Selects: How Dementia Works

Summary

Summary of "Stuff You Should Know" Episode: "How Dementia Works"

Introduction

In the June 7, 2025 episode of "Stuff You Should Know," hosted by Josh Clark, Charles W. "Chuck" Bryant, and Noel, the trio embarks on an in-depth exploration of dementia. The episode aims to demystify dementia by discussing its various types, symptoms, causes, treatments, and the profound impact it has on both individuals and their caregivers.

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Defining Dementia

Dementia is often misconstrued as a singular disease, but Josh clarifies early on that it is a syndrome encompassing a range of cognitive impairments. "[Dementia is] actually super misunderstood. It gets confused with Alzheimer's a lot or there's a lot of different kinds of dementia," Josh explains (03:25). Unlike normal age-related forgetfulness, dementia involves significant declines in memory, reasoning, and other cognitive functions.

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Types of Dementia

1. Alzheimer's Disease (AD)

   • Prevalence: Accounts for approximately 60-70% of dementia cases.
   • Characteristics: Marked by neurofibrillary tangles (tau proteins) and beta-amyloid plaques leading to neuronal death.
   • Genetic Factors: Genetics play a significant role, with mutations in the apolipoprotein E gene increasing risk. Noel mentions, "If you have a family history of dementia of Alzheimer's, you have a higher likelihood" (09:19).

2. Vascular Dementia

   • Prevalence: Constitutes about 20% of dementia cases.
   • Characteristics: Resulting from reduced blood flow to the brain, often due to strokes or mini-strokes.
   • Personal Insight: Noel shares her grandfather’s experience, highlighting how a major stroke can lead to dementia characterized by aphasia (10:02).

3. Lewy Body Dementia (LBD)

   • Prevalence: Represents 5-15% of cases.
   • Characteristics: Includes symptoms like intense hallucinations and motor issues similar to Parkinson's disease.
   • Notable Example: The hosts discuss renowned individuals like Robin Williams who suffered from LBD (13:54).

4. Frontotemporal Dementia (FTD)

   • Prevalence: Accounts for about 5% of dementia cases.
   • Characteristics: Affects personality, behavior, and language due to atrophy in the frontal and temporal lobes.
   • Distinct Onset: Typically arises between ages 40 and 75, distinguishing it from other dementias (15:58).

5. Other Forms

   • Creutzfeldt-Jakob Disease: A rare prion disease leading to rapid neuronal loss.
   • Traumatic Brain Injury: Repeated concussions in athletes can result in dementia over time (22:49).

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Symptoms and Diagnosis

Dementia's hallmark is a combination of memory loss and other cognitive impairments. Josh emphasizes, "when you forget your keys more often, you snap your finger and go, 'I forgot my keys again. What is wrong with me?'"—a contrast to normal forgetfulness (04:34).

1. Memory Impairment: Difficulty forming new memories and recalling recent events.
2. Communication Issues: Aphasia or problems with language production and comprehension.
3. Behavioral Changes: Increased aggression, apathy, and risky behaviors.
4. Emotional Fluctuations: Depression, anxiety, and withdrawal due to awareness of cognitive decline.

Diagnostic Tools:

• Mini-Mental State Examination (MMSE): Assesses cognitive function through a series of questions, with scores indicating severity (27:04).
• Clock Drawing Test: Evaluates verbal understanding, memory, spatial skills, and constructive abilities by having patients draw a clock at a specified time (27:34).

Notably, Noel suggests revisiting their May 2011 episode titled "Remember Our Memory" for additional insights (06:26).

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Treatment and Management

While there's no cure for dementia, several approaches can help manage symptoms and improve quality of life:

1. Medications:

   • Cholinesterase Inhibitors: Enhance communication between neurons by suppressing enzymes that break down acetylcholine (42:35).
   • Memantine: Inhibits glutamate to prevent neuron death (42:37).
   • Antipsychotics: Used primarily for managing hallucinations in Lewy Body Dementia.

2. Lifestyle and Preventative Measures:

   • Mental Stimulation: Engaging in puzzles like crosswords and Sudoku can help maintain cognitive function (44:42).
   • Moderate Alcohol Consumption: Some studies suggest that up to two drinks a day for men and one for women may have a protective effect against dementia (44:20).

3. Environmental Adjustments:

   • Dementia Villages: Innovative communities like Hojve Village in Amsterdam provide a supportive environment where dementia patients can live safely while maintaining some independence (46:30).

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Caregiver Challenges

Caring for someone with dementia is profoundly taxing, often leading to caregiver burnout. Noel highlights alarming statistics: "Your risk of death as a woman if your husband has dementia increases 28% in the first year after they're diagnosed" (39:46).

• Emotional Toll: Caregivers may experience depression, anxiety, and resentment, especially when facing unpredictable patient behaviors.

• Physical Strain: The constant demand can lead to exhaustion and reduced personal health.

• Strategies for Relief:

  • Respite Care: Taking breaks through community support or professional services.
  • Support Networks: Engaging with family, friends, and support groups to share the caregiving burden (41:11).

