Rewriting the Script on Dementia and Alzheimer’s: An Insightful Discussion with Dr. Choctaw

1 00:00:00,501 --> 00:00:02,424 Speaker 1: Welcome to the healthy, wealthy and wise 2 00:00:02,524 --> 00:00:08,105 podcast with Dr William Chokta, MDJD. Our mission is to empower 3 00:00:08,144 --> 00:00:11,917 you with the knowledge and the tools you need to thrive in all 4 00:00:12,118 --> 00:00:16,204 aspects of your life. Join us now as we discuss everything 5 00:00:16,285 --> 00:00:19,823 from nutrition and exercise to money management and personal 6 00:00:19,862 --> 00:00:24,753 growth. Dr Chokta will provide insightful advice on how to 7 00:00:24,794 --> 00:00:28,064 improve your physical and financial health, as well as 8 00:00:28,123 --> 00:00:31,460 your emotional and mental well-being. Whether you're 9 00:00:31,481 --> 00:00:35,936 looking to boost your energy levels, unlock financial freedom 10 00:00:35,936 --> 00:00:40,228 or cultivate a more positive mindset, we've got you covered. 11 00:00:41,880 --> 00:00:45,901 Get ready to become the best version of yourself? So let's 12 00:00:45,941 --> 00:00:49,552 get started. Here's Dr William Chokta, MDJD. 13 00:00:50,055 --> 00:00:54,067 Speaker 2: Good morning. I'm Dr William T Chokta and I'm 14 00:00:54,107 --> 00:00:57,283 delighted to have you with us today. Today, we have a very 15 00:00:57,343 --> 00:00:59,920 important topic that we're going to talk about. We're going to 16 00:00:59,941 --> 00:01:04,483 talk about dementia versus Alzheimer's, but before we get 17 00:01:04,543 --> 00:01:08,884 started, let me just make a general comment. Each month, we 18 00:01:08,965 --> 00:01:13,418 strive to provide you, with our listeners, with mental, physical 19 00:01:13,418 --> 00:01:17,546 and spiritual strength by giving actionable advice, tips, 20 00:01:17,927 --> 00:01:23,563 guidance and information to help you achieve your own personal, 21 00:01:23,885 --> 00:01:28,364 professional and spiritual goals . We consider the health of the 22 00:01:28,444 --> 00:01:34,180 mind, body and spirit paramount as a single unit that provides a 23 00:01:34,180 --> 00:01:38,829 cumulative strength greater than the individual parts to 24 00:01:38,950 --> 00:01:44,606 strengthen the whole person. So again, welcome with joining us 25 00:01:44,727 --> 00:01:48,341 today for this very important topic. As I said, we're going to 26 00:01:48,341 --> 00:01:52,831 talk about dementia versus Alzheimer's. Which is it and why 27 00:01:52,831 --> 00:01:56,206 is it important? In other words , why is it important for you to 28 00:01:56,206 --> 00:02:00,784 know about dementia and Alzheimer's and understand the 29 00:02:00,825 --> 00:02:04,584 difference between the two? As always, we like to start off 30 00:02:04,625 --> 00:02:08,507 with our beliefs. I believe life is about being of service to 31 00:02:08,668 --> 00:02:13,064 others. I believe knowledge is power. I believe leaders can 32 00:02:13,104 --> 00:02:18,000 change the world. We also always like to put up an outline. This 33 00:02:18,000 --> 00:02:21,540 gives you an idea about what we're going to talk about and, 34 00:02:21,561 --> 00:02:24,629 as important, it lets you know, when we're just about done, 35 00:02:25,099 --> 00:02:27,293 we're going to talk about dementia, we're going to define 36 00:02:27,373 --> 00:02:30,820 it. Then we're going to define Alzheimer's disease. We're going 37 00:02:30,820 --> 00:02:36,497 to go through the diagnosis and treatment and also give you 38 00:02:36,538 --> 00:02:40,901 some suggestions about prevention. This is part of our 39 00:02:40,961 --> 00:02:43,889 masterclass series. The topic today, as all of these 40 00:02:43,968 --> 00:02:48,245 presentations, and our goal overall is to help you to have a 41 00:02:48,245 --> 00:02:54,042 more healthy, wealthy and wise lifestyle and allow you to be 42 00:02:54,201 --> 00:03:01,582 mental, physically and spiritually healthy. So what is 43 00:03:02,485 --> 00:03:05,572 dementia and how does it differ from Alzheimer's disease? 44 00:03:06,439 --> 00:03:11,088 Dementia is a general term for decline in cognitive ability 45 00:03:11,689 --> 00:03:15,703 that includes memory loss and thinking difficulties. Let me 46 00:03:15,763 --> 00:03:21,026 say that again. Dementia is a general term for decline in 47 00:03:21,106 --> 00:03:25,703 cognitive ability that includes memory loss and thinking 48 00:03:25,984 --> 00:03:30,705 difficulties. In other words, dementia is an umbrella term 49 00:03:31,127 --> 00:03:36,784 that has to do with difficulty with memory. So it's an umbrella 50 00:03:36,784 --> 00:03:41,167 term. Dementia is not a disease . It is basically a category, if 51 00:03:41,167 --> 00:03:45,240 you will, an umbrella category that includes a number of 52 00:03:45,300 --> 00:03:49,081 different disease under it. Alzheimer's, on the other hand, 53 00:03:49,483 --> 00:03:57,429 is a specific brain disease. Alzheimer's is a specific brain 54 00:03:57,688 --> 00:04:01,305 disease and, what's more important, alzheimer's is the 55 00:04:01,385 --> 00:04:05,161 most common cause of dementia. So there are a number of 56 00:04:05,181 --> 00:04:10,451 different causes of this umbrella term called dementia 57 00:04:11,719 --> 00:04:15,532 and of those different terms. Alzheimer's is one of them and 58 00:04:15,573 --> 00:04:22,303 the most common one causing dementia. So again, dementia, 59 00:04:22,625 --> 00:04:29,538 general umbrella term for memory difficulties or inability to 60 00:04:29,620 --> 00:04:35,346 make proper decisions. It's a disease of the brain that is the 61 00:04:35,346 --> 00:04:42,363 most common cause of dementia. So if we were to first just take 62 00:04:42,363 --> 00:04:47,021 a look at dementia and this again is an umbrella term for 63 00:04:47,180 --> 00:04:51,475 issues that have to deal and that cause dementia we look at 64 00:04:51,535 --> 00:04:54,987 things like individuals who begin to develop difficulty with 65 00:04:54,987 --> 00:04:57,386 language. They can't find the right words to say what they 66 00:04:57,425 --> 00:05:00,427 want to say. They have difficulty solving problems. 