June 7, 2025 • 48 mins
The number of people suffering from dementia is expected to explode in the coming decades and, in a pleasant surprise, countries around the world are taking steps to plan for the increase in friendly, caring ways. Find out all about this devastating disease and what's being done to prepare in this classic episode.
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Speaker 1 (00:01):
Good morning everyone. I hope you're enjoying yourself and having
a great weekend with friends, family, loved ones, or I
don't know, even people you might dislike a little bit.
How dementia works. This is a pretty brutal episode, everybody.
This is from November fourth, twenty fifteen, but there's some
really good information in it. If you are suffering from dementia,
(00:21):
or someone in your family is suffering from dementia, you
have our deepest empathy because it is tough stuff, and
we hope this episode can bring you a little bit
of comfort because knowledge is power and understanding things is
what we're all about, and that can really help sometimes
when you're dealing with something as devastating as dementia.
Speaker 2 (00:40):
So how dementia works, right here.
Speaker 3 (00:42):
Right now, Welcome to Stuff You Should Know, a production
of iHeartRadio.
Speaker 4 (00:56):
Hey, and welcome to the podcast. I'm Josh Clark with
Charles w Chuck Bryant and Noel. The Stint of Noel continues.
Everybody's like, stuff you should Noel. No, No, that's not
what we're calling it. It's the Stint of Noel. All right,
Stuff you should Knowel. That's too clever.
Speaker 2 (01:16):
Yeah, it's a little cutesy. Yeah, that's all all right.
Speaker 4 (01:20):
It's my only aversion to it. All right, all right?
What do you are you with? Stuff you should know?
Speaker 2 (01:26):
Changing the name of our show after eight years?
Speaker 4 (01:28):
No, just the Noel's stint the name of it. Remember
the Summer of Sam?
Speaker 2 (01:33):
Oh? Yeah? Yeah, sure, why not?
Speaker 4 (01:35):
I don't like it?
Speaker 2 (01:36):
All right?
Speaker 4 (01:38):
Should we come up with the third idea?
Speaker 2 (01:40):
Yeah?
Speaker 1 (01:42):
The stint of nol sounds too much like something's wrong
with Noel.
Speaker 4 (01:47):
That's why I like it. It's hilarious. There's nothing wrong
with Noel, my god. And if you think there is,
you need to answer to me.
Speaker 2 (01:54):
There's something you should know.
Speaker 4 (01:58):
I see, that's what I'm saying. It sounds like something Strickland.
Would it come up with?
Speaker 2 (02:02):
Oh? You know? And we haven't been in a flame
war with Strickland in a while.
Speaker 4 (02:06):
It has been a while. It's been too long. I've
gotten soft. You just launched one across the bow, so.
Speaker 2 (02:13):
Chuck.
Speaker 4 (02:13):
Yes, are you familiar with dementia?
Speaker 2 (02:17):
Yeah?
Speaker 4 (02:17):
Sure, are you running? Your family doesn't.
Speaker 1 (02:20):
Run in the family, But my grandmother, who lived to
be one hundred, had dementia at some point, which you know,
when you love to be one hundred. That's I don't
know about likely, but it's not surprising.
Speaker 4 (02:32):
It's probably pretty likely. It's not from what I understand,
it's not a just a natural consequence of age, right,
but it's pretty prevalent.
Speaker 2 (02:44):
Sure.
Speaker 4 (02:46):
And dementia's actually super misunderstood. It gets confused with Alzheimer's
a lot, or there's a lot of different kinds of dementia,
But dementia is actually it's not a disease. It's a
set of symptoms that's brought on by disease.
Speaker 2 (02:58):
Yeah.
Speaker 1 (02:59):
I think that is widely misunderstood. Yeah, but you are
totally correct.
Speaker 2 (03:04):
A set of symptoms, and.
Speaker 1 (03:07):
It is not just your garden variety forgetfulness that comes
as you age.
Speaker 4 (03:13):
No, because that is age related and that is normal.
Speaker 1 (03:15):
The totally age related things called age associated memory impairment,
and that is uh. I think, I mean that happens
to everyone, right, It's just.
Speaker 4 (03:24):
Like you forget your keys more often, that kind of stuff. Sure,
But when you do forget your keys more often, you
snap your finger and go, ah, I forgot my keys again,
what is wrong with me? Yeah, that's normal.
Speaker 1 (03:35):
One of the big tells of true dementia is when
you don't realize that you're forgetting right.
Speaker 2 (03:40):
So that's when it gets scary.
Speaker 4 (03:42):
Right, And we said that it's not a natural consequence
of age. And one of the things that I turned
up in researching this is we're not exactly sure what
causes dementia. We don't even know if some of the
telltale signs of dementia are the cause of dementia in
some cases or the result of dementiae. Not entirely certain,
(04:02):
but it is very widespread among the aged population. In
the United States. I think five point three million Americans
have dementia right now.
Speaker 2 (04:12):
Wow.
Speaker 4 (04:13):
And as our population ages, because the baby boomers are
starting to get older, I think they're expecting something like
sixteen million Americans are going to have it by twenty fifty.
Sixteen million is I think how many? About how many
people have it around the world right now? And in
America alone, we're going to have that number in twenty fifty. Yeah,
and it's very expensive, Actually, how much money a lot?
(04:37):
You ready for this?
Speaker 2 (04:38):
Yeah?
Speaker 4 (04:39):
In twenty fifteen, we have spent two hundred and twenty
six billion dollars on healthcare for dementia a while, and
they're expecting by I believe twenty fifty, when we are
caring for sixteen million in twenty fifteen dollars, not futuristic,
much more inflated fifty do right in twenty fifteen dollars,
(05:02):
We'll be spending about one point two trillion dollars on
dementia if somebody doesn't do something.
Speaker 2 (05:08):
Man.
Speaker 4 (05:09):
Yeah, it's very expensive. It's also extraordinarily sad as far
as diseases or symptoms of diseases. Yeah, yeah.
Speaker 1 (05:18):
And I also want to recommend our May twenty eleven episode,
A podcast to remember. Our memory episode ties heavily into this,
So if you haven't listened to that one yet, go
listen to that one, either before or after.
Speaker 4 (05:30):
Or if you listen to it and forgot, go back
and listen to it.
Speaker 2 (05:33):
That's right.
Speaker 1 (05:34):
So dementia itself is not diagnosed. It's not simply memory loss.
It's memory loss along with one of the following at
least one of the following one or more. Aphasia, which
is if you can't understand or produce language any longer,
a praxia, and all these are super sad if you've
(05:54):
ever seen.
Speaker 2 (05:54):
Them up close.
Speaker 1 (05:56):
A praxia if you cannot make certain movements even though
your body physically is healthy, right, agnosia, which is you
don't recognize objects like the remote control or your grandkids,
stuff like that. And then executive dysfunction when you have
a lot of troubles planning and organizing and reasoning. So
that along with the memory loss or at least one
(06:17):
of these, you could be diagnosed with dementia, right.
Speaker 4 (06:21):
And so, like we said, dementia is a set of symptoms, right, Yes,
it's actually brought on by disease. And the most common
cause of dementia I think something like sixty or seventy
percent or something like that of dementia cases is brought
on by Alzheimer's disease.
Speaker 1 (06:38):
I could have sworn we did one on Alzheimer's, but
we have not. Yeah, I don't think we have.
Speaker 2 (06:43):
I don't know. We've talked about it enough.
Speaker 4 (06:44):
I think, yeah, it's popped up plenty of times, but
we've never just done a straight up Alzheimer's. Alzheimer's brings
on dementia through something called neurofibrillary fibrillary tangles also known
as beta I'm sorry, tau protein tangles. Yeah, and beta
amyloid plaques, right.
Speaker 1 (07:06):
Yeah, and the plaquesa's like a just a protein build up,
a sticky protein build.
Speaker 4 (07:10):
Up, Yeah, which is so when you when your neurons
fire and you have a thought, it's an electrochemical process,
and there's residual that is left behind, and these residuals
can build up in your synapses and cause your synapses
to not fire as well. And when your synapses don't
fire as well, they start to die off, and the
neurons that are there that lead from these synapses or
(07:31):
lead to these synapses, die themselves and you have neural loss.
Like literally the brain cells in your brain are dying
off at a rapid rate. Yeah, and when it's caused
by beta proteins and TAO or beta amyloid plaques and
tau proteins in the cells, then what you have is Alzheimer's.
Speaker 1 (07:50):
Yeah, And they aren't sure the cause of Alzheimer's still,
Genetics is they think has a lot to do with it.
Speaker 2 (07:58):
And you can live with Alzheimer's for while.
Speaker 1 (08:00):
Up to a decade, although they said in this article
many says three to five years is more common.
Speaker 2 (08:07):
So, yeah, it definitely shortened your lifespan.
Speaker 4 (08:10):
And like you said, genes are definitely part of the
risk factors. A polypo protein, a polopo protein. E okay,
I think, which is weird. If you have a mutation
on this gene, you have a higher risk of Alzheimer's,
even though the gene just codes for a protein that
carries cholesterol through your bloodstream. Yeah, doesn't have anything to
(08:34):
do with the TAU protein tangles or anything like that
as far as I know. That's weird. Also, if you
have a family history of dementia, you're you have of Alzheimer's,
you have a higher likelihood. And then if you have
down syndrome, you are at a higher risk of developing
Alzheimer's in middle age.
Speaker 1 (08:53):
Oh really yeah, interesting, So that's and we will do
one on Alzheimer's. But that's how Alzheimer's can call dementia.
There's also vascular dementia, which is that was the case
with my grandfather who he had a stroke, and it
accounts for about twenty percent of dementia cases.
Speaker 2 (09:12):
And you know, stroke is when.
Speaker 1 (09:15):
You have a loss of blood supply to the brain
or a hemorrhage or a blood clot and it can
be either one big stroke event which causes a lot
of damage. And that's a single INFARCD dementia, or it
can be a lot of the accumulation of symptoms because
of a lot of little mini strokes you have over
(09:36):
the years.
Speaker 4 (09:37):
Right, and then the damage just builds up and you
finally once that last one that does the straw that
breaks the camel's back. Yeah, and you have dementia that
happens pretty rapidly after that last that last one, that
last stroke you have.
Speaker 1 (09:52):
Yeah, and that's a multi infarc when it's a bunch
of them, and little many strokes are common a lot.
Sometimes you have them and don't even realize you've had them.
Right with my grandfather, he had the big one and
oh really, Yeah, we talked about this before and I
think something about speech, but yeah, he lost his ability
to speak, you know, English.
Speaker 4 (10:14):
So that would be a phasia.
Speaker 1 (10:16):
Yes, he couldn't produce language, well, he produced, Yes, he
cannot produce language. He said things, but it you know,
it didn't make any sense, gotcha. But he had an understanding.
You could see the frustration. Yeah, you know, I know
how to how I'm supposed to. My grandmother is driving us,
let's say, and she doesn't know how to get there.
He does, and he can't tell her, but he's telling her. Yeah,
(10:40):
it's just coming out all mixed up.
Speaker 4 (10:41):
And that's that's a hallmark of dementias. There's emotional changes
in the person because they they're not communicating like they
want to say, people aren't responding like they want the
people to and they'll get snippy and then ultimately say withdrawal.
They'll just give up on communicating at all because it's
too frustrating or just too sad, you know, yeah, which
(11:04):
is it's one of the common results of dementia. It's
a comorbidity. No, it's a complication.
Speaker 2 (11:10):
Yeah.
Speaker 1 (11:10):
And then and with the single stroke event or actually
or with the multi strokes, it's.
Speaker 2 (11:17):
Different for everyone.