---

Innovations and Initiatives

1. Dementia Friendly America Initiative:

   • Purpose: Train individuals in service industries to recognize and compassionately interact with dementia patients.
   • Implementation: Grants fund training programs for staff in restaurants, banks, and retail to create a supportive environment (37:08).

2. Dementia Villages:

   • Hojve Village: A prototype in Amsterdam where dementia patients live in themed group houses, maintaining routines in safe settings with support staff (46:30).
   • Global Expansion: Similar models are emerging in Canada and Miami, emphasizing community integration over clinical settings.

---

Conclusion

"How Dementia Works" provides a comprehensive overview of dementia, highlighting its multifaceted nature and the urgent need for societal adaptation. The hosts underscore the importance of early diagnosis, effective treatment management, and supportive caregiving to mitigate the disease's impact. Additionally, community-driven initiatives like Dementia Friendly America and dementia villages offer promising models for improving the lives of those affected.

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Notable Quotes with Timestamps:

• Josh Clark [03:25]: "Dementia is actually super misunderstood. It gets confused with Alzheimer's a lot or there's a lot of different kinds of dementia."
• Noel [10:02]: "He lost his ability to speak."
• Josh Clark [27:34]: "You don't have the constructive skills to pay the bills, you may have dementia."
• Noel [37:08]: "How do you recognize it and how to react to it in a friendly and helpful manner."
• Noel [39:46]: "Your risk of death as a woman if your husband has dementia increases 28% in the first year after they're diagnosed."
• Josh Clark [44:42]: "Moderate alcohol consumption...staves off dementia."

Key Takeaways:

• Dementia is a complex syndrome, not a singular disease, with multiple types and causes.
• Early diagnosis and intervention can significantly improve management and quality of life.
• Caregivers face immense challenges, necessitating support systems and respite care.
• Innovative community models like dementia villages and nationwide initiatives are crucial for future care strategies.

---

This detailed summary captures the essence of the podcast episode, providing listeners with a thorough understanding of how dementia works, its implications, and the ongoing efforts to support those affected.

Transcript

[Josh Clark]

This is an Iheart podcast.

[Charles W. Chuck Bryant]

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[Noel]

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 4, 2015, but there's some really good information in it. If you are suffering from dementia or someone in your family is suffering from dementia, you have our deepest empathy because it is tough stuff and we hope this episode can bring you a little bit of comfort because knowledge is power and understanding things is what we're all about. And that can really help sometimes when you're dealing with something as devastating as dementia. So how dementia works right here, right now. Welcome to Stuff youf Should Know, a production of iHeartRadio.

[Josh Clark]

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 knoll. No, no, that's not what we're calling it. It's the stint of Noel. All right, Stuff you should know. That's too clever. Yeah, it's a little cutesy. Yeah, that's all. That's my only aversion to it all Right. What are you. Are you with stuff you should know.

[Noel]

Changing the name of our show after eight years?

[Josh Clark]

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

[Noel]

Oh, yeah, yeah, sure. Why not?

[Josh Clark]

I don't like it. All right, should we come up with the third idea?

[Noel]

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

[Josh Clark]

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

[Noel]

There's something you should know now.

[Josh Clark]

See, that's what I'm saying.

[Noel]

Yeah.

[Josh Clark]

It sounds like something Strickland would have come up with.

[Noel]

Ooh. You know, man, we haven't been in a flame war with Strickland in a while.

[Josh Clark]

It has been a while. It's been too long. Gotten soft.

[Noel]

You just launched one across the bow.

[Josh Clark]

So, Chuck.

[Noel]

Yes.

[Josh Clark]

Are you familiar with dementia?

[Noel]

Yeah, sure.

[Josh Clark]

Are you running your family?

[Noel]

Doesn't run in the family, but my grandmother, who lived to be 100, had dementia at some point, which, you know, when you live to be a hundred. That's. I don't know about likely, but it's not surprising.

[Josh Clark]

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

[Noel]

Sure.

[Josh Clark]

And dementia is 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 draw it on but disease.

[Noel]

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.

[Josh Clark]

No, because that is age related and normal.

[Noel]

That is a totally age related thing. It's called age associated memory impairment. And that is, I think, I mean, that happens to everyone. Right.

[Josh Clark]

It's just like you forget your keys more often, that kind of stuff.

[Noel]

Sure.

[Josh Clark]

But when you do forget your keys more often, you snap your finger and go, I forgot my keys again. What is wrong with me? Yeah, that's normal.

[Noel]

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

[Josh Clark]

Right.

[Noel]

So that's when it gets scary.

[Josh Clark]

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 dementia?

[Noel]

Yeah.

[Josh Clark]

Not entirely certain, but it is very widespread among the aged population in the United states. I think 5.3 million Americans have dementia right now.

[Noel]

Wow.

[Josh Clark]

And as our population ages, because the baby boomers are starting to get older, I think they're expecting something like 16 million Americans are going to have it by 2050. 16 million is, I think, how many. About how many people have it around the world right now. In America alone, we're going to have that number in 2050.

[Noel]

Yeah.

[Josh Clark]

And it's very expensive, actually.

[Noel]

How much money?

[Josh Clark]

A lot. You ready for this?

[Noel]

Yeah.

