Selects: How Dementia Works | STUFF YOU SHOULD KNOW

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 4th, 2015. Uh, but there's some really good. information in it. Uh, if you are. suffering from dementia or someone in. your family is suffering from dementia, you have our uh, 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. So, how dementia works right here, right. now. Welcome to Stuff You Should Know, a. production of iHeart Radio. Hey, and welcome to the podcast. I'm. Josh Clark with Charles W. Chuck Bryant.

and null. The stint of null continues. Everybody's like, "Stuff you should. null." No. No, that's not what we're. calling it. It's the stint of null. All. right. Stuff you should know. That's too. clever. Yeah, it's a little cutesy. Yeah, that's. all. All right. That's my only aversion. to it. All right. What do you Are you. with stuff you should know? changing the. name of our show after eight years now. No, just the uh null stint. The name of.

it. Remember the summer of Sam? Oh, yeah. Yeah, sure. Why not? I don't like. it. All right. Should we come up with. the third idea? Yeah. The stint of null. sounds too much like something's wrong. with null. That's why I like it. It's. hilarious. There's nothing wrong with null by God. And if you think there is, you need to. answer to me. There's something you. should know. Now, see, that's what I'm saying. Yeah. It sounds like something uh Strickland.

would have come up with. You know, man, we haven't been in a flame war with. Strickland in a while. It has been a. while. It's been too long. It's gotten. soft. You just launched one across the. bow. So, um Chuck, yes. Are you familiar. with dementia? Uh yeah, sure. Are you. running in your family? doesn't run in. the family, but my grandmother who lived. to be hundred uh had dementia at some. point, which you know, when you live to. be 100, that's I don't know about.

likely, but it's not surprising. It's. probably pretty likely. It's um it's. not, from what I understand, it's not a. um just a natural consequence of age, right? But it it's pretty prevalent. Sure. Um and dementia is 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, right? It's a set of symptoms that's. brought on by disease. Yeah, I think. that is widely misunderstood. Yeah. Uh.

but you are totally correct. A set of. symptoms and. um it is not just your garden variety um. forgetfulness that comes as you age. No, cuz that is age related and normal. That. is a totally age related thing. It's. called age associated memory impairment. and that is uh I think I mean that. happens to everyone right it's just like. you forget your keys more often that. kind of stuff sure but when you do. forget your keys more often you go snap.

your finger and go I forgot my keys. again what is wrong with me. that's normal one of the big tells of of. true dementia is when you don't realize. that you're forgetting right so that's. that's when it gets scary right and um. 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 dementia. Yeah. Not.

entirely certain. But um it is very. widespread among the aged population. In. the United States, I think 5.3 million. Americans have dementia right now. Wow. And as our population ages, because the. baby boomers are starting to get older, um I think they're expecting something. like 16 million Americans are going to. have it by 2050. 16 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 2050. Yeah. And it's very. expensive, actually. Uh how much money? A lot. You ready for. this? Yeah. In 2015, we have spent. $226 billion on health care for dementia. alone. Wow. Um, and they're expecting. by, I believe, 2050 when we are caring. for 16 million in 2015, not futuristic, much more inflated $250, $2050, right?

In 2015, we'll be spending about $1.2. two trillion dollars on dementia if. somebody doesn't do something, man. Yeah. It's It's very expensive. It's. also extraordinarily sad as far as um. diseases or symptoms of diseases. Yeah. Yeah. And uh I also want to recommend. our May 2011 episode, a podcast to. remember. Oh yeah. 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. Or if you listen to it and.

forgot, go back and listen to it. That's. right. Uh so dementia itself is not um. diagnosed uh it's not simply memory. loss. It's memory loss um along with one. of the following at least one of the. following one or more. Um aphasia which. is uh if you can't understand or produce. language any longer. Uh araxia and all. these are super sad if you've ever seen. them up close. Uh araxia if you cannot. make certain movements even though your. body physically is healthy right? um.

agnosia, which is uh you don't recognize. um objects like the remote control or. your grandkids, stuff like that. Uh and. then executive dysfunction um when you. have a lot of troubles planning and. organizing and reasoning. So that along. with the memory loss, at least one of. these, you could be diagnosed with. dementia, right? And so like we said, dementia is a set of symptoms, right? Yes. It's it's actually brought on by. disease. And the most common cause of. dementia, I think something like um 60.

or 70% or something like that of. dementia um cases is brought on by. Alzheimer's disease. I could have sworn. we did one in Alzheimer's, but we have. not. Yeah, I don't think we have. I. don't know. We've talked about it. enough. I think it's Yeah, it's popped. up plenty of times, but we've never just. done a straightup Alzheimer's one. Alzheimer's um brings on dementia. through um something called. neuroiary fibrillary tangles also known. as beta I'm sorry tow protein tangles.

