Podcasts about disease research center

Creatine for Alzheimer's — let's separate the hype from the hope. A new study has caused a stir in June 2025, but lead researcher Matthew K. Taylor told us: “ I don't think I can recommend it to a patient that this is going to ultimately have some sort of cognitive influence.” We speak to Dr. Taylor and Dr. Russell Swerdlow in this episode, discussing: • Role of creatine in your brain, and why it matters for energy metabolism • What the 2025 study found (and why it wasn't designed to prove effectiveness) • How scientific nuance gets lost in supplement hype • Why even promising early data must be handled with care • The vital difference between hype and hope Dr. Russell Swerdlow, MD is Director of the University of Kansas Alzheimer's Disease Research Center. Dr. Matthew Taylor, PhD, RD is Associate Professor of Dietetics & Nutrition at the University of Kansas Medical Center. This is... Your Brain On Creatine. SUPPORTED BY: NEURO World. Help your brain thrive, now and into the future: https://neuro.world/  ‘Your Brain On' is hosted by neurologists, scientists, and public health advocates Ayesha and Dean Sherzai.  ‘Your Brain On... Creatine' • SEASON 5 • EPISODE 8 LINKS  Dr. Taylor at the University of Kansas: https://www.kumc.edu/mtaylor3.html Dr. Swerdlow at the University of Kansas: https://www.kumc.edu/rswerdlow.html REFERENCES 1. Smith AN, Choi IY, Lee P, Sullivan DK, Burns JM, Swerdlow RH, Kelly E, Taylor MK. Creatine monohydrate pilot in Alzheimer's: Feasibility, brain creatine, and cognition. Alzheimer's & Dementia: Translational Research & Clinical Interventions. 2025 Apr;11(2):e70101. 2. Taylor MK, Burns JM, Choi IY, et al. Protocol for a single-arm, pilot trial of creatine monohydrate supplementation in patients with Alzheimer's disease. Pilot Feasibility Study. 2024;10(1):42.  3. Habeck C, Risacher S, Lee GJ, et al. Relationship between baseline brain metabolism measured using [18 F]FDG PET and memory and executive function in prodromal and early Alzheimer's disease. Brain Imaging Behav. 2012;6(4):568-83.  4. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports. Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18.

Everyone has habits. Some are beneficial for brain health while others are less so, but it turns out that habits as simple as brushing your teeth at the same time each morning can help your brain adapt to changes from cognitive impairment. Dr. Gordon Giles joins the podcast to dive into the fascinating world of neurological rehabilitation and how building small, consistent habits can rewire the brain and support healthy lifestyle choices. He also gives a sneak peek into his upcoming talk for the Healthy Living with Mild Cognitive Impairment (MCI) program titled “Unlocking the Power of Habits, Routines and Strategies.” Guest: Gordon Giles, PhD, OTR/L FAOTA, professor emeritus, Samuel Merritt University Show Notes Learn more about Dr. Giles at his profile on the Samuel Merritt University website. Register and learn more about Dr. Giles' upcoming Healthy Living with MCI event, happening on June 20, 2025, and future programs on our website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

It's estimated that 4.3 million older adults across the United States live alone with cognitive impairment. How do these individuals navigate the challenges and concerns that arise due to these memory and thinking changes, and what recommendations are there to support them as they continue living independently? Dr. Elena Portacolone joins Dementia Matters to discuss her research focused on identifying these challenges and developing equitable policies and programs for older adults living alone with cognitive impairment in the United States and worldwide. Guest: Elena Portacolone, PhD, MBA, MPH, principal investigator, Living Alone with Cognitive Impairment Project, professor of sociology, Institute for Health & Aging, Pepper Center Scholar, Division of Geriatric Medicine, University of California San Francisco (UCSF) Show Notes Read more about Dr. Portacolone and her work at her profile on UCSF's website. Learn more about UCSF's Living Alone with Cognitive Impairment project, led by Dr. Portacolone, on their website. Learn about the Guiding an Improved Dementia Experience (GUIDE) Model, mentioned by Dr. Portacolone at 22:51, on the Centers for Medicare and Medicaid Services (CMS) website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

How important is one's family history when determining Alzheimer's risk? Returning guests Drs. Jessica Langbaum and Sterling Johnson discuss the latest research on family history and genetic risk factors and share their perspectives on the topic, specifically focusing on the role of the APOE gene as a risk factor. Guests: Sterling Johnson, PhD, leader, Wisconsin Registry for Alzheimer's Prevention (WRAP), associate director, Wisconsin Alzheimer's Disease Research Center, associate director, Wisconsin Alzheimer's Institute, lead principal investigator, ADRC Consortium for Clarity in ADRD Research Through Imaging (CLARiTI), Jean R. Finley Professor of Geriatrics and Dementia, UW School of Medicine and Public Health, and Jessica Langbaum, PhD, senior director of research strategy, Banner Alzheimer's Institute, overseer, Observational Research Program, Clinical Trials Program, Alzheimer's Prevention Initiative, director, Alzheimer's Prevention Registry, director, Arizona Alzheimer's Disease Research Center Show Notes Read Dr. Langbaum's viewpoint, “The Risk of Alzheimer Disease in APOE4 Homozygotes,” on the Journal of American Medical Association (JAMA) website. Read Dr. Johnson's article, “APOE4 homozygosity represents a distinct genetic form of Alzheimer's disease,” on Nature Medicine's website. Read Dr. Chin's opinion piece, “What to do if your family has a history of Alzheimer's,” mentioned at 2:04 on the Wisconsin State Journal's website. Please note there is a paywall to access the article. Read Dr. Tobey Betthauser's paper, “Multi-method investigation of factors influencing amyloid onset and impairment in three cohorts,” mentioned by Dr. Johnson at 16:50, on the National Library of Medicine's website. Learn more about the Banner Alzheimer's Institute on their website.  Read about the GeneMatch program from the Alzheimer's Prevention Registry on their website.  Learn more about the Arizona Alzheimer's Disease Research Center on their website.  Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

A Menomonee Falls couple donated their daughter's brain for science, only to learn the hospital threw part of it out. In this episode of Open Record, FOX6 Investigator Bryan Polcyn shares the unexplained error that has Children's Wisconsin apologizing to a grief-stricken family. You'll learn how the whole brain wasn't lost. However, according to the researcher who asked for it to be preserved, it was the most important part.  Also in this episode, we talk to Dr. Jeffrey Nirschl with the Wisconsin Alzheimer's Disease Research Center about the importance of brain donation for advancing scientific research. Learn more about your ad choices. Visit podcastchoices.com/adchoices

LEXINGTON, Ky. (May 8, 2025) – THIS IS AN ENCORE PRESENTATION. The University of Kentucky Alzheimer's Disease Research Center at the Sanders-Brown Center on Aging is celebrating 40 years of research and community impact. The center is world-renowned for its significant contributions to the field through the decades. As the UK-ADRC celebrates this milestone, we reflect on how the Center has evolved over the years and highlight some of its notable achievements. This episode of Behind the Blue features a conversation with Dr. Linda Van Eldik, Director of the Sanders-Brown Center on Aging and Alzheimer's Disease Center. Van Eldik highlights the 40-year journey of the Center, focusing on its origins, community engagement, and the evolution of Alzheimer's research.  The discussion covers the importance of understanding dementia through biomarkers, the significance of translational research, and the center's commitment to preventative strategies and lifestyle interventions. She emphasizes the need for community outreach, education, and the role of philanthropy in advancing research efforts.  Behind the Blue is available via a variety of podcast providers, including iTunes and Spotify. Become a subscriber to receive new episodes of “Behind the Blue” each week. UK's latest medical breakthroughs, research, artists and writers will be featured, along with the most important news impacting the university. Behind the Blue is a joint production of the University of Kentucky and UK HealthCare. Transcripts for this or other episodes of Behind the Blue can be downloaded from the show's blog page.  To discover how the University of Kentucky is advancing our Commonwealth, click here.

Having a relative or loved one receive a dementia diagnosis can be challenging for families, especially for families with children. How can parents, guardians and other adults explain these complex memory and thinking changes to children in a way they'll understand? One possible way – children's books. Dr. Tomás León joins the podcast to discuss his collection of children's books focused on different kinds of dementia, including Alzheimer's disease, frontotemporal dementia, Lewy body dementia and vascular dementia. He discusses his inspiration for the four stories, the writing and translation process, and the importance of helping children understand what's happening to their loved ones, as well as shares advice on how to address these difficult conversations. Guest: Tomás León, MD, psychiatrist, Memory and Neuropsychiatry Clinic, Hospital del Salvador, Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute (GBHI) Show Notes Read more about Dr. León's children's books and download copies of the Here's Grandma! collection for free in English and Spanish on the Global Brain Health Institute's website. Learn more about Dr. León through his profile on the Global Brain Health Institute's website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

The Research Education Component (REC) focuses on educating, mentoring and training the next generation of researchers at the over 30 Alzheimer's Disease Research Centers (ADRCs) across the United States, offering a range of fellowships, educational activities and events like the annual Alzheimer's Disease and Related Dementias (ADRD) Research Day. In honor of this year's ADRD Research Day, early career researchers Isa Hayde and Dr. Yang Yeh join the podcast to discuss how REC has impacted their research journeys, as well as share a preview of their lightning presentations. Guests: Isa Hayde, undergraduate student, Clark Lab, and Yang Yeh, PhD, postdoctoral fellow, Lamming Lab Show Notes Learn more about REC and the Wisconsin ADRC's Alzheimer's Disease and Related Dementias Research Day on our website. Listen to the podcast with Drs. Barb Bendlin and Tyler Ulland, “Gut Feelings: The Links Between Gut Health and Alzheimer's Disease,” mentioned by Dr. Chin at 5:30, on our website, Spotify, Apple Podcasts and all other major podcast platforms. Learn more about Dr. Yang Yeh and the Lamming Lab on the Lamming Lab website. Learn more about Dr. Lindsay Clark's lab on their website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Early detection is a top priority in the field of Alzheimer's research, and one indicator of Alzheimer's disease is the buildup of tau in the brain. What is tau, though? How can we detect this protein, and what can it tell us about a person's symptoms or disease progression? Dr. Gil Rabinovici, a leader in the field of brain imaging, joins Dementia Matters this week for an in-depth discussion on the role of tau PET scans in Alzheimer's disease detection, research and clinical care. Guest: Gil Rabinovici, MD, professor, Department of Neurology, University of California San Francisco (UCSF), director, UCSF Alzheimer's Disease Research Center, study chair, Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) and New IDEAS studies, co-principal investigator, Alzheimer's Network for Treatment and Diagnostics (ALZ-NET), Longitudinal Evaluation of Alzheimer's Disease Study (LEADS) Show Notes Are you a clinician interested in receiving continuing education (CE) credits for listening to this episode? Find credit designation information, disclosures and evaluation information on our website and on the UW–Madison Interprofessional Continuing Education Partnership (ICEP) website. The accreditation for this course expires 4/7/2026. After this date, you will no longer be able to access the course or claim credit. Read “Criteria for Diagnosis and Staging of Alzheimer's Disease,” mentioned by Dr. Rabinovici at 18:43, on the Alzheimer's Association's website. Listen to our past episode with Dr. David Wolk, “LATE, Explained,” mentioned by Dr. Rabinovici at 26:31 on Spotify, Apple Podcasts and on our website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Receiving a diagnosis of Alzheimer's disease or a related dementia can be a complicated experience. While some experience relief at being able to put a name to their concerns, many worry about telling loved ones or being treated differently due to the stigma surrounding the word “dementia.” Mike Zuendel joins the podcast to share his experience of being diagnosed with Mild Cognitive Impairment (MCI) due to Alzheimer's disease and how he's pushing back against the stigma surrounding dementia. He also talks about how early detection and treatment have allowed him to lead a normal life with cognitive impairment. Guest: Mike Zuendel, member, board of directors, Banner Alzheimer's Institute Foundation, member, Alzheimer's Patient Advisory Board, Center for Information and Study on Clinical Research Participation, founder, Initiative to Change the D-Word, founder, CEO, Legacy Bridge Private Family Offices Show Notes Learn more about Mike Zuendel on his profile on the Initiative to Change the D-Word's website. Learn more about MCI by listening to other MCI-related episodes of Dementia Matters. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Holistic medicine, alternative medicine, complementary medicine – you may have heard these terms or seen them used online and wondered what they mean. Each term refers to the concept of integrative medicine, a comprehensive approach to healthcare that focuses on treating a person's mind, body and spirit rather than addressing symptoms or a specific disease through a combination of medical treatments and other evidence-based therapies. By integrating practices like nutrition, mindfulness, supplements and other alternative therapies with traditional care, integrative medicine aims to promote overall wellness, enhance healing and improve quality of life, especially for individuals managing chronic conditions like dementia. Dr. David Rakel, a leader in integrative medicine, joins the podcast to share about how this holistic approach can help people experiencing memory change and how diet, mindset and lifestyle can play a crucial role in supporting brain health.  Guest: David Rakel, MD, professor, chair, University of Wisconsin Department of Family Medicine and Community Health, founder, University of Wisconsin Osher Center for Integrative Health Show Notes Learn more information about the Healthy Living With Mild Cognitive Impairment (MCI) program and register for upcoming events by  visiting our website. Learn more about Dr. Rakel from his profile on the UW Madison Department of Family Medicine and Community Health website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Caring for a loved one with Alzheimer's disease or a related dementia can be challenging, with no two journeys being the same. Who better to turn to for caregiving support, tips and advice, then, than other caregivers who have been on similar paths? Steve O'Leary and Virginia Naeve join Dementia Matters to share their different experiences caring for their partner and parent respectively, their goal to help other caregivers on their journeys through their podcast Spotlight on Care and more. Guests: Steve O'Leary, co-host, Spotlight on Care, member, leadership council, University of California, Irvine Institute for Memory Impairments and Neurological Disorders (UCI MIND), and Virginia Naeve, co-host, Spotlight on Care, volunteer, UCI MIND Show Notes Listen to the Spotlight on Care podcast on the UCI MIND website, Apple Podcasts, Spotify or wherever you listen to podcasts. Read Virginia's blog, A New Path for Mom, online. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.  

