Dementia Matters

When talking about dementia caregiving, researchers are often working toward new treatments and strategies for supporting people with Alzheimer’s disease and dementia. But how can we push the topic further and learn how we can better support dementia caregivers themselves? Dr. Eric Larson joins the podcast to discuss possible interventions to support patients with dementia and their caregivers and care partners. Dr. Larson chaired a National Academy of Medicine committee focused on researching dementia caregiving interventions. As part of their report titled “Meeting the Challenge of Caring for Persons Living with Dementia and Their Care Partners and Caregivers: A Way Forward,” the committee found that two models, the Collaborative Care Model and REACH (Resources for Enhancing Alzheimer’s Caregiving Health), had the most evidence of benefits for supporting people with dementia and their care partners and caregivers. Discussing this new report, the recent approval of aducanumab, and the field of geriatrics as a whole, Dr. Larson shines a light on the nuances of dementia research and dementia caregiving.

Guest: Eric Larson, MD, MPH, Senior Investigator, Kaiser Permanente Washington Health Research Institute

1:07 - What sparked your interest in becoming a geriatrician and Alzheimer’s disease/dementia researcher?

2:35 - What would you say to young medical students looking for a specialty, and even considering geriatrics?

3:33 - Why do you think the field fails to attract younger doctors?

5:13 - What is the role of the National Academy of Medicine, and why did it conduct and release this report on caregiving?

7:29 - Can you offer us a brief summary of the findings or the key things that you think our audience should know about?

10:48 - What are the current limitations of the existing research on dementia care interventions for patients and caregivers, and how can we overcome those limitations?

12:38 - What is the difference between a care partner and a caregiver as you note in the report?

14:03 - What are some community, policy, or societal interventions that really should be explored?

15:46 - Does this report mean that we stop programs with low-strength of benefits, and if not, how do we continue to evaluate these programs and expand on them?

17:12 - Given the FDA approval of aducanumab, do you worry that more attention and resources will be pulled away from care work and care partner/caregiving that’s needed in research and clinical care toward this medication?

19:42 - What would you say to someone about to become an Alzheimer’s disease caregiver or care partner?

Read Dr. Eric Larson’s bio on the Kaiser Permanente Washington Health Research Institute’s website.

Find a free download of the National Academies’ report, “Meeting the Challenge of Caring for Persons Living with Dementia and Their Care Partners and Caregivers: A Way Forward,” here.

To learn more about the National Academies, find them on their website. For information about their research, publications, and events focused on dementia and Alzheimer’s disease, visit this page from their website.

Find other resources related to this report by the National Academy of Medicine here:

• Report Highlights

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Vince Tien and Dr. Dung Trinh join the podcast to discuss the many ways Alzheimer’s disease affects the Asian Americans and Pacific Islanders (AAPI) community. Vince Tien and Dr. Trinh both work as part of 360 Clinic, a multi-specialty medical group focused on telehealth services. With their experience in healthcare and telehealth services amidst the pandemic, Tien and Dr. Trinh describe the barriers and stigma that discourage the AAPI community from seeking help for dementia and the ways that we can dismantle those barriers. 

Guests: Vince Tien, co-founder, CEO, 360 Clinic, and Dung Trinh, MD, chief medical officer, 360 Clinic

Episode Topics:

1:13 Vince Tien, what is your background in healthcare? How did you get involved in Alzheimer's disease and dementia care?

3:43 Dr. Trinh, what is your experience in caring for people with Alzheimer’s disease and dementia?

6:06 What are the health-related needs of AAPI communities? And, when it comes to dementia and Alzheimer’s disease, what are these communities’ needs?

7:44 Is there a certain perception of dementia, Alzheimer’s disease, and cognition within the AAPI community? 

9:22 How do you find common ground between accessibility issues of technology and the benefits of telehealth?

13:07 What role does stigma play in the Asian American or Vietnamese communities specifically when it comes to Alzheimer’s disease? How does it affect caregiving and family members?

14:18 How do we start destigmatizing Alzheimer’s disease, dementia, and cognitive change within the Asian American community?

16:06 How does healthcare address the cultural, economical, linguistic barriers that Asian Americans experience regarding public health messages and care?

17:18 How can healthcare systems and organizations provide care for underresourced and underrepresented families who are suffering from dementia-related illnesses?

19:58 What would be the one thing you’d want the Asian American community to know about Alzheimer’s disease and dementia care?

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Show Notes:

To learn more about 360 Clinic, find them at their website, Instagram, and Twitter.

Learn more about Dr. Dung Trinh at his LinkedIn and his Facebook Page.

Learn more about Vince Tien at his LinkedIn.

