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>> ON THIS EPISODE OF "CYCLE OF HEALTH," UNDERSTANDING ALZHEIMER'S DISEASE.

WE SIT DOWN WITH THREE EXPERTS TO DISCUSS THE SCIENCE BEHIND THE DISEASE THE LATEST IN RESEARCH, MEMORY CARE SERVICES AVAILABLE IN OUR REGION, AND IF WE CAN REDUCE THE RISK.

WE ALSO VISIT A LOCAL RESEARCH CENTER WHERE A NEW, GLOBAL CLINICAL TRIAL IS TAKING PLACE.

WE HOPE YOU'LL JOIN US FOR THIS IMPORTANT DISCUSSION, COMING UP ON CYCLE OF HEALTH.

>> HELLO AND WELCOME TO "CYCLE OF HEALTH."

I'M Dr. RICH O'NEILL TONIGHT'S TOPIC, "UNDERSTANDING ALZHEIMER'S DISEASE."

ACCORDING TO THE ALZHEIMER'S ASSOCIATION, MORE THAN 6 MILLION AMERICANS ARE LIVING WITH THIS DISEASE AND THAT NUMBER IS PROJECTED TO REACH NEARLY 13 MILLION BY 2050.

SO WHO IS MOST AT RISK?

HOW CAN WE BEST PREVENT THIS DISEASE?

ARE THERE NEW TREATMENTS ON THE HORIZON?

AND HOW CAN WE BETTER CARE FOR THOSE WHO MAY ALREADY HAVE AN ALZHEIMER'S DIAGNOSIS?

WE HOPE TO ANSWER THESE QUESTIONS AND MORE ON TONIGHT'S SHOW.

JOINING ME TO EXPLORE THIS TOPIC ARE: DR. SHARON BRANGMAN, DIRECTOR OF THE CENTER OF EXCELLENCE FOR ALZHEIMER'S DISEASE AT UPSTATE UNIVERSITY HOSPITAL.

COLLEEN DILLENBECK, CLINICAL TRIALS MANAGER FOR THE GERIATRICS DEPARTMENT AT UPSTATE UNIVERSITY HOSPITAL AND MARY KOENIG, ADMINISTRATOR OF THE HERITAGE MEMORY LIFE COMMUNITY AT LORETTO THANK YOU ALL FOR BEING HERE.

>> AND Dr. BRANGMAN, WHAT IS ALZHEIMER'S?

WHAT IS GOING ON IN THE BRAIN THERE?

>> WELL ALZHEIMER'S IS A BRAIN DISEASE WHERE THE NERVE CELLS START TO BREAK DOWN AND AREAS OF THE BRAIN START TO SHRINK AND THEY DON'T FUNCTION WELL.

AND WE OFTEN THINK OF ALZHEIMER'S AS A MEMORY PROBLEM AND THAT MIGHT BE THE INITIAL SIGNS OF A PROBLEM THAT'S GOING ON.

BUT ALZHEIMER'S DISEASE IS MUCH MORE THAN THAT.

IT IMPACTS THE WAY WE THINK, MAKE DECISIONS, HOW WE FUNCTION DAY TO DAY, TAKING CARE OF OURSE LVES AND IT IMPACTS BEHAVIOR.

HOW PEOPLE ACT.

WHETHER THEY MIGHT HAVE DEPRESSION OR START TO HALLUCINATE OR HAVE STRANGE IDEAS.

SO IT REALLY IMPACTS MORE THAN JUST MEMORY.

>> YOU KNOW, MY MOM HAD ALZHEIMER'S, AS YOU KNOW, BECAUSE I WAS PART OF YOUR JER YAT GERIATRIC PROGRAM WITH HER.

LONG BEFORE SHE HAD A DIAGNOSE, SHE STARTED TO DO WEIRD THINGS THAT THE FAMILY WAS THINKING, WHY IS SHE DOING THAT, THINKING PEOPLE WERE COMING INTO HER HOUSE AND STEALING STUFF, THINGS LIKE THAT, BUT THAT WAS PART OF WHAT, LOOKING BACK, WE STARTED TO REALIZE THAT WAS ALZHEIMER'S.

WE DIDN'T REALIZE IT AT THE TIME.

ONE OF THE THINGS PEOPLE ASK IS WHAT ABOUT NORMAL MEMORY CHANGES AND THE DIFFERENCE BETWEEN THAT AND ALZHEIMER'S?

CAN YOU WEIGH IN ON THAT?

