SPEAKER_00: 0:01

Welcome to the Healthy Matters Podcast with Dr. David Hilden, primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health, health care, and what matters to you. And now here's our host, Dr. David Hilden.

SPEAKER_04: 0:18

Hello, everybody, and welcome to episode seven of the podcast. I am your host, Dr. David Hilden. You know, most of us take our brains for granted, right up to the point where they stop working the way we expect them to. On today's show, we're going to be talking about our brains and what it takes to keep them healthy. The exciting news is that we're learning more than ever before about how brain health isn't just something we react to when problems arise. It's something we can actively protect and support throughout our lives. Joining me for this important conversation is Hennepin Healthcare Neurologist Dr. Benham Sabayan and from the Minnesota Department of Health, Patty Takawira. Benham, Patty, welcome to the podcast. Thank you so much for having us. And thanks for being back, Benham. You're a repeat guest on the show, as I appreciate you doing that. And Patty, welcome.

SPEAKER_02: 1:02

Thank you for having me.

SPEAKER_04: 1:03

Dr. Sabayan is a neurologist here, and we've introduced him on a previous episode, but you're new to the podcast. Patty, could you tell me what do you do at the Minnesota Department of Health?

SPEAKER_02: 1:12

Sure. I'm leading a unit in our health promotion and chronic disease division called our Aging and Healthy Communities Unit. And we focus on dementia risk reduction and promoting early detection and diagnosis of dementia, caregiver health and well-being, and promoting healthy aging across the life course.

SPEAKER_04: 1:28

Well, that's great that that's what you do, because it conveniently that's what we're talking about today. So I'm glad to have you here. Welcome to our show. Let's start by laying the groundwork. Ben, maybe you start us out. Brain health 101. When people hear brain health, they immediately think about probably dementia and you know confusion, things like that. But from a neurologist's perspective, how do you define brain health in terms that even a guy like me might understand?

SPEAKER_03: 1:52

That's an excellent question. And I wanted to start with the fact that brain health is not the absence of brain diseases. And brain health is about the state of brain structural and functional integrity that would help and support us to do things that are meaningful and joyful for our life, like thinking, cognitive function, motor, sensory, balance, movements. When we talk about brain health, we are not talking about not having a disease. We are talking about preserving our brain's function and structure in a way that we would be far away from a threshold that you would get there and then you would manifest a disease like a stroke or dementia or Parkinson disease. So brain health is about prevention and developing a resilience against having a pathology and a disease that would affect your life and quality of life. I wear my bike helmet.

SPEAKER_04: 2:49

That's prevention, isn't it? And what more could there possibly be? That's what we're gonna talk about today, a little bit more. So I gather from what you've started saying is that we ought to be thinking about this before it's a problem later in life.

SPEAKER_03: 3:02

Exactly. And the good news is that we have so much resilience and reserve in our brain that we get hits, we get exposure to risk factors that can damage our brain structure and function. But we have some reserve. What we need to do, we need to make sure that we would boost that reserve and we develop some resilience to prevent getting to the condition that we would develop the symptoms and ultimately the disease. So that would mean that there are strategies that we can use and take to be able to strengthen our brain in order to avoid something bad is happening decades later, years later, or months later.

SPEAKER_04: 3:45

Okay, hold that thought. I'm gonna come back to you, Patty. I might ask you, you're you work at, and I'm gonna make a plug here. I don't work for the state of Minnesota, but the Minnesota Department of Health is one of the premier public health agencies, I believe, in this country. So thank you for what you're doing on behalf of citizens of the state. From your perch, what does preventive brain health mean to you?

SPEAKER_02: 4:04

Yeah, I think when it comes to dementia, for example, there are risk factors that are non-modifiable, like age or genetics, and then there are things we can do and can change, like eating healthy and getting physical activity, preventing traumatic brain injury by wearing your helmet.

SPEAKER_04: 4:19

No, but you're gonna tell me I'm not supposed to smoke either.

