Selects: How Dementia Works

Good morning everyone. I hope you're enjoying yourself and having a great weekend with friends, family, loved ones, or I don't know, even people you might dislike a little bit. How dementia works. This is a pretty brutal episode, everybody. This is from November fourth, twenty fifteen, but there's some

So how dementia works, right here.

Right now, Welcome to Stuff You Should Know, a production of iHeartRadio.

Hey, and welcome to the podcast. I'm Josh Clark with Charles w Chuck Bryant and Noel. The Stint of Noel continues. Everybody's like, stuff you should Noel. No, No, that's not what we're calling it. It's the Stint of Noel. All right, Stuff you should Knowel. That's too clever.

Yeah, it's a little cutesy. Yeah, that's all all right.

It's my only aversion to it. All right, all right? What do you are you with? Stuff you should know?

Changing the name of our show after eight years?

No, just the Noel's stint the name of it. Remember the Summer of Sam?

Oh? Yeah? Yeah, sure, why not?

I don't like it?

All right?

Should we come up with the third idea?

Yeah?

The stint of nol sounds too much like something's wrong with Noel.

That's why I like it. It's hilarious. There's nothing wrong with Noel, my god. And if you think there is, you need to answer to me.

There's something you should know.

I see, that's what I'm saying. It sounds like something Strickland. Would it come up with?

Oh? You know? And we haven't been in a flame war with Strickland in a while.

It has been a while. It's been too long. I've gotten soft. You just launched one across the bow, so.

Chuck.

Yes, are you familiar with dementia?

Yeah?

Sure, are you running? Your family doesn't.

Run in the family, But my grandmother, who lived to be one hundred, had dementia at some point, which you know, when you love to be one hundred. That's I don't know about likely, but it's not surprising.

It's probably pretty likely. It's not from what I understand, it's not a just a natural consequence of age, right, but it's pretty prevalent.

Sure.

And dementia's actually super misunderstood. It gets confused with Alzheimer's a lot, or there's a lot of different kinds of dementia, But dementia is actually it's not a disease. It's a set of symptoms that's brought on by disease.

Yeah.

I think that is widely misunderstood. Yeah, but you are totally correct.

A set of symptoms, and.

It is not just your garden variety forgetfulness that comes as you age.

No, because that is age related and that is normal.

The totally age related things called age associated memory impairment, and that is uh. I think, I mean that happens to everyone, right, It's just.

Like you forget your keys more often, that kind of stuff. Sure, But when you do forget your keys more often, you snap your finger and go, ah, I forgot my keys again, what is wrong with me? Yeah, that's normal.

One of the big tells of true dementia is when you don't realize that you're forgetting right.

So that's when it gets scary.

Right, And we said that it's not a natural consequence of age. And one of the things that I turned up in researching this is we're not exactly sure what causes dementia. We don't even know if some of the telltale signs of dementia are the cause of dementia in some cases or the result of dementiae. Not entirely certain, but it is very widespread among the aged population. In the United States. I think five point three million Americans have dementia right now.

Wow.

And as our population ages, because the baby boomers are starting to get older, I think they're expecting something like sixteen million Americans are going to have it by twenty fifty. Sixteen million is I think how many? About how many people have it around the world right now? And in America alone, we're going to have that number in twenty fifty. Yeah, and it's very expensive, Actually, how much money a lot? You ready for this?

Yeah?

In twenty fifteen, we have spent two hundred and twenty six billion dollars on healthcare for dementia a while, and they're expecting by I believe twenty fifty, when we are caring for sixteen million in twenty fifteen dollars, not futuristic, much more inflated fifty do right in twenty fifteen dollars, We'll be spending about one point two trillion dollars on dementia if somebody doesn't do something.

Man.

Yeah, it's very expensive. It's also extraordinarily sad as far as diseases or symptoms of diseases. Yeah, yeah.