[Josh Clark]

In 2015, we have spent $226 billion on health care for dementia alone. And they're expecting by, I believe, 2050, when we are caring for 16 million in $2015. Not futuristic, much more inflated. 250. $2050.

[Noel]

Right.

[Josh Clark]

In $2015, we'll be spending about $1.2 trillion 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.

[Noel]

Yeah. And I also want to recommend our May 2011 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.

[Josh Clark]

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

[Noel]

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, apraxia. And all these are super sad if you've ever seen them up close. Apraxia, if you cannot make certain movements even though your body physically is healthy.

[Josh Clark]

Right.

[Noel]

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, at least one of these, you could be diagnosed with dementia.

[Josh Clark]

Right. And so, like we said, dementia is a set of symptoms, right?

[Noel]

Yes.

[Josh Clark]

It's actually brought on by disease. And the most common cause of dementia, I think something like 60 or 70% or something like that of dementia cases is brought on by Alzheimer's disease.

[Noel]

I could have sworn we did one in Alzheimer's, but we have not.

[Josh Clark]

Yeah, I don't think we have.

[Noel]

I don't know if we've talked about it enough, I think.

[Josh Clark]

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

[Noel]

Yeah.

[Josh Clark]

And beta amyloid plaques. Right.

[Noel]

Yeah. And the plaques are just a protein buildup. A sticky protein buildup.

[Josh Clark]

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. 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 off at a rapid rate.

[Noel]

Yeah.

[Josh Clark]

And when it's caused by beta proteins and tau, or beta amyloid plaques and tau proteins in the cells, then what you have is Alzheimer's.

[Noel]

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 a while, up to a decade. Although they said in this article, Molly says three to five years is more common. So. Yeah, it definitely shortens your lifespan.

[Josh Clark]

And like you said, genes are definitely part of the risk factors. A polypoprotein, a polypoprotein 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.

[Noel]

Yeah.

[Josh Clark]

It doesn't have anything to do with the tau protein tangles or anything like that, as far as I know. That's weird. Also, if you have a family history of dementia of Alzheimer's, you have a higher likelihood. And then if you have down syndrome, you are at a higher risk of developing Alzheimer's in middle age.

[Noel]

Oh, really?

[Josh Clark]

Yeah. Interesting.

[Noel]

So that's. And we will do one on Alzheimer's. But that's how Alzheimer's can cause dementia. There's also vascular dementia, which is. That was a case with my grandfather, who. He had a stroke and it accounts for about 20% of dementia cases. And, you know, a stroke is when you have a loss of blood supply to the. To the brain or a hemorrhage and blood clot, and it can Be either one big stroke event which causes a lot of damage and that's a single infarct 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.

[Josh Clark]

Right. And then the damage just builds up and you finally, once, once that last one, that, that is the straw that breaks the camel's back.

[Noel]

Yeah.

[Josh Clark]

And you have dementia that happens pretty rapidly after that last, that last one, that last stroke you have.

[Noel]

Yeah. And that's a multi infarct when it's a bunch of them. And little mini strokes are common. Sometimes you have them and don't even realize you've had them.

[Josh Clark]

Right.

[Noel]

With my grandfather, he had the big one.

[Josh Clark]

Oh, really?

[Noel]

Yeah. We talked about this before and I think something about speech, but yeah. He lost his ability to speak, you.

[Josh Clark]

Know, English, so there would be aphasia.

[Noel]

Yes.

[Josh Clark]

He couldn't produce language.

[Noel]

Well, he produced. Yes, he could not produce language. He said things, but it, you know, it didn't make any sense.

[Josh Clark]

Gotcha.

[Noel]

But he had an understanding. You could see the frustration. You know, I know how to, how I'm supposed to. My grandmother is driving us, let's say, and he, she doesn't know how to get there. He does. And he can't tell her, but he's telling her.

[Josh Clark]

Yeah.

[Noel]

It's just coming out all mixed up.

[Josh Clark]

And that's, that's a hallmark of dementia is 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 withdraw. They'll just give up on communicating at all because it's too frustrating or just too sad, you know?

[Noel]

Yeah.

[Josh Clark]

Which is one of the common results of dementia. It's a comorbidity. No, it's a complication.

[Noel]

Yeah. 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.

[Josh Clark]

Right.

[Noel]

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.

[Josh Clark]

Right.

[Noel]

That was like the most noticeable thing.

[Josh Clark]

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

[Noel]

It was a long time ago.

[Josh Clark]

We were talking about speech like We're Nicky's area or Broca's area. Yeah, yeah, something like that.

[Noel]

Totes.

[Josh Clark]

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.

[Noel]

With Alzheimer's. With Alzheimer's, but not as much with the stroke.

[Josh Clark]

Yeah. With vascular dementia, you know, there might be some other things where, like, part of the face is sagging or the patient can't move their arm or something like that, but, yeah, the personality will remain intact because those regions of the brain aren't affected like they are in Alzheimer's.

[Noel]

Yes. And then in about 5 to 15% of dementia cases, it stems from something called Lewy Body Dementia, which we were just talking about. They think Robin Williams might have suffered from.

[Josh Clark]

He definitely did.

[Noel]

He definitely did.