SPEAKER_02: 4:21

I am gonna tell you that you're not supposed to smoke. And if you are smoking, quit, actually, is maybe the more important point. You know, we're in the business of preventing and managing chronic disease, especially in the area where I work at MDH. And, you know, dementia is more and more being considered a chronic disease in the past that maybe wasn't the narrative as much. And we have opportunities to address that and teach the public about that and kind of work with providers and community partners to promote brain health as a way to prevent dementia.

SPEAKER_04: 4:51

I have to admit, you know, I'm a general internist and I've heard about preventive cardiology since I was in med school. You know, well, here's what you gotta do: protect your heart. You know, you're supposed to exercise and you're supposed to eat like you live in the south of France, and you're supposed to not smoke, and you're supposed to check your cholesterol. I didn't hear a lot about preventive neurology. I didn't, frankly, I don't think I ever heard the term brain health, but I did learn about strokes. I learned a little bit about dementia and all those things that can happen. So, what's a preventive neurologist? Are you a preventive neurologist, Benham? What are you? I'm a preventive neurologist.

SPEAKER_03: 5:20

Okay, you're a preventive neurologist. Uh this is a very emerging field. So a few years ago, I uh, along with my uh mentors, we put out a paper in the June of Neurology, American Economic Neurology, that we need to move on from a reactive approach to neurological conditions, and we need to be in a proactive approach, meaning that the vast majority of neurological conditions, including stroke, dementia, Parkinson's disease, even epilepsy, migraine, and multiple sclerosis, they have a very prolonged preclinical phase. They don't happen overnight, and that phase would give us the opportunity to change the trajectories that would lead to disease manifestation. And this is a unique feature of our brain that, as I said, because there's enough resilience and reserve that you can actually strengthen it, you might be able to be in a very proactive mode, but it needs investment years and significant lifestyle changes. When does that start?

SPEAKER_04: 6:29

Yeah. It takes investments earlier because I gotta tell you, Dr. Sabayan, I'm not sure I have any brain reserve right now. The world is swirling, the hospital's swirling, there's stuff going on. Yes. I don't think I'm gonna be able to figure out where my car keys are later today. What do you mean? Starting like at birth or starting when? What are you talking about?

SPEAKER_03: 6:47

Right. So that's exactly the focus of organizations like America Climate Neurology and other academic organizations, that there are life stages, and we need to have a customized preventive approach for each life stage. You know that when uh babies are born, every day there are millions and millions of neurons and new connections. So you need to apply certain approaches to be able to promote those connections and development of that reserve early on. But when you are in your midlife and you start exposing yourself to TBI, traumatic brain injury, certain lifestyle, inactivity, smoking, drinking, that is a different life stage and requires different strategies. So it is never too late. We have actually very good evidence, even in advanced ages, you can still do some interventions that would lead to improvement of cognitive function or reduce the risk of a stroke, for instance. So it is never too late, but the there's a keyword here, and the key word is awareness. So you need to know where you are standing, you need to know what are the options out there, and you need to be empowered to be able to do the changes, which is most difficult thing. Easier, easiest thing in the world is taking appeal. But lifestyle changes, brain health-oriented lifestyle changes specifically, are the most difficult ones, and that's why many people would need education, knowledge, and support for that. And that's something that we are really proud that at Hennepin Healthcare, uh, Hennepin County Medical Center. This is something that we are doing and we are promoting. And we are one of the uh few centers in the country that are really actively working in the field of preventive neurology.

SPEAKER_04: 8:32

So you said that it's at various stages and you have to uh awareness. So infants aren't, well, they're aware of things, but they're not aware of their brain health. What uh can we just like real quickly, through various stages, what do people need to be aware of? Starting with infancy, and I would assume what you mean is their parents.

