The Future of Alzheimer's: New Research, Earlier Detection, and Hope for Families

In this episode of Second Half Conversations, Sondra Ziegler sits down with Ginny Funk, Director of Programs for the Alzheimer's Association, to explore a question that affects millions of individuals and families:

What do we know about Alzheimer's today, and what gives us reason to hope about the future?

For many families, Alzheimer's disease and dementia can bring fear, uncertainty, and difficult questions about what lies ahead. But our understanding of these diseases is changing rapidly. Advances in research are helping us learn more about what happens in the brain, how risk may be reduced, how Alzheimer's can be detected earlier, and how new treatments may slow disease progression for some people.

Ginny begins by explaining an important distinction: dementia and Alzheimer's are not the same thing. Dementia is a broad term describing cognitive decline that interferes with daily life, while Alzheimer's disease is the most common cause of dementia. She also explains why significant cognitive changes should not automatically be dismissed as a normal part of aging—and why some dementia-like symptoms may have other, potentially reversible causes.

Sondra and Ginny discuss the warning signs families should watch for, including changes in memory, judgment, problem-solving, communication, mood, behavior, and the ability to complete familiar everyday tasks. They also explore why Alzheimer's can sometimes lead to personality changes, anxiety, suspicion, anger, or withdrawal, and why understanding these behaviors as possible effects of changes in the brain can be important for families and caregivers.

The conversation then turns to brain health and risk reduction. While age and genetics cannot be changed, research suggests that factors such as cardiovascular health, physical activity, diet, healthy sleep, social engagement, hearing and vision health, and continuing to challenge the brain may play an important role in reducing the risk of cognitive decline.

Another major area of progress is earlier detection. Ginny discusses advances in biomarkers, brain imaging, and newer blood tests that may help identify Alzheimer's-related brain changes as part of a broader diagnostic process. Because some changes in the brain may begin many years before noticeable symptoms appear, earlier evaluation is becoming increasingly important.

Sondra and Ginny also discuss the changing treatment landscape. After years in which medications primarily focused on managing symptoms, newer disease-modifying treatments are now available that may slow the progression of Alzheimer's for some individuals in the earlier stages of the disease. These treatments are not a cure, but they represent an important shift—and research into additional treatments and therapies continues.

For anyone worried about changes in themselves, a spouse, a parent, or another loved one, Ginny's message is clear: seek answers and support early, and don't try to navigate the journey alone.

The Alzheimer's Association provides education, local resources, support groups, guidance for families and caregivers, and a 24/7 Helpline staffed by trained professionals.

Alzheimer's Association: alz.org
24/7 Helpline: 1-800-272-3900

The central message is one of informed hope: Alzheimer's is not a normal part of aging, and while there is still no cure, earlier detection, new treatments, ongoing research, and greater support are giving individuals and families more options than ever before.

Highlights from this episode:

• The difference between dementia and Alzheimer's disease
• Why Alzheimer's and dementia are not a normal part of aging
• Warning signs that may indicate something more serious than everyday forgetfulness
• How Alzheimer's can affect judgment, mood, personality, communication, and behavior
• Why some dementia-like symptoms may have other causes
• What happens in the brain as Alzheimer's disease progresses
• How early Alzheimer's-related brain changes may begin
• The role of cardiovascular health, exercise, diet, sleep, and social engagement in brain health
• Why hearing and vision health may also matter
• How continuing to learn and challenge the brain may support cognitive health
• Advances in biomarkers, brain imaging, and blood tests for earlier detection
• Why getting an evaluation early can open the door to more options
• How the Alzheimer's treatment landscape is changing
• New disease-modifying treatments that may slow progression for some people
• What researchers are studying next
• Resources and support available through the Alzheimer's Association
• Why caregivers and families do not have to navigate Alzheimer's alone
  
  

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Creators and Guests

Host

Sondra Ziegler

Executive Director of Ziegler Estate Law Firm

What is Second Half Conversations?

The second half of life can be full of meaningful moments—more time with family, new opportunities, and the freedom to focus on what matters most. At the same time, it often brings important questions about planning, caregiving, relationships, and the future.

So that’s exactly what we talk about.

We'll tackle difficult topics like estate planning and care navigation, strategic aspects of taxes and business succession planning, and the dynamics of relationships and seasons that come with the second half of life.

Because if done right, the second half can be the better half.

Sondra Ziegler: 00:00

Welcome to Second Half Conversations. I'm your host, Sondra Ziegler. This is a space to discuss all kinds of topics about the second half of life, from complicated legal topics like wealth protection and business succession planning that we break down in a practical way, to long term care planning and care navigation when you have a loved one on a care journey, to leaning into fully experiencing new seasons of life, of work and relationships. Our team and guests are here to equip you to take full advantage of where you're at. Because if done right, the second half is the better half. Let's get to it.

Sondra Ziegler: 00:41

Welcome back to Second Half Conversations, where we explore the issues that matter most in the second half of life and help families navigate aging with greater confidence and clarity. Today's topic is one that touches millions of families. Almost everyone knows someone who has been affected by Alzheimer's disease or another form of dementia. It can be frightening, confusing, and heartbreaking, both for the person experiencing it and for the people who love them.

Sondra Ziegler: 01:09

But there is also reason for hope. Over the last few years, researchers have made significant advances in understanding Alzheimer's disease, detecting it earlier, reducing risk, and even developing treatments that can slow progression in some people. To help us understand where the science stands today, I'm joined by Ginny Funk from the Alzheimer's Association. She's the Director of Programs. Ginny, thank you for being here today.

Ginny Funk: 01:37

Oh, thank you so much. We really appreciate this opportunity.

Sondra Ziegler: 01:41

Well, let's just dive in. What is dementia and what is Alzheimer's? Because a lot of people use those terms interchangeably. So help us understand the difference between the two.