What would happen if caregiving strategies were inspired by wonder rather than memory? That’s what Dr. Anne Basting, founder and president of the nonprofit TimeSlips, asked when she began her research into how the arts could be integrated into dementia caregiving. Basting joins the podcast to discuss her caregiving approach rooted in creative engagement and imagination. From storytelling to beautiful questions to performance, Basting describes a new way of caregiving that helps caregivers and families meet patients and loved ones where they’re at to have meaningful connections and spark joy in the later years of life.

Guest: Anne Basting, PhD, professor of English at the University of Wisconsin-Milwaukee, founder and president of TimeSlips, author of Creative Care

1:31 - What inspired you to bring the arts and humanities to dementia care?

4:51 - Why did you write Creative Care, and what do you want readers to leave with?

7:49 - What are “beautiful questions” and can you offer a few examples?

14:32 - What is in the Creative Care Imagination Kit and why is each component important to the process?

15:49 - You’ve staged theater productions in care facilities as part of this process. How do performers in these plays respond to being a part of theater and how does the audience respond to the performances?

18:43 - How can people get involved in this organization and what do you recommend to people who would like something like this in a local care facility?

19:48 - What would you say to someone about to embark on the caregiving journey with someone with dementia?

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Read Anne Basting’s biography on her website.

Learn more about Anne Basting’s book, Creative Care: A Revolutionary Approach to Dementia and Elder Care, and her Creative Care Imagination Kit on her website here.

Learn about Anne Basting’s nonprofit organization, TimeSlips, at its website for information on services, resources, and ways to get involved. Also find TimeSlips on Facebook, Twitter, Instagram, and YouTube.

Researchers have produced many studies on how smoking affects parts of the body, such as the lungs or heart, but what about the brain? In today’s podcast, Adrienne Johnson, PhD, discusses her research on cigarette smoking and risk for dementia and Alzheimer’s disease. As part of a 2021 study, she found a person’s risk for dementia and Alzheimer's disease can be affected by how recently they’ve smoked. Diving into her research, the effects of smoking on different communities, and resources to support current smokers as they quit, Dr. Johnson details the impact of smoking on the brain and her hopes to develop new interventions to motivate smokers to quit for good.

Guest: Adrienne Johnson, PhD, assistant scientist at the University of Wisconsin Center for Tobacco Research and Intervention

1:17 What sparked your interest in studying the effects of cigarette smoking and, particularly, how it affects cognitive decline?

3:47 What are the effects of smoking on Alzheimer’s disease risk and/or general cognitive decline?

5:28 Why do you think there’s a difference in risk levels for Alzheimer’s disease and then for dementia?

6:27 Are there other things you can share about what you have found with your preliminary studies on smoking as a risk factor for Alzheimer’s disease?

8:38 You haven’t found a quantity relationship between the amount a person smokes and their risk for Alzheimer’s disesase, but rather a relationship based on smoking recency. Could you describe that further?

11:12 You’ve also done work on how there’s more disadvantaged communities that might be suffering from tobacco use compared to others. Can you speak on that?

13:01 How can caregivers and/or family motivate or support current smokers so that they can quit?

14:25 Is there a difference in a population that already has cognitive impairment? Do you have different strategies that we might use to support those individuals?

18:16 What are you looking to study in the future?

19:21 Can you share some resources where listeners can get help to stop smoking or where they can find resources for a loved one?

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Read Dr. Adrienne Johnson’s biography on the UW Center for Tobacco Research and Intervention (UW-CTRI) website.

To learn more about the UW Center for Tobacco Research and Intervention (UW-CTRI) and the work they do, find them on their website, Twitter, Facebook, YouTube, and Instagram.

Find resources on how to quit smoking here:

• Learn more information about smoking, vaping, and how to quit at https://ctri.wisc.edu

Elisa Ghezzi, DDS, PhD, joins the podcast to discuss the importance of maintaining oral health throughout one’s life, and especially as one grows older. Discussing the effects of oral health on our systemic health, oral health’s connection to dysphagia, and how caregivers can help dementia patients care for their teeth, Dr. Ghezzi provides insight on how vital it is to care for our oral health as we age.

Guest: Elisa Ghezzi, DDS, PhD, adjunct clinical assistant professor, University of Michigan School of Dentistry, provider, Voiage Portable Dentistry

1:15 - How did you get interested in oral health in older adults?

3:28 - Why isn’t there more training or education in general dentistry for an older population?

4:34 - What are oral diseases, and what are their effects on systemic health?

6:00 - Is there an association between oral disease and cognition or cognitive impairment?

