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The Neuroscience Institute at Catholic Health
Catholic Health is a leader in the diagnosis, treatment and comprehensive care of complex neurological disorders affecting the brain, spine and nervous system
We provide advanced diagnostics, innovative therapies, new techniques, and groundbreaking treatments for all patients, including those with serious, rare, or complex neurological conditions.
Our multidisciplinary team works together to provide patient-centered care through a full range of neurological services that address a wide array of neurological conditions, including those listed below.
Using advanced techniques and technology, we closely evaluate your condition to develop an individualized treatment plan that addresses your specific needs and aligns with your lifestyle and goals. Our team of neurologists and neurosurgeons collaborates to accurately diagnose and treat conditions that involve the nervous system.
Expert Insight from Neurologist, Dr. Bruce Mayerson
Today on Catholic Health Conversations in Care, an in-depth conversation on Alzheimer's and dementia.
We'll take a look at breakthroughs in early detection and treatment, and Catholic Health's ongoing compassionate care.
Welcome to Catholic Health Conversations in Care.
I'm Colleen McVey.
Well, do you know someone with Alzheimer's or dementia, or someone caring for a loved one?
Most, if not all of us, do.
It is a devastating disease with no cure, but advancements are being made in early detection, diagnosis, and treatment.
And joining us today with the latest on all of that is Dr. Bruce Mayerson, Catholic Health's co-chairman of neurosciences and chief of neurology at St. Catherine of Siena Hospital.
Dr. Mayerson, welcome, welcome, welcome.
I'm so happy you're here.
So much to talk about today.
Good afternoon.
Thank you for having me.
I guess this is a, this affects millions of us.
Right now-
Oh nearly, what, seven and a half million Americans?
Yeah, in the order of seven million, between.
Over 65.
Yeah.
Living with Alzheimer's.
Correct.
But I wanna start-
Okay with something that really I didn't know about for a very long time, and I think a lot of people are confused about.
I, I thought Alzheimer, Alzheimer's and dementia were the same thing.
Give me-
So, yeah, so, so this is a common, question that comes up in the office.
We see a lot of patients with dementia and memory problems, and it's one of the most common things that family members say is, "Well, is this dementia?" if we start talking about this.
And I, this is my, my trademark line is always, "All Alzheimer's is dementia, but not all dementia is Alzheimer's."
And what I mean by that is that there are many different n- neurodegenerative illnesses that can cause dementia, which is a progressive d- declining cognitive function over time.
By far the most common is Alzheimer's disease, but, again, there are many others, vascular dementia, Lewy body disease, other diseases that can cause dementia that are not Alzheimer's disease.
Mm-hmm.
And Alzheimer's disease is a, is a very specific type of dementia.
Right.
And again, important 'cause it's the most common one.
Right, and that's where, like I said, nearly seven and a half million Americans over the age of 65 now living with Alzheimer's, which that's about 11% of the population over 65.
Yeah, yeah.
That affects so many people living with it, so many people taking care of people with Alzheimer's.
And with the aging, baby boomers-
Yes it's really, become a, a, you know, almost epidemic.
And I can't tell you the, the number of, people I see on a weekly basis whose chief complaint, in the office is memory loss.
Mm-hmm.
So it's, it's, it's an, it's a major issue.
Yeah, I was looking up with Alzheimer's Association, and this statistic I just was so surprised at, one in three older Americans dies from Alzheimer's.
It's, it, it is more than the, the breast and pancreatic cancer put together- yeah, pr- combined.
Right.
Yeah.
So I didn't realize that many Americans are dying from it.
Ev- you know, it seems like everybody knows someone, has a family member, has a friend who is suffering from this condition.
And, because of, you know, the nature of the condition affecting, you know, the brain and, and really the very essence of who you are, it's particularly devastating to families.
And that's why I think it's taken such a, a front role.
Let's talk about detection, because, I mean, that's where it's gonna start, and I feel like it's gonna start with the patient.
I'm the one that's gotta realize, okay, maybe it's time for me to talk to a specialist about memory loss or what's going on with me.
So what am I looking for?
So the, the, the, the, what you're saying is, is, is important because I think that obviously if the patient is recognizing their symptoms, that's, that's c- very concerning to them and, and disconcerting.
That said, oftentimes people who come to the office with these complaints are actually not the ones complaining.
