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This article is sponsored by the Academy for Continued Healthcare Learning, an independently owned and operated full-service medical education company that has been developing certified health care education for nearly twenty years.
With a special thanks to NAMI Chicago, the accompanying CME activity designed for clinicians in primary care is supported by educational grants from Lilly and Genentech, a member of the Roche Group.
Alzheimer’s disease has a devastating impact on patients, their families, and society as a whole. Patients suffer a loss of independence, reduced quality of life, and disability. Families caring for their loved ones with Alzheimer’s disease experience more physical and psychological ailments and financial difficulties. As significant as these burdens are, they will only increase as the number of patients increases. Estimates indicate that the number of patients with Alzheimer’s disease in the U.S. will increase from approximately 6 million in 2022 to approximately 12 million in 2050. Consequently, it is absolutely vital that patients, families, and clinicians take steps to better identify Alzheimer’s disease earlier so it can be treated earlier.
Unfortunately, studies have shown that up to 67 percent of patients who are screened for thinking and memory deficits in primary care and are found to have signs of impairments refuse further diagnostic testing. Why? There are a variety of reasons, including:
- A perceived lack of benefit of diagnosis, such as limited treatment options and no cure
- Difficulty in accepting a diagnosis of Alzheimer’s disease
- A perception that diagnosis would require a lot of expensive tests but may be inaccurate
- Stigma associated with Alzheimer’s disease
- Fear of losing independence
But do earlier diagnosis and intervention matter? Yes! A study from 2021 found that early medication use reduced the risk of patients requiring admission to 24-hour care facilities. In addition, recent practical recommendations from experts published in the Journal of Internal Medicine outlined the benefits of timely recognition and diagnosis of Alzheimer’s disease in primary care, including:
- Patient/family education and counseling
- Maximizing time available for medical and financial planning
- Early introduction of strategies and tools to maximize independence
- Early intervention for memory loss, mood and anxiety disorders, and psychosis
- Potential delay in admission to nursing homes
- Earlier opportunity to connect with support agencies
- Opportunity to participate in clinical trials of new medications
For families, there are specific benefits of an earlier diagnosis of Alzheimer’s disease, including:
- Reductions in anxiety and depression
- Time to adjust to changes in a patient’s function, mood, and personality
In fact, in a survey of family care providers, nearly 50 percent of respondents indicated that they would have preferred an earlier diagnosis of Alzheimer’s disease. In addition, family care providers who believed the diagnosis was delayed were more likely than others to report sadness, depression, and despair for years after the diagnosis.
What can clinicians do in primary care settings to move toward earlier diagnosis of Alzheimer’s disease?
- Increase understanding of early signs and symptoms of Alzheimer’s disease
- Conduct annual assessments of thinking and memory in all patients ≥65 years of age or, if such assessments are not practical, ask about signs and symptoms in patients with known risk factors for Alzheimer’s disease (e.g., family history, advanced age, and cardiovascular risk factors)
- Use objective tools to monitor thinking and memory
- Use easily available imaging methods (e.g., magnetic resonance imaging) if Alzheimer’s disease is suspected
- Consider using specific biomarker tests to confirm a diagnosis of Alzheimer’s disease
It is also important for clinicians to carefully consider how they communicate with patients and families. Family care providers indicate that better communication about a diagnosis of Alzheimer’s disease reduces sadness, depression, and despair and leads to greater acceptance and reassurance.
To better support clinicians in the primary care setting, the Academy for Continued Healthcare Learning (ACHL), in collaboration with Dr. Andrew E. Budson, developed an educational activity to model ways in which conversations between patients/families and clinicians can be improved to assist in the earlier diagnosis of Alzheimer’s disease.
Click here to access the activity and receive CME credit. Be sure to take this step toward improving the diagnosis of Alzheimer’s disease today!
Participant biographies
Andrew E. Budson, MD, is s chief of cognitive behavioral neurology at the Veterans Affairs Boston Healthcare System, associate director at the Boston University Alzheimer’s Disease Research Center, professor of neurology at Boston University School of Medicine, and lecturer in neurology at Harvard Medical School.
Jess Rappé is the president of a design and marketing firm in Chicago. She is passionate about mental wellness and is a long-time volunteer and board member of the National Alliance on Mental Illness (NAMI) Chicago. Her journey with Alzheimer’s is through her experience as a primary caregiver for her mother, who has been living with the disease since diagnosis nearly four years ago.