67 00:05:00,959 --> 00:05:05,153 They have confusion of time and place in terms of where they're 68 00:05:05,173 --> 00:05:09,180 supposed to be and what they're supposed to be doing. They may 69 00:05:09,221 --> 00:05:14,547 have some changes in personality . They end up having examples of 70 00:05:14,547 --> 00:05:18,605 poor judgment. They sort of make decisions that are not wise 71 00:05:18,605 --> 00:05:22,660 and out of character of what they would usually make. They 72 00:05:22,699 --> 00:05:26,661 have problems communicating and they misplace things. Now, we 73 00:05:26,761 --> 00:05:29,908 all misplace things, but we're talking about individuals who do 74 00:05:29,908 --> 00:05:36,848 it on a broader basis. So if we look at Alzheimer's and 75 00:05:36,889 --> 00:05:42,461 dementia and compare the two again, dementia is not a disease 76 00:05:42,461 --> 00:05:47,685 and Alzheimer's is, and dementia is a very general term 77 00:05:48,927 --> 00:05:54,100 that involves difficulty with cognition or thinking. Dementia, 78 00:05:54,100 --> 00:05:57,952 on the other hand, is a complex set of diseases that 79 00:05:58,596 --> 00:06:02,723 progressively get worse over time. So let's drill down a 80 00:06:02,764 --> 00:06:06,766 little more closely now. With dementia, we say it has to do 81 00:06:06,826 --> 00:06:10,300 with recent memory loss that affects daily life, but a person 82 00:06:10,300 --> 00:06:13,084 with dementia would have troubling remembering 83 00:06:13,125 --> 00:06:18,463 conversations or may even ask repeated questions because their 84 00:06:18,463 --> 00:06:22,101 short-term memory has been compromised. In terms of 85 00:06:22,622 --> 00:06:26,875 difficulty performing regular tasks, someone with dementia 86 00:06:26,954 --> 00:06:30,821 might have a difficulty driving a familiar route. Let's say you 87 00:06:30,862 --> 00:06:34,062 drive a certain distance to work every day. Let's say it takes 88 00:06:34,083 --> 00:06:37,564 you 20 to 30 minutes to get to work. You go the same streets 89 00:06:37,704 --> 00:06:41,327 each time, but if you're developing dementia you may have 90 00:06:41,327 --> 00:06:46,343 difficulty going through that familiar route and consequently 91 00:06:47,646 --> 00:06:51,362 be late for work. Sometimes Individuals with language, 92 00:06:51,944 --> 00:06:56,540 individuals with dementia, might have difficulty following or 93 00:06:56,740 --> 00:07:00,687 starting conversations. They may use the wrong words and 94 00:07:00,728 --> 00:07:05,122 primarily because they're unable to remember the proper words 95 00:07:05,141 --> 00:07:08,019 that they should use. In this particular conversation we're 96 00:07:08,040 --> 00:07:11,944 talking about dementia now. Disorientation of time and place 97 00:07:11,944 --> 00:07:15,166 Disorientation with dementia will be confused with the time 98 00:07:15,228 --> 00:07:19,072 of day and what's appropriate to do for that time, in other 99 00:07:19,093 --> 00:07:24,278 words, for lunchtime. They may be confused whether it's 100 00:07:24,338 --> 00:07:29,161 lunchtime or breakfast time, etc . Etc. Decrease for judgment. We 101 00:07:29,161 --> 00:07:34,730 talked about bad decisions, about their appearance, and 102 00:07:34,790 --> 00:07:39,295 indeed, they may start having difficulty in how they appear 103 00:07:39,375 --> 00:07:44,221 physically and how they dress and how they prepared for a 104 00:07:44,262 --> 00:07:50,132 particular event, or even going to work Problems with complex 105 00:07:50,232 --> 00:07:54,716 tasks. A person with dementia will have a difficulty keeping 106 00:07:54,735 --> 00:07:59,180 track of finance, let's say paying the bills on time, maybe 107 00:07:59,240 --> 00:08:03,584 difficulty managing a certain meal. Maybe this person fixes 108 00:08:03,684 --> 00:08:08,091 meals for the family meal or female, but they may not 109 00:08:08,170 --> 00:08:12,076 remember the steps, the individual steps, to making a 110 00:08:12,115 --> 00:08:17,961 cake or making bread or other types of meals Basic things that 111 00:08:17,961 --> 00:08:22,971 they've done for years now become problematic. One of the 112 00:08:23,050 --> 00:08:26,274 other more obvious things is misplacing things. Again, we all 113 00:08:26,274 --> 00:08:30,860 misplace things, but the distinction I like to use is I 114 00:08:30,901 --> 00:08:36,110 may misplace my keys periodically, and that itself 115 00:08:36,171 --> 00:08:40,474 may not be that big a deal. However, individuals with 116 00:08:40,575 --> 00:08:46,198 dementia, particularly advancing dementia, misplace items in the 117 00:08:46,198 --> 00:08:51,384 wrong place. For instance, if I misplace my keys on the desk, 118 00:08:52,144 --> 00:08:58,533 that itself may not be a major issue, but if I misplace my keys 119 00:08:58,533 --> 00:09:04,559 in the refrigerator, that then is more suggestive of a dementia 120 00:09:04,559 --> 00:09:11,351 type of problem than just mild forgetfulness, etc. Etc. Changes 121 00:09:11,351 --> 00:09:15,437 in mood or behavior, personalities may switch very 122 00:09:15,517 --> 00:09:20,224 quickly. Emotions may switch very quickly to the extent that 123 00:09:20,264 --> 00:09:24,293 they are out of the ordinary. Again, we all may have different 124 00:09:24,293 --> 00:09:27,178 emotions, but these are things that will jump out to you, 125 00:09:27,360 --> 00:09:31,697 either within yourself or with those around you. That may be 126 00:09:31,756 --> 00:09:36,972 suggestive of a dementia type problem Relating to others. 