Yeah. And um beta amalloid plaques. right. Yeah. And the the plaques are. like just a protein buildup a sticky. protein buildup. 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. Yeah. 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 that are that lead from.

these synapses or 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 tow or beta amaloid plaques. and tow proteins in the cells, then what. you have is Alzheimer's. Yeah. And uh. they aren't sure the cause of. Alzheimer's still. Um genetics is uh. they think has a lot to do with it. Um. and you can live with Alzheimer's for a.

while. Uh up to a decade, although they. said in this article, Molly says 3 to 5. years is uh more common. So yeah, it. definitely shortens your lifespan. And. like you said, um genes are definitely. part of the risk factors. Um a. polyoprotein a poloprotein E. Okay. I. think um 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 do with the tow protein tangles or. anything like that. as far as I know. That's weird. Um, also if you have a. family history of dementia, you're you. have a of Alzheimer's, you have a higher. likelihood. Um, and then if you um have. Down syndrome, uh you are at a higher. risk of developing Alzheimer's in middle. age. Oh, really? Yeah. Interesting. So, um that's and we will do one on. Alzheimer's, but that's how Alzheimer's. can cause dementia. Uh there's also uh.

vascular dementia which is uh that was a. case with my grandfather who he had a. stroke and it accounts for about 20% of. dementia cases and uh you know a stroke. is when you have a a loss of blood. supply to the to the brain or a. hemorrhage and or blood clot and it can. be either um one big stroke event uh. which causes a lot of damage and that's. a single infar dementia right or it can.

be a lot of uh the accumulation of uh. symptoms because of a lot of little mini. strokes you have over the years, right? And then the damage just builds up and. you finally once once that last one that. that is the straw that breaks the. camel's back. Yeah. And you have. dementia. Um that happens pretty rapidly. after that last that last one that last. stroke you have. Yeah. And that's. multi-infark when it's a bunch of them. Um and little mini strokes are common a. lot. Sometimes you have them and don't. even realize you've had them. Right. Uh.

with my grandfather, he he had the big. one and Oh, really? Yeah. We talked. about this before and I think something. about speech, but um yeah, he lost his. ability to speak uh you know, English. Mhm. Uh so that would be a fasia. Yes. He couldn't produce language. Well, he. produced Yes. He could not 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. Uh, you know, I know how to how I'm supposed to uh my.

grandmother is driving us, let's say, and he she doesn't know how to get. there. He does, and he can't tell her, but he's telling her. Yeah. It's just. coming out all mixed up. And that's. that's a hallmark of dementia is um. 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 withdraw. They'll just. give up on communicating at all because.

it's too frustrating or just too sad, you know. Yeah. Um which is a it's one. of the common results of dementia. It's. a comorbidity. No, it's a complication. Yeah. And then and with the uh single. stroke event um or actually or with the. multi uh strokes, it's different for. everyone. 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 uh you know paralysis on one side. of the face or body uh 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, right? That was like the. most noticeable thing. I remember you. telling me about your grandfather. before. I don't remember what it was. You're talking about speech like where. Nikki's area or Broke his area. Yeah. Yeah. Something like that. Totes. So. with Alzheimer's, it first attacks the. hippocampus, which means that it's going. to take away your um episodic memory,

which is your memory of recent events, right? Yeah. uh and then it starts to move its way. into other areas of the brain where 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 um where like part of the face is. sagging or or the patient can't move. their arm or something like that. But. yeah, the personality will remain intact. because those regions of the brain.

aren't affected like they are in. Alzheimer's. Yes. And then in about 5 to. 15% of dementia cases, uh it stems from. something called uh Louis body dementia. Um which we were just talking about, they think Robin Williams might have. suffered from. He definitely did. He. definitely did. Yeah. They found in his. autopsy he had I think he was diagnosed. with it before he died and Okay. That. was one of the reasons why he took his. life. Yeah. Because that can cause. severe uh intense hallucinations. Uh. yeah, big time. Did you look those up?

