1 00:00:05,120 --> 00:00:10,480 >> WELCOME TO TODAY'S FOCUS ON 2 00:00:10,480 --> 00:00:12,560 AGING FEDERAL PARTNERS WEBINAR 3 00:00:12,560 --> 00:00:13,440 SERIES WEBINAR. 4 00:00:13,440 --> 00:00:17,920 NEXT SLIDE PLEASE. 5 00:00:17,920 --> 00:00:20,120 OUR WEBINAR TODAY IS ENTITLED 6 00:00:20,120 --> 00:00:21,840 PROMOTING HEALTHY AGING TO 7 00:00:21,840 --> 00:00:25,600 REDUCE DEMENTIA RISK AS A NEW 8 00:00:25,600 --> 00:00:29,000 NATIONAL GOAL. 9 00:00:29,000 --> 00:00:29,960 IF YOU HAVE QUESTIONS TODAY THAT 10 00:00:29,960 --> 00:00:33,800 YOU WOULD LIKE TO SUBMIT TO HAVE 11 00:00:33,800 --> 00:00:35,000 THEM ANSWERED, PLEASE CLICK ON 12 00:00:35,000 --> 00:00:38,120 THE LIVE FEEDBACK BUTTON AS YOU 13 00:00:38,120 --> 00:00:39,600 SEE HERE ON THE SLIDE BESIDE 14 00:00:39,600 --> 00:00:41,960 THIS BIG YELLOW ARROW AT THE 15 00:00:41,960 --> 00:00:44,160 BOTTOM OF THE VIDEO CAST PAGE TO 16 00:00:44,160 --> 00:00:45,160 SUBMIT YOUR QUESTION. 17 00:00:45,160 --> 00:00:47,120 WE WILL TAKE ALL QUESTIONS AT 18 00:00:47,120 --> 00:00:49,400 THE END OF THE SESSION AND WE 19 00:00:49,400 --> 00:00:50,960 WILL DO OUR BEST TO GET LIEU AS 20 00:00:50,960 --> 00:00:53,680 MANY OF THOSE AS POSSIBLE IN 21 00:00:53,680 --> 00:00:54,480 ADDITION TO SOME OF THE 22 00:00:54,480 --> 00:00:56,360 QUESTIONS YOU HAVE SUBMITTED TO 23 00:00:56,360 --> 00:01:00,080 US IN ADVANCE. 24 00:01:00,080 --> 00:01:01,000 NEXT SLIDE. 25 00:01:01,000 --> 00:01:03,480 I'M DR. LISA MACGUIRE CENTERS 26 00:01:03,480 --> 00:01:04,760 FOR DISEASE CONTROL AND 27 00:01:04,760 --> 00:01:05,880 PREVENTION. 28 00:01:05,880 --> 00:01:07,760 I WILL SERVE AS YOUR MODERATOR 29 00:01:07,760 --> 00:01:08,240 TODAY. 30 00:01:08,240 --> 00:01:11,440 NEXT SLIDE. 31 00:01:11,440 --> 00:01:14,720 THE NATIONAL ALZHEIMER'S PLAN WE 32 00:01:14,720 --> 00:01:17,840 SEE OPT RIGHT HAND SIDE OF THE 33 00:01:17,840 --> 00:01:21,840 SCREEN HAS HAD UNTIL 2021 FIVE 34 00:01:21,840 --> 00:01:22,600 VERY AMBITIOUS GOALS. 35 00:01:22,600 --> 00:01:27,680 NEXT SLIDE PLEASE. 36 00:01:27,680 --> 00:01:31,480 IN 2020, THE ADVISORY COUNCIL 37 00:01:31,480 --> 00:01:33,200 ASKED MYSELF AS WELL AS MY 38 00:01:33,200 --> 00:01:36,120 COLLEAGUES TO FORM AN AD HOC 39 00:01:36,120 --> 00:01:37,640 SUBCOMMITTEE TO EXPLORE THE 40 00:01:37,640 --> 00:01:40,240 EVIDENCE ON RISK REDUCTION AND 41 00:01:40,240 --> 00:01:42,760 TO PRESENT OUR FINDINGS AND OUR 42 00:01:42,760 --> 00:01:44,280 OUTCOMES TO THE ADVISORY COUNCIL 43 00:01:44,280 --> 00:01:51,320 DURING THE JULY 2021 MEETING. 