127 00:09:37,855 --> 00:09:40,840 Individuals with dementia may have difficulty remembering 128 00:09:41,561 --> 00:09:45,287 individuals and being able to communicate with those 129 00:09:45,346 --> 00:09:49,374 individuals who they've known before. And loss of initiative. 130 00:09:51,476 --> 00:09:55,303 Persons may just may not feel like they have much energy, just 131 00:09:55,303 --> 00:09:58,850 don't want to do very much and not interested in things all of 132 00:09:58,870 --> 00:10:02,845 a sudden, whereas maybe before they were very engaged in 133 00:10:02,904 --> 00:10:06,873 various different activities. So again, we're talking primarily 134 00:10:06,913 --> 00:10:11,619 about dementia now. Dementia is the umbrella term that involves 135 00:10:11,740 --> 00:10:16,365 cognitive ability or lack of ability, cognitive meaning 136 00:10:16,424 --> 00:10:22,058 thinking. So dementia is a umbrella term that has to do 137 00:10:22,119 --> 00:10:27,509 with inability to think the way you normally would think to get 138 00:10:27,528 --> 00:10:31,075 things done. Another important aspect of dementia that we've 139 00:10:31,115 --> 00:10:34,760 touched on slightly, but let's delve a little deeper is the 140 00:10:34,821 --> 00:10:39,234 psychological symptoms of dementia Personality changes. 141 00:10:39,354 --> 00:10:44,361 You may live with a spouse who begins to develop dementia, who 142 00:10:44,501 --> 00:10:47,847 suddenly may shift in personality and behavior to the 143 00:10:47,888 --> 00:10:51,073 extent that you notice it. And I mentioned spouse because our 144 00:10:51,115 --> 00:10:55,965 spouses notice us more closely than most others, so you, the 145 00:10:56,004 --> 00:10:59,932 spouse, would be the first one to know to notice, but you seem 146 00:11:00,032 --> 00:11:04,076 more down the last couple of weeks or the last couple of 147 00:11:04,136 --> 00:11:09,744 months, or you seem more combative, or something to that 148 00:11:09,803 --> 00:11:14,714 effect. A part of the psychological symptoms can 149 00:11:15,053 --> 00:11:19,640 include anxiety. Maybe the individual now worries more or 150 00:11:19,701 --> 00:11:23,330 frets more about things than they used to, but the little 151 00:11:23,350 --> 00:11:26,491 things that didn't bother them now just sort of appear to make 152 00:11:26,511 --> 00:11:32,259 them very upset and very uncomfortable. And again, the 153 00:11:32,298 --> 00:11:36,630 depression you know not wanting to do anything, not finding any 154 00:11:36,751 --> 00:11:42,921 joy or pleasure in anything Many times can be suggestive of a 155 00:11:42,980 --> 00:11:47,399 type of depression. Obsessive tendencies Again, these are 156 00:11:47,879 --> 00:11:53,212 actions of the mind and that translate into behavior that 157 00:11:53,253 --> 00:11:55,600 cause us to do certain things that we just would not 158 00:11:55,720 --> 00:12:00,605 ordinarily do and where we obsess over something over and 159 00:12:00,705 --> 00:12:04,317 over and over again in a way that stands out and does not 160 00:12:04,356 --> 00:12:10,273 appear to be normal for us. Pollucinations of paranoia. 161 00:12:10,534 --> 00:12:12,601 Pollucinations mean you see or hear things that are not there. 162 00:12:13,715 --> 00:12:16,505 You hear sounds that are not really there and you see people 163 00:12:16,606 --> 00:12:20,139 or figures, or imagine that you're seeing things that are 164 00:12:20,200 --> 00:12:24,636 not there. Inappropriate behavior. Your behavior is a 165 00:12:24,697 --> 00:12:29,046 difficult one, but the way this shows up is individuals who may 166 00:12:29,187 --> 00:12:33,182 laugh in a situation that appears to be inappropriate. 167 00:12:34,475 --> 00:12:38,822 Someone shares a very sad story or very sad experience and this 168 00:12:38,903 --> 00:12:45,014 person would laugh or just act inappropriately. These are 169 00:12:45,076 --> 00:12:51,268 suggestions, some cognitive, ie thinking abnormality that may be 170 00:12:51,268 --> 00:12:55,364 associated with this umbrella term that we call dementia, 171 00:12:58,399 --> 00:13:02,129 agitations in mood and just getting upset, a lot or little 172 00:13:02,229 --> 00:13:06,256 noises that bother you more than they used to. If the gardener 173 00:13:06,277 --> 00:13:10,873 is outside more in the lawn, the sound of the lawnmower may just 174 00:13:10,873 --> 00:13:15,179 drive you up the wall, and then just a general lost of interest 175 00:13:15,179 --> 00:13:21,181 . Let me say a quick word about depression, because depression 176 00:13:21,240 --> 00:13:27,916 will basically be impacted by dementia and Alzheimer's, but