Ellie Freedman is the owner of Wildwood Tavern in Niles, Illinois. Ellie’s father was diagnosed with Alzheimer’s disease in 2010, and she was the primary caregiver and medical liaison throughout her father’s illness.
This article is sponsored by the Academy for Continued Healthcare Learning, an independently owned and operated full-service medical education company that has been developing certified health care education for nearly twenty years.
With a special thanks to the National Alliance on Mental Illness (NAMI) Chicago, the accompanying CME activity designed for clinicians in primary care is supported by educational grants from Lilly and Genentech, a member of the Roche Group.
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Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today we have a special sponsored episode from the Academy for Continued Healthcare Learning, supported by educational grants from Lilly and Genentech, a member of the Roche Group. A special thanks to the National Alliance on Mental Illness Chicago for participating in this program. Today we will be discussing Alzheimer’s disease: advice and strategies for patients, caregivers, and primary care clinicians. Find out more at diagnose-alz.org. That’s diagnose, dash, alz.org.
Today I’m joined by three individuals. First is Dr. Andrew Budson. He is chief of cognitive behavioral neurology at the Veterans Affairs Boston Healthcare System and associate director at my alma mater, the Boston University Alzheimer’s Disease Research Center, professor of neurology at Boston University School of Medicine, and lecturer in neurology at Harvard Medical School. Next is Jess Rappé. Jess is president of a design and marketing firm in Chicago. She’s passionate about mental wellness and is a longtime volunteer and board member of the National Alliance on Mental Illness Chicago. Her journey with Alzheimer’s is through her experience as a primary caregiver for her mother, who has been living with the disease since diagnosis nearly four years ago. And finally, we have Ellie Freedman. Ellie is the owner of Wildwood Tavern in Niles, Illinois. Ellie’s father was diagnosed with Alzheimer’s disease in 2010, and she was the primary caregiver and medical liaison throughout her father’s illness. Andrew, Jess, and Ellie, welcome to the show.
Andrew E. Budson: Thank you.
Kevin Pho: All right, Andrew, we’re going to start with you. What is the role of the primary care clinician in the diagnosis of Alzheimer’s disease?
Andrew E. Budson: Well, first, it’s important for the primary care provider to look for any symptoms that are suggestive of Alzheimer’s. Next, it’s important to do a workup, of course, including a history of the thinking and memory problems, a physical and neurological exam, some blood work to rule out vitamin deficiencies and thyroid disorders, and a brain scan to look for a stroke or other neurological problem. Then, using all that information, I would like the primary care provider to sort out whether it’s normal aging, whether it’s Alzheimer’s, or whether it’s something else. If it’s Alzheimer’s, I feel very comfortable with the primary care provider themselves doing the counseling and the treatment. If it’s something else, that’s a good time to refer the individual to a memory specialist.
Kevin Pho: So I do just want to follow up, because I’m an internal medicine physician myself. When someone comes into the exam room, what would be some tip-offs, some presentations, that would make me think I would need to do further evaluation for Alzheimer’s?
Andrew E. Budson: Sure. If the patient themselves says, “You know, I’m having trouble remembering my appointments,” or, “I’ve noticed that I’m late in paying bills,” or, “I’m having trouble finding my words,” “I’m getting lost going to places I normally could go to,” or, “I’m losing things left and right, like never happened to me before,” that’s one tip-off that would be concerning. But as you well know, often it’s the families that are coming in, and they’re saying, “You know, my mother is repeating the same question again and again and again,” or, “My father is telling me the same stories over and over and over again.” And often when the family speaks with the individual, they say, “I don’t have any memory problems. My memory is just fine.” All of those things would make me concerned.
Kevin Pho: And Jess, what part did primary care clinicians play in your mother’s diagnosis?
Jess Rappé: Well, it’s interesting, because listening to Andrew’s gold standard, or how you’d like it to go, I was listening to you thinking, does that parallel my experience? And in some ways, yes. I would say that the primary care doctor was obviously the first go-to place for my parents, and they did provide some screening. I would say in our experience it was very light, in terms of a simple, few-question cognitive screen, and it didn’t really evolve into blood work and some of those subsequent steps until my mom’s cognitive issues started presenting themselves physically, i.e. she started falling down. And so when she began to fall, all of a sudden it was like, “Oh, why is she falling?”
And so it was a response to maybe a more physical manifestation of a cognitive issue that we’d been asking the doctor about for some time, but we weren’t getting a lot of traction there. So the screening happened, and some blood work eventually happened, but as her experience became more about worries about falling or hitting her head or other things, at that point we were referred to a neurologist. But that took some time.