Dementia diagnoses affect families in many different ways. One of the most challenging to navigate is that of younger-onset dementia (YOD), a form of dementia that affects someone below the age of 65. This diagnosis can be particularly jarring for young families, as resources, support and research for this form of dementia are limited. When Diana Cose's husband Lorenzo received this diagnosis, she decided to change that by founding Lorenzo's House, a nonprofit that supports families grappling with younger-onset dementia and works toward lessening the stigma surrounding it. Diana Cose joins the podcast with programs lead Patti LeFleur to share their experiences with younger-onset dementia and how Lorenzo's House brings light in the darkness. Guests: Diana Cose, founding executive director, Lorenzo's House, Patti LeFleur, youth and lighthouse outreach lead, Lorenzo's House Show Notes Learn more about Lorenzo's House and their free programs on their website. Follow Lorenzo's House on their Instagram, Facebook and LinkedIn for updates and more information. Learn about early-onset dementia, mentioned by Dr. Chin at 27:30, listen to our episode with Dr. Susanne Seeger, “Early-onset Alzheimer's Disease: What to Know and What to Expect” on our website. Learn more about the documentary on autosomal dominant Alzheimer's disease, mentioned by Dr. Chin at 28:05, on CBS News' website and watch the documentary on Paramount+. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.  

Today we have Dr. Karl Herrup, a neurobiologist known for his investigations into the roles that DNA damage and noncoding genetic variants have in Alzheimer's disease. Joining Ken today to interview Karl is Dr. Tommy Wood, a visiting scientist here at IHMC.  Tommy also is an associate professor of pediatrics and neuroscience at the University of Washington, where he focuses on brain health across lifespan. He has been our guest several times on STEM-Talk and we will have links to those interviews in our show notes for today's episode. After more than a century of research, the underlying cause of Alzheimer's remains a mystery. For the past few decades, the leading theory has been the amyloid cascade hypothesis, which proposes that abnormal amyloid plaques in the brain are the central cause of the disease. Today we talk to Karl about his lab and research as well as his view that the amyloid cascade hypothesis is not only flawed,  but also could be holding back research for a cure of Alzheimer's. A professor of neurobiology and an investigator in the Alzheimer's Disease Research Center at the University of Pittsburgh School of Medicine, Herrup is the author of How Not to Study a Disease: The Story of Alzheimer's. Show notes: [00:03:50] Tommy asks Karl what he was like as a kid to open the interview. [00:04:36] Tommy asks Karl about his educational environment growing up. [00:05:10] Ken mentions that Karl went to Brandies University originally with the intent of becoming a physician and asks Karl what happened to change his mind. [00:06:14] Ken asks Karl if it is true that his father was disappointed with Karl's decision to abandon medical school in favor of genetics. [00:07:02] Tommy mentions that Karl began researching genetics in the late 1960s when researchers were just beginning to unravel the secrets of DNA. Tommy asks Karl to discuss why this was such an exciting time to study genetics. [00:08:38] Tommy asks Karl what prompted him to pursue a PhD in neuroscience. [00:11:34] Continuing on the theme of happy accidents, Ken asks if it was also an accident that led to Karl moving to Switzerland for a second post-doc. [00:12:36] Ken asks Karl to expound on his experience taking an overseas post-doc, which was not a common practice in the 1970s. [00:14:11] Ken mentions that Karl has seemed to benefit in his life from the combination of preparation and the willingness to explore opportunities that present themselves. [00:15:00] Tommy mentions that when Karl arrived back in the US from Switzerland, he accepted a faculty position at Yale and asks him to discuss this experience. [00:17:06] Tommy mentions that after Yale, Karl had several faculty appointments, including a seven-year stint in Hong Kong, and asks Karl to talk about that experience. [00:21:36] Tommy asks Karl why, in 2019, he moved back to his hometown to become a professor of neurobiology at the University of Pittsburgh and co-investigator at the university's Alzheimer's research center. [00:24:45] Ken asks Karl to talk about his lab at the University of Pittsburgh, which focuses on the biology of neurodegeneration. [00:26:32] Ken asks Karl if there was anything specific that caused him to shift his focus at this stage in his career so heavily towards Alzheimer's research. [00:28:21] Tommy comments on Karl's hypothesis of the aging brain, noting that it would make sense for the same processes involved in the developing brain to relate to what we see in the aging brain, as these processes are continuous throughout the lifespan. [00:29:54] Tommy pivots to talk about Karl's book, entitled “How Not to Study a Disease: The Story of Alzheimer's” for which Karl interviewed a number of experts and colleagues, asking each one to define Alzheimer's disease in their own words. [00:30:51] Tommy reiterates the point that we still do not have a universally accepted definition of Alzheimer's disease and asks Karl wh...

LEXINGTON, Ky. (January 29, 2025) – The University of Kentucky Alzheimer's Disease Research Center at the Sanders-Brown Center on Aging is celebrating 40 years of research and community impact. The center is world-renowned for its significant contributions to the field through the decades. As the UK-ADRC celebrates this milestone, we reflect on how the Center has evolved over the years and highlight some of its notable achievements. This episode of Behind the Blue features a conversation with Dr. Linda Van Eldik, Director of the Sanders-Brown Center on Aging and Alzheimer's Disease Center. Van Eldik highlights the 40-year journey of the Center, focusing on its origins, community engagement, and the evolution of Alzheimer's research.  The discussion covers the importance of understanding dementia through biomarkers, the significance of translational research, and the center's commitment to preventative strategies and lifestyle interventions. She emphasizes the need for community outreach, education, and the role of philanthropy in advancing research efforts.  Behind the Blue is available via a variety of podcast providers, including iTunes and Spotify. Become a subscriber to receive new episodes of “Behind the Blue” each week. UK's latest medical breakthroughs, research, artists and writers will be featured, along with the most important news impacting the university. Behind the Blue is a joint production of the University of Kentucky and UK HealthCare. Transcripts for this or other episodes of Behind the Blue can be downloaded from the show's blog page.  To discover what's wildly possible at the University of Kentucky, click here.

What exactly does a mild cognitive impairment (MCI) diagnosis mean, and what should you do after receiving one? Hearing this diagnosis from a doctor can bring up a lot of emotions and questions for individuals and family members. Jennifer McAlister joins Dementia Matters to offer advice for next steps after receiving an MCI diagnosis and share strategies and resources that have been successful for individuals she's worked with over the course of her career. Guest: Jennifer McAlister, outreach and partnerships manager, Outreach, Recruitment & Engagement Core, Wisconsin Alzheimer's Disease Research Center   Show Notes Find Jen's “Next Steps After Diagnosis” flowchart, mentioned at 41:22, on our website and as a PDF. View and download a PDF of the decision-making tool, mentioned at 28:57, online. Learn more about the Wisconsin ADRC's Healthy Living with Mild Cognitive Impairment (MCI) series on our website. Watch the Healthy Living with MCI series on YouTube. Learn more about MCI by listening to our past podcast episode, “Our Evolving Understanding of Mild Cognitive Impairment” on our website, Spotify, Apple Podcasts, and all podcast platforms.   Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

A new study made national headlines, estimating that in the next three decades, around 42% of adults over the age of 55 will develop dementia. Allison Lindauer is an associate professor of neurology at the Oregon Alzheimer’s Disease Research Center at OHSU. She joins us to share what we know about dementia and what people can do to prevent it.

