Dayna Ritchey - Dementia and Alzheimer's Introduction

In this episode, we delve into the profound challenges faced by individuals and families affected by dementia and Alzheimer's disease. We explore the emotional, physical, and financial toll these conditions take, and discuss the latest research and treatments aimed at improving quality of life. Through personal stories and expert interviews, we shed light on the daily struggles and triumphs of caregivers and patients alike. Join us as we navigate the complexities of memory loss, the importance of early diagnosis, and the hope that advancements in science bring to those battling these debilitating diseases.

Learn more at https://www.alz.org/cincinnati or call our 24/7 Helpline at 800-272-3900.

Transcript

In this episode, we welcome Dana Ritchie, Program Director with the Alzheimer's Association of the Greater Cincinnati and Miami Valley Chapters to the podcast. I'm your host, Amy Frederick, along with my partner, Connie Gaylor. We'll be sharing a series of podcasts focused on Alzheimer's and dementia. Thank you, Amy, and thank you, Dana, for your continued partnership with the city. For residents who may not know, Dana partnered with the city In 2023 to facilitate four community presentations on the topics we will be discussing in this series. That series was so well received. That we knew we wanted to translate that to a podcast series to make it available on our Smashing the Stigma podcast channel. Dana, I think the purpose of this first podcast is to provide an overview for our listeners on dementia and Alzheimer's. Most people assume that you are the same thing. But there are different types of dementia. Is that correct? Yeah, that is correct. Um, and smashing the stigma goes well with our disease because this is something people don't talk a lot about and therefore they don't understand the terminology. Dementia is an umbrella term for any kind of cognitive issues we may be having. So it's similar to if I. Just said I had cancer. That's just an umbrella term and you have specific types of cancer that you may be dealing with. And if I said that you'd likely ask me what type of cancer do I have? So dementia is the same way. It's a collection term, it's an umbrella term of any kind of symptoms with cognition which could impact our speech, our behaviors, our executive functioning, our ability to follow processes Any of those types of things can be cognitive issues. Alzheimer's is a specific type of dementia, and you hear so much about Alzheimer's itself because it's the most common type of dementia. I'll tell you another type of dementia you hear a lot about, but it's less common, and that is traumatic brain injury. So usually when I say that, people kind of get, okay, There's this umbrella term called dementia and things like traumatic brain injury, Alzheimer's, vascular dementia, Parkinsonian dementia, Things like Lewy body dementia, which may sound familiar to people because we now know from Robin Williams' autopsy he had Lewy body dementia and then frontotemporal dementia. Which unfortunately I'm familiar with. My father-in-law had frontotemporal dementia. My mother had Alzheimer's. Frontotemporal dementia might sound familiar to some of you as well. That is what Bruce Willis's family has disclosed that he has as well as Wendy Williams. So these are all different types of dementia. Um, and they can start in different parts of the brain. Unfortunately, most of those we talked about are, are not ones that have a cure and most of them are progressive. Dane, I think there is a common misconception that dementia is just a part of aging and we can often dismiss the symptoms because of that. Uh, can you expand on that? Yeah. Um, so dementia itself is not a normal part of aging. So all those things I mentioned, Alzheimer's, Parkinsonian dementia, vascular dementia, those are not things that we should just all expect will happen to us as we get older. Um, it is true that as we age, sometimes we're a little more forgetful We can be a little more slow in trivial pursuits or even reaction times in other cases, but that is just a frustrating part of getting a little older. What's happening when we have A type of dementia, and let's say specifically Alzheimer's since that's the most common type of dementia, there's actual damage that is happening to our brain. So we have hundreds of thousands of neurons. That connect all the parts of our brain together, connect our brain into our body so that people like me who talk with their hands I don't even think about that. I can't even control that. That just happens. Those are signals coming from my neurons down to my hands. And those neurons, when we have dementia, we're seeing the hallmarks of plaques and tangles. And those pathways, those electrical pathways connecting all our brain together are slowly dying off. Um, and so it can impact different parts of the brain at different parts of the time. But the brain is technically prematurely shrinking. And we now have the type of technology we can see that difference between a normal brain at seventy-five and a brain that has been impacted by Alzheimer's at seventy-five and you can see that. Um, shrink, shrinkage, shrinkage happening. Um, so that is why it's more than just normal aging. You know, I try to provide some levity when I talk about this disease because it is, um, you know, a little bit depressing of a disease, but people will always say, um, Well, I mean, should I be concerned? It took me a little extra time to find my car at Kroger the other day and And I always joke and say, well, we're still not at Kroger, so I guess you figured it out. Um, and that's a good thing because typically being able to figure out something, even if it Takes you a little longer is the normal sign of aging versus something that's much more, um, you know, concerning that may potentially be Alzheimer's or another type of dementia. The other thing I just want to point out is there are things that we are naturally at a higher risk to get as we age. That could also present with symptoms that people think are Alzheimer's. So