Stan, Clarence, Barry, and the Health Chatter team chat with Patty Takawira, who leads the Aging and Healthy Communities Unit at the Minnesota Department of Health, about Alzheimer’s.Patty works alongside a passionate team to reduce the risk of Alzheimer’s and related dementias, promote early detection, and support the health and wellbeing of both caregivers and individuals living with dementia. Her work is rooted in advancing health equity and ensuring that all Minnesotans have the opportunity to age with dignity, connection, and care. Listen along as Patty Takawira shares their expertise about Alzheimer’s and aging in Minnesota.Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.More about their work can be found at https://www.huemanpartnershipalliance.org/
Chapter 1: What is the main topic discussed in this episode?
Hello, everybody. Welcome to Health Chatter. Today's show is on a tough subject, Alzheimer's. And there's a lot to talk about. We have a great guest. Stay tuned. I'll introduce her in just a minute. We have a great crew that helps us do these shows and get them out to you, the listening audience, in great form. Maddie Levine-Wolfe, who actually did the background research for this show.
So, Maddie, thank you for that. And she's also one of our recorders for our shows. Erin Collins, Deandra Howard, also our great, great researchers, along with Sheridan Nygaard. Matthew Campbell is our production person that gets out all the shows to you in beautiful form with a little bit of music attached to it.
I have a great colleague, two great colleagues, Clarence Jones and Barry Baines, who help us get information out to you in some kind of a logical order based on all the things that are going on in health. Clarence has been with the show since day one. Barry's been with us as our medical advisor for about a little over a year now. So thanks to both of you. It's great having you as well.
Human Partnership, H-U-E-M-A-N, Partnership is our sponsor for our shows. You can check them out at humanpartnershipalliance.org.
Chapter 2: How does Patty Takawira's work relate to Alzheimer's prevention?
H-U-E-M-A-N, partnershipalliance.org. Check us out at hellchatterpodcast.org. where you can listen to all the shows or read them in transcript form and also delve into some of the research that we provide for all of you. So thanks again to all of you. So today, Alzheimer's. And wow, there's a lot that's going on in this field.
And we have a wonderful, wonderful guest with us, Patty Takawira, who I've known for a while. She's truly a dear colleague. Patty and I were, she worked with me in the cardiovascular unit when she first started at the Minnesota Department of Health. But now at the Department of Health, she leads the Aging and Healthy Communities Unit within the Center for Health Promotion.
Works with a small but mighty team, as she describes it at MDH, passionate about advancing health equity, which we're gonna get into as it relates to Alzheimer's, for sure. Her work focuses on collaborating with statewide partners to create solutions to help reduce dementia risk.
She's got a wonderful family, and I remember fondly her kids coming into my office, and I was always giving them a little piece of candy, but I'm sure they've They've grown up into wonderful, wonderful children. So thanks, Patty, for being with us. By the way, Patty, she's got some really great, great talent.
And not only is she a good community health-oriented person, but she's an excellent grant writer, too. Boy, we really appreciated her writing skills when I was at the health department. So thank you for connecting with all of us in the healthcare arena. And thanks for being with us today. So, all right. Alzheimer's. All right.
So let's talk about, we're going to be talking about it, I think, from kind of like a medical perspective and also a public health perspective.
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Chapter 3: What are the differences between dementia and Alzheimer's?
So let's start it out this way, Patty. Obviously you're at the state health department. So Let's focus specifically on the types of things that you do as it relates to Alzheimer's with that public health lens on.
Yeah. And I don't know if you remember, Stan, but we didn't just work together. You actually hired me. And now that I'm thinking about it, Clarence was the first person I really met with. in my role at MDH.
Really?
Yeah. I went to Southside and we, we connected around the, the CVH grant, the Clippers and Curls grant.
Yep. Yep. Yep. Yep.
Yeah. Wow.
Great, great history. Yeah. But you are a gem. So, all right. So now Alzheimer's tell me, let, let, let public health from a public health perspective, give it that kind of insight.
Right. So, From a public health perspective, we're trying to approach dementia in a more upstream way. and this research is relatively new, but 45% of dementia risk factors are potentially modifiable. And that research keeps growing and expanding. So that's like a relatively new concept that this, you know, there's something people can do to potentially influence the trajectory.
It's not necessarily just faded. So communicating that is one of the biggest challenges pieces of our work right now and what we've found and are realizing more and more every day that is that the way that we need to do that is with strong partnerships with community partners who can who can engage trusted messengers to communicate that so that's That's one of the areas.
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Chapter 4: How can early detection influence Alzheimer's outcomes?
Well, dementia is an umbrella term that describes a set of symptoms, and Alzheimer's is the most common form of dementia. So when we're talking about Alzheimer's, we're just being more specific.
So Barry, I'm sure in the work that you did, you were involved with Alzheimer's and or dementia. Go ahead.