Ginny Funk: 01:56

Okay, absolutely. And that, by the way, is the most commonly asked question, no matter what class we're giving or where we are, what's the difference between Alzheimer's and dementia? So the best way that we describe it is to get a visual image of an umbrella. And the umbrella term is dementia, not Alzheimer's disease, but dementia. So you have this big broad term and dementia means cognitive loss, which who doesn't feel like they have cognitive loss at the end of a tough day or a tough week.

Ginny Funk: 02:32

But dementia means it's serious, and it is happening repeatedly, and it is causing further and further decline. So it's not a little bit of forgetfulness or a little bit of just hesitation. But dementia means cognitive decline that continues progressing and interferes with daily living. So dementia is this big broad umbrella term for symptoms, symptoms of cognitive decline. But the next most important question we ask is what's causing those symptoms.

Ginny Funk: 03:10

So we call Alzheimer's disease, the long handle that comes down underneath the umbrella, Alzheimer's disease, because that disease in the brain causes individuals to have dementia symptoms. And it accounts for sixty to eighty percent of all cases of dementia. The other most commonly cause common causes of dementia are vascular dementia. There's also Lewy body dementia. There's frontotemporal dementia, and there's over a 100 causes of dementia.

Ginny Funk: 03:49

So most people have heard of Parkinson's disease, individuals with Parkinson's disease often later as those symptoms progress, they develop dementia symptoms. So dementia is a broad term and we also kind of we do say it's similar to if you said the word cancer, your next question would be, well, what kind of cancer? I don't even know how many types of cancer there are, but that would help. You need to know that in order to determine next steps. And so again, dementia is a broad term for you're having symptoms of cognitive decline, but the most important next question is, but what's causing those because there are also reversible causes of dementia.

Ginny Funk: 04:39

So it's really important to, to understand the warning signs, but also get them checked out, because maybe it's something that could be treated and reversed. So for example, a urinary tract infection can cause people to have dementia symptoms. But that's an infection in the body that causes their symptoms and that can be treated and therefore the dementia goes away. What we're talking about today though, is Alzheimer's disease and related dementias, the ones that are diseases of the brain that we don't yet have a cure for, and we're doing everything possible to try to find that.

Sondra Ziegler: 05:25

Thank you. Thank you for that. You know, it's so interesting. I heard about bladder or urinary tract infections being a cause of dementia symptoms a few years ago. You know, a lot of people don't know that, but you know, so many of our elderly population have recurring urinary tract infections, both male and female.

Ginny Funk: 05:53

Yes.

Sondra Ziegler: 05:53

And so that's a really important one to understand that, you know, if your loved one who maybe is in assisted living or nursing home, maybe isn't as mobile as they used to, not moving around a whole lot, and suddenly has these symptoms, we do need to test for simpler causes like that that could be treated right away. Yes. And so okay. Yes, absolutely. Help us understand what symptoms distinguish normal aging from something more serious.

Sondra Ziegler: 06:28

This is a question we get a lot. How do we know when we should start paying closer attention?

Ginny Funk: 06:34

Yes. And and going back to that, that cognitive decline, not, oh, gosh, I walked into this room, and I can't remember why I walked in here. We all do that. That is not considered a dementia symptom. A dementia symptom is something that you would consider very different.

Ginny Funk: 06:54

You're seeing something different than the person has ever done before in basic activities of daily living. So for example, yes, memory loss is is one of the symptoms, but it's not again, why did I come in this room? Or where did I lay my keys down? It's more serious as in going out to the car and not understanding how to start the car or being able to describe the utensil that it takes to start the car, like saying, what's the name of this? And they can't say the word keys.

Ginny Funk: 07:30

So it's, it's much more serious decline memory loss that disrupts daily life. Also things like challenges in planning or solving problems. So, we don't necessarily think about it, but all day long, our brain is solving problems. Is being rational. It's thinking of how to do things.

Ginny Funk: 07:53

Just kind of go on autopilot. For example, in the morning, brushing our teeth, there are so many steps to that. If you start noticing that someone is like, for example, you walk in and they're putting toothpaste on a hairbrush, that is something is out of ordinary where the brain is not telling them the you the correct utensil to use. And so that would be and let's say you don't just see that once, but you see that more often, and it's starting to happen more often, completing familiar tasks, they're starting to wear the same clothes over and over and over and maybe starting to neglect hygiene. It's again, it's one of those things where the brain is not able to follow the basic steps of how to do something that they've always been able to do.

Ginny Funk: 08:47

Another warning sign is confusion with time or place. For individuals who are retired and don't really look at a calendar. And so if you ask them, well, what day is it? They, they generally might say, well, I don't know, it's Wednesday or Thursday, but confusion with time or place as a dementia symptoms means that individual is not even in the same time frame that we're in they're talking about 1967 as if it's happening right now or they get somewhere and they're not able to even say how they got there, what timeframe it is. Sometimes people come out of their home and they're wearing inappropriate clothing because they don't even know what season it is.

Ginny Funk: 09:34

There's also language. There are language symptoms where an individual might start repeating themselves and they don't even know that they're repeating themselves and that you've already answered whatever they asked or their writing starts to look differently they're not able to follow a basic conversation without getting lost in the middle and not knowing how to either start back up or again, maybe they start retelling the same thing over and over, misplacing things, and then losing the ability to retrace their steps. So there's some some accusations that can be that can start in the beginning where I didn't put that there or, you know, where are my things and not remembering that they moved them, and they are not able to retrace their steps and figure out where they moved them. Again, we all misplace things. Oh my gosh.