>> IT'S IMPORTANT TO KNOW THAT MEMORY LOSS IS NOT A NORMAL PART OF AGING.

AS WE GET OLDER, IT TAKES A LITTLE LONGER TO REPRIEVE AND-- TO RETRIEVE AND PROCESS INFORMATION BUT YOU CAN STILL DO IT.

IT'S LIKE HAVING A COMPUTER WITH A HARD DRIVE THAT'S FULL OF INFORMATION.

IT TAKES A LITTLE WHILE TO PULL THE FINALS UP FILES UP BUT YOU SHOULD BE ABLE TO PULL IT UP.

MANY OF US HAVE HAD THE EXPERIENCE WHERE WE CAN'T REMEMBER SOMEONE'S NAME AND THEN MAYBE AN HOUR LATER WE REMEMBER IT.

THOSE THINGS ARE NORMAL.

IT'S SLOW RETRIEVAL.

HOWEVER, IF YOU DON'T REMEMBER THE NAME OR IF YOU REMEMBER SOMETHING THAT IS COMPLETELY INACCURATE, OR IF YOUR MEMORY LOSS IS STARTING TO AFFECT FUNCTION, THAT'S WHEN WE START TO GET CONCERNED.

>> WHAT SHOULD SOMEBODY DO IF THEY SUSPECT THEY OR A LOVED ONE MIGHT HAVE ALZHEIMER'S?

>> WELL, WE ENCOURAGE PEOPLE TO GET AN EVALUATION.

THE EVALUATION IS VERY QUICK.

IT DOESN'T HURT.

I THINK A LOT OF PEOPLE ARE IN DENIAL BUT EVERY TYPE OF MEMORY LOSS DOESN'T MEAN YOU NECESSARILY HAVE DEMENTIA.

SOMETIMES PEOPLE ARE ON MEDICATION THAT HAVE SIDE EFFECTS IMPACTING THEIR BRAIN OR THEIR BLOOD SUGAR IS OUT OF CONTROL OR THEIR BLOOD PRESSURE IS TOO HIGH.

IT CAN AFFECT YOUR BRAIN.

IT IS IMPORTANT TO GET IT CHECKED OUT AND THAT'S WHAT WE ENCOURAGE PEOPLE TO DO.

>> SO REALLY YOU ARE LOOKING AT A WHOLE PHYSICAL REALLY TO RULE OUT OTHER POSSIBILITIES.

IF YOU ARE SCARED TO DEATH YOU MIGHT HAVE ALZHEIMER'S, GOOD TO GO TO THE DOCTOR TO RULE OUT SOMETHING NOT SO TERRIFYING.

>> EXACTLY.

WE DO A COMPREHENSIVE EVALUATION.

WE LOOK AT YOUR MEDICAL HISTORY, ALL THE MEDICATIONS YOU TAKE.

WE TALK ABOUT YOUR PHYSICAL FUNCTION, HOW YOU GET THROUGH THE DAY, WHAT YOUR MOOD IS.

WE SEE SOME PEOPLE WHO ARE VERY DEPRESSED AND IT LOOKS LIKE THEY HAVE DEMENTIA BUT WHEN WE TREAT THEIR DEPRESSION,THEIR MEMORY IS FINE.

SO THAT'S WHY WE DON'T WANT PEOPLE TO JUMP TO CONCLUSIONS.

IT'S IMPORTANT TO GET AN EVALUATION.

>> SO I KNOW YOU GUYS IN YOUR PROGRAM, PARTICIPATE IN A NUMBER OF WHAT ARE CALLED CLINICAL TRIALS WHICH ARE RESEARCH STUDIES ON MEDICATIONS THAT ARE POSSIBLY MIGHT BE HELPFUL FOR ALZHEIMER'S AND MISS COLLEEN DILLENBECK IS THE DIRECTOR OF THAT PROGRAM.

WHAT ARE SOME OF THE TRIALS GOING ON?

LET ME ASK SOMETHING ELSE FIRST?

WHAT ARE THE BENEFITS OF PARTICIPATING IN CLINICAL TRIAL OR RESEARCH PROGRAM?

>> YEAH, SO RESEARCH STUDIES OFFER PATIENTS THE OPPORTUNITY TO USE AN INVESTIGATIONAL MEDICATION OR A MEDICATION THAT MIGHT BE HELPFUL BEFORE IT'S APPROVED FOR WIDESPREAD USE.

SO THEY HAVE THAT EARLY ACCESS TO IT.