Speaker 1 (11:18):
There isn't any single like, well, this is going to
happen because this person had a stroke, right, It could
be a variety of different things from you know, paralysis
on one side of the face or body bowel and
bladder control problems. He didn't have any of those. He
looked totally the same physically, He walked and talked the same,
except for the fact that they weren't real words.
Speaker 4 (11:39):
Right.
Speaker 2 (11:39):
That was like the most noticeable thing.
Speaker 4 (11:41):
I remember you telling me about your grandfather before I
don't remember what it was.
Speaker 2 (11:45):
It was a long time.
Speaker 4 (11:46):
We were talking about speech, like where Nicky's area or
broke his area? Yeah, yeah, something like that. So with Alzheimer's,
it first attacks the hippocampus, which means that it's going
to take away your episodic memory, which is your memory
of recent events, right, Yeah, and then it starts to
move its way into other areas of the brain where
(12:08):
your judgment is affected, your speech patterns are going to
be affected. Your personality is very much affected and changes
with Alzheimer's. With Alzheimer's, but not as much with the stroke. Yeah.
With vascular dementia, you know, there might be some other
things where like part of the faces sagging, or the
patient can't move their arm or something like that, but yeah,
the personality will remain intact because those regions of the
(12:30):
brain aren't affected like they are in Alzheimer's.
Speaker 2 (12:33):
Yes.
Speaker 1 (12:33):
And then in about five to fifteen percent of dementia
cases it stems from something called Louis body dementia.
Speaker 2 (12:42):
Which we were just talking about. They think Robin Williams
might have suffered from.
Speaker 4 (12:45):
He definitely did.
Speaker 2 (12:46):
He definitely did.
Speaker 4 (12:47):
Yeah. They found in his autops that he had I
think he was diagnosed with it before he died. No, okay,
that was one of the reasons why he took his life.
Speaker 1 (12:54):
Yeah, because that can cause severe intense hallucinations.
Speaker 4 (12:58):
Yeah big time. Did you look up?
Speaker 2 (13:00):
Oh yeah, man, very scary stuff.
Speaker 4 (13:02):
You like, very apparently A typical one is very brightly
colored animal or person. Yeah, that you see in great
detail for many minutes on daily a daily basis, like
just intense hallucinations.
Speaker 2 (13:14):
I'm sure you think you're you know, losing it, right.
Speaker 4 (13:16):
And that's one of the first symptoms of Louis body dementia.
Speaker 1 (13:19):
And it was discovered by Frederick Louis and nineteen twelve.
And it has has nothing to do with your body.
A Louis body is there are deposits again protein deposits
of the alpha.
Speaker 2 (13:32):
Sinucleon that appear on the brain.
Speaker 1 (13:34):
So don't think of body in the terms of like
your physical body, right. And this is also president Louis
Body's and Parkinson's. So as a result, not only are
you going to have symptoms similar to Alzheimer's with Louis
body dementia, but also some of the tremors and balance
issues of Parkinson's right, which is super sad as well.
Speaker 4 (13:55):
Is that what Michael J. Fox has Parkinson's?
Speaker 2 (13:58):
Yeah?
Speaker 4 (13:59):
Yeah, and that's that's what the movie Awakenings was about.
When they wasn't it like a group of Parkinson's patients
that like L.
Speaker 2 (14:05):
Dobo worked on, was that Parkinson's I can't remember.
Speaker 4 (14:07):
I think they didn't. They didn't realize what they thought
they were locked in or something in there. I realized
their Parkinson's strummers were so acute that they were like
they were not even shaking, they were just fretly. Yeah. Interesting,
They're just their muscles were totally contracted rather than contracting
and relaxing again and again.
Speaker 2 (14:24):
And Robert Williams, Yeah, how about that?
Speaker 1 (14:27):
Yeah, then we have something that used to be well
it's called now fronto temporal dementia. It used to be
called Pick's disease, but now Pick's disease is a specific.
Speaker 4 (14:41):
Version which I couldn't really suss out what the difference is,
could you know?
Speaker 2 (14:47):
I couldn't either, as.
Speaker 4 (14:47):
Long as it wasn't just me, I feel better.
Speaker 1 (14:49):
But ft D is really an umbrella term. It's about
five percent of dementia cases, and it's going to affect personality,
behavior and language, like big time, big time, and it's
where your frontal and temporal lobes are actually atrophying and shrinking.
Speaker 4 (15:07):
Right. And the reason why is you remember with Alzheimer's
you have beta amyloid plaques and tau protein tangles.
Speaker 2 (15:13):
Yeah.
Speaker 4 (15:14):
Well, with the fronto temporal dementia, you don't have the
beta amyloid plaqs. You just have the tau protein tangles.
But it's enough to cause massive neuronal loss.
Speaker 2 (15:24):
Yeah.
Speaker 1 (15:24):
And this is like I think a lot of people
at first think they might have tourette Yeah, because you
can yell things out inappropriate behaviors.
Speaker 4 (15:35):
Yeah, Like if your grandfather suddenly becomes hyper interested in
sex and likes to talk about it in public, or yeah,
exposes himself to people in public, there's a pretty good
chance that he has developed fronto temporal dementia.
Speaker 1 (15:49):
Or if I did, because it's unusual in that it
attacks younger people. It's gonna onset between forty and seventy
five years old, which distinguishes it from their types of dementia.
Speaker 4 (16:01):
Yeah. And if your grandfather used to do that stuff already,
then that's not the case. The key here is that,
like this has come out of the blue, somebody is
really just completely changed in their personality. They might get
into really risky behavior like gambling all of a sudden.
Speaker 1 (16:16):
Yeah, shoplifting Yeah, and like risky investments are like pulling
all their money out of the bank.
Speaker 4 (16:23):
Yeah. And with picks disease too. Apparently apathy is a
big indicator of this. There's a big personality change and
the person is no longer they have no empathy, they
have blunted emotions. Yeah, and then they may also be
engaging in risky behavior. So basically your grandpa or your
grandma has just turned into like the transporter you know,
(16:47):
or me or you well, yeah, you're five. You lack empathy.
Speaker 2 (16:52):
No no, no, I'm just saying, oh, I see, because.
Speaker 4 (16:54):
It affects you sing like they turned into you. Oh no, no, no,
you have blunted emotions and amble.
Speaker 2 (17:01):
There's also Huntington's disease.
Speaker 1 (17:03):
This is it seems like much more physical in nature,
uncontrollable movements, although there are changes in personality, but real fidgety, herky, jerky.
Your brain loses the ability to control coordination essentially, right,
which is I think fifty percent chance of inheriting the gene.
(17:25):
But you can live with it for up to twenty years. Yeah,
which seems like, as far as dementia go, is one
of the longer life expectancies.
Speaker 4 (17:35):
But again, I mean, like I would guess this has
kind of become clear. The hallmark of dementia is memory
loss paired with some other problem like not being able
to create speech any longer recognize speech, or not being
able to move that kind of thing, or not being
able to plan. And like we said, well we should
(17:56):
probably take a break. Huh.
Speaker 1 (17:58):
Yeah, we got a couple of more types that we'll
talk about and then some other good stuff. Okay, right
after this, the last two, actually the last three we're
(18:25):
going to talk about, because there are many many other
kinds of dementia, Like, we could spend hours and hours
talking about all the different kinds hours, But we have
talked about kreutz felt yakup disease and I.
Speaker 2 (18:38):
Can't remember which one, and we say that all the time.
Speaker 4 (18:41):
Is there a disease that kills by preventing sleep?
Speaker 2 (18:44):
Oh?
Speaker 4 (18:44):
Is that the one which we should have rightly called
how prion diseases work?
Speaker 1 (18:48):
Yeah, because is a prion infection. It's very rare, about
one out of a million people will be affected in
any given.
Speaker 4 (18:56):
Year, like mad cow disease or KU Yeah, exactly. It's
a sponge of form disease. Yeah, so crazy, it is.
It's very interesting. It could be genetic. But and I
thought we also talked about it in an organ transplant.
Speaker 1 (19:14):
I think so, because it can occur because of infected
tissue that you are implanted with or from an organ.
Speaker 4 (19:21):
Yeah. And this is neuronal loss due to the like
holes literally being eaten into your brain by this disease. Yeah.
And then you can also get dementia from when you
have HIV. If you are a boxer or say a
football player in the NFL, you may have dementia from
(19:43):
a traumatic brain injury like a concussion of repeated concussions.
And there are plenty of diseases. There's also reversible dementia too.
If you have a vitamin deficiency, if you take certain medications,
you can develop dementia, but this is reversible for the
(20:06):
most part. Though, age associated dementia is not reversible. And
like we said, it's kind of tricky to diagnose this
stuff because it is normal for people to become more
forgetful as you age, and then to make it even
more confounding if you're a diagnostician. Not only do people
(20:28):
get more forgetful, there's an intermediate stage between dementia, a
dementia diagnosis, and just normal age related forgetfulness, and that
is called mild cognitive impairment. So if you can catch
this from what I understand, and we'll talk about treatments
and everything later, but if you can catch things like
Alzheimer's and other diseases that lead to dementia early, although
(20:53):
there's no cure for any of them, you can manage
them a lot better and delay to death like the
real devastation associated with it. Yeah, by a significant amount
of time. Catching is the tricky part, and especially if
you have dementia, you don't really realize that there's any
kind of problem. So you're probably not going to take
(21:16):
yourself to the doctor.
Speaker 1 (21:18):
No, but you what you should do is listen to
your loved ones because they are going to be looking
at you a little more closely then you can.
Speaker 2 (21:26):
You know that they have more perspective. Yeah, exactly, that's
what you're looking for.
Speaker 1 (21:33):
So don't get you know, don't get offended if a
loved one says, let's go get you checked out, because
you can do something if you catch it early on.
Speaker 4 (21:39):
Right, unless you're very wealthy and it's your no good
nephew that you've never trusted anyway, you know, very true,
then maybe bring a lawyer in on it's right, see
what's up.
Speaker 2 (21:51):
So if you do go get checked out.
Speaker 1 (21:53):
From the second you walk in the door, your doctor
is going to be eyeballing you and looking for any
signs just from their their trained eye, like you know,
from how you walk to the way you answer questions
to how they interact with you.
Speaker 2 (22:09):
They want to know you.
Speaker 1 (22:10):
They're gonna have to know your history because they need
to have some context to compare it to right.
Speaker 4 (22:16):
Like were you always a compulsive gambler? Is just like
new behavior?
Speaker 1 (22:20):
Yeah, and it helps to bring you know if if
you're older, maybe bring your grown son or daughter with you.
Speaker 2 (22:27):
Or whoever has a lot of fountact.
Speaker 1 (22:29):
Sure, although your spouse you never know what, I don't know,
maybe trying to get read of you.
Speaker 4 (22:35):
Oh yeah, like that no good nephew, Yeah.
Speaker 1 (22:37):
Exactly, I'm just kidding, of course, although I'm sure that happens.
Then there are a couple of tests that they usually
do in conjunction with one another. The many mental state
examination the MMS just a lot of basic questions there
for mental tasks.
Speaker 4 (22:56):
But they're coded.
Speaker 2 (22:57):
The tasks are yeah, and they're scored individually.
Speaker 4 (23:00):
Yeah, and when you say question three, this person got
an eight on you can go over and be like, yeh, dementia.
And it's actually pretty effective, actually it is. And there's
another test that ties into the MMSEC that they both
indicate one another, which apparently they're both really good at
(23:22):
indicating dementia because this other test called the clock drawing test.
Did you look this thing up? Yeah?
Speaker 1 (23:27):
I thought this was pretty fascinating, It really is. It
seems really like why would someone tell someone to draw
a clock at a certain time.
