Retirement news: Highly-regarded doctor on Alzheimer's warning signs

The Street

Dr. Manisha Parulakar of Hackensack University Medical Center shares how to know when you need to get checked.

Transcript

00:00this morning on brn signs it's time to take your memory loss seriously and joining me now to

00:11discuss this and a lot more dr manisha parulakar of hackensack university medical center dr parulakar

00:18great to see you thanks for joining us in the program this morning thank you for inviting me

00:23yeah it's great we're talking about memory and i guess my first question is how do you figure out

00:31whether or not forgetfulness needs to be taken more serious and that it could lead to

00:39a potential alzheimer's or dementia diagnosis

00:42before i used to jokingly tell my patients that if you forget what you forgot we have a problem

00:52and we need to we need to get a formal assessment and formal evaluation

00:58the topic has changed a little bit more now especially because we do have the new treatment

01:05options available which are for patients with mild cognitive impairment so not necessarily the

01:12diagnosis the pre pre-dementia stage of mild cognitive impairment and what that looks like is

01:20if you are having difficulty doing your day-to-day task something that you've been doing for years

01:27and had no problems but now all of a sudden you need a much longer time to complete that task maybe

01:34that's paying the bills managing your calendar managing a project if you are having a harder time and

01:42you're requiring much longer time and many more resources to finish it maybe there is something going

01:48on and you should talk to your doctor about it and and and so that takes some personal awareness

01:55but what about um a family member i mean is this something that a family member could check

02:01with their loved one uh you know to see if hey you know they're just not completing the tasks

02:07the way they used to complete the task but but and also doctor um you know we we slow down a little

02:14bit as we age i know i'm a lot slower than i was in my 20s absolutely and those are those are two

02:20important points and one is that some slowing down does happen to all of us that's the loss of brain

02:26plasticity and all of us are going to have that as we age being said that it still should not interfere

02:33with our activities that we were doing so well so we should still be able to pay our bills the same

02:39way that we were doing 10 years ago i may have a difficult time figuring out setting up a new

02:45process so if i was setting up a new account to do that that may take a little bit longer but if i was

02:53doing something like handwriting my checkbook i should be able to do that in a timely manner so if i'm

02:58taking much longer and if i'm asking many more questions and that's something the family members can

03:03observe is that if the loved one are they asking a lot of questions for their usual activity

03:09are they not able to do the cooking that they were doing without going back to the the recipe

03:15or asking questions about recipe are they just repeating questions that they're forgetting the

03:21conversation that they had uh not that long ago so those are all warning signs that okay there's

03:27something going on so so doctor if you if you see something going on what's the first and you're a loved

03:33one let's just say uh or an individual you you feel something's not right what's the first step you

03:40should take should you call your internist your general practitioner or do you go directly to

03:45someone like yourself who's a specialist in cognitive functions and alzheimer's and dementia

03:50i would say it depends on what access you have so if you do have access to a memory center around you

03:58reaching out to them and making an appointment is a great idea because they have all the resources and

04:04and they can really especially when it comes to mild cognitive impairment which is a very

04:08um it's a diagnosis it's a accurate diagnosis it does require a lot of multiple steps to get there

04:14so if you have access that would be great but unfortunately we don't have those many memory centers around

04:21so talking to your primary care physician is a great first step and they could start with some

04:28of the basic testing and then decide whether further investigation is needed yeah and and then they would

04:35refer to you to someone like yourself or or someone else to help address and and see what the root

04:43cause of it of it could be uh doctor you mentioned as we age you know the brain is not as elastic i

04:51think is the term you use but are there are there things that we can do to create better elasticity

04:59and improve the longevity of our of our thoughts of our brains of our memories absolutely and i think

05:07that's the reason why it is so crucial for us to start thinking about our brain in our 40s and 50s

05:13and not because we definitely know that alzheimer's is a very long process it's about it's going on for

05:20about 10 15 years before it starts producing those memory symptoms so it really is important for all

05:27of us to to work on the plasticity and to maintain our function of the brain and the big threats for

05:34our brain health are our chronic conditions so managing your high blood pressure managing your