>> SOMEBODY SIGNS UP AND THEY CAN TRY OUT A MEDICATION.

THEY MIGHT GET THE PLA PLACEBO, RIGHT, BECAUSE THAT'S THE STANDARD FOR TESTING THESE THINGS.

BUT THEY MIGHT GET THE MEDICATION AND THEY CAN FIND GOOD, POSSIBLY GOOD RESULTS FROM THAT.

>> CORRECT.

>> WELL, WE RECENTLY VISITED THE VELOCITY CLINICAL RESEARCH IN EAST SYRACUSE TO EXPLORE A NEW CLINICAL TRIAL RELATED TO THE PREVENTION OF ALZHEIMER'S DISEASE.

LET'S TAKE A LOOK AT SOME OF THE WORK THEY ARE DOING.

>> MY NAME IS LISA, SENIOR DIRECTOR OF OPERATIONS AT VELOCITY.

WE SPECIALIZE IN ALZHEIMER'S DISEASE RESEARCH.

SPECIFICALLY WE ARE LOOKING AT INVESTIGATIONAL TREATMENTS THAT COULD HOPEFULLY SLOW, STOP OR PREVENT ALZHEIMER'S DISEASE.

A CLINICAL TRIAL IS THE PROCESS THAT WE HAVE SET UP IN THE UNITED STATES TO EVALUATE NEW INVESTIGATIONAL TREATMENTS TO SEE IF THEY'RE BOTH SAFE AND EFFECTIVE.

>> THE STUDY THAT IS OCCURRING HERE AT VELOCITY CLINICAL IS VERY EXCITING AND IT'S ONE OF THE FIRST STUDIES INVOLVING THE PREVENTION POTENTIALLY OF ALZHEIMER'S DISEASE.

ROBERT TOPELLO, M.D., INTERNIST, WORK AS A PRINCIPLE INVESTIGATOR AT VELOCITY RESEARCH.

PRINCIPLE INVESTIGATOR IS A PHYSICIAN WHO OVERSEES THE CLINICAL STUDIES.

I'M RESPONSIBLE FOR OVERSEEING THE TREATMENTS THAT PEOPLE GET TO MAKE SURE THAT THE PATIENTS DO OKAY, THAT THINGS OCCUR SAFELY.

DISWHRT FIRST THING WE HAVE TO DO IS IDENTIFY PEOPLE WHO HAVE RISK.

THE EASIEST WAY DO THAT IS LOOK FOR PEOPLE WITH FAMILY HISTORY AND IF THEY'RE INTERESTED IN RESEARCH, WE BRING THEM HERE INTO THE CLINIC AND WE LOOK FOR SOMETHING CALLED A BIOMARKER IN THEIR BLOOD AND THAT BIOMARKER IS THE SPECIFIC SIGNIFIER THAT THERE MIGHT BE THE VERY, VERY EARLIEST PARTS OF THE DISEASE PROCESS IN THEIR BRAIN.

>> BLOOD TEST IS ABNORMAL, THEN WE ALSO TAKE THE NEXT STEP WHICH IS DOING BRAIN IMAGING STUDIES WHICH CAN IDENTIFY AND SHOW THE PRESENCE OF AMYLOID PROTEIN WHICH ONCE AGAIN IS A VERY STRONG INDICATOR, NOT A GUARANTEE, THAT YOU ARE AT MUCH HIGHER RISK OF ALZHEIMER'S.

>> TRUTH BE TOLD, WE ARE PROBABLY GOING TO EVALUATE THOUSANDS OF PEOPLE AROUND THE WORLD WHO DON'T HAVE THOSE BIOMARKERS.

THERE IS A REALLY LARGE FUNNELING PROCESS TO FIND THE RIGHT PATIENTS FOR CLINICAL TRIALS.

OFTEN HAVE YOU TO LOOK AT 10 TO FIND ONE.

AND IF THEY DO END UP QUALIFYING, THEN THEY WOULD BE INVOLVED IN A DOUBLE BLIND STUDY.

SO SOME OF THE FOLKS IN THAT RESEARCH WOULD GET THE ACTUAL INVESTIGATIONAL TREATMENT AND THOARS WOULD GET A PLACEBO BUT WE ARE LOOKING AT A TREATMENT THAT IS ATTEMPTING TO BREAK DOWN AND REMOVE PLAQUE FROM THE BRAIN.

>> BEFORE WE GIVE MEDICATION TO THE GENERAL POPULATION, WE HAVE TO BE CONVINCED IT IS SAFE AND EFFECTIVE.