SPEAKER_03: 8:50

I think it starts in the womb. In the womb, okay. And you're not messing around. No, there are actually studies showing that those people, even preconception, honestly, that they are really thoughtful about overall physical fitness, that would lead to better health of a baby in the womb. And of course, you need to kind of avoid all sorts of exposures, and you need to make sure that you're feeding your baby nutrients and you are not exposing yourself to so many toxins and medicines and exposures that you're, I think actually, this is one area that we are really well educated about. But when it when it gets to a baby, we know that in addition to all the things that we do as parents, there are things that you need to be aware of that we know that, for example, those kids who are inactive, they have overrates, they are not exposed to intellectual and cognitive challenges, like multiple languages or different activities. They have the opportunity to actually increase their reserve and resilience with being exposed to those activities, meaning learning new skills, language, instruments, music, and being exposed to healthy environments, which is out of the hands of parents, but is something that we all need to think about.

SPEAKER_04: 10:09

So there is something to play in Mozart for your baby or reading them from the New York Times. You know, I read to my kids aloud from the newspaper when they were three weeks old. And so my kids are fairly, you know, I think that I can take credit for that.

SPEAKER_03: 10:23

Yeah. Yeah. I mean, it doesn't have to be New York Times necessarily, but I don't even know what it was, I'm just saying that. Yeah, but but definitely we need to work on uh exposing ourselves early on, and it goes all the way to silver ages, to new learning newest skills, having cognitive challenges, and getting connected with our environment and making sure that we are really protecting ourselves from negative exposures. Those negative exposures could be traumatic brain injury, could be mental health issues, could be toxins, could be medicines, could be diet, so many other things that through the modern life we are really kind of exposing ourselves to.

SPEAKER_04: 11:06

What about those middle years? I think you call them the middle age. And so my birthday's coming up in a few days, so careful. What years are we talking here? And what should you do in those middle years or the pre-silver years?

SPEAKER_03: 11:19

The pre-silver, I love that. So the pre-silver years are very, very important because we know that, for example, Alzheimer's and dementia, it has a preclinical phase of two or three decades. So if you will be able to start in your 20s or 30s or 40s with physical activity, making sure that your medical conditions like high blood pressure, diabetes, high cholesterol, heart condition, kidney condition, and other systemic factors are well taken care of. If you're up to date with all your vaccinations, moving all the way to the older age, you know that, for example, shingles vaccine is associated with lower risk of dementia later in life. Wait, say that again?

SPEAKER_04: 12:02

The shingles vaccine is associated with lower risk of dementia. Yes. And all right, folks, yeah.

SPEAKER_03: 12:09

Now there's you got another reason to go get your vaccine. Yes. So so there are so many things that you can do and achieve, and the science is rapidly evolving and we are learning so much. So for each stage, especially for middle age, working on your cardiovascular risk factors, those appointments with primary care provider. You're a primary care provider, right?

SPEAKER_04: 12:32

Yeah. So when I'm hounding you about your blood pressure, it's because I'm trying to help your brain.

SPEAKER_03: 12:37

Yes, exactly. You're in the business of brain health as a primary care provider. And I think we should be all thankful to our primary care providers. Those habits, those early treatments, early detections, they all determine the trajectory of brain structural and functional integrity later in life, and obviously protecting someone from developing dementia, stroke, Parkinson disease, and so many other conditions.

SPEAKER_04: 13:05

So it sounds like the brain and the body are pretty connected. I guess so. I guess they are. Okay, we're gonna continue the conversation, but first we're gonna take a really quick break. So stay with us and we'll be right back.

SPEAKER_01: 13:20

When Hennepin Healthcare says, we're here for life, they mean here for you, your life, and all that it brings. Hennepin Healthcare as a hospital, HCMC, a network of clinics in the metro area, and an integrative health clinic in downtown Minneapolis. They provide all of the primary and specialty care you'd expect to find, as well as services like acupuncture and chiropractic care. Learn more at Hennepinhealthcare.org. Hennepin Healthcare is here for you and here for life.

SPEAKER_04: 13:56

Okay, we're back. Now, as long as we're talking about prevention and early detection, Patty, what do you wish people would know about early detection and when they might want to do something about it?

