2: and we already have these measures. What we need to

466
00:25:07,520 --> 00:25:10,360
Speaker 2: do is validate them so we know how to use them.

467
00:25:11,359 --> 00:25:16,040
Speaker 1: And then ultimately, I mean, the costs associated with caregiving

468
00:25:16,080 --> 00:25:19,679
Speaker 1: and all that, they're pretty extreme when you're talking about dementia.

469
00:25:19,760 --> 00:25:24,040
Speaker 1: I mean it's not just an actual financial cost, but

470
00:25:24,440 --> 00:25:27,240
Speaker 1: the emotional cost to the people around you. Too, is significant,

471
00:25:27,280 --> 00:25:30,640
Speaker 1: and I think that is when you talk about dementia,

472
00:25:30,840 --> 00:25:33,720
Speaker 1: that's the fear that hits people first. It's not just

473
00:25:34,480 --> 00:25:37,200
Speaker 1: the idea of well I might not remember, it's what

474
00:25:37,240 --> 00:25:39,919
Speaker 1: would happened to my family, how would they afford this?

475
00:25:40,280 --> 00:25:43,399
Speaker 1: What would they go through? So I do think that

476
00:25:43,600 --> 00:25:46,760
Speaker 1: as these studies are coming out there, that we should

477
00:25:46,760 --> 00:25:49,520
Speaker 1: be putting more focus and more attention on this because

478
00:25:49,960 --> 00:25:52,760
Speaker 1: we are very naive about how to take care of

479
00:25:52,800 --> 00:25:54,880
Speaker 1: ourselves and prevent illness.

480
00:25:55,200 --> 00:25:57,879
Speaker 2: Yeah, so our biggest push, both in the research and

481
00:25:57,920 --> 00:26:00,600
Speaker 2: in the clinical arena we've recruited another expert here and

482
00:26:00,640 --> 00:26:04,399
Speaker 2: we're working with other experts, is on caregiving and both

483
00:26:04,480 --> 00:26:09,120
Speaker 2: paid and unpaid, and too often it's just knowing how

484
00:26:09,160 --> 00:26:13,280
Speaker 2: to get it, knowing where services are and maybe maybe

485
00:26:13,280 --> 00:26:16,280
Speaker 2: doctor m Zerker will expand. And then the other thing

486
00:26:16,280 --> 00:26:20,840
Speaker 2: we've spent a lot of time on is uncensory losses vision.

487
00:26:20,880 --> 00:26:22,560
Speaker 2: We want to study and we've done a lot with

488
00:26:22,680 --> 00:26:26,679
Speaker 2: hearing and hearing aids are getting better and better, and

489
00:26:26,720 --> 00:26:30,040
Speaker 2: there's a national campaign to know your hearing number, and

490
00:26:30,080 --> 00:26:33,119
Speaker 2: on any given cell phone you can download an app

491
00:26:33,160 --> 00:26:34,800
Speaker 2: and test yourself and if you have a.

492
00:26:34,760 --> 00:26:39,119
Speaker 1: Prole go yes, that's so interesting. I have no idea.

493
00:26:39,320 --> 00:26:42,639
Speaker 2: Look up the Know Your Hearing Number campaign and a

494
00:26:42,680 --> 00:26:46,040
Speaker 2: friend Frank Linn and his colleague Nick Read are very

495
00:26:46,119 --> 00:26:49,720
Speaker 2: much trying to get everybody as another number love pressure, cholesterol,

496
00:26:49,760 --> 00:26:54,120
Speaker 2: but also hearing. And we've published last year that among

497
00:26:54,240 --> 00:26:57,080
Speaker 2: the people are at high risk for cognitive decline in

498
00:26:57,119 --> 00:27:00,000
Speaker 2: the first three years, you can reduce the decline by

499
00:27:00,040 --> 00:27:03,719
Speaker 2: one half in those people randomized to hearing it. We

500
00:27:03,800 --> 00:27:06,679
Speaker 2: also had it was complicated because some people with hearing

501
00:27:06,720 --> 00:27:10,800
Speaker 2: loss were sort of the worried well and didn't have

502
00:27:11,000 --> 00:27:13,320
Speaker 2: cognitive decline in the first three years, in which case

503
00:27:13,359 --> 00:27:16,000
Speaker 2: you couldn't improve it. But probably getting it early is

504
00:27:16,040 --> 00:27:18,800
Speaker 2: good for later, and it's good for sort of addressing

505
00:27:18,840 --> 00:27:22,320
Speaker 2: issues of social isolation and other issues like that. But

506
00:27:22,480 --> 00:27:26,000
Speaker 2: hearing adidas are making dramatic leaps. They do take patients,

507
00:27:26,440 --> 00:27:29,840
Speaker 2: they're getting cheaper. There's more over the counter, but you

508
00:27:29,960 --> 00:27:31,760
Speaker 2: have to get the fittings right and when you don't

509
00:27:31,840 --> 00:27:34,000
Speaker 2: like it, you have to work with ideologists. And while

510
00:27:34,040 --> 00:27:36,000
Speaker 2: you has a whole program with also co clear implants

511
00:27:36,000 --> 00:27:37,760
Speaker 2: for those who need much more advanced care.