Speaker 2 (23:35):
Of the day.
Speaker 4 (23:36):
Yeah, Usually they say draw a clock showing that it's
ten after eleven. Yeah, And it makes a lot of
sense in a lot of ways because it draws on
all these different kinds or different regions of the brain,
different skills. Right, So, like, first of all, you have
to remember what a clock is and what it signifies.
(23:56):
That's a big one. What it looks like, Yeah, is
a clock isn't made of like squiggly lines or anything
like that. You have to remember how a clock is
laid out the order that the numbers go in that
it doesn't keep going after twelve to thirteen, fourteen, fifteen.
And then once you got all this, you have to
show the hands showing that it's ten after eleven, So
(24:18):
the hands won't be pointing at ten and eleven. It
should be the longer hand should be pointing at the two,
and the shorter hand should be just past the eleven. Right,
that's right. This requires a tremendous amount of brain power,
even though it's very simple and straightforward, and you can
tell a lot about a person's mental faculties just by
having them draw this.
Speaker 1 (24:37):
Yeah, the four specific things that requires are verbal understanding, memory,
spatially coded knowledge, and constructive skills. And if any of
those are off in conjunction with the MMSC, then they're
going to have a pretty good idea where you fall
on the dimention scale.
Speaker 4 (24:51):
If you don't have the constructive skills to pay the bills,
you may have dementia.
Speaker 1 (24:56):
That's right, and they actually I looked at one study
about the clock drawing test. Basically I think it was
just a more recent like, hey, let's go in and
really look at this thing again, and it checks out.
Speaker 2 (25:07):
Yeah, they stood behind it and said, yeah, it's actually
a really good indicator.
Speaker 4 (25:10):
Yeah, like it really holds up. And I think they
developed it in the sixties, but it didn't take off
until the eighties, and then they.
Speaker 2 (25:17):
Like it as sixties thing.
Speaker 4 (25:18):
It does, you know, but it's something you can do anywhere.
And now they're starting to gather these different clocks that
people with different types of dementia are drawing and basically
compiling them into a data base so you know what
to look for. Even more like, oh, somebody draws a
clock that has like a thirteen, fourteen, fifteen on it, right,
they may have this type of dimension.
Speaker 1 (25:37):
Right, and this one looks like Sabad or Dahli drew it, right.
Then they might have this kind of dementia, yeah, or
they might just be super talented creative.
Speaker 2 (25:46):
Yeah, you never know. All right, let's should we take
another break?
Speaker 4 (25:51):
Why not? Is it time? Sure?
Speaker 1 (25:53):
All right, we'll be back after this to talk about
treatment and some of the other pitfalls of dementia.
Speaker 4 (26:18):
So, Chuck, we've kind of I think it's almost goes
without saying, like the problems associated with dementia, like you
lose your ability to reason in a lot of cases,
you lose your ability to move and take care of yourself,
You lose your memories, you have trouble forming new memories,
you have trouble recognizing people. So living life is extremely difficult.
(26:43):
But there's also like other complications that you may or
may not think of. Right, So, let's say you're an
elderly person and you have a battery of medications that
you need to take for unrelated heart disease. Do you
think you're going to remember to take those medications? Probably not.
Even if you have like a time or set or
some sort of calendar or something like that, you may
(27:06):
have trouble even remembering that you have a calendar that
you need to go check out to see what's on there,
let alone to take the medication that's indicated that's on
that calendar.
Speaker 1 (27:16):
Yeah, that's a big problem. Nutrition itself is a big problem.
Speaker 2 (27:20):
Either you forget to eat altogether, or you think you've
already eaten, or you.
Speaker 1 (27:26):
Physically have deteriorated so that you can't control the muscles
to chew and swallow.
Speaker 2 (27:32):
Any good joke, right, it's real danger.
Speaker 4 (27:34):
So when people die from Alzheimer's, it sounds kind of strange.
If you think about it, it's like, well, no, they
forgot they lost their memory or whatever, right, No, the
brain is actually being slowly destroyed, yeah, periodically, and eventually
it's going to reach the parts of the brain where
you can't swallow any longer. Then you die from that
kind of thing. You also can lose your sense of hunger,
(27:56):
like you just aren't hungry anymore. Yeah, it's kind of
tough to eat, especially when you're not thinking or remembering
that you should eat, when you're just not hungry.
Speaker 1 (28:04):
Ever, Yeah, it's a tough one. Hygiene Reduced hygiene is
a big one. A lot of times in severe dementia cases,
you either are unable to bathe and dress yourself and
brush your teeth, or you forget to it just falls
by the wayside. I know that was the case with
my grandmother. She needed, you know, she needed to be
(28:25):
bathed by my dad.
Speaker 4 (28:27):
Because she lost interest in it or because she just
couldn't do it anymore.
Speaker 2 (28:31):
Uh, I think both.
Speaker 4 (28:33):
Yeah. Yeah, that's another indicator. You said that when you
go in for a diagnosis, the doctor is going to
be watching you and just kind of sizing you up.
One of the things I look for is whether you
look disheveled. Yeah, that's a big one. And especially if
your son or daughter is saying like, this is really
bizarre behavior because mom always like dressed to the nines.
Speaker 2 (28:53):
Yeah, when now she left the house.
Speaker 4 (28:55):
She just wears this dirty old bathrobe all the time
and doesn't ever want to take a shower. Yeah, that's
usually an indicator of dementia.
Speaker 1 (29:02):
Yeah, it's not like she just gave up and doesn't
care anymore, right, it's part of the symptoms.
Speaker 2 (29:07):
Yeah, taking hold.
Speaker 4 (29:08):
Although another problem with dementia and one of the confounding factors,
is that depression can be a byproduct or co morbidity
of dementia. Because you recognize that your life is changing
in ways that you're not happy about. You can't communicate anymore,
you forget stuff all the time, you can become depressed.
(29:29):
So then that could lead to you giving up on
taking showers and dressing as well.
Speaker 1 (29:33):
Yeah, and not only depressed, but agitated and aggressive riddle
with anxiety. A lot of your emotional well being and
emotional health will be slipping away from you.
Speaker 4 (29:45):
Yeah. And again this can be a direct result of
chemical changes in your brain due to dementia, or it
can be like this is the result of you recognizing
these changes and just becoming upset about them.
Speaker 1 (30:00):
We talked about communication and the hallucinations. You're going to
have trouble sleeping as well in a lot of cases. Yeah,
and then personal safety. A lot of people die every
day because of accidents that happen as a result of dementia.
Speaker 4 (30:15):
Right, People who shouldn't be driving to get into cars.
And there's this there's a push that's going on now,
I think in the last year or so as part
of the Council line Aging, like the United States Council
line Aging, there's a new initiative called the Dementia Friendly
America Initiative.
Speaker 2 (30:32):
Really neat.
Speaker 4 (30:33):
Yeah. It's basically saying, look, we've got about one in
eight people over sixty five in the US have dementia.
We're about to have way more than that in the
next couple decades. We need to be prepared for this
kind of thing. So let's start training America how to
recognize the signs of dementia and then how to react
to it in a friendly and helpful manner so that
(30:55):
people who are wandering around with dementia don't withdraw eighty
thousand dollars from their bank account and walk around with
it in their pockets outside.
Speaker 2 (31:05):
Yeah, and how do you do that.
Speaker 1 (31:06):
You get some money from the government as a grant
to go out and hire people to literally go to
businesses and go to restaurants and talk to waiters and
waitresses or should I just say waitrons, go to banks
and talk to tellers, go to anywhere where there's interaction
with another human, grocery store check out people, and literally
(31:30):
train them on, like you said, how to recognize it
and how to kindly deal with these people.
Speaker 4 (31:36):
Right exactly. Apparently one of the things you teach people
in service industries is not take it personally. Right that
if somebody's behaving irratically or they're using incorrect words, and
they're of a certain age, the chances are they probably
have dementia, and there's ways of dealing with it. Apparently,
responding to it in a soft, friendly manner tends to
(31:59):
get results from the dementia patient, especially if you are
not being an aggressive jerky, right exactly, Just being nice
will yeah, frequently get good results. And yeah, it is
a pretty neat initiative.
Speaker 2 (32:16):
Absolutely and necessary. Yeah, you know, but.
Speaker 4 (32:21):
It's it's I'm stricken by the idea that people are
planning out this far ahead. Yeah, for this kind of thing.
Speaker 1 (32:29):
It's exceptional, it is, and it's scary but awesome. So
if you do have a family member, one thing that's
important to remember. There's something called the caregiver burden that
my dad and his wife definitely experienced. It is really
really tough on you, on your family, and it can
actually take a physical toll. They have some stats here
(32:52):
if you your risk of death as a woman if
your husband has dementia increases twenty eight percent eight percent
in the first year after they're diagnosed. Yeah, and only
twenty two percent for a husband whose wife is diagnosed,
and then.
Speaker 4 (33:10):
Still pretty significant incag sure, just from the dementia diagnosis.
Speaker 1 (33:15):
And what they recommend in this article is to take
care of yourself first, because they found that if you
are not going into this with the right attitude and
you are upset or have anxiety, you're just gonna do
more harm anyway.
Speaker 2 (33:31):
So get yourself right, take care of yourself.
Speaker 1 (33:34):
And go into it in the right frame of mind,
and you'll actually be able to help better.
Speaker 4 (33:37):
Yeah, And this caregiver burden or caregiver burnout is a
very real thing physically too, Like you have low energy,
you're you have low productivity, you become snippy, resentful, angry,
and you can end up basically mistreating your own parent
or spouse. Yeah, because you're so upset with this horrific disease.
(33:59):
One of the all of dementia is that there's no
two days that are alike. And when you're dealing with
the dementia patient, what worked yesterday isn't going to necessarily
work today. Well, if you can no longer predict what
your life is going to be like from day to
day and you're spending I think I saw this one
study that found an average of twenty two hours a
(34:21):
week of unpaid care by spouse's wives, daughters, that kind
of thing, you can very easily get stressed out. The
main thing you have to do is ask for respite care.
Like you can't do it by yourself. You have to
have other family members, members of your church, your community
come and give you a break so you can go
(34:43):
do other stuff for a while. Absolutely, and I mean
you could totally see how you could just very easily
evolve a really unhealthy dynamic if you're just trying to
do it yourself. Because you lose perspective. This becomes your norm,
even though it's totally abnormal.
Speaker 1 (35:00):
Yeah, and boy, you talk about a really sad way
to damage what previously was a good relationship with a
parent or something is devastating, you know.
Speaker 2 (35:12):
So there are drugs that they use to help stave off.
Speaker 1 (35:16):
Dementia, mainly right now. They are colon esturays inhibitors, and
they suppress colon esterrays, which is an enzyme that breaks
down acetylathena colin, which we've talked about before. That's what
(35:36):
helps transmit messages between neurons.
Speaker 4 (35:40):
So that will help, Yeah, because if you're not communicating
as much as you were before, at least the communication
that is going on can stick around longer, exactly. You know.
It seems primitive as far as like brain drugs go,
but it makes sense, you know. Yeah.
Speaker 1 (35:59):
And then there's another one, and are they still using
this belief mamantine and it inhibitates inhibits glutamate, which we
talked about before, which causes neuron death when overstimulated.
Speaker 4 (36:12):
Yeah.
Speaker 2 (36:12):
I can't remember where we talked about that one either.
Speaker 4 (36:14):
I just remember glutamate from the Umami episode.
Speaker 2 (36:18):
Yeah, it was definitely that one.
Speaker 4 (36:20):
And then there's also stuff you can so these drugs
will help some.
Speaker 2 (36:25):
That's for non vascular dementia.