Informal care partners are essential to the care of people living with dementia, but they often experience significant burden and receive minimal training, support, and resources. Multicomponent interventions can mitigate burden and other negative consequences of caregiving. In this episode, Gordon Smith, MD, FAAN speaks with Angelina J. Polsinelli, PhD, ABPP-CN, author of the article “Care Partner Burden and Support Services in Dementia” in the Continuum® December 2024 Dementia issue. Dr. Smith is a Continuum® Audio interviewer and professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Polsinelli is an assistant professor of clinical neurology at the Indiana University School of Medicine in Indianapolis, Indiana. Additional Resources Read the article: Care Partner Burden and Support Services in Dementia Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Full interview transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Smith: This is Dr Gordon Smith. Today, I've got the great pleasure of interviewing Dr Angelina Polsinelli about her article on care partner burden and support services in dementia. This article appears in the December 2024 Continuum issue, which is on dementia. Ange, welcome to the podcast. And maybe you can begin by just introducing yourself to our audience?  Dr Polsinelli: Yeah. Well, thank you for having me. I'm very excited to be here. I'm Ange Polsinelli. I'm a neuropsychologist at Indiana University School of Medicine, where I work in the Department of Neurology. I also work with the Longitudinal Early Onset Alzheimer's Disease study that's led by Liana Apostolova. And I also do some work with the Outreach, Recruitment and Engagement Core of the Indiana Alzheimer's Disease Research Center. This topic that we're going to talk about today is extremely near and dear to my heart. Dr Smith: Well, thanks for joining me. And of course, IU is a powerhouse for Alzheimer's and basketball, in that order. So, we're really excited to have you. I'd like to get right into it. I'll emphasize, we were chatting a little bit about this, Ange, before we started recording, that your topic today is so important for all of us. And I think, you know, this is a podcast that not only neurologists listen to, but students and, and I think increasingly members of the lay public. And this conversation is going to be very important for neurologists and our neurology learners. But I lost my grandmother to Alzheimer's disease. I lost my uncle just in the last week. So, this touches all of us. So, I'm really excited. And then with that in mind, I wanted to begin with a statistic that- you can correct me if I misunderstood it, but it really blew my mind. And that is across the world, as I understand it, care partners provide one hundred and thirty three billion hours of care for people living with dementia yearly, which is pretty staggering. But what's really amazing is that by 2030 that number is expected to go to one point four trillion hours, which I couldn't grab my mind around it. So, I figured I'd try and determine how many years of person work is that and if my math is right, that's almost a hundred and sixty million person years of worth caring for people with dementia yearly across the world. One, are those numbers right? Did I get it right? And then, assuming so, can you put a human face or experience to these numbers?  Dr Polsinelli: Yeah, unfortunately those numbers are correct. And with our increasing aging population across the world, that's why you're getting that, you know, exponential increase in care per hours, compounded by the fact that the majority of the caregiving that happens is not done by doctors, physicians, but it's done by these informal care partners, these family members, these friends, these siblings, children, who are providing these really important services and unfortunately not being trained to do this, doing it largely on their own in a lot of respect. But again, these are people who are loved ones of the person living with dementia. There are a variety of kinships, as I mentioned, siblings, children, spouses, friends; and all sorts of age ranges as well. A large majority of them being spouses, and then the second largest majority being children. So, kind of a sandwich generation of people who are caring for parents with Alzheimer's or dementia and then caring for children as well. Dr Smith: Yeah, I was actually struck by the statistic that a quarter of caregivers or so called sandwich caregivers; in other words, they're taking care of a parent and a child. But listen to what you said. But just to call it out, two-thirds of care partners are women, which is a striking statistic.  Dr Polsinelli: Absolutely. Women are not only more likely to have dementia, but they are also more likely to be the care partners of somebody who has dementia. And so, the research shows, too, that if you're a care partner, you're at higher risk of developing dementia yourself. So, there's a lot of risk for women when it comes to dementia, development of dementia, but also that the burden and the majority of care needs that are that are supported by women as well. Dr Smith: Right. And there's a lot to unpack in that observation, and maybe we can come back to that. But I wonder if you might talk to us a little bit about the risk of dementia in women caregivers. That's really striking. Is there any thought regarding mechanism for that? Why is that the case? Is it a shared risk factor? Is it cause and effect? What's the story?  Dr Polsinelli: So, there are - this is kind of a dissociable or different - kind of two aspects to this, this question. There's the fact that women are at higher risk for developing dementia in general. I think the researchers feel sort of out about why exactly that is. It's not just that women are at higher risk or more likely to develop dementia because they're living longer than men, but there's probably some hormonal aspects of their higher risk factor for dementia. But then there's the other aspect of it too, is that as caregivers, caregivers are at higher risk of developing dementia. And because caregivers tend to be women, that increases or compounds the risk for women as well. We know with caregiving, particularly with someone who's living with dementia, there's more risk of developing things like depression, high stress, health problems, psychological distress, and all of these things increase somebody 's risk for developing dementia as well. Dr Smith: So, I wonder if you might talk a little more, Ange, about what you mean by burden? I think we have in our mind what that is. But in reading your article, there's a lot of- a lot more to it than may meet the eye. Dr Polsinelli: Yeah, it is a more complicated, I guess, topic or terminology that's gone through several iterations over the course of doing research into burden. But when we think about burden, it's really a kind of a combination of both objective experiences and subjective experiences. And these objective, subjective experiences fall into the categories of physical burden, emotional burden, psychological burden. So, there's a lot of different areas of life in which someone can experience burden. But really, it's a combination of factors of both the objective experience, lived experience, and the person 's perception of that experience or what they're dealing with. I should also mention that it appears to be more of that subjective experience or that perception that people have of their objective experience of stressors or burden. That really does determine the person's response to that, if whether they actually perceive their lived experience as being burdensome.  Dr Smith: One of the things I found really interesting was the societal and cultural context surrounding this, that there are different cultural expectations and societal dynamics, both in the nature of the burden care partners may feel and how they're viewed. I wonder if you could talk about that? I think it's something that it would seem all of us need to be attuned to as we're working with our patients and their families.  Dr Polsinelli: Yeah, this is a topic we could talk for a very long time on. I will try and- I will try not to kind of provide too much of a, or too lengthy of a response. But what we know now is basically that our models of stress and burden that we have typically used or historically used do not incorporate a lot of factors of cultural identity of social and structural determinants of health factors. And so, what we understand now is that stress and the way that people perceive burden is influenced by so many other factors than just kind of an experience and a perception. Because that perception is influenced by so many factors, including, as you mentioned, cultural factors that include how society's familial expectations for us, cultural expectations for us, as well as what our resources are that are determined by, again, structural and social determinants of health, what our community resources are. They're just a lot of different factors that go into how somebody perceives their ability to cope with, again, this kind of life-altering diagnosis that their loved one has received and them being the person who is caring for them through that. Dr Smith: Your article actually goes through in some detail the types of burdens and what drives the burden. And that changes over time. And so I wonder if maybe you can talk a little bit about what the specific natures of the burden are from the caregiver perspective. I mean, what  sort of tasks there are, you know, from the many of us who take care of patients, we still don't know unless we've been in the room or in the home watching this happen. So maybe you can describe that for those of our listeners who maybe haven't lived through this?  Dr Polsinelli: Yeah, absolutely. I will say upfront that the caregiving experience is going to be different for every single person. And again, kind of dependent on some of those factors that I mentioned before. So, it's going to look different for most people. It's also going to look different through the dementia journeys. The experiences and the requirements earlier on in dementia are going to be a vastly different than what occurs later on when dementia is in the more late stage, moderate or severe stages of the disease. Those care responsibilities absolutely change over the spectrum of that time as well. We know that early on the stage of disease, primary care partner might be spending forty plus hours a day. So, a full-time- or not a day. I'm sorry, a week. So, a full time job carrying it. But that number increases up to a hundred and fifty or so hours per week once the person is more advanced in their disease. So, I say that because the number of hours, I think, make all, like- putting that into perspective of somebody having a full time, multiple full time jobs, basically providing care, I think is really important. But the responsibilities of the care partner are going to range from everything from just helping the person early on in terms of managing finances or managing them, making sure they're reminding them to take their medications, scheduling their medical appointments for them, maybe taking over all of the driving to get them to their appointments or to get them to family outings and things like that. They're going to be the ones that's going to be the most responsible for reminding people to do something: to eat, to maybe stay on track for a recipe or something that they are making. So, kind of being the eyes and ears for this person right away, basically right at the beginning, even early stages. And then that progresses over time to the person who is caregiving, who is doing potentially everything for this person. So that means helping them use the restroom when they need to, helping them shower. So, there's a physical component to the caregiving as well as that- sort of what we call instrumental support in terms of organizing medical appointments and things like that. They're just basically doing it all for that person.  Dr Smith: So, what about a busy clinician who has half an hour to see a dementia patient follow up? Kind of hard to- in these days, you know, we've got, you know, these new therapies to think about as well. What advice do you have to neurologists and other professionals caring for patients? Dr Polsinelli: Yeah. And I think neurologists, I mean, we all have limited time. And I know neurology in particular is like primary care, has even more constrained time. I think one of the biggest things that neurologists can do is really check in with the care partner. So, take a moment to check in with the care partner who's there with the person with dementia to see how are they doing. You're looking for signs of burden or stress, so things like physical complaints like headaches or stomach ache, mentioning feeling burnt out or overwhelmed, maybe feeling depressed or something like that. There's also some short kind of questionnaires that you could give care partners prior to an appointment that they could fill out. You could kind of get a sense of where is this person at this point and then help connect them potentially to some resources that might be available. And I would refer people to that article that has a list of resources in there that you could just basically print out and give to somebody.  Dr Smith: Yeah, I was going to make the same point, Ange. Your article is a treasure trove of information. And you know, I'm certainly, I keep all of these on file, as you might imagine, but I'm keeping it in hand for future use. One of the things you talk about that really hit home for me among many is the idea of self-care, and I think sometimes the best care partners are susceptible to burnout because they they're so dedicated. You made the airplane oxygen mask metaphor, which I love. So maybe you can talk about what airplane oxygen masks have to do with dementia care and what advice you have for us and helping our patient's care partners take care of themselves? Dr Polsinelli: Yeah, absolutely. Self-care is the number one thing I tell care partners to do. It's also one of the hardest things for care partners to do. Like you mentioned, there is a deep, generally speaking, a deep love and caring for the person with who is living with dementia. And the focus becomes on them. And understandably so, the care partners sort of loses focus on themselves and making sure that they're doing okay. So I oftentimes use this oxygen airplane metaphor for people, which is basically, you know, when you're in an airplane and if there's some kind of pressure change in an airplane, they always tell you, put your oxygen mask on first before you help somebody else because you're not going to be any good to anybody if you're passed out. In the airplanes, the pressure changes, you know. You need to be available. you need to be getting what you need in order to help somebody else. So, I think that metaphor, that analogy really works well in dementia care is you need to be- the care partner needs to be caring for themselves and replenishing themselves in order to be the best care partner they can be for their loved one.  Dr Smith: Another challenge that, it strikes me as shared between people living with dementia and their care partner is that of social isolation and loneliness, right? If you're working a hundred and fifty hours a week doing anything, you don't have time to care for yourself or very hard to engage in social connections. And one of the loud messages I think I heard from your article is the power of social connectedness, both in terms of resilience and in many different ways. I wonder if you can talk a little bit about loneliness? And I just reflect that in a postpandemic world, this is probably a bigger issue than it was four years ago or four years and three months ago. Dr Polsinelli: Yeah, absolutely. Loneliness and social isolation was a big problem before, and it's even worse now is when I'm hearing from my patients. What I'm seeing in the literature is this postpandemic time is even more has been even more isolating and more problematic for people, but this social network cannot be, as you said, it cannot be overstated in terms of the importance for people. So that social network is important for not only providing potential instrumental care - so that practically care that care partners can use can lean on other people to come into the home to do things for the person living with dementia so the care partner can go practice self-care or go do those errands that need to be done - but also the emotional support as well that social networks can provide for people. And also, you know, social networks for not just the person, the care partner, but for the person living with dementia as well. We know that social engagement in particular is really good for brain health. I mean, we don't think about it, but social engagement is a very cognitive activity. And so, it helps give the brain a bit of a workout. So that social network is important for a lot of different reasons, and understandably a lot harder to maintain in this sort of postpandemic world as well. Dr Smith: As our time starts to come to- close to a close, we're not done yet, but I think we're probably going to have to start winding up. I wonder if we could pivot to something positive and then talk about the joy in this. And by that, I mean you describe and I think we've witnessed relationships and caring, caregiving situations that, as challenging as they are, provides fulfillment and the connection one has with a loved one or sort of that social aspect. Are there things that- predictive of that kind of positivity, and are there ways that we as professional caregivers for patients and their families can facilitate that? Dr Polsinelli: Yeah, there are. There are a couple of things. So, one of which is basically the quality of relationship between the care partner and the person living with dementia already. So that's the quality of that relationship. The better the quality of that relationship, the more likely it is that the care partner will experience more meaning and fulfillment and joy associated with caregiving, kind of outweighing that burden. But the additional piece of that is the more resources, the more mastery they feel about their caregiving or care partnering abilities, the more competent they feel and their ability to do good by the person, their loved one, the person living with dementia, the more likely they are to find that role fulfilling and meaningful. And I think that's where neurologists and other providers can kind of come in as helping people make sure that they have those resources that they are connecting to places where they can learn skills for giving appropriate care so that they can feel confident in what they're doing. There's the preexisting relationship piece that matters a lot. But I think that there's a lot of modifiability that neurologists have, too, in making a positive impact on the care partner and the person living with dementia. Dr Smith: That's really great advice, Ange. And I definitely will refer our listeners yet again to your article, which is a compendium of useful advice about this, both in terms of the text itself and in tables that provide lists of resources, websites, books, organizations, good case examples. It's a home run and I hope all of our listeners check it out. I'd like to wind up by talking a little bit about your work. And as I understand it, you obviously are very passionate about this topic, but you have specific interests in caregiver burden and underserved and marginalized communities. And then, we've touched on this, but this is a huge percentage of our population. And when you look out globally, it's even bigger than that. Tell us about what you're working on. And then maybe following that, what's the future look like? Where are we going to see advances in this in the coming years?   Dr Polsinelli: So just a really quick kind of brief history is that I've worked in dementia for almost twenty years or so now. And what I've consistently seen is when you give care partners good supports and education and resources, there are better outcomes for them and their families. The unfortunate thing is, a lot of these really great interventions and things that we have are not necessarily really accessible by a lot of people, but particularly not accessible by those living in underserved communities. The last few years in particular, I've really shifted into wanting to better understand that and better understand how do we provide culturally and socially appropriate interventions and education for these care partners and their families. With the current research project that I'm working on, we're looking at better understanding the needs of care partners of people who have early onset Alzheimer's disease, specifically from Black and African American individuals and other underrepresented groups. Again, the idea of this is to understand the needs before building an intervention for these groups, and I'm very excited about it. I know that there are lots of really great people who are working in this area, including Dr Dilworth Anderson and Kalisha Bonds Johnson, doing really fabulous work in this area. So, and building on what they're doing as well. In terms of what the future holds, one, I think we absolutely need to, we have lots of really great care partner interventions out there that have been lots of research going on, but it's not really transitioning into the clinical sphere. It's really kind of staying in that research sphere. So, I think it's really important that we get some implementation scientists who are taking those interventions and moving them into the clinical sphere, into the sort of like everyday, how do these actually work for people sphere. And then similar to some of this conversation we're having in terms of serving, making sure our interventions and making sure that our resources are appropriate and accessible for underserved communities, we really need to be taking a look at what these communities need rather than kind of saying, this is what's available. Kind of, hopefully this works for you. Speaking with these communities, engaging stakeholders and understanding what are the needs in these groups so that we can provide the appropriate resources, the appropriate interventions, the appropriate supports for care partners and people living with dementia. Dr Smith: And I'm just thinking, imagine what this looks like with effective treatments for Alzheimer's disease, that slow progression. And you know, that's going to make the caregiving even more important, it seems to me. But there's an opportunity to make it a better rewarding and a better-supported system as we develop these new therapies. So, this is a, like a Clarion call for learners listening that they should all become dementia neurologists and neuropsychologists like here. Thank you. That was outstanding. Say, Ange, I want to thank you a lot for a really engaging conversation. This fulfilled every hope I had coming into it. I was really excited to talk to you. I always love talking to neuropsychologists, but I think again, this is really useful for neurologists, learners, people who are nonneurologists everyone. And so, thank you very much. I've learned a lot and I really would encourage everyone to check out the article.  Dr Polsinelli: Well, thank you so much for having me on and giving me the opportunity to talk about the stuff that is really important to me and, I think, to most of us out there. So, hopefully people find the article and the resources in there useful and, and thanks again for having me.  Dr Smith: I'm sure they will. Again, today I've been interviewing Dr Angelina Polsinelli, whose article on care partner burden and support service in dementia appears in the most recent issue of Continuum, which is on dementia. Be sure to check out Continuum audio episodes from this and other issues. And thanks to you, our listeners, for joining us today. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/AudioCME. Thank you for listening to Continuum Audio.