512
00:27:37,840 --> 00:27:40,120
Speaker 1: It's interesting how much more patient we are with doing

513
00:27:40,200 --> 00:27:42,480
Speaker 1: things for our vision than we are for doing things

514
00:27:42,520 --> 00:27:45,360
Speaker 1: for our hearing. If you can't see something, you totally

515
00:27:45,400 --> 00:27:48,879
Speaker 1: freak out and you'll sit for hours with somebody to

516
00:27:48,960 --> 00:27:53,600
Speaker 1: help you. We're a stubborn group. Okay, So I want

517
00:27:53,640 --> 00:27:58,720
Speaker 1: to get into a few of really quick before we go. Hypertension, diabetes,

518
00:27:58,800 --> 00:28:02,000
Speaker 1: high high cholesterol, all of these things that we are

519
00:28:02,160 --> 00:28:05,480
Speaker 1: testing for. We do know. I know that people are

520
00:28:06,640 --> 00:28:10,360
Speaker 1: there's this pushback against medicine in some cases, especially when

521
00:28:10,359 --> 00:28:11,679
Speaker 1: it's like I don't want to take a stat and

522
00:28:11,720 --> 00:28:14,880
Speaker 1: I don't want to take this. So explain to us

523
00:28:14,960 --> 00:28:18,000
Speaker 1: when you see that number and that number goes down,

524
00:28:18,320 --> 00:28:21,640
Speaker 1: how much is that protecting you from something else that

525
00:28:21,680 --> 00:28:23,920
Speaker 1: you're not recognizing, like dementia.

526
00:28:26,800 --> 00:28:28,160
Speaker 3: Well, I think that.

527
00:28:30,520 --> 00:28:32,480
Speaker 4: The way I look at it is when you're talking

528
00:28:32,520 --> 00:28:36,000
Speaker 4: about brain health. You know, the brain is connected to

529
00:28:36,000 --> 00:28:39,120
Speaker 4: all the organs in our body, and you can't treat

530
00:28:39,440 --> 00:28:43,000
Speaker 4: someone's memory loss without optimizing the health of their heart,

531
00:28:43,080 --> 00:28:45,040
Speaker 4: the health of their kidney, the health of their blood

532
00:28:45,080 --> 00:28:48,560
Speaker 4: vesters or lungs, et cetera. And so I really stressed

533
00:28:48,600 --> 00:28:53,240
Speaker 4: with my patients how important it is to, you know,

534
00:28:53,320 --> 00:28:57,920
Speaker 4: optimize their vascular risk factors through both medicine and both lifestyle,

535
00:28:58,680 --> 00:29:02,000
Speaker 4: even in middle a. I think that this is a

536
00:29:02,040 --> 00:29:05,960
Speaker 4: critical inroads to optimizing your brain help for the future.

537
00:29:07,200 --> 00:29:11,880
Speaker 4: And you know, it is sometimes a tough conversation to

538
00:29:13,040 --> 00:29:16,080
Speaker 4: get people to control their diabetes better, to change their diet,

539
00:29:16,240 --> 00:29:20,400
Speaker 4: but it really pays enormous dividends. And I also highlight

540
00:29:20,480 --> 00:29:24,320
Speaker 4: that it's not just about vascular dementia. Vascular risk factors

541
00:29:24,360 --> 00:29:27,880
Speaker 4: also play a role in Alzheimer's dementia as well, so

542
00:29:28,280 --> 00:29:32,360
Speaker 4: they can also prevent multiple types of dementia as well

543
00:29:32,360 --> 00:29:34,400
Speaker 4: by controlling these factors.

544
00:29:35,240 --> 00:29:38,440
Speaker 1: And so ultimately is the goal of what you're doing

545
00:29:38,680 --> 00:29:41,720
Speaker 1: a cure or preventative or both.

546
00:29:42,080 --> 00:29:44,560
Speaker 3: I think it's both, always both.

547
00:29:44,920 --> 00:29:47,280
Speaker 2: There's a quote from the Lancet Commission It's never too

548
00:29:47,280 --> 00:29:50,720
Speaker 2: early or too late to address dementia risks, right, And

549
00:29:50,760 --> 00:29:53,400
Speaker 2: I think the important thing is different things at different stages.

550
00:29:53,960 --> 00:29:57,080
Speaker 2: And the wonderful thing is you start early, even education

551
00:29:57,200 --> 00:30:02,120
Speaker 2: for children, better education, better cognit development gets you resilience

552
00:30:02,160 --> 00:30:04,880
Speaker 2: and lower dementiists And that's working and helping us as

553
00:30:04,880 --> 00:30:08,240
Speaker 2: a society. As we've gotten more education in midlife, the

554
00:30:08,320 --> 00:30:11,880
Speaker 2: vascar risk factors are incredibly important. And then I think

555
00:30:11,920 --> 00:30:14,720
Speaker 2: once you get past age seventy five, you're going to

556
00:30:14,800 --> 00:30:18,160
Speaker 2: need to deal with some issues. And past eighty five,

557
00:30:18,280 --> 00:30:21,600
Speaker 2: I think these you know, maybe you know the sensory

558
00:30:21,640 --> 00:30:25,239
Speaker 2: deficits and the teamwork in terms of care, people can

559
00:30:25,280 --> 00:30:26,520
Speaker 2: do amazing things together.