Speaker 4 (36:27):
Right. With vascular dementia, you're gonna want to take blood
thinners that's superagulates, yeah, to keep more strokes from coming
along and making the whole thing worse. And then with
like Louis Body disease, to deal with things like the
hallucinations and stuff, you will probably also be given anti
psychotics as well. And one thing that they're starting to
realize more and more is very difficult to really figure
(36:50):
out what kind of dementia people have just from what's
the scan MRI scan, and you can really go back
and accurately identify types of dementia from autopsies right right,
And so for more and more autopsies, they're finding that
there's a lot of what's called mixed dementia where you
(37:13):
have Alzheimer's and vascular dementia, or where you have Alzheimer's
and Louis Body's disease. And so it can be really
tough to suss out all the different kinds of dementia
a person might have. But if you can do that,
then you can you can put them on a drug
regimen that could really kind of help more than just
treating the Alzheimer's, letting the Louis body go unrecognized and
(37:36):
rampant they're unchecked. There's also preventative stuff you can do too.
Oh yeah, yeah, like what crossword puzzles?
Speaker 1 (37:46):
Yeah, I told you. Emily's grandmother, Mary is ninety five. Yeah,
and very sharp. Yeah, and she does.
Speaker 2 (37:54):
Word puzzles all the livelong day and is soku.
Speaker 1 (37:59):
Yeah she does. She does all kinds of word puzzles. Yeah,
things that I have never even heard of.
Speaker 4 (38:03):
Supposedly that helps stave it off. Yeah, apparently this one's great.
Alcohol moderate alcohol consumption, which is two a day or
for men or one a day for women. Okay, it
has a protective effect. It staves off, stays off dementia.
They're not sure why, they're not sure what kind of
alcohol is the best. They just know that for some reason,
(38:27):
alcohol has a protective.
Speaker 1 (38:29):
Effect, probably up to that two drinks, and then it's
probably bad after that.
Speaker 4 (38:33):
Yes, then it becomes very bad after that. Yeah. So
you want to just moderate them.
Speaker 1 (38:37):
Ount right, in all things, people, moderation, moderation, And then
there are some things that you can do.
Speaker 2 (38:48):
Here's the thing.
Speaker 1 (38:49):
There's a debate on whether or not you are tricking
your loved one by doing things like giving them an
appliance that doesn't work, so they can pretend that they're
ironing or something because they used to love to take
care of their laundry themselves. So here, let me remove
(39:10):
the cord from this iron and and is.
Speaker 2 (39:14):
That tricking someone?
Speaker 4 (39:15):
Is it not?
Speaker 1 (39:16):
And a lot of people think, no, that's what you
should do because it makes them feel like they're being useful.
They're not gonna get hurt or hot iron, so it's
all good. Other people say no, that means that they're
not hanging on to that last bit of reality they
may have.
Speaker 2 (39:33):
I think it's fine.
Speaker 4 (39:34):
I think it's fine too. And there's actually there's a
an entire village set up in I think like just
outside of Amsterdam.
Speaker 2 (39:43):
Yeah, this is awesome, called Hojuwei.
Speaker 4 (39:45):
Right, Yeah, how would you say that?
Speaker 1 (39:47):
I have no idea, because Dutch is the weirdest, the
weirdest language.
Speaker 4 (39:52):
We'll say that, okay, okay, And it's a it is
a it's an what's called the dementia village basically, yeah,
where everyone who lives in this village. I think one
hundred and fifty people all have dementia, and they live
in group houses.
Speaker 2 (40:08):
They're well, there's caretakers that live there too, but.
Speaker 4 (40:10):
Okay, yes, you're right. Yeah, and they live in the
group houses with them. Yes, And a lot of the
people realize that this is their nurse or just think
it's a good friend of theirs. Yeah, they don't really
remember where when they became friends, yeah, exactly. Yeah. And
the houses they live in have different themes according to
how the people lived, depending on whether they're blue collar,
(40:33):
whether they their memories go back to the seventies. This
whole place is basically set up so that it's a
very non threatening safe place for these people just kind
of live and move about within sure safely, yeah, safely.
And so they can go to the grocery store, they
can go to the movies, they can go ride a bike.
Speaker 1 (40:55):
And everyone, the people at the movie theater know that
the people there have dementia, right like every they're real
movie theater workers and real waiters in the restaurant, especially
trained exactly. So it's a less clinical setting than say
a nursing home. And a lot of people say this
is awesome because it's as close to real normal life
(41:16):
that they were used to as they're going to get Yeah, exactly.
Then of course there's other people that poopoo and say no,
you're tricking these people.
Speaker 4 (41:22):
But you can say, hey, okay, here's the big difference
with this place. If this, If this dementia patient gets
lost in Manhattan and they run across a city worker
who's collecting garbage, that city worker may do absolutely nothing
to help them.
Speaker 2 (41:39):
Yeah.
Speaker 4 (41:40):
In HOJV village, Yeah, that city worker especially trained to
get that person back to their house or alert their
caretaker that this person is having a crisis or something
like that.
Speaker 1 (41:52):
It's what we're trying to train people to do in
the future. Yes, they've just isolated it to a community.
Speaker 4 (41:56):
Yeah, so there's I mean, when you break it down
to that distinction, I don't really see anything wrong with it,
especially when you are protecting the patients themselves. It's not
like you're doing it to experiment on them, no, no,
you know, or because they'll produce gold in their urine
or something like that. You know, like this is strictly
(42:18):
for their protection, yeah, but also allowing them to live
a free life outside of a clinical setting, right, I
don't see much wrong with that, I do get what
the bioethicists are saying, like, yeah, sure, you're robbing someone
of their dignity by lying to them, by diluting them,
or playing into their fantasies. Strictly speaking, Yes, in the
real practical world, I think this is great.
Speaker 1 (42:39):
If I'm at that point, then and play into my
fantasy exactly, please.
Speaker 4 (42:44):
It is nineteen eighty four all the time.
Speaker 1 (42:49):
In fact, one of the people that work there say
that people that do criticize it at a very good point.
He's like, they don't understand what we're doing here. These
aren't actors. They're like real employees of these places. They're
just helping out right, you know.
Speaker 4 (43:02):
And so Hojvei village. I hope I'm saying that right
because I'm really putting myself out there.
Speaker 2 (43:07):
Oh, I'm sure you're not.
Speaker 4 (43:09):
It's become this kind of ideal standard of care. But
it's also really expensive.
Speaker 2 (43:15):
Yeah, I'm sure.
Speaker 4 (43:15):
So in a country where there's a lot of socialized medicine,
it could do pretty well, like in the Netherlands or
in Canada.
Speaker 1 (43:22):
Yeah, when they take care of people even though they
don't have money, right, Exactly.
Speaker 4 (43:25):
There's one called in Canada. It's called Pentanguishani Pentanguishini, Ontario.
They have one, it's a little smaller than the one
in Amsterdam. They're also building one in Miami as well.
So it is starting to take hold. People do believe
(43:45):
in it, and apparently the patient's families are very happy
with this kind of thing too well.
Speaker 2 (43:51):
And hopefully with the initiative of what's it called All.
Speaker 1 (43:54):
Dementia America DFA, yeah or yeah, hopefully with those efforts,
more and more people will because it's coming.
Speaker 4 (44:04):
Oh yeah, it's coming.
Speaker 2 (44:05):
A lot more folks are going to be out there
that we need to take care of.
Speaker 4 (44:08):
Yeah, we don't know how to cure dementia. We just
know it's coming.
Speaker 1 (44:13):
I'm going to be one of them, you think, so
sure at some point if I make it that long.
Speaker 4 (44:20):
But you know, not everybody gets dementia no matter how
long you live.
Speaker 2 (44:24):
I don't know.
Speaker 1 (44:24):
I got a feeling really, yeah, it does run in
my family a little bit. Yeah, and I have my
father's family jeans more than my mother's. I feel like,
so if if I had my mother's jeans, they all
died from heart attacks and strokes and heart disease.
Speaker 2 (44:45):
Young, not a lot of cancer. Yeah pretty young.
Speaker 4 (44:48):
Yeah, so if you make it past sixty five, yeah,
you beat the heart stuff.
Speaker 2 (44:54):
Than the Bryant jeans.
Speaker 4 (44:57):
Yeah. Well we're all going down one way and they love.
Speaker 2 (44:59):
To be a hundred.
Speaker 4 (45:00):
Yeah you know, yeah, man, I thought it was something.
Oh yeah, I wonder, Chuck, if like our specific like us,
you and me specifically, creaming all this information in every
week is actually beneficial, or if we're just setting ourselves
up for massive cases of dementia because we're just pushing
(45:21):
stuff in and getting it out, pushing in new stuff
and getting it out, Like are we abusing our brains
or are we exercising it? I question that sometimes.
Speaker 1 (45:29):
I bet someone out there, I bet there's a neurologist
who has a good gut instinct answer to that.
Speaker 4 (45:34):
Let us know. I want to know good news are bad? Okay, neurologists.
Speaker 1 (45:39):
There's going to be a subject a line that just says, neurologists, guys,
you're screwed.
Speaker 4 (45:44):
Yeah, I have bad news. If you want to know
more about dementia, you can type that word into your
favorite search engine and it will bring up tons of
information and great resources. You can also type it into
the search bar house to works and it'll bring up
a great article. Since I said search bar, its time.
Speaker 1 (46:00):
For listener mil I'm gonna call this when Hecky Krasnaw
lives okay, although I don't think he is with us. Hey, guys,
only just started recently listening to the show. It's been
a fantastic way to pass time and learned something interesting.
Speaker 2 (46:18):
I'm a home taught high schooler.
Speaker 1 (46:19):
So every time I listen to an episode of your show,
I get a history or science credit.
Speaker 2 (46:24):
How about that.
Speaker 4 (46:25):
That's pretty great.
Speaker 1 (46:26):
But as great as that is, it's not why I'm emailing.
I actually have a fun fact for you guys from
your playto episode in which you mentioned Captain Kangaroo. Well,
my great grandfather worked on that show. He produced the
songs for it, as well as several Christmas carols, including
Frosty the Snowman and his biggest claim to fame.
Speaker 2 (46:46):
Rudolph the Red Nose Reindeer.
Speaker 4 (46:48):
That is awesome.
Speaker 2 (46:49):
I've always thought it was.
Speaker 1 (46:50):
Very funny that a Jewish guy was responsible for the
popularity of Christmas carols.
Speaker 2 (46:54):
My family all still.
Speaker 1 (46:56):
Jewish watches the Claymation Rudolph movie every year. Begare because
of that our own little taste of that irony.
Speaker 2 (47:02):
Yeah. I don't want to tell.
Speaker 1 (47:04):
You what to do, because I'm sure you have a
lot of episodes on your plate already, But I'm just saying,
Hecky Krasnaw was a pretty interesting person. There might just
be enough material for an episode on him up to you.
Speaker 4 (47:17):
Nice.
Speaker 2 (47:17):
Thanks for helping me with my school work. That is
from Aiden in Maryland.
Speaker 4 (47:22):
Awesome, Thank you very much. Aiden.
Speaker 2 (47:24):
And when I say Hecky Krasnew lives, I mean lives.
Speaker 4 (47:27):
On sure like Viva La Hecky. Yeah, if you want
to tell us about someone interesting in your family, we
love that kind of stuff. Also, if you are caring
for a dementia patient, we want to hear the highs
and the lows of that. Just kind of bringing on
home for us. Will you? You can send us an
email to stuff podcast at house Stuff works dot com
(47:47):
and as always, joined us at our home on the web,
Stuff Youshould Know dot com.
Speaker 3 (47:54):
Stuff You Should Know is a production of iHeartRadio. For
more podcasts my Heart Radio, visit the iHeartRadio up, Apple Podcasts,
or wherever you listen to your favorite shows.