SPEAKER_02: 14:07

Well, I think one important thing to know is that this isn't something that's just happening in our 60 plus years. So we know from statewide data that those who do support subjective cognitive decline, which means that they're experiencing issues with their memory or they they feel that they're experiencing issues with their memory. It's the self-report data. But half of those people are from ages 45 to 60, not just 60 plus.

SPEAKER_04: 14:29

So people in 40 to 60s talk about they think they're losing. It's like our Dr.

SPEAKER_02: 14:33

Sabyan said, there's these there's the pre-clinical phase, and then there's the early phase of you know mild cognitive decline. You're moving through. You don't just, you know, one day you have your memory and the next day you don't. It didn't happen overnight. So it wasn't like a light stage.

SPEAKER_04: 14:50

Aaron Powell, so what should someone do? I'm 42 years old and I think I'm forgetting my car keys too much or whatever the whatever it might be.

SPEAKER_02: 14:56

And in that data, those people that are experiencing this, even when they've been to the doctor in the last year, aren't necessarily talking to their doctor about those symptoms. And based on some other, you know, kind of qualitative data, we're pretty sure that their doctors are often not bringing it up either.

SPEAKER_04: 15:11

So I think um Well, from my N of one, I'm not bringing up with a lot of 42-year-olds. Are you starting to get forgetful? And they're not bringing it up with me.

SPEAKER_02: 15:19

Right. But I think there are signs and symptoms to be aware of, and they extend beyond just memory loss. A memory loss that's disrupting your daily life. I have a ton of memory loss, especially short term. I have three little kids. I often don't know what I'm supposed to be doing or why I walked into a room. We're not necessarily talking about that. Um, but it's really disrupting your daily life. It also can be like poor judgment. You don't know how to play a game that you used to play every day. You are your mood is changing, you're not managing money well. Like there's lots of other symptoms beyond just that simple memory loss. And and that's not necessarily getting detected in the clinic setting, right? That's absolutely I wouldn't imagine it is.

SPEAKER_04: 15:58

How is that coming to your attention at the state public health agency?

SPEAKER_02: 16:01

Well, you know, from a public health perspective, we're really moving beyond like individual care and individual services and just the individual in general, and really thinking about population health and the systemic barriers that are getting in the way. So, from our perspective, you know, these things are getting noticed at work, at home, maybe at the bank. So, what is the mechanism for people out in the community to be having this experience, or maybe their caregiver notices it, and actually getting to a place where they're having a cognitive screening or assessment and that whole pathway to diagnosis and getting care and support. And there's a lot of barriers within that pathway and a lot to work on and opportunity to improve that, but it kind of takes everyone working together. And so I mean, like from community organizations that are sort of trusted messengers for certain population groups, where wherever you go, where you get support in your native language, we all need to have this level of awareness in order for this to Yeah, it's not just at your doctor's office.

SPEAKER_04: 16:55

Right.

SPEAKER_02: 16:56

We have a partner who is we have a partner who's working with beauty salons because there are people who are coming there and they're sitting in the chair and they're having these conversations. When the family brings something like that up, there's a trusted person who could say, You should really talk to your doctor about this.

SPEAKER_04: 17:08

Yeah, yeah. So your job sounds like it's bringing a lot of people together. That's kind of what it sounds like.

SPEAKER_02: 17:13

And I think the point is that dementia is not just just detected in the clinic, it's detected in the community. And therefore, those linkages between the two, you know, and then people are getting to the clinic and and they might get a diagnosis or they might get a referral to a neurologist. But in the three months between or longer, getting from primary care to that visit, you know, what support are they getting? Because there are community supports, but if if the primary care provider doesn't have a way to get them there or a way to suggest, you know, then they're kind of just dealing with it on their own. It is scary. That's the other thing. And I think the final thing too is that we also know from that same statewide data, we can actually see that caregivers are experiencing some of those same risk factors at a higher risk.