Oh yeah, man. Scary stuff. 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 ba on daily basis like. just intense hallucinations. I'm sure. you think you're, you know, losing it, right? And that's one of the first. symptoms of Louisbody dementia. Uh and. it was discovered by Frederick Louie in. uh 1912. And it has has nothing to do. with your body. A louisi body is uh. there are are deposits uh again protein.

deposits of the alpha uh suclean uh that. appear on the brain. So don't think of. body in the terms of like your physical. body right uh and this is also uh. present louisi bodies and Parkinson's. So, as a result, not only are you going. to have symptoms similar to Alzheimer's. with Louisbody dementia, but also some. of the tremors and balance issues of. Parkinson's, right? Which is uh super. sad as well. Is that what Michael J. Fox. has? Parkinson's. Yeah. Yeah. And that's.

what the movie Awakenings was about, weren't they? Wasn't it like a group of. Parkinson's patients that like LDO. worked on? Was that Parkinson's? I can't. remember. I think they didn't they. didn't realize what they thought they. were locked in or something and then. they realized their Parkinson's tremors. were so acute that they were like they. were not even shaking. They were just. completely Yeah. Interesting. They're. just their muscles were totally. contracted rather than contracting and. relaxing again and again. And Robin. Williams. Yeah. How about that? Yeah. Uh. then we have something that used to be.

well it's called now fronttotemporal. dementia. Mhm. Uh, it used to be called. Pix disease, but now Pix disease is a. specific version, which I couldn't. really sus out what the difference is. Could you? No, I couldn't either. As. long as it wasn't just me, I feel. better. But, uh, FTD is a is really an. umbrella term. Um, it's about, uh, 5% of. dementia cases, and it's going to. affect, uh, personality and behavior and.

language like big time. Big time. I mean. it's where your frontal and temporal. loes are actually atrophying and. shrinking right and the reason why is um. you remember with Alzheimer's you have. beta amalloid plaques and tow protein. tangles yeah well with the front. temporal dementia you don't have the. beta amalloid plaques you just have the. towel protein tangles but it's enough to. cause massive neuronal loss yeah and. this is like I think a lot of people at. first um think they might have um. Tourett Yeah. Uh because you can uh yell.

things out, inappropriate behaviors. Uh. yeah, like if your grandfather suddenly. becomes hyperinterested in sex and like. likes to talk about it in public or. exposes himself to people in public, there's a pretty good chance that he has. developed front temporal um dementia or. if I did because um it's unusual in that. it attacks uh younger people. um it's. going to onset between 40 and 75 years. old which uh distinguishes it from other.

types of dementia. Yeah. And if your. grandfather used to do that stuff. already then that's not the case. The. the the key here is that like this has. come out of the blue. Somebody has. really just completely changed in their. personality. They might get into really. risky behavior like gambling all of a. sudden. Yeah. Shoplifting uh and you. like risky investments or like pulling. all their money out of the bank. Yep. And with Pix disease too, um the. apparently apathy is a big uh indicator.

of this. There's a big personality. change and the person is no longer they. have no empathy. They um 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? Or me. Or you. Well, yeah. You're 40 and 75. You lack. empathy. No, no, no. I'm just saying. it's Oh, I see. Because it affects young. like they turned into you. Oh, no, no, no, no. You have blunted emotions and. you gamble. Uh there's also Huntington's.

disease. Uh this is uh it seems like. much more physical in nature. Uh. uncontrollable movements. Uh although. there are changes in in personality, but. um real fidgety, herkyjerky, uh your. brain loses the ability to control. coordination essentially, right? which. is uh I think uh 50% chance of. inheriting the gene, but you can live. with it for up to 20 years. Yeah. Which seems like as far as.

dementia goes, one of the longer uh life. expecties. Mhm. 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. Um, and like we said, well, we should. probably take a break, huh? Uh, yeah. We. got a couple of more types that we'll.

talk about and then some other good. stuff. Okay. Right after this. Uh the last two, actually the last three. we're 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 uh we have talked about. Cordzfelt Yakup disease and I can't. remember which one and we say that all. the time. Is there a disease that kills. by preventing sleep? Oh, is that the. one? Which we should have rightly called. how pron diseases work. Yeah, because is. is a pron infection. Uh it's very rare. About one um out of a million people. will be affected in any given year. Like. mad cow disease. Yeah. Or kuru. Yeah.