Ginny Funk: 10:37

Where are my keys? Where's my phone? But this is something where you start to find the keys or the phone in the refrigerator or food in the bottom of a drawer where it doesn't make sense, and they don't know that they've necessarily done that. Decreased or poor judgment. One of the the early warning signs is maybe someone is doing something again, you've you've never noticed before, but they're starting to not be able to keep track of their money the way they used to.

Ginny Funk: 11:08

Or if someone calls on the phone and says, hey, I'm here to help, give you a new roof, and they give out their birthday and their social security number and their credit card number over the phone to someone they lose that up there's something wrong in the brain that's not you know red flash of don't do that warning warning, don't give out your information like that. Another symptom is withdrawal. If you think about all these warning signs, people do start to withdraw from conversations, from interactions, even with their closest loved ones, family, because sometimes in the beginning, they absolutely do know something's wrong. Something's off with me. People are treating me differently.

Ginny Funk: 11:57

They're saying that I'm repeating myself and they're getting really frustrated with me. And so you can start to see people withdraw. So if you notice these warning signs again, the next step is to get an assessment and find out okay, what could be causing that because Alzheimer's and the other related dementias, a lot of times they kind of come on subtle, whereas we were talking before, a urinary tract infection can make someone look like immediately something is very wrong. Maybe they're talking and they they don't make any sense and their behaviors are very bizarre, and they're acting very differently. That's different than Alzheimer's and other dementias where it sometimes can be more subtle things that you start to notice that, you know, money is disappearing and they can't keep track of things and they're not able to just keep up with the daily things that they've always been doing.

Sondra Ziegler: 12:56

It makes me think of stories we've heard families tell sometimes when they come in, you know, for estate planning, you know, where maybe the person who has the dementia may become paranoid. Like you're saying, the inability to retrace their steps for their brain to catch up with them and say, Oh, I know where my keys are, or I know where I put my phone. Since they're not able to do that, then there can be accusations of, You took my keys, or You took my phone, or the loved one that they've always relied on to help them with things suddenly they don't trust them anymore. They think they're stealing money from them, or like you say, are susceptible to scams from complete strangers that are calling on the phone. Another one, was just talking with my mom about this, they have some friends who, you know, wife realized there was something wrong in terms of memory with her husband when he could no longer remember how to get to Walmart.

Sondra Ziegler: 14:04

You know, that's somewhere he had been, you know, how many hundreds or thousands of times, and suddenly he couldn't remember, you know, how to drive there. But we're going to talk in a minute about where to go from there, what the next steps are, but talk to us a little bit about what is happening in the brain. You know, when researchers look at the brain of someone with Alzheimer's disease, what are they seeing?

Ginny Funk: 14:33

Yeah, and and it's amazing. So Alzheimer's disease specifically has been around for over one hundred years. It's actually, when you're so brilliant, you discover something they name it after you. It was Doctor. Alzheimer clear back in 1906, who was documenting and seeing very different behaviors in some of his patients.

Ginny Funk: 14:58

And what they were able to do back then was after someone passed away, they were able to look at slides of items in the brain and be able to determine okay, these don't belong these are causing cell death, and nerve cell death and the connections between cells. And those are called plaques and tangles. So if you hear plaques and tangles, that is, is beta amyloid plaques and amyloid is a protein that is normally produced in the brain. But in Alzheimer's disease, it clumps. It clumps into plaques between nerve cells, and it actually causes nerve cells and tissue loss and nerve cells to die.

Ginny Funk: 15:43

Then you also have tau tangles, so plaques and tangles. Tau normally helps keep brains healthy. In Alzheimer's disease, though, they get twisted into tangles, and that blocks nutrients from moving through the cells also contributing to cell death. So those two are considered still to this day the kind of hallmark brain changes of Alzheimer's disease. However, there is fast forward from that long ago.

Ginny Funk: 16:17

There are so many other things being studied now and due to research and science and funding of research, they can now go in and look at the brain whilst inside while someone is living. And that has made such incredible difference. Again, think about other organs that they've been able to do miracles, you know, fixing and all the things with, so many other things. But with the brain, it's made a huge difference now that they can do scans and actually look at things happening in the brain while someone is living. So they are now they look at things like inflammation and all the vascular changes that can happen.

Ginny Funk: 17:00

And there's metabolic changes and there's proteins in the brain. So they're always looking at others, you know, what else is happening in the brain to determine what you know, and also just trying to find that answer. Why? Why does this develop in millions of people's brains, but it also does not develop in millions of people's brains. And so we say over and over, Alzheimer's and dementia are not a normal part of aging.

Ginny Funk: 17:32

We are not all growing old. Well, are, but that's happening. But we are not all going to develop these diseases. And so but those are truly there's a picture there are pictures that sometimes will show in our classes, especially with families that show what these plaques and tangles are actually doing to the brain, and it causes the brain to go through atrophy. And it's very hard to look at these photos, but at the same time, we show them in our classes because these are just awful diseases.

Ginny Funk: 18:10

But what makes them so hard is you can't see them. You you know, if if someone comes in with a broken leg, you just immediately have these thoughts. Oh, boy, that must be painful. How difficult? I wonder what, you know, how do they do this, this and this.

Ginny Funk: 18:24

But with Alzheimer's in these brain diseases, since we can't see it, and oftentimes in the beginning stages, the person still very much looks like themselves, you can't see the damage that's being done. And that is why individuals are having dementia symptoms and doing the things that they're doing that they've never been doing before. Because it's actually brain damage. These are actually destroying the brain as they progress through the brain. So, but again, we're, yeah.

Sondra Ziegler: 18:57

Oh, I was just gonna ask, how long before symptoms appear do some of these changes actually begin from what we know now?

Ginny Funk: 19:07

That's also changed dramatically with every all of so much has happened in the last twenty to twenty five years, that now researchers tell us that it's estimated that some of these changes could start happening in the brain up to twenty years earlier.