we can get urinary tract infections, thyroid issues, vitamin deficiencies, dehydration. All of these are things that were a much higher likelihood. Of having issues with as we age and all of them have symptoms that can look very similar to brain fog, forgetfulness, change in personality, typical things that you think about. When it comes to Alzheimer's and dementia. So back to the smashing the stigma idea. That's what we're all about because nobody wants to be diagnosed with Alzheimer's or another dementia. So they just don't talk to their physician. About their concerns, even that concern about it's taking me longer to find my car at Kroger. I always recommend talk to your doctor about that. Have a quick little blood test and make sure you don't have some of these other issues. Because all those other issues are treatable. And if I could tell you, oh, you're just dehydrated, you'd go take care of that. Um, I can't say for sure if that's your issue until you talk to your doctor and you get at least some cursory testing done so we can rule out these. These other things. And that's so true. My grandmother, um, never was diagnosed with, with, with Alzheimer's, but I could tell when she probably had a UTI or something. Because then I would start thinking these are signs of dementia and we go to the doctor, she'd get treated with antibiotics, it would clear that brain fog up. Yeah. You know, now I know that there's many people who will be listening who's dealing with With parents that actually have Alzheimer's. So I don't want to discredit that. Right. But I think that sometimes we can jump to that fear of thinking that's what it is when it's something that we could get a handle on by, you know, Getting treatment when we need to. Yeah. Well, and the other thing that's true about today that wasn't true when my grandmother was diagnosed with Alzheimer's is their We know more about the disease and there may be some treatment options that will help you and we also have some prescription medication that may at least help you deal with some of the symptoms as well. All those things are only going to help you in those very earliest stages. So in my life, for example, my mom lived alone. My father passed away when she was only fifty-two and so she lived a good twenty years on her own. She's very independent, but she was a little bit of a hermit. And so she was able to hide a lot of the symptoms that she was experiencing and actually didn't really have the wherewithal to understand she was experiencing those symptoms, you know, Alzheimer's. One of the hallmark first symptoms is short term memory loss. So she didn't understand that she was causing a lot of the stress in her life. She just thought everybody was going crazy. Um, she was so stressed out just trying to send an email and it was all the computer's fault. Um, her mailman was nutso, you know, it was everybody else's fault. It had nothing to do with her and her opinion. She just lacked that kind of awareness. There's actually a term for that called Anna's agnosium. Um, when we don't, we're, we lack that self-awareness of a medical problem we have because of the medical problem. Um, and so by the time my sister and I really figured out. Something is not right with mom and there's not, you know, really good explanation explanation for what she's dealing with. She was well past those early stages. In hindsight, she probably lived with this disease several years before. We noticed anything. And so it is really important to speak to your doctor because You know, today, if that were the case, any treatment options wouldn't have, she would have not been a candidate for. We missed that whole window by the time we got to the physician and even the drugs that were available. To help us with her symptoms, they did help her, um, but just for a very short period of time, they ran their course, um, pretty quickly in her. She also then kind of took away her options of having a voice for herself too. Um, you know, she did a good job fortunately of having some planning in place around Power of attorneys for legal and financial needs. Um, she was able to tell us a little bit about what she would like in, you know, final stages of her life, but she really Took herself out of the equation of having a voice in that situation because again, by the time she was diagnosed, she really struggled to make good, valid decisions for herself. Um, and you know, we were fortunate and there's no one in our family to fight whether she, you know, was in her right mind and. And those types of things, but have we not had those, those legal documents in place before she was diagnosed, you know, some long lost cousin could come in and say, Hey, you're trying to. You're trying to take over mom's decisions and she signed these papers after she was medically diagnosed with dementia. So you have to think about all those kinds of things. You know, on average, a person lives with Alzheimer's. forty-eight years, four to eight years after they're diagnosed. That all depends on, you know, their general health. Uh, but you can live as long as twenty years. With this disease. So think about, you know, a good part of that not being competent enough to make your own decisions and who will make those for you and have the legal right to make those for you. Knowing sooner what you're encountering does give you options of having a voice while you still have that ability to make your own decisions. Yeah, that's good. That's really good. That advice that I don't know that I'd heard before. So that, that's good. I'm glad you said that so our listeners are thinking outside of just the disease itself, but the legalities of it. Yeah, you, um, you know, this is a little out of scope, but we do some education with wealth advisors and financial advisors and insurance folks, you know, people in A financial industry because now, you know, we've, we have, there's a lot of processes that folks like that will put in place to protect us from scams. Right, and a lot of protections to the technology that manages our funds, manages our bank accounts for us. So, you