It's family members, it's friends, it's people they work with who are telling them things and, and frequently they're unaware of it, which is actually one of the symptoms of dementia-
Okay
is, is being unaware of it.
So, you know, it, d- depending on who, there are people who are aware of it clearly, but the ones that aren't, pose a special challenge when we're trying to evaluate them and, and, and examine them, with the, with the standard tests that we use.
So it's-
Okay.
Well, what are, like, what are some of the symptoms?
Well, the most common, the most common symptom that we see with Alzheimer's disease is memory loss.
It typically affects short-term memory, which means memory for recent events, things maybe that were just learned.
Remote memory tends to be intact.
So I often hear somebody will say, "Oh, I remember," or the family will say, "Oh, she or he remembers something from 30, 40 years ago like it was yesterday, but they can't remember where we just went for lunch."
Or where we just said we were going for lunch or that, that sort of thing.
So that manifests as repetition of, of questions, which is a, a very common first sign or symptom that, that there is something wrong, again, typically noted by close family members, yeah, spouses and, and children.
And I guess, somebody who maybe has a family history would worry a little bit more about this?
Sure.
I- that's a, that's a actually a very common one.
You know, having a family history of Alzheimer's disease does not guarantee that you will get Alzheimer's disease, but obviously it increased the risk, and there are genes that we can look for to, to assess and, and risk stratify people, when, when, when appropriate.
Okay.
So let's, let- let's go next, the next step, diagnosis.
Right into diagnosis.
So-
Right into it.
Yeah, so, so, up until these newer drugs came out, we really did not have a great way to diagnose Alzheimer's disease w- i- in life, when people were alive.
I mean, the gold standard was autopsy, at which point-
Mm-hmm
it doesn't matter to-
Yeah most people affected, right?
Of course.
However, with these new, drugs that have become available, diagnostically, we have really had an explosion in, in what, what we can do to make the diagnosis of disease.
Three, three main ways, that, that we can do it.
O- one is with, CSF, cerebrospinal fluid.
We can do a minimally invasive lumbar puncture, spinal tap, drain some fluid from the back, take the fluid, send it to the lab, and check for the abnormal proteins that may be present, elevated or decreased in Alzheimer's disease.
That's the most, invasive way, and again, it is, it is minimally invasive.
The, the other way, which has become really sort of the standard by which we're deciding which patients would be good candidates for treatment, is a PET scan called an Amyvid scan, A-M-Y-V-I-D, and it looks for the amyloid protein, which is the abnormal protein that accumulates in the brains of people who have Alzheimer's disease.
And the last way, is by blood work.
We actually now have a blood test called the-
Really?
Yes.
It's called a p-tau.
It's, it's, it's fresh.
Oh, okay.
P-tau217.
I would say m- it's been months since it has become commercially available.
Wow.
Most insurance companies and Medicare I don't think are, are paying for it, but I think for, $400 out of pocket, you can do that.
That's probably the easiest and-
Yes
least invasive thing.
Oh, wow.
That's, that's-
Yeah
that's amazing.
So it's very ex- yeah, yeah, phosphorylated tau217.
Okay.
So-
Yeah, which is, which is nice.
So we didn't have any of these things-
No
you know.
I mean, they were available in the research setting for, for decades, but in terms of making the diagnosis in patients who come to your office, we, we didn't have any of this available.
Okay.
So it's very exciting.
Oh, that, that is extremely exciting.
Yes.
Okay, so now I'm gonna go to treatment.
Okay.
And that too, there, there's, you know, there are advancements.
Yeah.
I mean, you can do anything.
I, yeah, you know, i- i- again, w- as, as we discussed earlier, there was, a lot of therapeutic nihilism around this disease, because we really didn't have anything that could affect the natural course of the illness, and even the medicines that we used for some symptomatic-type treatment, i- i- you know, didn't w- were, did not have a robust effect.
They weren't a dramatic, you know, sort of improvement for, for most people.
But over the past three to four years, the FDA has approved three, and now they're only using two, of these monoclonal antibodies, which are infusions, drugs that you go to an infusion center for and get an intravenous infusion, and you do that either twice a month or once a month, depending on which drug you're, you're using.
And you get the infusion, you relax, watch TV, you have people around you serving you, and after the infusion is complete, you go home and, you know, that's the end of the story until the next cycle.