Kevin Pho: And Ellie, when did you first become aware of your father’s possible memory problems, and how long was it before the problems were mentioned to a clinician?
Ellie Freedman: I personally didn’t notice. My mom came and finally told us. A friend had noticed, when my dad was golfing, that he couldn’t find his golf ball anymore, and that was very unusual. He happened to be a psychiatrist, and he mentioned to my mom that my dad might be having memory problems. When he’d go for his annual visits to his primary care physician, there was nothing done at that point, and no questions were asked of my mother or anybody else about whether he was having memory problems.
And then she finally told us, and once she told all five of us kids, that’s when I took over and said, “Well, we need to look into this further and find out why, what’s causing that.” And then I also noticed that he, who was always talking or eating, and we called him Jaws, stopped his social interactions. His social life started to regress, and he wasn’t as socially interactive with people as he had been in the past.
Kevin Pho: So Andrew, as you listen to these stories, would you say that these are typical presentations of what you would see in the exam room?
Andrew E. Budson: Well, it’s interesting, and I think it highlights that every individual with Alzheimer’s disease is a little bit different, and they present in a little bit of a different way. Jess explained that one of the manifestations that she experienced was trouble with falls, and that is atypical of garden-variety Alzheimer’s disease, but it sometimes can happen. If there are many strokes, or if there’s a parkinsonian disorder, then falls can come about.
And then we heard from Ellie that there was trouble not only losing things, like golf balls, but also becoming withdrawn and becoming less likely to initiate actions, activities, social events, and conversations. What we call apathy is actually very common and is one of the earlier signs of Alzheimer’s disease. It can also, however, be due to depression, so that’s always something that I’m working, and I know the primary care providers work, to sort out: Is this trouble with depression, or is this an early sign of Alzheimer’s disease?
Kevin Pho: Ellie, at what point did the primary care clinician indicate that they suspected Alzheimer’s disease, and how did they discuss it with your father and your family members?
Ellie Freedman: Basically, my father also had depression, like Dr. Budson said, and the onset of Parkinson’s, so it was kind of like a three-for-all, three things at one time. He was also part of the VA in Chicago, at the Great Lakes facility, and we just started bringing him to a neurologist there. Our primary care physician said, “I would recommend you go see a neurologist and have a brain scan and do testing.” So he really didn’t play a part at all. He just recommended, “Let’s go see a neurologist.”
Kevin Pho: And Jess, what initial steps did the primary care clinician take or recommend? Was it a test or a referral?
Jess Rappé: After quite a bit of prompting, and me feeling like the annoying daughter, saying, “Something’s not right with my mom. Something’s not right with my mom,” it was like, “OK, you need to see a neurologist.” So then the referral was made, and we took it from there and did a pretty comprehensive neuropsych evaluation and scans.
Kevin Pho: So talk about that neuropsych evaluation. What did that entail?
Jess Rappé: I was trying to dig up the results before we talked today, because I remember being so fascinated by the report that came of it. I attended the family conference at the end, after all the tests were done, and it was comprehensive and very educational. They did do a great job. They spent quite a bit of time with my mom doing a variety of cognitive exercises, in addition to those scans, and they showed us sort of where she fell on the bell curve, right, and how she compared to others at her age. She was just 70 years old when this test was taking place.
And so it was really informative and educational for me, and very overwhelming for my parents, a lot to take in. But if I recall, the culmination of that was that a firm diagnosis is difficult, but what we’re seeing here are symptoms that are consistent with white matter disease and what appears to be consistent with Alzheimer’s. So it was presented as a guide for what we appear to be observing with your mom.
Kevin Pho: Andrew, what advice would you give primary care clinicians for navigating the initial diagnostic steps, and how would you discuss them with patients and their families?
Andrew E. Budson: The first thing I want to say is, I feel strongly that any of you primary care providers out there who are listening have the tools that you need to make a basic diagnosis of Alzheimer’s disease. As I mentioned, take a history, do the physical and neurological exam, get some blood work, do the scan, and do a little cognitive testing in your office if you have the capabilities, either yourself or an assistant, or refer the patient to a neuropsychologist or somebody that can do that testing. There are also questionnaires that you can have your secretary hand to the individual or hand to the family in the waiting room. They can give you a lot of information, which will suggest whether Alzheimer’s disease is likely to be present or not.