44 00:01:51,320 --> 00:01:54,080 I SERVE AS THE FEDERAL ADVISORY 45 00:01:54,080 --> 00:01:55,760 COUNCIL MEMBER TO LEAD THIS 46 00:01:55,760 --> 00:01:57,800 EFFORT AND I ENLISTED A COUPLE 47 00:01:57,800 --> 00:02:01,800 OF MY COLLEAGUES FROM OTHER 48 00:02:01,800 --> 00:02:02,560 ORGANIZATIONS. 49 00:02:02,560 --> 00:02:04,520 FIRST MATTHEW BOMB BART, VICE 50 00:02:04,520 --> 00:02:07,680 PRESIDENT OF HEALTH AND POLICY 51 00:02:07,680 --> 00:02:10,440 AT THE ALZHEIMER'S ASSOCIATION 52 00:02:10,440 --> 00:02:12,600 AND KELLY O'BRIEN, DIRECTOR OF 53 00:02:12,600 --> 00:02:15,440 BRAIN ECHO SYSTEMS AGAINST 54 00:02:15,440 --> 00:02:16,760 ALZHEIMER'S DISEASE TO SERVE AS 55 00:02:16,760 --> 00:02:17,040 CO-CHAIRS. 56 00:02:17,040 --> 00:02:19,280 WE IDENTIFIED EIGHT WORK GROUP 57 00:02:19,280 --> 00:02:20,400 CO-CHAIRS THAT I WILL SHOW YOU 58 00:02:20,400 --> 00:02:23,280 IN A SECOND AND WE COLLECTIVELY 59 00:02:23,280 --> 00:02:26,160 IDENTIFIED THE RISK FACTORS THAT 60 00:02:26,160 --> 00:02:29,200 WE WANTED TO EXAMINE AS WELL AS 61 00:02:29,200 --> 00:02:31,240 INVITED PEOPLE BASED ON THEIR 62 00:02:31,240 --> 00:02:32,880 EXPERTISE TO JOIN THIS WORK 63 00:02:32,880 --> 00:02:36,320 GROUP OR THESE WORK GROUPS. 64 00:02:36,320 --> 00:02:37,320 NEXT SLIDE PLEASE. 65 00:02:37,320 --> 00:02:39,480 THE FIRST WORK GROUP YOU SEE 66 00:02:39,480 --> 00:02:45,280 HERE WAS LED BY DR. JOSHUA C 67 00:02:45,280 --> 00:02:46,840 CHODES AND THEY LOOKED AT 68 00:02:46,840 --> 00:02:48,720 OBESITY DIET SLEEP AND TRAUMATIC 69 00:02:48,720 --> 00:02:50,360 BRAIN INJURY WITH A SERIES OF 70 00:02:50,360 --> 00:02:55,280 EXPERTS THEY INVITED. 71 00:02:55,280 --> 00:03:01,280 THE NEXT WORK GROUP WAS LED BY 72 00:03:01,280 --> 00:03:04,280 DR. LOUR RA WETSALL AND CAROLINA 73 00:03:04,280 --> 00:03:05,440 COATS AND THEY LOOK AT PHYSICAL 74 00:03:05,440 --> 00:03:07,840 ACTIVITY TOBACCO USE AND 75 00:03:07,840 --> 00:03:08,240 ALCOHOL. 76 00:03:08,240 --> 00:03:11,920 NEXT SLIDE PLEASE. 