know, a lot of the industry leaders protect us from bad things and they're now starting to talk about as far as part of their fraud prevention with their clients. How do we protect you from a potential future you? How, what can we put in place with your permission that helps us from And enabling you to make decisions that you wouldn't normally make. So for example, now my father-in-law had already been diagnosed at this point, but. In one phone call, he canceled a pretty sizable life insurance account and there were no questions asked that a man in his 70s would cancel a life insurance policy he'd had For over fifty years. And then one phone call, he was able to do that at that time. Um, and so we really need to support our loved ones that need that kind of help and support earlier. Even to think about this is something that potentially could happen to you. You know, there's almost seven million Americans that have Alzheimer's. And it can even happen to you younger. So we do think of this as a senior citizen sixty-five or older disease, but there's. Um, about 200,000 Americans that actually have what's called younger onset Alzheimer's. They're in their 40s and their 50s when they're diagnosed. Think about, you know, if you're older than that, think about, um, what you were doing in your forties and fifties. Most of us were still raising kids. You're still fully employed. If you worked outside the home, your family may even be relying on your Healthcare and your benefits. And if you have to step away from all of those things, uh, because of this disease, that's going to be much more life altering for your family. Financially and, and a lot of other ways as well so you really do have to face that this is something this are a lot of other things right that could happen that could incapacitate you sooner than you expect and make sure that you have. You know, uh, plans in place that, that your family or trusted friends can help you through things like this. Wow. You, um, you've mentioned you kind of referred to stages. Can you kind of, Walk us through what the different stages of Alzheimer's is, what it looks like. Yeah. Um, so you can read books that will talk about seven stages, five stages, nine stages. Um, they're not wrong. Nobody's wrong, but the association tends to talk about the disease in just three stages, a little more easy. So we combine. A couple of stages, um, in, in to each other, but the way we talk about them is, um, early, middle and late or medical terms, um, mild, moderate, severe. Dementia or Alzheimer's and when you're in those earliest, that early stage, You know, that's, that's the stage where, um, it may be hard for people to even recognize that you are experiencing problems and you may not recognize it in yourself. Um, but Things are slowly getting harder. You're having a lot more problems with just your daily life. These are issues that impact your daily life, not just like every Christmas. I can't remember how to put up the. Christmas lights in my new home or something like that is something that's generally impacting your daily life. So it can look like, um, medication management, you know, how we got my mom to. Finally talked to us about what she was experiencing was we asked her if she had started any new medication recently. And we got really lucky because she had just started on a thyroid medication. And when she showed it to us, you know, it talked about how you needed to take it and, and some of the side effects, which she was having. Um, and then my sister was able to ask her. Are you taking this as it's, as it's prescribed? This is what it says. And my mom was able to say, I can't say for sure that I am. And it was easy for her to say because, you know, Then maybe that's why she's experiencing these things, right? We all went into the doctor's appointment hoping that maybe that's why she was experiencing these things, but she was able to tell us, I don't think I'm managing my medication properly or. It can go the other way, right, where it's not you're forgetting to take medicine, you take medicine over and over, um, and Higher doses in the day than you're supposed to. So it could be something like your pharmacist telling you you're not allowed to have any refills yet. Yet you just took the last pill today and he's telling you you've got two more weeks before you can get refills. That's an indication that you've, you have potentially been taking Your pills more often than you're supposed to, or somebody else is taking those pills for you. But, you know, if you're not in a situation where you think someone else could be taking your medicine, that could be a good indication, indication that you're not. Taking something as prescribed. So those are easy things that could happen in early stage finding ourselves You know, uh, struggling maybe to get home, um, just all of a sudden being lost in very familiar places, um, having a hard time, um. With even our words and word finding or writing can show up in the early stages, but for the most part in the early stage People can live rather independently. My mom, as I said, lived independently in that early stage and really even had we known, she would just have needed a little bit of supervision. And could have had a, and did have a great quality of life on her own. The middle stage tends to be the longest of the stages. Although everyone progresses at a different rate, each stage is a different amount of time. Symptoms can vary per person. Um, the middle stage tends to be the longest and tends to be the most difficult for everyone. Because in the middle stages, we are having a lot more problems with memory loss, with following processes. They can even be processes we've known since we were children, like brushing our teeth. But those processes are rather complex, actually, so if we all Decided that we were going to write down all the steps on piece of paper to teach someone to brush their teeth. It's a good page. If not more, there's lots of pieces to, to that step. And so if we, people are telling us, you know, we're not, oh, you're Your wife's telling your breasts