Exactly. Um, it's a sponge form disease. Yeah. So crazy. It is. It's very. interesting. Uh, could be genetic. Um, but and I thought we also talked about. it in organ transplant. Did we? Uh, I. think so because it can occur um because. of infected tissue uh that you are. implanted with uh or from an organ. Yeah. And this is neuronal loss due to. the like holes literally being eaten. into your brain by this disease.

Yeah. Um and then you can also get. dementia um from from when you have HIV. Uh if you are a boxer or say a football. player in the NFL, you may have dementia. from a traumatic brain injury like a. concussion or repeated concussions. Yeah. Um and there are plenty of. diseases. There's also um reversible. dementia, too. If you have a vitamin. deficiency, uh if you um. uh take certain medications,

um you can develop dementia, but this is. reversible, right? For the most part. though, age associated dementia is not. reversible, right? And like we said, it's kind of tricky to diagnose this. stuff because it is normal for people to. for become more forgetful as you age. Mhm. And then to make it even more. confounding, if you're a a. diagnostician, not only are do people. get more forgetful, there's an. intermediate stage between dementia, a.

dementia diagnosis, and just normal age-. related forgetfulness. Yeah. And that is. um 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 um other diseases that lead to. dementia early, although there's no cure. for any of them, you can you can manage. them a lot better and delay say death or.

like the real devastation associated. with it. Yeah. By a significant amount. of time. But it's catching it is the. tricky part. And especially if you have. dementia, you don't really realize that. there's any kind of problem. Um, so. you're probably not going to take. yourself to the doctor. No. Uh, 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 uh. than you can, you know, that that uh. they have more perspective. Yeah,

exactly. That's what looking for. Um, so. don't get, you know, don't get offended. if if a loved one says, "Let's go get. you checked out." Because you can do. something if you catch it early on. 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. That's right. See what's up. Uh, so. if you do go get checked out, um, from. the second you walk in the door, your. doctor is going to be eyeballing you and. looking for any signs.

um just from their their trained eye. like you know from how you walk to the. way you answer questions uh to how they. interact with you. Uh they want to know. you're they're going to have to know. your history um because they need to. have some context to uh compare it to, right? Like were you always a compulsive. gambler or is this like new behavior? Yeah. And it helps to bring you know if. if um if you're older maybe bring your. grown son or daughter with you or. whoever has a lot of contact. Sure. Sure. Uh although your spouse, you never.

know what. I don't know. They may be. trying to get rid of you. Oh, yeah. Like. that. No good nephew. Yeah, exactly. Um. I'm just kidding. Of course, although. I'm sure that happens. Uh then there are. a couple of tests that they usually do. in conjunction with one another. Um the. mini mental state examination, the MMSE. Um just a lot of basic questions there. um for mental tasks, but they're coded. the tasks are. Yeah. And they're scored. individually. Yeah. Um and when you when.

you say question three, this person got. an eight on Yeah. Uh you can go over and. be like, "Yeah, dementia." And it's. actually pretty effective actually. It. is. And there's another test that ties. into the MMSE that um they both indicate. one another, which apparently they're. both really good at indicating dementia, but this other test is called the clock. drawing test. Did you look this thing. up? Yeah, I thought it was pretty. fascinating. It really is. Yeah, it. seems really like why would someone tell.

someone to draw a clock at a certain. time of the day? Yeah. Usually they say. draw a clock and showing that it's 10. after 11. 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 um skills, right? So like. first of all, you have to remember what. a clock is. Yeah. and what it signifies. That's a big one. What it looks like. Uh. yeah, is a clock isn't made of like.

