Navigating COVID-19 with Wellness Leadership: Steps from Dr. Choctaw

100:00:00,501 --> 00:00:02,424Speaker 1: Welcome to the healthy, wealthy and wise 200:00:02,524 --> 00:00:08,105podcast with Dr William Chokta, MDJD. Our mission is to empower 300:00:08,144 --> 00:00:11,917you with the knowledge and the tools you need to thrive in all 400:00:12,118 --> 00:00:16,204aspects of your life. Join us now as we discuss everything 500:00:16,285 --> 00:00:19,823from nutrition and exercise to money management and personal 600:00:19,862 --> 00:00:24,753growth. Dr Chokta will provide insightful advice on how to 700:00:24,794 --> 00:00:28,064improve your physical and financial health, as well as 800:00:28,123 --> 00:00:31,460your emotional and mental well-being. Whether you're 900:00:31,481 --> 00:00:35,936looking to boost your energy levels, unlock financial freedom1000:00:35,936 --> 00:00:40,228or cultivate a more positive mindset, we've got you covered. 1100:00:41,880 --> 00:00:45,901Get ready to become the best version of yourself? So let's 1200:00:45,941 --> 00:00:49,552get started. Here's Dr William Chokta, MDJD. 1300:00:50,055 --> 00:00:54,067Speaker 2: Good morning. I'm Dr William T Chokta and I'm 1400:00:54,107 --> 00:00:57,283delighted to have you with us today. Today, we have a very 1500:00:57,343 --> 00:00:59,920important topic that we're goingto talk about. We're going to 1600:00:59,941 --> 00:01:04,483talk about dementia versus Alzheimer's, but before we get 1700:01:04,543 --> 00:01:08,884started, let me just make a general comment. Each month, we 1800:01:08,965 --> 00:01:13,418strive to provide you, with our listeners, with mental, physical1900:01:13,418 --> 00:01:17,546and spiritual strength by giving actionable advice, tips, 2000:01:17,927 --> 00:01:23,563guidance and information to helpyou achieve your own personal, 2100:01:23,885 --> 00:01:28,364professional and spiritual goals. We consider the health of the 2200:01:28,444 --> 00:01:34,180mind, body and spirit paramount as a single unit that provides a2300:01:34,180 --> 00:01:38,829cumulative strength greater than the individual parts to 2400:01:38,950 --> 00:01:44,606strengthen the whole person. So again, welcome with joining us 2500:01:44,727 --> 00:01:48,341today for this very important topic. As I said, we're going to2600:01:48,341 --> 00:01:52,831talk about dementia versus Alzheimer's. Which is it and why2700:01:52,831 --> 00:01:56,206is it important? In other words, why is it important for you to2800:01:56,206 --> 00:02:00,784know about dementia and Alzheimer's and understand the 2900:02:00,825 --> 00:02:04,584difference between the two? As always, we like to start off 3000:02:04,625 --> 00:02:08,507with our beliefs. I believe lifeis about being of service to 3100:02:08,668 --> 00:02:13,064others. I believe knowledge is power. I believe leaders can 3200:02:13,104 --> 00:02:18,000change the world. We also alwayslike to put up an outline. This3300:02:18,000 --> 00:02:21,540gives you an idea about what we're going to talk about and, 3400:02:21,561 --> 00:02:24,629as important, it lets you know, when we're just about done, 3500:02:25,099 --> 00:02:27,293we're going to talk about dementia, we're going to define 3600:02:27,373 --> 00:02:30,820it. Then we're going to define Alzheimer's disease. We're going3700:02:30,820 --> 00:02:36,497to go through the diagnosis andtreatment and also give you 3800:02:36,538 --> 00:02:40,901some suggestions about prevention. This is part of our 3900:02:40,961 --> 00:02:43,889masterclass series. The topic today, as all of these 4000:02:43,968 --> 00:02:48,245presentations, and our goal overall is to help you to have a4100:02:48,245 --> 00:02:54,042more healthy, wealthy and wise lifestyle and allow you to be 4200:02:54,201 --> 00:03:01,582mental, physically and spiritually healthy. So what is 4300:03:02,485 --> 00:03:05,572dementia and how does it differ from Alzheimer's disease? 4400:03:06,439 --> 00:03:11,088Dementia is a general term for decline in cognitive ability 4500:03:11,689 --> 00:03:15,703that includes memory loss and thinking difficulties. Let me 4600:03:15,763 --> 00:03:21,026say that again. Dementia is a general term for decline in 4700:03:21,106 --> 00:03:25,703cognitive ability that includes memory loss and thinking 4800:03:25,984 --> 00:03:30,705difficulties. In other words, dementia is an umbrella term 4900:03:31,127 --> 00:03:36,784that has to do with difficulty with memory. So it's an umbrella5000:03:36,784 --> 00:03:41,167term. Dementia is not a disease. It is basically a category, if5100:03:41,167 --> 00:03:45,240you will, an umbrella category that includes a number of 5200:03:45,300 --> 00:03:49,081different disease under it. Alzheimer's, on the other hand, 5300:03:49,483 --> 00:03:57,429is a specific brain disease. Alzheimer's is a specific brain 5400:03:57,688 --> 00:04:01,305disease and, what's more important, alzheimer's is the 5500:04:01,385 --> 00:04:05,161most common cause of dementia. So there are a number of 5600:04:05,181 --> 00:04:10,451different causes of this umbrella term called dementia 5700:04:11,719 --> 00:04:15,532and of those different terms. Alzheimer's is one of them and 5800:04:15,573 --> 00:04:22,303the most common one causing dementia. So again, dementia, 5900:04:22,625 --> 00:04:29,538general umbrella term for memorydifficulties or inability to 6000:04:29,620 --> 00:04:35,346make proper decisions. It's a disease of the brain that is the6100:04:35,346 --> 00:04:42,363most common cause of dementia. So if we were to first just take6200:04:42,363 --> 00:04:47,021a look at dementia and this again is an umbrella term for 6300:04:47,180 --> 00:04:51,475issues that have to deal and that cause dementia we look at 6400:04:51,535 --> 00:04:54,987things like individuals who begin to develop difficulty with6500:04:54,987 --> 00:04:57,386language. They can't find the right words to say what they 6600:04:57,425 --> 00:05:00,427want to say. They have difficulty solving problems. 