And I also want to recommend our May twenty eleven episode, A podcast to remember. Our memory episode ties heavily into this, So if you haven't listened to that one yet, go listen to that one, either before or after.

Or if you listen to it and forgot, go back and listen to it.

That's right.

So dementia itself is not diagnosed. It's not simply memory loss. It's memory loss along with one of the following at least one of the following one or more. Aphasia, which is if you can't understand or produce language any longer, a praxia, and all these are super sad if you've ever seen.

Them up close.

A praxia if you cannot make certain movements even though your body physically is healthy, right, agnosia, which is you don't recognize objects like the remote control or your grandkids, stuff like that. And then executive dysfunction when you have a lot of troubles planning and organizing and reasoning. So that along with the memory loss or at least one of these, you could be diagnosed with dementia, right.

And so, like we said, dementia is a set of symptoms, right, Yes, it's actually brought on by disease. And the most common cause of dementia I think something like sixty or seventy percent or something like that of dementia cases is brought on by Alzheimer's disease.

I could have sworn we did one on Alzheimer's, but we have not. Yeah, I don't think we have.

I don't know. We've talked about it enough.

I think, yeah, it's popped up plenty of times, but we've never just done a straight up Alzheimer's. Alzheimer's brings on dementia through something called neurofibrillary fibrillary tangles also known as beta I'm sorry, tau protein tangles. Yeah, and beta amyloid plaques, right.

Yeah, and the plaquesa's like a just a protein build up, a sticky protein build.

Up, Yeah, which is so when you when your neurons fire and you have a thought, it's an electrochemical process, and there's residual that is left behind, and these residuals can build up in your synapses and cause your synapses to not fire as well. And when your synapses don't fire as well, they start to die off, and the neurons that are there that lead from these synapses or lead to these synapses, die themselves and you have neural loss. Like literally the brain cells in your brain are dying

Yeah, And they aren't sure the cause of Alzheimer's still, Genetics is they think has a lot to do with it.

And you can live with Alzheimer's for while.

Up to a decade, although they said in this article many says three to five years is more common.

So, yeah, it definitely shortened your lifespan.

And like you said, genes are definitely part of the risk factors. A polypo protein, a polopo protein. E okay, I think, which is weird. If you have a mutation on this gene, you have a higher risk of Alzheimer's, even though the gene just codes for a protein that carries cholesterol through your bloodstream. Yeah, doesn't have anything to do with the TAU protein tangles or anything like that

Oh really yeah, interesting, So that's and we will do one on Alzheimer's. But that's how Alzheimer's can call dementia. There's also vascular dementia, which is that was the case with my grandfather who he had a stroke, and it accounts for about twenty percent of dementia cases.

And you know, stroke is when.

You have a loss of blood supply to the brain or a hemorrhage or a blood clot and it can be either one big stroke event which causes a lot of damage. And that's a single INFARCD dementia, or it can be a lot of the accumulation of symptoms because of a lot of little mini strokes you have over the years.

Right, and then the damage just builds up and you finally once that last one that does the straw that breaks the camel's back. Yeah, and you have dementia that happens pretty rapidly after that last that last one, that last stroke you have.

Yeah, and that's a multi infarc when it's a bunch of them, and little many strokes are common a lot. Sometimes you have them and don't even realize you've had them. Right with my grandfather, he had the big one and oh really, Yeah, we talked about this before and I think something about speech, but yeah, he lost his ability to speak, you know, English.

So that would be a phasia.

Yes, he couldn't produce language, well, he produced, Yes, he cannot produce language. He said things, but it you know, it didn't make any sense, gotcha. But he had an understanding. You could see the frustration. Yeah, you know, I know how to how I'm supposed to. My grandmother is driving us, let's say, and she doesn't know how to get there. He does, and he can't tell her, but he's telling her. Yeah, it's just coming out all mixed up.