[Josh Clark]

Yeah. They found in his autopsy. I think he was diagnosed with it before he died. That was one of the reasons why he took his life.

[Noel]

Yeah. Because that can cause severe, intense hallucinations.

[Josh Clark]

Yeah, big time. Did you look those up?

[Noel]

Oh, yeah, man. Scary stuff.

[Josh Clark]

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

[Noel]

I'm sure you think you're losing it.

[Josh Clark]

Right. And that's one of the first symptoms of Lewy Body Dementia, and it was.

[Noel]

Discovered by Frederick Lewy in 1912. And it has nothing to do with your body. A Lewy body is. There are deposits, again, protein deposits of the alpha synuclein that appear on the brain. So don't think of body in the terms of, like, your physical body.

[Josh Clark]

Right.

[Noel]

And this is also present Lewy bodies and Parkinson's. So as a result, not only are you going to have symptoms similar to Alzheimer's with Lewy Body dementia, but also some of the tremors and balance issues of Parkinson's.

[Josh Clark]

Right.

[Noel]

Which is super sad as well.

[Josh Clark]

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

[Noel]

Yeah.

[Josh Clark]

Yeah. And that's what the movie Awakenings was about, weren't they. Wasn't it, like, a group of Parkinson's patients that, like, El Dobo worked on?

[Noel]

Is that Parkinson's? I can't remember.

[Josh Clark]

I think they didn't realize what they thought they were locked in or something and then realized their Parkinson's tremors were so Acute. That they were like. They were not even shaking. They were just completely. Yeah.

[Noel]

Interesting.

[Josh Clark]

Their muscles were totally contracted rather than contracting and relaxing again and again.

[Noel]

And Robin Williams.

[Josh Clark]

Yeah.

[Noel]

How about that?

[Josh Clark]

Yeah.

[Noel]

Then we have something that used to be. Well, it's called now frontotemporal dementia. It used to be called Pick's disease, but now Pick's disease is a specific.

[Josh Clark]

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

[Noel]

No, I couldn't either.

[Josh Clark]

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

[Noel]

But FTD is really an umbrella term. It's about 5% of dementia cases. And it's gonna affect personality and behavior and language, like, big time. Big time. And it's where your frontal and temporal lobes are actually atrophying and shrinking.

[Josh Clark]

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

[Noel]

Yeah.

[Josh Clark]

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

[Noel]

Yeah. And this is like. I think a lot of people at first think they might have Tourette.

[Josh Clark]

Yeah.

[Noel]

Because you can yell things out. Inappropriate behaviors.

[Josh Clark]

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

[Noel]

Or if I did, because it's unusual in that it attacks younger people, it's going to onset between 40 and 75 years old, which distinguishes it from other types of dementia.

[Josh Clark]

Yeah. And if your grandfather used to do that stuff already, then that's not the case. The key here is that 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.

[Noel]

Yeah. Shoplifting. Like, risky investments or like, pulling all their money out of the bank.

[Josh Clark]

Yep. And with Pick's 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, 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.

[Noel]

Well, yeah. Between 40 and 75, you lack empathy. No, no, no. I'm just saying it's because it affects young people.

[Josh Clark]

I'm saying, like, they turned into you.

[Noel]

Oh, no, no, no, no.

[Josh Clark]

You have blunted emotions and you gamble.

[Noel]

There's also Huntington's disease. This is 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.

[Josh Clark]

Right.

[Noel]

Which is I think 50% chance of inheriting the gene. But you can live with it for up to 20 years.

[Josh Clark]

Yeah.

[Noel]

Which seems like as far as dementia goes, one of the longer life expectancies.

[Josh Clark]

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?

[Noel]

Yeah. We got a couple of more types that we'll talk about and then some other good stuff.

[Josh Clark]

Okay.

[Noel]

Right after this.

[Josh Clark]

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[Noel]

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 of hours, but we have talked about Creutzfeld Jakob disease and I can't remember which one, and we do that all the time.

[Josh Clark]

Is there a disease that kills by preventing sleep?

[Noel]

Oh, is that the one which we.

[Josh Clark]

Should have rightly called How Prion Diseases Work?

[Noel]

Yeah. Because it's a prion infection. It's very rare. About one out of a million people will be affected in any given year.

[Josh Clark]

Like mad cow disease.

[Charles W. Chuck Bryant]

Yeah.

[Josh Clark]

Or kuru.

[Noel]

Yeah, exactly.

[Josh Clark]

It's a spongiform disease.

[Noel]

Yeah.

[Josh Clark]

So crazy.

[Noel]

It is. It's very interesting. Could be genetic, but. And I thought we also talked about it in organ transplant.

[Josh Clark]

Did we?

[Noel]

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

[Josh Clark]

Yeah. And this is neuronal loss due to the holes literally being eaten into your brain by this disease.

[Noel]

Yeah.

[Josh Clark]

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 or repeated concussions.

[Noel]

Yeah.