really bad or your dentist is saying, I don't think you're brushing your teeth. You know, that could indicate that, well, I start to brush my teeth, but then I get lost in the process and I don't finish it. Um, so we can be getting lost a lot more when we're driving and so this is a stage where We start to lose our independence a little bit for our own safety and typically our family wants to get more involved and should get more involved or if we don't have someone that's involved where. Struggling and our quality of life is really diminishing. It can involve even more issues with speaking. And word finding some people have a symptom called, um, aphasia, meaning that they can't get their words out. They have a problem speaking, um, in general. And so. What we need to understand is humans in general will also behave in certain ways as a form of communication. So behaviors are a way we all communicate. If you have teenagers out there, you know what I'm talking about, right? They come home from school. They don't talk to you about school. They walk straight in their room, close their door. Sometimes they stomp on the way in there. Those are behaviors and there's a communication behind those behaviors. So when we're having a hard time finding our words or expressing our emotions, emotions, or speaking in general, We'll use behaviors more and not all behaviors when we have dementia are safe. Um, like we're more forgetful. So if we have electric stove or we like to light candles, that can be a risk because we can forget that we've done those things and we can easily start a fire. Um, so there's lots of dangers that could be involved. Um, this may be a time where we're forgetting to pay bills. We're forgetting to pay our property taxes. Um, and you know, the great folks in Montgomery County don't know there's anything wrong with us, so they are Proceeding as if we're not paying our property taxes and taking actions, um, that our family doesn't even realize behind the scenes all that's happening, that we're, um, you know, behind on lots of things. It can be a real safety risk in that middle stage. Um, the other thing that tends to happen with Alzheimer's, so Alzheimer's itself Starts in the part of the brain called the hippocampus part of the brain. It is where we store our short-term memories. One of the things that it's, it's responsible for. We actually restore our long-term memories in a totally different part of the brain, and I'm sure we'll talk about that at some point. While we sleep, they move from the short-term memory area to the long-term memory area, and that's why sleep is so important. Um, for us and our future cognition, but when our short-term memory is that short-term, uh, area of the brain is being impacted by Alzheimer's. We're relying much more on those long-term memories and that part of our brain and that part of our brain, if you have a typical Alzheimer's process, which. Very few people do, but for the most part we hold on to the long-term memories the longest. And so you may notice as a family member that your loved one is talking Like it's 1975, not 2025. They think they're younger. Um, we've had folks that call the police because they have a peeping Tom. And when the officer gets there, they show them their mirror. Because they don't recognize their own image. Uh, they believe that they're much younger, uh, cause they're almost living their life backwards. Um, they'll. A lot of times a reason a person wanders and gets lost outside their home when they have dementia is because they are living in another era. So they are trying to find children at the school bus. And these children are potentially now fifty and have their own grandchildren. But in their mind, they believe they have a first grader and a third grader who have not shown up and they must go find these children. And imagine the urgency, a sense of urgency and. How you were behaving if, if you believed that that was true, um, or that they are late for work. They have got to get to work. They are going to be fired from work. My family relies on this paycheck and you potentially have been retired for thirty years, but in your mind you're still working. It could even be more of a safety risk if you believe you're in the middle of the Vietnam War, right? Um, so if you're living your life in other decades, you may not recognize your own spouse, your own children, it's not that you don't Remember them, but you know, my spouse is a young man or I'm not even married yet. Um, so you'll notice a lot of those things in the middle stage that. Really make it more difficult on the family, can provide more safety issues to the loved one, and a lot of times in that stage is when we may have to move our loved one into more secure Situation like a memory care community or just start to get more help inside the home to keep them safe. The late stage of the disease. Typically is the one where our mobility is the most impacted and processes in the body are starting to shut down. So the brain is the computer for our whole body. And so it can, you know, have an impact in our heart. Um, if we haven't had a stroke or heart issues, we may start encountering them in the late stage. Um, it again. Impacting speech or written communication and then our mobility can also be impacted. So we may now have problems getting out of a chair on our own, walking on our own. Um, so we may be bedridden. Um, it may have impacted our ability to eat on our own. So to feed ourselves or to swallow properly. Uh, we're likely having to rely on someone else to dress us, to bathe us, to help us with the restroom. We're probably incontinent in the later stages. And so you can imagine that in the late stages you need round the clock care, whether that's in your own home or if that's in a senior living community, um, you know, the late stages can be the hardest when it comes To care. And again, no one can tell you. How long you'll stay in each stage. Some people stay in that late stage actually longer than they even stayed in the middle stage. The disease is very unique because how we use our brains is very unique.