6700:05:00,959 --> 00:05:05,153They have confusion of time and place in terms of where they're 6800:05:05,173 --> 00:05:09,180supposed to be and what they're supposed to be doing. They may 6900:05:09,221 --> 00:05:14,547have some changes in personality. They end up having examples of7000:05:14,547 --> 00:05:18,605poor judgment. They sort of make decisions that are not wise7100:05:18,605 --> 00:05:22,660and out of character of what they would usually make. They 7200:05:22,699 --> 00:05:26,661have problems communicating and they misplace things. Now, we 7300:05:26,761 --> 00:05:29,908all misplace things, but we're talking about individuals who do7400:05:29,908 --> 00:05:36,848it on a broader basis. So if welook at Alzheimer's and 7500:05:36,889 --> 00:05:42,461dementia and compare the two again, dementia is not a disease7600:05:42,461 --> 00:05:47,685and Alzheimer's is, and dementia is a very general term 7700:05:48,927 --> 00:05:54,100that involves difficulty with cognition or thinking. Dementia,7800:05:54,100 --> 00:05:57,952on the other hand, is a complexset of diseases that 7900:05:58,596 --> 00:06:02,723progressively get worse over time. So let's drill down a 8000:06:02,764 --> 00:06:06,766little more closely now. With dementia, we say it has to do 8100:06:06,826 --> 00:06:10,300with recent memory loss that affects daily life, but a person8200:06:10,300 --> 00:06:13,084with dementia would have troubling remembering 8300:06:13,125 --> 00:06:18,463conversations or may even ask repeated questions because their8400:06:18,463 --> 00:06:22,101short-term memory has been compromised. In terms of 8500:06:22,622 --> 00:06:26,875difficulty performing regular tasks, someone with dementia 8600:06:26,954 --> 00:06:30,821might have a difficulty driving a familiar route. Let's say you 8700:06:30,862 --> 00:06:34,062drive a certain distance to workevery day. Let's say it takes 8800:06:34,083 --> 00:06:37,564you 20 to 30 minutes to get to work. You go the same streets 8900:06:37,704 --> 00:06:41,327each time, but if you're developing dementia you may have9000:06:41,327 --> 00:06:46,343difficulty going through that familiar route and consequently 9100:06:47,646 --> 00:06:51,362be late for work. Sometimes Individuals with language, 9200:06:51,944 --> 00:06:56,540individuals with dementia, mighthave difficulty following or 9300:06:56,740 --> 00:07:00,687starting conversations. They mayuse the wrong words and 9400:07:00,728 --> 00:07:05,122primarily because they're unableto remember the proper words 9500:07:05,141 --> 00:07:08,019that they should use. In this particular conversation we're 9600:07:08,040 --> 00:07:11,944talking about dementia now. Disorientation of time and place9700:07:11,944 --> 00:07:15,166Disorientation with dementia will be confused with the time 9800:07:15,228 --> 00:07:19,072of day and what's appropriate todo for that time, in other 9900:07:19,093 --> 00:07:24,278words, for lunchtime. They may be confused whether it's 10000:07:24,338 --> 00:07:29,161lunchtime or breakfast time, etc. Etc. Decrease for judgment. We10100:07:29,161 --> 00:07:34,730talked about bad decisions, about their appearance, and 10200:07:34,790 --> 00:07:39,295indeed, they may start having difficulty in how they appear 10300:07:39,375 --> 00:07:44,221physically and how they dress and how they prepared for a 10400:07:44,262 --> 00:07:50,132particular event, or even going to work Problems with complex 10500:07:50,232 --> 00:07:54,716tasks. A person with dementia will have a difficulty keeping 10600:07:54,735 --> 00:07:59,180track of finance, let's say paying the bills on time, maybe 10700:07:59,240 --> 00:08:03,584difficulty managing a certain meal. Maybe this person fixes 10800:08:03,684 --> 00:08:08,091meals for the family meal or female, but they may not 10900:08:08,170 --> 00:08:12,076remember the steps, the individual steps, to making a 11000:08:12,115 --> 00:08:17,961cake or making bread or other types of meals Basic things that11100:08:17,961 --> 00:08:22,971they've done for years now become problematic. One of the 11200:08:23,050 --> 00:08:26,274other more obvious things is misplacing things. Again, we all11300:08:26,274 --> 00:08:30,860misplace things, but the distinction I like to use is I 11400:08:30,901 --> 00:08:36,110may misplace my keys periodically, and that itself 11500:08:36,171 --> 00:08:40,474may not be that big a deal. However, individuals with 11600:08:40,575 --> 00:08:46,198dementia, particularly advancingdementia, misplace items in the11700:08:46,198 --> 00:08:51,384wrong place. For instance, if Imisplace my keys on the desk, 11800:08:52,144 --> 00:08:58,533that itself may not be a major issue, but if I misplace my keys11900:08:58,533 --> 00:09:04,559in the refrigerator, that then is more suggestive of a dementia12000:09:04,559 --> 00:09:11,351type of problem than just mild forgetfulness, etc. Etc. Changes12100:09:11,351 --> 00:09:15,437in mood or behavior, personalities may switch very 12200:09:15,517 --> 00:09:20,224quickly. Emotions may switch very quickly to the extent that 12300:09:20,264 --> 00:09:24,293they are out of the ordinary. Again, we all may have different12400:09:24,293 --> 00:09:27,178emotions, but these are things that will jump out to you, 12500:09:27,360 --> 00:09:31,697either within yourself or with those around you. That may be 12600:09:31,756 --> 00:09:36,972suggestive of a dementia type problem Relating to others. 