And it, it, it's not a cure.
It's, it, right.
It's-
You're finding it, it does what?
So what, what it does is it slows down the cognitive decline in, in patients with, with Alzheimer's disease.
It, it, it is not a cure, but, but it, it, the, it has a modest impact on slowing down the progression of the illness, and again, we never had that before.
So for us, this is-
Yeah
this is huge news.
This is huge news.
Huge.
Is there anything we can do preventatively?
Yeah, I, you know, I think that, lifestyle, modifications and treating other, medical conditions are, are the best ways in general to, decrease your risk of, of developing this.
Risk factors for vascular disease like hypertension, diabetes, cholesterol, things like that, and managing those are, are one way to, to mitigate your risk.
As far as, other interventions that one can do on their own, I think exercise may be the most important one, which is a regular regimen of, of exercise, both aerobic, anaerobic.
I think, diet, including in particular the Mediterranean diet, which can be a, a, a, you know, a, a very, tasty way to eat-
Mm-hmm
that is healthy as well, and, things like, treating, sleep apnea, so that you do get restorative sleep.
And, one underrated risk factor is hearing loss.
Yeah, hear- hearing loss is interesting because not only is it a risk factor for getting dementia itself, but it can also make dementia look worse because sometimes people speaking to people-
Yeah
don't know what they're hearing and what they're not hearing.
Yeah.
So I, it's a, it's a, that's a big one-
That's a- that I think people don't think about, a lot.
Yeah, I think there are a lot of people out there right now going-
Yeah
going, "What?"
"What?"
Yeah.
I, besides what I can't hear, you, you know, what.
Yeah.
I, I'm deaf in one ear.
What did you say?
I'm deaf in one ear, so I can't make, you know.
But, that's so amazing.
Yeah.
Yeah.
So there, there are things we can do-
Okay
is the, is the bottom line.
That's, even at that risk factor of not hearing-
Yeah
to know about that.
Yeah.
Okay.
So I want everybody, we're, you, can, will you stick around for a little bit?
Yeah, of course.
Okay.
Pleasure.
I want everyone to, to, you can find out more about Catholic Health Alzheimer's and Dementia Program.
The website is catholichealthi, l-i.org.
There's also a phone number, 631-474-6285.
So we'll be back with Dr. Meyerson, but coming up next, a Long Island woman shares her story on finding help and hope thanks to Catholic Health Dementia and Alzheimer's Program.
We will be right back.
We'll take a look at breakthroughs in early detection and treatment, and Catholic Health's ongoing compassionate care.
Welcome to Catholic Health Conversations in Care.
I'm Colleen McVey.
Well, do you know someone with Alzheimer's or dementia, or someone caring for a loved one?
Most, if not all of us, do.
It is a devastating disease with no cure, but advancements are being made in early detection, diagnosis, and treatment.
And joining us today with the latest on all of that is Dr. Bruce Mayerson, Catholic Health's co-chairman of neurosciences and chief of neurology at St. Catherine of Siena Hospital.
Dr. Mayerson, welcome, welcome, welcome.
I'm so happy you're here.
So much to talk about today.
Good afternoon.
Thank you for having me.
I guess this is a, this affects millions of us.
Right now-
Oh nearly, what, seven and a half million Americans?
Yeah, in the order of seven million, between.
Over 65.
Yeah.
Living with Alzheimer's.
Correct.
But I wanna start-
Okay with something that really I didn't know about for a very long time, and I think a lot of people are confused about.
I, I thought Alzheimer, Alzheimer's and dementia were the same thing.
Give me-
So, yeah, so, so this is a common, question that comes up in the office.
We see a lot of patients with dementia and memory problems, and it's one of the most common things that family members say is, "Well, is this dementia?" if we start talking about this.
And I, this is my, my trademark line is always, "All Alzheimer's is dementia, but not all dementia is Alzheimer's."
And what I mean by that is that there are many different n- neurodegenerative illnesses that can cause dementia, which is a progressive d- declining cognitive function over time.
By far the most common is Alzheimer's disease, but, again, there are many others, vascular dementia, Lewy body disease, other diseases that can cause dementia that are not Alzheimer's disease.
Mm-hmm.
And Alzheimer's disease is a, is a very specific type of dementia.
Right.
