Pełna transkrypcja odcinka Promoting Dementia Screening While Dispelling Dementia Myths

shout-out, know what to do. 00:02:43.599 --> 00:02:48.719 Leave a review or a comment on Apple Podcasts or YouTube with marking up everywhere. 00:03:17.120 --> 00:03:23.280 Today's episode Promoting Dementia Screening While Dispelling Dementia Myths. 00:03:23.520 --> 00:03:24.800 Hello, everybody. 00:03:25.039 --> 00:03:26.400 We are in Detroit. 00:03:26.560 --> 00:03:28.639 Yes, I do love this city. 00:03:28.879 --> 00:03:34.240 I love the people and I love the work that they are doing in the world of dementia care. 00:03:34.319 --> 00:03:42.400 So we are at the Rosa Parks Geriatric Center in Detroit, Michigan, with three of the baddest chicks on the block. 00:03:42.560 --> 00:03:42.800 Okay. 00:03:43.280 --> 00:03:46.719 You didn't know that dementia care could be sexy, but look, we're looking at it. 00:03:46.800 --> 00:03:47.680 We're looking at it right now. 00:03:47.840 --> 00:03:54.080 So introduce yourselves and let us know what your connection is to the Rosa Parks Geriatric Center. 00:03:54.479 --> 00:03:59.199 My name is Lisa Ben Zemmerick, and I uh am a nurse practitioner in the center. 00:03:59.360 --> 00:04:07.520 I uh see primary care patients as well as part of my role, and what brings me here today is that I coordinate the memory evaluation center. 00:04:07.599 --> 00:04:15.039 So I'm responsible for the testing and I'm part of an interprofessional team of nursing, physicians, and social work. 00:04:16.079 --> 00:04:17.120 So hello, my name is Dr. 00:04:17.199 --> 00:04:18.079 Cynthia McNeil. 00:04:18.240 --> 00:04:19.600 I am also a nurse practitioner. 00:04:19.759 --> 00:04:36.639 I do work in internal medicine, but my role for this particular project is that I'm the principal investigator for a federal-funded uh program called the Geriatric Workforce Enhancement Program, where we partner with different entities in the city of Detroit to improve the care that geriatrics receive. 00:04:36.800 --> 00:04:49.439 So I'm coming out of Wayne State University, College of Nursing, as the lead for this particular grant in collaboration with other interdisciplinary colleagues to improve care and to address dementia specifically. 00:04:50.000 --> 00:04:50.879 My name is Dr. 00:04:51.040 --> 00:04:52.000 Bibband Diol. 00:04:52.319 --> 00:04:59.759 I am an assistant professor at Wayne State University and I am a physician in the Rosa Parks Clinic. 00:04:59.920 --> 00:05:08.079 I do the primary care for elderly as well as I also do the memory clinic in collaboration with Lisa. 00:05:09.279 --> 00:05:10.160 I told y'all. 00:05:10.319 --> 00:05:11.920 Didn't I say bad chicks? 00:05:12.160 --> 00:05:15.360 And I and I think I was kind of downplayed it. 00:05:15.519 --> 00:05:19.600 They didn't even bother to tell you what all they've done before they took on these roles. 00:05:19.759 --> 00:05:22.800 I'm not gonna take you through that, but just know it's fancy. 00:05:23.040 --> 00:05:26.319 They're fancy and they know a lot, and they're about to

tell us a lot. 00:05:26.639 --> 00:05:36.079 So we're here today to really talk about dispelling the myths of dementia and to encourage people to get screening. 00:05:36.399 --> 00:05:54.000 So many people, we hear it here at the parenting up community, and I hear it like at the hair salon, where people are afraid to go get a test because it's like, well, if I don't know I have it, some kind of way it'll go away. 00:05:54.560 --> 00:05:56.639 It's an ostrich syndrome. 00:05:56.959 --> 00:06:03.600 So the first thing is I would like for you all to share with us is it hard for to have these tests? 00:06:03.759 --> 00:06:05.040 Is the screening easy? 00:06:05.199 --> 00:06:06.160 Does it hurt? 00:06:06.639 --> 00:06:07.920 No, none of the above. 00:06:08.160 --> 00:06:09.360 It is easy to do. 00:06:09.519 --> 00:06:16.480 Um it we uh at the memory clinic, we tend to um chat people up a little bit to relax them. 00:06:16.639 --> 00:06:19.519 Um we uh will ask simple questions. 00:06:19.600 --> 00:06:23.040 Uh it just helps us kind of guide our uh assessment. 00:06:23.360 --> 00:06:34.319 Um the what the first very simple one is asking um, we give you three words to remember and then um have you draw a clock, and then we ask you those three words. 00:06:34.480 --> 00:06:37.120 So it's nothing terribly invasive. 00:06:37.199 --> 00:06:40.639 Um, and that's how we start out to see if there's a problem or not. 00:06:40.959 --> 00:06:47.360 Now, who how do I sign up for this screening or this test that you just described? 00:06:47.519 --> 00:06:50.319 Does my primary care have to refer me to you? 00:06:50.480 --> 00:06:53.600 Can I just call you, send an email? 00:06:53.759 --> 00:06:54.480 How's that happen? 00:06:54.959 --> 00:06:56.000 Any of the above. 00:06:56.079 --> 00:06:58.959 Um, our goal is to really start the second time. 00:06:59.120 --> 00:07:00.000 Any of the above. 00:07:00.560 --> 00:07:05.680 I um I really think that the goal here is to get people diagnosed earlier. 00:07:05.839 --> 00:07:11.360 Um, when I first came into this role, it was uh 30 years ago, and there wasn't a lot um for people. 00:07:11.920 --> 00:07:14.639 No way you've been working 30 years in 28. 00:07:16.959 --> 00:07:21.360 But there wasn't a lot to offer people, and now we have a lot of treatments that we can offer. 00:07:21.439 --> 00:07:28.399 We're looking for people that are early stage, so a lot of those treatments are uh uh uh made for those individuals. 00:07:28.560 --> 00:07:32.560 So it's important that people know um and we can help as if we know. 00:07:32.720 --> 00:07:35.439 It's uh that kind of if you know, we can help you. 00:07:35.600 --> 00:07:37.759 If you don't, then we don't, you know. 00:07:38.000 --> 00:07:39.680 So okay, Dr. 00:07:39.759 --> 00:07:54.639 McNeil, I would ask you, uh, as the principal investigator, what have you seen to show uh I guess what have you seen that seems like it's the reason people are hesitant to get screened? 00:07:54.879 --> 00:08:00.480 Like, so they've heard, hey, you can come in, but then they don't. 00:08:01.120 --> 00:08:03.680 Have you got any reasons on why that might be? 00:08:04.000 --> 00:08:04.560 A lot of reasons. 00:08:04.720 --> 00:08:06.879 There's a whole grocery list of reasons why that occurs. 00:08:07.199 --> 00:08:09.120 One of the reasons is there's barriers. 00:08:09.199 --> 00:08:11.040 Like not everybody has access to care. 00:08:11.199 --> 00:08:18.319 Not everybody has access to this information to really understand of the importance of just screening and health promotion just in general. 