SPEAKER_04: 17:53

Right.

SPEAKER_02: 17:54

So when we talk about hypertension, smoking, depression, it's almost like caregiving is a social determinant of health in and of itself. And a primary care provider like yourself, if you have someone who you know is caregiving for someone living with dementia, I can think of a bunch of them in right now. Right, who also have like three kids and work a full-time job, they might not only need support and information about how to care for that person, but they need support to care for themselves.

SPEAKER_04: 18:18

Right. So they're trying to care with a patient or their loved one with dementia, but they also maybe aren't looking at their own hypertension and they're smoking and they're not exercising and they're stressed.

SPEAKER_02: 18:26

And you can imagine the stress is just compounding.

SPEAKER_04: 18:29

We've been talking, Patty, a lot about dementia. Is that the main brain health outcome we're talking about? Because you, Benam earlier, said strokes and other things, but people kind of think of strokes as, well, it is a cerebrovascular thing. And are we talking about dementia here? Either one of you. Is that the main thing we're talking about?

SPEAKER_03: 18:45

So dementia is one of the most pressing neurological conditions. And the reason for that is one is aging of our population, and the other one was that until just a few years ago, there was no treatment or even proper early detection markers for that.

SPEAKER_04: 19:02

For dementia.

SPEAKER_03: 19:03

But now we are in a different situation, and that's a good news. So, over the last honestly, four or five years, the landscape is changing in a way that if you are able to detect a person or to kind of capture the condition in very earlier stages, what we call it mild cognitive impairment and has its own definition or mild Alzheimer disease. It comes with symptoms, it comes with some clinical evaluation, and there are some imaging and blood biomarkers now for that available. We can capture these people early on, and there are now some disease modifying treatments out there.

SPEAKER_04: 19:43

Those two things that you have just said, I want to tell the listening public, are game changing. I've been practicing now about 25 years. We did not have a blood biomarker. Basically, folks, that's a lab test that can maybe say if you are at risk of dementia. And the second thing was a disease modified. Modifying treatment. In other words, we have something to offer you that might make you better or at least improve or slow down the progression. So let's touch on those two things a little bit. What do you mean by blood markers and what are the disease modifying treatments? Yes.

SPEAKER_03: 20:13

So we know that when you have a patient with advanced dementia, things are too late.

SPEAKER_04: 20:19

Yeah, it's very late then. Yeah.

SPEAKER_03: 20:20

The brain structure has changed so significantly that there's no reversibility to that. The brain function has been affected because of the change in the brain structure. But early on, when there are some signals for changes that would lead to cognitive impairment and dementia, this is your golden time to really identify the right patient for the right treatment and start modifying the course. And that's what I and other colleagues, as preventive neurologists, as a vascular neurologist, we are doing. So we identify, for example, a patient comes with subjective memory complaints. This is really affecting some day-to-day activities. Then you would do cognitive assessment. You would look at the brain with neuroimaging, like MRI. You will run some blood tests that you always do as a primary care program.

SPEAKER_04: 21:14

Yeah, we do blood tests all the time.

SPEAKER_03: 21:16

Thyroid function, B2L, folate, making sure that there are no other infections going on. And then you exclude those factors, you would confirm that these individuals would have some markers of disease pathology, meaning Alzheimer's disease, in their brain, either through the blood test. And we look at the brain MRI, and then we perform some functional and cognitive assessments. That would tell us that the person is in the earliest stage of cognitive impairment, and that person would be eligible for early treatments. How much it would change right now, it is not huge, but I see that like as early days of chemotherapy, where you start attacking the biology that would lead to the uh Alzheimer's and dementia, and then you will figure out which individual would benefit most from what type of intervention. That's where we are standing right now and it's happening.

SPEAKER_04: 22:16

Is it possible that we could get to a point where you could get a blood test when you're much younger, even that says you're at high risk and your test is negative? Could it be as simple as that?