squiggly lines or anything like that. Um. you have to remember how a clock is laid. out. The order that the numbers go in, that it doesn't keep going after 12 to. 13, 14, 15. And then once you got all. this, you have to show the hands showing. that it's 10 after 11. So the hands. won't be pointing at 10 and 11. It. should be uh the longer hand should be. pointing at the two and the shorter hand. should be just past the 11. 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. Yeah. The four specific things it. requires are verbal understanding, uh. memory, spatially coded knowledge, and. constructive skills. And if any of those. are off in conjunction with the MMSSE, then they're going to have a pretty good. idea of where you fall on the dementia. scale. If you don't have the. constructive skills to pay the bills, you may have dementia. That's right. And. they actually um 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, right? And it checks out. Yeah. They they stood behind it and. said, yeah, it's actually a really good. indicator. Yeah. Like it really holds. up. And they I think they developed it. in the 60s, but it didn't take off until. the 80s. And then they start 60s thing. It does, you know, but it's something. you can do anywhere. And now they're. starting to gather these um different. clocks that people with different types. of dementia are drawing and basically. compiling them into a database so you.

know what to look for even more. Like, oh, somebody draws a clock that has like. a 13, 14, 15 on it, right? They may have. this type of dimension, right? Or this. one looks like Salvador Dolli drew it, right? uh then they might have this kind. of dementia. Yeah. Or they might just be. super talented and creative. Yeah. You. never know. Um all right, let's uh. should we take another break? Why not? Is it time? Sure. All right. We'll be. back after this to talk about uh. treatment and uh some of the other uh. pitfalls of dementia.

[Music]. So, Chuck, we've kind of um I think it's. it almost goes without saying like the. the problems associated with with. dementia, like you lose your ability to. um reason in a lot of cases. You lose.

your ability to to move and take care of. yourself. You lose your memories. You. have trouble forming new memories. you. have trouble recognizing people. Um so. living life is extremely difficult. Yeah. Um 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. Yeah. Do you. think you're going to remember to take. those medications? Right. Probably not.

Even if you have like a timer set or. some sort of calendar or something like. that, you may 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. Yeah, that's a big. problem. Uh nutrition itself is a big. problem. uh either. you forget to eat altogether or you. think you've already eaten or you uh. physically have deteriorated so that you. can't control the muscles to chew and uh.

to chew and swallow and you could uh. choke, right? It's a real danger. 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. It's like, no, the brain is. actually being slowly destroyed. Yeah. periodically and eventually it's going. to reach the parts of the brain where. like you can't swallow any longer and. then you die from that kind of thing. Um. you also can lose your sense of hunger. 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 um when. you're just not hungry ever. Yeah, it's. a tough one. Uh hygiene uh reduce. hygiene is a big one. Um, 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 uh it. just falls by the wayside. Um, I know. that was the case with my grandmother. She needed, you know, she needed to be. bathed uh by my dad cuz she lost. interest in it or because she just.

couldn't do it anymore. Uh, I think. both. Yeah. Yeah. Um, that's another. indicator. You said that when you go in. for a diagnosis, the doctor's going to. be watching you and and just kind of. sizing you up. One of the things to look. for is whether you look disheveled. Yeah. That's a big one. And especially. if you're son or daughter saying like. this is really bizarre behavior because. mom always like dressed to the nines. Yeah. When she left the house, she just. wears this dirty old bathrobe all the. time and doesn't ever want to take a. shower. Yeah. That's that's usually an.

indicator of dementia. Yeah. It's not. like she just gave up and doesn't care. anymore, right? It's it's part of the. symptoms. Yeah. Taking hold. Although. another problem with dementia and and. one of the confounding factors is that. depression can be a byproduct or. comorbidity of dementia. Yeah. 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. Um so then that could lead to.

you giving up on taking showers and. dressing as well. Yeah. And not only. depressed but um agitated and aggressive. um riddled with anxiety. Uh a lot of. your emotional well-being and emotional. health will be uh slipping away from. you. Yeah. And again this can be a. direct result of chemical changes in. your brain. Yeah. due to dementia or it. can be like you're this is the result of. you recognizing these changes and and. just becoming upset about them. Uh we.

talked about communication um and the. hallucinations. Uh you're going to have. trouble sleeping as well in a lot of. cases. Yeah. Uh and then personal. safety. Um a lot of people die every day. because. of accidents that happen as a result of. dementia. Right. People who shouldn't be. driving get into cars. Yeah. Um, and. there's this there's a a push that's. going on now. I think in the last year. or so, um, as part of the Council on. Aging, like the United States Council on. Aging, there's a new initiative called.