And that's that's a hallmark of dementias. There's emotional changes in the person because they they're not communicating like they want to say, people aren't responding like they want the people to and they'll get snippy and then ultimately say withdrawal. They'll just give up on communicating at all because it's too frustrating or just too sad, you know, yeah, which is it's one of the common results of dementia. It's a comorbidity. No, it's a complication.

Yeah.

And then and with the single stroke event or actually or with the multi strokes, it's.

Different for everyone.

There isn't any single like, well, this is going to happen because this person had a stroke, right, It could be a variety of different things from you know, paralysis on one side of the face or body bowel and bladder control problems. He didn't have any of those. He looked totally the same physically, He walked and talked the same, except for the fact that they weren't real words.

Right.

That was like the most noticeable thing.

I remember you telling me about your grandfather before I don't remember what it was.

It was a long time.

We were talking about speech, like where Nicky's area or broke his area? Yeah, yeah, something like that. So with Alzheimer's, it first attacks the hippocampus, which means that it's going to take away your episodic memory, which is your memory of recent events, right, Yeah, and then it starts to move its way into other areas of the brain where your judgment is affected, your speech patterns are going to be affected. Your personality is very much affected and changes

Yes.

And then in about five to fifteen percent of dementia cases it stems from something called Louis body dementia.

Which we were just talking about. They think Robin Williams might have suffered from.

He definitely did.

He definitely did.

Yeah. They found in his autops that he had I think he was diagnosed with it before he died. No, okay, that was one of the reasons why he took his life.

Yeah, because that can cause severe intense hallucinations.

Yeah big time. Did you look up?

Oh yeah, man, very scary stuff.

You like, very apparently A typical one is very brightly colored animal or person. Yeah, that you see in great detail for many minutes on daily a daily basis, like just intense hallucinations.

I'm sure you think you're you know, losing it, right.

And that's one of the first symptoms of Louis body dementia.

And it was discovered by Frederick Louis and nineteen twelve. And it has has nothing to do with your body. A Louis body is there are deposits again protein deposits of the alpha.

Sinucleon that appear on the brain.

So don't think of body in the terms of like your physical body, right. And this is also president Louis Body's and Parkinson's. So as a result, not only are you going to have symptoms similar to Alzheimer's with Louis body dementia, but also some of the tremors and balance issues of Parkinson's right, which is super sad as well.

Is that what Michael J. Fox has Parkinson's?

Yeah?

Yeah, and that's that's what the movie Awakenings was about. When they wasn't it like a group of Parkinson's patients that like L.

Dobo worked on, was that Parkinson's I can't remember.

I think they didn't. They didn't realize what they thought they were locked in or something in there. I realized their Parkinson's strummers were so acute that they were like they were not even shaking, they were just fretly. Yeah. Interesting, They're just their muscles were totally contracted rather than contracting and relaxing again and again.

And Robert Williams, Yeah, how about that?

Yeah, then we have something that used to be well it's called now fronto temporal dementia. It used to be called Pick's disease, but now Pick's disease is a specific.

Version which I couldn't really suss out what the difference is, could you know?

I couldn't either, as.

Long as it wasn't just me, I feel better.

But ft D is really an umbrella term. It's about five percent of dementia cases, and it's going to affect personality, behavior and language, like big time, big time, and it's where your frontal and temporal lobes are actually atrophying and shrinking.

Right. And the reason why is you remember with Alzheimer's you have beta amyloid plaques and tau protein tangles.

Yeah.

Well, with the fronto temporal dementia, you don't have the beta amyloid plaqs. You just have the tau protein tangles. But it's enough to cause massive neuronal loss.

Yeah.

And this is like I think a lot of people at first think they might have tourette Yeah, because you can yell things out inappropriate behaviors.

Yeah, Like if your grandfather suddenly becomes hyper interested in sex and likes to talk about it in public, or yeah, exposes himself to people in public, there's a pretty good chance that he has developed fronto temporal dementia.