And how do you discuss it with the individual or their family? I think you say something like, “Mrs. Jones, you’ve shared with me that you’ve noticed a couple of minor memory lapses. We’re going to run a couple of tests to make sure you don’t have a vitamin deficiency or a thyroid disorder, and we want to do a brain scan to make sure it’s not a stroke or some type of brain disease.” So that’s usually how I go about starting off the evaluation.
Kevin Pho: Now, Andrew, how often do patients or family members decline additional testing for Alzheimer’s disease, and from your experience, why does that happen?
Andrew E. Budson: It definitely happens sometimes. One reason that the individual or their family would decline is they feel, “You can’t do anything about memory loss. It’s relentlessly progressive, so why should I bother doing the evaluation?” Another problem that sometimes can come up is the individual is afraid of a diagnosis of Alzheimer’s disease, or the family is afraid of, for example, telling their parent that they have Alzheimer’s, feeling it would be catastrophic. In my experience, usually the individual is OK with it, because they’ve usually noticed that they have some memory problems. It’s not generally a surprise to them. And I can honestly say more people feel relieved that finally they know what’s going on, there are treatments available, and they’re going to get help.
But I will say the biggest problem that I hear in my clinic is that a lot of their doctors haven’t sorted out what was going on before they came to see me. And I think it can be difficult. I know when I was in medical school, which was a year or two ago, it really wasn’t covered. It wasn’t really discussed. And I worry that a lot of primary care providers are feeling like they don’t know exactly how to make this diagnosis, or whether they should be making this diagnosis. And again, I want to send the message out there: You can do this. It’s not that difficult.
Kevin Pho: Jess, what was the impact of the possibility of Alzheimer’s disease on your family relationships? What were some of the reasons for continuing the diagnostic process?
Jess Rappé: So the second part of your question I’ll address first. It’s just seeking to understand, and in continuing that process, just to feel some relief and understanding of what was happening with my mother, so we could best respond and care for her. So I think for us, knowing that it was likely Alzheimer’s, I could quickly get resources for myself to understand how I could more effectively communicate with her, how I could help my father understand these changes in his life, and how we could help my mother not be afraid. And Andrew’s right. My mother didn’t fear that. She was like, “OK.”
But also, there’s the stigma just around the word Alzheimer’s. I hear people say, “Oh, sure, my mom has some dementia, but it would never be Alzheimer’s.” It’s just our own human coping skills, and sort of our fear of certain diagnoses based on what we’ve been led to believe those words mean. So I think the word Alzheimer’s, in my experience, scares people. That’s why conversations like this are important, to have these conversations and take the stigma away from that word. It’s simply a diagnosis, and it’s simply a very broad potential pathway for your loved one that is just helpful, so you can understand and respond, not to put you in a pigeonhole and be a tragic outcome.
Kevin Pho: And Ellie, I’m going to ask you a similar question. What was the impact of the possibility of Alzheimer’s disease on your family relationships, and what were the reasons for stopping the diagnostic process?
Ellie Freedman: The reason for stopping the diagnosis was my mother’s choice, because she was very much with it when she knew my father was diagnosed with that, and we kids were not going to fight with her. That’s her husband. We let her make that decision. My father, I think, was OK with it, although he did get depressed about it. And that was probably the hardest part for her, and for her also, admitting that he had Alzheimer’s was the hardest thing too. At that time, there was no path of, “OK, this medicine will help you go on for X number of years,” or, “It will help your memory loss be delayed further.” There was nothing at that point, so she didn’t want to go any further with testing. It was very difficult for her even to look at the brain scan and see how much of the brain had deteriorated already, and that was very painful for her, so she didn’t want to go any further.
The dynamics in our family: There are five of us kids, and three of us stepped up to really support her in any way that we could. And I think that was more important at that point for her, for the whole functioning of the whole thing, because my dad was going to be taken care of no matter what, right? It was her that needed more taking care of, to understand it and to accept it.
Kevin Pho: You’re listening to a special sponsored episode from the Academy for Continued Healthcare Learning, supported by educational grants from Lilly and Genentech, a member of the Roche Group. A special thanks to the National Alliance on Mental Illness Chicago for participating in this program. We’re discussing Alzheimer’s disease: advice and strategies for patients, caregivers, and primary care clinicians. Find out more at diagnose-alz.org. That’s diagnose, dash, alz.org. Jess, how was the diagnosis of Alzheimer’s disease eventually made?