AND BEYOND A SHADOW OF A DOUBT.

THE INVESTIGATIONAL DRUGS GENERALLY TAKE A LONG TIME, EVEN IF THINGS GO WELL.

THEY TAKE YEARS TO COME TO MARKET.

>> AND SO WE ARE ACTUALLY ONE OF THE CLINICS THAT GATHERS THAT DATA.

THAT SITS WITH PATIENTS, THAT PROVIDES THEM THE TREATMENTS THAT MANAGES AND EVALUATES THOSE SIDE EFFECTS.

AND THAT HELPS IN UNDERSTANDING WHETHER OR NOT THOSE TREATMENTS ARE EFFECTIVE AND SAFE.

SO ONCE WE GET THROUGH THAT PROCESS, THINGS CAN BE EVALUATED BY THE FDA AND THE TREATMENTS CAN BE APPROVED OR NOT APPROVED IF THE DATA IS GOOD OR NOT GOOD.

>> WE LOOK AT THE BLOOD TESTS, WE LOOK AT THE SCANS AND IT'S IMPORTANT TO INVESTIGATE, YOU KNOW, THE MEDICATION TO SEE WHAT IT DOES TO THE BLOOD WORK AND THE SCANS.

BUT ULTIMATELY, THE GOAL OF THESE STUDIES IS TO PROVE THAT THEY MAKE PEOPLE BETTER.

EVEN A LITTLE BIT OF AN IMPROVEMENT IN THE TREATMENT OF ALZHEIMER'S WOULD HAVE A MAJOR IMPACT.

>> WE WANT TO SEE, AND I WOULD LOVE TO BE A PART OF, MAKING A DIFFERENCE IN THE LIVES OF THOSE WHO ARE AFFECTED AND THEIR FAMILY MEMBERS.

THERE IS NOTHING MORE CRUEL THAN WATCHING PEOPLE GET ROBBED OF THEIR MEMORIES AND GETTING ROBBED TRULY OF THE HISTORY OF THEIR LIFE.

>> OUR GOAL IS TO PREVENT IT ALL TOGETHER.

IDEALLY THAT'S WHAT WE WOULD LOVE TO SEE.

BUT EVEN IF THIS TURNS OUT TO SLOW DOWN THE CONDITION, THAT WOULD BE A MAJOR IMPROVEMENT.

IT WOULD BUY PATIENTS YEARS TO ENJOY THEIR FAMILIES AND RETAIN THEIR MEMORIES.

>> WE WOULD LOVE TO SEE A DAY WHEN THE REALITY OF ALZHEIMER'S IS ABOUT EARLY PREVENTION AND THAT'S WHAT THIS STUDY IS ABOUT.

>> WHAT TYPES OF PATIENTS ARE TAKING PART IN THESE RESEARCH STUDIES.

>> WE HAVE STUDIES FOR ALL AREAS OF DEMENTIA.

MILD COGNITIVE IMPAIRMENT ALL THE WAY TO ALZHEIMER'S DISEASE, MILD AND MODERATE ALZHEIMER'S DISEASE.

>> SO THERE IS A WIDE RANGE OF HOW, IF SOMEBODY THINKS THEY MIGHT HAVE ALZHEIMER'S OR THEY REALLY KNOW, YOU MIGHT BE ABLE TO SIGN UP ANYWAY.

>> WE ARE ALWAYS DOING NEW STUDIES SO WE KEEP A LIST OF INTERESTED PEOPLE WHO ARE INTERESTED IN OUR RESEARCH AND WHEN WE GET A NEW STUDY, WE CAN GO TO THE LIST AND LET THEM KNOW.

>> ARE THERE OTHER BENEFITS FOR PARTICIPATING IN A TRIAL BESIDE GETTING THE MEDICATION?

>> YEAH, THERE IS AN INDIRECT BENEFIT THAT I'VE FOUND.

SO FOR ONE THING, PATIENTS REALLY WANT TO HELP US FIND TREATMENTS THAT WORK FOR ALZHEIMER'S.

SO NOT ONLY DO THEY SIGN UP FOR THESE STUDIES TO HOPEFULLY HELP THEMSELVES, THEY WANT TO HELP FUTURE GENERATIONS.

THEY WANT TO HELP THEIR GRANDKIDS NOT HAVE TO GO THROUGH THIS.

IT'S ALTRUISTIC AND THEY'RE VERY DEDICATED TO IT.