Dana, what does treatment look like for someone diagnosed with Alzheimer's or some type of related dementia? Yeah, um, so right now there's no cure for Alzheimer's. We've come a long way in this disease, um, You know, thirty forty years ago it was true that you could not be accurately 100% diagnosed with Alzheimer's without an autopsy. So not very helpful to the family and those Years that you struggled. Uh, that's no longer the case. Uh, we now have advanced quite a bit in science and we know Exactly what we're looking for in the brain. We have the ability with imaging to see those things in the brain. So with things like PET scans, um, we also know what we're looking for in certain body fluids. So spinal tap fluid. Uh, getting a spinal tap is a way that you could get an accurate diagnosis of Alzheimer's and now through blood. Um, so the Alzheimer's association has been. Funding lots of research where we've now figured out biomarkers that are in just a very small blood sample that we can use to diagnose someone with Alzheimer's. Now we're just Training the healthcare community on how, what they're looking for and how to read those blood results. But we've come a long way in knowing what it looks like in the brain. We do not know what causes what we're seeing in the brain. We have a lot of great hypothesis. There's a lot of great research happening right now, but it's basically like. There's a leak in your basement and you don't know where the leak's coming from. So every once in a while it floods and you clean it up, but you can't stop the leak because you don't know the cause of the leak. So we're starting to advance with some treatment options, but I don't expect we're going to have a cure until we know exactly what's causing these things that we see. And so that's why we, we're the largest nonprofit funder of research trying to understand these pieces. Um, when you're in that early stage, The treatment options that are now available through the FDA um, and you know, are not easy things to execute, but um, there is some treatment That you can take through infusions right now and if you're a candidate for those treatments it may keep you in that early stage a little longer. Um, right now it looks like Three to six months as, as people are on this treatment. Some people are getting even more time in that early stage at that, um, with those treatments. Um, there are some. You know, side effects with the treatments that you'll need to understand and you do have to be a candidate. So you do have to have PET scans, have some very specific testing done to make sure this treatment will help you. Um, because it's looking for a very specific type of protein buildup in your brain. And if you don't have that protein buildup, then we're just, um, you know, throwing money down the toilet for those treatments. Um, they also can be kind of costly, although now, uh, centers for Medicare are covering these treatments. Um, but again, the very best treatment out there. Is really only gonna help you in the very earliest stages of the disease and only increase the amount of time that you'll stay in the early stage before you start to decline. Now that's still huge if you've ever had a loved one who had Alzheimer's. That's big to be able to keep them early stage three months more. Think of all the memories that you could create for yourself and your family. At that higher quality of life, um, think of all the plans that you could put in place at that higher quality of life when they can still make their own decisions. Although some people look at that and feel like that's not really a big deal. I would say if you've ever had a really close relative with this disease, that could be a huge deal. So you do want to make sure if you're in the early stages that You have a neurologist that talks to you about treatment options and that you're able to make your own decisions on whether you want to pursue a treatment, um, or not. There's a lot more treatments in the pipeline that research is funding and then they're very different, um, very different research that's happening right now. Not all of them are targeting that kind of protein. In fact, we have lots of research that's focused on lifestyle changes. So it could be as easy as I eat blueberries every morning. And Connie's not allowed to have any blueberries and we see if our cognition, uh, is any different over that time period. So a lot of people, you know, the biggest issue for us finding a treatment Money is a big piece of it, but even if we had all the money in the world, it's having enough people in our clinical trials and diverse people in our clinical trials. Something I haven't said yet that's really important. Is that African Americans are older African Americans are twice as likely to have Alzheimer's or another dementia than white older white Hispanics are one and a half times more likely to have. Alzheimer's are another dementia than Caucasian. So this is a disease that for some reason impacts those communities more. We believe it's the relationship between the heart and the brain and that those two communities are more. Likely to have heart related issues and that's what's bringing their risk so much higher for a brain related disease like Alzheimer's or another dementia. But if that, those, those are the facts, unfortunately. And if you think about clinical trials, then they have to be well represented African Americans and Hispanics. In our clinical trials. And