While there are many kinds of dementia, like Alzheimer's disease and Lewy body dementia, there's one that researchers have only recently identified. LATE, or Limbic-predominant Age-related TDP-43 Encephalopathy, is a newly-characterized type of dementia associated with abnormal clumps of a protein called TDP-43. So, what exactly do we know about LATE? Dr. David Wolk joins the podcast to share what key features of LATE are, how it compares to Alzheimer's disease and impacts treatment, and what next steps are needed to better understand this neurodegenerative disease. Guest: David Wolk, MD, director, Penn Alzheimer's Disease Research Center, co-director, Penn Memory Center, co-director, Penn Institute on Aging, chief, Division of Cognitive Neurology, professor of neurology, University of Pennsylvania Perelman School of Medicine Show Notes Learn more about LATE on the National Institute on Aging's website and on Penn Memory Center's website. Read Dr. Wolk's article, "Clinical criteria for limbic-predominant age-related TDP-43 encephalopathy," on the journal Alzheimer's & Dementia's website. Learn more about Dr. Wolk in his profile on the Penn Memory Center website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

The holidays can be a stressful time for everyone, especially those with dementia and their care partners. In preparation for this season, Dr. Alexis Eastman joins Dementia Matters for our last episode of 2024. Drs. Chin and Eastman discuss strategies for managing the potential stress of holiday traveling and gatherings, important safety considerations and more. Guest: Alexis Eastman, MD, geriatrician, Senior Medical Director of Ambulatory Medical Specialties, UW Health, associate clinical professor, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health Show Notes Listen to our past episode with Dr. Eastman, “Holiday Tips for Dementia Caregivers,” on our website. Find more resources and tips for the holidays in “Resources for navigating the holidays with Alzheimer's” on our website. Want to support Dementia Matters? Make an end-of-year gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

High in fats and low in carbs, ketogenic diets were originally developed in the 1920s to treat children with epilepsy. Now, they've gained popularity for weight loss, and even improved cognitive function. But how much truth is there in the purported brain health benefits we see on social media? In this episode of ‘Your Brain On...', we separate the facts from the fads, and discuss: • What one might eat on a typical ketogenic diet • How ketogenic diets affect brain metabolism • The different ways your brain uses sources of energy — glucose vs. ketones • The latest data on ketogenic diet in Alzheimer's disease patients • What we know about how ketogenic diets and treatment of Alzheimer's • The outcome differences between ketogenic diets and ketone supplements in Alzheimer's • Other evidence-based nutritional approaches for brain health  For this episode, we welcome two world-renowned professionals in the field of nutrition and neuroscience: DR. MATTHEW TAYLOR, PhD, RD, Assistant Professor, Dietetics and Nutrition, Kansas University Medical Center DR. RUSSELL SWERDLOW, MD, Gene and Marge Sweeney Professor of Neurology; Director, Alzheimer's Disease Research Center, Kansas University Medical Center This is... Your Brain On Ketogenic Diets. ‘Your Brain On' is hosted by neurologists, scientists and public health advocates Ayesha and Dean Sherzai. ‘Your Brain On... Ketogenic Diets' • SEASON 4 • EPISODE 4   FOLLOW US Instagram: @thebraindocs Website: TheBrainDocs.com More info and episodes: TheBrainDocs.com/Podcast   REFERENCES 1. Wheless, James W. "History of the ketogenic diet." Epilepsia 49 (2008): 3-5. 2. Krolak-Salmon, Pierre, Russell H. Swerdlow, Thibault Mastain, Catherine Dive-Pouletty, Nick Pooley, and Masoumeh Kisomi. "Efficacy and Safety of Exogenous Ketones in People with Mild Neurocognitive Disorder and Alzheimer's Disease: A Systematic Literature Review." Nutrition Reviews (2024): nuae098. 3. Taylor, Matthew K., Debra K. Sullivan, Jonathan D. Mahnken, Jeffrey M. Burns, and Russell H. Swerdlow. "Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer's disease." Alzheimer's & Dementia: Translational Research & Clinical Interventions 4 (2018): 28-36. 4. Taylor, Matthew K., Russell H. Swerdlow, and Debra K. Sullivan. "Dietary neuroketotherapeutics for Alzheimer's disease: an evidence update and the potential role for diet quality." Nutrients 11, no. 8 (2019): 1910. 5. Koppel, Scott J., and Russell H. Swerdlow. "Neuroketotherapeutics: a modern review of a century-old therapy." Neurochemistry international 117 (2018): 114-125. 6. O'Neill, Blair, and Paolo Raggi. "The ketogenic diet: Pros and cons." Atherosclerosis 292 (2020): 119-126. 7. Crosby, Lee, Brenda Davis, Shivam Joshi, Meghan Jardine, Jennifer Paul, Maggie Neola, and Neal D. Barnard. "Ketogenic diets and chronic disease: weighing the benefits against the risks." Frontiers in nutrition 8 (2021): 702802.

Vascular cognitive impairment is a common and often underrecognized contributor to cognitive impairment in older individuals, with heterogeneous etiologies requiring individualized treatment strategies.  In this episode, Katie Grouse, MD, FAAN speaks with Lisa C. Silbert, MD, MCR, FAAN, an author of the article “Vascular Cognitive Impairment,” in the Continuum December 2024 Dementia issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Silbert is is co-director at Oregon Alzheimer's Disease Research Center, a Gibbs Family Endowed professor of neurology, a professor of neurology at Oregon Health & Science University, a staff neurologist, director of Cognitive Care Clinic, and director of the Geriatric Neurology Fellowship Program at Portland Veterans Affairs Health Care System in Portland, Oregon. Additional Resources Read the article: Vascular Cognitive Impairment Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum Journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Lisa Silbert about her article on vascular cognitive impairment, which is part of the December 2024 Continuum issue on dementia. Welcome to the podcast and please introduce yourself to our audience.  Dr Silbert: Hi Katie. Thanks for having me here today. Like you mentioned, my name is Lisa Silbert. I am a behavioral neurologist at Oregon Health and Science University and my research focus is in the area of vascular contributions to cognitive impairment and dementia. Dr Grouse: It's such a pleasure to have you and I really enjoyed reading your article. Just incredibly relevant, I think, to most practicing general neurologists, and really to any subspecialty. I'd like to start by asking, what do you think is the main takeaway point of your article for our listeners?  Dr Silbert: Yeah. I think, you know, the field of vascular cognitive impairment has changed and evolved over the last several decades. And I would say the main take-home message is that vascular cognitive impairment or vascular dementia is no longer a diagnosis that is only considered in someone who's had acute decline following a clinical stroke. That we have to expand our awareness of vascular contributions to cognitive impairment and consider other forms of the disease that can cause a more subacute or slowly progressive form of cognitive impairment. And there are many, many forms of vascular cognitive impairment that present in a more slowly progressive manner. The other thing I would say as a major take-home message is that we know that cerebrovascular disease is a very common copathology with other forms of dementia and that it lowers one 's threshold for manifesting cognitive impairment in the context of multiple pathologies. And so, in this way, vascular cognitive impairment should be considered as a contributing and potentially modifiable factor in any dementia.  Dr Grouse: I found that last point just really, really fascinating. And also, you know, the reminder that a combination of pathologies are more common than any one. To your initial point, I'm actually curious, could you kind of outline for us how you approach diagnosing vascular cognitive impairment?  Dr Silbert: Yeah. So with everything in neurology, a lot of it comes down to the initial history taking. And so part of the work up always includes a very detailed history of the presentation of cognitive impairment. Any time there is an acute change in cognition, vascular contribution should be considered, particularly if it's in the context of a clinical stroke or some kind of event that might have lowered cerebral blood flow to the brain. And then having said that, I already mentioned there are many forms of vascular cognitive impairment that can mimic neurodegenerative disease in terms of its course. So being more slowly progressive. And so because of that neuroimaging, and in particular MRI, has become an extremely valuable tool in the workup of anyone who presents with cognitive impairment in order to evaluate contributions from cerebral vascular disease. And so, MRI is a really helpful tool when it comes to teasing out what may be contributing to a patient's clinical syndrome, as well as their other comorbid medical issues, including stroke risk factors and other kind of medical conditions that might contribute to reduce cerebral blood flow. Dr Grouse: I'd love to talk a little bit more about that. You know, as is often the case with neurologic disease associated with vascular pathology, the importance of prevention, you know, focusing on prevention of vascular diseases is so important. What are some things that we can make sure to focus on with our patients and, you know, particularly anything new to be aware of in counseling them? Dr Silbert: Yeah, I'm really glad you asked me that question because like I mentioned, you know, cerebral vascular disease is so common, it lowers one's threshold for cognitive impairment in the face of other age-related brain pathologies. And so, it's really important for all of us to focus on preserving our cognitive health, even starting in midlife. And so, there are a number of areas that I counsel my patients on when it comes to preserving cerebral health and maximizing cerebrovascular health. And so, these stem from the American Heart Association's Life's Essential 8 because we know that preserving cardiovascular health is likely going to also preserve cerebral vascular health. And so, some of the things that I'm very commonly discussing with my patients are controlling stroke risk factors such as blood pressure, blood sugars and cholesterol, maintaining a healthy weight, and then also working towards a lifestyle that includes a healthy diet, no smoking, regular exercise. And then new within the last couple years is also the recommendation that people get adequate sleep, which is something that hasn't been focused on previously. Dr Grouse: I was really interested in reading your article to learn about enlarged perivascular spaces and the role as a mediating factor in the interaction between through a vascular dysfunction and development and progression of neurodegenerative pathology. Can you elaborate on this further? Dr Silbert: So, this is an area that's still largely unknown in the field, and it's an area where there's a lot of emerging work being done. The short answer is, we really don't know with great certainty how it directly connects with accumulating Alzheimer's pathology. But there is some evidence to suggest that the perivascular space is involved in the clearance of toxic solutes from the brain, including Alzheimer's disease pathology. And so there's a lot of work looking at how potentially cerebrovascular risk factors might affect the clearance of those toxic solutes through the perivascular space, including pulse pressure changes that might occur with accumulating cerebrovascular disease and other potential contributors. But one thing I can say with more certainty is that the, you know, location of perivascular spaces is thought to help distinguish those who might have cognitive symptoms due to cerebrovascular disease versus due to cerebral amyloid angiopathy. Or I guess I should say location is helpful in terms of recognizing vascular contributions to cognitive impairment that's due to arteriolosclerosis versus that due to cerebral amyloid angiopathy. In so much that… when we see a lot of perivascular spaces in the basal ganglia in the subcortical structures, that is thought to be more associated with arteriolosclerosis and hypertension type related vascular cognitive impairment. Whereas when we see multiple perivascular spaces within the centrum semiovale, that tends to be more associated with cerebral amyloid angiopathy. Dr Grouse: That's so interesting. And on the topic ofcerebral amyloid angiopathy, you did go into this a good deal. And you know, I think I encourage everybody to revisit the article to remind themselves about, you know, the findings that can increase the suspicion of tribal amyloid angiopathy. However, you also talked about transient focal neurologic episodes, which I think is just a great reminder that, you know, these can occur in this setting and definitely not to miss. Tell us more about what to look for with these types of episodes.  Dr Silbert: Transit focal neurologic episodes can be very difficult to tease apart from a transient ischemic attack. And these transient focal neurologic episodes due to CAA can present in a number of different ways. And I think the important take home message for that is that in people who have neuroimaging evidence of CAA to inform them that they are at increased risk for having these focal neurologic episodes and that if they do present to a hospital or an emergency department with any kind of neurologic event, that those treating them are aware that they have evidence of CAA on their neuroimaging because the treatment of course is quite different. So, it's someone presenting with ATIA who has transient neurologic symptoms might be considered urgently to get a thrombolytic or, you know, TPA, whereas someone who has known cerebral amyloid angiopathy or suspected CAA, they likely already have microbleeds on their neuroimaging and in those cases thrombolytics and TPA would be contraindicated and not helpful in terms of the etiology of their neurologic symptoms. Dr Grouse: That's a really good point to make. And I think also in your article you mentioned the use of aspirin if you're suspecting ATIA versus a, you know, a transient amyloid related focal neurologic episode. You know, one you would treat with aspirin and the other one you wouldn't.  Dr Silbert: That's right.  Dr Grouse: Another sort of interesting topic you delved into was cerebral microinfarct and how this can also contribute to vascular impairment. Could you elaborate a little more on that? Dr Silbert: Yeah. So cerebral microinfarcts are kind of the hidden cause of or a hidden cause of vascular cognitive impairment. And it's extremely challenging because by definition they are not visible on routine clinical neuroimaging. It's something that we are more aware of based on pathological studies and neuroimaging studies that have been done at ultra-high field strength like 7T MRI. And so, we are just learning more about how prevalent they are in certain conditions and how we can only look at these after death when we're looking at brain tissue and then go back and realize that these play a significant role in cognitive decline when someone is alive. It's important to understand that we're probably only appreciating kind of the tip of the iceberg when we're evaluating a patient and looking at their neuroimaging. That what we're actually seeing on MRI are only the things that are actually quite relatively big and obvious. And that a lot of these neuroimaging features of vascular cognitive impairment are actually associated with pathologic features that we're missing such as microinfarcts. But the hope is that by treating all individuals, particularly those who already have signs of vascular cognitive impairment, by modulating their stroke risk factors and focusing on maintaining brain health, that those will, interventions will also reduce the incidence of microinfarcts. Dr Grouse: What do you think is the greatest inequity or disparity you see in treating patients with vascular cognitive impairment? Dr Silbert: I think the greatest disparity is- really starts way before I treat a patient. That relates to really focusing on healthy lifestyle factors early in life and being able to, you know, afford fruits and vegetables, and having the advantages of being able to exercise regularly, and just being aware that all of these things are extremely important before older age. So, these are things that, you know, I think more education and awareness and greater access to healthcare will definitely improve access to. Even preventative healthcare is a disparity and not available across all of the population and geographic locations. So, I think of the- all the dementias, vascular cognitive impairment probably has the greatest association with health and social disparities in terms of primary prevention and access to care.  Dr Grouse: All really important things to consider. I have to say when, you know, reading your article, dare I say I came away with a little bit of hope thinking, you know, even with, you know, how little we still, you know, or how much we still need to do to really learn how to fight Alzheimer's and, you know, prevent it and, and, you know, help with its progression. The idea that in so many cases, even just doing what we can to prevent the vascular or cognitive impairment can really help any type of dementia. That was really a strong message for me. Do you mind elaborating on that a little more?  Dr Silbert: No, not at all. I agree. I really am hopeful about the prevention and treatment of dementias and through the treatment and prevention of cerebrovascular disease. I think that is a true reality, just like, you know, as we were discussing before, the treatment and prevention of cerebrovascular disease really should be a part of the treatment of any type of cognitive impairment and recommendations for prevention of cognitive impairment. This is the, you know, one thing we know is largely modifiable and preventable in most cases. I think the, really the key thing is just education and making sure that people understand that these are things that really need to be, they need to be engaged in in midlife and that it's much harder to reverse these- the damages once you have them in later life. Having said that, I do think that there's greater awareness of maintaining healthy lifestyle and maintaining awareness of stroke risk factors. And I think we're already starting to see a reduction in dementia worldwide in several large population-based studies, and probably that is due to more attention to the modifying stroke risk factors. So, I agree with you, it's very encouraging.  Dr Grouse: Is there anything exciting on the horizon that you can tell us about that we should all be keeping our eyes out for? Dr Silbert: Yeah. So, you know, I'm really interested in this connection between vascular cognitive impairment and Alzheimer's disease. And it's a real area of exciting new research. And so I think we're going to have more answers as to how, whether and how, cerebrovascular disease is directly linked to accumulating neurodegenerative disease or neurodegenerative pathologies. The other area that's, I think, really exciting, that's moving forward, is the in the area of blood-based biomarkers for vascular cognitive impairment. As these emerge, we'll be able to really identify those at greatest risk for vascular cognitive impairment, but also identify novel mechanisms that lead to VCI that can be targeted for therapeutic intervention. Dr Grouse: Well, I'm really excited to see what's coming down the pipeline and what more we'll learn in this area. So, thank you so much for everything you've done to contribute to this field. Dr Silbert: Yeah.  Dr Grouse: I wanted to ask a little bit more about you. What drew you to this work?  Dr Silbert: Well, actually, so my very first published manuscript in medical school was a case report and review on MELAS, which is mitochondrial encephalopathy with lactic acidosis and strokelike syndrome. And so, I was really fortunate to have Dr Jose Biller, who is a renowned expert in stroke and cerebrovascular disorders, as my mentor for that paper. And so, that got me really interested in neuroimaging findings of cerebral vascular disease. And so when I was a fellow at Oregon Health and Science University, I was then really fortunate to  be able to work with Jeffrey Kaye's oldest old population. And in working with that population, I really became interested in their neuroimaging findings of these white matter lesions and just realizing how prevalent they were in that population, you know, it just led me to start investigating their clinical significance and etiology, which kind of led me along this path. Dr Grouse: You know, Lisa, thank you so much. I really learned a lot from your article, and I think our listeners will definitely find that it was very helpful for their practice. Thank you so much for joining us. Dr Silbert: Thank you so much, Katie. It's been really fun.  Dr Grouse: Again, today I've been interviewing Dr Lisa Silbert, whose article on vascular cognitive impairment appears in the most recent issue of Continuum on dementia. Be sure to check out Continuum audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/AudioCME. Thank you for listening to Continuum Audio.