[Josh Clark]

And there are plenty of diseases. There's also reversible dementia Too. If you have a vitamin deficiency, if you take certain medications, you can develop dementia, but this is reversible. For the most part though, age associated dementia is not reversible. And like we said, it's kind of tricky to diagnose this stuff because it is normal for people to become more forgetful as you age. And to make it even more confounding, if you're a diagnostician, not only do people get more forgetful, there's an intermediate stage between dementia, a dementia diagnosis and just normal age related forgetfulness and that is called mild cognitive impairment. So if you can catch this, from what I understand, and we'll talk about treatments and everything later, but if you can catch things like Alzheimer's and other, other diseases that lead to dementia early, although there's no cure for any of them, you can manage them a lot better and delay say death or like the real devastation associated with it by a significant amount of time. But it's catching is the tricky part. And especially if you have dementia, you don't really realize that there's any kind of problem. So you're probably not going to take yourself to the doctor.

[Noel]

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're more perspective. Yeah, exactly. That's what I was 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.

[Josh Clark]

Right. Unless you're very wealthy and it's your no good nephew that you've never trusted anyway, you know.

[Noel]

Very true.

[Josh Clark]

Then maybe bring a lawyer in on it.

[Noel]

That's right.

[Josh Clark]

See what's up.

[Noel]

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 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 they're going to have to know your history because they need to have some context to compare it to.

[Josh Clark]

Right. Like were you always a compulsive gambler? Is this like new behavior?

[Noel]

Yeah. And it helps to bring, you know, if you're older, maybe bring your grown son or daughter with you or whoever has a lot of contact. Sure, sure. Although your spouse, you never know. What, I don't know, maybe trying to get rid of you.

[Josh Clark]

Oh yeah, like that. No good Nephew.

[Noel]

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, the Mini Mental State Examination, the mmse. Just a lot of basic questions there for mental tasks.

[Josh Clark]

But they're coded. The tasks are.

[Noel]

Yeah. And they're scored individually.

[Josh Clark]

Yeah. And when you. When you say question three, this person got an eight on.

[Noel]

Yeah.

[Josh Clark]

You can go over and be like, yep, dementia. It's actually pretty effective. Actually.

[Noel]

It is.

[Josh Clark]

And there's another test that ties into the mmse, that they both indicate one another, which apparently they're both really good at indicating dementia. But this other test called the clock drawing test, did you look this thing up?

[Noel]

Yeah. I thought this was pretty fascinating.

[Josh Clark]

It really is.

[Noel]

It seems really like, why would someone tell someone to draw a clock at a certain time of the day?

[Josh Clark]

Yeah. Usually they say, draw a clock showing that it's 10 after 11.

[Noel]

Yeah.

[Josh Clark]

And it makes 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.

[Noel]

Yeah.

[Josh Clark]

And what it signifies. That's a big one.

[Noel]

What it looks like.

[Josh Clark]

Yeah. Clock isn't made of, like, squiggly lines or anything like that. You have to remember how a clock is laid out, the order that the numbers go in, that it doesn't keep going after 12 to 13, 14, 15. And then once you got all this, you have to show the hands, showing that it's 10 after 11. So the hands won't be pointing at 10 and 11. It should be the longer hand should be pointing at the 2, and the shorter hand should be just past the 11, right?

[Noel]

That's right.

[Josh Clark]

This requires a tremendous amount of brain power, even though it's very simple and straightforward. And you can tell a lot about a person's mental faculties just by having them draw this.

[Noel]

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

[Josh Clark]

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

[Noel]

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.

[Josh Clark]

Yeah.

[Noel]

They stood behind it and said, yeah, it's actually A really good indicator.

[Josh Clark]

Yeah. Like it really holds up. And I think they developed it in the 60s, but it didn't take off until the 80s. And then they.

[Noel]

Seems like a 60s thing.

[Josh Clark]

It does, 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 database so you know what to look for even more. Like, oh, somebody draws a clock that has like a 13, 14, 15 on it.

[Noel]

Right.

[Josh Clark]

They may have this type of dimension.

[Noel]

Right. Or this one looks like Salvador Dali drew it.

[Josh Clark]

Right.

[Noel]

Then they might have this kind of dementia.

[Josh Clark]

Yeah.

[Noel]

Or they might just be super talented and creative. You never know. All right, let's. Should we take another break?

[Josh Clark]

Why not?

[Noel]

Is it time?

[Josh Clark]

Sure.

[Noel]

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

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[Josh Clark]

Thanks.

[Unknown]

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[Charles W. Chuck Bryant]

That's right, we're talking about bombas. Of course, because bombas make socks that keep up with whatever your summer looks like. Whether you're running a marathon or just a few errands.

[Josh Clark]

Yeah.

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[Charles W. Chuck Bryant]

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[Josh Clark]

So Chuck, we've kind of, I think it's, it 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 may not think of. Right. So let's say you're an elderly person and you have a battery of medications that you need to take for unrelated heart disease.

[Noel]

Yeah.

[Josh Clark]

Do you think you're going to remember to take those medications?

[Noel]

Right.

[Josh Clark]

Probably not. Even if you have like a timer set or some sort of calendar or something like that, you may have trouble even remembering that you have a calendar that you need to go check out to see what's on there, let alone to take the medication that's indicated that's on that calendar.

[Noel]

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 and you could choke.

[Josh Clark]

Right.

[Noel]

That's a real danger.

[Josh Clark]

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?