Or if I did, because it's unusual in that it attacks younger people. It's gonna onset between forty and seventy five years old, which distinguishes it from their types of dementia.

Yeah. And if your grandfather used to do that stuff already, then that's not the case. The key here is that, like this has come out of the blue, somebody is really just completely changed in their personality. They might get into really risky behavior like gambling all of a sudden.

Yeah, shoplifting Yeah, and like risky investments are like pulling all their money out of the bank.

Yeah. And with picks disease too. Apparently apathy is a big indicator of this. There's a big personality change and the person is no longer they have no empathy, they have blunted emotions. Yeah, and then they may also be engaging in risky behavior. So basically your grandpa or your grandma has just turned into like the transporter you know, or me or you well, yeah, you're five. You lack empathy.

No no, no, I'm just saying, oh, I see, because.

It affects you sing like they turned into you. Oh no, no, no, you have blunted emotions and amble.

There's also Huntington's disease.

This is it seems like much more physical in nature, uncontrollable movements, although there are changes in personality, but real fidgety, herky, jerky. Your brain loses the ability to control coordination essentially, right, which is I think fifty percent chance of inheriting the gene. But you can live with it for up to twenty years. Yeah, which seems like, as far as dementia go, is one of the longer life expectancies.

But again, I mean, like I would guess this has kind of become clear. The hallmark of dementia is memory loss paired with some other problem like not being able to create speech any longer recognize speech, or not being able to move that kind of thing, or not being able to plan. And like we said, well we should probably take a break. Huh.

Yeah, we got a couple of more types that we'll talk about and then some other good stuff. Okay, right after this, the last two, actually the last three we're going to talk about, because there are many many other kinds of dementia, Like, we could spend hours and hours talking about all the different kinds hours, But we have talked about kreutz felt yakup disease and I.

Can't remember which one, and we say that all the time.

Is there a disease that kills by preventing sleep?

Oh?

Is that the one which we should have rightly called how prion diseases work?

Yeah, because is a prion infection. It's very rare, about one out of a million people will be affected in any given.

Year, like mad cow disease or KU Yeah, exactly. It's a sponge of form disease. Yeah, so crazy, it is. It's very interesting. It could be genetic. But and I thought we also talked about it in an organ transplant.

I think so, because it can occur because of infected tissue that you are implanted with or from an organ.

Yeah. And this is neuronal loss due to the like holes literally being eaten into your brain by this disease. Yeah. And then you can also get dementia from when you have HIV. If you are a boxer or say a football player in the NFL, you may have dementia from a traumatic brain injury like a concussion of repeated concussions. And there are plenty of diseases. There's also reversible dementia too.

No, but you what you should do is listen to your loved ones because they are going to be looking at you a little more closely then you can.

You know that they have more perspective. Yeah, exactly, that's what you're looking for.

So don't get you know, don't get offended if a loved one says, let's go get you checked out, because you can do something if you catch it early on.

Right, unless you're very wealthy and it's your no good nephew that you've never trusted anyway, you know, very true, then maybe bring a lawyer in on it's right, see what's up.

So if you do go get checked out.

From the second you walk in the door, your doctor is going to be eyeballing you and looking for any signs just from their their trained eye, like you know, from how you walk to the way you answer questions to how they interact with you.

They want to know you.

They're gonna have to know your history because they need to have some context to compare it to right.

Like were you always a compulsive gambler? Is just like new behavior?

Yeah, and it helps to bring you know if if you're older, maybe bring your grown son or daughter with you.

Or whoever has a lot of fountact.

Sure, although your spouse you never know what, I don't know, maybe trying to get read of you.

Oh yeah, like that no good nephew, Yeah.

Exactly, I'm just kidding, of course, although I'm sure that happens. Then there are a couple of tests that they usually do in conjunction with one another. The many mental state examination the MMS just a lot of basic questions there for mental tasks.

But they're coded.

The tasks are yeah, and they're scored individually.

