Reducing Dementia Risk: From Sleep Studies to Flossing

Dr. Clionsky, author of  Dementia Prevention: Using Your Head to Save Your Brain, is back  on the podcast and he sheds light on the often underestimated influence of conditions like sleep apnea and UTIs on our cognitive well-being, particularly as we age. Discover how early recognition and management of these health concerns can play a pivotal role in safeguarding against dementia.

Dr. Clionsky introduces an invaluable tool – his free online survey available at braindoc.com. This survey is tailored to assess personal dementia risk and provides customized prevention strategies, empowering listeners to take proactive steps towards brain health.

Tune in now to gain exclusive insights from Dr. Clionsky and embark on a journey towards a sharper, healthier mind!

SeniorLivingGuide.com Podcast sponsored by TransMed Care Long Distance Medical Transportation

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Transcript

Darleen Mahoney [00:00:03]:

Let me introduce you to doctor Mitch Clionsky He is a board certified neuropsychologist who has treated more than 20,000 patients with cognitive problems. He and his physician wife, Doctor Emily Clionsky, have written a book, dementia prevention, using your head to save your brain, and I'm super excited to have him. This is actually his second podcast with us because there was so much more information that we could get into the first one, which is dementia prevention. Yes, prevention. So if you haven't checked out that podcast, listen to that one as well, because this is somewhat of a part two. Thank you so much for joining us today, Doctor Clionsky.

Mitchell [00:00:44]:

I'm so happy to be back. We had great fun the last time. I think it gave me an opportunity to delve into some areas that most people do not appreciate. And the fact that you can reduce your risk of dementia by 50%. One of two cases of dementia are preventable, I think is a very powerful message. So every time we get a chance to talk more about it, I hope that we're going to save some more brains.

Darleen Mahoney [00:01:12]:

Absolutely. I really appreciate you joining me again. And I know we talked a lot about something that was really like.

Mitchell [00:01:23]:

Blew my mind.

Darleen Mahoney [00:01:24]:

Blew my mind.

Darleen Mahoney [00:01:25]:

There you go. So we talked a lot about the sleep, sleep apnea and those types of things. Those were like the biggest topics on the previous podcast that we did. I had no idea how important sleep and diagnosing areas of, I guess, the apnea or not being able to sleep, what causes that?

Mitchell [00:01:48]:

It's the lack of oxygen. When you have sleep apnea, it's not so much that your sleep is terrible, although it often is, because you're awakening multiple times, because you can't breathe, or it actually affects how often you have to get up to go to the bathroom in the middle of the night. So when you don't get enough oxygen, it increases the rate at which your kidneys pull off fluid from around your heart and your lungs and turn it into urine. So those people who are getting up three or four times every night to go pee, they're going to the urologist rather than the neurologist or the pulmonologist, the breathing doctor, to figure out what's going on. And that creates a problem because they're not addressing the real problem. Not enough breathing. They stop breathing multiple times. Therefore, not enough oxygen gets to their brain.

Mitchell [00:02:46]:

They attribute it to either being women who've given birth. They say, well, it's my bladder. So they get bladder slings or they get medications to tighten up their bladder. If they're men, they say, oh, it's due to my prostate. Well, it actually isn't. The prostate actually just gets in the way of your urinating and completely emptying your bladder. There's nothing in your prostate that creates urine. So they have this attribution, this belief that it's one thing or the other, and then they go about it the wrong way rather than looking at the central problem, which is I keep not breathing multiple times while I'm sleeping.

Mitchell [00:03:31]:

That's a very treatable problems. And if you're over the age of 58, the statistics tell us one out of two of you have this problem. So it's really common.

Darleen Mahoney [00:03:41]:

Yeah, well, and I know that for women specifically, and men may experience the same thing as they get older, sleep becomes an issue. I mean, most I know I have this issue, I have a problem sleeping. I've had it for quite a while. I don't know why, because my brain doesn't turn off, is what I feel like. It's. It does. But a lot of my friends that are in the same age group and older, they are all experiencing the same thing. They don't sleep all the way through the night.

Darleen Mahoney [00:04:07]:

They get up, they maybe go get something to eat or they watch a little tv. They have to do something to decompress, to go back to sleep. So it's so not unusual to have this as a general problem. So the fact that you should really probably just have it checked out to be safe. And the sleep side for, like, the apnea, I think that's a great idea. And I think you mentioned, I think they can do it with just something on your finger. Is that correct?