77 00:03:11,920 --> 00:03:15,120 THE THIRD WORK GROUP WAS LED 78 00:03:15,120 --> 00:03:17,720 BYE-BYE JOE CHUNG AND MARILYN 79 00:03:17,720 --> 00:03:19,720 ALBERT WHO LOOKED AT SOCIAL ICE 80 00:03:19,720 --> 00:03:20,560 LAKES, DEPRESSION HEARING LOSS 81 00:03:20,560 --> 00:03:22,720 AND COGNITIVE ACTIVITY. 82 00:03:22,720 --> 00:03:26,200 NEXT SLIDE PLEASE. 83 00:03:26,200 --> 00:03:29,880 THE FOURTH WORK GROUP WAS LED BY 84 00:03:29,880 --> 00:03:32,560 (INDISCERNIBLE) DR. REBECCA 85 00:03:32,560 --> 00:03:37,480 GOTTESMAN AND THEY LOOKED AT 86 00:03:37,480 --> 00:03:38,320 HYPERTENSION, HYPERLIPIDEMIA AND 87 00:03:38,320 --> 00:03:42,040 DIABETES. 88 00:03:42,040 --> 00:03:43,800 WHILE WE DON'T KNOW FOR CERTAIN 89 00:03:43,800 --> 00:03:45,640 WHAT IF ANYTHING CAN PREVENT 90 00:03:45,640 --> 00:03:46,560 ALZHEIMER'S DISEASE, WE DO KNOW 91 00:03:46,560 --> 00:03:48,480 THAT THERE'S SOME GOOD EVIDENCE 92 00:03:48,480 --> 00:03:50,480 TO SUGGEST THAT THERE ARE 93 00:03:50,480 --> 00:03:54,080 SEVERAL MODIFIABLE RISK FACTORS 94 00:03:54,080 --> 00:03:55,800 THAT MIGHT LOWER PERSON'S CHANCE 95 00:03:55,800 --> 00:03:58,080 IN DEVELOPING ALZHEIMER'S 96 00:03:58,080 --> 00:04:00,120 DISEASE OR DELAY ONSET WHILE 97 00:04:00,120 --> 00:04:02,880 PROMOTING HEALTHY AGING. 98 00:04:02,880 --> 00:04:05,200 THESE TEN RISK FACTORS WERE THE 99 00:04:05,200 --> 00:04:06,920 ONES IDENTIFYD BY OUR WORK GROUP 100 00:04:06,920 --> 00:04:12,880 MEMBERS IN OUR AD HOC ADVISORY 101 00:04:12,880 --> 00:04:14,120 COUNCIL MEETING HAVING EVIDENCE 102 00:04:14,120 --> 00:04:16,280 AS BEING IMPACTFUL AND BEING 103 00:04:16,280 --> 00:04:19,080 RIGHT FOR PUBLIC HEALTH 104 00:04:19,080 --> 00:04:23,120 INTERVENTION. 105 00:04:23,120 --> 00:04:25,800 THIS GRAPHIC SHOWS US THE 106 00:04:25,800 --> 00:04:28,000 DIFFERENT GOALS OF THE NATIONAL 107 00:04:28,000 --> 00:04:30,400 ALZHEIMER'S PROJECT ACT, THE 108 00:04:30,400 --> 00:04:33,680 NATIONAL PLAN, 2021 UPDATE, IT 109 00:04:33,680 --> 00:04:36,000 SHOWS US THE FIVE GOALS AND 110 00:04:36,000 --> 00:04:38,160 ADDITION OF SIX GOAL THAT WAS 111 00:04:38,160 --> 00:04:41,280 ADDED TO THE 2021 PLAN WHICH IS 112 00:04:41,280 --> 00:04:42,680 ACCELERATE ACTION TO PROMOTE 113 00:04:42,680 --> 00:04:46,920 HEALTHY AGING AND REDUCE RISK 114 00:04:46,920 --> 00:04:47,720 FACTORS FOR ALLS MYOMERE'S 115 00:04:47,720 --> 00:04:48,760 DISEASE AND PREVENTION. 