Sondra Ziegler: 19:26

Wow.

Ginny Funk: 19:27

And then the symptoms don't start to show for most individuals 65 and older is when the symptoms of dementia start to show. There are also younger onset individuals who are younger than 65. My goodness, people in their 40s and 50s and early 60s who have younger onset, but that's more rare in the majority of individuals.

Ginny Funk: 19:52

It's symptoms showing after 65. So the difficulty now is also kind of raising that awareness that Alzheimer's and other dementias have always kind of been considered, you know, oh, those are just old individuals or you get old and you just, oh, you just get a little bit of that. But now there's so much more research and focus on looking at the brain of individuals younger to try to, again, get ahold of this before it even starts to progress.

Sondra Ziegler: 20:24

You know, one thing I hear from families is, and you touched on this a little bit earlier, but my loved one isn't just forgetting things, their personality seems fundamentally different. Tell us about how Alzheimer's can affect mean, you mentioned judgment in terms of not falling prey to the scammer that calls on the phone and their inability to sort of, be alert to the the idea that someone's taking advantage of them. But what about mood, behavior, other sorts of decision making skills?

Ginny Funk: 21:00

Yes, absolutely. And we do, we kind of use the saying, if you've seen one person with Alzheimer's disease, you've seen one person, because everybody is different. Not everyone has the same symptoms. Not everyone has the same behaviors. But because the we don't even think of our brain as an organ in the body necessarily, but it is the most important organ.

Ginny Funk: 21:25

It's telling, it's telling everything what to do. It's telling how we move, how we talk, how we function, how we, it holds our emotions, it holds our behaviors, it holds our judgment. And so when those parts of the brain start to become damaged, you do start to see individuals who who have behavioral changes, mood changes, something even as small as just just changing the time of an appointment or something and and and you know all of us can have a bad day so we do this comparison of this is kind of normal aging and this is no watch for this as a symptom of of dementia it doesn't mean it's Alzheimer's but as a symptom someone has this catastrophic reaction to something that you think, well, I did it's not a big deal. I just said we were going to do it at this time instead of this time. And they have this really big reaction or oftentimes anxiety you'll see someone who's very anxious that you've never seen them like that before or very confused in just trying to get to a doctor's appointment and it takes two hours to get going out of the house Mood changes where not everyone goes through this, but those that part of the brain that kind of regulates and says, okay, that's not a big deal. We don't have to worry about that. Or, you're telling me that I need to bathe, and I'm saying, no. I don't need to because I just did, but my brain doesn't understand. No. You haven't.

Ginny Funk: 23:02

And so sometimes anger and frustration can come out because an individual, they don't know that they don't know. And so here's someone telling them, you need to do this, or you, you know, you need to bathe, or you need to get in there and brush your teeth, or you need to go, go make a sandwich, go get something to drink so you don't get a UTI. But their brain doesn't have those connections to be able to understand what you're asking, and then they start, they can get very frustrated. And we talk about, you know, fear oftentimes comes out as as anger. So while there are, yes, there are-

Sondra Ziegler: 23:46

That's true for everybody, I think, by the way.

Ginny Funk: 23:49

It is.

Sondra Ziegler: 23:50

At least from my observation, you know, if you look at the root of of someone getting angry, it's because they think you're taking something from them or have taken something from them. There's like an it's it's yeah, there's fear.

Ginny Funk: 24:03

Absolutely. I talk with caregivers, I'll say, okay, think about the last time you were really angry about something, and then be honest with yourself. Deep down, deep down. What's your fear? Is there a fear and it's coming out? And so for individuals who have Alzheimer's or another form of dementia, there's a lot of fear.

Ginny Funk: 24:27

We have individuals in early stage who share what this is like living, better to hear from. And they talk about, yes, they're, you know, I'm concerned. What, what am I doing? What am I supposed to be doing? Why aren't things working?

Ginny Funk: 24:42

Why am I spilling things? Why am I, falling? Why, why are different things happening? And I'm getting very frustrated. And so that can oftentimes come out as behavioral type things of anger, of of mood changes, of, you know, don't tell me I can't drive because they're they're not recognizing what's happening.

Ginny Funk: 25:05

They don't know that they don't know. And it's all that pop those different parts of the brain that are being affected by the damage of just not being able to, handle things the way that they have always been able to up to that point. Not everyone goes through. I hear this a lot. Oh, you know, our grandmother, she she just got so angry, and she she started cursing, and we'd never heard that out of her mouth before.

Ginny Funk: 25:33

And we, which I I love to share this story. My mother was always a cursor, but when I went on this journey with her, I would tell caregivers to please don't take offense because she's just always been like that. She's always had a mouth like that. This is not something that's changing, but This is not new. Say, yeah.

Ginny Funk: 25:53

When people say, god, you know, they're she just did all this angry stuff, and and they just have all these behaviors. And and now dad has it, and we're we're you know, we know he's gonna be the same, and we just say, wait. Oh, every single person is different. Sometimes we have family say, you know, actually we get along better now than we did before because they don't remember and we're not, you know, arguing over the things we used to. And so you just you never know what is gonna happen.

Ginny Funk: 26:26

So you don't want to assume, Oh, it's gonna be just like another loved one who went through this, because it usually isn't. It's something different.

Sondra Ziegler: 26:36

It could be different. Yeah. I know one family in particular had the situation where, you know, mom started cursing on a regular basis and had never used bad language before, and they were just appalled. But you know, what they learned was part of those brain changes affect the language center of the brain eventually as the disease progresses, and normal conversational speech becomes very difficult, and sometimes the things that are left are swear words, or music was another one tends to stay longer. And so even after some people have lost the ability to engage in an appropriate conversation back and forth with you, they could still sit down at the piano and play music.