>> SO WHEN PEOPLE ARE HAVING ALZHEIMER'S SYMPTOMS, OFTEN TIMES THEY MIGHT GO TO A PROGRAM LIKE YOURS, MARY.

>> YES.

THE HERITAGE AT LORETTO.

LORETTO IS A LEADER IN MEMORY CARE SERVICES.

WE HAVE A WHOLE CONTINUUM OF CARE FOR PEOPLE WITH DEMENTIA, STARTING FIRST WITH THE HERITAGE, WHICH WAS THE FIRST FACILITY IN CENTRAL NEW YORK, ACTUALLY BACK IN 1992, FOR SOMEBODY WITH DEMENTIA.

INTERESTING THAT PRIOR TO THE HERITAGE, IF YOU HAD BEEN DIG NOSED WITH DEMENTIA, YOU HAD TWO CHOICES.

YOU WENT TO A NURSING HOME OR YOU STAYED AT HOME.

CONSEQUENTLY, THERE WERE A LOT OF PEOPLE IN NURSING HOMES THAT DIDN'T NEED TO BE THERE AND A LOT OF PEOPLE AT HOME WHO WERE NOT SAFE AT HOME.

LORETTO HAS BEEN VERY INNOVATIVE IN STARTING DEMENTIA PROGRAMS AND MOST RECENT LOY WE HAVE THE MEMORY LIFE COMMUNITY WHICH IS STATE-OF-THE-ART DESIGNED FROM THE GROUND UP WITH BEST PRACTICES AND THE LATEST RESEARCH FOR DEMENTIA.

>> SO WHEN YOU SAY BEST PRACTICES, WHAT ARE THE THINGS PEOPLE ACTUALLY DO FOR PEOPLE WHO HAVE ALZHEIMER'S OR THE BEGINNING OF IT?

>> SO THERE IS A LOT OF GREAT RESEARCH ON THERE AND EVEN THOUGH WE CAN'T STOP THE PROGRESSION, WE CAN HELP PEOPLE REALLY LEARN TO LIVE WITH THE DISEASE.

MAXIMIZE PEOPLE'S INDEPENDENCE AND PRESERVE THEIR DIGNITY; FOR EXAMPLE, AND I CAN SPEAK TO THIS BECAUSE WHEN WE WERE DEVELOPING THE BOR, I WAS VOFTD IN THE MEETINGS AND WE WOULD TALK ABOUT HOW CAN WE INCREASE PEOPLE'S APPETITE.

THAT'S AN ISSUE.

WE ARE GOING TO USE RED TABLE WARE.

HOW CAN WE HELP PEOPLE PARTICIPATE IN THEIR SELF CARE, WHICH IS ANOTHER ISSUE.

WELL, WE ARE GOING TO PUT RADIANT FLOORING IN THE BATHROOMS BECAUSE BEING COLD IS OFTEN AN ISSUE FOR PEOPLE WITH DEMENTIA.

>> I DON'T LIKE TO GO TO THE BATHROOM WHEN IT'S COLD.

>> I KNOW.

>> IN THE MIDDLE OF THE NIGHT.

>> AND, FOR EXAMPLE, ADDING WINDOWS.

THERE IS LOTS OF NATURAL SUNLIGHT.

WE KNOW THE BENEFITS OF NATURAL SUNLIGHT.

PEOPLE OFTEN HAVE A PROBLEM BETWEEN BEING, YOU KNOW, SLEEPING DURING THE DAY AND AWAKE AT NIGHT AND GETTING THEIR DAYS MIXED UP.

SO LOTS OF NATURAL SUNLIGHT.

IT'S ALL DEVELOPED AROUND A FOUNDER'S GARDEN SO THEY CAN GO IN AND WE KNOW THE BENEFIT OF PLANTS.

WE USE DIFFERENT DOOR WAYS FOR PEOPLE TO HELP IN WAY FINDING BECAUSE WE KNOW THAT THAT CAN BE AN ISSUE.

SO THERE IS ALL THESE BEST PRACTICES THAT I WOULD SAY AT THAT TIME WE KNOW IS INVOLVED IN ALL OF OUR FACILITIES.

EVERY DECISION THAT WE MAKE IS BASED AROUND WHAT IS BEST FOR OUR PEOPLE.

>> SO WHEN YOU SAY WAY FINDING, THAT'S AN INTERESTING TERM I'VE NEVER HEARD BEFORE, BUT ARE YOU SAYING-- IS THAT ONE OF THE-- Dr. BRANGMAN, IS THAT ONE OF THE SIGNS OF ALZHEIMER'S, HAVING DIFFICULTY FINDING YOUR WAY AROUND THE UNIVERSE?