00:08:18.399 --> 00:08:28.399 So that just mindset of, you know, if I just ignore it, whether that's my blood pressure, whether that's my diabetes, whether that's my memory issues, I don't have to address it. 00:08:28.480 --> 00:08:29.360 It doesn't exist. 00:08:29.519 --> 00:08:31.680 So that that's one of the main things. 00:08:31.839 --> 00:08:33.759 And like I said, the other thing is just access. 00:08:33.840 --> 00:08:35.440 You know, people don't know where to go. 00:08:35.600 --> 00:08:45.360 Um, and I take responsibility to some of that as a primary care provider because when you look at the statistics, a lot of primary care providers don't feel comfortable having these conversations. 00:08:45.600 --> 00:08:50.879 They don't feel comfortable doing initial screening or have we even passing out resources. 00:08:51.039 --> 00:08:58.639 So as somebody that works in internal medicine, but I'm also a professor at the university and I train future providers, I really want to address that. 00:08:58.799 --> 00:09:11.360 I want to make sure that people are equipped because as our population ages, this is going to be more of a frequent conversation that needs to occur, and we need providers that are confident to have these conversations and know where the resources are. 00:09:11.519 --> 00:09:13.039 So that's another thing that I've heard. 00:09:13.120 --> 00:09:24.240 I've heard participants or clients say, Well, I had concerns, but my primary care gave me a referral to someplace and they was they didn't have an opening for nine months or 10 months. 00:09:24.320 --> 00:09:28.080 Um, or I had some concerns, or somebody just told me that's just part of aging. 00:09:28.159 --> 00:09:36.799 So a lot of that type of behavior on the end of the provider uh side is something that we're trying to address with this federal funding. 00:09:36.960 --> 00:09:50.240 Increasing education, increasing training so that we have more providers that are available, A, and prepare, B, to really have these conversations and get these people linked to the necessary screenings and treatments that are out here. 00:09:50.559 --> 00:09:50.960 That's right. 00:09:52.879 --> 00:09:55.440 Does that sound way better than what you heard on the internet? 00:09:55.759 --> 00:09:56.399 I think so. 00:09:56.639 --> 00:09:57.360 I think so. 00:09:57.600 --> 00:09:58.799 Doc, what

about you? 00:09:58.879 --> 00:10:06.399 When people come to the memory clinic, the to the memory portion of the clinic, they do a lot here, y'all. 00:10:07.279 --> 00:10:15.039 They do a lot, and I don't, and I want to make sure I am not mis um labeling any of the different departments. 00:10:15.200 --> 00:10:17.679 But you're very involved at the memory clinic. 00:10:17.759 --> 00:10:17.840 Yes. 00:10:18.240 --> 00:10:30.639 When individuals come initially, what are some of the things that you've noticed that they say, I'm here because my child noticed something, I kept getting lost coming home from work. 00:10:30.799 --> 00:10:32.960 What are the things that prompt them to come? 00:10:33.279 --> 00:10:36.159 So all of these are very common uh complaints. 00:10:36.320 --> 00:10:40.720 Um the main thing that I do want people to know is there's no fear. 00:10:40.879 --> 00:10:42.720 Don't fear the diagnosis. 00:10:42.960 --> 00:10:45.440 There are so many stages to dementia. 00:10:45.679 --> 00:10:49.279 There's one thing called mild cognitive impairment, which is not even dementia. 00:10:49.360 --> 00:10:51.039 It's very early, early signs. 00:10:51.200 --> 00:10:57.360 And all people with that kind of uh memory problem does not automatically, you know, progress to dementia. 00:10:57.440 --> 00:11:06.000 But knowing about this and planning and creating a safety net in your life is very important because uh if you're not aware, you won't know. 00:11:06.240 --> 00:11:09.120 And then you cannot create that safety network around you. 00:11:09.360 --> 00:11:29.440 So when patients come to me, some of them are very aware, they have a good insight, they know that there's something wrong, and they bring it up with either our as we as a primary care physician or to their own primary care physicians, or they look up memory clinics and stuff like that, and they just re-refer themselves to come and uh talk about it. 00:11:29.679 --> 00:11:39.759 Um, thus, most of the time it's also the family because they notice things and they are you know um uh concerned about their the the memory. 00:11:39.919 --> 00:11:58.159 So when family members notice that they are repetitive or they're forgetting their medicines or some other incident that has happened, like somebody's uh finances are not in order, or somebody uh involved them in a fraud or something, or they they got lost while driving. 00:11:58.399 --> 00:12:07.919 So there are so many instances that sometimes precipitate a family member to intervene, and the patient themselves may not know that they are having a problem. 00:12:08.080 --> 00:12:10.240 Uh so it all it is all stages. 00:12:10.399 --> 00:12:25.600 Sometimes they can catch it very early because their family's paying more attention to the person, and sometimes they are not living with the the the uh patient, and they f the incident happens and then everybody kind of thinks, rethinking. 00:12:25.840 --> 00:12:26.159 Panics. 00:12:26.320 --> 00:12:27.039 That's happened in my house. 00:12:27.759 --> 00:12:28.799 And then was like my phone. 00:12:29.200 --> 00:12:30.720 Yeah, and there was like, oh my god. 00:12:30.879 --> 00:12:42.799 And and we also notice something that is very common in elderly when couples are uh together, um they compensate for each other and nobody notices the deficiencies. 00:12:43.039 --> 00:13:00.799 Unfortunately, if one of them passes or is not no longer there, then the person who's uh behind, we uh is a lot more changes are noticed noticeable in that person, which were not like when the couple was together and compensating with with each other. 00:13:00.960 --> 00:13:14.399 So there can be many scenarios, but one thing that you have to understand is that for norm for uh uh memory problems are not a normal part of aging, it is a disease process. 00:13:14.639 --> 00:13:28.799 So when you grow older, you can slow down in getting information, take more time in um uh getting that information, uh, but it's still not normal older adults should not have dementia. 00:13:28.879 --> 00:13:39.840 It is something that you need to be aware of and it impacts your personal life, your medical health, a lot of things around you, and you need a support system to get through it. 00:13:40.080 --> 00:13:41.360 And I think what I heard Dr. 00:13:41.440 --> 00:13:49.440 Jol say a couple times, it's important to bring what we like in the clinic is to bring um family or friends with the person. 