560
00:30:27,840 --> 00:30:31,640
Speaker 1: Well, I mean, I'm very impressed. This has been completely

561
00:30:31,760 --> 00:30:36,520
Speaker 1: enlightening because I do I think that probably once you've

562
00:30:36,560 --> 00:30:38,920
Speaker 1: gone through something like cancer, you think about your health

563
00:30:39,280 --> 00:30:42,240
Speaker 1: in a different way and you try to be more proactive.

564
00:30:43,320 --> 00:30:46,080
Speaker 1: But I mean even the hearing thing and the testing

565
00:30:46,160 --> 00:30:49,280
Speaker 1: of your plaques and brain and all of that, that's

566
00:30:49,280 --> 00:30:51,560
Speaker 1: something I don't think about on a regular basis. So

567
00:30:51,760 --> 00:30:53,520
Speaker 1: it's nice when you see a study that you can

568
00:30:53,560 --> 00:30:56,040
Speaker 1: have the doctors actually come on and talk about it

569
00:30:56,080 --> 00:30:58,320
Speaker 1: and get into a little bit more death depth. So

570
00:30:58,520 --> 00:31:01,800
Speaker 1: I thank you so much, doctor Korsh and doctor Mazerker,

571
00:31:01,840 --> 00:31:03,240
Speaker 1: thank you so much for being here.

572
00:31:04,440 --> 00:31:05,400
Speaker 3: Thanks for having us you.

573
00:31:06,120 --> 00:31:10,520
Speaker 1: Absolutely And just a question, doctor Korish, is there's some

574
00:31:10,600 --> 00:31:12,920
Speaker 1: place where people can find you guys, that they can

575
00:31:12,960 --> 00:31:16,040
Speaker 1: follow this and find out where what you what else

576
00:31:16,080 --> 00:31:17,120
Speaker 1: you're doing on the stuff.

577
00:31:17,800 --> 00:31:19,800
Speaker 2: I mean, Google is great, right, you just Google my

578
00:31:19,920 --> 00:31:23,360
Speaker 2: name is pretty unique, so you really fast we're mostly

579
00:31:23,400 --> 00:31:27,040
Speaker 2: doing research and the neurology department and YU is number

580
00:31:27,040 --> 00:31:28,720
Speaker 2: one in the world, so they've got I think now,

581
00:31:28,720 --> 00:31:32,480
Speaker 2: three hundred physicians. So I think the idea of you know,

582
00:31:32,520 --> 00:31:36,640
Speaker 2: the NYU Liane going search will do very well. Okay,

583
00:31:36,800 --> 00:31:38,880
Speaker 2: awesomes name looks pretty unique too.

584
00:31:38,960 --> 00:31:42,160
Speaker 1: Yeah, I was gonna say doctor Masserker's name is pretty unique.

585
00:31:41,920 --> 00:31:43,560
Speaker 3: Also, yes, might be the only one.

586
00:31:45,160 --> 00:31:47,040
Speaker 1: Well then I guess people will definitely be able to

587
00:31:47,080 --> 00:31:48,840
Speaker 1: find you as well. Thank you so much.

588
00:31:48,880 --> 00:31:51,280
Speaker 2: Thanks for joinering number the app that you can look

589
00:31:51,320 --> 00:31:51,960
Speaker 2: up as Mimi.

590
00:31:52,680 --> 00:31:54,880
Speaker 1: Okay, perfect, how do you what was that again?

591
00:31:55,000 --> 00:31:57,240
Speaker 2: Spell it? It's am I am I am.

592
00:31:57,160 --> 00:31:59,160
Speaker 1: I am I. Okay, we should be able to find that.

593
00:31:59,760 --> 00:32:01,600
Speaker 2: Yeah, and I'm you know, we have a colleague here

594
00:32:01,600 --> 00:32:03,240
Speaker 2: who is doing tons of great research.

595
00:32:02,920 --> 00:32:06,040
Speaker 1: With that wonderful Thank you both for joining me today.

596
00:32:06,040 --> 00:32:08,400
Speaker 3: I appreciate it, pleasure, Thanks for doing.

597
00:32:08,760 --> 00:32:12,200
Speaker 1: Absolutely Thank you all for joining us on this podcast.

598
00:32:12,560 --> 00:32:16,080
Speaker 1: For more episodes, go to the iHeartRadio app, Apple Podcasts,

599
00:32:16,160 --> 00:32:18,560
Speaker 1: or wherever you get your podcasts and join us next time.

600
00:32:18,680 --> 00:32:19,400
Speaker 1: Have a blessed ey