the Dementia Friendly America. Initiative. Really neat. Yeah. It's. basically saying, look, we've got about. one in eight people over 65 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. people who are wandering around with. dementia don't withdraw $80,000 from.

their bank account and and walk around. with it in their pockets out outside. Yeah. And how do you do that? you you. get some money uh from the government as. a grant to go out and uh hire people to. literally go to businesses and go to. restaurants and talk to waiters and and. waitresses. Yeah. Or should I just say. waitrons. Sure. Uh go to banks and talk. to tellers, go to uh anywhere where. there's interaction with another human. uh grocery store checkout people y and.

literally train them on like you said. how to recognize it and how to kindly. deal with these people. Right. Exactly. Um apparently one of the things you. teach uh people in service industries is. not take it personally. Right. That if. somebody's behaving erratically 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. um. apparently responding to it in a soft. friendly manner. Yeah. Tends to get.

results from the the dementia patient. Um especially if you are not You mean. not being an aggressive jerk, right? Exactly. Just being nice will will Yeah. frequently get good results. Um and. yeah, it is a pretty neat initiative. Absolutely. Um and and necessary. Yeah. you know, but it's it's I'm stricken by. the idea that people are planning out. this far ahead Yeah. for this kind of. thing. It's exceptional. It is. And.

scary, but awesome. Uh so, if you do. have a family member, one thing that's. um important to remember, there's. something called the caregiver burden. Yeah. Uh that my dad and his wife. definitely experience. It is really, really tough. Yeah. on you uh on your. family uh and it can actually take a. physical toll. Um they have some stats. here. If you uh your risk of death uh as. a woman if your husband has dementia. increases. 28% 28% in the first year after they're.

diagnosed. Yeah. And only uh 22% for a. husband whose wife is diagnosed. Um and. then that's still a pretty significant. increase. Oh, sure. Just from the. dementia diagnosis. Uhhuh. Yeah. And um. what they recommend in this article is. to take care of yourself first. Uh. 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 going to do more harm.

anyway. Right. So get yourself right, take care of yourself, and go into it in. the right frame of mind and you'll. actually be able to help better. Yeah. And this this caregiver burden or. caregiver burnout is a very real thing. physically, too. like you um have low. energy, you're you have low. productivity, you become snippy, uh. resentful, angry, and you can end up. basically mistreating your own parent or. spouse. Yeah. Because you're so upset. with this horrific disease. One of the. hallmarks of dementia is that the that.

there's no two days that are alike. Yeah. And when you're dealing with the. the dementia patient, what worked. yesterday isn't going to necessarily. work today. Yeah. 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 22 hours a week. of unpaid care Yeah. by spouses, wives, daughters, that kind of thing. Um you. you can very easily get stressed out.

The main thing you have to do is ask for. respit care. Like you can't do it by. yourself. Yeah. And I I mean, you could totally see how. you could just very easily. evolve a really unhealthy dynamic. Yeah. If you're just trying to do it yourself. because you lose perspective. This. becomes your norm even though it's. totally abnormal. Yeah. And boy, you.

talk about a a really sad way to. damage what previously was a good. relationship with a parent or something. Yeah. Uh is devastating. Sure. You know, um so there are drugs that they use uh. to help stave off dementia. Um mainly right now they are uh colon. eststerase inhibitors. Mhm. Uh and they. suppress colonestase, which is an enzyme. that breaks down uh uh acetto.

acetylthene. Acetyloline. Acetyloline. Yeah. Which. we've talked about before. That's what. helps transmit uh messages between. neurons, right? So that'll help. Yeah. Because if you're not communicating as. much as you were before Yeah. at least. the communication that is going on can. stick around longer. Exactly. you know, it's seems primitive as far as like. brain drugs go, but it makes sense, you. know. Yeah. And then there's another. one, uh, are they still using this? Uh,

I believe so. Uh, mantene. Uhhuh. Uh, and it inhibitates uh inhibits. glutamate, which we've talked about. before, uh, which causes neuron death. uh, when over stimulated. Yeah. I can't. remember where we talked about that one. either. I just remember glutamate from. the umami episode. Yeah, was definitely. in that one. Um, and then there's also. stuff you can So, these drugs will help. some. That's for non-vascular dementia, right? With with vascular dementia, you're going to want to take blood.