Mitchell [00:04:33]:

Home sleep studies in your own bed use different devices. One of them is a thing that just goes over your finger. Others go around your chest or under your nose. Depends on which company your doctor is going to refer you to. But in every case, they're painless. They are easy. It's only one night. It's in your own bed.

Mitchell [00:04:55]:

And it gives your doctor and the consulting sleep medicine doctor a wealth of experience and information about how well you're sleeping. Whether your, you know, your heart rate is slowing down while you're sleeping is deceleration kinds of phenomena, whether your oxygen levels are dropping significantly. So it tells them a lot for a very low investment of time and energy, which is why we recommend it pretty much routinely for the people we see in midlife or older. Yeah, because you're right. It's not just the apnea, too. You're talking about sleep difficulties, falling asleep, staying asleep consistently, getting up too early in the morning. And we now know that the right amount of sleep for most people is about 7 hours, plus or minus one or 2 hours. If you're getting less than 5 hours sleep, you really do have a problem you need to pay attention to.

Mitchell [00:05:53]:

And if you're an adult, not a teenager, because teenagers need more sleep. But if you're an adult and you're sleeping or needing to sleep more than 9 hours, you need to look into that as well, because there's a reason why you're not feeling restored and rested after a normal amount of sleep.

Darleen Mahoney [00:06:09]:

Yeah.

Mitchell [00:06:10]:

And it's a huge, huge problem for all kinds of people, for all kinds of reasons. Some of it is self caused. I mean, you probably know people like this. They're tired during the day, so they go to bed early, but they don't go to sleep. It's too early to go to sleep. So they set up shop in their bed. They got their devices, they got their tv, they got the devices which are now broadcasting blue light into their eyes and waking up their brains when they're trying to go to sleep. They're talking on the phone, they're socializing, they're texting, they're emailing, they're flipping through Facebook, they're flipping through TikTok, doing everything else that's confusing their brain about what they're supposed to be doing.

Darleen Mahoney [00:06:54]:

Yeah.

Mitchell [00:06:54]:

So the devices that we're using at night in our bed actually contribute to some of the sleep problems that we have.

Darleen Mahoney [00:07:02]:

Yeah.

Mitchell [00:07:03]:

Another problem we see is people hold on to things that bother them and don't deal with them during the day. Then they go to bed, and as they're relaxing, as they're essentially surrendering to sleep, the thing they were supposed to do, the call they were supposed to make, the thing that's coming up tomorrow that they're not prepared for, the irritation that they felt towards someone in their life, the fear they had when someone said something that disappointed, that all kinds of different things now start to play out and interfere with their falling asleep. So one of the things I used to do years ago, back when I did a lot of psychotherapy, rather than dealing with cognitive impairment, was I used to work with people on developing a routine before they went to bed to put aside the concerns that kept them awake. And I'll share that with you.

Darleen Mahoney [00:08:06]:

I totally want to hear this. I'm so sorry.

Darleen Mahoney [00:08:08]:

Okay.

Mitchell [00:08:08]:

It's a really easy technique.

Darleen Mahoney [00:08:09]:

Yeah.

Mitchell [00:08:10]:

But you have to do it consistently.

Darleen Mahoney [00:08:12]:

Okay.

Mitchell [00:08:12]:

Here's the technique about 07:00, before anything else is going on, that you're planning to go to bed, you sit down and you mentally review all of the things that have bothered you that day that you didn't get a chance to do, that you're worried about coming up, and you write them down physically using old fashioned paper and pen or pencil. So you're writing all of these things down. You try to be as thorough as possible because it can take a little time at the beginning to go through. I'm worried about my cousin because he's going in for an operation, and so and so is not doing so well in school, and I'm worried about that. And you just write all these things down. And the plans that you have because you don't want your brain to have to rehearse your schedule for tomorrow while you're trying to sleep.

Darleen Mahoney [00:09:03]:

And I think that when you're sleeping, it's. Or trying to go to sleep, they're bigger.

Mitchell [00:09:09]:

Oh, yeah.

Darleen Mahoney [00:09:09]:

Yeah.