Actually, that's why I was just raising my hand is that we're kind of chomping at the bit to get into hearing all the stuff that Patty is doing and all those good things. And again, I think for our listening audience and also for our panel members who were in the podcast.
It never hurts to kind of go over things about specifically the difference between dementia, Alzheimer's dementia, and of course, Patty, you hit the nail right on the head, the idea that dementia is the broad umbrella, and then underneath it, there's a number of different kinds of dementia, of which Alzheimer's dementia is the most common. So I just wanted to
jump in and make sure that we at least had a basic leveling of the playing field so that we, you know, we don't get confused between Alzheimer's disease, which is really Alzheimer's dementia. And so to be fair about that. And that that's just where I was going to your, to your point. I dealt with a lot of, you know, as a family doctor, again,
I was one of those womb to tomb doctors, you know, delivering babies all the way to the end of life where a lot of my care in the last 20 years of my practice was in hospice and end of life care. And over time, what wound up happening is I would say the majority of the hospice patients that we wound up having
reflected the commonality of alzheimer's dementia when it got very advanced that became one of the most common diagnoses and end-of-life care in hospice it was in stage and stage dementia of which alzheimer's was uh the most common so you know i said you know it's very difficult because there's very a lot of things with the families and how do you go about it and
You know, at the end of life component, you can't get upstream. Yeah. You know, and that's why I'm like really, you know, excited and interested to hear about some of the things that Patty's doing. I don't know if I'm getting to your specific... questions or queries of me, Stan. So feel free to keep poking the bear. All right.
Clarence, go ahead. Yeah. So I'm glad you asked that question about the difference between Alzheimer's and dementia. Because one of the stories I always talk about the fact that, you know, in thinking about this particular topic, I said, I wouldn't mind getting Alzheimer's, but I didn't want dementia. You know,
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Chapter 5: What role do chronic diseases play in Alzheimer's risk?
So anyway, that's my opening salvo.
All right. So Patty, it's like, I'll use myself as an illustration. It's like I'm forgetful. You know, I forget certain things. It's just like, you know, it's just like, I get up from my chair and I go do something. Then I realize, wait a minute, what did I get up from my chair to just do? It's like, so there's the part of the question I have is what's, what's normal versus what's abnormal.
What should we just normally expect as, as we get, older, maybe it's just because life is becoming more complicated and our minds get all scattered and everything. But what's normal versus, wait a minute, this is something that you really need to pay attention to now.
Right. And I think this is really kind of step one, I think, for both providers and the general public to understand is when to you know, get to that next step of talking to your provider about what's going on. So a typical age-related change would be something like missing a monthly payment or forgetting which day it is and remembering it later or
you know, losing things from time to time, forgetting what word you're trying to say. Um, and I, you know, I get these examples from the Alzheimer's association because they're really good at promoting this message about, uh, what is normal aging and what are signs and symptoms of Alzheimer's or dementia.
Um, so those are, those are typical age related changes, or, you know, if you're a busy mom, I would say that those are typical for me too. Um, But something like difficulty having a conversation, losing track of like what season it is or not, you know, you're noticing that your loved one's not able to manage their budget or or even they're doing something that I know one of our colleagues at the
public health center of excellence on early detection was talking us through, you know, the idea of using tools like the mini cog, those are great, but also if you're, you know, in the home of, of you know, a loved one or a community member who's been like cooking rice every day, their entire life.
And all of a sudden they're looking really confused about how to go about this thing that they have always, you know, that is, that is concerning. So I think it's, it's really how is it, you know, is it poor judgment and decision-making? Is it, you know, how common or, you know, how often is it happening? Is it,
Is it like, oh, I kind of forgot for a second, but then I remembered or literally an inability to retrace your steps like you don't know you're confused. You know, you get lost and you're in the car and you're just like lost and you don't know how to get back. So I would say that those are kind of the differences. But, you know, it's a little nuance. So it makes sense if you're if you feel lost.
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Chapter 6: Why are certain populations at higher risk for Alzheimer's?
You know, there are other things that, and Barry, maybe you could, you can talk about this a little bit. As people age and correct me if I'm wrong, but they have a tendency to remember long-term memory stuff, you know, it happened, you know, a while back versus You know, something that might have happened just yesterday. Is there some credence to that overall?
You know, short-term, long-term distinction here? Barry, you're on mute. Barry, you're on mute. Read my lips. Here's your lips, okay. Read your lips, okay. Was that short-term or long-term memory?
Yeah, that's an example of short-term memory. I didn't remember that I had my mute button on. But it is mostly a short-term memory piece that we see more of. And oftentimes some longer-term memory does remain intact there. But I think what's very interesting, you know, Patty, is what you said, what those studies showed between the 45 and 65, you know, population.
I mean, some subjective decline happens, oftentimes forgetting things, if you just don't get too anxious about it, oftentimes it'll come back to you. you know, that you will, it's not like it's lost forever. That usually does come back. But this is just something I wonder about in the younger population.