12700:09:37,855 --> 00:09:40,840Individuals with dementia may have difficulty remembering 12800:09:41,561 --> 00:09:45,287individuals and being able to communicate with those 12900:09:45,346 --> 00:09:49,374individuals who they've known before. And loss of initiative. 13000:09:51,476 --> 00:09:55,303Persons may just may not feel like they have much energy, just13100:09:55,303 --> 00:09:58,850don't want to do very much and not interested in things all of 13200:09:58,870 --> 00:10:02,845a sudden, whereas maybe before they were very engaged in 13300:10:02,904 --> 00:10:06,873various different activities. Soagain, we're talking primarily 13400:10:06,913 --> 00:10:11,619about dementia now. Dementia is the umbrella term that involves 13500:10:11,740 --> 00:10:16,365cognitive ability or lack of ability, cognitive meaning 13600:10:16,424 --> 00:10:22,058thinking. So dementia is a umbrella term that has to do 13700:10:22,119 --> 00:10:27,509with inability to think the way you normally would think to get 13800:10:27,528 --> 00:10:31,075things done. Another important aspect of dementia that we've 13900:10:31,115 --> 00:10:34,760touched on slightly, but let's delve a little deeper is the 14000:10:34,821 --> 00:10:39,234psychological symptoms of dementia Personality changes. 14100:10:39,354 --> 00:10:44,361You may live with a spouse who begins to develop dementia, who 14200:10:44,501 --> 00:10:47,847suddenly may shift in personality and behavior to the 14300:10:47,888 --> 00:10:51,073extent that you notice it. And Imentioned spouse because our 14400:10:51,115 --> 00:10:55,965spouses notice us more closely than most others, so you, the 14500:10:56,004 --> 00:10:59,932spouse, would be the first one to know to notice, but you seem 14600:11:00,032 --> 00:11:04,076more down the last couple of weeks or the last couple of 14700:11:04,136 --> 00:11:09,744months, or you seem more combative, or something to that 14800:11:09,803 --> 00:11:14,714effect. A part of the psychological symptoms can 14900:11:15,053 --> 00:11:19,640include anxiety. Maybe the individual now worries more or 15000:11:19,701 --> 00:11:23,330frets more about things than they used to, but the little 15100:11:23,350 --> 00:11:26,491things that didn't bother them now just sort of appear to make 15200:11:26,511 --> 00:11:32,259them very upset and very uncomfortable. And again, the 15300:11:32,298 --> 00:11:36,630depression you know not wanting to do anything, not finding any 15400:11:36,751 --> 00:11:42,921joy or pleasure in anything Manytimes can be suggestive of a 15500:11:42,980 --> 00:11:47,399type of depression. Obsessive tendencies Again, these are 15600:11:47,879 --> 00:11:53,212actions of the mind and that translate into behavior that 15700:11:53,253 --> 00:11:55,600cause us to do certain things that we just would not 15800:11:55,720 --> 00:12:00,605ordinarily do and where we obsess over something over and 15900:12:00,705 --> 00:12:04,317over and over again in a way that stands out and does not 16000:12:04,356 --> 00:12:10,273appear to be normal for us. Pollucinations of paranoia. 16100:12:10,534 --> 00:12:12,601Pollucinations mean you see or hear things that are not there. 16200:12:13,715 --> 00:12:16,505You hear sounds that are not really there and you see people 16300:12:16,606 --> 00:12:20,139or figures, or imagine that you're seeing things that are 16400:12:20,200 --> 00:12:24,636not there. Inappropriate behavior. Your behavior is a 16500:12:24,697 --> 00:12:29,046difficult one, but the way this shows up is individuals who may 16600:12:29,187 --> 00:12:33,182laugh in a situation that appears to be inappropriate. 16700:12:34,475 --> 00:12:38,822Someone shares a very sad story or very sad experience and this 16800:12:38,903 --> 00:12:45,014person would laugh or just act inappropriately. These are 16900:12:45,076 --> 00:12:51,268suggestions, some cognitive, ie thinking abnormality that may be17000:12:51,268 --> 00:12:55,364associated with this umbrella term that we call dementia, 17100:12:58,399 --> 00:13:02,129agitations in mood and just getting upset, a lot or little 17200:13:02,229 --> 00:13:06,256noises that bother you more thanthey used to. If the gardener 17300:13:06,277 --> 00:13:10,873is outside more in the lawn, thesound of the lawnmower may just17400:13:10,873 --> 00:13:15,179drive you up the wall, and thenjust a general lost of interest17500:13:15,179 --> 00:13:21,181. Let me say a quick word about depression, because depression 17600:13:21,240 --> 00:13:27,916will basically be impacted by dementia and Alzheimer's, but in17700:13:27,916 --> 00:13:31,091general, depression is one of those things, and we're going to17800:13:31,091 --> 00:13:34,177talk about it in terms of seniors. Now. My definition of 17900:13:34,236 --> 00:13:37,625senior is an individual who's six or five years of age and 18000:13:37,765 --> 00:13:42,342older. Keep in mind, however, that dementia, alzheimer's and 18100:13:42,383 --> 00:13:46,879depression can occur at any age for an adult, but we're talking 18200:13:46,919 --> 00:13:50,895about the most common types of situations. Seniors who are 18300:13:50,936 --> 00:13:54,664depressed. Usually the majority of them do not believe that 18400:13:54,725 --> 00:13:59,197depression is a health problem, and this is a general problem 18500:13:59,238 --> 00:14:06,916with mental health illnesses themselves is that we tend to 18600:14:07,035 --> 00:14:16,311not give them the attention and the concern that we should or 18700:14:16,331 --> 00:14:21,283that we would say if one were tobreak a leg or get chest pain 18800:14:21,583 --> 00:14:26,556or get a laceration on the arm or the foot, whereas we would 18900:14:26,655 --> 00:14:30,566act very quickly, move to get resolution, whereas with 19000:14:30,586 --> 00:14:36,239depression, many times we excuseit away, partly because we 19100:14:36,278 --> 00:14:41,457don't understand it as well as we should. But my point is, all 19200:14:41,498 --> 00:14:45,514that does is it complicates the problem, it delays treatment, it19300:14:45,514 --> 00:14:51,465delays resolution of the problem and it tends to self 19400:14:51,684 --> 00:14:56,018increase the severity of the problem itself. 80% of people 19500:14:56,057 --> 00:15:00,986with depression can be treated successfully with medication, 19600:15:01,368 --> 00:15:05,461psychotherapy or combination of the two. Let me say that again, 19700:15:06,215 --> 00:15:12,42680% of people with depression can be treated successfully with19800:15:12,426 --> 00:15:17,316medication, psychotherapy or combination of the two. This is 19900:15:17,395 --> 00:15:21,924a treatable problem that affectsthe brain and we need to look 20000:15:22,065 --> 00:15:27,075at it as such and then be able to have it taken care of. And 20100:15:27,095 --> 00:15:31,650again, as I mentioned before, most of us adults who get 20200:15:31,671 --> 00:15:35,297depression know very little about it, and that then, as I 20300:15:35,356 --> 00:15:40,086said before, complicates treatment and access to 20400:15:40,125 --> 00:15:43,919appropriate care. One of the things that's also significant 20500:15:44,100 --> 00:15:48,596is that, as one gets older and heart conditions or heart 20600:15:48,636 --> 00:15:52,750related conditions become more prominent, a good number of 20700:15:52,811 --> 00:15:56,961individuals or patients who develop heart attacks also have 20800:15:57,081 --> 00:16:01,417an associated depression along with it, and it's important to 20900:16:02,678 --> 00:16:08,009make the point that the body is a unit that is very complex 21000:16:08,274 --> 00:16:13,644Think of the world's most complex computer available and 21100:16:13,765 --> 00:16:17,654everything is interrelated. Everything is interrelated, and 21200:16:17,676 --> 00:16:21,143so one needs to think of the body as a unit with interrelated21300:16:21,143 --> 00:16:25,822, interacting parts, because so one area affects the other area,21400:16:25,822 --> 00:16:28,780and that's why it's so important to have more of a, in 21500:16:28,802 --> 00:16:32,917my judgment, more of a holistic approach mind, body and spirit 21600:16:33,719 --> 00:16:37,905as we deal with a number of these physical and or 21700:16:37,946 --> 00:16:42,941psychological problems. Now, I mentioned earlier, when I was 21800:16:42,980 --> 00:16:46,995talking about dementia versus Alzheimer's, that Alzheimer's is21900:16:46,995 --> 00:16:49,977the most common cause of dementia, and that is true. 22000:16:50,654 --> 00:16:53,859There are other causes. There are actually four of the causes 22100:16:53,958 --> 00:16:58,275of dementia, and I'll just mention them briefly. Vascular 22200:16:58,296 --> 00:17:02,111dementia, which has to do with blood flow to the brain, has 22300:17:02,152 --> 00:17:06,957something called Lewy body dementia. These are individuals 22400:17:07,057 --> 00:17:11,404who have had dementia and were found to have certain types of 22500:17:13,288 --> 00:17:16,743material in the brain that distinguish them from others. 22600:17:17,515 --> 00:17:22,125There's a frontal temporal lobe type dementia, which is unique, 22700:17:22,755 --> 00:17:25,297and then there's a mixed type dementia. But again, remember, 22800:17:25,317 --> 00:17:29,996the most common type of dementiais Alzheimer's disease, and 22900:17:30,036 --> 00:17:33,398we'll speak about Alzheimer's. So let's take a look at 23000:17:33,499 --> 00:17:39,784Alzheimer's. Okay, let's leave dementia in general aside. As a 23100:17:40,044 --> 00:17:45,200overall category, alzheimer's has a lot of areas that make it 23200:17:45,421 --> 00:17:51,781unique in a bad way. The first thing is it's in stages, which 23300:17:51,862 --> 00:17:56,181is good. The first, the early stage, or the mild stage a 23400:17:56,221 --> 00:18:00,737patient may have memory loss, mood swings, slow to learn to 23500:18:00,777 --> 