in 177 00:13:27,916 --> 00:13:31,091 general, depression is one of those things, and we're going to 178 00:13:31,091 --> 00:13:34,177 talk about it in terms of seniors. Now. My definition of 179 00:13:34,236 --> 00:13:37,625 senior is an individual who's six or five years of age and 180 00:13:37,765 --> 00:13:42,342 older. Keep in mind, however, that dementia, alzheimer's and 181 00:13:42,383 --> 00:13:46,879 depression can occur at any age for an adult, but we're talking 182 00:13:46,919 --> 00:13:50,895 about the most common types of situations. Seniors who are 183 00:13:50,936 --> 00:13:54,664 depressed. Usually the majority of them do not believe that 184 00:13:54,725 --> 00:13:59,197 depression is a health problem, and this is a general problem 185 00:13:59,238 --> 00:14:06,916 with mental health illnesses themselves is that we tend to 186 00:14:07,035 --> 00:14:16,311 not give them the attention and the concern that we should or 187 00:14:16,331 --> 00:14:21,283 that we would say if one were to break a leg or get chest pain 188 00:14:21,583 --> 00:14:26,556 or get a laceration on the arm or the foot, whereas we would 189 00:14:26,655 --> 00:14:30,566 act very quickly, move to get resolution, whereas with 190 00:14:30,586 --> 00:14:36,239 depression, many times we excuse it away, partly because we 191 00:14:36,278 --> 00:14:41,457 don't understand it as well as we should. But my point is, all 192 00:14:41,498 --> 00:14:45,514 that does is it complicates the problem, it delays treatment, it 193 00:14:45,514 --> 00:14:51,465 delays resolution of the problem and it tends to self 194 00:14:51,684 --> 00:14:56,018 increase the severity of the problem itself. 80% of people 195 00:14:56,057 --> 00:15:00,986 with depression can be treated successfully with medication, 196 00:15:01,368 --> 00:15:05,461 psychotherapy or combination of the two. Let me say that again, 197 00:15:06,215 --> 00:15:12,426 80% of people with depression can be treated successfully with 198 00:15:12,426 --> 00:15:17,316 medication, psychotherapy or combination of the two. This is 199 00:15:17,395 --> 00:15:21,924 a treatable problem that affects the brain and we need to look 200 00:15:22,065 --> 00:15:27,075 at it as such and then be able to have it taken care of. And 201 00:15:27,095 --> 00:15:31,650 again, as I mentioned before, most of us adults who get 202 00:15:31,671 --> 00:15:35,297 depression know very little about it, and that then, as I 203 00:15:35,356 --> 00:15:40,086 said before, complicates treatment and access to 204 00:15:40,125 --> 00:15:43,919 appropriate care. One of the things that's also significant 205 00:15:44,100 --> 00:15:48,596 is that, as one gets older and heart conditions or heart 206 00:15:48,636 --> 00:15:52,750 related conditions become more prominent, a good number of 207 00:15:52,811 --> 00:15:56,961 individuals or patients who develop heart attacks also have 208 00:15:57,081 --> 00:16:01,417 an associated depression along with it, and it's important to 209 00:16:02,678 --> 00:16:08,009 make the point that the body is a unit that is very complex 210 00:16:08,274 --> 00:16:13,644 Think of the world's most complex computer available and 211 00:16:13,765 --> 00:16:17,654 everything is interrelated. Everything is interrelated, and 212 00:16:17,676 --> 00:16:21,143 so one needs to think of the body as a unit with interrelated 213 00:16:21,143 --> 00:16:25,822 , interacting parts, because so one area affects the other area, 214 00:16:25,822 --> 00:16:28,780 and that's why it's so important to have more of a, in 215 00:16:28,802 --> 00:16:32,917 my judgment, more of a holistic approach mind, body and spirit 216 00:16:33,719 --> 00:16:37,905 as we deal with a number of these physical and or 217 00:16:37,946 --> 00:16:42,941 psychological problems. Now, I mentioned earlier, when I was 218 00:16:42,980 --> 00:16:46,995 talking about dementia versus Alzheimer's, that Alzheimer's is 219 00:16:46,995 --> 00:16:49,977 the most common cause of dementia, and that is true. 220 00:16:50,654 --> 00:16:53,859 There are other causes. There are actually four of the causes 221 00:16:53,958 --> 00:16:58,275 of dementia, and I'll just mention them briefly. Vascular 222 00:16:58,296 --> 00:17:02,111 dementia, which has to do with blood flow to the brain, has 223 00:17:02,152 --> 00:17:06,957 something called Lewy body dementia. These are individuals 224 00:17:07,057 --> 00:17:11,404 who have had dementia and were found to have certain types of 225 00:17:13,288 --> 00:17:16,743 material in the brain that distinguish them from others. 226 00:17:17,515 --> 00:17:22,125 There's a frontal temporal lobe type dementia, which is unique, 227 00:17:22,755 --> 00:17:25,297 and then there's a mixed type dementia. But again, remember, 228 00:17:25,317 --> 00:17:29,996 the most common type of dementia is Alzheimer's disease, and 229 00:17:30,036 --> 00:17:33,398 we'll speak about Alzheimer's. So let's take a look at 230 00:17:33,499 --> 00:17:39,784 Alzheimer's. Okay, let's leave dementia in general aside. As a 231 00:17:40,044 --> 00:17:45,200 overall category, alzheimer's has a lot of areas that make it 232 00:17:45,421 --> 00:17:51,781 unique in a bad way. The first thing is it's in stages, which 233 00:17:51,862 --> 00:17:56,181 is good. The first, the early stage, or the mild stage a 234 00:17:56,221 --> 00:18:00,737 patient may have memory loss, mood swings, slow to learn to 235 00:18:00,777 --> 00:18:05,710 