The reason why they may not bring it up is that people are very fearful of getting, you know, getting dementia. And for the older population, Clarence is sort of like what you were saying. It's sort of, as you get older, it's more expectant. And it's more accepted in that way. But when you're younger, I think there's a bigger fear.
Plus, I know that there has been a marked increase in early onset dementia. And I don't know if... um you know some of the studies sort of you know looked at that but actually personal experience i've had three friends of mine whose spouses all developed early onset dementia like in their late 50s early 60s um and that's that's against it's not necessarily alzheimer's but it's another piece
of this dementia puzzle um that's uh that's very you know that's very scary and very devastating so yeah i want to make a clarification it wasn't my grandmother it was my great-grandmother oh okay
One generation removed.
Yeah, you know, one generation removed. Yeah, yeah, yeah. Anyway, the other part, though, is I had an aunt who developed early onset, and she had when she was like 45. I mean, so, and I, again, I, you know, the doctor said this, but I didn't, I just didn't, I had no idea what he was talking about.
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Chapter 7: How can caregivers be better supported in their roles?
And then they, another report came out in 2024 that added some additional risk factors that were considered modifiable, but. Um, yeah, midlife hypertension, controlling hypertension, and then, um, also preventing obesity and diabetes and type two diabetes. Um, and so of course there's, you know, there's vascular dementia.
So it's not just like you, you're, um, you're getting Alzheimer's disease, but there's other those other types of dementia, like vascular dementia, that, you know, kind of the heart brain connection is really, really important.
So I think, and then people living with dementia also typically experience multiple chronic conditions and have to manage those as well, which obviously is more complicated when you're experiencing dementia. And then I would add that dementia caregivers are also experiencing higher rates of chronic conditions and depression.
And, you know, so there's, there's just a lot to think about with chronic disease and this issue. Um, I have an analogy for the, for the memories, the short-term long-term memories that you mentioned from, I think I learned this in a dementia friends champion training, but the analogy is like a bookshelf.
So your most resilient, I guess, memories are at the bottom, the sturdy part of the bookshelf. And those are kind of like the last to go. So your more short-term memories are kind of at that top less sturdy part. So thinking about it that way kind of helped it make sense to me. And then about stigma.
So when we were working on our dementia strategic plan, this is like the importance of community input, because I don't think we would have teased out this nuance without really working with the community to consider kind of our biggest priorities in the state. But there's discrimination, which is kind of like your dementia-friendly community work is really important. working to support, right?
Like making your community dementia friendly, signage, you know, support for people living with dementia and caregivers, but then there's reducing stigma and that's a different concept. And so we have both of those as key strategies within our educate and activate category of the dementia strategic plan, because the stigma issue is so strong and really
nuanced across different cultural communities. So it just, you know, and it needs to be addressed in a really culturally specific way through trusted messengers, which I think will resonate with Clarence. So yeah, I just wanted to mention that too.
You know, like when you go for a physical exam to your primary care provider, they do this little quick screening thing, right? Where it says, okay, Stan, remember these three words, table, chair, and roof or something. Then they have you do something else, okay? And then they come back, okay, what were the three words? Is that a screener?
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Chapter 8: What are the future implications of Alzheimer's research and funding?
So our work on dementia at MDH is partially funded through the BOLD Act, Building Our Largest Dementia Infrastructure. And through that funding, there's also three centers of excellence to support state grantees. The University of Minnesota operates as the bold center of excellence on dementia caregivers, and they're building out a ton of resources. And I think.
a while back there was this campaign that Wilder led about kind of like helping people identify as a caregiver, because that's not necessarily how people identify, but that's sort of how the resources are communicated. So if you are just kind of finding yourself in this role and it just feels like your familial duty and, and it's not all negative, right? It's not like, oh, the burden, the,
Like it's hard and it feels hard, but you might not identify it with it being a burden, just like culturally that might not make any sense. So I think the way, just like how we're talking about risk factors or earlier detection and diagnosis, it needs to be kind of a culturally community specific approach. to connecting caregivers to resources. And they really need resources.
And the other thing is that there are a lot of resources. So this is where kind of our public health role in building clinical community linkages comes in. Because if the provider, the care team really needs to know what the resources are locally, culturally, and have a way to, to identify that people are a caregiver for one.
So that could be, you know, making sure that that caregiver is, because sometimes they're not really asked any questions in the visit. And, you know, even if you're
like that sandwich generation caregiver and you're in your own primary care visit, wouldn't it be good to know someone's dealing with that and that it is a social determinant of health for chronic disease and that making sure that they're getting resources that they need.
So in my ideal world, like there's, there's these awesome connections happening between community resources and, and care teams and, and, you know, and then we can have a bunch of conversations about the community health worker role and, building on that, so.
Clarence. I think Sam for that question, because that was where I was going to go about this caregiver piece, because, you know, I tell the story that I was a caregiver of a caregiver and that wore me out.
Whoa.
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