Yeah, and when you say question three, this person got an eight on you can go over and be like, yeh, dementia. And it's actually pretty effective, actually it is. And there's another test that ties into the MMSEC that they both indicate one another, which apparently they're both really good at indicating dementia because this other test called the clock drawing test. Did you look this thing up? Yeah?

I thought this was pretty fascinating, It really is. It seems really like why would someone tell someone to draw a clock at a certain time.

Of the day.

Yeah, Usually they say draw a clock showing that it's ten after eleven. Yeah, And it makes a lot of sense in a lot of ways because it draws on all these different kinds or different regions of the brain, different skills. Right, So, like, first of all, you have to remember what a clock is and what it signifies. That's a big one. What it looks like, Yeah, is a clock isn't made of like squiggly lines or anything

Yeah, the four specific things that requires are verbal understanding, memory, spatially coded knowledge, and constructive skills. And if any of those are off in conjunction with the MMSC, then they're going to have a pretty good idea where you fall on the dimention scale.

If you don't have the constructive skills to pay the bills, you may have dementia.

That's right, and they actually I looked at one study about the clock drawing test. Basically I think it was just a more recent like, hey, let's go in and really look at this thing again, and it checks out.

Yeah, they stood behind it and said, yeah, it's actually a really good indicator.

Yeah, like it really holds up. And I think they developed it in the sixties, but it didn't take off until the eighties, and then they.

Like it as sixties thing.

It does, you know, but it's something you can do anywhere. And now they're starting to gather these different clocks that people with different types of dementia are drawing and basically compiling them into a data base so you know what to look for. Even more like, oh, somebody draws a clock that has like a thirteen, fourteen, fifteen on it, right, they may have this type of dimension.

Right, and this one looks like Sabad or Dahli drew it, right. Then they might have this kind of dementia, yeah, or they might just be super talented creative.

Yeah, you never know. All right, let's should we take another break?

Why not? Is it time? Sure?

All right, we'll be back after this to talk about treatment and some of the other pitfalls of dementia.

So, Chuck, we've kind of I think it's almost goes without saying, like the problems associated with dementia, like you lose your ability to reason in a lot of cases, you lose your ability to move and take care of yourself, You lose your memories, you have trouble forming new memories, you have trouble recognizing people. So living life is extremely difficult. But there's also like other complications that you may or

Yeah, that's a big problem. Nutrition itself is a big problem.

Either you forget to eat altogether, or you think you've already eaten, or you.

Physically have deteriorated so that you can't control the muscles to chew and swallow.

Any good joke, right, it's real danger.

So when people die from Alzheimer's, it sounds kind of strange. If you think about it, it's like, well, no, they forgot they lost their memory or whatever, right, No, the brain is actually being slowly destroyed, yeah, periodically, and eventually it's going to reach the parts of the brain where you can't swallow any longer. Then you die from that kind of thing. You also can lose your sense of hunger,

Ever, Yeah, it's a tough one. Hygiene Reduced hygiene is a big one. A lot of times in severe dementia cases, you either are unable to bathe and dress yourself and brush your teeth, or you forget to it just falls by the wayside. I know that was the case with my grandmother. She needed, you know, she needed to be bathed by my dad.

Because she lost interest in it or because she just couldn't do it anymore.

Uh, I think both.

Yeah. Yeah, that's another indicator. You said that when you go in for a diagnosis, the doctor is going to be watching you and just kind of sizing you up. One of the things I look for is whether you look disheveled. Yeah, that's a big one. And especially if your son or daughter is saying like, this is really bizarre behavior because mom always like dressed to the nines.

Yeah, when now she left the house.

She just wears this dirty old bathrobe all the time and doesn't ever want to take a shower. Yeah, that's usually an indicator of dementia.

Yeah, it's not like she just gave up and doesn't care anymore, right, it's part of the symptoms.

Yeah, taking hold.