[Unknown]

No.

[Josh Clark]

The brain is actually being slowly destroyed periodically and eventually it's going to reach the parts of the brain where like you can't swallow any longer, then you die from that kind of thing. You also can lose your sense of hunger. Like you just aren't hungry anymore. Kind of tough to eat, especially when you're not thinking or remembering that you should eat when you're just not hungry ever. Yeah, it's a tough one.

[Noel]

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.

[Josh Clark]

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

[Noel]

I think both.

[Josh Clark]

Yeah.

[Noel]

Yeah.

[Josh Clark]

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 they'll 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.

[Noel]

Yeah. When she left the house, she just.

[Josh Clark]

Wears this dirty old bathrobe all the time and doesn't ever want to take a shower.

[Noel]

Yeah.

[Josh Clark]

That's usually an indicator of dementia.

[Noel]

Yeah. It's not like she just gave up and doesn't care anymore. It's part of the symptoms taking hold.

[Josh Clark]

Although another problem with dementia and one of the confounding factors is that depression can be a byproduct or comorbidity of the dementia.

[Noel]

Yeah.

[Josh Clark]

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.

[Noel]

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

[Josh Clark]

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.

[Noel]

We talked about communication and the hallucinations. You're gonna have trouble sleeping as well in a lot of cases.

[Josh Clark]

Yeah.

[Noel]

And then personal safety. A lot of people die every day because of accidents that happen as a result of dementia.

[Josh Clark]

Right. People who shouldn't be driving get into cars.

[Noel]

Yeah.

[Josh Clark]

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 on Aging, like the United States Council on Aging, there's a new initiative called the Dementia Friendly America Initiative.

[Noel]

Really neat.

[Josh Clark]

Yeah. It's Basically saying, look, we've got about 1 in 8 people over 65 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 kind of thing. So let's start training America how to recognize the signs of dementia and then how to react to it in a friendly and helpful manner so that people who are wandering around with dementia don't withdraw $80,000 from their bank account and walk around with it in their pockets outside.

[Noel]

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?

[Josh Clark]

Sure.

[Noel]

Go to banks and talk to tellers. Go to anywhere where there's interaction with another human grocery store checkout people and literally train them on, like you said, how to recognize it and how to kindly deal with these people.

[Josh Clark]

Right, Exactly. Apparently, one of the things you teach people in service industries is not take it personally.

[Noel]

Right.

[Josh Clark]

That if somebody's behaving erratically 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.

[Noel]

You mean not being an aggressive jerk?

[Josh Clark]

Right, Exactly. Just being nice will.

[Noel]

Yeah.

[Josh Clark]

Frequently get good results. And. Yeah. It is a pretty neat initiative.

[Noel]

Absolutely. And necessary.

[Josh Clark]

Yeah.

[Noel]

You know, but it's.

[Josh Clark]

It's. I'm stricken by the idea that people are planning out this far ahead.

[Noel]

Yeah.

[Josh Clark]

For this kind of thing. It's exceptional.

[Noel]

It is. And 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 experience. 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 28%. 28% in the first year after they're diagnosed, and only 22% for a husband whose wife is diagnosed, that's still a.

[Josh Clark]

Pretty significant increase just from the dementia diagnosis.

[Noel]

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

[Josh Clark]

Right.

[Noel]

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.

[Josh Clark]

Yeah. And this caregiver burden or caregiver burnout is a very real thing physically, too. Like, you have low energy, you have low productivity, you become snippy, resentful, angry, and you can end up basically mistreating your own parent or spouse because you're so upset with this horrific disease. One of the hallmarks 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 work today. Well, if you can no longer predict what your life is going to be like from day to day and you're spending. I think I saw this one study that found an average of 22 hours a week of unpaid care by spouses, wives, daughters, that kind of thing. You can very easily get stressed out. The main thing you have to do is ask for respite care. Like, you can't do it by yourself.

[Noel]

Yeah.

[Josh Clark]

You have to have other family members, members of your church, your community come and give you a break so you can go do other stuff for a while.

[Noel]

Absolutely.

[Josh Clark]

And, I mean, you could totally see how you could very easily evolve a really unhealthy dynamic if you're just trying to do it yourself because you lose perspective. This becomes your norm, even though it's totally abnormal.

[Noel]

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. So there are drugs that they use to help stave off dementia, mainly right now. They are cholinesterase inhibitors, and they suppress cholinesterase, which is an enzyme that breaks down acetoacetyl.

[Josh Clark]

Acetylcholine.

[Noel]

Acetylcholine, which we've talked about before. That's what helps transmit messages between neurons.

[Josh Clark]

Right.

[Noel]

So that'll help.

[Josh Clark]

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.

[Noel]

Exactly.

[Josh Clark]

You know, it seems primitive as far as, like, brain drugs go, but it makes sense, you know?

[Noel]

Yeah. And then there's another one. Are they still using this?

[Josh Clark]

I believe so.

[Noel]

Memantine. And it inhibits glutamate. Glutamate, which we've talked about before, which causes neuron death when overstimulated. Yeah, I can't remember where we talked about that one either.

[Josh Clark]

I just remember glutamate from the Umami episode.