00:18:05,710react, uncomfortable with due situations, prefer the familiar 23600:18:05,935 --> 00:18:09,058Actually, that's probably all ofus I know. I certainly prefer 23700:18:09,098 --> 00:18:13,656the familiar and still perform basic tasks. We talk about stage23800:18:13,656 --> 00:18:22,334one, a mild Alzheimer's diseaseof the brain, and may have 23900:18:22,374 --> 00:18:25,520slowing in speech and understanding and periodically 24000:18:25,580 --> 00:18:29,386lose the train of thought. It's important also to understand 24100:18:30,109 --> 00:18:34,994that Alzheimer's can cause significant psychiatric problems24200:18:34,994 --> 00:18:41,682itself, separate and apart fromthe milds or various types of 24300:18:41,721 --> 00:18:46,266psychiatric symptoms that you may see in mild forms of 24400:18:46,326 --> 00:18:54,258dementia. So in stage one Alzheimer's, the patient may 24500:18:54,278 --> 00:18:59,544become aware of a loss of control, maybe just of their 24600:18:59,604 --> 00:19:04,654personality or their mood. They may become more irritable than 24700:19:04,694 --> 00:19:07,299normal, they may become more fearful than normal, more 24800:19:07,421 --> 00:19:11,092restless, more depressed. These are things that tend to be 24900:19:11,291 --> 00:19:15,176outside of the normal for that particular person and they tend 25000:19:15,196 --> 00:19:20,082to be noticed most closely by close members of the family and 25100:19:20,362 --> 00:19:23,465or those who work and associate with that person on a regular 25200:19:23,506 --> 00:19:28,118basis. That's stage one of Alzheimer's disease, a physical 25300:19:28,599 --> 00:19:35,097disease of the brain. Okay, thatprogressively gets worse, and 25400:19:35,157 --> 00:19:39,210so then we go to stage two, moderate Alzheimer's. Here 25500:19:39,250 --> 00:19:44,275disability occurs. Distant past may be recalled, but recent 25600:19:44,315 --> 00:19:47,278events become difficult to remember. They can remember 25700:19:47,337 --> 00:19:51,281things that happened 20 years ago, but many times they cannot 25800:19:51,342 --> 00:19:55,726remember things that happened 20minutes ago or maybe even 20 25900:19:55,806 --> 00:19:59,934seconds ago. So it's the recent events that become difficult to 26000:19:59,974 --> 00:20:05,923remember. They are not able to comprehend location, day and 26100:20:05,963 --> 00:20:09,836time, and we talked about this abit in general with dementia, 26200:20:10,175 --> 00:20:12,840but here we're talking about it progressively getting worse, 26300:20:13,182 --> 00:20:17,474progressively getting worse. Andone of the more distressing 26400:20:17,535 --> 00:20:21,403parts about Alzheimer's is that they may not recognize familiar 26500:20:21,462 --> 00:20:24,413people. And this is the situation where a mother or a 26600:20:24,492 --> 00:20:28,278father cannot but does not recognize their son or their 26700:20:28,317 --> 00:20:32,083daughter or the grandson or the granddaughter, members of the 26800:20:32,143 --> 00:20:35,971family members that they work with. And this can be obviously 26900:20:36,011 --> 00:20:39,537not only very distressing for the patient but very distressing27000:20:39,537 --> 00:20:45,484for the family and friends and co-workers who associate with 27100:20:45,505 --> 00:20:51,855this person. Which then takes usto stage three of Alzheimer's, 27200:20:52,135 --> 00:20:58,863and here the patient is unable to care for themselves 27300:20:59,203 --> 00:21:05,055appropriately. Many times they are less and less responsive. 27400:21:05,675 --> 00:21:09,702They are unable to recognize anyone, unable to recognize 27500:21:09,923 --> 00:21:14,155anyone. So you can imagine this brain now that's damaged and 27600:21:14,195 --> 00:21:17,422diseased, that's getting progressively, progressively, 27700:21:17,481 --> 00:21:21,973progressively worse. They may have lost a bowel or bladder 27800:21:22,013 --> 00:21:25,759function, a bladder control. They may lose the ability to 27900:21:25,818 --> 00:21:29,124chew and swallow and certainly when they can't do that then 28000:21:29,144 --> 00:21:33,012they need to be fed. Many times that may require tube peeing. 28100:21:33,773 --> 00:21:37,479The challenge with that is not just the tube peeing, but if 28200:21:37,519 --> 00:21:40,482they are not able to chew and swallow because, remember, these28300:21:40,482 --> 00:21:43,086are all brain, everything is under the control of the brain. 28400:21:43,589 --> 00:21:49,277But if that modality goes and you put something in your mouth 28500:21:49,356 --> 00:21:53,381and you don't remember how to chew and swallow, instead of 28600:21:53,421 --> 00:21:57,226going into the stomach that material can easily go into the 28700:21:57,266 --> 00:22:02,080lung and then create a significant problem, 28800:22:03,270 --> 00:22:06,775particularly being vulnerable topneumonia and various types of 28900:22:06,855 --> 00:22:12,603respiratory infections which canquickly proceed to cardiac 29000:22:12,682 --> 00:22:18,974arrest, mortality and death. So what are some things on the more29100:22:18,974 --> 00:22:23,240positive side that we can do tosort of slow down or prevent 29200:22:23,340 --> 00:22:28,454dementia and or dementia relatedissues? It's amazing how eating29300:22:28,454 --> 00:22:34,493healthy and eating properly