react, uncomfortable with due situations, prefer the familiar 236 00:18:05,935 --> 00:18:09,058 Actually, that's probably all of us I know. I certainly prefer 237 00:18:09,098 --> 00:18:13,656 the familiar and still perform basic tasks. We talk about stage 238 00:18:13,656 --> 00:18:22,334 one, a mild Alzheimer's disease of the brain, and may have 239 00:18:22,374 --> 00:18:25,520 slowing in speech and understanding and periodically 240 00:18:25,580 --> 00:18:29,386 lose the train of thought. It's important also to understand 241 00:18:30,109 --> 00:18:34,994 that Alzheimer's can cause significant psychiatric problems 242 00:18:34,994 --> 00:18:41,682 itself, separate and apart from the milds or various types of 243 00:18:41,721 --> 00:18:46,266 psychiatric symptoms that you may see in mild forms of 244 00:18:46,326 --> 00:18:54,258 dementia. So in stage one Alzheimer's, the patient may 245 00:18:54,278 --> 00:18:59,544 become aware of a loss of control, maybe just of their 246 00:18:59,604 --> 00:19:04,654 personality or their mood. They may become more irritable than 247 00:19:04,694 --> 00:19:07,299 normal, they may become more fearful than normal, more 248 00:19:07,421 --> 00:19:11,092 restless, more depressed. These are things that tend to be 249 00:19:11,291 --> 00:19:15,176 outside of the normal for that particular person and they tend 250 00:19:15,196 --> 00:19:20,082 to be noticed most closely by close members of the family and 251 00:19:20,362 --> 00:19:23,465 or those who work and associate with that person on a regular 252 00:19:23,506 --> 00:19:28,118 basis. That's stage one of Alzheimer's disease, a physical 253 00:19:28,599 --> 00:19:35,097 disease of the brain. Okay, that progressively gets worse, and 254 00:19:35,157 --> 00:19:39,210 so then we go to stage two, moderate Alzheimer's. Here 255 00:19:39,250 --> 00:19:44,275 disability occurs. Distant past may be recalled, but recent 256 00:19:44,315 --> 00:19:47,278 events become difficult to remember. They can remember 257 00:19:47,337 --> 00:19:51,281 things that happened 20 years ago, but many times they cannot 258 00:19:51,342 --> 00:19:55,726 remember things that happened 20 minutes ago or maybe even 20 259 00:19:55,806 --> 00:19:59,934 seconds ago. So it's the recent events that become difficult to 260 00:19:59,974 --> 00:20:05,923 remember. They are not able to comprehend location, day and 261 00:20:05,963 --> 00:20:09,836 time, and we talked about this a bit in general with dementia, 262 00:20:10,175 --> 00:20:12,840 but here we're talking about it progressively getting worse, 263 00:20:13,182 --> 00:20:17,474 progressively getting worse. And one of the more distressing 264 00:20:17,535 --> 00:20:21,403 parts about Alzheimer's is that they may not recognize familiar 265 00:20:21,462 --> 00:20:24,413 people. And this is the situation where a mother or a 266 00:20:24,492 --> 00:20:28,278 father cannot but does not recognize their son or their 267 00:20:28,317 --> 00:20:32,083 daughter or the grandson or the granddaughter, members of the 268 00:20:32,143 --> 00:20:35,971 family members that they work with. And this can be obviously 269 00:20:36,011 --> 00:20:39,537 not only very distressing for the patient but very distressing 270 00:20:39,537 --> 00:20:45,484 for the family and friends and co-workers who associate with 271 00:20:45,505 --> 00:20:51,855 this person. Which then takes us to stage three of Alzheimer's, 272 00:20:52,135 --> 00:20:58,863 and here the patient is unable to care for themselves 273 00:20:59,203 --> 00:21:05,055 appropriately. Many times they are less and less responsive. 274 00:21:05,675 --> 00:21:09,702 They are unable to recognize anyone, unable to recognize 275 00:21:09,923 --> 00:21:14,155 anyone. So you can imagine this brain now that's damaged and 276 00:21:14,195 --> 00:21:17,422 diseased, that's getting progressively, progressively, 277 00:21:17,481 --> 00:21:21,973 progressively worse. They may have lost a bowel or bladder 278 00:21:22,013 --> 00:21:25,759 function, a bladder control. They may lose the ability to 279 00:21:25,818 --> 00:21:29,124 chew and swallow and certainly when they can't do that then 280 00:21:29,144 --> 00:21:33,012 they need to be fed. Many times that may require tube peeing. 281 00:21:33,773 --> 00:21:37,479 The challenge with that is not just the tube peeing, but if 282 00:21:37,519 --> 00:21:40,482 they are not able to chew and swallow because, remember, these 283 00:21:40,482 --> 00:21:43,086 are all brain, everything is under the control of the brain. 284 00:21:43,589 --> 00:21:49,277 But if that modality goes and you put something in your mouth 285 00:21:49,356 --> 00:21:53,381 and you don't remember how to chew and swallow, instead of 286 00:21:53,421 --> 00:21:57,226 going into the stomach that material can easily go into the 287 00:21:57,266 --> 00:22:02,080 lung and then create a significant problem, 288 00:22:03,270 --> 00:22:06,775 particularly being vulnerable to pneumonia and various types of 289 00:22:06,855 --> 00:22:12,603 respiratory infections which can quickly proceed to cardiac 290 00:22:12,682 --> 00:22:18,974 arrest, mortality and death. So what are some things on the more 291 00:22:18,974 --> 00:22:23,240 positive side that we can do to sort of slow down or prevent 292 00:22:23,340 --> 00:22:28,454 dementia and or dementia related issues? It's amazing how eating 293 00:22:28,454 --> 00:22:34,493 healthy and eating properly is