Ginny Funk: 27:38

Yes.

Sondra Ziegler: 27:38

And so that's disorienting to the family, you know, here's someone who can't really talk to me on a conversational level, but they can cuss me out or play me a song.

Ginny Funk: 27:50

Yes.

Sondra Ziegler: 27:51

You know?

Ginny Funk: 27:51

Yes.

Sondra Ziegler: 27:52

And so that's that's really hard, like you say, when they don't have an outward wound or disability that we can see, it's all invisible, and it changes all the time. And so that's so difficult for families walking through this. So for years, people have assumed that Alzheimer's or dementia was just sort of unavoidable. And I think this goes to what you just said. A whole lot of people are going to get it, but a whole lot of people aren't.

Sondra Ziegler: 28:26

So that's what we're trying to understand. Today, we seem to hear a lot more about prevention and brain health. So one of the most encouraging areas of research is what we're learning about risk reduction. Can we talk about the lifestyle and health factors that researchers now believe influence brain health?

Ginny Funk: 28:49

Yes, absolutely. There are, there are two things that we know we call them non modifiable. We're aging, and age is the number one risk factor still for developing Alzheimer's disease. However, so so as we age, our risk increases as we age over 65 and older, it it definitely the prevalence increases. We we're aging, we know we're aging.

Ginny Funk: 29:17

It bothers me so much when I hear people say anything derogatory about aging. Cause I just think, well, which, which way are you headed? Which direction are you headed in? We're all headed in that. What's the alternative?

Sondra Ziegler: 29:28

Right.

Ginny Funk: 29:29

We're going to grow lovingly old. The other thing that's non modifiable is our genetics. We are born into who we are born from. And we we know that that increases one's risk, But we don't actually call Alzheimer's a hereditary disease because people develop Alzheimer's who have no family history. So while it increases your risk, we now know a lot of other things increase risk.

Ginny Funk: 30:01

That also means though, that we have the ability to modify our risks. So we know now cardiovascular health, out of above everything else, the focus is so much on what's good for your heart is good for your brain. It makes sense. That's a logical thing. But now there's the research and the science to back that up that our cardiovascular health and, and oxygen and everything that our blood pumps to our brain, if that's not working, that has a significant effect on our brain's ability to work.

Ginny Funk: 30:38

Cardiovascular health, which I'm sorry, kind of to say that the, the thing that goes modifiable with that is that exercise and keeping our heart healthy as much as possible is about the most important thing that we can do physical activity and it's not well you got to go to the gym and all that kind of stuff it's what do you do in your daily life that you can get your heart working get your heart beat up every day in a way that will help your heart, work better. And that in turn helps your brain better because of the research that's been done that shows what exercise does. There's of course studies on diet. What we put into our body absolutely has an effect on our heart health and therefore our brain health. So they talk about the importance of the mind diet or also the Mediterranean diet that it's not about limiting every you know all those things that taste the best but it's about being mindful of what you are putting in because that affects your heart health and then your brain health.

Ginny Funk: 31:56

Sleep, we hear a lot about sleep studies that sleep and good healthy sleep is considered just an incredible opportunity for almost like a sloughing of the bad stuff off while we sleep good. So that the next day we're able to we do make better choices. We do feel like, you know, eating better, there's so much to that, social engagement. They they did a large study that found people who are isolated, developed Alzheimer's at higher prevalence than the than people who who have connections who have social connections who stay connected because if you think about when someone's isolated what are they doing to to get their heart rate up to eat well, to interact with others to challenge their brain, traumatic brain injury, which there's also, you know, studies about the importance of wearing a helmet if you're doing sports and, and physically taking care of your brain, challenging your your brain. It's almost like use it or lose it that the more no matter what age, it's never too early or too late to start putting some of these in place.

Ginny Funk: 33:19

Blood pressure, there was a large, study on blood pressure that showed that and it's, know, high blood pressure and its impact on, stroke, heart disease, all of those things, ups people's, increases individuals risk for for Alzheimer's disease.

Sondra Ziegler: 33:40

What about hearing loss?

Ginny Funk: 33:43

Yes.

Sondra Ziegler: 33:44

I've heard about that one being a key one.

Ginny Funk: 33:46

And that's something that is is newer. Same thing with with vision. If, if an individual has long term hearing loss and, and oftentimes we do recommend families sometimes, something can be happening in the brain, but it gets kind of chalked up to, oh, they can't hear me. You know, I've told them I've told them a 100 times how to work the new door and to make sure they close it a certain way and lock it a certain way. And they just they're not listening.

Ginny Funk: 34:15

They can't hear me. They're not doing it. What we recommend, get your hearing. Get their hearing checked because it may not necessarily be hearing in that they can't hear what you're saying, but their brain is not able to understand the directions that you're giving them so long term hearing loss is kind of being looked at okay how it's almost like how much harder does your brain have to work in order to process and hear what someone is saying if you're having hearing loss, but also to understand what they're saying. So those are Yeah.

Sondra Ziegler: 34:55

Some of these, like you say, feed into each other. You know, like if you have I mean, you are not treating hearing loss, then your social engagement's gonna decline because it's just hard. It's hard to hear what people are saying and respond appropriately. Yes. And if you're not getting sleep, then you don't feel like going to the thing that you've been invited to.

Sondra Ziegler: 35:18

And, you know, if you haven't been exercising, then maybe you also are not as likely to want to go and do things and be with people because you don't feel as well. Like, I can just see all of those things sort of contributing, you know, and feeding into like a snowballing where someone does just withdraw. So if we can address these issues and stay on top of them, you know, as we get older, we can set ourselves up for success.