With the recent surge in artificial intelligence and machine learning technology, one of the most exciting fields it could revolutionize is health care and, more specifically, the field of cognitive care and research. Dr. Marina Sirota and Alice Tang join the podcast to share their research on how AI could be used to predict one's risk of developing Alzheimer's disease based on their electronic health records. They also discuss what needs to be done to improve these algorithms and other ways this technology could be used in Alzheimer's disease research. Guests: Marina Sirota, PhD, associate professor, University of California San Francisco (UCSF), principal investigator, Sirota Lab, and Alice Tang, MD/PhD student, University of California San Francisco, postdoctoral fellow, Sirota Lab Show Notes Read Alice Tang and Dr. Sirota's study, “Leveraging electronic health records and knowledge networks for Alzheimer's disease prediction and sex-specific biological insights,” online through the journal Nature.. Learn more about Sirota Lab on their website. Learn more about Dr. Sirota on her UCSF profile. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Lisa C. Silbert, MD, MCR, FAAN, who served as a guest editor of the Continuum® December 2024 Dementia issue. They provide a preview of the issue, which publishes on December 2, 2024. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Silbert is co-director at Oregon Alzheimer's Disease Research Center, a Gibbs Family Endowed professor of neurology, a professor of neurology at Oregon Health & Science University, a staff neurologist, director of Cognitive Care Clinic, and director of the Geriatric Neurology Fellowship Program at Portland Veterans Affairs Health Care System in Portland, Oregon. Additional Resources Continuum website: ContinuumJournal.com Subscribe to Continuum: shop.lww.com/Continuum More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology, clinical review and CME journal from the American Academy of Neurology.  Thank you for joining us on Continuum Audio, a companion podcast to the journal.  Continuum Audio features conversations with the guest editors and authors of Continuum who are the leading experts in their fields. Subscribers to the Continuum Journal have access to exclusive audio content not featured on the podcast. If you're not already a subscriber, we encourage you to become one. For more information, please visit the link in the show notes.  Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today I'm interviewing Dr Lisa Silbert, who recently served as Continuum's co-guest editor for our latest issue on dementia alongside Dr Lianna Apostolova. Dr Silbert is a professor in the Department of Neurology at Oregon Health and Science University of the School of Medicine in Portland, Oregon, where she's also the director of the Neuroimaging Core and now the co-director of the Alzheimer's Disease Research Center. She also serves as director of the dementia clinic at the VA Portland Healthcare System. Which, Dr Silbert, sounds like a lot of work? Anyway, welcome. I really appreciate you taking the time to join us today and co-guest editing this issue. Why don't you introduce yourself a little bit to our listeners?  Dr Silbert: Well, thank you so much for interviewing with me today and for inviting me to be the guest, co-guest editor of this issue. It's a really exciting time for dementia care and dementia research. As you already said, my name is Lisa Silbert. I'm in Oregon Health and Science University in Portland, Oregon. I've been involved in caring for dementia patients and their families for over twenty years now and been involved in a lot of really exciting research during that time. But I would say now is probably the most dynamic time in dementia research and care that I've seen. So, it's really, really exciting to be here.   Dr Jones: It really is an interesting time. So, I look back  in our last issue of Continuum focusing on dementia came out in 2022, which doesn't sound like that long ago, but a lot has changed, right? With the anti-amyloid monoclonals for Alzheimer's disease, new biomarkers and so on. And as the guest editor, you have this unique view, Dr Silbert, of the issue and the whole topic of dementia. As you were reading these really outstanding articles, what was the biggest “aha” moment for you or the biggest change in practice that you saw that's come up over the last couple of years?     Dr Silbert: I think, you know, in reading through the different manuscripts or chapters in this issue, it really struck home the advances that have been made throughout all the different areas of dementia. Not just- so, we hear a lot about Alzheimer's biomarkers and Alzheimer's treatments on the horizon, which is really exciting, but this is happening across other dementias as well. There's biomarkers on the horizon for a Lewy body disease and potentially for some of the frontaotemporal dementias. And so that to me really struck home as this is really, across the board, a change in the entire field that we're looking at.  Dr Jones: That is exciting. And I'd like to come back to some of those biomarker developments because I think that's an area where we've really been lacking in neurology as a specific way to diagnose those disorders. I think a topic which you just alluded to that a lot of our listeners and readers are thinking about are those antiamyloid monoclonal therapies for Alzheimer's disease. So, addicanumab, lecanumab and most recently the approval of donanemab. For these drugs specifically, how are you using them in your practice and how should our listeners be thinking about these drugs?  Dr Silbert: These are, you know, relatively new, really exciting new and emerging therapies for Alzheimer's disease. They are shown to remove amyloid from the brain. Patients who have clinical manifestations of Alzheimer's disease, and that is those in the stages of mild cognitive impairment or mild dementia. We are using lecanemab at Oregon Health and Science University through our therapeutics and clinical units. It's a really exciting time and it's a time where we have to be, also, cautious about who undergoes these therapies. So being really informed about the use, who's appropriate to undergo these therapies, what kind of safety tests need to be undergone, how do you assess risk in individual patients so that you can counsel them.  So, all of these factors need to be weighed in when you're making a decision about whether or not to treat a patient with a monoclonal antibody therapy. And specifically, we do neuroimaging to assess whether there are already the presence of microhemorrhages in the brain. We do genetic testing to look for APOE 4 genotypes that can increase the risk of Aria, which is amyloid-related imaging abnormalities. And all of these factors go into how we counsel patients and discuss whether or not to pursue treatment with monoclonal antibodies.    Dr Jones: So certainly a complex patient selection process and drug administration and monitoring of therapy for those patients.  And that- it brings to mind for me how we already have too few neurologists in the US. And now for a really prevalent disorder, Alzheimer's disease, we're making it a lot more complicated to deliver these new disease-modifying therapies. What do you think or what do you see as the role of the neurologists in caring for patients with dementia? And do these developments change that role?  Dr Silbert: For now, I think these developments make it even more important in a way that neurologists are involved in making a very specific clinical diagnosis of which dementia is playing a factor in the patient 's clinical presentation. I think one thing to note is with these emerging biomarkers, a lot of them can be positive before there are clinical symptoms and multiple etiologies are also very prevalent. And so just having one positive biomarker, it doesn't necessarily tell you what's going on with an individual patient. You need to take the whole picture into consideration. So, I think a really detailed evaluation by the neurologist, especially with these emerging therapies that have potential risks, is extremely important right now. Just getting a test is really not sufficient. You really have to take the entire clinical picture into account and know the ins and outs of the risks involved in these disease-modifying therapies.  Dr Jones: Which brings us back to something you mentioned earlier, right? Which is good news. We have on the horizon new potential biomarkers for other neurodegenerative causes of dementia. I can foresee and maybe I'm, you know, being an alarmist here, Dr Silbert, but if we have sensitive biomarkers for other neurodegenerative conditions, we know patients often have copathologies. Is that going to help clarify things? Is it going to confuse us? How is that going to work?  Dr Silbert: Well, I think ultimately, it's going to help clarify things. Because there are multiple pathologies that are common in age related cognitive impairment, any kind of additional specific input that we can get with different biomarkers is going to be helpful in putting the pieces together to come up with what's happening clinically with each individual patient. Ultimately, I think these biomarkers, they're not- any one biomarker isn't going to be a solution to diagnosis, but putting them together to help improve early and accurate diagnosis is really the goal here. Having a very early diagnosis, having a very accurate diagnosis will improve our ability to give prognosis and also improve effective treatment strategies moving forward. I think that these biomarkers have the promise in facilitating that for us.  Dr Jones: And progress is always a good thing. We just have to learn how to adapt and use the evidence appropriately. There have been and I think most of our listeners will be familiar with some of the controversies related to these, these new disease-modifying drugs for Alzheimer's disease. Do you want to walk us through a couple of those, and what are your thoughts about those controversies?  Dr Silbert: Yeah, these new therapies, they're very exciting for everyone in the field, but they, like you mentioned, they're not without their controversies. I think one controversy or one potential downside to these therapies is access to them. Like you already mentioned there, there's really not enough neurologists out there. There's not enough behavioral neurologists out there. There's limitations to infusion centers, sites and prescribers. Access to these therapies is is significantly limited. They are requiring infusions quite frequently. So, if you're not living near specialty care, you're not really able to feasibly undergo these kinds of treatments. Another controversy is the fact that the treatment effects are considered by some to be fairly modest when looking at the clinical data and in association with that, there are risks involved. Like I already mentioned, there's the amyloid-related imaging abnormalities, which sounds kind of like a benign thing, but they really consist of microhemorrhages that can lead to bigger hemorrhages and edema in the brain. These risks are relatively small - they are seeing more commonly in those who have a specific genotype, an APOE E 4 genotype - but they're risks nonetheless.  And so, there's controversy about the risk-benefit ratio and access to care with these new therapies.  Dr Jones: It's very exciting, but we should be cautious, right? I recall a few years ago as a program director, a neurology residency program director, interest in different areas of neurology would often follow developments in those areas, right? Lots of interest in autoimmune neurology when those developments would proceed in neuro oncology, etc. And I wonder if the therapeutic advances in in behavioral neurology and neurodegenerative cognitive disorders, I wonder if that's going to stimulate interest among our trainees to pursue behavioral neurology? Do you have a view on that or have you seen much change in interest in in this field?  Dr Silbert: You know, we are seeing a lot more interest in our trainees. The residents are very interested in these new therapies and how to apply them. And I'm really excited about that.  I'm hopeful that this will stimulate interest in the field. And we need those specialists, we need those sub specialists to undergo fellowship training in behavioral neurology and geriatric neurology so that we have more access to the subspecialty care and delivering these new therapies. So, I agree with you, I'm hopeful about it and I am seeing new interest in our trainees about these new therapies.  Dr Jones: We can hope so. And all the other fellowship directors will be anxious if neurology residents start leaving to go into behavioral neurology. But there's certainly demand. And I know that under the best of circumstances, dementia is so common. It's something that we have to care for in partnership with primary care and community resources. And these disease-modifying therapies capture a lot of attention, but it's really a small part of the continuum of care of these patients. And Dr Silbert as an expert, you know, if we put that disease-modifying therapy to the side for a second and just said, well, what are the biggest gaps in the care for patients with dementia? What do you see as those biggest gaps and, and what can we do to fix them at not just a neurology level, but at a societal level?  Dr Silbert: That's a big question. And you know, what I see almost every day are gaps in the support mechanisms for families who are caring for patients with dementia. These caregivers are under a lot of stress and oftentimes they just don't have the resources to take care of somebody who at some point will often need twenty-four hour care and supervision. Caregivers are older, usually of older age themselves and have their medical issues as well. And then we're just not doing a good job as a nation in in supporting patients and their families with like supportive care and respite care that's really needed. So, you know, I'm not just seeing and treating patients with dementia, but I'm seeing and I'm really trying to support and care for those who are taking care of patients with dementia. To me, that's the biggest gap in our system. Dr Jones: Yeah. And as I look through this issue of Continuum, we touched on not only the conventional topics in dementia and behavioral neurology. I'm really happy in hindsight that we have invited some discussion of the psychiatric symptoms in dementia, which I think are really important and often underrecognized and maybe undermanaged or mismanaged, and really also focusing on the caregiver burden and support services. We do have an article dedicated to that as well, and I think that'll be useful to our readers and listeners when we when we publish those podcasts. We we've heard this year especially a lot of public conversation about cognitive impairment and dementia. I sometimes wonder if that public attention is helpful and constructive for the population of patients with dementia. Sometimes I wonder if that conversation is counterproductive. What's your take on that?  Dr Silbert: You know, I think it's- it can be a mixed bag, but ultimately, it's in the conversation. We're talking about it. And I think that's only a good thing. There's more public awareness of it.  There is more interest in therapies. So, I think at the end of the day, talking about it, making it more prevalent in the ether, it stimulates the conversation and discussion. And even if there's controversies about it, we're talking about it. And I think that's kind of the first step in acknowledging that we need more support, we need more therapies.  Dr Jones: Yeah, I agree. And I think often patients with neurologic disorders and their caregivers and families often appreciate being seen.   Dr Silbert: Yeah, no, absolutely true. So, I'd say in regards to the monoclonal antibody treatments, you know, despite the controversies with these new treatments, I think there's a real promise and a real hope and a real excitement across a lot of behavioral neurologists, including myself, that this is just the beginning. That even if these first line, first generation therapies maybe have downsides, that there'll be second generation and third generation variations on these kinds of treatments that are going to be more accessible, have less side effects and hopefully be more clinically effective. And, and down the line, the other real hope for the field is that these maybe second generation therapies will actually delay the onset or prevent clinical manifestation of the disease. And that's the real goal here.  Dr Jones: And that's a great segue to the to the next thing I wanted to ask you about and you, you may have already answered the question. We talked about how we have and will have new biomarkers which will help us with diagnosis. We have hopefully the first phase in increasingly effective disease modifying therapies for Alzheimer, maybe prevent Alzheimer's disease. Wouldn't that be great? Are there any other things on the horizon that you see maybe for other neurodegenerative disorders from a therapeutic perspective? What do you, what do you think the next big thing will be in that area?  Dr Silbert: Well, that's a great question. I think, you know, there's a lot of exciting research in Lewy body dementia and targeting alpha synuclein pathologies. We really need biomarkers.  So, we're ways off from therapeutics, but I think there's a lot of exciting progress in that area.  Dr Jones: So, like many areas of neurology, there are rewarding and challenging aspects to the care of these patients. What  do you- what's the most rewarding aspect of your practice, Dr Silbert?   Dr Silbert: You know, a lot of… I hear from trainees over the years that, you know, they can't imagine or it's difficult for them to think about caring for patients who have a neurodegenerative disease that has no cure. But I feel like that's a lot of what neurologists do. We don't necessarily cure all diseases, but we treat the patient throughout their disease process. And to me that is extremely satisfying. You know, I enjoy listening to patients' stories and hearing about what they have been through over the years. And I really feel, like, appreciated for the care that I provide in giving not just an accurate diagnosis, which a lot of people come in lacking, but talking about future planning and, really, treatment throughout the course of the disease. And I was in clinic yesterday and talking to one of my patients' caregivers, and we were talking about a particularly difficult behavioral manifestation that her husband was going through. And we were talking through how to manage it. And she said to me, you know, Dr Silbert, I really feel like I have a partner in going through this disease. And you know, that's kind of what it's all about for me. So, to me, it's extremely rewarding field. It's also a very exciting field, especially right now with all these new biomarkers and treatments. So, I just think there isn't a better area of neurology to be involved in right now.   Dr Jones: What a great place to land and end the interview. And I hope our listeners and our readers really do enjoy this issue. It's really a fantastic, not just an update, but a survey of a very dynamic aspect of the field of neurology. And Dr Silbert, I want to thank you for joining us and thank you for such a thorough and fascinating discussion on caring for patients with dementia.    Dr Silbert: It was my pleasure. Thank you.    Dr Jones: Again, we've been speaking with Dr Lisa Silbert, co-guest editor, alongside Dr Leanna Apostolova for Continuum 's most recent issue on dementia. Please check it out, and thank you to our listeners for joining us today.  Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. Thank you for listening to Continuum Audio. 