Speaker 4 (48:09):
Mm hmm
Good morning everyone. I hope you're enjoying yourself and having
a great weekend with friends, family, loved ones, or I
don't know, even people you might dislike a little bit.
How dementia works. This is a pretty brutal episode, everybody.
This is from November fourth, twenty fifteen, but there's some
really good information in it. If you are suffering from dementia,
(00:21):
or someone in your family is suffering from dementia, you
have our deepest empathy because it is tough stuff, and
we hope this episode can bring you a little bit
of comfort because knowledge is power and understanding things is
what we're all about, and that can really help sometimes
when you're dealing with something as devastating as dementia.
Speaker 2 (00:40):
So how dementia works, right here.
Speaker 3 (00:42):
Right now, Welcome to Stuff You Should Know, a production
of iHeartRadio.
Speaker 4 (00:56):
Hey, and welcome to the podcast. I'm Josh Clark with
Charles w Chuck Bryant and Noel. The Stint of Noel continues.
Everybody's like, stuff you should Noel. No, No, that's not
what we're calling it. It's the Stint of Noel. All right,
Stuff you should Knowel. That's too clever.
Speaker 2 (01:16):
Yeah, it's a little cutesy. Yeah, that's all all right.
Speaker 4 (01:20):
It's my only aversion to it. All right, all right?
What do you are you with? Stuff you should know?
Speaker 2 (01:26):
Changing the name of our show after eight years?
Speaker 4 (01:28):
No, just the Noel's stint the name of it. Remember
the Summer of Sam?
Speaker 2 (01:33):
Oh? Yeah? Yeah, sure, why not?
Speaker 4 (01:35):
I don't like it?
Speaker 2 (01:36):
All right?
Speaker 4 (01:38):
Should we come up with the third idea?
Speaker 2 (01:40):
Yeah?
Speaker 1 (01:42):
The stint of nol sounds too much like something's wrong
with Noel.
Speaker 4 (01:47):
That's why I like it. It's hilarious. There's nothing wrong
with Noel, my god. And if you think there is,
you need to answer to me.
Speaker 2 (01:54):
There's something you should know.
Speaker 4 (01:58):
I see, that's what I'm saying. It sounds like something Strickland.
Would it come up with?
Speaker 2 (02:02):
Oh? You know? And we haven't been in a flame
war with Strickland in a while.
Speaker 4 (02:06):
It has been a while. It's been too long. I've
gotten soft. You just launched one across the bow, so.
Speaker 2 (02:13):
Chuck.
Speaker 4 (02:13):
Yes, are you familiar with dementia?
Speaker 2 (02:17):
Yeah?
Speaker 4 (02:17):
Sure, are you running? Your family doesn't.
Speaker 1 (02:20):
Run in the family, But my grandmother, who lived to
be one hundred, had dementia at some point, which you know,
when you love to be one hundred. That's I don't
know about likely, but it's not surprising.
Speaker 4 (02:32):
It's probably pretty likely. It's not from what I understand,
it's not a just a natural consequence of age, right,
but it's pretty prevalent.
Speaker 2 (02:44):
Sure.
Speaker 4 (02:46):
And dementia's actually super misunderstood. It gets confused with Alzheimer's
a lot, or there's a lot of different kinds of dementia,
But dementia is actually it's not a disease. It's a
set of symptoms that's brought on by disease.
Speaker 2 (02:58):
Yeah.
Speaker 1 (02:59):
I think that is widely misunderstood. Yeah, but you are
totally correct.
Speaker 2 (03:04):
A set of symptoms, and.
Speaker 1 (03:07):
It is not just your garden variety forgetfulness that comes
as you age.
Speaker 4 (03:13):
No, because that is age related and that is normal.
Speaker 1 (03:15):
The totally age related things called age associated memory impairment,
and that is uh. I think, I mean that happens
to everyone, right, It's just.
Speaker 4 (03:24):
Like you forget your keys more often, that kind of stuff. Sure,
But when you do forget your keys more often, you
snap your finger and go, ah, I forgot my keys again,
what is wrong with me? Yeah, that's normal.
Speaker 1 (03:35):
One of the big tells of true dementia is when
you don't realize that you're forgetting right.
Speaker 2 (03:40):
So that's when it gets scary.
Speaker 4 (03:42):
Right, And we said that it's not a natural consequence
of age. And one of the things that I turned
up in researching this is we're not exactly sure what
causes dementia. We don't even know if some of the
telltale signs of dementia are the cause of dementia in
some cases or the result of dementiae. Not entirely certain,
(04:02):
but it is very widespread among the aged population. In
the United States. I think five point three million Americans
have dementia right now.
Speaker 2 (04:12):
Wow.
Speaker 4 (04:13):
And as our population ages, because the baby boomers are
starting to get older, I think they're expecting something like
sixteen million Americans are going to have it by twenty fifty.
Sixteen million is I think how many? About how many
people have it around the world right now? And in
America alone, we're going to have that number in twenty fifty. Yeah,
and it's very expensive, Actually, how much money a lot?
(04:37):
You ready for this?
Speaker 2 (04:38):
Yeah?
Speaker 4 (04:39):
In twenty fifteen, we have spent two hundred and twenty
six billion dollars on healthcare for dementia a while, and
they're expecting by I believe twenty fifty, when we are
caring for sixteen million in twenty fifteen dollars, not futuristic,
much more inflated fifty do right in twenty fifteen dollars,
(05:02):
We'll be spending about one point two trillion dollars on
dementia if somebody doesn't do something.
Speaker 2 (05:08):
Man.
Speaker 4 (05:09):
Yeah, it's very expensive. It's also extraordinarily sad as far
as diseases or symptoms of diseases. Yeah, yeah.
Speaker 1 (05:18):
And I also want to recommend our May twenty eleven episode,
A podcast to remember. Our memory episode ties heavily into this,
So if you haven't listened to that one yet, go
listen to that one, either before or after.
Speaker 4 (05:30):
Or if you listen to it and forgot, go back
and listen to it.
Speaker 2 (05:33):
That's right.
Speaker 1 (05:34):
So dementia itself is not diagnosed. It's not simply memory loss.
It's memory loss along with one of the following at
least one of the following one or more. Aphasia, which
is if you can't understand or produce language any longer,
a praxia, and all these are super sad if you've
(05:54):
ever seen.
Speaker 2 (05:54):
Them up close.
Speaker 1 (05:56):
A praxia if you cannot make certain movements even though
your body physically is healthy, right, agnosia, which is you
don't recognize objects like the remote control or your grandkids,
stuff like that. And then executive dysfunction when you have
a lot of troubles planning and organizing and reasoning. So
that along with the memory loss or at least one
(06:17):
of these, you could be diagnosed with dementia, right.
Speaker 4 (06:21):
And so, like we said, dementia is a set of symptoms, right, Yes,
it's actually brought on by disease. And the most common
cause of dementia I think something like sixty or seventy
percent or something like that of dementia cases is brought
on by Alzheimer's disease.
Speaker 1 (06:38):
I could have sworn we did one on Alzheimer's, but
we have not. Yeah, I don't think we have.
Speaker 2 (06:43):
I don't know. We've talked about it enough.
Speaker 4 (06:44):
I think, yeah, it's popped up plenty of times, but
we've never just done a straight up Alzheimer's. Alzheimer's brings
on dementia through something called neurofibrillary fibrillary tangles also known
as beta I'm sorry, tau protein tangles. Yeah, and beta
amyloid plaques, right.
Speaker 1 (07:06):
Yeah, and the plaquesa's like a just a protein build up,
a sticky protein build.
Speaker 4 (07:10):
Up, Yeah, which is so when you when your neurons
fire and you have a thought, it's an electrochemical process,
and there's residual that is left behind, and these residuals
can build up in your synapses and cause your synapses
to not fire as well. And when your synapses don't
fire as well, they start to die off, and the
neurons that are there that lead from these synapses or
(07:31):
lead to these synapses, die themselves and you have neural loss.
Like literally the brain cells in your brain are dying
off at a rapid rate. Yeah, and when it's caused
by beta proteins and TAO or beta amyloid plaques and
tau proteins in the cells, then what you have is Alzheimer's.
Speaker 1 (07:50):
Yeah, And they aren't sure the cause of Alzheimer's still,
Genetics is they think has a lot to do with it.
Speaker 2 (07:58):
And you can live with Alzheimer's for while.
Speaker 1 (08:00):
Up to a decade, although they said in this article
many says three to five years is more common.
Speaker 2 (08:07):
So, yeah, it definitely shortened your lifespan.
Speaker 4 (08:10):
And like you said, genes are definitely part of the
risk factors. A polypo protein, a polopo protein. E okay,
I think, which is weird. If you have a mutation
on this gene, you have a higher risk of Alzheimer's,
even though the gene just codes for a protein that
carries cholesterol through your bloodstream. Yeah, doesn't have anything to
(08:34):
do with the TAU protein tangles or anything like that
as far as I know. That's weird. Also, if you
have a family history of dementia, you're you have of Alzheimer's,
you have a higher likelihood. And then if you have
down syndrome, you are at a higher risk of developing
Alzheimer's in middle age.
Speaker 1 (08:53):
Oh really yeah, interesting, So that's and we will do
one on Alzheimer's. But that's how Alzheimer's can call dementia.
There's also vascular dementia, which is that was the case
with my grandfather who he had a stroke, and it
accounts for about twenty percent of dementia cases.
Speaker 2 (09:12):
And you know, stroke is when.
Speaker 1 (09:15):
You have a loss of blood supply to the brain
or a hemorrhage or a blood clot and it can
be either one big stroke event which causes a lot
of damage. And that's a single INFARCD dementia, or it
can be a lot of the accumulation of symptoms because
of a lot of little mini strokes you have over
(09:36):
the years.
Speaker 4 (09:37):
Right, and then the damage just builds up and you
finally once that last one that does the straw that
breaks the camel's back. Yeah, and you have dementia that
happens pretty rapidly after that last that last one, that
last stroke you have.
Speaker 1 (09:52):
Yeah, and that's a multi infarc when it's a bunch
of them, and little many strokes are common a lot.
Sometimes you have them and don't even realize you've had them.
Right with my grandfather, he had the big one and
oh really, Yeah, we talked about this before and I
think something about speech, but yeah, he lost his ability
to speak, you know, English.
Speaker 4 (10:14):
So that would be a phasia.
Speaker 1 (10:16):
Yes, he couldn't produce language, well, he produced, Yes, he
cannot produce language. He said things, but it you know,
it didn't make any sense, gotcha. But he had an understanding.
You could see the frustration. Yeah, you know, I know
how to how I'm supposed to. My grandmother is driving us,
let's say, and she doesn't know how to get there.
He does, and he can't tell her, but he's telling her. Yeah,
(10:40):
it's just coming out all mixed up.
Speaker 4 (10:41):
And that's that's a hallmark of dementias. There's emotional changes
in the person because they they're not communicating like they
want to say, people aren't responding like they want the
people to and they'll get snippy and then ultimately say withdrawal.
They'll just give up on communicating at all because it's
too frustrating or just too sad, you know, yeah, which
(11:04):
is it's one of the common results of dementia. It's
a comorbidity. No, it's a complication.
Speaker 2 (11:10):
Yeah.
Speaker 1 (11:10):
And then and with the single stroke event or actually
or with the multi strokes, it's.
Speaker 2 (11:17):
Different for everyone.
Speaker 1 (11:18):
There isn't any single like, well, this is going to
happen because this person had a stroke, right, It could
be a variety of different things from you know, paralysis
on one side of the face or body bowel and
bladder control problems. He didn't have any of those. He
looked totally the same physically, He walked and talked the same,
except for the fact that they weren't real words.