Ginny Funk: 35:47

Yes, yes, but there are things that we can do to lower our risk for cognitive decline and dementia symptoms. Absolutely. And again, calling them modifiable in that there are basic things that we can do to try to, even if it's in symptoms at bay for a few more additional years, whereas maybe, you know, we might have, they do studies on, individuals who continue to stay in school, and have different education up to up to certain levels actually can still develop Alzheimer's disease, but it's considered they developed it later in years than they would have had they not had that. So again, we we don't we don't have we don't use the P word. We don't have prevention yet.

Ginny Funk: 36:45

But that is absolutely one of our goals that we find a way to prevent this, that we find a way to stop it if it's already developed in someone and then cure if you truly do already have the disease.

Sondra Ziegler: 37:01

That was going to be one of my questions is or just something I think is fascinating to think about. And I know they're doing research along these lines. But when people do actively engage in learning in their older years and creating those new neural pathways. It's just interesting what does that do to disease progression, or does it act as a preventative in some ways, or help, like you say, they're finding that it maybe delays the onset, perhaps. But yeah, I just think all of that is fascinating.

Sondra Ziegler: 37:43

The way that our brain works at creating new neural pathways, like if someone, for instance, who's never studied music suddenly takes up learning piano when they're, know, 75 years old, What that does in terms of creating those new pathways, it's just fascinating.

Sondra Ziegler: 38:03

But I want to move on to, sorry, did I interrupt you?

Ginny Funk: 38:09

Oh, I was just, you know, we get asked about things like maybe someone will see something on the internet about, you know, do these crossword puzzles, and you'll have this happen and or do this and you'll and so what we talk about is, okay, if that's your thing, or let's say you love to read or you love to do crosswords, but let's say you've mastered it, you're not challenging your brain, we're asking you to take it to the next level, read something that it is almost like a mind crunch, you need to take it up to the next level. So you are firing off nerve cells, the connections between them, no matter what age you are, use them, use them, use them. But but if it's something you've already mastered, then you're not really you're not, you know, that's not really what you're doing. So absolutely.

Sondra Ziegler: 38:59

That's a good that's a good tip. Yeah, we need to kind of step outside of our normal.

Ginny Funk: 39:03

Yes.

Sondra Ziegler: 39:05

Okay, so another area generating a lot of attention is earlier diagnosis. So can you talk to us a little bit about what has changed with regard to diagnosis?

Sondra Ziegler: 39:17

I know this may be an area that's evolving most rapidly. Like twenty years ago, Alzheimer's was often diagnosed after symptoms were already very advanced. How far have we come in detecting Alzheimer's earlier?

Ginny Funk: 39:31

It really is incredible. Again, thinking about this has been around over one hundred years, a huge chunk of time was just absolutely missed. And we kind of think about, okay, this was and it still does have stigma, embarrassment, all those things that if you think about, we kind of compare to cancer, I can very much remember a point when we didn't, you know, cancer was a no, no, and certainly, like breast cancer, but now who doesn't know what pink is, right? I mean, now there are actual things that can help survivors. And so same thing with Alzheimer's disease, we just had a, too long of a time period, but there have been things like cerebral spinal fluid, there are now more biomarkers than ever, then you had PET scans for the brain.

Ginny Funk: 40:27

Now there are actual Tau PET scans for the brain where they can actually see if an individual has a Tau tangles in the brain. And fast forward now there are blood tests, blood tests to be able to help in the diagnosis, not by itself. It's not considered to be okay, just go in and get a blood test now. And it'll tell you whether you're going to get or whether you have Alzheimer's disease, but it can help with making the diagnosis and looking at biomarkers in the blood of which we have, you know, we've never had that before. This is this is new stuff.

Ginny Funk: 41:10

There has never been more attention paid to Alzheimer's or related dementias. And a lot of that has to do with awareness because people are sharing so much more than they ever have. And there's a demand. There's also more demand from people who are living in early stages who are saying, look, we, you know, we need so much more directed towards this in science and to be able to have better ways to make a diagnosis, because up to this point, getting a diagnosis, and it still is, it can be incredibly it can be difficult it can be expensive it can be very hard to get let's just be honest get a doctor's appointment to even get in to see someone even in big cities we just need a little bit more of everything all around, but to the point where we'll be able to go into a doctor's office and determine just like they do when they take our blood to determine, you know, how is our, how is our blood pressure? How's our cholesterol?

Ginny Funk: 42:13

How's our, you know, all those things. The same thing is happening with Alzheimer's disease where now we'll have the ability to not have to go through quite so much testing, but be able to make the process more simple for getting a diagnosis. Because right now, there is still quite a lot of, well, we have to rule this out, and we have to rule out it's not an infection, and we have to rule out, you know, all these things. So it's it's, it's amazing how far it's come. We still have-

Sondra Ziegler: 42:48

The blood test that you mentioned. Is that generally available now?

Ginny Funk: 42:54

It is. However, two blood tests are currently FDA cleared today. In specialty care, in individuals who already have symptoms 55 and older, they can detect Alzheimer's related brain changes up to ten years before cognitive symptoms appear. There's also a blood test for primary care and it's used to help rule out amyloid buildup so neither test diagnosis Alzheimer's on its own both are part of a broader diagnostic workup that needs to be done to be able to again hopefully if there's the possibility of getting a scan. There's so many things that go into the diagnosis.

Ginny Funk: 43:46

A lot of times also it needs fam we need family members and friends to be able to share what's happening with an individual as well, because if you send an individual by themselves to a doctor appointment, very, very common. I'm fine. There's nothing wrong with me. Something's wrong with the rest of my family. They're complaining about me, but I'm I'm fine.