The field of biomarkers is constantly evolving, leading to developments in diagnosing and treating different kinds of dementia, but what exactly are biomarkers and how has our understanding of these measures changed over time?  Dr. Henrik Zetterberg joins Dementia Matters to talk about the latest updates in research on fluid biomarkers. Dr. Zetterberg goes in depth on the role and properties of different biomarkers and how new measures and tools, like blood tests, are impacting diagnostic tests for Alzheimer's and other neurodegenerative diseases. Guest: Henrik Zetterberg, MD, PhD, professor of neurochemistry, University of Gothenburg, University College London, visiting professor, University of Wisconsin–Madison, Biomarker Core co-leader, Wisconsin Alzheimer's Disease Research Center Show Notes Learn more about Dr. Zetterberg on his University College London and University of Gothenburg profiles. Learn more about blood tests in our episode with Dr. Thomas Karikari, “Update on Blood Tests for Alzheimer's Disease,” on our website. Learn more about the different biomarker procedures, such as lumbar punctures, through the Biomarker Videos on our website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

If you're one of the 11 million Americans providing unpaid care to a loved one with Alzheimer's disease, you know that caregiving is both incredibly rewarding and challenging. What makes caring for someone with dementia so emotionally and physically demanding, and what resources and strategies are available to help? In this episode, Bonnie Nuttkinson joins us to discuss the unique needs of dementia caregivers, tips for navigating each stage of the disease and ways to find support along the caregiving journey. Guest: Bonnie Nuttkinson, MS, research program coordinator, Wisconsin Alzheimer's Disease Research Center   Show Notes Read the Alzheimer's Association's 2024 Facts and Figures report that Dr. Chin mentioned at 7:29 Get 10 tips and more resources for caregivers from the Caregiver Action Network that Dr. Chin mentioned at the 12-minute mark. Visit “Resources for People with Dementia and Care Partners” on the Wisconsin ADRC website. Find caregiving resources on the National Institute on Aging's (NIA) Alzheimer's Caregiving website. Download or order The Caregiver's Handbook from the National Institute on Aging (NIA) for free. Alzheimers.gov has information and resources for caregivers managed by the NIA at the National Institutes of Health (NIH). Find local elder care resources with the Elder Care Locator that Bonnie mentioned at 23:30.  Learn more about Bonnie from her profile on the BerbeeWalsh Department of Emergency Medicine website. Read “UW–Madison Alzheimer's program staff featured in Badger Talks series during National Family Caregivers Month” on the Wisconsin ADRC website.   Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

In the ever-evolving field of Alzheimer's disease research, the development of disease-modifying therapies has sparked both excitement and debate. Two new publications from University of Kentucky researchers highlight critical advancements and their intersection with other fields that are considered more successful in advances to date. The collaborative papers were led by Greg Jicha, M.D., Ph.D., and Pete Nelson, M.D., Ph.D., both with UK's Sanders-Brown Center on Aging. The work showcases the profound impact of partnerships across UK — in this case between the Alzheimer's Disease Research Center and the UK Markey Cancer Center. Dr. Greg talks with Nelson about this team approach to tackling this vexing disease.

In the 52nd episode of the RehabCast, our host Dr. Bill Niehaus first meets four different highlighted speakers who will be presenting at the 2024 ACRM conference with PhD Elizabeth Stegemöller, an associate professor from Iowa State University, who discusses her groundbreaking research on how singing can improve motor symptoms in people with Parkinson's disease. Dr Niehaus then welcomes Alarcos Cieza, who leads rehabilitation initiatives at the World Health Organization, talks about the global push to make rehabilitation a public health priority, followed by Dr. Jeff Burns, co-director of the University of Kansas Alzheimer's Disease Research Center, who explores how lifestyle interventions such as exercise, diet, and sleep can prevent or slow down Alzheimer's disease. And then in closing he welcomes Brooke Murtaugh and Dr. A. Shapiro-Rosenbaum who discuss providing patient-centered education to loved ones of people dealing with disorders of consciousness brain injury. #RehabCast is the PM&R podcast for all of rehabilitation medicine: physiatry, occupational therapy, physical therapy, speech language pathology, neuropsychology, rehabilitation nursing, and more. #Parkinson #Singing #MusicTherapy #Alzheimers #BrainInjury #RehabCast #ACRM #Rehabilitation To contact the RehabCast team go to https://acrm.org/publications/archives-of-pm-r/rehabcast/ Contact Dr Niehaus at https://twitter.com/NHausMD or https://www.instagram.com/nhausmd/

The idea of getting older and slowly losing memory of everything and everyone around us is something that can cause lots of dread and anxiety. Beyond the sensationalized depictions in shows such as Grey's Anatomy, let's explore the real impacts of Alzheimer's disease and how it can affect our families and loved ones. Joining me for this important conversation is cognitive neuropsychologist and Associate Director of the Rush Alzheimer's Disease Research Center, Dr. Lisa L. Barnes. Dr. Barnes has published over 300 manuscripts, received many NIH grants, and is the Principal Investigator of two longitudinal community-based studies of older African Americans. During our conversation, we discussed the common symptoms and presentations of Alzheimer's, the link between Alzheimer's and traumatic stress, and the importance of including Black folks in clinical trials when studying various medical interventions for Alzheimer's. About the Podcast The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves. Resources & Announcements How are you feeling as Election Day approaches? We know this day can bring up all kinds of emotions, and that's exactly why we're hosting a virtual space for self-care, where you can recharge and connect with other sisters feeling the same way. Join us on November 5th, from 12–4 PM ET, via Zoom for our Election Day Self Care Room. Grab your ticket here.  Grab your copy of Sisterhood Heals.   Where to Find Dr. Barnes Twitter LinkedIn Email    Stay Connected Is there a topic you'd like covered on the podcast? Submit it at therapyforblackgirls.com/mailbox. If you're looking for a therapist in your area, check out the directory at https://www.therapyforblackgirls.com/directory. Take the info from the podcast to the next level by joining us in the Therapy for Black Girls Sister Circle community.therapyforblackgirls.com Grab your copy of our guided affirmation and other TBG Merch at therapyforblackgirls.com/shop. The hashtag for the podcast is #TBGinSession.   Make sure to follow us on social media: Twitter: @therapy4bgirls Instagram: @therapyforblackgirls Facebook: @therapyforblackgirls   Our Production Team Executive Producers: Dennison Bradford & Maya Cole Howard Senior Producer: Ellice Ellis Associate Producer: Zariah TaylorSee omnystudio.com/listener for privacy information.