always an issue and eating a 294 00:22:34,534 --> 00:22:37,696 balanced diet, fruits and vegetables the same thing that 295 00:22:37,737 --> 00:22:42,001 we tell I talk about in terms of heart disease, cholesterol, 296 00:22:42,041 --> 00:22:48,074 diabetes, etc. Same same approach. Similarly, exercise, 297 00:22:48,275 --> 00:22:52,601 regular exercise, stimulates the brain, stimulates the body, has 298 00:22:52,601 --> 00:22:57,875 a very positive approach Keeping mentally active, 299 00:22:58,455 --> 00:23:03,369 consciously engaging in activity , attending various events, if 300 00:23:03,390 --> 00:23:07,415 you retired, attending various social events with friends, 301 00:23:07,516 --> 00:23:12,864 family, attending church, attending taking a class, etc. 302 00:23:13,003 --> 00:23:17,916 Etc. Things you don't want to do is you want to stop smoking. If 303 00:23:17,916 --> 00:23:22,172 you are a smoker, any type of tobacco you want to stop. If you 304 00:23:22,172 --> 00:23:25,459 drink alcohol, you want to stop . Now I'm one of those 305 00:23:25,519 --> 00:23:29,732 physicians that will not give you a pass If you drink beer or 306 00:23:29,813 --> 00:23:33,199 wine. There's some who, some reason, have decided that beer 307 00:23:33,219 --> 00:23:36,403 and wine is not really, are not really alcohol. Yes, they are. 308 00:23:37,371 --> 00:23:40,837 So you need to stop drinking altogether. Why? Because it has 309 00:23:40,897 --> 00:23:46,795 a negative effect on the mind and on the body. As we know that 310 00:23:46,795 --> 00:23:50,602 alcohol, that our Alzheimer's disease, is increasing in this 311 00:23:50,642 --> 00:23:53,313 country, and that's not surprising because the 312 00:23:53,353 --> 00:23:59,622 population is increasing. The single biggest generation is 313 00:23:59,662 --> 00:24:05,474 getting older, called the baby boomers, and so it's no surprise 314 00:24:05,474 --> 00:24:08,479 then that now you're going to have more individuals with 315 00:24:08,538 --> 00:24:14,230 dementia and more individuals with the Alzheimer's disease. So 316 00:24:14,230 --> 00:24:19,036 , again, to summarize a bit, in terms of Alzheimer's, it's a 317 00:24:19,096 --> 00:24:23,901 physical damage to the brain which then translates itself 318 00:24:24,362 --> 00:24:28,846 into significant damage in terms of cognition and function, 319 00:24:30,371 --> 00:24:33,434 particularly function in terms of activity, of daily living, 320 00:24:33,915 --> 00:24:36,519 and many times that's one of the ways that you can pick up that 321 00:24:36,538 --> 00:24:41,586 there's something significantly wrong in an individual mentally 322 00:24:42,230 --> 00:24:46,015 when those activities of daily living getting up in the morning 323 00:24:46,015 --> 00:24:49,339 , brushing your teeth, taking a shower, eating breakfast, 324 00:24:49,400 --> 00:24:54,872 driving to work, going to participate with the group the 325 00:24:54,971 --> 00:24:57,558 individual can no longer do those things. They're certainly 326 00:24:57,578 --> 00:25:04,979 not do them safely. So when one thinks of Alzheimer's 327 00:25:05,118 --> 00:25:08,644 particularly, I want you to you think of two terms one, 328 00:25:08,743 --> 00:25:13,576 cognition, and the other term, function. Cognition first, 329 00:25:13,957 --> 00:25:18,230 cognition is just a fancy way of saying thinking, thinking. So 330 00:25:18,391 --> 00:25:23,958 the person with Alzheimer's is not able to think normally, not 331 00:25:24,057 --> 00:25:28,202 able to think in a way that allows them to do those things 332 00:25:28,242 --> 00:25:31,810 that they need to do on a regular basis. Second word 333 00:25:32,031 --> 00:25:37,618 function. Function is action. So I can think that I want to have 334 00:25:37,618 --> 00:25:42,529 a ham sandwich, but that I want to make a ham sandwich, but 335 00:25:42,651 --> 00:25:46,397 functionally I need to be able to get up, find the meat, find 336 00:25:46,417 --> 00:25:50,353 the bread, put them together and make a sandwich. So Alzheimer's 337 00:25:50,353 --> 00:25:56,813 attacks both those areas. One, the thinking becomes quickly 338 00:25:56,893 --> 00:26:00,916 impaired or significantly impaired, so that you then see 339 00:26:00,997 --> 00:26:05,162 the massive decrease, or deterioration, if you will, of 340 00:26:05,182 --> 00:26:09,045 the function on the other side, and these are what we call ADL 341 00:26:09,205 --> 00:26:12,724 activities of daily living bathing, dressing, grooming, 342 00:26:12,885 --> 00:26:18,285 feeding oneself, et cetera, et cetera. And so when one loses 343 00:26:18,365 --> 00:26:23,161 that functionality, then it becomes very, very obvious, and 344 00:26:23,501 --> 00:26:26,964 then one can end up being a danger to themselves or to 345 00:26:27,164 --> 00:26:33,240 others, and so the cognitive issues, the thinking issues and 346 00:26:33,260 --> 00:26:38,221 the functional issues become much more pronounced. Now it's 347 00:26:38,300 --> 00:26:41,626 also important to keep in mind that Alzheimer's disease is 348 00:26:41,666 --> 00:26:44,367 treatable. There are medications that can treat Alzheimer's 349 00:26:44,387 --> 00:26:47,328 disease. Obviously, the effectiveness of the medication 350 00:26:47,400 --> 00:26:52,661 depends on the stage and depends on the symptomatology. But 351 00:26:52,701 --> 00:26:55,703 acetylcholinesis, race inhibitors, is one category of 352 00:26:55,743 --> 