thinners. Yeah. To keep more strokes. from coming along and making the whole. thing worse. Um, and then with like. Louis body disease to deal with things. like the hallucinations and stuff, you'll probably also be given. antiscychotics as well. Yeah. Um, and. one thing that they're starting to. realize more and more, it's very. difficult to really figure out what kind. of dementia people have just from um, uh, what's the scan? MRI. Yeah. MRI. scans. Yeah. Um, and you can really go.

back and accurately identify types of, um, dementia from autopsies. Right. Right. And so from more and more autopsies, they're finding that there's a lot of. what's called mixed dementia where you. have Alzheimer's and vascular dementia, right? Or where you have Alzheimer's and. Louis bodies disease. Um, and so it can. be really tough to sus 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. and letting the Louis body go. unrecognized and rampant. Yeah. Yeah. Or. unchecked. There's also preventative. stuff you can do, too. Oh, yeah. Yeah. Like what? Cross word puzzles. Yeah. I. told you Emily's grandmother, Mary, is. 95. Yeah. And very sharp. Yeah. Uh and. she does word puzzles all the live long. day. And is it Suku? Yeah. She does she.

does all kinds of word puzzles. Yeah. Things that I have never even heard of. Supposedly that helps stave it off. Oh. yeah. apparently um this one's great. Alcohol, moderate alcohol consumption, which is uh two a day for men or one a. day for women. Okay. Uh has a protective. effect. It staves off Alz or staves 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 alcohol has a pro protective. effect. Uh probably up to that two.

drinks and then it's probably bad after. that. Yes. Then it becomes very bad. after that. Yeah. So you want a just. moderate amount, right? In all things, people moderation. Moderation. Uh and. then uh there are some things that you. can. do. Here's the thing. There's a a debate. on whether or not um you are tricking. your loved one by doing things like um. giving them an appliance that doesn't.

work so they can pretend that they're. ironing or something, right? Because. they used to love to take care of their. laundry themselves. So here, let me. remove the cord from this iron. And uh. and is that tricking someone? Is it not? Uh, 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 going to get hurt with a hot iron. Yeah. 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. Right. I think it's fine. I think. it's fine, too. And there's actually um. there's a an entire village set up in I. think like uh just outside of Amsterdam. Yeah. This is awesome. Called Hogee, right? Yeah. Horve. How would you say. that? I I have no idea because Dutch is. a weirdest the weirdest language on it. We'll say that. Okay. Okay. Um and uh. it's a it is a it's an what's called a. dementia village basically. Yeah. Where.

everyone who lives in this village I. think 150 people all have dementia and. they live in group houses that are Well, there's caretakers that live there too, but Okay. Yes, you're right. Um 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. a good friend of theirs. Yeah. They they. don't really remember where when they. became friends. A cool roommate. Yeah. Exactly. Um and the houses they live in. have different themes according to how. the people lived depending on whether.

they were bluecollar, whether they their. memories go back to the 70s. This whole. place is basically set up so that it's a. very um non-threatening safe place for. these people to just kind of live and um. move about within. Sure. Safely. Yeah. Safely. Um and so they they can go to. the grocery store, they can go to the. movies, they can go ride a bike. 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. Specially 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 that they. were used to as they're going to get. Yeah. Exactly. Uh then of course there's. other people that poo poo and say, "No, you're tricking these people." But but. you can say, "Hey, okay, here's 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. Yeah. In Ho village, yeah, that city worker is specially trained to. get that person back to their house or. alert their caretaker that this person. uh is having a crisis or something like. that. It's what we're trying to train. people to do in the future. Yes. They've. just isolated it to a community. Yeah. 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 the patients themselves. It's not like you're doing it to. experiment on them. No. You know, or. because they'll they'll produce gold in. their urine or something like that, you. know, like this is strictly for their. protection. Yeah. But also allowing them. to 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, yes,

you're robbing someone of their dignity. by lying to them, by deluding them or. playing into their fantasies. Strictly. speaking, yes. In the real practical. world, I think this is great. If I'm at. that point, then and play into my. fantasies. Exactly. Please. Um, it is. 1984 all the time. Uh, in fact, one of. the people that work there say that. people that do criticize it, it's 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, and so. Hoj Village, I hope I'm saying that. right cuz I'm really putting myself out. there. Oh, I'm sure you're not. It's. become this kind of ideal standard of. care, but it's also really expensive. Yeah, I'm sure. So, in a country where. there's a lot of socialized medicine, it. could do pretty well, like in the. Netherlands or in Canada. Yeah. when. they take care of people even though. they don't have money. Right. Exactly. There's there's one called um in Canada. it's called. um.