And again, important 'cause it's the most common one.
Right, and that's where, like I said, nearly seven and a half million Americans over the age of 65 now living with Alzheimer's, which that's about 11% of the population over 65.
Yeah, yeah.
That affects so many people living with it, so many people taking care of people with Alzheimer's.
And with the aging, baby boomers-
Yes it's really, become a, a, you know, almost epidemic.
And I can't tell you the, the number of, people I see on a weekly basis whose chief complaint, in the office is memory loss.
Mm-hmm.
So it's, it's, it's an, it's a major issue.
Yeah, I was looking up with Alzheimer's Association, and this statistic I just was so surprised at, one in three older Americans dies from Alzheimer's.
It's, it, it is more than the, the breast and pancreatic cancer put together- yeah, pr- combined.
Right.
Yeah.
So I didn't realize that many Americans are dying from it.
Ev- you know, it seems like everybody knows someone, has a family member, has a friend who is suffering from this condition.
And, because of, you know, the nature of the condition affecting, you know, the brain and, and really the very essence of who you are, it's particularly devastating to families.
And that's why I think it's taken such a, a front role.
Let's talk about detection, because, I mean, that's where it's gonna start, and I feel like it's gonna start with the patient.
I'm the one that's gotta realize, okay, maybe it's time for me to talk to a specialist about memory loss or what's going on with me.
So what am I looking for?
So the, the, the, the, what you're saying is, is, is important because I think that obviously if the patient is recognizing their symptoms, that's, that's c- very concerning to them and, and disconcerting.
That said, oftentimes people who come to the office with these complaints are actually not the ones complaining.
It's family members, it's friends, it's people they work with who are telling them things and, and frequently they're unaware of it, which is actually one of the symptoms of dementia-
Okay
is, is being unaware of it.
So, you know, it, d- depending on who, there are people who are aware of it clearly, but the ones that aren't, pose a special challenge when we're trying to evaluate them and, and, and examine them, with the, with the standard tests that we use.
So it's-
Okay.
Well, what are, like, what are some of the symptoms?
Well, the most common, the most common symptom that we see with Alzheimer's disease is memory loss.
It typically affects short-term memory, which means memory for recent events, things maybe that were just learned.
Remote memory tends to be intact.
So I often hear somebody will say, "Oh, I remember," or the family will say, "Oh, she or he remembers something from 30, 40 years ago like it was yesterday, but they can't remember where we just went for lunch."
Or where we just said we were going for lunch or that, that sort of thing.
So that manifests as repetition of, of questions, which is a, a very common first sign or symptom that, that there is something wrong, again, typically noted by close family members, yeah, spouses and, and children.
And I guess, somebody who maybe has a family history would worry a little bit more about this?
Sure.
I- that's a, that's a actually a very common one.
You know, having a family history of Alzheimer's disease does not guarantee that you will get Alzheimer's disease, but obviously it increased the risk, and there are genes that we can look for to, to assess and, and risk stratify people, when, when, when appropriate.
Okay.
So let's, let- let's go next, the next step, diagnosis.
Right into diagnosis.
So-
Right into it.
Yeah, so, so, up until these newer drugs came out, we really did not have a great way to diagnose Alzheimer's disease w- i- in life, when people were alive.
I mean, the gold standard was autopsy, at which point-
Mm-hmm
it doesn't matter to-
Yeah most people affected, right?
Of course.
However, with these new, drugs that have become available, diagnostically, we have really had an explosion in, in what, what we can do to make the diagnosis of disease.
Three, three main ways, that, that we can do it.
O- one is with, CSF, cerebrospinal fluid.
We can do a minimally invasive lumbar puncture, spinal tap, drain some fluid from the back, take the fluid, send it to the lab, and check for the abnormal proteins that may be present, elevated or decreased in Alzheimer's disease.
That's the most, invasive way, and again, it is, it is minimally invasive.
The, the other way, which has become really sort of the standard by which we're deciding which patients would be good candidates for treatment, is a PET scan called an Amyvid scan, A-M-Y-V-I-D, and it looks for the amyloid protein, which is the abnormal protein that accumulates in the brains of people who have Alzheimer's disease.
And the last way, is by blood work.
We actually now have a blood test called the-
Really?
Yes.
It's called a p-tau.
It's, it's, it's fresh.