00:26:59,805 medication for Alzheimer's. Metamantin is another category 353 00:27:00,626 --> 00:27:06,309 of medication for Alzheimer's. And so if there's a suspicion of 354 00:27:06,309 --> 00:27:11,141 yourself or those around you that Alzheimer's may be a 355 00:27:11,201 --> 00:27:15,481 potential issue, certainly speak to your healthcare professional 356 00:27:15,481 --> 00:27:20,386 and get an evaluation and decide whether treatment is 357 00:27:20,467 --> 00:27:23,227 necessary. In addition to medication. Various types of 358 00:27:23,287 --> 00:27:26,461 therapy, cognitive stimulation therapy, cognitive 359 00:27:26,521 --> 00:27:30,780 rehabilitation therapy all those things are available to help 360 00:27:31,001 --> 00:27:34,505 one's thinking ability. They'll have to preserve that thinking 361 00:27:34,565 --> 00:27:43,064 ability over time. So in terms of prevention and some may argue 362 00:27:43,064 --> 00:27:47,267 whether it's preventable or not , but I would suggest I don't 363 00:27:47,307 --> 00:27:51,327 see a downside to trying to prevent Alzheimer's or dementia. 364 00:27:51,327 --> 00:27:54,902 And so some of those things that one can do in terms of 365 00:27:54,961 --> 00:27:58,203 prevention is certainly socialize and talk with friends, 366 00:27:58,203 --> 00:28:02,482 or interact with friends and family more Quite. Honestly, I 367 00:28:02,544 --> 00:28:05,761 find this interesting. I used to consider myself well, consider 368 00:28:05,781 --> 00:28:10,169 myself an introvert, and my point is this is when everybody 369 00:28:10,230 --> 00:28:12,800 wants to be an extrovert, because it's healthier to be an 370 00:28:12,901 --> 00:28:17,321 extrovert, certainly as it relates to brain and brain types 371 00:28:17,321 --> 00:28:23,102 of cognitive difficulties Stay physically active. What we do 372 00:28:23,162 --> 00:28:27,862 know that there is a mind-body connection and that when you 373 00:28:27,942 --> 00:28:30,584 exercise you feel better and when you feel better you 374 00:28:30,644 --> 00:28:34,160 exercise more. Abort substances and we talked about that in 375 00:28:34,200 --> 00:28:38,105 terms of drugs and alcohol, recreational drugs and alcohol 376 00:28:39,107 --> 00:28:42,381 and smoking and practice cognitive training. In other 377 00:28:42,401 --> 00:28:47,641 words, the mind really is the brain really is a muscle, and so 378 00:28:47,641 --> 00:28:52,541 , like with any other muscle or computerized muscle, if you will 379 00:28:52,541 --> 00:28:58,066 , repetition in a positive way can help it, and so those, these 380 00:28:58,066 --> 00:29:02,009 are some things that we may have under our own control, that 381 00:29:02,009 --> 00:29:08,800 we can do. So another way of saying some of that is some have 382 00:29:08,800 --> 00:29:15,305 suggested that 40% of dementia cases can be prevented with 383 00:29:15,365 --> 00:29:18,921 lifestyle changes. There's some basic lifestyle changes and some 384 00:29:18,921 --> 00:29:21,826 of those lifestyle changes that we've talked about. One is to 385 00:29:21,945 --> 00:29:26,048 increase education, exercise that mind, talk to people either 386 00:29:26,048 --> 00:29:32,042 formally, informally, interact intellectually, increase the 387 00:29:32,083 --> 00:29:34,746 physical activity. Remember the mind and the body go together 388 00:29:36,122 --> 00:29:40,826 and they help each other and also, at the same time, increase 389 00:29:40,826 --> 00:29:44,907 social contact, be more of a social butterfly, if you will. 390 00:29:45,299 --> 00:29:49,180 That that is beneficial to you in a long-term process. And 391 00:29:49,221 --> 00:29:53,364 things you wanna decrease are things like high blood pressure, 392 00:29:53,364 --> 00:29:56,486 meaning that you wanna make sure that it's under control. 393 00:29:56,787 --> 00:29:59,767 Keep your doctor appointments, take your medication regularly, 394 00:30:01,200 --> 00:30:05,541 check your blood pressure at home yourself. Also, you wanna 395 00:30:05,561 --> 00:30:09,201 control obesity, smoking, depression, make sure your 396 00:30:09,241 --> 00:30:14,941 diabetes is under control, eliminate alcohol intake. You 397 00:30:14,980 --> 00:30:17,324 wanna avoid head injury, and head injury is something that 398 00:30:17,365 --> 00:30:21,288 becomes more prominent in elderly patients, again 65 years 399 00:30:21,288 --> 00:30:25,428 of age and older, and part of that is because balance begins 400 00:30:25,448 --> 00:30:30,786 to deteriorate long before anything else and so quick turns 401 00:30:30,786 --> 00:30:35,289 coming downstairs, going upstairs, standing on ladders 402 00:30:35,961 --> 00:30:40,204 all problematic with elderly patients 65 years of age and 403 00:30:40,325 --> 00:30:43,800 older. And so you wanna avoid that because obviously any type 404 00:30:43,862 --> 00:30:48,903 of external trauma to the head or to the brain increases the 405 00:30:49,064 --> 00:30:53,266 rate of progression of something like dementia and possible 406 00:30:53,426 --> 00:30:57,665 Alzheimer's disease. Again, prevention, social engagement, 407 00:30:57,705 --> 00:31:01,943 physical exercise, avoid substance abuse, mental exercise 408 00:31:01,943 --> 00:31:08,272 , reading classes, get a hobby. In summary, dementia is not a 409 00:31:08,333 --> 00:31:11,827 disease, but rather an umbrella term that describes a wide range 410 00:31:11,827 --> 00:31:15,051 of symptoms that affects people's ability to perform 411 00:31:15,265 --> 00:31:19,290 everyday activities on their own . Alzheimer's is a disease of 412 00:31:19,310 --> 00:31:23,444 the brain that leads to dementia . Dementia and indeed is the 413 00:31:23,484 --> 00:31:28,286 most common type of dementia and arguably one of the most 414 00:31:28,326 --> 00:31:32,550 serious types of dementia. Common symptoms of dementia 415 00:31:32,611 --> 00:31:38,088 include thinking issues, decreased memory, poor judgment, 416 00:31:38,088 --> 00:31:41,153 decreased focus, changes in language, decreased behavior. 