[Noel]

Yeah. Was definitely in that one.

[Josh Clark]

And then there's Also stuff you can. So these drugs will help some.

[Noel]

That's for non vascular dementia.

[Josh Clark]

Right. With vascular dementia, you're going to want to take blood thinners.

[Noel]

That's just to prevent coagulants.

[Josh Clark]

Yeah. To keep more strokes from coming along and making the whole thing worse. And then with, like, Lewy Body disease to deal with things like the hallucinations and stuff, you'll probably also be given antipsychotics as well.

[Noel]

Yeah.

[Josh Clark]

And one thing that they're starting to realize more and more is very difficult to really figure out what kind of dementia people have. Just from. What's the scan?

[Noel]

Mri.

[Josh Clark]

Yeah. MRI scans.

[Noel]

Yeah.

[Josh Clark]

And you can really go back and accurately identify types of dementia from autopsies.

[Noel]

Right, right.

[Josh Clark]

And so from more and more autopsies, they're finding that there's a lot of what's called mixed dementia, where you have Alzheimer's and vascular dementia, or where you have Alzheimer's and Lewy body's disease. And so it can be really tough to suss out all the different kinds of dementia a person might have. But if you can do that, then you can put them on a drug regimen that could really kind of help more than just treating the Alzheimer's and letting the Lewy body go unrecognized and rampant or unchecked. There's also preventative stuff you can do, too.

[Noel]

Oh, yeah?

[Josh Clark]

Yeah.

[Noel]

Like what?

[Josh Clark]

Crossword puzzles.

[Noel]

Yeah. I told you. Emily's Grandmother, Mary is 95.

[Josh Clark]

Yeah.

[Noel]

And very sharp. And she does word puzzles all the livelong day.

[Josh Clark]

And. Is it Sudoku?

[Noel]

Yeah. She does all kinds of word puzzles.

[Josh Clark]

Yeah.

[Noel]

Things that I have never even heard of.

[Josh Clark]

Supposedly that helps David off.

[Noel]

Oh, yeah.

[Josh Clark]

Apparently this one's great. Alcohol. Moderate alcohol consumption, which is two a day for men or one a day for women, 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.

[Noel]

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

[Josh Clark]

Yes. Then it becomes very bad after that. So you want to just. Moderate amount.

[Noel]

Right. In all things people.

[Josh Clark]

Moderation.

[Noel]

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 going to get hurt with a 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.

[Josh Clark]

Right.

[Noel]

I think it's fine.

[Josh Clark]

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

[Noel]

Yeah, this is awesome.

[Josh Clark]

Called Hojwe, right? Yeah, Hojve. How would you say that?

[Noel]

I have no idea. Because Dutch is the weirdest language on the planet.

[Josh Clark]

We'll say that. Okay.

[Noel]

Okay.

[Josh Clark]

And it's what's called a dementia village, basically, where everyone who lives in this village, I think 150 people, all have dementia and they live in group houses.

[Noel]

Well, there's caretakers that live there too.

[Josh Clark]

But okay, yes, you're right. And they live in the group houses with them.

[Noel]

Yes.

[Josh Clark]

And a lot of the people realize that this is their nurse or just think it's a good friend of theirs. They don't really remember when they became friends.

[Noel]

That's a cool roommate.

[Josh Clark]

Yeah, exactly. And the houses they live in have different themes according to how the people lived, depending on whether they were blue collar, whether their memories go back to the 70s. This whole place is basically set up so that it's a very non threatening, safe place for these people to kind of live and move about within.

[Noel]

Sure, safely.

[Josh Clark]

Yeah, safely. And so they can go to the grocery store, they can go to the movies, they can go ride a bike.

[Noel]

And everyone, the people at the movie theater know that the people there have dementia.

[Josh Clark]

Right.

[Noel]

They're real movie theater workers and real waiters in the restaurant.

[Josh Clark]

Specially trained.

[Noel]

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 gonna get.

[Josh Clark]

Yeah, exactly.

[Noel]

Then of course there's other people that poo poo and say, no, you're tricking these people.

[Josh Clark]

But you can say, hey, okay, here's the big difference with this place. If you, 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. In Hojvay village, that city worker is specially trained to get that person back to their house or alert their caretaker that this person is having a crisis or something like that.

[Noel]

It's what we're trying to train people to do in the future.

[Josh Clark]

Yes.

[Noel]

They've just isolated it to a community.

[Josh Clark]

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.

[Noel]

No, no.

[Josh Clark]

You know, or. Because they'll produce gold in their urine or something like that. You know, like this is strictly for their protection.

[Noel]

Yeah.

[Josh Clark]

But also allowing them to live a free life outside of a clinical setting.

[Noel]

Right.

[Josh Clark]

I don't see much wrong with that. I do get what the bioethicists are saying, like. Yes, you're robbing someone of their dignity by lying to them, by deluding them or playing into their fantasies. Strictly speaking, yes. In the real practical world, I think this is great.

[Noel]

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

[Josh Clark]

Exactly.

[Noel]

Please.

[Josh Clark]

It is 1984 all the time.

[Noel]

In fact, one of the people that work there say that people that do criticize. It's 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.