What if you could test your cognition from the comfort of your own home using a smartphone? Drs. David Berron and Lindsay Clark have spent years researching cognitive neuroscience, culminating in a 2024 published study investigating the effectiveness of a smartphone app as a tool for detecting cognitive impairment outside of a clinic or research setting. Drs. Berron and Clark join Dementia Matters to discuss how the app and tests were developed, the benefits and drawbacks of this approach  and the implications of remote testing in the healthcare field. Guests: David Berron, PhD, Clinical Cognitive Neuroscience research group leader, German Center for Neurodegenerative Diseases (DZNE), and Lindsay Clark, PhD, licensed neuropsychologist, clinical core co-lead, Wisconsin Alzheimer's Disease Research Center (ADRC), assistant professor, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health Show Notes Read Drs. Berron and Clark's study, “A remote digital memory composite to detect cognitive impairment in memory clinic samples in unsupervised settings using mobile devices,” online through the journal npj Digital Medicine. Learn more about Dr. Berron and his research on his website. Learn more about Dr. Clark on her profile on the Wisconsin ADRC's website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

How do caregivers find the strength to continue day after day, navigating the complexities of dementia?It's a journey that demands resilience, patience, and an often-overlooked capacity to find joy in the simplest moments. Our guest, Angela Lunde, M.A., has dedicated over 20 years to understanding the experiences of those living with dementia and their care partners. Her insights into the emotional landscape of caregiving are both profound and encouraging.       Angela is not just a researcher but a true advocate, working tirelessly to improve the quality of life for people impacted by dementia. She serves as an Associate in Neurology at the Mayo Clinic's Alzheimer's Disease Research Center and has contributed to numerous publications and books on topics ranging from mild cognitive impairment to innovative solutions for wellbeing. Angela believes in the power of community and the importance of reducing stigma, integrating persons with dementia into everyday life, and supporting those who care for them. Today, Angela sheds light on the ways caregivers find resilience, how new patterns of communication can transform relationships, and the role of acceptance in navigating the caregiving journey.       In this episode, we'll also discuss the Connect2Caregivers Study at Mayo Clinic, a research initiative aimed at providing peer-to-peer emotional support for dementia caregivers. We'll be joined by Joan Carp, a care partner for her husband living with Alzheimer's, who has personally experienced the benefits of a mindfulness-based dementia caring program. Together, we talk about the real-life challenges caregivers face, the surprising sources of strength they tap into, and the importance of creating supportive, connected communities. Whether you're a caregiver, a family member, or someone interested in the well-being of those impacted by dementia, this conversation promises to be heartfelt, insightful, and inspiring.   Resources mentioned: Mindfulness Based Dementia Care – Presence Care - https://presencecareproject.com/   Book: Day to Day – A guide for offering care and support - https://mcpress.mayoclinic.org/product/day-to-day-living-with-dementia/   Mayo Clinic Dementia Hub - https://connect.mayoclinic.org/blog/dementia-hub/   Connect2caregivers https://connect.mayoclinic.org/discussion/seeking-current-and-former-family-caregivers/   Dementia Action Alliance https://daanow.org/   Lorenzo's House https://lorenzoshouse.org/   Alzheimer's Association https://www.alz.org/   LBDA https://www.lbda.org/   AFTD https://www.theaftd.org/   We are not medical professionals and are not providing any medical advice. If you have any medical questions, we recommend that you talk with a medical professional of your choice. willGather has taken care in selecting its speakers but the opinions of our speakers are theirs alone. Thank you for your continued interest in our podcasts.   Please follow for updates, rate & review!     For more information about our guest, podcast & sponsorship opportunities, visit www.willgatherpodcast.com            *This episode is brought to you by Gigi Betty co., a boutique gift shop raising awareness and funds for caregivers and care partners. Show now at www.gigibettyco.com. Use the special code WILLGATHER20 for 20% off your order- Just for our podcast listeners!  

Stem cell models derived from patients with Parkinson's disease are valuable tools that are helping researchers around the world to better understand the underlying causes of neurodegeneration and to develop biomarkers and new therapies. To maximize the potential impacts of these tools, it is critical that they are developed and shared according to the principles of open science. In her interview, Dr. Birgitt Schüle discusses her work developing alpha-synuclein cell lines, challenges and opportunities in the field, and important considerations surrounding open science. She goes in-depth on how the cell lines were developed, characterized, and deposited with the American Tissue and Cell Collection (ATCC) with funding support from The Michael J. Fox Foundation, as well as how these cells can be used to fuel future discoveries. Birgitt is an Associate Professor in the Department of Pathology at Stanford University School of Medicine and Co-Director of the Alzheimer's Disease Research Center, Neuropathology, and Induced Pluripotent Stem Cell (iPSC) Core. This podcast is geared toward researchers and clinicians. If you live with Parkinson's or have a friend or family member with PD, listen to The Michael J. Fox Foundation Parkinson's Podcast. Hear from scientists, doctors and people with Parkinson's on different aspects of life with the disease as well as research toward treatment breakthroughs at https://www.michaeljfox.org/podcasts.

Stem cell models derived from patients with Parkinson's disease are valuable tools that are helping researchers around the world to better understand the underlying causes of neurodegeneration and to develop biomarkers and new therapies. To maximize the potential impacts of these tools, it is critical that they are developed and shared according to the principles of open science. In her interview, Dr. Birgitt Schüle discusses her work developing alpha-synuclein cell lines, challenges and opportunities in the field, and important considerations surrounding open science. She goes in-depth on how the cell lines were developed, characterized, and deposited with the American Tissue and Cell Collection (ATCC) with funding support from The Michael J. Fox Foundation, as well as how these cells can be used to fuel future discoveries. Birgitt is an Associate Professor in the Department of Pathology at Stanford University School of Medicine and Co-Director of the Alzheimer's Disease Research Center, Neuropathology, and Induced Pluripotent Stem Cell (iPSC) Core. This podcast is geared toward researchers and clinicians. If you live with Parkinson's or have a friend or family member with PD, listen to The Michael J. Fox Foundation Parkinson's Podcast. Hear from scientists, doctors and people with Parkinson's on different aspects of life with the disease as well as research toward treatment breakthroughs at https://www.michaeljfox.org/podcasts.

If you get the recommended eight hours of sleep per night, you spend a third of your life asleep. Why dedicate so much time to sleeping, and how can one get the most out of those eight hours? In this episode, Dr. Allison Reiss joins us for an insightful conversation about how sleep helps the brain, what the brain does while we are asleep, tips for improving one's sleep hygiene and much more.  Guest: Allison Reiss, MD, internal medicine physician, head, Inflammation Laboratory, New York University (NYU) Langone Hospital-Long Island, associate professor of medicine, NYU Grossman Long Island School of Medicine, member, Medical, Scientific & Memory Screening Advisory Board, Alzheimer's Foundation of America Show Notes For more information about sleep, listen to our episode with Dr. Steven Barczi, “The Importance of Sleep for a Healthy Life,” mentioned by Dr. Chin at 1:40. Learn more about Dr. Reiss and her publications from her profile on the NYU Grossman Long Island School of Medicine website. Learn more about the Alzheimer's Foundation of America's Medical, Scientific & Memory Screening Advisory Board, which includes Drs. Chin and Reiss, by visiting their website. Learn more about the Wisconsin Registry for Alzheimer's Prevention (WRAP) on their website. View 9 sleep tips from the Wisconsin Alzheimer's Disease Research Center (ADRC) Watch a recording of “Sleeping Your Way to Better Brain Health” presented by Dr. Steven Barczi. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Dr. Reisa Sperling returns for another episode of Dementia Matters. After covering her research focused on preclinical Alzheimer's disease in part one, Dr. Sperling dives deeper into the different factors that can impact cognitive decline and early-stage Alzheimer's disease and how clinical trials are shaping the field's understanding of detecting, treating and preventing the disease. Guest: Reisa Sperling, MD, director, Center for Alzheimer Research and Treatment (CART), co-principal investigator, Harvard Aging Brain Study, principal investigator, Alzheimer's Clinical Trials Consortium (ACTC), co-leader, A4 Study, co-leader, AHEAD 3-45 Study, professor of neurology, Harvard Medical School   Show Notes Listen to our first episode with Dr. Sperling, “Defining and Addressing Preclinical Alzheimer's Disease,” on Spotify, Apple Podcasts and on our website. Read more about the Harvard Aging Brains Study on their website. Read more about the AHEAD Study on their website. Watch “Voices from the AHEAD Alzheimer's Disease Trial,” featuring Dr. Cynthia Carlsson and a research participant, on YouTube.  Learn more about the Anti-Amyloid Treatment in Asymptomatic Alzheimer's disease (A4) study here. Learn more about Dr. Sperling in her profile on the Massachusetts General Hospital website.   Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

In the past few years, Big Pharma has released not one, but three new treatments for Alzheimer's disease. Aducanemab (2021), Lecanemab (2023), and Donanemab (2024), are the first treatments to effectively clear the brain of amyloid plaques — the sticky protein clumps whose build-up in the brain has defined the disease for decades. The problem? They may not help patients at all.Today's guest, Stanford neurologist Mike Greicius, considers the new amyloid-clearing drugs a major disappointment — and worse, says they likely do more harm than good for patients.Despite this critique, Greicius, thinks that the next few years will be an exciting time for novel Alzheimer's therapies, as growing biological understanding of Alzheimer's risk and resilience bear fruit with promising new approaches to treatment.Learn More:Greicius is the Iqbal Farrukh and Asad Jamal Professor of Neurology and Neurological Sciences at Stanford Medicine, and a member of the Knight Initiative for Brain Resilience and Alzheimer's Disease Research Center at Stanford University.Amyloid Drug Skepticism:Substantial Doubt Remains about the Efficacy of Anti-Amyloid Antibodies(Commentary, Journal of Alzheimer's Disease, 2024)New Drug Approved for Early Alzheimer's (New York Times, 2024)Alzheimer's drug adoption in US slowed by doctors' skepticism (Reuters, 2024)One step back: Why the new Alzheimer's plaque-attack drugs don't work (Stanford Medicine Scope Blog, 2024)Alzheimer's Genetics Research:Knight-funded research uncovers gene mutations that may prevent Alzheimer's Disease (Knight Initiative for Brain Resilience, 2024)Why is a common gene variant bad for your brain? (Stanford Medicine Magazine, 2024)Scientists find genetic Alzheimer's risk factor tied to African ancestry (Stanford Medicine, 2023)Episode CreditsThis episode was produced by Michael Osborne, with production assistance by Morgan Honaker, and hosted by Nicholas Weiler. Art by Aimee Garza.Send us a text!Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience. Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.

What if there was a way to detect Alzheimer's disease before clinical signs and symptoms even appeared? Dr. Reisa Sperling joins Dementia Matters for a two-part series covering her research on detecting and treating Alzheimer's disease at the earliest possible stage, known as preclinical Alzheimer's. In this episode, Dr. Sperling goes in-depth on amyloid and tau proteins and the implications on early detection and treatment strategies forAlzheimer's disease. Guest: Reisa Sperling, MD, director, Center for Alzheimer Research and Treatment (CART), co-principal investigator, Harvard Aging Brain Study, principal investigator, Alzheimer's Clinical Trials Consortium (ACTC), co-leader, A4 Study, co-leader, AHEAD 3-45 Study, professor of neurology, Harvard Medical School   Show Notes Read more about the Harvard Aging Brains Study on their website. Read more about the AHEAD Study on their website. Watch “Voices from the AHEAD Alzheimer's Disease Trial,” featuring Dr. Cynthia Carlsson and a research participant, on YouTube.  Learn more about the Anti-Amyloid Treatment in Asymptomatic Alzheimer's disease (A4) study here. Learn more about Dr. Sperling in her profile on the Massachusetts General Hospital website.   Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

An expanding field of research is looking at how the gut affects different parts of people's health, but how does it affect brain health? Drs. Barb Bendlin and Tyler Ulland join the podcast to talk about their 2023 study, which suggests a link between gut health, aging and changes related to Alzheimer's disease. They discuss their findings on how gut inflammation could impact brain health, as well as explain what it means to have good gut health and how food, medications, where one lives and other factors can impact the gut microbiome. Guests: Barbara Bendlin, PhD, professor, Division of Geriatrics and Gerontology, deputy director, University of Wisconsin (UW) Center for Health Disparities Research, and Tyler Ulland, PhD, associate professor of pathology and laboratory medicine, UW School of Medicine and Public Health, leader, Ulland Lab Show Notes Learn more about the 2024 Fall Community Conversation: The Impact of Social Connections on Brain Health and register to attend in person on our website. Read Dr. Bendlin and Dr. Ulland's study, “Gut inflammation associated with age and Alzheimer's disease pathology: a human cohort study,” on the National Library of Medicine website. Learn more about Dr. Bendlin and Dr. Uland's study in the article, “Gut inflammation linked to aging and Alzheimer's disease,” on the UW School of Medicine and Public Health website. Learn more about Dr. Ulland from his profile on the Ulland lab webpage. Learn more about Dr. Bendlin from her profile on the UW Center for Health Disparities Research website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