is always an issue and eating a 29400:22:34,534 --> 00:22:37,696balanced diet, fruits and vegetables the same thing that 29500:22:37,737 --> 00:22:42,001we tell I talk about in terms ofheart disease, cholesterol, 29600:22:42,041 --> 00:22:48,074diabetes, etc. Same same approach. Similarly, exercise, 29700:22:48,275 --> 00:22:52,601regular exercise, stimulates thebrain, stimulates the body, has29800:22:52,601 --> 00:22:57,875a very positive approach Keeping mentally active, 29900:22:58,455 --> 00:23:03,369consciously engaging in activity, attending various events, if 30000:23:03,390 --> 00:23:07,415you retired, attending various social events with friends, 30100:23:07,516 --> 00:23:12,864family, attending church, attending taking a class, etc. 30200:23:13,003 --> 00:23:17,916Etc. Things you don't want to dois you want to stop smoking. If30300:23:17,916 --> 00:23:22,172you are a smoker, any type of tobacco you want to stop. If you30400:23:22,172 --> 00:23:25,459drink alcohol, you want to stop. Now I'm one of those 30500:23:25,519 --> 00:23:29,732physicians that will not give you a pass If you drink beer or 30600:23:29,813 --> 00:23:33,199wine. There's some who, some reason, have decided that beer 30700:23:33,219 --> 00:23:36,403and wine is not really, are not really alcohol. Yes, they are. 30800:23:37,371 --> 00:23:40,837So you need to stop drinking altogether. Why? Because it has 30900:23:40,897 --> 00:23:46,795a negative effect on the mind and on the body. As we know that31000:23:46,795 --> 00:23:50,602alcohol, that our Alzheimer's disease, is increasing in this 31100:23:50,642 --> 00:23:53,313country, and that's not surprising because the 31200:23:53,353 --> 00:23:59,622population is increasing. The single biggest generation is 31300:23:59,662 --> 00:24:05,474getting older, called the baby boomers, and so it's no surprise31400:24:05,474 --> 00:24:08,479then that now you're going to have more individuals with 31500:24:08,538 --> 00:24:14,230dementia and more individuals with the Alzheimer's disease. So31600:24:14,230 --> 00:24:19,036, again, to summarize a bit, in terms of Alzheimer's, it's a 31700:24:19,096 --> 00:24:23,901physical damage to the brain which then translates itself 31800:24:24,362 --> 00:24:28,846into significant damage in termsof cognition and function, 31900:24:30,371 --> 00:24:33,434particularly function in terms of activity, of daily living, 32000:24:33,915 --> 00:24:36,519and many times that's one of theways that you can pick up that 32100:24:36,538 --> 00:24:41,586there's something significantly wrong in an individual mentally 32200:24:42,230 --> 00:24:46,015when those activities of daily living getting up in the morning32300:24:46,015 --> 00:24:49,339, brushing your teeth, taking a shower, eating breakfast, 32400:24:49,400 --> 00:24:54,872driving to work, going to participate with the group the 32500:24:54,971 --> 00:24:57,558individual can no longer do those things. They're certainly 32600:24:57,578 --> 00:25:04,979not do them safely. So when one thinks of Alzheimer's 32700:25:05,118 --> 00:25:08,644particularly, I want you to you think of two terms one, 32800:25:08,743 --> 00:25:13,576cognition, and the other term, function. Cognition first, 32900:25:13,957 --> 00:25:18,230cognition is just a fancy way ofsaying thinking, thinking. So 33000:25:18,391 --> 00:25:23,958the person with Alzheimer's is not able to think normally, not 33100:25:24,057 --> 00:25:28,202able to think in a way that allows them to do those things 33200:25:28,242 --> 00:25:31,810that they need to do on a regular basis. Second word 33300:25:32,031 --> 00:25:37,618function. Function is action. SoI can think that I want to have33400:25:37,618 --> 00:25:42,529a ham sandwich, but that I wantto make a ham sandwich, but 33500:25:42,651 --> 00:25:46,397functionally I need to be able to get up, find the meat, find 33600:25:46,417 --> 00:25:50,353the bread, put them together andmake a sandwich. So Alzheimer's33700:25:50,353 --> 00:25:56,813attacks both those areas. One, the thinking becomes quickly 33800:25:56,893 --> 00:26:00,916impaired or significantly impaired, so that you then see 33900:26:00,997 --> 00:26:05,162the massive decrease, or deterioration, if you will, of 34000:26:05,182 --> 00:26:09,045the function on the other side, and these are what we call ADL 34100:26:09,205 --> 00:26:12,724activities of daily living bathing, dressing, grooming, 34200:26:12,885 --> 00:26:18,285feeding oneself, et cetera, et cetera. And so when one loses 34300:26:18,365 --> 00:26:23,161that functionality, then it becomes very, very obvious, and 34400:26:23,501 --> 00:26:26,964then one can end up being a danger to themselves or to 34500:26:27,164 --> 00:26:33,240others, and so the cognitive issues, the thinking issues and 34600:26:33,260 --> 00:26:38,221the functional issues become much more pronounced. Now it's 34700:26:38,300 --> 00:26:41,626also important to keep in mind that Alzheimer's disease is 34800:26:41,666 --> 00:26:44,367treatable. There are medicationsthat can treat Alzheimer's 34900:26:44,387 --> 00:26:47,328disease. Obviously, the effectiveness of the medication 35000:26:47,400 --> 00:26:52,661depends on the stage and dependson the symptomatology. But 35100:26:52,701 --> 00:26:55,703acetylcholinesis, race inhibitors, is one category of 35200:26:55,743 --> 