00:13:49.600 --> 00:13:49.679 Okay. 00:13:50.080 --> 00:13:54.399 Because that um that kind of gives us our our second look at things. 00:13:54.480 --> 00:13:55.120 So while Dr. 00:13:55.279 --> 00:14:02.720 Jill and I are with the family, or with the patient, testing them and examining them, our social workers with the family getting their side of the story. 00:14:02.799 --> 00:14:04.080 And it's frequently what Dr. 00:14:04.240 --> 00:14:19.120 Jill said, like, especially with a couple, the one individual's passed away, they the family says, Oh, she didn't have trouble till yesterday, when really we figure out that they probably had been having issues, but the spouse had been covering for them or helping them out. 00:14:19.440 --> 00:14:23.279 That is precisely what happened with uh my maternal grandparents. 00:14:24.000 --> 00:14:29.360 And uh my mom and her siblings were caught completely off guard. 00:14:29.679 --> 00:14:39.600 My grandmother passed first, and so my grandfather, it appeared that he was heartbroken and didn't know up from down because his wife died. 00:14:39.759 --> 00:14:44.240 When we backed into a lot of family conversations, they had been compensating. 00:14:44.320 --> 00:14:44.639 Yes. 00:14:44.879 --> 00:14:46.960 We didn't know how much he couldn't see. 00:14:47.279 --> 00:14:50.799 He couldn't see, but she couldn't lift anything. 00:14:50.960 --> 00:14:52.720 She had gotten very, very weak. 00:14:52.879 --> 00:15:13.200 So they had this whole little system with

doing the laundry where she would sort it and walk with him and get his hand in point and have him pick it up and then walk him all the way out to where the to where the washing machine and dryer was and tell him to put we were like, how long have you how long did how long was this a good idea? 00:15:13.440 --> 00:15:13.679 That's right. 00:15:14.000 --> 00:15:23.519 You know, and and then we also a lot of us felt guilty like and poo-poo on us, like how much had we not been around during the time when they do in the laundry to see this? 00:15:23.600 --> 00:15:27.120 Like when they said, Oh, we're going back to the back to get the laundry, why was it taking two of them? 00:15:27.519 --> 00:15:32.960 Just things that we didn't notice because they did it so smoothly and they never complained. 00:15:33.519 --> 00:15:41.519 So um that that right there in your face, like hiding in plain sight, is a is a very real thing. 00:15:42.080 --> 00:15:49.840 Something I would like you all to clarify for those of us who don't have white coats, okay? 00:15:50.080 --> 00:15:53.200 Um screening versus testing. 00:15:53.519 --> 00:15:55.039 We get a little confused on that. 00:15:55.200 --> 00:16:08.399 Like testing, screening, a lot of times we put them all together, us lay people, and it sounds like I gotta give you blood, you're gonna stick something, I I gotta be in hospital overnight. 00:16:08.639 --> 00:16:19.919 And so I would really like you all to clarify how simple and non-invasive this stuff is in like what's screening and then what is testing. 00:16:20.399 --> 00:16:23.279 Well, screening is the uh mini cog that Dr. 00:16:23.440 --> 00:16:24.879 uh Diole talked about. 00:16:25.039 --> 00:16:27.919 Um page and you just ask. 00:16:28.960 --> 00:16:32.480 Give them three words, have them draw a clock, and then you have them recall those two. 00:16:32.799 --> 00:16:33.200 And it is over. 00:16:33.600 --> 00:16:34.000 And it's over. 00:16:34.320 --> 00:16:35.120 It's over, y'all. 00:16:35.279 --> 00:16:43.679 Now, depending on how they score there, if they score a certain amount um that indicates they need more testing, then we do a test. 00:16:44.080 --> 00:17:00.639 We the one we do here in our clinic is called the slums, but they're all similar, the mini cog or um the mocha, uh, the MMSC, and they're looking at orientation, they look at problem solving, ability to understand a uh uh a uh paragraph, they ask questions. 00:17:01.200 --> 00:17:01.679 Also written? 00:17:02.240 --> 00:17:02.960 They're paper pencil. 00:17:03.279 --> 00:17:07.279 These are paper pencils, so after the screening, you get to paper pencil testing. 00:17:07.680 --> 00:17:08.240 If they need that. 00:17:08.400 --> 00:17:16.640 If they need that, it if you only if you need it, but so I'm am I like let's say if this were me, am I just like sitting in your office doing this? 00:17:16.880 --> 00:17:18.319 Do y'all do it virtually? 00:17:19.039 --> 00:17:20.720 No, we no, we do it in the

office. 00:17:20.880 --> 00:17:24.240 I do it with the patient, it's usually my myself and the patient. 00:17:24.400 --> 00:17:29.519 Um it it's paper pencil, 30 questions, uh very simple to do. 00:17:29.759 --> 00:17:30.000 Okay. 00:17:30.240 --> 00:17:38.319 Um I uh the other thing we do is a geriatric depression scale because oftentimes older people can be depressed and that will affect their memory. 00:17:38.400 --> 00:17:39.759 Um and after that, Dr. 00:17:39.920 --> 00:17:48.240 Gio examines them, and then based on the physical, we will do um, they will have a blood draw looking for reversible causes. 00:17:48.480 --> 00:17:50.319 Um, thyroid, B12. 00:17:50.400 --> 00:17:56.559 Some of these uh tests can get off as people get older, and that can affect their memory, but we can fix that, those types of things. 00:17:56.799 --> 00:17:57.920 Like things we could fix. 00:17:58.319 --> 00:18:00.480 And then we will do an imaging study, and Dr. 00:18:00.640 --> 00:18:01.839 Jewel can speak to that. 00:18:02.079 --> 00:18:02.319 Right. 00:18:02.640 --> 00:18:12.079 So um it all starts with, of course, the screening, the the the more complicated tests after like a simple screening, then we then we get into it. 00:18:12.240 --> 00:18:17.680 So the first thing is of course that simple question telling I have a memory problem, and then we take on forward. 00:18:17.839 --> 00:18:23.759 So depending upon how bad the memory problem is, um it we we kind of progress from there. 00:18:24.000 --> 00:18:29.759 Now, the reason for the testing, like we have blood tests now, but they were not available uh before. 00:18:29.920 --> 00:18:37.920 So everything was very clinical history from the patient, do the testing or the screening and the questionnaire, everything was paper pen. 00:18:38.160 --> 00:18:42.079 So there was no definite saying that hey, this is the test and it will diagnose you. 00:18:42.240 --> 00:18:56.720 No, it is a combination of all these things, and at the end of it, uh, your story, family story, testing, uh lab work, and then we figure out what kind of uh um memory problem it is because there are many different kinds of dementia. 00:18:56.799 --> 00:19:16.240 There is a slowly progressive, which is the Alzheimer's, and there is vascular, there's Louis Bari, there is frontal, so there's a lot of kinds, so it's just not one kind, dementia is just a one common umbrella that somebody has a memory problem that's interfering with their day-to-day functioning or uh making them not be able to be completely independent. 00:19:16.400 --> 00:19:24.960 Um, so uh, but that is like further down, but everybody doesn't have to go through it because they might not be at that stage to be further tested. 00:19:25.039 --> 00:19:44.160 Um, so it was used to be clinical, and um the reason we do imaging in the past we used to just do a simple CAT scan without contrast just to make sure that there is no tumor, there is no stroke, there is nothing else in the brain