Darleen Mahoney [00:09:09]:

I mean, you, in your mind, it's all these different things. And then you wake up and you. It's not such a big deal.

Mitchell [00:09:15]:

So after you write this down, you then take the paper and you put it someplace safe. My favorite response to this was my patient who put it in her freezer. I said, your freezer? She said, yeah. Two reasons. Number one, nobody else has got to go in there looking for it, so I don't have to worry about security for my family. And the second is, I thought it would be nice to put it on ice. It had a certain feel to it.

Darleen Mahoney [00:09:42]:

I love that.

Mitchell [00:09:42]:

Put it away because you now tell yourself, I don't have to think about that. I've got it all set for tomorrow morning when I can go get my list and look what I have to do and deal with what was on it. I will tell you, if you do this over the course of several nights or more, you will find a reduction in those kinds of thoughts that keep you awake at night. Because now you're crossing things off the new list that you're writing. You rewrite the list every night it gets smaller, it gets changed over time. And you find that I can relax. I've got that covered. I'll deal with it when I'm fresh.

Mitchell [00:10:23]:

I'll deal with it when the sun's up. And if I've had a cocktail or two, I'll be in a better state of sobriety at that point as well. That's the time to deal with it.

Darleen Mahoney [00:10:34]:

I think that's so amazing. Women specifically. I feel like definitely noodle things over a lot. And sometimes it's not just your tasks, but it's, oh, she said this, or did I fend somebody? Or, you know, you start like replaying issues in your day that you may not have really thought about or that it was kind of naggy during the day, but you didn't really address it because you're doing this and doing that. So writing all those things down, you know, I think can get it off your chest as well. You know, I used to, back in the day, I used to wake up and write stuff down and then honestly could go back to sleep.

Mitchell [00:11:08]:

I still do that.

Darleen Mahoney [00:11:09]:

Yeah.

Mitchell [00:11:10]:

I get ideas for posts I want to do for when we were writing the book dementia prevention, I was getting up with ideas about, that's how I want to phrase that went through a long period of time. We're trying to decide on the best title for the book because after the colon of dementia prevention, we couldn't agree on what it was supposed to say. After that, you know, it eventually ended up being using your head to save your brain. But we had all kinds of different titles that we couldn't agree upon. And that's why I get up and write in the middle of the night, because if I didn't write them, I'd be afraid. I forget about the, by the time the morning came and then I wouldn't be able to come up with it. But at least it got it off my brain. So I think that is a good technique.

Darleen Mahoney [00:11:54]:

Absolutely. I love that idea. It really does work. So if you're listening, just give it a whirl. So what are some other things? I know that we really talked a lot about the sleep and, but there were other things that you could do or you could look at or you could, you know, analyze about your current life or situation or habits that would be helpful in preventing dementia. So what are some of the other.

Mitchell [00:12:19]:

Things we didn't chat about couple that surprise people. One of those has to do with your dental hygiene. Turns out that there is a relationship, a significant relationship, between gingivitis, which is the inflammation of your gums and gum disease, and the infections that cause that. That can cross the blood brain barrier and impact your brain, any kind of inflammation. So we oftentimes see people and they're doing okay. They're having some mild problems, but then they come down with a bad case of the flu, or they have UTI or they have some other disease state that's temporary. For most people, it's pneumonia. They don't breathe as well.

Mitchell [00:13:16]:

They have an increase in their temperature, they have an inflammation, and their cognition goes way down and sometimes does not come back to where it was before this infection. So I'm a big believer that you want to limit your chances by having routine vaccinations for things that we know can cause these kinds of problems, like pneumonia. We have pneumonia vaccines these days. You don't want to end up with anything that's going to cause you to have any increased inflammation. So you want to really not just brush your teeth, but as I tell people. You want to use the f word.

Darleen Mahoney [00:14:00]:

Yes.

Darleen Mahoney [00:14:01]:

And this is a PG relations.

Mitchell [00:14:03]:

I like to get people's attention.

Darleen Mahoney [00:14:04]:

I'd say this is a PG show, so. Or a podcast, I should say. So.

Mitchell [00:14:10]:

This is safe for work. Okay. So my dental hygienist taught me the f word.

Darleen Mahoney [00:14:16]:

Yes.

Mitchell [00:14:16]:

The word for it is floss.