00:26:59,805medication for Alzheimer's. Metamantin is another category 35300:27:00,626 --> 00:27:06,309of medication for Alzheimer's. And so if there's a suspicion of35400:27:06,309 --> 00:27:11,141yourself or those around you that Alzheimer's may be a 35500:27:11,201 --> 00:27:15,481potential issue, certainly speakto your healthcare professional35600:27:15,481 --> 00:27:20,386and get an evaluation and decide whether treatment is 35700:27:20,467 --> 00:27:23,227necessary. In addition to medication. Various types of 35800:27:23,287 --> 00:27:26,461therapy, cognitive stimulation therapy, cognitive 35900:27:26,521 --> 00:27:30,780rehabilitation therapy all thosethings are available to help 36000:27:31,001 --> 00:27:34,505one's thinking ability. They'll have to preserve that thinking 36100:27:34,565 --> 00:27:43,064ability over time. So in terms of prevention and some may argue36200:27:43,064 --> 00:27:47,267whether it's preventable or not, but I would suggest I don't 36300:27:47,307 --> 00:27:51,327see a downside to trying to prevent Alzheimer's or dementia.36400:27:51,327 --> 00:27:54,902And so some of those things that one can do in terms of 36500:27:54,961 --> 00:27:58,203prevention is certainly socialize and talk with friends,36600:27:58,203 --> 00:28:02,482or interact with friends and family more Quite. Honestly, I 36700:28:02,544 --> 00:28:05,761find this interesting. I used toconsider myself well, consider 36800:28:05,781 --> 00:28:10,169myself an introvert, and my point is this is when everybody 36900:28:10,230 --> 00:28:12,800wants to be an extrovert, because it's healthier to be an 37000:28:12,901 --> 00:28:17,321extrovert, certainly as it relates to brain and brain types37100:28:17,321 --> 00:28:23,102of cognitive difficulties Stay physically active. What we do 37200:28:23,162 --> 00:28:27,862know that there is a mind-body connection and that when you 37300:28:27,942 --> 00:28:30,584exercise you feel better and when you feel better you 37400:28:30,644 --> 00:28:34,160exercise more. Abort substances and we talked about that in 37500:28:34,200 --> 00:28:38,105terms of drugs and alcohol, recreational drugs and alcohol 37600:28:39,107 --> 00:28:42,381and smoking and practice cognitive training. In other 37700:28:42,401 --> 00:28:47,641words, the mind really is the brain really is a muscle, and so37800:28:47,641 --> 00:28:52,541, like with any other muscle or computerized muscle, if you will37900:28:52,541 --> 00:28:58,066, repetition in a positive way can help it, and so those, these38000:28:58,066 --> 00:29:02,009are some things that we may have under our own control, that38100:29:02,009 --> 00:29:08,800we can do. So another way of saying some of that is some have38200:29:08,800 --> 00:29:15,305suggested that 40% of dementia cases can be prevented with 38300:29:15,365 --> 00:29:18,921lifestyle changes. There's some basic lifestyle changes and some38400:29:18,921 --> 00:29:21,826of those lifestyle changes thatwe've talked about. One is to 38500:29:21,945 --> 00:29:26,048increase education, exercise that mind, talk to people either38600:29:26,048 --> 00:29:32,042formally, informally, interact intellectually, increase the 38700:29:32,083 --> 00:29:34,746physical activity. Remember the mind and the body go together 38800:29:36,122 --> 00:29:40,826and they help each other and also, at the same time, increase38900:29:40,826 --> 00:29:44,907social contact, be more of a social butterfly, if you will. 39000:29:45,299 --> 00:29:49,180That that is beneficial to you in a long-term process. And 39100:29:49,221 --> 00:29:53,364things you wanna decrease are things like high blood pressure,39200:29:53,364 --> 00:29:56,486meaning that you wanna make sure that it's under control. 39300:29:56,787 --> 00:29:59,767Keep your doctor appointments, take your medication regularly, 39400:30:01,200 --> 00:30:05,541check your blood pressure at home yourself. Also, you wanna 39500:30:05,561 --> 00:30:09,201control obesity, smoking, depression, make sure your 39600:30:09,241 --> 00:30:14,941diabetes is under control, eliminate alcohol intake. You 39700:30:14,980 --> 00:30:17,324wanna avoid head injury, and head injury is something that 39800:30:17,365 --> 00:30:21,288becomes more prominent in elderly patients, again 65 years39900:30:21,288 --> 00:30:25,428of age and older, and part of that is because balance begins 40000:30:25,448 --> 00:30:30,786to deteriorate long before anything else and so quick turns40100:30:30,786 --> 00:30:35,289coming downstairs, going upstairs, standing on ladders 40200:30:35,961 --> 00:30:40,204all problematic with elderly patients 65 years of age and 40300:30:40,325 --> 00:30:43,800older. And so you wanna avoid that because obviously any type 40400:30:43,862 --> 00:30:48,903of external trauma to the head or to the brain increases the 40500:30:49,064 --> 00:30:53,266rate of progression of somethinglike dementia and possible 40600:30:53,426 --> 00:30:57,665Alzheimer's disease. Again, prevention, social engagement, 40700:30:57,705 --> 00:31:01,943physical exercise, avoid substance abuse, mental exercise40800:31:01,943 --> 00:31:08,272, reading classes, get a hobby. In summary, dementia is not a 40900:31:08,333 --> 00:31:11,827disease, but rather an umbrella term that describes a wide range41000:31:11,827 --> 00:31:15,051of symptoms that affects people's ability to perform 41100:31:15,265 --> 00:31:19,290everyday activities on their own. Alzheimer's is a disease of 41200:31:19,310 --> 00:31:23,444the brain that leads to dementia. Dementia and indeed is the 41300:31:23,484 --> 00:31:28,286most common type of dementia andarguably one of the most 41400:31:28,326 --> 00:31:32,550serious types of dementia. Common symptoms of dementia 41500:31:32,611 --> 00:31:38,088include thinking issues, decreased memory, poor judgment,41600:31:38,088 --> 00:31:41,153decreased focus, changes in language, decreased behavior. 