so we need people who will sign up for clinical trials. And we not only need people who've been diagnosed with the diseases, but healthy, Senior citizens as well. We have to have a control in there. A lot of times people are concerned about participating in a clinical trial because they don't want to be a pin cushion, right? We don't want to be injected with things. We don't know what they are. But again, a lot of these research projects right now are not that. You can find, there are a lot like that, but there, you can find some where it's just I'm going to change my level of exercise or I'm going to change your nutrition or I'm going to change how much socialization you have or your cognitive exercise. Have to be things that, you know, pills and shots and medications and things like that. If you're interested in learning more about clinical trials, the Alzheimer's Association has a free service to help you find trials that you may Um, be applicable for. So, um, we have, uh, something called trial match, uh, program. Again, it's free. We're not signing you up for a trial. We just take down some information about you and then provide you all the options of where there are clinical trials and then you need to take that next step. But if you want to know more about Trial match, uh, please call our 24-7 helpline, which is 800-272- 3900 or you can go to our website, which is alz.org and look under clinical trials there, but that's how we're going to get more treatments and eventually find that cure. So now you talked about treatment and early diagnosis, but is there a way to prevent dementia related diseases? Yeah. So there's a lot of research as I started to say around lifestyle changes, um, And again, this isn't a hundred percent. I can't, we're not to the point where we can tell people a couple, a cup of blueberries every day will keep you from having dementia, but. We do know that there is a correlation in, um, some of these areas of our lifestyle and our cognition. And as well as heart disease, as well as cancer, a lot of these things that we know can, um, lower your risk of dementia are very similar things to lower your risk to heart disease and cancer as well. So there are things like, um, exercising, right? And our nutrition. Those are two really important things. I mentioned this when I was talking about why we think maybe African Americans and Hispanics are at a higher risk of dementia. The heart and the brain are best friends. Um, 25% of the blood and every heartbeat goes to your brain. As well as oxygen in that blood. So if you have a regular heartbeats, if you have a high blood pressure, even diabetes, anything that's a cardiovascular issue. That can impact the blood flow that's going into your brain. So we have a lot more research around heart disease as a, as a, Society, so we do know for heart disease, we have to have a certain amount of exercise and we have to follow certain nutritional guidelines, right? The more fried foods, the higher your risk of heart disease. So that's also true of dementia. So we want to be focused on heart health. And making sure that, um, you know, we're feeding our body the best things for heart health and we're exercising regularly. And you don't have to go overboard on that, um, exercise piece, you know. Studies even show, uh, thirty minutes a day, five, three to five days a week can be beneficial and it doesn't have to be running a marathon or. Riding 500 miles on your bike, it can be just taking a nice walk. Um, really you're wanting to get your heart rate up to the point that If you're carrying on a conversation with somebody or you're talking to somebody on your phone, they know you're exercising. You can still have a conversation, you can still speak just fine, but you're huffing and puffing a little. Um, I see those people who are reading a book on their treadmill. You really can't get your heart rate up too high if you're going to be able to follow a book, you know, and the lines across the text in a book. You need a little higher than that, but you also don't have to be, you know, to the point you can't catch your breath at all. You just need to be where I can still talk to you just fine. It's just a little, uh, a little bit of a windedness in what I'm saying and Um, when it comes to your nutrition. The Mediterranean diet's a great diet to follow. Uh, there's also a diet called the MIND diet. That's an acronym. It's M-I-N-D and it's basically, um, kind of, uh, An altered Mediterranean diet. And so it follows the same principles, but it focuses a little bit deeper than the Mediterranean diet. So the Mediterranean diet, for example, Um, talks about the importance of vegetables. Mind diet talks about the importance of green, dark, leafy vegetables over Lighter vegetables, um, Mediterranean diet will talk about fruits, uh, and the mind diet just goes deeper and talks about the importance of certain types of berries, uh, for example. So just a little Deeper click into the Mediterranean diet. Uh, there's lots of books and websites about the mind diet and what you need to do to follow that. Um, but it's, it's pretty basic stuff that a lot of us have heard before. Uh, the other two things though that, well, there's more than two, but things that surprise people. I mentioned about sleep and the importance of sleep, and that's because not only are your short-term memories moving over to the long-term memory part of your brain. We now know there's cleanup