Speaker 4 (11:39):
Right.
Speaker 2 (11:39):
That was like the most noticeable thing.
Speaker 4 (11:41):
I remember you telling me about your grandfather before I
don't remember what it was.
Speaker 2 (11:45):
It was a long time.
Speaker 4 (11:46):
We were talking about speech, like where Nicky's area or
broke his area? Yeah, yeah, something like that. So with Alzheimer's,
it first attacks the hippocampus, which means that it's going
to take away your episodic memory, which is your memory
of recent events, right, Yeah, and then it starts to
move its way into other areas of the brain where
(12:08):
your judgment is affected, your speech patterns are going to
be affected. Your personality is very much affected and changes
with Alzheimer's. With Alzheimer's, but not as much with the stroke. Yeah.
With vascular dementia, you know, there might be some other
things where like part of the faces sagging, or the
patient can't move their arm or something like that, but yeah,
the personality will remain intact because those regions of the
(12:30):
brain aren't affected like they are in Alzheimer's.
Speaker 2 (12:33):
Yes.
Speaker 1 (12:33):
And then in about five to fifteen percent of dementia
cases it stems from something called Louis body dementia.
Speaker 2 (12:42):
Which we were just talking about. They think Robin Williams
might have suffered from.
Speaker 4 (12:45):
He definitely did.
Speaker 2 (12:46):
He definitely did.
Speaker 4 (12:47):
Yeah. They found in his autops that he had I
think he was diagnosed with it before he died. No, okay,
that was one of the reasons why he took his life.
Speaker 1 (12:54):
Yeah, because that can cause severe intense hallucinations.
Speaker 4 (12:58):
Yeah big time. Did you look up?
Speaker 2 (13:00):
Oh yeah, man, very scary stuff.
Speaker 4 (13:02):
You like, very apparently A typical one is very brightly
colored animal or person. Yeah, that you see in great
detail for many minutes on daily a daily basis, like
just intense hallucinations.
Speaker 2 (13:14):
I'm sure you think you're you know, losing it, right.
Speaker 4 (13:16):
And that's one of the first symptoms of Louis body dementia.
Speaker 1 (13:19):
And it was discovered by Frederick Louis and nineteen twelve.
And it has has nothing to do with your body.
A Louis body is there are deposits again protein deposits
of the alpha.
Speaker 2 (13:32):
Sinucleon that appear on the brain.
Speaker 1 (13:34):
So don't think of body in the terms of like
your physical body, right. And this is also president Louis
Body's and Parkinson's. So as a result, not only are
you going to have symptoms similar to Alzheimer's with Louis
body dementia, but also some of the tremors and balance
issues of Parkinson's right, which is super sad as well.
Speaker 4 (13:55):
Is that what Michael J. Fox has Parkinson's?
Speaker 2 (13:58):
Yeah?
Speaker 4 (13:59):
Yeah, and that's that's what the movie Awakenings was about.
When they wasn't it like a group of Parkinson's patients
that like L.
Speaker 2 (14:05):
Dobo worked on, was that Parkinson's I can't remember.
Speaker 4 (14:07):
I think they didn't. They didn't realize what they thought
they were locked in or something in there. I realized
their Parkinson's strummers were so acute that they were like
they were not even shaking, they were just fretly. Yeah. Interesting,
They're just their muscles were totally contracted rather than contracting
and relaxing again and again.
Speaker 2 (14:24):
And Robert Williams, Yeah, how about that?
Speaker 1 (14:27):
Yeah, then we have something that used to be well
it's called now fronto temporal dementia. It used to be
called Pick's disease, but now Pick's disease is a specific.
Speaker 4 (14:41):
Version which I couldn't really suss out what the difference is,
could you know?
Speaker 2 (14:47):
I couldn't either, as.
Speaker 4 (14:47):
Long as it wasn't just me, I feel better.
Speaker 1 (14:49):
But ft D is really an umbrella term. It's about
five percent of dementia cases, and it's going to affect personality,
behavior and language, like big time, big time, and it's
where your frontal and temporal lobes are actually atrophying and shrinking.
Speaker 4 (15:07):
Right. And the reason why is you remember with Alzheimer's
you have beta amyloid plaques and tau protein tangles.
Speaker 2 (15:13):
Yeah.
Speaker 4 (15:14):
Well, with the fronto temporal dementia, you don't have the
beta amyloid plaqs. You just have the tau protein tangles.
But it's enough to cause massive neuronal loss.
Speaker 2 (15:24):
Yeah.
Speaker 1 (15:24):
And this is like I think a lot of people
at first think they might have tourette Yeah, because you
can yell things out inappropriate behaviors.
Speaker 4 (15:35):
Yeah, Like if your grandfather suddenly becomes hyper interested in
sex and likes to talk about it in public, or yeah,
exposes himself to people in public, there's a pretty good
chance that he has developed fronto temporal dementia.
Speaker 1 (15:49):
Or if I did, because it's unusual in that it
attacks younger people. It's gonna onset between forty and seventy
five years old, which distinguishes it from their types of dementia.
Speaker 4 (16:01):
Yeah. And if your grandfather used to do that stuff already,
then that's not the case. The key here is that,
like this has come out of the blue, somebody is
really just completely changed in their personality. They might get
into really risky behavior like gambling all of a sudden.
Speaker 1 (16:16):
Yeah, shoplifting Yeah, and like risky investments are like pulling
all their money out of the bank.
Speaker 4 (16:23):
Yeah. And with picks disease too. Apparently apathy is a
big indicator of this. There's a big personality change and
the person is no longer they have no empathy, they
have blunted emotions. Yeah, and then they may also be
engaging in risky behavior. So basically your grandpa or your
grandma has just turned into like the transporter you know,
(16:47):
or me or you well, yeah, you're five. You lack empathy.
Speaker 2 (16:52):
No no, no, I'm just saying, oh, I see, because.
Speaker 4 (16:54):
It affects you sing like they turned into you. Oh no, no, no,
you have blunted emotions and amble.
Speaker 2 (17:01):
There's also Huntington's disease.
Speaker 1 (17:03):
This is it seems like much more physical in nature,
uncontrollable movements, although there are changes in personality, but real fidgety, herky, jerky.
Your brain loses the ability to control coordination essentially, right,
which is I think fifty percent chance of inheriting the gene.
(17:25):
But you can live with it for up to twenty years. Yeah,
which seems like, as far as dementia go, is one
of the longer life expectancies.
Speaker 4 (17:35):
But again, I mean, like I would guess this has
kind of become clear. The hallmark of dementia is memory
loss paired with some other problem like not being able
to create speech any longer recognize speech, or not being
able to move that kind of thing, or not being
able to plan. And like we said, well we should
(17:56):
probably take a break. Huh.
Speaker 1 (17:58):
Yeah, we got a couple of more types that we'll
talk about and then some other good stuff. Okay, right
after this, the last two, actually the last three we're
(18:25):
going to talk about, because there are many many other
kinds of dementia, Like, we could spend hours and hours
talking about all the different kinds hours, But we have
talked about kreutz felt yakup disease and I.
Speaker 2 (18:38):
Can't remember which one, and we say that all the time.
Speaker 4 (18:41):
Is there a disease that kills by preventing sleep?
Speaker 2 (18:44):
Oh?
Speaker 4 (18:44):
Is that the one which we should have rightly called
how prion diseases work?
Speaker 1 (18:48):
Yeah, because is a prion infection. It's very rare, about
one out of a million people will be affected in
any given.
Speaker 4 (18:56):
Year, like mad cow disease or KU Yeah, exactly. It's
a sponge of form disease. Yeah, so crazy, it is.
It's very interesting. It could be genetic. But and I
thought we also talked about it in an organ transplant.
Speaker 1 (19:14):
I think so, because it can occur because of infected
tissue that you are implanted with or from an organ.
Speaker 4 (19:21):
Yeah. And this is neuronal loss due to the like
holes literally being eaten into your brain by this disease. Yeah.
And then you can also get dementia from when you
have HIV. If you are a boxer or say a
football player in the NFL, you may have dementia from
(19:43):
a traumatic brain injury like a concussion of repeated concussions.
And there are plenty of diseases. There's also reversible dementia too.
If you have a vitamin deficiency, if you take certain medications,
you can develop dementia, but this is reversible for the
(20:06):
most part. Though, age associated dementia is not reversible. And
like we said, it's kind of tricky to diagnose this
stuff because it is normal for people to become more
forgetful as you age, and then to make it even
more confounding if you're a diagnostician. Not only do people
(20:28):
get more forgetful, there's an intermediate stage between dementia, a
dementia diagnosis, and just normal age related forgetfulness, and that
is called mild cognitive impairment. So if you can catch
this from what I understand, and we'll talk about treatments
and everything later, but if you can catch things like
Alzheimer's and other diseases that lead to dementia early, although
(20:53):
there's no cure for any of them, you can manage
them a lot better and delay to death like the
real devastation associated with it. Yeah, by a significant amount
of time. Catching is the tricky part, and especially if
you have dementia, you don't really realize that there's any
kind of problem. So you're probably not going to take
(21:16):
yourself to the doctor.
Speaker 1 (21:18):
No, but you what you should do is listen to
your loved ones because they are going to be looking
at you a little more closely then you can.
Speaker 2 (21:26):
You know that they have more perspective. Yeah, exactly, that's
what you're looking for.
Speaker 1 (21:33):
So don't get you know, don't get offended if a
loved one says, let's go get you checked out, because
you can do something if you catch it early on.
Speaker 4 (21:39):
Right, unless you're very wealthy and it's your no good
nephew that you've never trusted anyway, you know, very true,
then maybe bring a lawyer in on it's right, see
what's up.
Speaker 2 (21:51):
So if you do go get checked out.
Speaker 1 (21:53):
From the second you walk in the door, your doctor
is going to be eyeballing you and looking for any
signs just from their their trained eye, like you know,
from how you walk to the way you answer questions
to how they interact with you.
Speaker 2 (22:09):
They want to know you.
Speaker 1 (22:10):
They're gonna have to know your history because they need
to have some context to compare it to right.
Speaker 4 (22:16):
Like were you always a compulsive gambler? Is just like
new behavior?
Speaker 1 (22:20):
Yeah, and it helps to bring you know if if
you're older, maybe bring your grown son or daughter with you.
Speaker 2 (22:27):
Or whoever has a lot of fountact.
Speaker 1 (22:29):
Sure, although your spouse you never know what, I don't know,
maybe trying to get read of you.
Speaker 4 (22:35):
Oh yeah, like that no good nephew, Yeah.
Speaker 1 (22:37):
Exactly, I'm just kidding, of course, although I'm sure that happens.
Then there are a couple of tests that they usually
do in conjunction with one another. The many mental state
examination the MMS just a lot of basic questions there
for mental tasks.
Speaker 4 (22:56):
But they're coded.
Speaker 2 (22:57):
The tasks are yeah, and they're scored individually.
Speaker 4 (23:00):
Yeah, and when you say question three, this person got
an eight on you can go over and be like, yeh, dementia.
And it's actually pretty effective, actually it is. And there's
another test that ties into the MMSEC that they both
indicate one another, which apparently they're both really good at
(23:22):
indicating dementia because this other test called the clock drawing test.
Did you look this thing up? Yeah?
Speaker 1 (23:27):
I thought this was pretty fascinating, It really is. It
seems really like why would someone tell someone to draw
a clock at a certain time.
Speaker 2 (23:35):
Of the day.
