Dementia Matters

This episode explores genetic risk factors for early- and late-onset Alzheimer’s disease. Host Nathaniel Chin and guest Corinne Engelman discuss the research looking into genetic risk for Alzheimer’s disease and the uncertainty that comes with genetic testing. Guest: Corinne Engelman, MSHP, PhD, associate professor, Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health Episode Topics: What are the genetic influences on a person’s risk for Alzheimer’s disease? 2:07 What genes affect individuals with early-onset dementia? 2:56 What is the impact of genes that counter one another? 5:34 How much can our lifestyle choices affect our genetic risk? 7:52 How is the genetic testing being analyzed? 9:03  What can at-home genetic testing tell us about Alzheimer’s disease? 10:06 How essential is the role of genetic counselor? 11:47 Have we found any genetic risks related to the aging process? 13:21 What advice do you have for people interested in maximizing their genetic outcome when it comes to Alzheimer's disease risk? 14:40 

Our guest, Dr. Kimberly Mueller, joins us to discuss cognitively stimulating activities and the impact of social engagement on brain health. Guest: Kimberly Mueller, PhD, CCC-SLP, Assistant Professor, Department of Communications Sciences and Disorders, University of Wisconsin-Madison Episode Topics: What are cognitively stimulating activities? 1:25 Recent studies: 2:50 Are some activities better than others? 9:00 Are Jeopardy or other “active” television shows considered cognitively stimulating? 10:23 Are board games, crossword puzzles, and brain games considered cognitively stimulating activities? 11:22 Is there evidence showing the benefits of social engagement? 15:08 Advice for maintaining and strengthening brain health: 18:37

In this bonus episode, we continue our conversation with Dr. Howie Rosen on Frontotemporal Dementia (FTD). On last week’s episode, Dr. Rosen spoke on the genetic risk factors, trajectories and family caregiving experiences of FTD. Now, our conversation turns to the research looking into how the disease affects self-awareness, biomarkers and early detection, as well as ways people can volunteer for a research study. Guest: Howard “Howie” Rosen, MD, behavioral neurologist at the University of California San Francisco Memory and Aging Center Episode Topics:         FTD and self-awareness: 1:10         Research into biomarkers for Frontotemporal Dementia: 4:42         How can people help the research: 11:40

Frontotemporal dementia (FTD) is a type of dementia caused by degeneration in the temporal and frontal lobes of the brain. Our guest discusses the symptoms, risk factors, prevalence, and course of the disease, along with information on how a doctor diagnoses FTD and what families and caregivers can do after diagnosis. Guest: Howard “Howie” Rosen, MD, behavioral neurologist at the University of California San Francisco Memory and Aging Center Episode Topics: A definition of Frontotemporal Dementia (FTD) 1:02 How common is FTD? 3:53 Genetic risk factors of FTD: 4:30 Non-genetic risk factors of FTD: 6:40 Symptoms of FTD: 8:40 How a clinician diagnoses FTD: 14:03 What is the course of the disease? 16:20 What to do after a diagnosis: 18:51 Family and caregiver experience of FTD: 22:36 Community support and networking: 25:53

Our guests, Dr. Rebecca Koscik and Dr. Tobey Betthauser, are researchers investigating the trajectory of amyloid and tau proteins over time and the significance of amyloid chronicity. Koscik and Betthauser discuss their two recent publications on the topic and how amyloid PET scans have helped scientists better understand the early brain changes associated with Alzheimer’s disease. Guests: Rebecca Koscik, PhD, senior scientist, Tobey Betthauser, PhD, postdoctoral fellow, University of Wisconsin-Madison In this episode, we discuss ... How amyloid PET tracers work 7:17 Published research on amyloid duration 12:01 Research supporting amyloid chronicity 18:14

Our guest is Dr. Sterling Johnson, associate director of the Wisconsin Alzheimer’s Disease Research Center and principal investigator of the Wisconsin Registry for Alzheimer's Prevention (WRAP) study at the University of Wisconsin-Madison. The WRAP study is one of the largest and longest-running observational studies of Alzheimer's disease in the world. Dr. Johnson shares study findings, discusses advancements in brain imaging, and introduces the concept of amyloid chronicity. Guest: Sterling Johnson, PhD, professor of medicine (geriatrics), University of Wisconsin School of Medicine and Public Health Show Notes: What is the WRAP study? 3:28 Findings from the study: 8:06 WRAP studies outside of Wisconsin: 10:59 What is amyloid chronicity? 15:19  

Dr. J. Neil Henderson is an expert on diabetes and dementia, as well as creating culturally specific caregiver training programs for people who care for American Indian elders. Dr. Henderson, who is Oklahoma Choctaw, discusses cultural influences on caregiving and his work in improving brain health among American Indians and rural populations. Guest: J. Neil Henderson, PhD, professor, University of Minnesota School of Medicine, Duluth campus; executive director, Memory Keepers Medical Discovery Team on Health Disparities Show Notes: Trainable caregiving skills: 1:07 Impact of culture on caregiving: 6:29 American Indian and rural health disparities in memory: 10:35  

People diagnosed with Alzheimer’s disease before the age of 65 are said to have early-onset Alzheimer’s disease. While this diagnosis is rare, the condition is very serious for the patient and their loved ones. Our guest helps define the disease and its symptoms, walks listeners through a diagnosis, and points to unique considerations for patients and their caregivers. Guest: Susanne Seeger, MD, associate professor (clinical) of neurology, University of Wisconsin School of Medicine and Public Health  Key Moments: Defining early-onset Alzheimer’s disease and its symptoms: 0:58 Differentiating vascular and frontotemporal dementia from early-onset Alzheimer’s disease: 7:19 Most common memory and thinking complaints: 9:27 Diagnosing early-onset Alzheimer’s disease: 11:15 Issues people face after an early-onset Alzheimer’s disease diagnosis: 12:50 Where to go for help after a diagnosis: 14:35 Genetic considerations for patients and family members: 19:36

A common concern for families and dementia caregivers is when to start talking about palliative care and hospice with and for their loved ones with dementia. Our guest, Dr. Kate Schueller, recommends these conversations happen soon after a diagnosis, when the dementia patient can still be involved in planning their care. This episode talks about the difference between palliative care and hospice, the right time to initiative services, and other considerations for patients, families, and caregivers. Guest: Dr. Kate Schueller, MD, assistant professor of medicine, Division of Hematology, Medical Oncology and Palliative Care, University of Wisconsin School of Medicine and Public Health Key Moments: The difference between palliative care and hospice: 0:50 How palliative care helps dementia: 4:49 Further steps for families: 10:17 What palliative care and hospice offer for grief: 16:07

To many people, exercise can seem like an uncertain and intimidating new world. The confusing marketing around it can make it hard to find a healthy, sustainable exercise plan. But it's important for people to fit movement into their lives because a growing body of research is showing the positive effects that physical activity can have on your brain. Our guests Sarah Lose and Max Gaitan, research specialists and exercise physiologists, discuss building cognitive resilience, defining physical activity, and researching exercise and its links with brain health. Guests: Sarah Lose, Max Gaitan, Research Specialists and Exercise Physiologists, Okonkwo Lab, Alzheimer’s Disease Research Center, University of Wisconsin-Madison “Overall, what our lab has found, is that physical activity and fitness can diminish or dampen both the effects of age and a genetic risk, or predisposition, to developing Alzheimer's disease." - Sarah Lose (9:57) Key Moments: Clarifying the terms in exercise research: 1:21 Defining and understanding cognitive resilience: 4:29 Can physical activity help memory? 7:20 The future for exercise research: 12:22 Tips on exercise and staying healthy: 15:54