that would give you somebody a memory problem besides the dementia uh situation. 00:19:44.319 --> 00:19:46.720 So we have to rule out from our point of view. 00:19:46.799 --> 00:19:56.720 Uh, now we are more doing MRIs rather than CAT scans because it gives us more information about the brain structure, the areas that can affect memory. 00:19:56.799 --> 00:19:59.440 Uh, so it's a different way of looking at it. 00:19:59.599 --> 00:20:05.359 Um, but now we have a blood test that can tell us about Alzheimer's at least. 00:20:05.440 --> 00:20:33.759 So it is the the main uh proteins that are um uh responsible for um Alzheimer's are the tau protein and the amyloid deposits, and now um there are commercially available blood tests that can measure the level of the Tau protein, and it is a very good test, I think, or very um uh useful test telling us if somebody has Alzheimer's or no, but at least if it's negative, we know definitely they don't have Alzheimer's. 00:20:34.240 --> 00:20:39.519 If they have if the test comes there levels like negative, intermediate, and uh high levels. 00:20:39.599 --> 00:20:47.279 So high levels definitely show that somebody has tau proteins, but that doesn't mean they have the disease unless they have symptoms. 00:20:47.519 --> 00:20:55.839 So people can have these tests positive several years before the dementia actually sets in. 00:20:56.160 --> 00:20:58.559 So um you have to clinically coordinate. 00:20:58.640 --> 00:21:03.839 So I mean you can have a test positive, but if they don't have memory problems, that doesn't mean they have dementia. 00:21:04.079 --> 00:21:05.519 I'm so excited with so many questions. 00:21:05.599 --> 00:21:08.960 I gotta make sure I can get this in in order. 00:21:09.359 --> 00:21:10.160 This is very interesting. 00:21:10.559 --> 00:21:11.440 This is so interesting. 00:21:11.680 --> 00:21:12.079 It is. 00:21:12.240 --> 00:21:26.559 Um uh I don't like blood, so I I couldn't do the whole anything medical for real, but I like physics and I like science, like I like understanding why things are the way they are. 00:21:28.559 --> 00:21:46.400 First thing I want to ask on on what you just described, um, is in the interim from hey, there's some something, a plaque or amyloid or something I may be not saying the words correctly, but I'm not showing symptoms. 00:21:47.200 --> 00:21:50.880 What would be your suggestion on like what I should do? 00:21:51.200 --> 00:21:53.200 Do I wait till I see symptoms? 00:21:53.440 --> 00:21:59.759 Are there lifestyle changes or medicines that you all would suggest that could help me maybe not get? 00:22:00.160 --> 00:22:01.039 Get the symptoms? 00:22:01.359 --> 00:22:06.160 So the test, the blood test is really not indicated if you don't have symptoms. 00:22:06.480 --> 00:22:06.640 Okay. 00:22:06.880 --> 00:22:07.119 Right? 00:22:07.279 --> 00:22:09.759 So you have to have symptoms for a sub to order it. 00:22:10.319 --> 00:22:15.599 But there can be very, very strong family histories of uh Alzheimer's dementia. 00:22:16.000 --> 00:22:19.440 In those situations, there is a genetic testing available. 00:22:19.599 --> 00:22:28.160 But in addition to genetic testing that was always available before for the Apo E protein, uh now we have the blood test. 00:22:28.480 --> 00:22:29.920 So that can be used. 00:22:30.079 --> 00:22:31.839 People can always pay for it and get it done. 00:22:31.920 --> 00:22:37.599 You know, if the insurance doesn't cover, but it's not indicated to do it unless you have symptoms of dementia. 00:22:37.680 --> 00:22:39.200 Because we are we are trying to work up dementia. 00:22:39.279 --> 00:22:48.960 Otherwise, it's a lot of anxiety, a lot of people may not get symptoms, may not so it's it's it's a lot into it, like trying to figure out oh, let me find out if I have it or no. 00:22:49.279 --> 00:22:51.200 Because then you can do any test, I guess. 00:22:51.359 --> 00:22:58.480 But here the focus is that there are people who are worried about uh do they have Alzheimer's or a different kind of uh uh dementia. 00:22:58.559 --> 00:23:03.279 Yes, so this helps us differentiate very easily with just a blood test. 00:23:03.519 --> 00:23:11.680 In the past, you had to take a from the spinal tap, you had to do a lumbar puncture, it was more complicated, more like it was you wouldn't want to do that. 00:23:12.000 --> 00:23:14.000 Yeah, not if you don't not if you can just do a blood test. 00:23:14.240 --> 00:23:15.359 I definitely wouldn't want to do that. 00:23:15.680 --> 00:23:23.839 So so I think for us in our practice, we have started doing this more more so now than it was in the past because it is available now. 00:23:24.000 --> 00:23:37.920 So it helps us uh define what kind of dementia we are, and it also helps the patients to expect how their disease is gonna progress or what kind of treatments are available, and very important for those new infusion therapies are there. 00:23:38.079 --> 00:23:44.240 The earlier you diagnose, the earlier these people can avail those treatments. 00:23:44.400 --> 00:23:46.559 They are complicated treatments, I understand that. 00:23:46.640 --> 00:23:54.160 They're newer there, but if they meet the criteria and they are wanted, it's an option that's available, which was not available many years ago. 00:23:54.319 --> 00:23:54.480 Right. 00:23:54.799 --> 00:24:04.480 What are the types of symptoms that a person or someone who loves them was watching this segment and they can say, Oh yeah, you know what? 00:24:04.720 --> 00:24:06.960 My sister is doing something like that. 00:24:07.200 --> 00:24:10.640 I didn't even know that that might be a problem. 00:24:10.960 --> 00:24:23.599 Are there like uh the top five or ten or three that you all would say, if this is happening, you should probably come in for a screening either here or or wherever is close to where they live? 00:24:23.920 --> 00:24:25.839 Yeah, and I think like um Dr. 00:24:26.000 --> 00:24:27.920