Oh, okay.
P-tau217.
I would say m- it's been months since it has become commercially available.
Wow.
Most insurance companies and Medicare I don't think are, are paying for it, but I think for, $400 out of pocket, you can do that.
That's probably the easiest and-
Yes
least invasive thing.
Oh, wow.
That's, that's-
Yeah
that's amazing.
So it's very ex- yeah, yeah, phosphorylated tau217.
Okay.
So-
Yeah, which is, which is nice.
So we didn't have any of these things-
No
you know.
I mean, they were available in the research setting for, for decades, but in terms of making the diagnosis in patients who come to your office, we, we didn't have any of this available.
Okay.
So it's very exciting.
Oh, that, that is extremely exciting.
Yes.
Okay, so now I'm gonna go to treatment.
Okay.
And that too, there, there's, you know, there are advancements.
Yeah.
I mean, you can do anything.
I, yeah, you know, i- i- again, w- as, as we discussed earlier, there was, a lot of therapeutic nihilism around this disease, because we really didn't have anything that could affect the natural course of the illness, and even the medicines that we used for some symptomatic-type treatment, i- i- you know, didn't w- were, did not have a robust effect.
They weren't a dramatic, you know, sort of improvement for, for most people.
But over the past three to four years, the FDA has approved three, and now they're only using two, of these monoclonal antibodies, which are infusions, drugs that you go to an infusion center for and get an intravenous infusion, and you do that either twice a month or once a month, depending on which drug you're, you're using.
And you get the infusion, you relax, watch TV, you have people around you serving you, and after the infusion is complete, you go home and, you know, that's the end of the story until the next cycle.
And it, it, it's not a cure.
It's, it, right.
It's-
You're finding it, it does what?
So what, what it does is it slows down the cognitive decline in, in patients with, with Alzheimer's disease.
It, it, it is not a cure, but, but it, it, the, it has a modest impact on slowing down the progression of the illness, and again, we never had that before.
So for us, this is-
Yeah
this is huge news.
This is huge news.
Huge.
Is there anything we can do preventatively?
Yeah, I, you know, I think that, lifestyle, modifications and treating other, medical conditions are, are the best ways in general to, decrease your risk of, of developing this.
Risk factors for vascular disease like hypertension, diabetes, cholesterol, things like that, and managing those are, are one way to, to mitigate your risk.
As far as, other interventions that one can do on their own, I think exercise may be the most important one, which is a regular regimen of, of exercise, both aerobic, anaerobic.
I think, diet, including in particular the Mediterranean diet, which can be a, a, a, you know, a, a very, tasty way to eat-
Mm-hmm
that is healthy as well, and, things like, treating, sleep apnea, so that you do get restorative sleep.
And, one underrated risk factor is hearing loss.
Yeah, hear- hearing loss is interesting because not only is it a risk factor for getting dementia itself, but it can also make dementia look worse because sometimes people speaking to people-
Yeah
don't know what they're hearing and what they're not hearing.
Yeah.
So I, it's a, it's a, that's a big one-
That's a- that I think people don't think about, a lot.
Yeah, I think there are a lot of people out there right now going-
Yeah
going, "What?"
"What?"
Yeah.
I, besides what I can't hear, you, you know, what.
Yeah.
I, I'm deaf in one ear.
What did you say?
I'm deaf in one ear, so I can't make, you know.
But, that's so amazing.
Yeah.
Yeah.
So there, there are things we can do-
Okay
is the, is the bottom line.
That's, even at that risk factor of not hearing-
Yeah
to know about that.
Yeah.
Okay.
So I want everybody, we're, you, can, will you stick around for a little bit?
Yeah, of course.
Okay.
Pleasure.
I want everyone to, to, you can find out more about Catholic Health Alzheimer's and Dementia Program.
The website is catholichealthi, l-i.org.
There's also a phone number, 631-474-6285.
So we'll be back with Dr. Meyerson, but coming up next, a Long Island woman shares her story on finding help and hope thanks to Catholic Health Dementia and Alzheimer's Program.
We will be right back.
Headache & Migraine Program
The Catholic Health Headache & Migraine program offers expert diagnosis, advanced treatments and compassionate care. Our neurologists specialize in migraines and complex headache disorders, offering customized treatment plans that target the specific features of your condition to help you find lasting relief.
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