116 00:04:48,760 --> 00:04:51,480 THIS GRAPHIC SHOWS US ON THE 117 00:04:51,480 --> 00:04:54,280 DISEASE TRAJECTORY OF 118 00:04:54,280 --> 00:04:55,400 ALZHEIMER'S DISEASE AND RELATED 119 00:04:55,400 --> 00:04:59,000 DEMENTIA WHERE THE RISK FACTORS 120 00:04:59,000 --> 00:04:59,160 LIE. 121 00:04:59,160 --> 00:05:03,920 IN JULY OF 2021, THE ADVISORY 122 00:05:03,920 --> 00:05:05,680 COUNCIL UNANIMOUSLY SUPPORTED 123 00:05:05,680 --> 00:05:09,720 THE ADDING OF A PERMANENT RISK 124 00:05:09,720 --> 00:05:11,200 REDUCTION SUBCOMMITTEE TO THE 125 00:05:11,200 --> 00:05:12,800 ADVISORY COUNCIL AS WELL AS NEW 126 00:05:12,800 --> 00:05:13,320 GOAL 6. 127 00:05:13,320 --> 00:05:15,720 THIS IS THE FIRST GOAL ADDED TO 128 00:05:15,720 --> 00:05:17,560 THE PLAN SINCE FORMATION IN 129 00:05:17,560 --> 00:05:22,840 2021. 130 00:05:22,840 --> 00:05:24,640 OUR WEBINAR WILL EXPLORE THE 131 00:05:24,640 --> 00:05:26,760 LATE eSCIENCE ADVANCES ON RISK 132 00:05:26,760 --> 00:05:27,720 REDUCTION AND IMPORTANCE OF 133 00:05:27,720 --> 00:05:29,880 INCLUSION OF RISK REDUCTION AS 134 00:05:29,880 --> 00:05:31,680 NATIONAL PRIORITY. 135 00:05:31,680 --> 00:05:32,960 PRESENTERS WILL SHARE ACTIONS 136 00:05:32,960 --> 00:05:34,480 THAT CAN BE TAKEN BY PUBLIC 137 00:05:34,480 --> 00:05:37,680 HEALTH PROFESSIONALS, HEALTHCARE 138 00:05:37,680 --> 00:05:40,080 PROVIDERS, AND COMMUNITY SERVICE 139 00:05:40,080 --> 00:05:40,680 ORGANIZATIONS. 140 00:05:40,680 --> 00:05:42,360 THE CROSS CUTTING THEME OF 141 00:05:42,360 --> 00:05:44,560 SOCIAL DETERMINANTS OF HEALTH 142 00:05:44,560 --> 00:05:46,240 WILL ALSO BE ADDRESSED IN EACH 143 00:05:46,240 --> 00:05:51,080 OF OUR PRESENTATIONS. 144 00:05:51,080 --> 00:05:52,880 I HAVE A GROUP OF AMAZING 145 00:05:52,880 --> 00:05:54,160 PRESENTERS THAT ARE GOING TO 146 00:05:54,160 --> 00:05:56,880 SPEAK TO YOU TODAY. 147 00:05:56,880 --> 00:05:59,160 OUR FIRST PRESENTERS DR. SHERRY, 148 00:05:59,160 --> 00:06:01,720 SHE'S THE DEPUTY ASSISTANT 149 00:06:01,720 --> 00:06:03,480 SECRETARY FOR BEHAVIORAL HEALTH 150 00:06:03,480 --> 00:06:05,160 DISABILITY AND AGING POLICY 151 00:06:05,160 --> 00:06:07,720 WITHIN THE OFFICE OF THE 152 00:06:07,720 --> 00:06:08,880 ASSISTANT SECRETARY FOR PLANNING 153 00:06:08,880 --> 00:06:15,080 AND EVALUATION OR ASPE AT U.S. 154 00:06:15,080 --> 00:06:15,880 DEPARTMENT OF HEALTH AND YUM 155 00:06:15,880 --> 00:06:16,240 SERVICES. 