Darleen Mahoney [00:14:18]:

Absolutely.

Darleen Mahoney [00:14:19]:

Yeah.

Mitchell [00:14:19]:

It's what we don't do because it's tough. You get those strings, and you try to put them into your mouth. But I recently found this really cool thing. They're really curved kinds of toothpicks, and they're plastic, and you basically push them in between your teeth. I hated flossing. I did it under dress. Usually. It was after I went for my routine follow up care, and my dental hygienist would measure the pockets in my gums.

Mitchell [00:14:50]:

It's one of these places where you don't want to have deep pockets.

Darleen Mahoney [00:14:52]:

Right.

Mitchell [00:14:53]:

And she said, well, that's a four or five. And we got to come in there and scale that. We got to do this. And she talked to me about flossing, and I'd say, yeah, yeah, yeah. And I really planned to do it. Then I wouldn't.

Darleen Mahoney [00:15:05]:

Yeah.

Mitchell [00:15:05]:

Until I was getting close to my next visit, where I would do it for, like, three days.

Darleen Mahoney [00:15:13]:

Yeah.

Mitchell [00:15:14]:

Wasn't enough. But then she showed me these little gum picks, and it was like, wow, I could get these in the grocery store. I can get them in the pharmacy. They're not expensive. They have a little travel kit to them, little plastic. You can take them with you when you travel. And so now I do that twice a day, in addition to brushing, two or three times a day. And now I go back and she says, wow, you got the gums of a 30 year old.

Darleen Mahoney [00:15:40]:

Who knew?

Mitchell [00:15:41]:

Who knew? It's just that simple. But it's, again, one of those little things that you do over time, because I really want to keep all my teeth, and I really want to keep my gums in good shape. And so many people, as they get older, just stop doing that with really bad results. So that's one thing we can do. The other thing that most people don't recognize is that hearing loss is a reversible or improvable cause of dementia, 100%.

Darleen Mahoney [00:16:10]:

And to me, that's a no brainer, quote, unquote. But it really does make complete sense. So why is that? Why does the loss of hearing affect the dementia side? Because I do know that a lot of people. My dad had a loss of hearing. He didn't recognize it. He said he just had selective hearing. He just didn't hear my mother. But the reality is, is he really couldn't hear a lot.

Darleen Mahoney [00:16:35]:

But he was just so stubborn. Absolutely, 100% stubborn. He never did anything about it.

Mitchell [00:16:41]:

Yes, I see that all the time. Partly it's changing because of better technology for hearing aids that make them smaller and in most cases, pretty much invisible. Unless you're standing right up there looking in the person's ear, and you're seeing the little string kind of fiber that goes down from the back of their ear where the hearing appliance is into the hearing area, the ear canal, and those other ones that go into the ear itself. So there's nothing behind it. Depends on what you do best with and what stays in your ear the best. But what causes us to lose cognition or to have a greater proclivity toward declining is that our brain's not getting stimulated. It's the background noises. It's those birds chirping that you don't hear as well when you're losing your hearing.

Mitchell [00:17:43]:

It's the dog outside barking. It's the engine and the motorcycle outside. All of those daily noises actually stimulate your brain, so they're picking it up through a part of your brain surface called the auditory association cortex. Now, how do we know this is going on? Is based on some studies using a very specific kind of MRI scan, not the kind that you would get if you went to see a neurologist because of a concern about your brain. This is called volumetric imaging. Uses high speed computers to compute the relationships of very small areas to all the other ones and measure them. What they find is that the people with even subtle hearing loss have a thinning of the surface of their brain at the auditory association areas that connect with memory areas. So one of the reasons why you lose mental abilities is that you are consistently understimulating your brain.

Mitchell [00:18:51]:

The other thing that happens is there are what we now know to be background resting networks, those things that go on and connect different parts of our brain when we're not thinking in particular. And they know this because of a different kind of MRI. Also something you'll not get in your doctor's office or in the MRI lab down the road. This is called functional MRI fMRI. And this is done in a couple different ways. But the kind of way I were going to talk about this is when they bring people in and they simply have them get hooked up and sit in a room for several hours, and they're able to look at how different parts of the brain are in parallel with other parts, how they're connected, and they're able to identify these background resting networks. One of them is that is particularly impaired in people with hearing loss is called the salience Network. Now, something that's salient is meaningful.