Speaker 4 (23:36):
Yeah, Usually they say draw a clock showing that it's
ten after eleven. Yeah, And it makes a lot of
sense in a lot of ways because it draws on
all these different kinds or different regions of the brain,
different skills. Right, So, like, first of all, you have
to remember what a clock is and what it signifies.
(23:56):
That's a big one. What it looks like, Yeah, is
a clock isn't made of like squiggly lines or anything
like that. You have to remember how a clock is
laid out the order that the numbers go in that
it doesn't keep going after twelve to thirteen, fourteen, fifteen.
And then once you got all this, you have to
show the hands showing that it's ten after eleven, So
(24:18):
the hands won't be pointing at ten and eleven. It
should be the longer hand should be pointing at the two,
and the shorter hand should be just past the eleven. Right,
that's right. This requires a tremendous amount of brain power,
even though it's very simple and straightforward, and you can
tell a lot about a person's mental faculties just by
having them draw this.
Speaker 1 (24:37):
Yeah, the four specific things that requires are verbal understanding, memory,
spatially coded knowledge, and constructive skills. And if any of
those are off in conjunction with the MMSC, then they're
going to have a pretty good idea where you fall
on the dimention scale.
Speaker 4 (24:51):
If you don't have the constructive skills to pay the bills,
you may have dementia.
Speaker 1 (24:56):
That's right, and they actually I looked at one study
about the clock drawing test. Basically I think it was
just a more recent like, hey, let's go in and
really look at this thing again, and it checks out.
Speaker 2 (25:07):
Yeah, they stood behind it and said, yeah, it's actually
a really good indicator.
Speaker 4 (25:10):
Yeah, like it really holds up. And I think they
developed it in the sixties, but it didn't take off
until the eighties, and then they.
Speaker 2 (25:17):
Like it as sixties thing.
Speaker 4 (25:18):
It does, you know, but it's something you can do anywhere.
And now they're starting to gather these different clocks that
people with different types of dementia are drawing and basically
compiling them into a data base so you know what
to look for. Even more like, oh, somebody draws a
clock that has like a thirteen, fourteen, fifteen on it, right,
they may have this type of dimension.
Speaker 1 (25:37):
Right, and this one looks like Sabad or Dahli drew it, right.
Then they might have this kind of dementia, yeah, or
they might just be super talented creative.
Speaker 2 (25:46):
Yeah, you never know. All right, let's should we take
another break?
Speaker 4 (25:51):
Why not? Is it time? Sure?
Speaker 1 (25:53):
All right, we'll be back after this to talk about
treatment and some of the other pitfalls of dementia.
Speaker 4 (26:18):
So, Chuck, we've kind of I think it's almost goes
without saying, like the problems associated with dementia, like you
lose your ability to reason in a lot of cases,
you lose your ability to move and take care of yourself,
You lose your memories, you have trouble forming new memories,
you have trouble recognizing people. So living life is extremely difficult.
(26:43):
But there's also like other complications that you may or
may not think of. Right, So, let's say you're an
elderly person and you have a battery of medications that
you need to take for unrelated heart disease. Do you
think you're going to remember to take those medications? Probably not.
Even if you have like a time or set or
some sort of calendar or something like that, you may
(27:06):
have trouble even remembering that you have a calendar that
you need to go check out to see what's on there,
let alone to take the medication that's indicated that's on
that calendar.
Speaker 1 (27:16):
Yeah, that's a big problem. Nutrition itself is a big problem.
Speaker 2 (27:20):
Either you forget to eat altogether, or you think you've
already eaten, or you.
Speaker 1 (27:26):
Physically have deteriorated so that you can't control the muscles
to chew and swallow.
Speaker 2 (27:32):
Any good joke, right, it's real danger.
Speaker 4 (27:34):
So when people die from Alzheimer's, it sounds kind of strange.
If you think about it, it's like, well, no, they
forgot they lost their memory or whatever, right, No, the
brain is actually being slowly destroyed, yeah, periodically, and eventually
it's going to reach the parts of the brain where
you can't swallow any longer. Then you die from that
kind of thing. You also can lose your sense of hunger,
(27:56):
like you just aren't hungry anymore. Yeah, it's kind of
tough to eat, especially when you're not thinking or remembering
that you should eat, when you're just not hungry.
Speaker 1 (28:04):
Ever, Yeah, it's a tough one. Hygiene Reduced hygiene is
a big one. A lot of times in severe dementia cases,
you either are unable to bathe and dress yourself and
brush your teeth, or you forget to it just falls
by the wayside. I know that was the case with
my grandmother. She needed, you know, she needed to be
(28:25):
bathed by my dad.
Speaker 4 (28:27):
Because she lost interest in it or because she just
couldn't do it anymore.
Speaker 2 (28:31):
Uh, I think both.
Speaker 4 (28:33):
Yeah. Yeah, that's another indicator. You said that when you
go in for a diagnosis, the doctor is going to
be watching you and just kind of sizing you up.
One of the things I look for is whether you
look disheveled. Yeah, that's a big one. And especially if
your son or daughter is saying like, this is really
bizarre behavior because mom always like dressed to the nines.
Speaker 2 (28:53):
Yeah, when now she left the house.
Speaker 4 (28:55):
She just wears this dirty old bathrobe all the time
and doesn't ever want to take a shower. Yeah, that's
usually an indicator of dementia.
Speaker 1 (29:02):
Yeah, it's not like she just gave up and doesn't
care anymore, right, it's part of the symptoms.
Speaker 2 (29:07):
Yeah, taking hold.
Speaker 4 (29:08):
Although another problem with dementia and one of the confounding factors,
is that depression can be a byproduct or co morbidity
of dementia. Because you recognize that your life is changing
in ways that you're not happy about. You can't communicate anymore,
you forget stuff all the time, you can become depressed.
(29:29):
So then that could lead to you giving up on
taking showers and dressing as well.
Speaker 1 (29:33):
Yeah, and not only depressed, but agitated and aggressive riddle
with anxiety. A lot of your emotional well being and
emotional health will be slipping away from you.
Speaker 4 (29:45):
Yeah. And again this can be a direct result of
chemical changes in your brain due to dementia, or it
can be like this is the result of you recognizing
these changes and just becoming upset about them.
Speaker 1 (30:00):
We talked about communication and the hallucinations. You're going to
have trouble sleeping as well in a lot of cases. Yeah,
and then personal safety. A lot of people die every
day because of accidents that happen as a result of dementia.
Speaker 4 (30:15):
Right, People who shouldn't be driving to get into cars.
And there's this there's a push that's going on now,
I think in the last year or so as part
of the Council line Aging, like the United States Council
line Aging, there's a new initiative called the Dementia Friendly
America Initiative.
Speaker 2 (30:32):
Really neat.
Speaker 4 (30:33):
Yeah. It's basically saying, look, we've got about one in
eight people over sixty five in the US have dementia.
We're about to have way more than that in the
next couple decades. We need to be prepared for this
kind of thing. So let's start training America how to
recognize the signs of dementia and then how to react
to it in a friendly and helpful manner so that
(30:55):
people who are wandering around with dementia don't withdraw eighty
thousand dollars from their bank account and walk around with
it in their pockets outside.
Speaker 2 (31:05):
Yeah, and how do you do that.
Speaker 1 (31:06):
You get some money from the government as a grant
to go out and hire people to literally go to
businesses and go to restaurants and talk to waiters and
waitresses or should I just say waitrons, go to banks
and talk to tellers, go to anywhere where there's interaction
with another human, grocery store check out people, and literally
(31:30):
train them on, like you said, how to recognize it
and how to kindly deal with these people.
Speaker 4 (31:36):
Right exactly. Apparently one of the things you teach people
in service industries is not take it personally. Right that
if somebody's behaving irratically or they're using incorrect words, and
they're of a certain age, the chances are they probably
have dementia, and there's ways of dealing with it. Apparently,
responding to it in a soft, friendly manner tends to
(31:59):
get results from the dementia patient, especially if you are
not being an aggressive jerky, right exactly, Just being nice
will yeah, frequently get good results. And yeah, it is
a pretty neat initiative.
Speaker 2 (32:16):
Absolutely and necessary. Yeah, you know, but.
Speaker 4 (32:21):
It's it's I'm stricken by the idea that people are
planning out this far ahead. Yeah, for this kind of thing.
Speaker 1 (32:29):
It's exceptional, it is, and it's scary but awesome. So
if you do have a family member, one thing that's
important to remember. There's something called the caregiver burden that
my dad and his wife definitely experienced. It is really
really tough on you, on your family, and it can
actually take a physical toll. They have some stats here
(32:52):
if you your risk of death as a woman if
your husband has dementia increases twenty eight percent eight percent
in the first year after they're diagnosed. Yeah, and only
twenty two percent for a husband whose wife is diagnosed,
and then.
Speaker 4 (33:10):
Still pretty significant incag sure, just from the dementia diagnosis.
Speaker 1 (33:15):
And what they recommend in this article is to take
care of yourself first, because they found that if you
are not going into this with the right attitude and
you are upset or have anxiety, you're just gonna do
more harm anyway.
Speaker 2 (33:31):
So get yourself right, take care of yourself.
Speaker 1 (33:34):
And go into it in the right frame of mind,
and you'll actually be able to help better.
Speaker 4 (33:37):
Yeah, And this caregiver burden or caregiver burnout is a
very real thing physically too, Like you have low energy,
you're you have low productivity, you become snippy, resentful, angry,
and you can end up basically mistreating your own parent
or spouse. Yeah, because you're so upset with this horrific disease.
(33:59):
One of the all of dementia is that there's no
two days that are alike. And when you're dealing with
the dementia patient, what worked yesterday isn't going to necessarily
work today. Well, if you can no longer predict what
your life is going to be like from day to
day and you're spending I think I saw this one
study that found an average of twenty two hours a
(34:21):
week of unpaid care by spouse's wives, daughters, that kind
of thing, you can very easily get stressed out. The
main thing you have to do is ask for respite care.
Like you can't do it by yourself. You have to
have other family members, members of your church, your community
come and give you a break so you can go
(34:43):
do other stuff for a while. Absolutely, and I mean
you could totally see how you could just very easily
evolve a really unhealthy dynamic if you're just trying to
do it yourself. Because you lose perspective. This becomes your norm,
even though it's totally abnormal.
Speaker 1 (35:00):
Yeah, and boy, you talk about a really sad way
to damage what previously was a good relationship with a
parent or something is devastating, you know.
Speaker 2 (35:12):
So there are drugs that they use to help stave off.
Speaker 1 (35:16):
Dementia, mainly right now. They are colon esturays inhibitors, and
they suppress colon esterrays, which is an enzyme that breaks
down acetylathena colin, which we've talked about before. That's what
(35:36):
helps transmit messages between neurons.
Speaker 4 (35:40):
So that will help, Yeah, because if you're not communicating
as much as you were before, at least the communication
that is going on can stick around longer, exactly. You know.
It seems primitive as far as like brain drugs go,
but it makes sense, you know. Yeah.
Speaker 1 (35:59):
And then there's another one, and are they still using
this belief mamantine and it inhibitates inhibits glutamate, which we
talked about before, which causes neuron death when overstimulated.
Speaker 4 (36:12):
Yeah.
Speaker 2 (36:12):
I can't remember where we talked about that one either.
Speaker 4 (36:14):
I just remember glutamate from the Umami episode.
Speaker 2 (36:18):
Yeah, it was definitely that one.
Speaker 4 (36:20):
And then there's also stuff you can so these drugs
will help some.
Speaker 2 (36:25):
That's for non vascular dementia.