156 00:06:16,240 --> 00:06:18,520 WITHIN HER ROLE AT ASPE HER 157 00:06:18,520 --> 00:06:19,720 OFFICE OVERSEES THE 158 00:06:19,720 --> 00:06:21,800 IMPLEMENTATION OF THE NATIONAL 159 00:06:21,800 --> 00:06:24,920 ALZHEIMER'S PROJECT ACT AND 160 00:06:24,920 --> 00:06:25,760 COORDINATES POLICY DEVELOPMENT 161 00:06:25,760 --> 00:06:30,080 RELATED TO AGING AND DEMENTIA 162 00:06:30,080 --> 00:06:32,160 ACROSS HHS. 163 00:06:32,160 --> 00:06:34,640 OUR NEXT SPEAKER IS DR. LAURA 164 00:06:34,640 --> 00:06:36,440 BAKER. 165 00:06:36,440 --> 00:06:38,960 DR. BACKER IS PROFESSOR OF 166 00:06:38,960 --> 00:06:40,280 INTERNAL MEDICINE NEUROLOGY AND 167 00:06:40,280 --> 00:06:41,720 PUBLIC HEALTH SERVICES AND 168 00:06:41,720 --> 00:06:43,080 ASSOCIATE DIRECTOR OF THE WAKE 169 00:06:43,080 --> 00:06:44,680 FOREST ALZHEIMER'S DISEASE 170 00:06:44,680 --> 00:06:46,840 RESEARCH CENTER. 171 00:06:46,840 --> 00:06:48,720 HER WORK FOCUSES ON COGNITIVE 172 00:06:48,720 --> 00:06:51,560 AGING AND NON-PHARMACOLOGICAL 173 00:06:51,560 --> 00:06:53,400 INTERVENTIONS TO PROTECT BRAIN 174 00:06:53,400 --> 00:06:55,440 HEALTH AND PREVENT COGNITIVE 175 00:06:55,440 --> 00:06:57,240 DECLINE, ALZHEIMER'S DISEASE AND 176 00:06:57,240 --> 00:06:58,760 OTHER DEMENTIAS. 177 00:06:58,760 --> 00:07:02,040 CURRENTLY SHE IS THE PI OR CO-PI 178 00:07:02,040 --> 00:07:04,680 OF FOUR LARGE NATIONAL CLINICAL 179 00:07:04,680 --> 00:07:06,480 SETTINGS THAT COLLECTIVELY 180 00:07:06,480 --> 00:07:13,880 ENROLLEENROLL NEARLY 10,000 OLDER ADULT 181 00:07:13,880 --> 00:07:17,160 PARTICIPANTS. 182 00:07:17,160 --> 00:07:21,120 OUR THIRD SPEAKER IS MR. MATTHEW 183 00:07:21,120 --> 00:07:23,720 BOMGART, VICE PRESIDENT OF 184 00:07:23,720 --> 00:07:25,160 PUBLIC POLICY ALZHEIMER'S 185 00:07:25,160 --> 00:07:29,920 ASSOCIATION LEADING A RANGE OF 186 00:07:29,920 --> 00:07:31,080 PROJECTS AT THE POLICY AND 187 00:07:31,080 --> 00:07:31,880 HEALTH PROGRAMS. 188 00:07:31,880 --> 00:07:33,480 HE HAS CENTER OF SELECTION ON 189 00:07:33,480 --> 00:07:35,280 DEMENTIA RISK REDUCTION FUNDED 190 00:07:35,280 --> 00:07:36,280 BY THE CDC. 191 00:07:36,280 --> 00:07:41,720 IN ADDITION, MR. BOMGART LEADS 192 00:07:41,720 --> 00:07:42,800 ASSOCIATION GLOBAL POLICY 193 00:07:42,800 --> 00:07:45,840 EFFORTS AND WORKS ON THE 194 00:07:45,840 --> 00:07:48,120 ASSOCIATIONS ECONOMIC DATA, 195 00:07:48,120 --> 00:07:49,680 ECONOMIC DATA AND MODELING 196 00:07:49,680 --> 00:07:50,080 PROJECTS. 