Jim Duole mentioned a few of them. 00:24:28.079 --> 00:24:33.359 Um a lot of it is repetitiveness, um, forgetting to pay bills. 00:24:33.680 --> 00:24:36.640 Uh some of it is personality change. 00:24:36.799 --> 00:24:40.880 They may not have been they may be a different person now than they were in the past. 00:24:41.119 --> 00:24:43.039 Um what's an example of that? 00:24:43.440 --> 00:24:47.759 Well, you might have someone that was really easygoing, all of a sudden they become very agitated. 00:24:47.920 --> 00:24:54.240 Um, and that would be indicative of a different type of um di uh diagnosis than Alzheimer's disease. 00:24:54.559 --> 00:25:08.480 You um would have people that may forget to pay their bills, uh, they may um forget the grandchildren or the great grandchildren, especially when there gets to be more of them and they're more recent, uh, some of those things uh they forget. 00:25:08.720 --> 00:25:21.200 Usually when people come to us, and I think because we're geriatricians and say they have a memory problem, we usually sit up and take notice and at least, you know, do a mini cog and get them screened um uh right off the bat. 00:25:21.359 --> 00:25:35.039 I think what we talked about earlier with um other providers that are in the community, oftentimes they don't have time, they don't know what to do with the information if they were to find it, you know, and think, oh, now what do I do with them like uh Dr. 00:25:35.119 --> 00:25:36.720 McNeil was saying earlier. 00:25:36.960 --> 00:25:39.440 So I think would you add anything else to that? 00:25:39.759 --> 00:25:49.920 Yeah, so some of the other things that are like, you know, they will say, so the the symptoms that we are looking for are the symptoms that were not present before and is a change from their baseline. 00:25:50.240 --> 00:25:59.519 Like a somebody who is very good at cooking great, now forgetting the pots and pans on the stove and burning burning the pans down. 00:26:00.160 --> 00:26:15.839 Uh but these are like simple things, but for high prof high uh achieving professionals or highly functional individuals, like let's say there's a surgeon, he has done hundreds of cholysystectomies and stuff like that without having, and now he's making mistakes. 00:26:16.000 --> 00:26:29.599 The level of functioning is so high that with these tests, you may not they may not be forgetting things, but they are not as skilled as they were in the things that they have done all their life and are not making mistakes, is an indication that now this is not right. 00:26:29.680 --> 00:26:41.759 For a for a homemaker who's great at organizing parties, great at doing things, and now is suddenly not organizing it as well, could be very, very early signs of things that they have been doing and not able to do. 00:26:41.839 --> 00:26:47.920 So it just doesn't is memory, it's also their performance, their functionality, their executive function. 00:26:48.160 --> 00:26:50.480 So it could be at many different levels. 00:26:50.720 --> 00:27:01.359 Because for that person who is highly educated, highly skillful, to come down to a level of uh forgetting things uh is it takes a lot to come down from there. 00:27:01.440 --> 00:27:15.039 So you have to look at the person's baseline level of functioning and see what they were all normally doing that they're no longer doing it in an as skillful manner or in an as um you know normal manner for that. 00:27:15.359 --> 00:27:48.400 I think that thank you for saying it like that, because that helps um family members or just friends or neighbors that are around to I think hope hopefully this will help people be a little more emboldened and feel um like they have the the power or the standing to say something or take action because okay, so my friends are surgeon, and you know, he or she they're not forgetting anything, they're still showing up for a dinner party or pinakle party. 00:27:48.720 --> 00:27:56.720 But I surgeries that used to take them 30 minutes are now taking an hour, and that doesn't quite sound right. 00:27:56.880 --> 00:27:59.519 And but so often we we may say, Well, I don't want to get in it. 00:27:59.599 --> 00:28:01.599 They didn't ask me anything, it's not none of my business. 00:28:01.680 --> 00:28:04.240 They seem like they're doing okay, they're functioning. 00:28:04.400 --> 00:28:04.960 Who am I? 00:28:05.119 --> 00:28:06.079 What do I know? 00:28:06.480 --> 00:28:19.759 Well, after viewing this, what you know is that that's not the best um thing to ignore, and that's not typically just a part of aging is when you so abruptly can't function as well. 00:28:20.319 --> 00:28:34.000 No, and we'll get like uh in the especially after the holidays, a family comes in and you know, the the mom isn't making the turkey dressing like she'd done in the past, where that some of these higher level things, um, like Dr. 00:28:34.160 --> 00:28:39.359 Jill said, getting the dinner party together, we might have the stuffing and then later on we might have something else. 00:28:39.599 --> 00:28:46.400 And um that those are some of the things that families will say, you know, her stuff, you know, stuffing isn't how it used to be. 00:28:46.480 --> 00:28:48.559 And it may be simple things like that. 00:28:48.799 --> 00:28:53.440 It doesn't have to be these, you know, earth-shaking things, it can be simple things like that. 00:28:53.759 --> 00:28:56.160 Because change is change, change, yeah, change changes change. 00:28:56.640 --> 00:29:06.000 If you don't have a valid explanation for that change and it's not really what your my mom used to be or my dad used to be, and oh, you didn't never did this before, like that kind of a situation. 00:29:06.160 --> 00:29:11.920 You find things odd that are not the usual things for that person, it's always good to investigate further. 00:29:12.000 --> 00:29:14.079 It could be from other reasons to not only dementia. 00:29:14.160 --> 00:29:21.279 Some you know, I