41700:31:41,965 --> 00:31:49,607Alzheimer's increases that or copies that and makes it even 41800:31:49,688 --> 00:31:53,571worse. Quite honestly, alzheimer's occurs mostly in 41900:31:53,664 --> 00:31:59,094individuals over six to five years of age. In later stages 42000:32:00,307 --> 00:32:06,555Alzheimer's has huge damage to the brain in its ability to 42100:32:06,654 --> 00:32:11,188function. We call that the ability to do activities of 42200:32:11,248 --> 00:32:16,634daily living dressing, eating, brushing your teeth, grooming, 42300:32:16,775 --> 00:32:20,605etc. There is a very active Alzheimer's association that is 42400:32:20,685 --> 00:32:24,609located in Chicago, illinois. Their phone number is 42500:32:24,890 --> 00:32:32,2671-800-272-3900. If you believe that either you yourself or 42600:32:32,287 --> 00:32:37,882someone you know or family member has dementia in or 42700:32:37,902 --> 00:32:43,029Alzheimer's, certainly recommendthat you bring that up with 42800:32:43,090 --> 00:32:48,133your healthcare professional andget an evaluation and exam and 42900:32:48,556 --> 00:32:51,054whatever tests that need to be done. But you can also yourself 43000:32:51,105 --> 00:32:54,765call the Alzheimer's Associationand do your own research in 43100:32:55,346 --> 00:32:59,996independently. Knowledge is power, just so that you better 43200:33:00,076 --> 00:33:03,269understand what's going on. My basic principles. I always like 43300:33:03,349 --> 00:33:06,615to end with my basic principles.My first principle is God is in43400:33:06,615 --> 00:33:09,974charge. I am a physician of faith and indeed is my belief in43500:33:09,974 --> 00:33:12,953my faith in God that has sustained me over these years 43600:33:15,532 --> 00:33:19,192and allowed me to provide care for my patients. Second, I don't43700:33:19,192 --> 00:33:24,551have any bad days. I've fixed my own health and I've had bad 43800:33:24,573 --> 00:33:27,467days. I figured out about 30 years ago that whether I had a 43900:33:27,487 --> 00:33:32,519good day or a bad day was reallyup to me, and I made a decision44000:33:32,519 --> 00:33:35,164that I did not need any more bad days. I had had enough. So 44100:33:35,224 --> 00:33:39,867now my days are either good daysor great days. Principle number44200:33:39,867 --> 00:33:44,346three don't sweat the small stuff. Most stuff is small. I 44300:33:44,847 --> 00:33:48,209have learned not to allow small things to bother me as much as 44400:33:48,269 --> 00:33:52,346they used to. I have figured outthat most times I make the 44500:33:52,365 --> 00:33:56,547biggest deal, for the most part as I think it is. So I'm working44600:33:56,547 --> 00:33:59,369, I'm better not 100%, but I'm better about letting it go. 44700:34:00,787 --> 00:34:03,688Principle number four forgiveness is therapy. Whatever44800:34:03,688 --> 00:34:08,929occurs to you that you perceiveas negative, I suggest to you 44900:34:09,030 --> 00:34:14,320to immediately forgive. Forgive the individual, whatever the 45000:34:14,362 --> 00:34:17,570circumstances are. It does not matter what the facts are, just 45100:34:17,833 --> 00:34:22,246automatically forgive that. That, indeed, is therapy. And the 45200:34:22,266 --> 00:34:25,125final principle is everything isa relationship Work 45300:34:25,164 --> 00:34:27,373relationship, family relationship, et cetera, et 45400:34:27,393 --> 00:34:30,806cetera. Relationships are based on three things Mutual respect, 45500:34:30,867 --> 00:34:34,454mutual trust, good communication. If you have those things, you 45600:34:34,514 --> 00:34:38,150have a very good relationship. If you do not have those things,45700:34:38,150 --> 00:34:43,753you have work to do. These discussions, this podcast series45800:34:43,753 --> 00:34:48,378, is part of a masterclass series with a number of 45900:34:48,418 --> 00:34:51,005different topics, and I would encourage you to subscribe. 46000:34:51,606 --> 00:34:57,012Should you choose to, you can goto wwwbuzzsproutcom forward 46100:34:57,052 --> 00:35:04,132slash 210103. That's wwwbuzzsproutcom forward slash 46200:35:04,313 --> 00:35:15,583210103. And finally, be the change that you want to see in 46300:35:15,603 --> 00:35:18,492the world. Thank you and have a wonderful day. 46400:35:47,474 --> 00:35:50,391Speaker 1: And then take the next step of action and share it46500:35:50,391 --> 00:35:53,989with your family, friends and or your coworkers. They'll be 46600:35:54,028 --> 00:35:58,923glad you did so. Until the next time, live your best possible 46700:35:58,943 --> 00:36:02,378life the best possible way. You've been listening to the 46800:36:02,398 --> 00:36:05,938Healthy, Wealthy and Wise Podcast with Dr William Choctaw,46900:36:05,938 --> 00:36:07,646MDJD.