Ginny Funk: 44:12

I'm doing good. Everything is okay. And they send them out and hold on the family's in the background going wait wait a minute we're seeing some very you know strange things strange changes strange behaviors accusations again, being paranoid, being suspicious, things showing up in the wrong place, getting lost in the car or getting these, you know, unexplained, dents in the car. Just all these things can be very helpful also in order for physicians to be able to make an accurate diagnosis that otherwise if they just relied on the individual, they may because of fear, not share those things with their doctor.

Sondra Ziegler: 45:00

Right. So just so our listeners know, if they have a loved one who they believe may be experiencing some symptoms of dementia, Alzheimer's are another type form of dementia, a lot of times their first go to is going to be their primary care physician, right? Yes. But they're going to need to get a referral, right? Because the primary care physician is really not going to be able to diagnose that. Can you walk us through that?

Ginny Funk: 45:34

Yeah, and now more so than ever, there are more tools being developed to where you can get an accurate diagnosis in a primary care, physician office. But a lot of things, you know, it depends. Do they have updated information? Do they have the tools that they need? We have a whole, we do so much at the Alzheimer's Association, but we do have one section that we kind of call our help systems where we have help systems, staff that are helping to change how individuals, yes, if they go into, let's say an ER or a hospital system or a clinic, that we have tools available for physicians, nurses, practitioners to be able to make and help with getting an accurate diagnosis.

Ginny Funk: 46:28

So you didn't, you won't necessarily, you wouldn't necessarily have to go to a specialist like a neurologist or a geriatrician. But that depends on so many things where you live, what does the community have? You know, are you in a small town where maybe you don't even have a neurologist or a geriatrician? So we have a lot of educational materials, again, a lot of, resources for physicians to now be able to, you know, even start asking more of those questions when their patient comes in. Are you having any memory loss?

Ginny Funk: 47:06

Are you noticing changes? Are you concerned about yourself? Because when we do when they do nationwide studies, yes, people are concerned about this, but they're still hesitant to speak up to their doctor or the feedback is their doctor may not even be asking these questions. We're also trying to educate the general public that if you And the whole reason for this is that we wanna get to it early. There are stages to these diseases and a lot of the medications, treatments, support.

Ginny Funk: 47:44

I can't even tell you the number of times that I hear someone say, I wish we had known about this. I wish we had known about this five years ago, two years ago, last year. And that just is like, boy, I do too. Let me tell you, because the sooner we can find out what's wrong, the sooner we can help, we can figure out what to do next. What kind of support? What, you know, is there a medication? Is there a treatment? So much more than we've ever been able to before.

Sondra Ziegler: 48:16

And that early diagnosis of course matters most if there's something we can do about it. So let's talk about that current treatment, you know, landscape. For many years, families were told there was very little that doctors could do beyond treating symptoms. And that conversation thankfully has started to change. Can you walk us through some of today's treatment landscape?

Ginny Funk: 48:40

Yes, it really is amazing the changes that have happened, you know, in the early 2000s, there were things like Aricept and, Exelon, these medications that treat dementia symptoms, but they don't actually treat the underlying biology of the disease. Whereas fast forward to 2023, FDA approved the first ever treatment for Alzheimer's disease. It's called LEQEMBI brand, you know, first ever, this is the first ever treatment with LEQEMBI actually looking at the improvement and on clinical and clinical, scores where individuals stayed longer in earlier disease stages before they eventually kept progressing with the disease. And so Kisunla was next FDA approved in 2024. So two treatments now looking at, again, that individuals had slower progression of the disease, delay, actual changing of the brain, looking at, both attaching to and removing beta amyloid, targeting it at different stages of of plaque formation.

Ginny Funk: 50:15

That's what these medications do. So, they are not a cure. Wow. They do not cure, but they do treat. And we have met with families who have been on these treatments who now every treatment has possible side effects.

Ginny Funk: 50:37

Every treatment have what they call, you know, the black box that goes into. So it doesn't work for everyone just like other medications don't. But for those that have seen the changes, it's been phenomenal because it truly has, it's kept them in early stages of the disease for longer periods of time before they progressed into the middle and later stages of the disease.

Sondra Ziegler: 51:06

How important is it that people seek an early evaluation if they want to know whether these treatments might be appropriate?

Ginny Funk: 51:14

Absolutely. Just from the from the beginning from from learning again, going through and learning about warning signs of dementia and finding out okay, if we see in ourselves or in a loved one, that there are things that we we can't rack it up to oh it's just a little bit of it you know they're just getting older no these are these are symptoms these are red flags we need to get evaluated because again it could be up, it could be so many things that cause those things. But if it truly is determined to be Alzheimer's or vascular dementia or Lewy body, then we can, know, the medical world and the, support world, which is kind of where we are, just kind of wrap around and try to help families through from then on.

Sondra Ziegler: 52:07

That's really that is truly exciting that they've identified some ways to at least slow the progression in a lot of people. That's super hopeful. What can you tell us about sort of cause as you said, these, these, those two drugs were approved, you know, what 2023 and 2024.

Ginny Funk: 52:30

Yes.

Sondra Ziegler: 52:30

What are they working on now? What areas are showing the most promise in terms of what's next that science is working on. It truly is incredible. And not just in The United States, but across the world.

Ginny Funk: 52:45

There are so many studies happening, clinical trials, unique therapies, again, looking at inflammation and, tau studies, neurotransmitter receptors, things that I am no doctor, so. But, looking at other, maybe cognitive enhancers, behavioral neuropsychiatric symptoms, so many different things. We have a presentation where we there's actually I don't have it in front of me, but there's a wheel and it and it looks at all kinds of different areas of targets beyond just looking at amyloid and, you know, tau, amyloid and, tau tangles, but what other processes in the brain could be contributing to this? And okay, what else could be used towards this? So I can't think of what the word is.