8:50 - IDoes inflammation affect oral health?

10:00 - What can be done to prevent oral conditions?

13:39 - What can we do to help protect our teeth?

16:38 - What should older adults and people who are experiencing dementia do about flossing?

19:05 - For our audience members who might be caring for someone who has dementia,, what recommendations would you offer when the person they are caring for is resistant to the act of having someone brush their teeth?

22:10 - What is the relationship between oral health, oral disease, and dysphagia?

28:20 - What is the most pressing issue facing older adults and their oral health care?

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Dementia Matters has entered into the 2021 People's Choice Podcast Awards! If you enjoy our show and want to support us, register and vote before July 31st at www.podcastawards.com, and vote for us under the Health and People's Choice categories. We, the Dementia Matters team, hope that by participating, we can continue spreading our message and educate new listeners about Alzheimer’s Disease, Dementia, and brain health.

Our background music is "Cases to Rest" by Blue Dot Sessions.

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Neurologist and author Daniel Gibbs, PhD, joins the podcast to discuss his recent book, “A Tattoo on My Brain,” which details his journey from treating Alzheimer’s disease clinically for 25 years to being diagnosed with early-stage Alzheimer’s. Dr. Gibbs discusses early signs he experienced and daily life with the disease, as well as thoughts on the recent FDA-approved treatment aducanumab (marketed as Aduhelm).

Guest: Daniel Gibbs, PhD, neurologist

What inspired the title of your book, “A Tattoo on the Brain”? 1:01

What were these early signs of Alzheimer's disease that you recognized in yourself? 3:42

What were your impressions of the clinic process, and where is there room for improvement? 8:08

Can you share your view on family history? 9:17

What do you say to people about direct-to-consumer genetic testing, both as a recipient and as a clinician? 10:57

Did knowing your risk of Alzheimer's disease help or harm you? 12:42

Did you find any habit difficult to incorporate into your day? 13:17

How important was it for you to be involved in research and what did you gain from being a research participant? 17:15

How do you feel about the recent FDA approval of aducanumab for clinical use? 20:25

As a patient, would you sign up for this drug, and if you were still working as a neurologist, would you prescribe this drug? 22:59

How do you find the balance between enjoying daily life and engaging proactive activities meant to improve the future? 24:49

How can we reframe the way people understand Alzheimer's disease? 28:18

Was it difficult to publicly discuss your experience, and what have you learned from this process? 29:52

What do you hope the reader takes away from your book? 31:15

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For our 100th episode of Dementia Matters, Nina Silverberg, PhD, director of the Alzheimer's Disease Research Centers (ADRC) Program at the National Institute on Aging (NIA), joins the podcast to offer an overview of the ADRC Program as well as insight into the state of Alzheimer’s Disease research and its future. The NIA funds more than 30 Alzheimer’s Disease Research Centers across the country, including the Wisconsin ADRC.

Guest: Nina Silverberg, PhD, National Institute on Aging

Visit alzheimers.gov for information about Alzheimer's disease and related dementias, living with Alzheimer's disease, and caring for someone with the disease. The NIA's website provides helpful information about brain donation and offers a variety of publications on health topics related to dementia and aging.

• How did you get involved with Alzheimer's disease? 1:32

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Neuropsychologist and author Michelle Braun, PhD, joins the podcast to talk about lifestyle changes that can support brain health. “We have the ability to make our brain younger than our chronological age,” she says. Braun shares how and details strategies from her new book, “High-Octane Brain: 5 Science-Based Steps to Sharpen Your Memory and Reduce Your Risk of Alzheimer’s.” Hear about common misconceptions around aging, three possible brain health trajectories, and how to maximize your brain health.

Guest: Michelle Braun, PhD, neuropsychologist and national leader in the field of brain health

• What are the most common complaints that can be attributed to normal aging? 1:29

Dr. Braun will be a guest speaker at the Wisconsin Alzheimer’s Disease Research Center’s "Healthy Living with Mild Cognitive Impairment: Nutrition in Action" class on June 18, 2021. The class will be held virtually on Zoom and is free and open to the public. Register Here.

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Researchers at the University of California, San Francisco found that among older adults with cognitive impairment, the greater the air pollution in their neighborhood, the higher the likelihood of the presence of amyloid plaques in their brain. Lead researcher Leonardo Iaccarino, PhD, details his work examining air pollution and brain health outcomes and discusses possible ways individuals and society can lower the impact of air pollution on Alzheimer’s disease risk. 

Guest: Leonardo Iaccarino, PhD, University of California San Francisco Memory and Aging Center

• What sparked your interest in neuroscience and Alzheimer's disease research? 1:06

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