05:40diabetes managing your cholesterol are really essential to maintain that brain health the second

05:46big threat is our mobility so not moving enough is is an important risk factor so just having any

05:55mobility is better than none but continuing to move and newer data suggesting that we want to be

06:01mobile throughout the day so not just hitting the gym for one hour but then saying sedentary of the

06:07rest of the day that doesn't help either so staying active and not not sitting at one place for too long

06:13is helpful managing our sleep which is something else that we don't necessarily pay attention to a lot

06:19of people will walk around saying oh i do fine with four hours of sleep we know that's the time that our

06:26brain spends in in managing our deep memories creating new memories so we need to have that says six to

06:34seven hours of sleep ideally seven to eight hours of sleep to be able to recharge the brain for the next day

06:41um and then of course staying away from substances um we are finding more and more evidence that

06:48alcohol is really not good for us even small amounts of smoking some other substance use like

06:54marijuana they all have negative effects on your brain so staying away from substance use is another

06:59great way to um to maintain your brain health um and managing a lot of times the substance use is

07:04related to uh behavioral health issues so managing the behavioral health issues by getting the right help

07:10um meditation yoga are great ways to to help almost all behavioral health issues as a basic step

07:18so addressing all of them uh together or we can technically push um the risk of dementia to a much

07:26much later part of our life and last question for you doctor in terms of treatment are are we further

07:33long in terms of the research and medications that maybe can delay or even reverse some of the effects

07:41of these of this disease so a lot of yes we do have new medications especially for alzheimer's or

07:50mainly for alzheimer's that can be used in that mild cognitive stage of the disease or very early

07:55dementia disease um and it can it does have potential of progress slowing down the progression to some

08:02extent we don't have anything right now that actually reverses the disease so we're still working on that

08:09and a lot of studies are showing that the non-pharmacological interventions that we just talked about

08:15the exercise the sleep the brain exercises um can be equally helpful in slowing down the progression

08:24and sometimes even maybe reverse it especially if you're in the mild cognitive phase and if you

08:28address all of those um that can be potentially helpful yeah i mean and alzheimer's it sounds like

08:36doctor alzheimer's if you take the right steps alzheimer's doesn't have to be the end result of aging

08:41it doesn't have to be the the thing that ultimately we all get absolutely and and there are people

08:50telling us that that's true if you look at the blue zone um where people are living to be 100 and a lot

08:58of them have their their memory intact um so that that tells you that following those non-pharmacological

09:05interventions socializing um and having that support structure can protect our brain health and

09:12potentially help us prevent or at least push it to a much much later time part of our life

09:17well doctor you you talked about treatment i want to ask you about maybe the uh ask you about the

09:23blood test where we look at biomarkers how successful is that blood trust and should i go

09:29run out to the store and take it or to the doctor and take it and get it okay so um yes to first question

09:37no to second question so yes we have done a significant progress in in helping in building biomarkers

09:43um in alzheimer's and now we're using similar knowledge to look at louis body and other types

09:48of dementias as well um so we have much more we have gotten much more sophisticated to have that

09:53accurate diagnosis and yes we have moved from doing the cerebral spinal fluid to now blood to able to

10:00help us with those uh with the accurate diagnosis uh but those blood tests should be ordered in the

10:07context of um if somebody has memory issues has had some invested some workup and there is a

10:15possible diagnosis of alzheimer's so it's not a screening test we should not be just going and

10:21getting it um and we should not definitely be asking our doctors to say that hey you're doing

10:26my blood work can you add that screening test for alzheimer's as well yeah it's not going to be

10:30showing up on the on the lab core menu anytime soon i guess but it is it is it is on the it is on

10:36the lab core and quest menu and that's the reason i'm making a point even further that please don't

10:41ask for it just because it's on the menu yeah very very smart well doctor thank you so much again for

10:46joining us and we look forward to having you back on the program again very soon thank you so much

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11:02the show you were just watching and we're back again tomorrow for another edition of brn until

11:08that i'm jeff snyder stay safe keep on saving and don't forget roll with the changes

11:12you

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