>> A COMMON TERM FOR PEOPLE WHO WANDER AND GET LOST.

THEY DON'T RECOGNIZE FAMILIAR ENVIRONMENTS.

AND THAT IS A BIG CONCERN FOR CAREGIVERS WHERE SOMEONE CAN WANDER AWAY AND NOT KNOW HOW TO GET HOME.

SO A LOT OF FACILITIES ARE LOOKING AT WAYS FOR PEOPLE TO SAFELY WANDER BECAUSE IT'S SUCH A BIG DRIVE FOR SOME PEOPLE WITH DEMENTIA.

AND WE KNOW THAT MEDICATIONS DO NOT WORK WELL TO STOP THEM FROM WANDERING.

>> YOU KNOW, TAKING CARE OF MY MOM, WAS ABOUT A 15-YEAR PROCESS.

AND I WAS LEFT BY THE FAMILY PRETTY MUCH IN CHARGE OF DOING ALL OF THAT.

IT WAS THE MOST EMOTIONALLY DEMANDING THING I HAVE EVER DONE.

AND I HOPE NEVER TO HAVE ANYTHING AS DIFFICULT AS THAT AGAIN.

CAN YOU TALK ABOUT HOW DO YOUR FOLKS MANAGE THAT?

HOW DO YOU HELP FAMILIES WITH THAT.

>> CAREGIVERS HAVE SIGNIFICANT STRESS IN PROVIDING THIS CARE AND I HAVE READ ARTICLES THAT INDICATE THIS IS THE TOUGHEST KIND OF CARE GIVING, EVEN TOUGHER THAN TAKING CARE OF SOMEONE WITH CANCER BECAUSE YOU REALLY HAVE A 24/7 JOB AND YOU ARE WATCHING THE PERSON THAT YOU KNEW CHANGE RIGHT BEFORE YOUR EYES.

SOME PEOPLE CALL IT A DOUBLE DEATH.

THE PERSON IS STILL THERE BUT THEY'RE NOT THE EARN PERSON WHO YOU REMEMBER AND SOMETIMES THEY DON'T RECOGNIZE YOU ANYMORE SO IT'S SO HARD TO BE TAKING CARE OF SOMEONE AND THEY DON'T KNOW WHO YOU ARE.

>> MY MOTHER USED TO HIT ME.

WOULD I GO TO VISIT HER AND SOMETIMES SHE WOULD HIT ME.

WAIT A MINUTE.

I'M EXHAUSTED TRYING TO TAKE CARE OF YOU AND YOU ARE HITTING ME.

IT WAS REALLY A LOT.

>> SO IT'S VERY COMMON BECAUSE SHE PROBABLY DIDN'T RECOGNIZE YOU, THINKS SHE IS IN PERSONAL DANGER AND THIS IS ONE OF THE THINGS THAT IS SO HARD TO CAREGIVERS.

ALSO WHEN A PATIENT STARTS TO WANDER, YOU CAN TURN YOUR HEAD FOR ONE MINUTE AND THEY CAN SLIP OUT AND GET LOST OR IF THEY FORGET WHERE THE BATHROOM IS AND THEY LOSE CONTROL OF THEIR BLADDER OR BOWELS, THOSE ARE VERY, VERY STRESSFUL THINGS TO DO FOR ANOTHER PERSON AND MANY OF OUR CAREGIVERS ARE OLDER ADULTS AND EVEN THOUGH THEY WANT TO DO IT, THEY PHYSICALLY CAN'T DO IT.

SO ALZHEIMER'S DISEASE IS PRIMARILY A DISEASE OF AGING.

YOUR RISK FOR IT UNCREASES AS YOU GET OLDER AND WE OFTEN HAVE PARTNERS OR SPOUSES THAT ARE STUFF SUFFERING FROM MEDICAL OR PHYSICAL PROBLEMS AND CANNOT MANAGE THE CARE.

THERE IS A LOT OF GUILT AND SADNESS, EVEN WITH ADULT CHILDREN SUCH AS YOU WERE, THEY HAVE JOBS AND THEIR OWN FAMILIES AND THEY FIND IT HARD TO PROVIDE THE CARE.