197 00:07:50,080 --> 00:07:52,240 PRIOR TO JOINING THE ASSOCIATION 198 00:07:52,240 --> 00:07:55,000 HE SPENT NEARLY 20 YEARS WORKING 199 00:07:55,000 --> 00:07:57,800 IN THE U.S. SENATE. 200 00:07:57,800 --> 00:08:01,440 OUR NEXT SPEAKER, IS DR. 201 00:08:01,440 --> 00:08:02,480 ANN-MARIE NAVARRE. 202 00:08:02,480 --> 00:08:04,920 A PREVENTIVE CARDIOLOGIST IN 203 00:08:04,920 --> 00:08:06,760 ASSOCIATE PROFESSOR OF MEDICINE 204 00:08:06,760 --> 00:08:08,760 IN THE DIVISION OF CARDIOLOGY AT 205 00:08:08,760 --> 00:08:11,640 THE UNIVERSITY OF TEXAS SOUTH 206 00:08:11,640 --> 00:08:12,840 WESTERN MEDICAL CENTER. 207 00:08:12,840 --> 00:08:15,520 HER RESEARCH FOCUSES ON BLOOD 208 00:08:15,520 --> 00:08:17,360 PRESSURE AND CHOLESTEROL 209 00:08:17,360 --> 00:08:18,880 LOWERING FOR CARDIOVASCULAR 210 00:08:18,880 --> 00:08:20,040 DISEASE PREVENTION. 211 00:08:20,040 --> 00:08:24,880 SHE IS A DEPUTY EDITOR AT THE 212 00:08:24,880 --> 00:08:26,400 JAMA CARDIOLOGY AND BOARD MEMBER 213 00:08:26,400 --> 00:08:29,080 OF THE AMERICAN SOCIETY OF 214 00:08:29,080 --> 00:08:33,320 PREVENTATIVE CARDIOLOGY. 215 00:08:33,320 --> 00:08:35,000 MR. DONALD SMITH PRIOR TO 216 00:08:35,000 --> 00:08:37,880 JOINING TEXAS HEALTHY AGING AT 217 00:08:37,880 --> 00:08:39,840 HOME AS CEO, HE WAS EMPLOYED AS 218 00:08:39,840 --> 00:08:44,080 THE EXECUTIVE DIRECTOR OF THE 219 00:08:44,080 --> 00:08:47,080 TARROT COUNTY AREA AGENCY ON 220 00:08:47,080 --> 00:08:49,400 AGING, OUTED WAY OF TEAR RANT 221 00:08:49,400 --> 00:08:53,840 COUNTY, IN FORT WORTH TEXAS FOR 222 00:08:53,840 --> 00:08:55,520 15 YEARS, DEGREES IN GERONTOLOGY 223 00:08:55,520 --> 00:08:57,760 AND URBAN AFFAIRS AND 35 YEARS 224 00:08:57,760 --> 00:08:58,600 EXPERIENCE WORKING IN HEALTH 225 00:08:58,600 --> 00:09:01,600 HUMAN SERVICE AND GOVERNMENTAL 226 00:09:01,600 --> 00:09:03,440 ORGANIZATIONS IN FOUR AREA 227 00:09:03,440 --> 00:09:07,080 AGENCIES ON AGING. 228 00:09:07,080 --> 00:09:08,080 NOW, NEXT SLIDE PLEASE. 229 00:09:08,080 --> 00:09:11,720 WE WILL THEN FOLLOW WITH A Q&A 230 00:09:11,720 --> 00:09:12,600 SECTION. 231 00:09:12,600 --> 00:09:14,040 HERE IS A LIST OF SOME RESOURCES 232 00:09:14,040 --> 00:09:16,480 AND I THINK MANY PRESENTERS HAVE 233 00:09:16,480 --> 00:09:18,680 ALSO LIST OF RESOURCES THAT THEY 234 00:09:18,680 --> 00:09:22,240 HAVE INCLUDED IN THEIR 235 00:09:22,240 --> 00:09:25,280 PRESENTATION. 