Jess Rappé: It was through that neuropsych evaluation, and then really experiencing, all of a sudden, with that lens of “We think your mom has Alzheimer’s,” you start to look back, in hindsight, at all the other things that line up with that. And so it really made sense. So it was really that evaluation that put a pin in that, and then we could move into caregiving with some sense of clarity about what she was experiencing.
Kevin Pho: And Jess, when you received that firm diagnosis, what were some of the benefits of that?
Jess Rappé: For me, the benefits were that then we could say, “OK, I’m going to join a support group at NAMI.” I went to alz.org right away, and I was looking for caregiver resources, and my parents’ county, where they live, happens to have a great aging and disability resource center. It took me from a state of worry and wondering what was going on into sort of a state of, “OK, now let’s take some action to figure out how we can give my mom the best life possible.” So it just moved us from one stage to another in a way that was really helpful for our family.
Kevin Pho: And Ellie, in retrospect, would you have preferred knowing with greater certainty if your father had Alzheimer’s disease? Why or why not?
Ellie Freedman: Dementia or Alzheimer’s, they never really clarified for us what it was, but at least we knew what it was. And again, doing research online and looking at things, I would exercise him every day. I would get him outside to walk every day and make sure he was drinking enough water, those certain things that I just read about on our own, and keep him at home for as long as possible, because that was his environment, and he always said he never wanted to go in a nursing home. But we convinced my mom that when it’s time, you’ll know it’s time, and it was time at the end.
Even when he was in the nursing home, we would exercise him every day and take him outside, and even the nurses said, “Your dad lasted longer than most of the people do because of the care that you guys gave him.” So I feel that we just started a different path, because we knew what it was and how to handle it. And it was important to give my mom time away from it also, and we worked that into our plan: to make sure that she had time to get away, go do yoga or whatever she needed to do, so she could care for him when she needed to also.
Kevin Pho: Andrew, what would you tell primary care clinicians about the benefits of diagnosing Alzheimer’s disease, so they can better counsel their patients?
Andrew E. Budson: Sure. There are so many benefits. The first is, it’s of course important to rule out other things, rule out vitamin deficiencies, thyroid disorders, and strokes. Do they have some sort of collection of blood in their head because they had a fall, and they now have a subdural hematoma? Do they have too much fluid inside the brain, so-called hydrocephalus? So that’s the first reason.
And then I think it’s really important, when you’re making any sort of a diagnosis, to really work on helping the individual and their family to sort of confront this disease, and let them know what’s going on. And then we can prescribe medications. The cholinesterase inhibitors have been shown to be able to turn the clock back on the disorder for 6 to 12 months, and that turning the clock back will still stay with them 6 to 12 months later. It just doesn’t change the rate at which they go down, but they’re always going to be better off on that medication. And that improved function can help the individual do things they want to do on their bucket list. They can take that last vacation, do something with family, or write their memoirs, all those things, with that level of improved functioning.
And then it’s also very important to give time for folks like Jess and Ellie, time to do planning and get ready for the disease as it does progress. And lastly, I’m actually pretty excited that there are some new medications to treat Alzheimer’s disease that are being developed that may eventually slow down that ticking clock. So I’m very excited about the future, and I think it’s important to diagnose Alzheimer’s for all those reasons.
Kevin Pho: Jess, what advice would you give to patients and family members about a potential diagnosis of Alzheimer’s disease?
Jess Rappé: Advice. I would say, just remember, it’s not a death sentence, and it’s also a family disease, just like any diagnosis, right? It’s not the person that receives it. It’s all of us who love that person who receive that diagnosis. And that’s not intended to be a scary statement, but more of a supportive one, that we’re in this together, and that we all play a role, and we’re all grieving, and we’re all feeling impacts of it, in some ways much more than the individual with the diagnosis themselves.
I mean, it’s reverberated through our family, with some positive outcomes for sure. We’ve grown closer in a lot of ways. We’ve had to galvanize as siblings and figure out, “What are we going to do here?” And I feel really lucky that we are all on the same page with that caregiving role. But just remember that you’re not alone in this.
Kevin Pho: And Ellie, similar question. What advice would you give to primary care clinicians about the diagnostic process and how to discuss it with patients and their families?
Ellie Freedman: Real positive, because, like Jess said, it’s not a death sentence. You still have that person here, and everybody’s still functioning, and you have to plan for the future. Planning, I think, is the biggest thing. Take up the rugs from the floor so they don’t trip. You just have to plan and work together. I think working together is the best thing, and your siblings all come together to make sure that that person is taken care of, because it’s someone you care about and love.