SO IN OUR EXCELLENCE CENTER FOR ALZHEIMER'S DISEASE, WE HAVE SOCIAL WORKERS WHO WORK CLOSELY WITH US AND THEY DO A FAMILY ASSESSMENT, THEY FIGURE OUT WHAT THE RESOURCES ARE, THEY USE THAT WITH OUR FUNCTIONAL ASSESSMENT AND WE TRY TO COME UP WITH A CARE PLAN THAT PROVIDES THE MOST CARE FOR THE PATIENT AND THE MOST RESOURCES FOR THE CAREGIVER.

>> TERRIFIC.

NOW ONE OF THE THINGS THAT I REMEMBER WAS VERY CHALLENGING WAS MY MOTHER WOULD GET STUCK ON SOMETHING AND ASK ABOUT IT LIKE, NO KIDDING, MAYBE 20, 30, 40, 50 TIMES AND WOULD I WANT TO PULL MY AIR OUT.

WHAT DO YOU DO-- ANY OF YOU CAN WEIGH IN ON THIS.

WHAT DO YOU DO WHEN SOMEBODY IS DOING THAT AS A CAREGIVER?

>> SO REPETITION, YES, CAN BE EXHAUSTING BUT WHAT WE FIND IS WE USE VALIDATION.

WE USE REDIRECTION AND DISTRACTION.

SO LET ME GIVE YOU AN EXAMPLE.

IF YOUR 90-YEAR-OLD MOTHER IS SAYING WHERE IS MY MOTHER.

I'M LOOKING FOR MY MOTHER.

YOU CAN SAY SOMETHING LIKE WAS YOUR MOTHER A GOOD COOK?

I BET YOUR MOTHER WAS A GOOD COOK AND OFTEN TIMES THEY'LL GET TALKING ABOUT YES OR NO.

I'VE HEARD BOTH.

AND THEN SAY, YOU KNOW WHAT, LET'S GO GET A SNACK AND TRY TO DISTRACT THEM TO DO SOMETHING ELSE.

>> WOULD YOU AGREE Dr. BRANGHAMMAN.

>> DISTRACTION IS THE WAY TO GO BECAUSE SOMEONE DOES NOT HAVE THE CAPACITY TO ABSORB LONG EXPLANATIONS.

I HAD A PATIENT WHO DIDN'T REMEMBER HER HUSBAND PASSED AWAY AND EVERY TIME SHE ASKED FOR HIM, PEOPLE WERE TELLING HERSHEY HE DIED.

DON'T YOU REMEMBER?

IT WAS A BRAND NEW EXPERIENCE FOR HER.

SO WE-- THERE IS NO MEDICATIONS THAT HELP THIS.

SO WHAT WE DID WAS WE WORKED WITH THE CAREGIVERS AND SAID, I'M SURE HE WILL BE HERE SOON.

WHAT KIND OF WORK DID HE DO?

WHAT KINDS OF THINGS DID YOU USED TO DO TOGETHER SO YOU HELP WITH THE REMINISCING AND THE GOOD MEMORIES BECAUSE THE DEATH IS JUST NOT GETTING ABSORBED DUE TO THE BRAIN DISEASE AND IT DOES NO BENEFIT TO THE PATIENT AND IT EXHAUSTS THE CAREGIVERS TO DO REALITY CHECKS ALL THE TIME.

FOR THINGS THAT WE ALL KNOW ARE TRUE BUT THE PATIENT JUST CAN'T ABSORB AND RETAIN.

>> I SO I SAW-- PROBABLY ALL OF US SAW IN THE NEWS THERE WAS THAT DRUG APPROVED BY THE FDA FOR SOME ENORMOUS COST A YEAR LIKE $150,000 A YEAR, AND WAS VERY LITTLE EVIDENCE THAT IT ACTUALLY WORKED.

IS THAT ONE OF THE DRUGS THAT YOU GUYS HAVE WORKED ON AT UPSTATE?

ARE YOU TESTING THAT ONE OUT?

>> WE DID NOT-- WE WEREN'T INVOLVED IN THAT PARTICULAR STUDY.

WE ARE CURRENTLY DOING A STUDY THAT'S IN THE SAME CLASS OF DRUGS FOR THAT BUT YES THERE HAS BEEN CONTROVERSY OVER THAT DRUG APPROVAL.

>> Dr. BRANGMAN, IS THERE ANY DRUG AT ALL THAT HELPS PEOPLE AT THIS POINT.

>> THE MEDICATIONS THAT YOU MENTIONED NALT WE ARE ALSO STUDYING ARE AM-- ARE AMYLOID BUSTING MEDICATIONS.