happening in that hippocampus part of your brain while you're sleeping. So your body will naturally clean out some of the junk that's in your brain While you're getting good quality sleep. So the key is we have to get good quality sleep. So we're talking about seven to eight hours of good in a good uninterrupted sleep. Without any prescription medication, what we're trying to do is get our body into non REM sleep. That's a deeper level of sleep than REM. Non-REM sleep is when the cleanup happens, when the short-term memories move to the long-term part of the brain, but that seven to eight hours of sleep is how we get the most time in non-REM. REM sleep. When we take medication to get a good night's sleep, We stay more at that REM level. The medications just not allowing us to get to the deeper part of our sleep. And so that's why we need to try to get this kind of sleep naturally. You can try things like that are natural, like melatonin, um, for example, but all the things that are out there now talking about how to get a better night's sleep, you know, turning off your computer and your cell phone sooner and. Sleeping in a colder room, sleeping in an absolutely dark room, all those types of things, um, really paying attention to things like sleep apnea, which can also have a, an impact to the brain. That's really important. Um, I used to have to talk a lot about social engagement and socialization and why that's so important to the brain. And COVID helped us all understand that a little better. And we all got a little stir crazy when we couldn't socialize with other people. And then there's exercising your brain. So exercising your brain is really important, but how do you do that? And that can be really hard after you retire. Um, if you're still working or if you have worked outside the home, just think about all the things your brain has to remember or has to problem solve. For you to work outside your home. You could even work totally alone or not really be in a social job, but you have to remember passwords. You have to remember directions. Um, you may want to remember, you know, certain people's names that might help you if you forget your badge or forget your password. Uh, there's lots of Cognitive exercise involved in working outside the home or raising little kids, right? And so as we get older and we retire, it can be really hard to replicate that type of cognitive Exercise. Um, so what you want to do is focus on three things. Um, one, you want to learn new things, lifelong learners. Have the best cognition. They've actually studied nuns who are known to be lifelong learners. And, uh, there's a great study you can look up called the nun study. You know, some of those ladies, uh, had an autopsy and had all the conditions for Alzheimer's, but never presented with it. Um, and they believe their lifestyle had a lot to do with that. So learning new things, you don't have to go back to college. Um, if you don't want to, there's so many things we can learn just through YouTube at our libraries. At the parks department, um, learning any kind of new thing can be beneficial. You want to make sure the things you're doing are challenging. Um, my mom would do Sudoku. She did the easy Sudoku. So we were buying like one a week there for a while. She wasn't challenging herself. And I said, well, these seem to be pretty easy for you if we're buying Sudoku books so often. And she said, oh, yeah. It's like checking off my to-do list. I just love to get through them as quick as possible. And she didn't like the idea of moving up to advanced because that was going to be frustrating to her. So you don't want to be frustrating, but you do need to understand that Challenging your brain is beneficial to your brain. Um, so a little bit of a challenge take, you know, getting a little bit harder of a jigsaw puzzle, um, is really a benefit. To your brain. And then the last thing you want to do is, you know, kind of mix it up the things that you're doing to exercise your brain. So, um, you know, there's different parts of the brain parts that are artistic parts that are. More, you know, the problem solving or the, the quantitative or part of the brain and you want to be using all of those. So let's just take puzzles. If all we wanted to do was puzzles, um, let's just take that idea. And say, okay, in the morning, if you feel the best, maybe you do your crossword puzzles. Crosswords are getting at trivia, they're getting at spelling, that part of the more, um, you know, language based part of the brain. At lunch, you could do more of a numbers-based puzzle like Sudoku or something like that. That's a math part of the brain. At night, you could just pull out, like I said, the good old jigsaw. That's a visual puzzle. There's also tons of visual puzzles on. Our cell phones now, right? Candy crush and whatever's really in up to date right now. Um, but the, that's exercising a different part of your brain. Um, so all puzzles, but three very different types of brain exercises throughout the day. And then imagine if I threw in a painting class on top of that, like that's a totally different Part of the brain then because we're creating, um, art. So really kind of diversifying the things that you do throughout the day can help you get that kind of cognitive exercise benefit. You've given us a lot of good information. I'm just curious if, what would you say to somebody who's just been diagnosed or their family? What's the first thing