In this compendium episode, we review some of the best information and research that we've shared on the six pillars of brain health. With excerpts highlighting the importance of physical activity, diet, sleep, social engagement and more, our six guests show that there are numerous evidence-based lifestyle interventions that a person can incorporate into their daily lives to improve their brain health and delay the onset of or reduce their risk of developing Alzheimer's disease. Show Notes Learn more about the 2024 Fall Community Conversation: The Impact of Social Connections on Brain Health and register to attend in person on our website. Learn more about exercise and physical activity at 2:57 or by listening to the episode, “Building the Brain: Finding the Cognitive Benefits of Physical Activity,” on our website. Learn more about the MIND diet at 8:58 or by listening to the episode, “MIND Diet for Healthy Brain Aging,” on our website. Learn more about the importance of sleep at 14:28 or by listening to the episode, “The Importance of Sleep for a Healthy Life,” on our website. Learn more about mindfulness as a practice for managing stress at 21:22 or by listening to the episode, “Mindfulness: What Is It, What Are the Benefits, Where to Begin,” on our website. Learn more about cognitive engagement at 28:10 or by listening to the episode, “Exercise Your Mind: Cognitively Stimulating Activities and Social Engagement,” on our website. Learn more about social isolation and engagement at 34:44 or by listening to the episode, “The Impact of Social Isolation on Dementia Risk in Older Adults,” on Spotify, Apple Podcasts and on our website. Find more information about the six pillars of brain health and other prevention strategies on our website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

While genetics and lifestyle can influence one's riskof developing Alzheimer's disease, other unexpected factors can shift the possibility. One of these factors is personality. Dr. Emorie Beck joins Dementia Matters to share her research on the link between personality and Alzheimer's risk. Dr. Beck breaks down the Big Five traits that make up someone's personality and their effects on a person's cognitive health.  Guest: Emorie Beck, PhD, assistant professor, University of California, Davis Show Notes Read Dr. Beck's study, “Personality predictors of dementia diagnosis and neuropathological burden: An individual participant data meta-analysis,” through the Alzheimer's Association Journals website. Learn more about Dr. Beck on her profile on the UC–Davis website. Learn more about social isolation by listening to our episode, “The Impact of Social Isolation on Dementia Risk in Older Adults,” on Spotify, Apple Podcasts, and on our website. Find out your personality type by taking the FiveThirtyEight Personality Quiz Test your cognitive ability and participate in studies similar to Dr. Beck's on TestMyBrain.org  Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Dementia Matters Special Series: Voices of Research Participants When Ms. Carol Turner found out her family had a history of Alzheimer's disease, she wanted to know how she could help herself and others with similar experiences. After learning about the AHEAD Study, which is testing a treatment that could delay memory loss before Alzheimer's symptoms appear, she signed up to participate in this ground-breaking research. Ms. Turner joins the final episode in our Voices of Research Participants series to discuss her journey as a research participant, how she became an advocate for others in her community and the power of representation in clinical trials. Guest: Ms. Carol Turner, AHEAD Study participant Co-host: Sarah Walter, MSc, program administrator, Alzheimer's Clinical Trials Consortium (ACTC) and Alzheimer's Therapeutic Research Institute (ATRI)   Show Notes Listen to the rest of the Voices of Research Participants series, “From Caregiver to Research Participant: How One Woman's Experience as a Dementia Caregiver Drew Her to Alzheimer's Research,” “Living with Lewy Body: A Neurologist's Journey Through Research and Dementia Care,” and “Advocating for All: The Impact of Community and Equity in Dementia Research” on our website and all podcast platforms. Watch “Voices from the AHEAD Alzheimer's Disease Trial” featuring Cynthia Carlsson, MD, MS on the UW Clinical Trials Institute YouTube. Learn more about the AHEAD Study on their website. Learn more about Sarah Walter in her bio on the Alzheimer's Clinical Trials Consortium website. Find resources for people with dementia and their care partners on our website.   Connect with Us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

On this episode of Dementia Matters, Dr. Scott Roberts talks about disclosing genetic test results for APOE, a gene that can increase one's likelihood of developing Alzheimer's disease. While this information can be concerning, Dr. Roberts shares that it can empower individuals to take the necessary precautions to lower their risk of developing the disease. He discusses the Risk Evaluation and Education for Alzheimer's Disease (REVEAL) study, walks us through the APOE disclosure process and shares how it is evolving with the development of new Alzheimer's treatments. Guest: Scott Roberts, PhD, interim chair, professor of health behavior & health education, University of Michigan School of Public Health   Show Notes Read Dr. Roberts' article, “Genetic risk assessment for adult children of people with Alzheimer's disease: the Risk Evaluation and Education for Alzheimer's Disease (REVEAL) study,” on the SageJournals website. Decide if you're a fit forAPOE testing using Virginia Tech's ‘Gene Test or Not?' decision aid tool, mentioned at 17:00 in the episode. Learn more about Dr. Roberts on his University of Michigan profile. Learn more about APOE by listening to our episode, “DNA Is Not Your Destiny: Genetics and Alzheimer's Disease Risk,” with Dr. Corinne Engelman on our website. Read “WRAP data used in study finding a distinct, genetic form of Alzheimer's disease” on the Wisconsin Alzheimer's Institute (WAI) website.   Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Nathaniel Chin is an associate professor in the Division of Geriatrics and Gerontology and medical director of the Alzheimer's Disease Research Center at the University of Wisconsin School of Medicine and Public Health. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. N.A. Chin and C.M. Erickson. Alzheimer's Disease, Biomarkers, and mAbs — What Does Primary Care Need? N Engl J Med 2024;390:2229-2231.

In observance of Alzheimer's and Brain Awareness month, Dr. P and Kellee Bacote discuss the impact of cognitive illness in African American communities. Ms. Bacote is the Lead Community Outreach & Recruitment Project Manager at the Cleveland Clinic's Lou Ruvo Center for Brain Health, Cleveland Alzheimer's Disease Research Center.

Dementia Matters Special Series: Voices of Research Participants What do you do when dementia symptoms begin to upend your entire life? For Brother John-Richard Pagan, the answer was to persist in finding a diagnosis and a supportive community that aligned with his values. In this episode of our Voices of Research Participants series with co-host Sarah Walter, MSc, Br John-Richard describes how he went from a PhD student to a dementia research participant and his journey getting diagnosed with Lewy body dementia (LBD). Br John-Richard also discusses how his background in clinical psychology influenced his participation in research and his advocacy for disabled, LGBTQ+ and other marginalized community members in medical research. Guest: Br John-Richard Pagan, MS, veteran, monastic, Episcopal Ecumenical Community, advocate, Lewy Body Dementia Association (LBDA) Co-host: Sarah Walter, MSc, program administrator, Alzheimer's Clinical Trials Consortium (ACTC) and Alzheimer's Therapeutic Research Institute (ATRI)   Show Notes Listen to the first episode of the Voices of Research Participants series, “From Caregiver to Research Participant: How One Woman's Experience as a Dementia Caregiver Drew Her to Alzheimer's Research,” and “Living with Lewy Body: A Neurologist's Journey Through Research and Dementia Care,” on our website and all podcast platforms. Learn more about AGREEDementia and the Participants' Bill of Rights, mentioned at 17:10 and 30:12, on their website. Learn more about the Dementia Action Alliance on their website. Find support and resources from the Lewy Body Dementia Association on their website. Learn more about Sarah Walter in her bio on the Alzheimer's Clinical Trials Consortium website. Learn more about how to get a dementia diagnosis on our website. Find resources for people with dementia and their care partners on our website.   Connect with Us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

When it comes to dementia diagnoses, the earlier, the better, but why is it difficult to detect dementia in its early stages? Moreover, what strategies can be used to improve dementia detection? Dr. Josh Chodosh joins the podcast to answer these questions and discuss how public health initiatives could improve dementia diagnoses. He also talks about his work with the Building Our Largest Dementia (BOLD) Center, a public health center focused on early detection and ending the stigma around dementia. Guest: Joshua Chodosh, MD, director, division of geriatric medicine and palliative care, Michael L. Freedman professor of geriatric research, Grossman School of Medicine, New York University, staff physician, VA Harbor Healthcare System   Show Notes Learn more about the Building Our Largest Dementia (BOLD) Public Health Center of Excellence on Early Detection of Dementia on their website. Learn more about the Aging and Disability Resource Centers (ADRCs) in Wisconsin and across the country. Learn more about Dr. Chodosh on his NYU Langone Health bio. Learn more about how to get a dementia diagnosis on our website. Learn how to get a free virtual memory screening through the Alzheimer's Foundation of America (AFA) on their website.   Connect with Us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Picture this: you are supporting someone experiencing memory changes as a clinician, support person or care partner as they go through the memory clinic process. How do you navigate the challenging conversations surrounding symptoms, diagnoses, care plans and more that will come up? Dr. Toby Campbell joins the podcast to discuss the importance of shared decision-making and share strategies for clinicians, care partners and loved ones to help navigate these important conversations with respect and empathy. Guest: Toby Campbell, MD, MS, thoracic medical oncologist, chief of palliative care, UW Health, professor of hematology, medical oncology and palliative care, University of Wisconsin School of Medicine and Public Health Show Notes Are you a clinician interested in receiving continuing education (CE) credits for listening to this episode? Find credit designation information, disclosures and evaluation information on our website and on the UW–Madison Interprofessional Continuing Education Partnership (ICEP) website. The accreditation for this course expires 5/13/2025. After this date, you will no longer be able to access the course or claim credit. Learn more about the SPIKES strategy, mentioned at 20:48, by reading “Breaking bad news: the S-P-I-K-E-S strategy” for free online. Read Dr. Campbell's article, “Discussing Prognosis and Shared Decision-Making,” mentioned at 27:55 on ScienceDirect's website. Read Dr. Campbell's article, “Discussing prognosis: balancing hope and realism,” mentioned at 31:20 on The Cancer Journal's website. Learn more about PalliTALK and WeTALK on the University of Wisconsin Department of Medicine website. Learn more about Dr. Campbell through his profile on the University of Wisconsin Department of Medicine website. Find Wisconsin-based and online resources for people with dementia and care partners on our website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

Advances in Alzheimer's disease clinical trials are accelerating rapidly, leading to new insights and disease-modifying therapies, but how does the field continue bolstering that momentum? For Dr. Rema Raman, it's through improving inclusivity and training for early-career researchers. Recorded at the 2024 Alzheimer's Disease & Related Dementias Research Day, Dr. Raman joins the podcast to discuss her work in research recruitment and retention, the importance of training the next generation of clinical trialists in dementia research with the IMPACT-AD program and more from her featured presentation. Guest: Rema Raman, PhD, co-director, Institute of Methods and Protocols for Advancement of Clinical Trials in ADRD (IMPACT-AD), director, section of biostatistics, section of participant recruitment & retention section, Alzheimer's Therapeutic Research Institute, professor of neurology, University of Southern California Show Notes Watch our YouTube page for upcoming recordings of Dr. Raman's presentation and other featured speakers at Alzheimer's Disease & Related Dementias Research Day 2024. Learn more about Alzheimer's Disease & Related Dementias Research Day on our website. Learn more about the Institute of Methods and Protocols for Advancement of Clinical Trials in ADRD (IMPACT-AD) on their website. Learn more about Dr. Raman at her bio on the Keck School of Medicine website. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

All Home Care Matters was honored to welcome Dr. Barak Gaster M.D. as guest to the show to discuss the current state of evaluation and management of Alzheimer's disease. About Dr. Barak Gaster M.D.: Barak Gaster, MD is a professor of medicine at the University of Washington where he serves as the director of the Cognition in Primary Care Program which designs training and tools to improve dementia care in the primary care setting. He served on the leadership committee which guided the most recent CDC Healthy Brain Roadmap, he is a co-investigator at the University of Washington Alzheimer's Disease Research Center and is a governor-appointed member of the leadership council for the Washington Dementia Action Collaborative. He has more than 20 years experience as a primary care provider, and he is a nationally recognized expert on dementia in the primary care setting.

For more than a century, scientists have been studying Alzheimer's disease and developing theories about its underlying cause. The leading theory for decades has been that abnormal amyloid plaques in the brains of those who suffer from the disease are the central cause. But, according one renowned Alzheimer's researcher, this myopic focus is not only flawed, but may be holding back our search for a cure. Neurobiologist Karl Herrup argues that we need to go back to the drawing board, redefine the disease and understand the many factors that could cause it before we can race for a cure. A professor of neurobiology and an investigator in the Alzheimer's Disease Research Center at the University of Pittsburgh School of Medicine, Herrup is the author of How Not to Study a Disease: The Story of Alzheimer's.