And I always say my father died two and a half years before he really passed away, because he was a different person. So now this is a new person that you need to get to know and that you have to learn how to care for, and that’s OK. But he’s still your father. And I think that people can’t be afraid of that. I wish the stigma wasn’t there, because a lot of people are afraid of the word, and I think there needs to be more hope put into that word, that there is hope. It’s not like a death sentence right away. There is hope to keep going. And I think that’s the message that has to be sent out to the caregivers and the primary care physicians: This isn’t a death sentence. You can still function.
Kevin Pho: And Jess, what challenges do you face in taking care of your own mental, emotional, and physical health, and how do you overcome those challenges to take care of yourself?
Jess Rappé: Well, I guess there’s that desire to do everything right. You want your loved one to have the best possible, and you have to let go of what should be and say, “Where are we right now, and what’s the best today?” And that’s different than you expected, right? You have to accept the challenges, accepting that my relationship with my mom, and what’s possible for her in her 70s, is different than she dreamed of and than I dreamed of for the two of us. So accepting that. And I would say overcoming that is really in community, like even this, talking and hearing Ellie’s story, and talking to other people. Storytelling and sharing, for me, is just the way to heal and to stay stable and strong for my mom.
Kevin Pho: Andrew, what strategies would you suggest for helping primary care clinicians overcome the barriers to diagnosing Alzheimer’s disease in their practices?
Andrew E. Budson: Yeah, I think you just have to make diagnosing memory problems routine and part of your practice, just like you diagnose problems with any other organ system. I would ask about memory problems just like you ask about whether they are having symptoms of heart failure or asthma or GI problems or anything else. And I would even advocate incorporating either cognitive tests or those questionnaires that can be filled out in the waiting room every year for their patients who are 65 years and older.
Kevin Pho: All right, and I’m going to ask each of you for your take-home messages to the KevinMD audience. So Ellie, I’m going to start with you. What are some of your take-home messages that you want to share?
Ellie Freedman: I think it would be great, what Dr. Budson talked about, a checklist, if everybody did a baseline, like they do with colonoscopies. OK, do a baseline at 60 and see where your memory is, what your brain function is, and what your brain scan sees, and then do it every five years to see where you’re developing. I think a checklist that you should get from your doctor, to see if you’re having any of those issues currently. And I think it’s been since COVID: You go in to see your primary care, and they ask you about depression. “Are you depressed? Have you been depressed?” Why not have the same kind of questions asked at the end of a physical, or while you’re discussing things with your doctor?
I mean, that could make it so the word doesn’t become so taboo anymore. Everybody talks about it, and I believe everybody has been involved with or knows somebody who’s had Alzheimer’s or dementia. Maybe the information explaining the difference between the two of them, I think that would be very helpful. Just have a baseline and then be able to check it every five years, like a colonoscopy, or every 10 years.
Kevin Pho: Jess, what are some of your take-home messages to the KevinMD audience?
Jess Rappé: Yeah, I mean, I echo exactly that. As I think back about other physical challenges my mom had, whether it was gastrointestinal or different things, because she did have some thyroid issues, those were very proactively addressed. And the mental, cognitive stuff was sort of like, “Oh, OK, let’s talk about it.” It felt that there was even some residual stigma, even in how it was evaluated. It was sort of the last thing, and it was a little bit dismissed.
And so just bring that farther forward, more consistently, and treat it with that same lack of emotion. It’s a factual screen, and it helps us all not be afraid of it when we feel that energy from the physician, that it’s not something you need to be afraid of. I think that really carries a lot of weight, even in the words that are used, and when it’s presented in the exam, and how comfortable the physician is talking about it. It’s really, really powerful, the unspoken pieces.
Kevin Pho: And Andrew, we’ll end with you. What are some of your take-home messages that you want to leave us?
Andrew E. Budson: Most of the medications that are used to treat memory loss work best when they’re given early. So if you are concerned about memory loss in yourself or a loved one, my recommendation is, don’t delay. Make an appointment to see the doctor today.
Kevin Pho: Thank you very much for listening to this special sponsored episode from the Academy for Continued Healthcare Learning, supported by an educational grant from Lilly and Genentech, a member of the Roche Group. A special thanks to NAMI Chicago for their participation in this program. Find out more at diagnose-alz.org. That’s diagnose-alz.org. Jess and Ellie, thank you so much for sharing your stories, and Andrew, thank you so much for sharing your insight. Thanks for being on the show.
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