Pentanguishini Pentanguishini Ontario. They have one. It's a little smaller. than the one in in uh Amsterdam. They're. also building one in Miami as well. So, it is starting to take hold. People do. believe in it and apparently the. patients families are very happy with. this kind of thing too. Well, and. hopefully with the initiative of uh. what's it called? Alzheimer dementia. friendly friendly America. DFA. Yeah. Uh.org. Yeah. Hopefully with those.

efforts um more and more people will cuz. it's coming. Oh yeah, it's coming. A lot. more folks are going to be out there. that we need to take care of. Yeah. We. don't know how to cure dementia. We just. know it's coming. I'm going to be one of. them. You think so? Sure. at some point. if I'm if I make it that long. But you. know, not everybody gets dementia no. matter how long you live. I don't know. I got a feeling. Really? Yeah. It does run in my family a. little bit. Yeah. And and I have the my.

father's family genes more than my. mother's. I got you. I feel like. so if if I had my mother's genes, they all died from heart attacks and. strokes. Oh, okay. And heart disease. Young. Not a lot of cancer. Yeah. Pretty. young. Yeah. Um, so if you make it past. 65, Yeah. you you beat the heart stuff, then the Bryant jeans kick in the. dimension. Well, we're all going down. one way or another. I may live to be.

100. Yeah. You know. Yeah. Um, man, I thought of something. Oh, yeah. I wonder, Chuck, if like our spec, like us, you and me specifically, cramming all this information in every. week, Yeah. is actually beneficial or if. we're just setting ourselves up for. massive cases of dementia because we're. just pushing stuff in and getting it. out, pushing in new stuff and getting it. out. Like, are we are we abusing our. brains or are we exercising it? I. question that sometimes. I bet someone.

out there I bet there's a neurologist. who has a good gut instinct answer to. that one. Let us know. I want to know. Good news or bad. Okay, neurologists. There's going to be a subject line that. just says neurologist. Guys, you're. screwed. Yeah, I have bad news. Uh, 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 uh. the search bar, House of Works, and. it'll bring up a great article. Since I. said search bar, it's time for listener.

mail. Uh, I'm going to call this one. Hecky Krasnaw. Lives. Okay. although I don't think he. is with. us. Hey guys, only just started uh. recently listening to the show. It's. been a fantastic way to pass time and. learn something interesting. I'm a. home-taught high schooler, so every time. I listen to an episode of your show, I. get a history or science credit. How. about that? That is pretty great. Uh but. as great as that is, that's not why I'm. emailing. I actually have a fun fact for.

you guys uh from your Plato 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 uh several Christmas. carols, including Frosty the Snowman and. his biggest claim to fame, Rudolph the. Red-Nosed Reindeer. That is awesome. I've always thought it was very funny. that a Jewish guy was responsible for. the popularity of Christmas carols. My. family, all still Jewish, uh watches the. Claimation Rudolph movie every year.

because of that. Our own little taste of. that irony. Yeah. I I don't want to tell. you what to do because I'm sure you have. a lot of episodes on your plate already, but I'm just saying Hecky Kranaw was a. pretty interesting person. Uh there. might just be enough material for an. episode on him. Up to you. Nice. Thanks. for helping with my schoolwork. That is. from Aiden in. Maryland. Awesome. Thank you very much, Aiden. And when I say Hecky, Kranol. lives, I mean lives on. Sure. Like Viva. Leeki. Yeah. Yeah. Uh 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. Um just kind of bring. it on home for us, will you? You can. send us an email to. stuffodcastworks.com. And as always, join us at our home on the web, stuff. you should know.com. Stuff You Should Know is a production of. iHeart Radio. For more podcasts, iHeart. Radio, visit the iHeart Radio app, Apple.

Podcasts, or wherever you listen to your. favorite shows. [Music].