Mitchell [00:19:52]:

It grabs our attention. So people who have, under activation of their salience network, are missing things. The other thing that happens as a consequence, it's sort of a secondary effect of hearing loss is that people don't enjoy being with other people very much. They're missing the jokes. Yeah, they don't hear accurately. They're answering the wrong question. I had an aunt who had hearing loss but was refusing due to her own vanity because at age 88 and 89, she thought that she was still hot enough to get every guy in the room. It's hilarious stuff, but it was, it was her mo and I loved her.

Darleen Mahoney [00:20:34]:

For it, but she don't get her hearing.

Mitchell [00:20:37]:

I'm sorry.

Darleen Mahoney [00:20:37]:

I said, good for her.

Mitchell [00:20:39]:

Oh, yeah, she was a hot ticket.

Darleen Mahoney [00:20:40]:

Yeah.

Mitchell [00:20:41]:

But my aunt Dolores one day is at a party that my brother's attending. He's the one telling me the story. And she's talking to a woman who she had not seen in about three or four years. After the conversation, she comes up to my brother and says, that was so disgusting. I'm so irritated with her. My brother said, why? She said, you know, I haven't seen this woman in three or four years. The first thing she asks me is, how old are you? My brother practically falls off the couch. He says, no, that's not what she asked.

Mitchell [00:21:17]:

She asked, how are you? But she, through her own lens, which was concerned about her beauty and her hearing loss, got offended at this kind of response. But I see that all the time with my patients where I'm asking them one question, they're answering a slightly different question because they didn't hear the actual question I was asking. So if you want to improve your relationships with other people, despite the value of this being good for your brain, you're also going to have closer relationships and less conflict. If you actually are hearing what's going on, you're going to be more interested because you're going to miss some of the subtleties of the humor if you don't hear all the words.

Darleen Mahoney [00:22:02]:

Yeah, I really feel like if you do have that hearing loss and you're not doing anything about it, you're missing so much of social connections that you could be having. And I have seen the new hearing aids and they are very, very subtle. We have a friend that has them, and honestly, when she's wearing them, I have no idea that she has them in. So it's really been a game changer to have them because I do think the of the hearing aid that was so visible to everyone was a lot of the reasons that people were not going to the doctor to get their hearing checked. So I think that that's such a great tip for those that are listening that it doesn't have to be like this big.

Mitchell [00:22:44]:

Here's the irony of all the people that are concerned about someone seeing a hearing aid. If you look around, there's lots of people walking around with Airpods in their ears or other kinds of things that hook to their cell phone. They're wearing those all the time. Yeah, but they have a different label. So I think that maybe we could make them bigger if we just made them look just like those Airpods.

Darleen Mahoney [00:23:07]:

Yeah, that's like saying, I don't want to go to the eye doctor because I'm going to have to wear glasses. So you just avoid going to the eye doctor and your eyes continue to deteriorate.

Mitchell [00:23:17]:

So vision, if you have hearing loss and vision loss, that's a double whammy in terms of dementia risk. So you're absolutely right. Wearing glasses, I mean, again, people spend their time in this withdrawn state of understimulation that is fixable. We also see if we can get someone to wear hearing aids, because what I do for a living most of the time is I test people for their cognitive function. I'm a neuropsychologist. So they come in to see me because they're worried about losing their memory or they're worried about their thinking abilities, and we give them tests. Well, if you take someone who's got a hearing loss and you test them and then they come back six months later and now they're wearing hearing aids, their test scores improve generally. So they had something that was correctable.

Mitchell [00:24:05]:

So it's not just even in the long run. Gee, I'd like to prevent dementia five years down the road. Even in terms of current cognition, wearing hearing aids can make a real difference. And getting glasses or contact lenses or LAsik or cataracts removed, whatever it takes to improve your vision, can make a real difference in how you think.

Darleen Mahoney [00:24:28]:

Yeah.

Darleen Mahoney [00:24:28]:

And honestly, your quality of life in general, I would think, yeah. So I am going to ask you a question that you absolutely, 100% may not know the answer to. But I know a lot of our listeners are probably thinking this. Sometimes it can be cost. Do you know if Medicare covers hearing aids or hearing tests?