Speaker 4 (36:27):
Right. With vascular dementia, you're gonna want to take blood
thinners that's superagulates, yeah, to keep more strokes from coming
along and making the whole thing worse. And then with
like Louis Body disease, to deal with things like the
hallucinations and stuff, you will probably also be given anti
psychotics as well. And one thing that they're starting to
realize more and more is very difficult to really figure
(36:50):
out what kind of dementia people have just from what's
the scan MRI scan, and you can really go back
and accurately identify types of dementia from autopsies right right,
And so for more and more autopsies, they're finding that
there's a lot of what's called mixed dementia where you
(37:13):
have Alzheimer's and vascular dementia, or where you have Alzheimer's
and Louis Body's disease. And so it can be really
tough to suss out all the different kinds of dementia
a person might have. But if you can do that,
then you can you can put them on a drug
regimen that could really kind of help more than just
treating the Alzheimer's, letting the Louis body go unrecognized and
(37:36):
rampant they're unchecked. There's also preventative stuff you can do too.
Oh yeah, yeah, like what crossword puzzles?
Speaker 1 (37:46):
Yeah, I told you. Emily's grandmother, Mary is ninety five. Yeah,
and very sharp. Yeah, and she does.
Speaker 2 (37:54):
Word puzzles all the livelong day and is soku.
Speaker 1 (37:59):
Yeah she does. She does all kinds of word puzzles. Yeah,
things that I have never even heard of.
Speaker 4 (38:03):
Supposedly that helps stave it off. Yeah, apparently this one's great.
Alcohol moderate alcohol consumption, which is two a day or
for men or one a day for women. Okay, it
has a protective effect. It staves off, stays off dementia.
They're not sure why, they're not sure what kind of
alcohol is the best. They just know that for some reason,
(38:27):
alcohol has a protective.
Speaker 1 (38:29):
Effect, probably up to that two drinks, and then it's
probably bad after that.
Speaker 4 (38:33):
Yes, then it becomes very bad after that. Yeah. So
you want to just moderate them.
Speaker 1 (38:37):
Ount right, in all things, people, moderation, moderation, And then
there are some things that you can do.
Speaker 2 (38:48):
Here's the thing.
Speaker 1 (38:49):
There's a debate on whether or not you are tricking
your loved one by doing things like giving them an
appliance that doesn't work, so they can pretend that they're
ironing or something because they used to love to take
care of their laundry themselves. So here, let me remove
(39:10):
the cord from this iron and and is.
Speaker 2 (39:14):
That tricking someone?
Speaker 4 (39:15):
Is it not?
Speaker 1 (39:16):
And a lot of people think, no, that's what you
should do because it makes them feel like they're being useful.
They're not gonna get hurt or hot iron, so it's
all good. Other people say no, that means that they're
not hanging on to that last bit of reality they
may have.
Speaker 2 (39:33):
I think it's fine.
Speaker 4 (39:34):
I think it's fine too. And there's actually there's a
an entire village set up in I think like just
outside of Amsterdam.
Speaker 2 (39:43):
Yeah, this is awesome, called Hojuwei.
Speaker 4 (39:45):
Right, Yeah, how would you say that?
Speaker 1 (39:47):
I have no idea, because Dutch is the weirdest, the
weirdest language.
Speaker 4 (39:52):
We'll say that, okay, okay, And it's a it is
a it's an what's called the dementia village basically, yeah,
where everyone who lives in this village. I think one
hundred and fifty people all have dementia, and they live
in group houses.
Speaker 2 (40:08):
They're well, there's caretakers that live there too, but.
Speaker 4 (40:10):
Okay, yes, you're right. Yeah, and they live in the
group houses with them. Yes, And a lot of the
people realize that this is their nurse or just think
it's a good friend of theirs. Yeah, they don't really
remember where when they became friends, yeah, exactly. Yeah. And
the houses they live in have different themes according to
how the people lived, depending on whether they're blue collar,
(40:33):
whether they their memories go back to the seventies. This
whole place is basically set up so that it's a
very non threatening safe place for these people just kind
of live and move about within sure safely, yeah, safely.
And so they can go to the grocery store, they
can go to the movies, they can go ride a bike.
Speaker 1 (40:55):
And everyone, the people at the movie theater know that
the people there have dementia, right like every they're real
movie theater workers and real waiters in the restaurant, especially
trained exactly. So it's a less clinical setting than say
a nursing home. And a lot of people say this
is awesome because it's as close to real normal life
(41:16):
that they were used to as they're going to get Yeah, exactly.
Then of course there's other people that poopoo and say no,
you're tricking these people.
Speaker 4 (41:22):
But you can say, hey, okay, here's the big difference
with this place. If this, If this dementia patient gets
lost in Manhattan and they run across a city worker
who's collecting garbage, that city worker may do absolutely nothing
to help them.
Speaker 2 (41:39):
Yeah.
Speaker 4 (41:40):
In HOJV village, Yeah, that city worker especially trained to
get that person back to their house or alert their
caretaker that this person is having a crisis or something
like that.
Speaker 1 (41:52):
It's what we're trying to train people to do in
the future. Yes, they've just isolated it to a community.
Speaker 4 (41:56):
Yeah, so there's I mean, when you break it down
to that distinction, I don't really see anything wrong with it,
especially when you are protecting the patients themselves. It's not
like you're doing it to experiment on them, no, no,
you know, or because they'll produce gold in their urine
or something like that. You know, like this is strictly
(42:18):
for their protection, yeah, but also allowing them to live
a free life outside of a clinical setting, right, I
don't see much wrong with that, I do get what
the bioethicists are saying, like, yeah, sure, you're robbing someone
of their dignity by lying to them, by diluting them,
or playing into their fantasies. Strictly speaking, Yes, in the
real practical world, I think this is great.
Speaker 1 (42:39):
If I'm at that point, then and play into my
fantasy exactly, please.
Speaker 4 (42:44):
It is nineteen eighty four all the time.
Speaker 1 (42:49):
In fact, one of the people that work there say
that people that do criticize it at a very good point.
He's like, they don't understand what we're doing here. These
aren't actors. They're like real employees of these places. They're
just helping out right, you know.
Speaker 4 (43:02):
And so Hojvei village. I hope I'm saying that right
because I'm really putting myself out there.
Speaker 2 (43:07):
Oh, I'm sure you're not.
Speaker 4 (43:09):
It's become this kind of ideal standard of care. But
it's also really expensive.
Speaker 2 (43:15):
Yeah, I'm sure.
Speaker 4 (43:15):
So in a country where there's a lot of socialized medicine,
it could do pretty well, like in the Netherlands or
in Canada.
Speaker 1 (43:22):
Yeah, when they take care of people even though they
don't have money, right, Exactly.
Speaker 4 (43:25):
There's one called in Canada. It's called Pentanguishani Pentanguishini, Ontario.
They have one, it's a little smaller than the one
in Amsterdam. They're also building one in Miami as well.
So it is starting to take hold. People do believe
(43:45):
in it, and apparently the patient's families are very happy
with this kind of thing too well.
Speaker 2 (43:51):
And hopefully with the initiative of what's it called All.
Speaker 1 (43:54):
Dementia America DFA, yeah or yeah, hopefully with those efforts,
more and more people will because it's coming.
Speaker 4 (44:04):
Oh yeah, it's coming.
Speaker 2 (44:05):
A lot more folks are going to be out there
that we need to take care of.
Speaker 4 (44:08):
Yeah, we don't know how to cure dementia. We just
know it's coming.
Speaker 1 (44:13):
I'm going to be one of them, you think, so
sure at some point if I make it that long.
Speaker 4 (44:20):
But you know, not everybody gets dementia no matter how
long you live.
Speaker 2 (44:24):
I don't know.
Speaker 1 (44:24):
I got a feeling really, yeah, it does run in
my family a little bit. Yeah, and I have my
father's family jeans more than my mother's. I feel like,
so if if I had my mother's jeans, they all
died from heart attacks and strokes and heart disease.
Speaker 2 (44:45):
Young, not a lot of cancer. Yeah pretty young.
Speaker 4 (44:48):
Yeah, so if you make it past sixty five, yeah,
you beat the heart stuff.
Speaker 2 (44:54):
Than the Bryant jeans.
Speaker 4 (44:57):
Yeah. Well we're all going down one way and they love.
Speaker 2 (44:59):
To be a hundred.
Speaker 4 (45:00):
Yeah you know, yeah, man, I thought it was something.
Oh yeah, I wonder, Chuck, if like our specific like us,
you and me specifically, creaming all this information in every
week is actually beneficial, or if we're just setting ourselves
up for massive cases of dementia because we're just pushing
(45:21):
stuff in and getting it out, pushing in new stuff
and getting it out, Like are we abusing our brains
or are we exercising it? I question that sometimes.
Speaker 1 (45:29):
I bet someone out there, I bet there's a neurologist
who has a good gut instinct answer to that.
Speaker 4 (45:34):
Let us know. I want to know good news are bad? Okay, neurologists.
Speaker 1 (45:39):
There's going to be a subject a line that just says, neurologists, guys,
you're screwed.
Speaker 4 (45:44):
Yeah, I have bad news. If you want to know
more about dementia, you can type that word into your
favorite search engine and it will bring up tons of
information and great resources. You can also type it into
the search bar house to works and it'll bring up
a great article. Since I said search bar, its time.
Speaker 1 (46:00):
For listener mil I'm gonna call this when Hecky Krasnaw
lives okay, although I don't think he is with us. Hey, guys,
only just started recently listening to the show. It's been
a fantastic way to pass time and learned something interesting.
Speaker 2 (46:18):
I'm a home taught high schooler.
Speaker 1 (46:19):
So every time I listen to an episode of your show,
I get a history or science credit.
Speaker 2 (46:24):
How about that.
Speaker 4 (46:25):
That's pretty great.
Speaker 1 (46:26):
But as great as that is, it's not why I'm emailing.
I actually have a fun fact for you guys from
your playto episode in which you mentioned Captain Kangaroo. Well,
my great grandfather worked on that show. He produced the
songs for it, as well as several Christmas carols, including
Frosty the Snowman and his biggest claim to fame.
Speaker 2 (46:46):
Rudolph the Red Nose Reindeer.
Speaker 4 (46:48):
That is awesome.
Speaker 2 (46:49):
I've always thought it was.
Speaker 1 (46:50):
Very funny that a Jewish guy was responsible for the
popularity of Christmas carols.
Speaker 2 (46:54):
My family all still.
Speaker 1 (46:56):
Jewish watches the Claymation Rudolph movie every year. Begare because
of that our own little taste of that irony.
Speaker 2 (47:02):
Yeah. I don't want to tell.
Speaker 1 (47:04):
You what to do, because I'm sure you have a
lot of episodes on your plate already, But I'm just saying,
Hecky Krasnaw was a pretty interesting person. There might just
be enough material for an episode on him up to you.
Speaker 4 (47:17):
Nice.
Speaker 2 (47:17):
Thanks for helping me with my school work. That is
from Aiden in Maryland.
Speaker 4 (47:22):
Awesome, Thank you very much. Aiden.
Speaker 2 (47:24):
And when I say Hecky Krasnew lives, I mean lives.
Speaker 4 (47:27):
On sure like Viva La Hecky. Yeah, if you want
to tell us about someone interesting in your family, we
love that kind of stuff. Also, if you are caring
for a dementia patient, we want to hear the highs
and the lows of that. Just kind of bringing on
home for us. Will you? You can send us an
email to stuff podcast at house Stuff works dot com
(47:47):
and as always, joined us at our home on the web,
Stuff Youshould Know dot com.
Speaker 3 (47:54):
Stuff You Should Know is a production of iHeartRadio. For
more podcasts my Heart Radio, visit the iHeartRadio up, Apple Podcasts,
or wherever you listen to your favorite shows.
Speaker 4 (48:09):
Mm hmm
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Chuck Bryant
Josh Clark
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