417 00:31:41,965 --> 00:31:49,607 Alzheimer's increases that or copies that and makes it even 418 00:31:49,688 --> 00:31:53,571 worse. Quite honestly, alzheimer's occurs mostly in 419 00:31:53,664 --> 00:31:59,094 individuals over six to five years of age. In later stages 420 00:32:00,307 --> 00:32:06,555 Alzheimer's has huge damage to the brain in its ability to 421 00:32:06,654 --> 00:32:11,188 function. We call that the ability to do activities of 422 00:32:11,248 --> 00:32:16,634 daily living dressing, eating, brushing your teeth, grooming, 423 00:32:16,775 --> 00:32:20,605 etc. There is a very active Alzheimer's association that is 424 00:32:20,685 --> 00:32:24,609 located in Chicago, illinois. Their phone number is 425 00:32:24,890 --> 00:32:32,267 1-800-272-3900. If you believe that either you yourself or 426 00:32:32,287 --> 00:32:37,882 someone you know or family member has dementia in or 427 00:32:37,902 --> 00:32:43,029 Alzheimer's, certainly recommend that you bring that up with 428 00:32:43,090 --> 00:32:48,133 your healthcare professional and get an evaluation and exam and 429 00:32:48,556 --> 00:32:51,054 whatever tests that need to be done. But you can also yourself 430 00:32:51,105 --> 00:32:54,765 call the Alzheimer's Association and do your own research in 431 00:32:55,346 --> 00:32:59,996 independently. Knowledge is power, just so that you better 432 00:33:00,076 --> 00:33:03,269 understand what's going on. My basic principles. I always like 433 00:33:03,349 --> 00:33:06,615 to end with my basic principles. My first principle is God is in 434 00:33:06,615 --> 00:33:09,974 charge. I am a physician of faith and indeed is my belief in 435 00:33:09,974 --> 00:33:12,953 my faith in God that has sustained me over these years 436 00:33:15,532 --> 00:33:19,192 and allowed me to provide care for my patients. Second, I don't 437 00:33:19,192 --> 00:33:24,551 have any bad days. I've fixed my own health and I've had bad 438 00:33:24,573 --> 00:33:27,467 days. I figured out about 30 years ago that whether I had a 439 00:33:27,487 --> 00:33:32,519 good day or a bad day was really up to me, and I made a decision 440 00:33:32,519 --> 00:33:35,164 that I did not need any more bad days. I had had enough. So 441 00:33:35,224 --> 00:33:39,867 now my days are either good days or great days. Principle number 442 00:33:39,867 --> 00:33:44,346 three don't sweat the small stuff. Most stuff is small. I 443 00:33:44,847 --> 00:33:48,209 have learned not to allow small things to bother me as much as 444 00:33:48,269 --> 00:33:52,346 they used to. I have figured out that most times I make the 445 00:33:52,365 --> 00:33:56,547 biggest deal, for the most part as I think it is. So I'm working 446 00:33:56,547 --> 00:33:59,369 , I'm better not 100%, but I'm better about letting it go. 447 00:34:00,787 --> 00:34:03,688 Principle number four forgiveness is therapy. Whatever 448 00:34:03,688 --> 00:34:08,929 occurs to you that you perceive as negative, I suggest to you 449 00:34:09,030 --> 00:34:14,320 to immediately forgive. Forgive the individual, whatever the 450 00:34:14,362 --> 00:34:17,570 circumstances are. It does not matter what the facts are, just 451 00:34:17,833 --> 00:34:22,246 automatically forgive that. That , indeed, is therapy. And the 452 00:34:22,266 --> 00:34:25,125 final principle is everything is a relationship Work 453 00:34:25,164 --> 00:34:27,373 relationship, family relationship, et cetera, et 454 00:34:27,393 --> 00:34:30,806 cetera. Relationships are based on three things Mutual respect, 455 00:34:30,867 --> 00:34:34,454 mutual trust, good communication . If you have those things, you 456 00:34:34,514 --> 00:34:38,150 have a very good relationship. If you do not have those things, 457 00:34:38,150 --> 00:34:43,753 you have work to do. These discussions, this podcast series 458 00:34:43,753 --> 00:34:48,378 , is part of a masterclass series with a number of 459 00:34:48,418 --> 00:34:51,005 different topics, and I would encourage you to subscribe. 460 00:34:51,606 --> 00:34:57,012 Should you choose to, you can go to wwwbuzzsproutcom forward 461 00:34:57,052 --> 00:35:04,132 slash 210103. That's wwwbuzzsproutcom forward slash 462 00:35:04,313 --> 00:35:15,583 210103. And finally, be the change that you want to see in 463 00:35:15,603 --> 00:35:18,492 the world. Thank you and have a wonderful day. 464 00:35:47,474 --> 00:35:50,391 Speaker 1: And then take the next step of action and share it 465 00:35:50,391 --> 00:35:53,989 with your family, friends and or your coworkers. They'll be 466 00:35:54,028 --> 00:35:58,923 glad you did so. Until the next time, live your best possible 467 00:35:58,943 --> 00:36:02,378 life the best possible way. You've been listening to the 468 00:36:02,398 --> 00:36:05,938 Healthy, Wealthy and Wise Podcast with Dr William Choctaw, 469 00:36:05,938 --> 00:36:07,646 MDJD.