Ginny Funk: 53:46

But when they when there are medications, they often look at, studies where they might take a medication that say was for high blood pressure, and do a study and see does it help contribute to individuals with Alzheimer's disease. So there's kind of a cross of looking at things that are already developed and seeing what what might help and we know that every trial whether we get wonderful incredible positive news or negative okay it didn't work the way that we were hoping for All of it further study and helps scientists understand, okay, well, then we need to try the next thing and the next thing. So, there's more things in the pipeline than ever before, Again, because there's so much more awareness, and there's so much more demand. Because the prevalence of this, it is skyrocket skyrocketing. People are living longer. And now we know, again, if we can get to individuals even younger, that can have a huge impact.

Sondra Ziegler: 54:55

Let's finish with something practical. If someone listening today is worried about themselves, a spouse, a parent, another loved one, where should they start? What services does the Alzheimer's Association provide? Yeah, pretend this is day one of understanding that my loved one might have Alzheimer's or another form of dementia?

Ginny Funk: 55:24

Absolutely. So our recommendation is reach out to the Alzheimer's Association. We have a helpline. It's an 800 number. It is staffed with trained staffed professionals.

Ginny Funk: 55:39

There are always masters level and higher clinicians that are staffed. You can call it two in the morning, you can call on Christmas day, multiple length, many, many languages available. If you call our helpline, they are going to listen. They're going to ask, where are you? What is your zip code?

Ginny Funk: 55:57

So then they can start linking you to resources. You know, this is the chapter that's closest to you. Here are educational classes that are being offered in communities or I mean, we have a long list of classes that are so helpful in just learning the basics about the disease. How do you get a diagnosis to how do you handle behaviors? What about all the communication issues that come up?

Ginny Funk: 56:26

All of these are available online as well. So we have an absolutely excellent website. So our helpline is 1-800-272-3900. And our website is just alz.org. And you can go I go every day.

Ginny Funk: 56:46

I go in the search bar, and I'll put something in. And I'll, it'll just open up a whole round of things. Again, where are local resources? Are there support groups in my area? Is there a virtual support group I could join?

Ginny Funk: 57:00

If I need a list of physicians, neurologists, geriatricians, you can get that from speaking someone on helpline or you can go to our website. Just start from the beginning with we hope this isn't what it is, but if it is, what do how do we get to that point where we can, you know, get a diagnosis, find out what's happening, and then be surrounded with support if it does end up being Alzheimer's or another related dementia, as we say. And don't do this alone. There are, again, so many people who, because of the caregiving that they're providing, losing their health quicker than the person oftentimes with the disease. And we are there to just do everything we can to support everyone involved and not, not go this alone.

Ginny Funk: 57:59

Don't, don't do this on your own. People know where to go for resources for cancer or for diabetes. And, you know, that's what we're always continuously trying to raise awareness about the Alzheimer's Association. Reach out if you need any kind of support so that we can help get you in the right direction.

Sondra Ziegler: 58:17

Okay, before we wrap up, let's do just a quick lightning round. So what is the biggest Alzheimer's myth you consistently hear?

Ginny Funk: 58:27

Oh gosh. It's just old people, old people and everybody, everybody gets dementia, everybody gets Alzheimer's, old people do, it's just part of aging.

Sondra Ziegler: 58:39

That's right. If we've heard one thing today, if you're listening to that, to this know that the changes we're talking about are brain, their brain function changes. They're not just simple forgetting of simple facts. Okay, so what's one thing every caregiver should hear?

Ginny Funk: 59:01

That you're not alone. You do not have to go through this process alone. This is, I mean, I'm biased because I I now both parents. You don't have to do this by yourself. There's a lot of support available.

Ginny Funk: 59:18

We have a lot of suggestions and tips and just how do you get through the day if it's Alzheimer's and dementia? How do you get through the day? All the millions of difficult things that come up, we can help with that. We can help give suggestions. Have you tried this?

Ginny Funk: 59:36

Have you tried that? You do not have to do this alone just like you wouldn't with any other disease. These this is a disease. You can't see it, but it's a disease wreaking havoc. And there's a lot of things we can do to to just have it not be quite so difficult as we know that it is.

Sondra Ziegler: 59:58

That is so good. And last question, what's the most hopeful thing you've seen recently about Alzheimer's?

Ginny Funk: 01:00:08

I have to say treatments, you know, that that in all this time, this disease has been around. There have been medications that treat symptoms, but now we actually have disease modifying treatments that are helping individuals and making a really big difference first time ever. It's like go back to when the first treatment ever for any, you know, different types of cancer came available. Oh my goodness, it is. It is incredible.

Ginny Funk: 01:00:42

And what that does, by the way, is it has opened the door for so much more now coming down the pipeline. Now that we do have two FDA approved treatments, it's it has truly opened the door for so much more to come. And, you know, like for all of us, we needed all of this yesterday, but now finally, there's so much more happening, so much more, and we need it desperately.

Sondra Ziegler: 01:01:10

Yes, we do. Well, Ginny, thank you so much for joining us today and helping us understand not only where Alzheimer's research stands today, but where it's headed. And for our listeners, if today's conversation has raised questions or concerns about memory changes in yourself or someone you love, I encourage you to reach out to the Alzheimer's Association, get informed, and seek support early. Seek an early diagnosis. It may be a scary conversation to have, but it's the most empowering thing you can do for your loved one.

Sondra Ziegler: 01:01:44

The science is moving faster than many people realize, and while we still have a lot of work ahead of us, there's more reason for hope today than there ever has been. So thank you for joining us for Second Half Conversations. We'll see you next time.

Sondra Ziegler: 01:01:59

A quick reminder that today's conversation is for educational purposes only. It is not meant to be legal advice because to give you legal advice, we need to meet with you and know your specific situation. Thanks again for joining us today for this conversation and remember to make the second half the best half.