SPEAKER_03: 22:27

A good number of my patients in the clinic are those who don't have a stroke or dementia, but they have a very enriched family history of stroke and dementia. And they come to me, they say, What can I do to change this trajectory? I don't want my family history to be my destiny.

SPEAKER_04: 22:44

You don't want your family history to be your destiny when you have a lot of dementia and strokes in your family.

SPEAKER_03: 22:48

Yeah. We would first assess like basic things, making sure that these patient blood pressure is well taken care of. Cholesterol, smoking, alcohol, those kind of what we call a cardiovascular health. But there are many more factors beyond that. We would look for the vision, hearing, history of traumatic brain injury, recurrent falls without clear etiology, and all those kinds of things. So we would take care of that like a base of a pyramid. So you would take care of all the medical conditions that might be going on. And then in the next level, you would see what is the concern. Is it just the family history or no? Actually, I had this transient neurological condition. There was a day that I was running, and then I usually say hi to people and start a brief conversation. But that day, suddenly I could not get the word out. And that is already a signal for things like what we call a transient ischemic attack or early cognitive symptoms. So usually in my interviews, I interrogate those events and document that. I mentioned about awareness. Yeah, awareness you mentioned. And now we need to talk about early detection when things are not too late. I think this is a very important thing. You need to be aware that I have these symptoms. Early phase, mild symptoms are manageable. We can monitor them. And by the way, I need to kind of highlight one thing that that was not existing five, six years ago. Five, ten years ago, dementia and Alzheimer disease and cognitive impairment were like a dead-end situation. You would try to kind of prevent some harm. But now we have high-level evidence out there that if you would be able to start multi-domain intervention, meaning that you would tackle risk factors at the same time, like physical inactivity, high blood pressure, diabetes, and also cognitive training all at the same time, you are in the best position to prevent cognitive decline and dementia. This is not a myth. This is not just a viche anymore. This is strong evidence out there.

SPEAKER_04: 25:49

So if you want to know where those experts are, folks, they're at Hennepin Healthcare in the garden spot of the country, downtown Minneapolis. It's Dr. Sabayan. He is a global leader in research and care and early detection of brain health. So just a little uh a plug for a department that I don't work for. So I can just say that you're the best in the business. Now, Patty, a public health lens, what is the Minnesota Brain Health Initiative?

SPEAKER_02: 26:11

Yeah, so in my unit at MDH, we're working with community partners to increase awareness of these, you know, healthy habits for your brain, early signs and symptoms, how to talk to your doctor, those types of things. So we also have community partners that are really trying to, you know, build relationships within their own specific communities, whether that be like a geographic area or specific cultural community, and build those linkages between clinic and community. We have populations in Minnesota who don't have a way to, in their language, this concept of dementia, symptoms, and even a word for dementia does not exist. So the way that we spread awareness about this and communicate about it has to be community specific. So we're working with a lot of different partners to do that. When I think about accessing this type of amazing preventative care, I think about everyone in Minnesota and who has access to that and who may not. Questions we have would be like, are all of our primary care clinics in Minnesota prepared to utilize, you know, this advanced medical technology of biomarkers? Are there, you know, I'm gonna go with no lab access to, you know, are there partnerships to actually process those labs? Like we need to come together as a collective to make sure that like our policymakers are aware that these treatments and medical advancements are coming. We need to be prepared. What does that look like? What investment do we need from our state to be able to do those things? You know, MDH can't do that alone, or community partners can't do that alone. But we can share the story of what it looks like to try to get a diagnosis for dementia, which I have not come across anybody in my work so far that has had an easy time getting a dementia diagnosis and the support that they need. And I'm not even saying, like, even people who are privileged, even people who know exactly what to expect, it is really hard. There's so much work to be done. So it's it's great that there's this new emerging evidence and that there's these new tools, but the actual practical application of making sure that everyone has access to them is the thing that we are focused on.

SPEAKER_04: 28:08

That is such important work. Now, you are both involved in something later this month, Brain Awareness Day, January 22nd. What's that?