[Josh Clark]

Right. You know, and so Hojve Village. I hope I'm saying that right, because I'm really putting myself out there.

[Noel]

Oh, I'm sure you're not.

[Josh Clark]

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

[Noel]

Yeah. When they take care of people even though they don't have money.

[Josh Clark]

Right, exactly. There's one called. In Canada, it's called Pentaguisheny, 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.

[Noel]

Well, and hopefully with the initiative of. What's it called?

[Josh Clark]

Alzheimer's Dementia friendly. America.

[Noel]

America. DFA.org yeah. Hopefully with those efforts, more and more people will. Because it's coming.

[Josh Clark]

Oh, yeah, it's coming.

[Noel]

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

[Josh Clark]

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

[Noel]

I'm gonna be one of them.

[Josh Clark]

You think so?

[Noel]

Sure, at some point, if I make it that long.

[Josh Clark]

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

[Noel]

I don't know. I got a feeling.

[Josh Clark]

Really?

[Noel]

Yeah. It does run in my family a little bit.

[Josh Clark]

Yeah.

[Noel]

And I have the. My father's family genes more than my mother's.

[Josh Clark]

I gotcha.

[Noel]

I feel like. So if I had my mother's genes, they all died from heart attacks and strokes and heart disease.

[Josh Clark]

Young.

[Noel]

Not a lot of cancer. Yeah, pretty young.

[Josh Clark]

So if you make it past 65. Yeah, you beat the heart stuff.

[Noel]

Then the Bryant genes can cut the dimension.

[Josh Clark]

Well, we're all going down one way or another.

[Noel]

I may live to be 100, you know.

[Josh Clark]

Yeah, man, I thought of something. Oh, yeah? I wonder, Chuck, if like our specific, like us, you and me specifically cramming 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.

[Noel]

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

[Josh Clark]

Let us know. I want to know. Good news or bad? Okay, neurologists.

[Noel]

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

[Josh Clark]

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 Howse def works and it will bring up a great article. Since I said search bar, it's time for listener mail.

[Noel]

I'm gonna call this one Hecky Krasnol lives.

[Josh Clark]

Okay.

[Noel]

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 learn 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?

[Josh Clark]

That is pretty great.

[Noel]

But as great as that is, that's not why I'm emailing. I actually have a fun fact for you guys from your Play D'oh. 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. Several Christmas carols including Frosty the Snowman and his biggest claim to fame, Rudolph the Red Nosed Reindeer.

[Josh Clark]

That is awesome.

[Noel]

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 because of that. Our own little taste of that irony.

[Josh Clark]

Yeah.

[Noel]

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 Krasno was a pretty interesting person. There might just be enough material for an episode on him. Up to you.

[Josh Clark]

Nice.

[Noel]

Thanks for helping with my schoolwork. That is from Aiden in Maryland.

[Josh Clark]

Awesome. Thank you very much, Aiden.

[Noel]

And when I say Hickey Krasnow lives, I mean lives on.

[Josh Clark]

Sure. Like Viva la Hecky.

[Noel]

Yeah.

[Josh Clark]

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 bring it on home for us, will you? You can send us an email to stuff [e-mail] and as always, join us at our home on the Web StuffYou Should Know.com.

[Noel]

Stuff youf Should Know is a production of iHeartRadio. For more podcasts My Heart Radio, visit the iHeartRadio app. Apple Podcasts are wherever you listen to your favorite shows.

[Charles W. Chuck Bryant]

Let's face it, everybody. With travel come curveballs. From flight delays to lost luggage, they put even the best laid plans at thank goodness for Avis. With them. You know your rental car will come through and your plans are protected at all costs. Because it turns out Avis is here for your plans and they'll do whatever it takes to ensure you keep them, which is a big deal. And speaking of deals, you can save 20% when you pay now. Go to avis.complanonus to learn more.

[Unknown]

Avis Planonus OpenAI is a financial abomination, a thing that should not be an aberration, a symbol of rot at the heart of Silicon Valley. And I'm going to tell you why on my show, Better Offline, the rudest show in the tech industry, where we're breaking down why OpenAI, along with other AI companies, are dead set on lying to your boss that they can take your job. I'm also going to be talking with the greatest minds in the industry about all the other ways the rich and powerful are ruining the computer. Listen to Better offline on the iHeartRadio app Apple Podcasts wherever you happen to get your podcasts.

[Dexter Thomas]

Are there any pictures of you online? Then you could already be in a massive police database without even knowing it.

[Josh Clark]

Clearview scrapes together images from Facebook, from LinkedIn, from Venmo accounts.

[Dexter Thomas]

I'm Dexter Thomas, host of Kill Switch, a podcast about how living in the future is affecting us right now.

[Josh Clark]

Police, they are trusting the software with this magical ability to lead them to the right suspect.

[Dexter Thomas]

In this episode, we dive into how cops are using AI and facial recognition and sometimes getting it wrong and putting innocent people behind bars.

[Josh Clark]

So if your accuser is this algorithm, but you're not even being told that it was used, let alone given any of the details about how it works.

[Dexter Thomas]

Listen to Kill Switch on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

[Josh Clark]

This is an iHeart podcast.