Although another problem with dementia and one of the confounding factors, is that depression can be a byproduct or co morbidity of dementia. Because you recognize that your life is changing in ways that you're not happy about. You can't communicate anymore, you forget stuff all the time, you can become depressed. So then that could lead to you giving up on taking showers and dressing as well.

Yeah, and not only depressed, but agitated and aggressive riddle with anxiety. A lot of your emotional well being and emotional health will be slipping away from you.

Yeah. And again this can be a direct result of chemical changes in your brain due to dementia, or it can be like this is the result of you recognizing these changes and just becoming upset about them.

We talked about communication and the hallucinations. You're going to have trouble sleeping as well in a lot of cases. Yeah, and then personal safety. A lot of people die every day because of accidents that happen as a result of dementia.

Right, People who shouldn't be driving to get into cars. And there's this there's a push that's going on now, I think in the last year or so as part of the Council line Aging, like the United States Council line Aging, there's a new initiative called the Dementia Friendly America Initiative.

Really neat.

Yeah. It's basically saying, look, we've got about one in eight people over sixty five in the US have dementia. We're about to have way more than that in the next couple decades. We need to be prepared for this

Yeah, and how do you do that.

You get some money from the government as a grant to go out and hire people to literally go to businesses and go to restaurants and talk to waiters and waitresses or should I just say waitrons, go to banks and talk to tellers, go to anywhere where there's interaction with another human, grocery store check out people, and literally train them on, like you said, how to recognize it and how to kindly deal with these people.

Right exactly. Apparently one of the things you teach people in service industries is not take it personally. Right that if somebody's behaving irratically or they're using incorrect words, and they're of a certain age, the chances are they probably have dementia, and there's ways of dealing with it. Apparently, responding to it in a soft, friendly manner tends to get results from the dementia patient, especially if you are not being an aggressive jerky, right exactly, Just being nice

Absolutely and necessary. Yeah, you know, but.

It's it's I'm stricken by the idea that people are planning out this far ahead. Yeah, for this kind of thing.

It's exceptional, it is, and it's scary but awesome. So if you do have a family member, one thing that's important to remember. There's something called the caregiver burden that my dad and his wife definitely experienced. It is really really tough on you, on your family, and it can actually take a physical toll. They have some stats here if you your risk of death as a woman if your husband has dementia increases twenty eight percent eight percent

Still pretty significant incag sure, just from the dementia diagnosis.

And what they recommend in this article is to take care of yourself first, because they found that if you are not going into this with the right attitude and you are upset or have anxiety, you're just gonna do more harm anyway.

So get yourself right, take care of yourself.

And go into it in the right frame of mind, and you'll actually be able to help better.

Yeah, And this caregiver burden or caregiver burnout is a very real thing physically too, Like you have low energy, you're you have low productivity, you become snippy, resentful, angry, and you can end up basically mistreating your own parent or spouse. Yeah, because you're so upset with this horrific disease. One of the all of dementia is that there's no two days that are alike. And when you're dealing with the dementia patient, what worked yesterday isn't going to necessarily

Yeah, and boy, you talk about a really sad way to damage what previously was a good relationship with a parent or something is devastating, you know.

So there are drugs that they use to help stave off.

Dementia, mainly right now. They are colon esturays inhibitors, and they suppress colon esterrays, which is an enzyme that breaks down acetylathena colin, which we've talked about before. That's what helps transmit messages between neurons.

So that will help, Yeah, because if you're not communicating as much as you were before, at least the communication that is going on can stick around longer, exactly. You know. It seems primitive as far as like brain drugs go, but it makes sense, you know. Yeah.

And then there's another one, and are they still using this belief mamantine and it inhibitates inhibits glutamate, which we talked about before, which causes neuron death when overstimulated.

Yeah.

I can't remember where we talked about that one either.

I just remember glutamate from the Umami episode.

Yeah, it was definitely that one.

And then there's also stuff you can so these drugs will help some.

That's for non vascular dementia.