know that people don't uh really think that older adults use uh recreational drugs and stuff like that. 00:29:21.359 --> 00:29:24.079 That could be somebody who is just doing something else. 00:29:24.160 --> 00:29:30.240 I'm not saying everything is dementia, but at least it brings up the question why is this happening? 00:29:30.319 --> 00:29:34.240 Right, what uh what is the explanation for and then it leads to further. 00:29:34.400 --> 00:29:40.079 The other very important thing is to go on a drive with your parent and see how they are driving. 00:29:40.640 --> 00:29:41.599 Wait a minute now, John. 00:29:41.839 --> 00:29:47.839 You mean I'm supposed you're encouraging us to let the parent drive if they were driving with course. 00:29:49.759 --> 00:29:51.039 Hold on, wipe out. 00:29:52.559 --> 00:29:57.200 A lot of information comes from that because this is this is something they have been doing all their life, right? 00:29:57.519 --> 00:29:58.000 Driving. 00:29:58.240 --> 00:30:00.799 Uh, some of those things are very automatic. 00:30:01.119 --> 00:30:09.440 So I guess break uh like the mechanics of things, but how they're navigating the traffic, how they're navigating the directions, are they getting confused? 00:30:09.599 --> 00:30:11.839 Are they not so it gives you a lot of information? 00:30:12.000 --> 00:30:36.880 The reason I'm is asking is that uh asking like or saying this is that the two most important dangerous or potentially dangerous or things, in my opinion, are people who cook that can lead to a hazardous fire or something, and people are driving who have an impairment of certain kind and then causing an accident, hurting themselves or others. 00:30:37.039 --> 00:30:50.720 So those are some things we latch on very early in our practice because if we suspect people having memory issues, those are some of the things we address earlier than anything else because we want the safety first while we are working this out. 00:30:50.880 --> 00:30:56.960 We'll tell them sometimes to hold on to driving, let somebody drive till we work this out to make sure that everybody's safe. 00:30:57.039 --> 00:30:57.839 It's all about safety. 00:30:58.079 --> 00:31:15.759 I'm listening to this conversation, and I think that one of the things that I see a lot is that not just a spouse making excuses, but I think that the individual and the family, you know, over time will make, you know, oh, she was tired, you know, okay, okay, she was just, you know, fatigued. 00:31:15.920 --> 00:31:19.440 And so you don't get to see them until they're at their wits' end. 00:31:19.519 --> 00:31:21.920 So, like that's usually what my experience is. 00:31:22.000 --> 00:31:23.599 Like they're at their wits' end. 00:31:23.759 --> 00:31:37.920 It's been six months, twelve months, and they ran out of excuses to make to explain why the stove has been left on three or four times, or why you know, we lost the car three and four times at the mall and that kind of thing. 00:31:38.079 --> 00:31:50.480 So typically, by the time they get to being vocal about their concerns, they've already gone through months of, okay, let me just, you know, maybe I'm just tired, maybe this, maybe that, or even the loved ones, okay, making excuses. 00:31:50.640 --> 00:32:05.519 So that's one of the reasons I always think about making sure that we as providers advocate because when they open their mouth and vocalize to us their concern, they've already had six, eight, ten, twelve months of making excuses, trying to figure out what's going on. 00:32:05.599 --> 00:32:10.480 And if we don't do action, if we don't act right now to get them screened, to get them tested. 00:32:10.559 --> 00:32:14.720 I mean, we're just kind of again prolonging and making the situation worse. 00:32:14.799 --> 00:32:19.359 So I just hear like these stories and they they coincide with the stories that I've encountered. 00:32:19.519 --> 00:32:23.119 But one of the things that I would say is that they don't come right away. 00:32:23.279 --> 00:32:23.519 Right? 00:32:23.759 --> 00:32:26.000 They don't come after the second incident. 00:32:26.319 --> 00:32:38.240 They come, you know, 12 months later, 18 months later, and now it's this, I'm in my wits and now, and now it's a safety concern, and now I'm my children are talking about, you know, having me move into with them, that kind of thing. 00:32:38.400 --> 00:32:39.119 But it's a panic. 00:32:39.200 --> 00:32:39.279 Right. 00:32:39.519 --> 00:32:40.640 It's an all-out panic. 00:32:41.440 --> 00:32:48.720 When a person um is coming, I'm gonna say we'll start with getting screening, right? 00:32:48.799 --> 00:32:54.240 I think I've picked up on screening happens, and then how depending on how the screening goes, we might give you some tests. 00:32:54.480 --> 00:32:54.799 Is that right? 00:32:55.119 --> 00:32:55.359 That's correct. 00:32:55.599 --> 00:32:56.559 Listen here, okay? 00:32:56.720 --> 00:32:58.799 I've been paying attention, I've been paying attention. 00:32:59.359 --> 00:33:04.640 So can I make somebody come get screens? 00:33:04.880 --> 00:33:12.400 Like, like what if I have an auntie who, you know, I tell her we're about to go to lunch and then we show up at the Rose of Parks Jerry and City. 00:33:12.880 --> 00:33:14.799 Meet them all go ahead. 00:33:16.240 --> 00:33:17.279 Like, well, how does it be? 00:33:17.359 --> 00:33:18.079 I'm pretty good with that. 00:33:18.160 --> 00:33:21.680 I'm pretty good at controlling people and going along with me. 00:33:22.720 --> 00:33:23.440 So yeah. 00:33:23.759 --> 00:33:35.039 I think if you come at it from a more very relaxed perspective and you don't jam it down their throat, most people, I mean, in my career, I probably had maybe five people not get tested. 00:33:35.200 --> 00:33:37.440 I I can pretty much get people tested. 00:33:37.839 --> 00:33:41.519 And I think um it it is like you said, it's in the delivery. 00:33:41.680 --> 00:33:48.960 If you if

you're honest with people and we just want you to go and see, and people that don't think they have a problem with their memory, they're gonna come right in. 00:33:49.039 --> 00:33:53.680 And so we uh those people are great, but we pretty much can work with anybody. 00:33:54.160 --> 00:33:56.559 We do work with early. 00:33:57.200 --> 00:34:07.759 We might not be able to convince sometimes that they have a problem, but we we have a couple of visits and everything comes around to being it's it's a hard decision, it's a hard diagnosis to accept. 00:34:08.000 --> 00:34:15.360 People have fear of wo you know the disease, and uh and they know that once they are diagnosed, there is it is progressive. 00:34:15.519 --> 00:34:20.239 So it's hard, it's very hard, but every person is different, everybody's disease is different. 00:34:20.400 --> 00:34:27.280 I you cannot compare your memory issue to another person's memory issue because it's it's it there's a lot of things that get into it. 00:34:27.360 --> 00:34:44.400 So there's no need to fear, start with you know, screening and being aware and talk to your doctor, then they can always refer to you um to other other uh doctors, and there's there's a lot of help out there, there's a lot of awareness, and uh but uh but we have to do it. 00:34:44.639 --> 00:34:46.239 Yes, yes. 00:34:47.679 --> 00:35:00.000 I so appreciate you kind of giving a bit of a segue, if you will, on um dispelling the myths and the and or the fears. 00:35:00.639 --> 00:35:05.199 What are some top fears or popular fears? 00:35:05.280 --> 00:35:22.639 If that I don't I don't like saying popular fears, but I think it you know, fears that come up often such that you all are not surprised if you hear a particular myth or fear that has precluded a person or a family member from getting screened andor tested. 