SPEAKER_03: 28:17

So, Brain Health Awareness Day is an initiative that is started from at the Department of Neurology at Hennepin Healthcare. Our Department of Neurology that you work for? Yes. And that was very much inspired by so many activities happening nationally and internationally on increasing the awareness, the first keyword. That initiative would lead to multiple things. And I wanted to kind of kind of breach to what just Patty mentioned is that at the end of one spectrum is advanced dementia, patient with a stroke that was not receiving good care at the beginning, etc. Of course, we need to focus on that, but we need to really go way back to early signs, mild symptoms, and way back to the population, where we need to do population-level interventions. It should not be all just relying and focusing on one biomarker or one very expensive treatment. It should be really boosting the whole population level of physical activity, making sure that our diets are not having so much salt. So high sodium, low potassium. We need to be in the point that there's green environments and facilities for being physically active for us and for our kids. So that's really the focus of bringing off awareness day. That there is a spectrum there. We need to play an active role. We want to be aware. If you would have symptoms, our family would have symptoms, would get attention early on. But also as citizens, we need to have this feeling of responsibility that in every corner that we are living or we are working, we need to inform each other and we need to kind of think about and promote things that would prevent traumatic brain injury, bad diet, physical inactivity. So this is really the core of brain health awareness. And we are bringing together community partners and patient population and our own community to talk about that. Talking about that is very important. Brain conditions, in contrast, like when you have angina in your heart, you have chest pain. You have pain. But the pain of dementia doesn't manifest until it is too late. That organ somehow hides pain until it is too late. So that's why you need to be very aware and you need to talk about it and think about it all the time. And that's really the complexity of your deal.

SPEAKER_04: 30:45

Yeah, yeah. So that is January 22nd. Yes. We will put a link in our show notes to that event on that day. So I heard you say three words. I think they were awareness, early detection, and multi-domain interventions. Did I get it right? So each of you, if you could leave our listeners with one thought on the topic of brain health, what would it be?

SPEAKER_02: 31:04

I think what's feeling most important for me is the reality that for those who are at risk of dementia, whether it be genetics, whether it be that they're experiencing some of these risk factors like diabetes or hypertension or hearing loss, there is emerging evidence, right? That uh like lifestyle interventions with support from providers in your communities are effective at delaying decline. So that seems very empowering for me for both provider audience and a public audience.

SPEAKER_04: 31:30

That is a message of hope. Yeah.

SPEAKER_02: 31:32

Even if we just start there, it can be effective in a world where we've we've thought it was a dead end and there hasn't been anything to offer.

SPEAKER_04: 31:39

I love that message. There is there is something hopeful there. What would you say, Benham?

SPEAKER_03: 31:43

I think that was really the core. I want to kind of reiterate that brain health is not the absence of brain disease. And we can improve brain health and we can prevent things like dementia. We need to be ever off that.

SPEAKER_04: 31:57

Dr. Benham Sabayan and Patty Takerra from the Minnesota Department of Health, and Benham is from the Department of Neurology here at Hennepin Healthcare. Thank you for being on the show today. Thank you so much.

SPEAKER_02: 32:08

Thank you for having us.

SPEAKER_04: 32:09

Okay, listeners, January 22nd is Brain Health Awareness Day. Put it on your calendar and go to the show notes to get a link to more information about that important event and join us again in two weeks' time for our next show. And in the meantime, be healthy, be well.

SPEAKER_00: 32:23

Thanks for listening to the Healthy Matters Podcast with Dr. David Hilden. To find out more about the Healthy Matters Podcast or browse the archive, visit healthy matters.org. Got a question or a comment for the show? Email us at healthymatters at hcmeb.org. Or call 612-873-TALK. There's also a link in the show notes. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota, and engineered and produced by John Lucas at Highball. Executive producers are Jonathan Comito and Christine Hill. Please remember we can only give general medical advice during this program. And every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.