Right. With vascular dementia, you're gonna want to take blood thinners that's superagulates, yeah, to keep more strokes from coming along and making the whole thing worse. And then with like Louis Body disease, to deal with things like the hallucinations and stuff, you will probably also be given anti

Yeah, I told you. Emily's grandmother, Mary is ninety five. Yeah, and very sharp. Yeah, and she does.

Word puzzles all the livelong day and is soku.

Yeah she does. She does all kinds of word puzzles. Yeah, things that I have never even heard of.

Supposedly that helps stave it off. Yeah, apparently this one's great. Alcohol moderate alcohol consumption, which is two a day or for men or one a day for women. Okay, it has a protective effect. It staves off, stays off dementia. They're not sure why, they're not sure what kind of alcohol is the best. They just know that for some reason, alcohol has a protective.

Effect, probably up to that two drinks, and then it's probably bad after that.

Yes, then it becomes very bad after that. Yeah. So you want to just moderate them.

Ount right, in all things, people, moderation, moderation, And then there are some things that you can do.

Here's the thing.

There's a debate on whether or not you are tricking your loved one by doing things like giving them an appliance that doesn't work, so they can pretend that they're ironing or something because they used to love to take care of their laundry themselves. So here, let me remove the cord from this iron and and is.

That tricking someone?

Is it not?

And a lot of people think, no, that's what you should do because it makes them feel like they're being useful. They're not gonna get hurt or hot iron, so it's all good. Other people say no, that means that they're not hanging on to that last bit of reality they may have.

I think it's fine.

I think it's fine too. And there's actually there's a an entire village set up in I think like just outside of Amsterdam.

Yeah, this is awesome, called Hojuwei.

Right, Yeah, how would you say that?

I have no idea, because Dutch is the weirdest, the weirdest language.

We'll say that, okay, okay, And it's a it is a it's an what's called the dementia village basically, yeah, where everyone who lives in this village. I think one hundred and fifty people all have dementia, and they live in group houses.

They're well, there's caretakers that live there too, but.

Okay, yes, you're right. Yeah, and they live in the group houses with them. Yes, And a lot of the people realize that this is their nurse or just think it's a good friend of theirs. Yeah, they don't really remember where when they became friends, yeah, exactly. Yeah. And the houses they live in have different themes according to how the people lived, depending on whether they're blue collar,

And everyone, the people at the movie theater know that the people there have dementia, right like every they're real movie theater workers and real waiters in the restaurant, especially trained exactly. So it's a less clinical setting than say a nursing home. And a lot of people say this is awesome because it's as close to real normal life that they were used to as they're going to get Yeah, exactly. Then of course there's other people that poopoo and say no, you're tricking these people.

But you can say, hey, okay, here's the big difference with this place. If this, If this dementia patient gets lost in Manhattan and they run across a city worker who's collecting garbage, that city worker may do absolutely nothing to help them.

Yeah.

In HOJV village, Yeah, that city worker especially trained to get that person back to their house or alert their caretaker that this person is having a crisis or something like that.

It's what we're trying to train people to do in the future. Yes, they've just isolated it to a community.

Yeah, so there's I mean, when you break it down to that distinction, I don't really see anything wrong with it, especially when you are protecting the patients themselves. It's not like you're doing it to experiment on them, no, no, you know, or because they'll produce gold in their urine

If I'm at that point, then and play into my fantasy exactly, please.

It is nineteen eighty four all the time.

In fact, one of the people that work there say that people that do criticize it at a very good point. He's like, they don't understand what we're doing here. These aren't actors. They're like real employees of these places. They're just helping out right, you know.

And so Hojvei village. I hope I'm saying that right because I'm really putting myself out there.

Oh, I'm sure you're not.

It's become this kind of ideal standard of care. But it's also really expensive.

Yeah, I'm sure.

So in a country where there's a lot of socialized medicine, it could do pretty well, like in the Netherlands or in Canada.