AMYLOID IS AN ABNORMAL PROTEIN THAT BUILDS UP IN THE BRAINS.

IF YOU THINK OF THE NERVES IN THE BRAIN LIKE A DELICATE SPIDER WEB, WITH ALZHEIMER'S DISEASE IN SOME PEOPLE, THEY GET THIS ABNORMAL PROTEIN THAT KIND OF CLUTCHES UP THAT SPIDER WEB AND IT KEEPS THE NERVE CELLS FROM SENDING MESSAGES.

SO THE MEDICATION IS UNDER INTENSE RESEARCH ACTIVITY RIGHT NOW BREAKS UP THAT AM EMPLOYED OR ABNORMAL PROTEIN.

WHAT WE ARE TRYING TO SEE IS ONCE THE AM EMPLOYED IS-- AMYLOID IS REMOVED FROM THE BRAIN, DOES IT HELP THE BRAIN GET BETTER?

THAT'S THE BIG QUESTION.

THAT WAS THE CORONAVIRUS WITH THE-- THAT WAS THE QUESTION BEFORE BECAUSE WE KNOW MEDICATIONS ARE VERY GOOD AT BREAKING DOWN THE PROTEIN.

WHAT WE NEED TO KNOW NOW DOES THAT HAVE A BENEFIT TO THE PATIENT THAT OUTWEIGHS ANY POSSIBLE SIDE EFFECTS AND THAT'S WHY THERE ARE MULTIPLE COMPANIES LOOKING AT THIS TO SEE.

THAT HAS THE NEWEST RESEARCH BUT THERE ARE LOTS OF DIFFERENT AREAS THAT ARE BEING EVALUATED RIGHT NOW BECAUSE THIS IS SUCH A BIG PROBLEM NOT ONLY IN THE COUNTRY BUT AROUND THE WORLD.

>> ARE THERE THINGS YOU WOULD RECOMMEND THAT PEOPLE DO TO HELP THEM GO MORE SMOOTHLY AT HOME FOR CARING FOR SOMEBODY?

>> REACH OUT TO THE ALZHEIMER'S ASSOCIATION.

THEY HAVE A LOT OF GREAT RESOURCES, DEVELOP A CARE PLAN TEAM WITH YOUR FAMILY OR FRIENDS.

COME UP WITH A PLAN.

THERE ARE THINGS YOU CAN DO.

HOME CARE, SOCIAL DAY CARE PROGRAMS.

PEOPLE CAN PUT A PLAN TOGETHER AND IT USUALLY LASTS FOR A LENDS OF TIME UNTIL WANDERING BECOMES AN ISSUE.

SIX OUT OF 10 ALZHEIMER'S PATIENTS WANDER.

AT SOME POINT PEOPLE WILL NEED RESIDENTIAL CARE.

>> THAT'S ABOUT ALL THE TIME WE HAVE FOLKS I WANT TO THANK OUR PANELISTS FOR JOINING US.

DR. SHARON BRANGMAN, DIRECTOR OF THE CENTER OF EXCELLENCE FOR ALZHEIMER'S DISEASE AT UPSTATE UNIVERSITY HOSPITAL COLLEEN DILLENBECK, CLINICAL TRIALS MANAGER FOR THE GERIATRICS DEPARTMENT AT UPSTATE UNIVERSITY HOSPITAL AND MARY KOENIG, ADMINISTRATOR OF THE HERITAGE MEMORY LIFE COMMUNITY AT LORETTO BE SURE TO VISIT WCNY.ORG/CYCLEOFHEALTH FOR MORE INFORMATION ABOUT THIS AND OTHER EPISODES.

FOR CYCLE OF HEALTH, I'M DOCTOR RICH O'NEIL.

THANKS FOR CHECKING IN.

ED ON THE NEXT "CYCLE OF HEALTH" WOMEN'S HEALTH.

WE TALKED TO A WOMAN WHO OPENS UP ABOUT THE STRUGGLES SHE FACED DURING THE PANDEMIC AND HOW HER REDISCOVERED LOVE FOR HORSES HAS HELPED HER MANAGE.

THEN, JOIN US FOR A CONVERSATION WITH FOUR FEMALE DOCTORS TO DISCUSS THE IMPACT COVID HAS HAD AND WAYS WOMEN CAN RECLAIM THEIR OWN HEALTH.

WE HOPE YOU'LL JOIN US FOR THE CONVERSATION, ALL ON THE NEXT "CYCLE OF HEALTH."