that you would tell them to do? Because I would assume this is very overwhelming to someone. So what would, what would your best advice be? Yeah, I always tell people to call the Alzheimer's Association and get a care consultation. Our care consultations are free. And they are led by folks that have, that are nurses, social workers, geriatric care managers, people who understand this disease and all the resources needed by this disease. And so they can kind of put together a care plan for you. They, uh, we have local care consultants that can sit down with you in person. Um, and just talk, you know, ask you some questions and figure out where you need to focus first. Um, because you know that right after we get that diagnosis, probably in that next week is not when we go out and look for senior living that we may need. Five years from now, but that could be the time that where are our powers of attorney? Where are our wills? Do we have Advanced directives, um, or a living will on if we want, you know, reset the resuscitation or beating tubes, like getting. All those things in place that we need in place while we still have full cognition. That's where the clock, you know, is ticking there. So we might want to focus on that, but we can Help you plan other things. You know, maybe you've already had those things in place. Um, so there may be other things you need to focus on. You know, how are you going to tell your family if you're still working? Are you going to tell your employer and how do you do that without. Risking losing your job next week. Um, so we can kind of help you in your individual situation, put together that care plan, and then you can get as many free care consultations. As you need throughout the journey of this disease. And if you don't live in the local Cincinnati area, and actually, even if you do, you can call that 800 number. Give us that number again. It's 800 272-3900. You can also find it at alz.org. You can have a care consultation over the phone by calling that 800 number. If you'd prefer to talk to somebody in person in the state of Ohio, you can ask for a follow up call from your local Alzheimer's chapter and in the state of Ohio. Through grant funding that we've received from the Department on Aging, we still have local people, nurses, social workers, geriatric care managers that'll sit down with you in person. And help you with that care planning, which can be really beneficial because somebody on the 800 number, they're spread throughout the country. They may not know about Meals on Wheels in your neighborhood or. Um, counsel on aging in your, uh, county, those types of things. So, um, using the 800 number, asking if you're, you can get a follow-up call from your local chapter if you want to talk to a local person. That can really, I mean, it sounds selfish, but that is really the best first step because it is overwhelming. Um, it truly is overwhelming. And I think the other thing just less, uh, selfishly is. When you walk out of that appointment, remember you're the same person that walked into that appointment. Um, you know, don't take yourself out of the game prematurely. Uh, yes, maybe you. Might want to consider if you're still driving. At what point should I stop driving? Is it safe for me to still drive? But you don't have to bundle yourself up in bubble wrap. And go into a dark room and sit in the corner. Um, you still have so much life that you can live and you have to sometimes explain that to your family too. I'm the same guy that watched your grandchildren last week. Uh, that's, that's still me. It was just now we know that I have a disease. So, you know, if you. Maybe there was concerns about you watching the grandchildren last week, but people don't have to walk on eggshells around you at all times. Yeah, we want to keep you safe and everybody around you safe, but we don't have to just prematurely Disconnect from everyone or disconnect our loved ones from everyone because now we have a dementia too. So get out the bucket list, take, you know, those trips you've wanted to take. Get in contact with people you want to talk to again and spend as much time with them as you can. Um, there's lots of great social. Programs that the Alzheimer's Association offers that are free. We have a lot of people in those early stages making brand new friends that are lifelong friends now. Uh, cause they came to some of our social programs that we offer people for people who have the disease. So call us and live your life. Those are the two just most basic, um, Tips I would give someone who's just been diagnosed. Dana, this has been so informative. Um, thank you for sharing your personal experience with your mother. Um, we appreciate your vulnerability in doing that and you're using it in such a good way to help others. Thanks. Um, we appreciate just all of the, the ideas and. How you brought things down in examples, you know, that really helps to, to internalize this and make more sense of it when you're a family member. Um, I know that it's going to be very helpful for our listeners. Good. Thanks. So listeners, be sure to check back to this podcast channel for upcoming podcasts in this series. We plan to talk about warning signs and healthy habits for the brain communication and how that looks for an Alzheimer's patient. And lastly, behaviors to expect in Alzheimer's patients. Thank you so much, Dana, for joining us on behalf of my partner, Connie. Thank you for listening.