Yeah, when they take care of people even though they don't have money, right, Exactly.

There's one called in Canada. It's called Pentanguishani Pentanguishini, Ontario. They have one, it's a little smaller than the one in Amsterdam. They're also building one in Miami as well. So it is starting to take hold. People do believe in it, and apparently the patient's families are very happy with this kind of thing too well.

And hopefully with the initiative of what's it called All.

Dementia America DFA, yeah or yeah, hopefully with those efforts, more and more people will because it's coming.

Oh yeah, it's coming.

A lot more folks are going to be out there that we need to take care of.

Yeah, we don't know how to cure dementia. We just know it's coming.

I'm going to be one of them, you think, so sure at some point if I make it that long.

But you know, not everybody gets dementia no matter how long you live.

I don't know.

I got a feeling really, yeah, it does run in my family a little bit. Yeah, and I have my father's family jeans more than my mother's. I feel like, so if if I had my mother's jeans, they all died from heart attacks and strokes and heart disease.

Young, not a lot of cancer. Yeah pretty young.

Yeah, so if you make it past sixty five, yeah, you beat the heart stuff.

Than the Bryant jeans.

Yeah. Well we're all going down one way and they love.

To be a hundred.

Yeah you know, yeah, man, I thought it was something. Oh yeah, I wonder, Chuck, if like our specific like us, you and me specifically, creaming all this information in every week is actually beneficial, or if we're just setting ourselves up for massive cases of dementia because we're just pushing stuff in and getting it out, pushing in new stuff and getting it out, Like are we abusing our brains or are we exercising it? I question that sometimes.

I bet someone out there, I bet there's a neurologist who has a good gut instinct answer to that.

Let us know. I want to know good news are bad? Okay, neurologists.

There's going to be a subject a line that just says, neurologists, guys, you're screwed.

Yeah, I have bad news. If you want to know more about dementia, you can type that word into your favorite search engine and it will bring up tons of information and great resources. You can also type it into the search bar house to works and it'll bring up a great article. Since I said search bar, its time.

For listener mil I'm gonna call this when Hecky Krasnaw lives okay, although I don't think he is with us. Hey, guys, only just started recently listening to the show. It's been a fantastic way to pass time and learned something interesting.

I'm a home taught high schooler.

So every time I listen to an episode of your show, I get a history or science credit.

How about that.

That's pretty great.

But as great as that is, it's not why I'm emailing. I actually have a fun fact for you guys from your playto episode in which you mentioned Captain Kangaroo. Well, my great grandfather worked on that show. He produced the songs for it, as well as several Christmas carols, including Frosty the Snowman and his biggest claim to fame.

Rudolph the Red Nose Reindeer.

That is awesome.

I've always thought it was.

Very funny that a Jewish guy was responsible for the popularity of Christmas carols.

My family all still.

Jewish watches the Claymation Rudolph movie every year. Begare because of that our own little taste of that irony.

Yeah. I don't want to tell.

You what to do, because I'm sure you have a lot of episodes on your plate already, But I'm just saying, Hecky Krasnaw was a pretty interesting person. There might just be enough material for an episode on him up to you.

Nice.

Thanks for helping me with my school work. That is from Aiden in Maryland.

Awesome, Thank you very much. Aiden.

And when I say Hecky Krasnew lives, I mean lives.

On sure like Viva La Hecky. Yeah, if you want to tell us about someone interesting in your family, we love that kind of stuff. Also, if you are caring for a dementia patient, we want to hear the highs and the lows of that. Just kind of bringing on home for us. Will you? You can send us an email to stuff podcast at house Stuff works dot com and as always, joined us at our home on the web, Stuff Youshould Know dot com.

Stuff You Should Know is a production of iHeartRadio. For more podcasts my Heart Radio, visit the iHeartRadio up, Apple Podcasts, or wherever you listen to your favorite shows.

Mm hmm