Mitchell [00:24:46]:

So, some Medicare plans do cover hearing aids, but the cost for most people is not as great as they assume. It might be one of the big box stores that's national, and I won't give them a plug, but I'd love to because I love their products. Does free hearing aids for their members, free hearing tests for their members. They also have the best hearing aids at the cheapest prices. So not only am I married to a wonderfully beautiful, brilliant internal medicine doctor and psychiatrist, but she also has a hearing impairment. So about five years ago, she also does a lot of forensic work. So she sits on the witness stand as an expert in civil trials and criminal trials. And they got the lawyers asking her questions from about 15ft away.

Mitchell [00:25:57]:

She says to me one day, you know, I'm missing what they're asking me and having them repeat themselves, it's making me look like I don't know what I'm talking about. So where should I go? Because I see a lot more patients who talk about this with me. And I said, here's where you ought to go. We're members. So she goes down there, gets a free hearing test, and then gets a pair of state of the art hearing aids that could do all kinds of stuff, can be programmed through her cell phone for different kinds of environments that you can't even see. For $2,000, a pair uses these. Suddenly she can hear everything in the courtroom, sometimes things she shouldn't hear. Then, over the course of the ensuing four to five years, she says, my hearing is getting worse, I'm having to make more adjustments.

Mitchell [00:26:49]:

I'm going to go back and get retested. So now she goes back and gets retested. Yep, it's been a change. Gets new hearing aids. These are better. They don't require batteries, they're self charging overnight, and they're $500 cheaper than they were four to five years ago. So sort of like those flat screen tvs that the first ones cost like five grand. And the current ones cost like $300, and they're twice as big.

Mitchell [00:27:15]:

There is a much greater. You know, the reduction in cost is incredible. So that's where I send my patients because I learned it from them. They would come in to see me, and usually they'd complain about hearing aids, but they come in to see me. Like kids on Christmas morning, say, you'll never guess what I got.

Darleen Mahoney [00:27:34]:

Yeah.

Mitchell [00:27:35]:

And where I got them. And after a while, I figured both things out pretty quickly. But that's what I advise people to do, because they're almost. Not. Not entirely. I've had a couple people say, I don't like those, and I'm not going to do that. But by and large, most people just love them.

Darleen Mahoney [00:27:52]:

I think we should start making hearing aids hip. We can do them like in hot pink. We can do different types of patterns. We can do all kinds of things. Just like the earbuds. The earbuds they've made, really. Some of the earbuds are super cute. So I think we should, you know, that's something we should think about.

Mitchell [00:28:10]:

I think that apple should get into it because they already have the market for people, you know, when they look at the demographics of who's buying apple products, actually, they're older than the people who are buying their competitors. So maybe we could talk apple into making ones that look just like their earpods.

Darleen Mahoney [00:28:28]:

Yeah.

Darleen Mahoney [00:28:28]:

Oh, how fun would that be? I think we got something here. I think we got something.

Mitchell [00:28:33]:

You know, your dad had something I call awD. People look at me. What is that? I said, it's acquired wife deafness.

Darleen Mahoney [00:28:40]:

Yeah. Yep.

Darleen Mahoney [00:28:42]:

That's exactly it. Exactly. We actually had a friend of ours, son, who was six years old, and he got in trouble at school for not listening. And the teacher said, you know, you're not listening. He says, I can hear you. Or she's like, do you hear me? He says, I have selective hearing because he'd been hearing it at home. So, yes, it's contagious. So that's just a fun story.

Darleen Mahoney [00:29:09]:

So I did want to ask you as well, and I don't want to get too deep into it, but Utis in general. So what is the, what is the sign that you may have an UTI? And what connection is a Uti with dementia?

Mitchell [00:29:28]:

So the problem with memory or cognitive function, I think, causes confusion in Utis is it's pretty much exclusive to older people. It's more common in women than it is in men. If you're a young woman, you get a UTI you're just going to the bathroom more frequently, and you probably have some pain associated with it. If you're an older person, you may not experience pain, and you may not even recognize that you're going to the bathroom more often because you may already have some overactive bladder condition. But because you're older, it's going to impact your thinking that infection that's under there, that urinary tract infection, causes changes, at least temporarily, sometimes worse than that because it can trigger a progressive decline, but it's going to have some mean. We all know when we have an infection. We don't think that well, if you have bronchitis, you don't think as well. If you have a urinary tract infection, even if you're young, you don't think as well, temporarily.