00:35:22.960 --> 00:35:28.159 I think our history has it precludes people because they remember grandma that was senile. 00:35:28.480 --> 00:35:33.360 They remember um back in the day when we didn't have stuff to treat people with. 00:35:33.599 --> 00:35:33.840 Okay. 00:35:34.079 --> 00:35:45.440 And so I I shared earlier that when I worked in oncology for 10 years and I came here, and when I the first this was 30 years ago, and I was like, oh, there's not anything. 00:35:45.599 --> 00:35:50.639 I mean, it was it was a hard thing to tell people about, but now we have so much. 00:35:50.800 --> 00:35:56.559 We have medicines, we have oral medicines, we have IV medicines, we have so much to help people with. 00:35:56.880 --> 00:36:02.000 It's important that they get tested early so that we can do that, help people with that. 00:36:02.320 --> 00:36:12.400 I think their most important fear is the fear of losing their independence and being dependent on someone, things that they have taken for granted that I can do it. 00:36:12.559 --> 00:36:17.199 Uh, and and you know, then it involves their children, involves their other family members. 00:36:17.360 --> 00:36:19.280 It's very hard to be on the receiving end. 00:36:19.519 --> 00:36:19.760 Dr. 00:36:19.840 --> 00:36:20.239 McNeil. 00:36:20.559 --> 00:36:27.679 Yeah, I think one of the biggest things is just stigma around the diagnosis and just the word dementia. 00:36:27.840 --> 00:36:32.880 And I think that, you know, some of uh the community kind of plays into that, right? 00:36:33.039 --> 00:36:46.559 I think it's not only getting the individuals to get screened and diagnosed, but changing the mentality of and the culture of the society and the communities so that we can all be educated and we can all learn. 00:36:46.800 --> 00:36:58.880 And I've heard the most heartbreaking stories I've heard with those individuals diagnosed with dementia is that they went in, they did the testing, they got diagnosed, and their provider was like, okay, this is the end for you. 00:36:59.039 --> 00:36:59.920 Good luck to you. 00:37:00.000 --> 00:37:01.440 Uh get your affairs in order. 00:37:01.599 --> 00:37:03.199 And that was what they did to my mom. 00:37:03.440 --> 00:37:18.400 And that was so heartbreaking because I know there are communities, there are support systems, there are all kinds of, I've just spoken to members, churches, that spoke to members of different organizations that have dementia. 00:37:18.480 --> 00:37:24.079 They're advocating, they're speaking, they're teaching, like you're still valuable, you're still necessary. 00:37:24.639 --> 00:37:25.440 Going on vacation. 00:37:25.599 --> 00:37:25.760 Absolutely. 00:37:26.079 --> 00:37:32.239 Going on vacation, you know, doing creating organizations that led by people with it with dementia. 00:37:32.320 --> 00:37:39.599 Like there's still viability in that individual, and that diagnosis is just that it's not, it's not them. 00:37:39.760 --> 00:37:40.960 The diagnosis is not them. 00:37:41.280 --> 00:37:45.760 They just have this thing, just like diabetes or hypertension, that they have to navigate. 00:37:45.840 --> 00:37:46.000 Yeah. 00:37:46.159 --> 00:37:50.960 This is too common for us to recreate the wheel every time a family gets this diagnosis. 00:37:51.119 --> 00:37:53.679 I mean, we should just be surrounding them with all of these resources. 00:37:53.760 --> 00:37:57.280 And every rosa, every click, any, every clinic should be a Rosa Parks clinic. 00:37:57.519 --> 00:38:00.960 I hear, here, here, here, do that. 00:38:01.199 --> 00:38:01.840 That's the model. 00:38:02.320 --> 00:38:05.679 So that makes a phenomenal point. 00:38:06.079 --> 00:38:19.679 Let's say uh someone views this conversation and they're not in Metro Detroit, and they're either going to go talk to their provider or they want to know what they should put in the search engine on the internet. 00:38:20.159 --> 00:38:25.920 How do they try to find something similar to what you all have here? 00:38:26.400 --> 00:38:27.440 What do you call it? 00:38:28.320 --> 00:38:28.639 Care. 00:38:30.159 --> 00:38:30.639

Really care. 00:38:30.880 --> 00:38:31.039 Right. 00:38:31.199 --> 00:38:31.679 Underline. 00:38:32.000 --> 00:38:35.760 I think, you know, people really underestimate the Alzheimer's Association. 00:38:35.840 --> 00:38:43.280 And I and wherever you are, you know, they the Alzheimer's Association really, really try to really connect people with resources. 00:38:43.440 --> 00:38:47.199 They have a 1-800 number, you know, they could send a social worker out to your home. 00:38:47.280 --> 00:38:48.719 Like they have things. 00:38:49.039 --> 00:38:55.679 So if you are diagnosed with dementia, you know, I think that could be one of the initial resources that you reach out to. 00:38:55.840 --> 00:39:01.920 Call that 1-800 number, they'll ask you where you are, they'll get you aligned with resources in your particular community. 00:39:02.079 --> 00:39:05.920 Get involved with those support groups because they talk to each other. 00:39:06.000 --> 00:39:09.119 They tell you these are the things I do that work for me with my diagnosis. 00:39:09.599 --> 00:39:19.119 This is how I navigate this with, you know, I got a whiteboard, or I have a shared calendar with my family, or I have a camera that my family can log into. 00:39:20.639 --> 00:39:25.039 With technology nowadays, people are living in their homes even longer now, right? 00:39:25.599 --> 00:39:37.840 So embracing those strategies, embracing the resources, embracing organizations that have been committed to making this not a taboo type of situation and surroundings with resources. 00:39:38.000 --> 00:39:40.159 That would be what I would suggest. 00:39:40.719 --> 00:39:44.880 And every um state has area agency on aging. 00:39:45.039 --> 00:39:45.199 Okay. 00:39:45.440 --> 00:39:47.360 So whether it's agency. 00:40:00.800 --> 00:40:05.519 So that's another resource for individuals that would be more local. 00:40:05.840 --> 00:40:18.960 I think the churches are are downplayed a lot because they do have a lot of them, will have um elderly support in their church that someone is responsible for, whether it be the parish nurse. 00:40:19.119 --> 00:40:24.159 And so a lot of individuals I find are hesitant because they don't want people to know. 00:40:24.559 --> 00:40:28.960 But once you get beyond that, there's a great wealth of help there as well. 00:40:29.360 --> 00:40:30.639 Just past the threshold. 00:40:30.800 --> 00:40:31.039 Yeah. 00:40:31.280 --> 00:40:40.000 There's all this help, and that's and that's what we're doing here on the Parent and Help Podcast is to say, hey, just get to the other side, go over the threshold. 