Mitchell [00:30:40]:

Well, it's worse when you're old, as many things are. And it's worse if you're already beginning to have some cognitive changes. So the classic picture is somebody with mild cognitive impairment. They're not quite abnormal, but they're not really experiencing dementia yet. They get a UTI, and now they start being really weird. They get confused. They're not sure what day it is. They may be hallucinating.

Mitchell [00:31:08]:

And what you want to do then is rule that out. So you want to get them in to see a doctor or to an emergency room where they can do a urinalysis and rule that out, because if that's the case, that's quickly fixable and can make a huge difference. Then people, some of them have chronic utis, so it seems like a round, revolving door kind of process. And every couple of weeks, they're going in and they're on antibiotics almost constantly. And that creates a whole different set of problems, because, as you know, if you're on antibiotics, it also screws up in many people, their digestion. So you have secondary problems. And then you get some people who get sort of immune from the effects, the benefits of the antibiotics. So it becomes very complicated.

Mitchell [00:31:54]:

But that's the first stop, is somebody who could do a urinalysis.

Darleen Mahoney [00:31:57]:

I do think that, at least I know with my doctor, that's one thing she checks for once a year when you go in and you have all that $2,000 worth of blood work where they test for everything, including the bubonic plague, that's something that they're testing for as well. So just to have that on your routine and ask and make sure that that's being included in all of that, either blood work, I guess it's a urine sample.

Mitchell [00:32:21]:

And if you're watching this because your mom or your dad is experiencing some mild cognitive problems, that's also a place they start looking weird to you that day, more so than they normally do, you know, a change from the last time you talked with them. That's a good thing to check out because it is fixable and they might not even know they have it.

Darleen Mahoney [00:32:42]:

Yeah.

Darleen Mahoney [00:32:43]:

Yeah, absolutely. Well, I did want to ask you this question. If you're prone to have utis often when you're younger, does that mean you're more prone as you get older?

Mitchell [00:32:54]:

I don't know. Okay, so that's. So I'm more with the head. That's more with the tails.

Darleen Mahoney [00:33:00]:

Exactly. Well, I was just. I was just wondering if there's any kind of correlation to having them more frequently. Yeah.

Mitchell [00:33:07]:

Yeah.

Darleen Mahoney [00:33:07]:

Okay.

Darleen Mahoney [00:33:08]:

Well, something to noodle. Well, I really appreciate you joining us today. Is there any last thoughts before we sign off?

Mitchell [00:33:19]:

Let me just hit a couple high points about dementia, because I want to use whatever platform I can get to put out the word that dementia is a disease state, an illness. It's a progressive neurological condition. It's scary because in almost all cases, it gets worse. We don't want to wait until someone has dementia before starting to do something about it because it's usually not very effective to try to find a cure at that point. It's expensive. It causes a lot of heartache. What you want to be doing is looking at how you can prevent dementia. And the one place that I can send people for free that they can take a survey, a 25 question kind of online survey, and see where they are in their own dementia risk is to our website called braindoc.com.

Mitchell [00:34:21]:

And there's our dementia prevention checklist. And that's something you can get for no cost whatsoever. Fill it out. Some of the answers you're only going to get from your doctor. But once you fill it out, you're going to see where you're on target based on the most recent research, where you're off target in your health behaviors and illnesses and where you're near target and you just need some adjustment that'll give you a roadmap, a place to start for figuring out how you can increase your odds of being in the not dementia group.

Darleen Mahoney [00:34:52]:

Well, I really appreciate you sharing that and the efforts to educate people through that website. And we're going to include that link in the copy of the podcast.

Darleen Mahoney [00:35:00]:

It.

Darleen Mahoney [00:35:00]:

You can just click right on it. But it is braindoc.com.

Mitchell [00:35:08]:

Yes.

Daleen Mahoney [00:35:09]:

Perfect. Well, thank you so much for joining us today. I really appreciate it. Doctor Kleanski, I have really enjoyed just chatting with you on both of these podcasts and if you enjoyed this podcast, please share it with someone you care about and love if you think it will be a great resource to them. We're available on Spotify, Apple podcasts, good pods, and many more.