00:40:40.400 --> 00:40:52.320 And there are millions of people over here doing the work behind the scenes in clinics, in research labs, policy makers, things of things of all nature. 00:40:52.559 --> 00:40:53.840 This is going so well. 00:40:54.159 --> 00:40:57.360 And you all know I'm a talker, so I'm gonna try to. 00:40:57.679 --> 00:41:06.719 I know I have one question that's burning, that I have to get this one out, and after that, uh, you know, whatever your final thoughts may be that we can uh share with the audience. 00:41:08.079 --> 00:41:15.119 What age do you have to be to get screened or tested for dementia? 00:41:15.360 --> 00:41:20.559 Uh so there is no age to diagnose anybody with dementia. 00:41:20.639 --> 00:41:23.280 It's just a kind of dementia that we're looking at. 00:41:23.519 --> 00:41:25.519 So the thing is memory problems. 00:41:25.599 --> 00:41:28.239 If somebody has a memory problem, it can be any age and they do. 00:41:28.559 --> 00:41:29.199 It could be 30. 00:41:29.840 --> 00:41:31.039 Yeah, it's not as rare. 00:41:31.280 --> 00:41:31.920 I hope they don't have to be. 00:41:33.599 --> 00:41:33.679 Yes. 00:41:33.920 --> 00:41:34.239 But it can happen. 00:41:34.800 --> 00:41:38.559 There are there are rare cases of early dementia also in younger age. 00:41:38.719 --> 00:41:42.960 They're especially if they have a very, very strong family history uh of dementia. 00:41:43.199 --> 00:41:46.320 But there are other kinds of dementia like vascular if somebody had a stroke. 00:41:46.400 --> 00:41:54.320 So stroke can happen at any age, uh or at least, you know, if somebody has risk factors for it, and uh the dementia can be diagnosed at that time too. 00:41:54.559 --> 00:42:03.119 The only only I because many people think of dementia as that Alzheimer's old age dementia, that generally happens after the age of 60. 00:42:03.280 --> 00:42:08.800 Uh, you know, can happen, but every uh five years that you go, it kind of doubles the incidence. 00:42:08.880 --> 00:42:14.400 So it's higher as uh in higher age groups, the incidence is uh or the prevalence is more. 00:42:14.559 --> 00:42:24.159 Uh but uh the it has to start with um like having some kind of a memory issue or some kind of uh um incidence that involve memory. 00:42:24.480 --> 00:42:34.159 Um yeah, so we have patients, some that are in late late 50s, one of uh couple, but they have other diagnoses also that led to the to the memory loss. 00:42:34.239 --> 00:42:39.760 So I wouldn't say like it and result is dementia, but it could be other other reasons also. 00:42:40.719 --> 00:42:44.719 Well, this has been eye-opening, and it's actually given me a lot of hope. 00:42:44.960 --> 00:42:51.440 Because now I can uh speak with people with more confidence when I tell them about first of all, screening and testing. 00:42:52.000 --> 00:42:54.639 I'm not ashamed to admit I was like, it's how like that. 00:42:54.719 --> 00:42:55.519 That is not the same thing. 00:42:55.599 --> 00:42:58.239 I think they have said them together too many times. 00:42:58.559 --> 00:42:59.760 Screening and testing. 00:43:00.079 --> 00:43:01.760 And is it is a joiner, right? 00:43:01.920 --> 00:43:02.480 Yeah, okay. 00:43:02.719 --> 00:43:03.760 So thank you for that. 00:43:03.840 --> 00:43:12.400 Um thank you for all the work that you do in the community and how much advocacy

you, how much time, effort, and energy you're putting into it. 00:43:12.639 --> 00:43:21.920 Thank you so much for you and your team for the federal grant that is allowing us to do this on a continuing basis because momentum matters. 00:43:22.159 --> 00:43:25.840 I'm a huge sports fan, and you know, you don't want to lose momentum to the other team. 00:43:26.320 --> 00:43:28.079 And in this case, the other team is a disease. 00:43:28.159 --> 00:43:45.599 And so we we gaining we're gaining on it with the different treatments and the different uh screening and tests and the awareness of uh things like uh brain health and what we can do with our diet, and uh the goal is to keep the pressure on dementia and until we bring it down. 00:43:45.920 --> 00:43:46.239 That's right. 00:43:46.480 --> 00:43:47.599 Absolutely, absolutely. 00:43:47.920 --> 00:43:49.039 Well, thank you all so very much. 00:43:49.280 --> 00:43:49.440 Thank you. 00:43:49.840 --> 00:43:50.239 Thank you very much. 00:43:50.480 --> 00:43:50.639 Thank you. 00:43:50.800 --> 00:43:51.360 Thanks for having us. 00:43:51.760 --> 00:43:53.039 Yes, yes, thank you. 00:43:53.760 --> 00:44:04.719 The snuggle up screening, testing, testing, screening, testing, testing, one, two, testing, testing, one, two. 00:44:05.199 --> 00:44:08.079 Yes, people, go get tested. 00:44:08.320 --> 00:44:09.360 Get screened. 00:44:09.519 --> 00:44:10.000 Why? 00:44:10.159 --> 00:44:14.159 Well, because at a minimum, uh, let's have a baseline. 00:44:14.480 --> 00:44:19.039 I'm gonna uh suggest let's not wait till you have a whole bunch of problems. 00:44:19.360 --> 00:44:24.000 Go ahead and get a baseline screening of what your memory may be. 00:44:24.320 --> 00:44:24.559 Okay? 00:44:25.119 --> 00:44:27.280 And you know better than anyone else. 00:44:28.159 --> 00:44:34.079 If you're not quite right, you're with yourself when you get lost on the way to the mall. 00:44:34.320 --> 00:44:39.119 Or when you realize that your money is not adding up the way it used to. 00:44:40.480 --> 00:44:50.719 Love yourself enough to let go of the fear of being embarrassed if your mind has started to decline in some way. 00:44:50.880 --> 00:44:51.840 It's not your fault. 00:44:52.079 --> 00:44:53.519 You didn't do anything wrong. 00:44:53.840 --> 00:44:56.480 There's nothing for you to be ashamed about. 00:44:56.880 --> 00:45:04.880 Whether you're talking to a geriatric professional, your primary care professional, maybe there's somebody at your church. 00:45:05.119 --> 00:45:06.800 The point is, you're not alone. 00:45:06.960 --> 00:45:09.440 There are a lot of people out here doing the work. 00:45:09.679 --> 00:45:14.960 As you just saw with the members of the Rosa Parks Geriatric Center. 00:45:16.239 --> 00:45:25.679 They out here bust them butt, trying to make sure that we identify the disease earlier and that we do something about it. 00:45:25.840 --> 00:45:27.039 But it starts with us. 00:45:28.000 --> 00:45:29.039 I'm gonna get screen. 00:45:32.480 --> 00:45:33.840 Thank you for tuning in. 00:45:34.079 --> 00:45:35.679 I mean, really, really, really. 00:45:36.000 --> 00:45:38.079 Thank you so very much for tuning in. 00:45:38.559 --> 00:45:39.920 Weather podcast. 00:45:42.079 --> 00:45:46.559 Or if you're listening on your favorite podcast, are your platforms?