236 00:09:25,280 --> 00:09:26,800 BEFORE WE START WITH THE 237 00:09:26,800 --> 00:09:29,160 PRESENTATIONS, I WANT TO THANK 238 00:09:29,160 --> 00:09:31,880 THE PLANNING ECONOMY OF -- 239 00:09:31,880 --> 00:09:36,240 COMMITTEE, OF THIS SESSION, DR. 240 00:09:36,240 --> 00:09:38,880 HELEN WATTS, DR. TOMOS, A AND 241 00:09:38,880 --> 00:09:39,880 AARON LONG AND NATIONAL 242 00:09:39,880 --> 00:09:41,880 INSTITUTE ON AGING, ELIZABETH 243 00:09:41,880 --> 00:09:44,440 PICKETT GRAY SON DONLY AND NIA 244 00:09:44,440 --> 00:09:45,880 TECHNOLOGICAL SUPPORT. 245 00:09:45,880 --> 00:09:49,480 I ALSO WANT TO THANK EVA JEFFERS 246 00:09:49,480 --> 00:09:51,240 A FELLOW AT CDC FOR HER 247 00:09:51,240 --> 00:09:53,680 SIGNIFICANT INVOLVEMENT IN THE 248 00:09:53,680 --> 00:09:55,040 DEVELOPMENT OF GOAL 6. 249 00:09:55,040 --> 00:09:55,800 NEXT SLIDE. 250 00:09:55,800 --> 00:09:58,480 I'M GOING TO TURN IT OVER TO OUR 251 00:09:58,480 --> 00:09:59,200 NEXT SPEAKER. 252 00:09:59,200 --> 00:10:06,280 DR. TISA MARIE SHERRY. 253 00:10:06,280 --> 00:10:08,840 >> THANK YOU SO MUCH DR. 254 00:10:08,840 --> 00:10:09,520 MACGUIRE. 255 00:10:09,520 --> 00:10:12,120 MANY THANKS TO ALL OF YOU FOR 256 00:10:12,120 --> 00:10:13,080 HAVING US HERE. 257 00:10:13,080 --> 00:10:15,640 AS DR. MACGUIRE MENTIONED, I'M 258 00:10:15,640 --> 00:10:17,080 DEPUTY ASSISTANT SECRETARY FOR 259 00:10:17,080 --> 00:10:19,280 BEHAVIORAL HEALTH DISABILITY AND 260 00:10:19,280 --> 00:10:21,880 AGING POLICY IN ASPE AT HHS. 261 00:10:21,880 --> 00:10:23,680 IT IS MY PLEASURE TODAY TO BUILD 262 00:10:23,680 --> 00:10:25,760 ON THE WONDERFUL BACKGROUND THAT 263 00:10:25,760 --> 00:10:28,080 DR. MACGUIRE SHARED ABOUT 2021 264 00:10:28,080 --> 00:10:30,280 NATIONAL PLAN TO ADDRESS 265 00:10:30,280 --> 00:10:31,320 ALZHEIMER'S DISEASE AND OUR NEW 266 00:10:31,320 --> 00:10:38,840 RISK REDUCTION GOAL. 267 00:10:38,840 --> 00:10:44,520 SO SORRY I ADVANCED QUICKLY. 268 00:10:44,520 --> 00:10:47,080 SO THE NATIONAL PLAN TO ADDRESS 269 00:10:47,080 --> 00:10:47,680 ALZHEIMER'S DISEASE WAS 270 00:10:47,680 --> 00:10:49,240 ESTABLISHED BY THE NATIONAL 271 00:10:49,240 --> 00:10:51,680 ALZHEIMER'S PROJECT ACT OR NAPA, 272 00:10:51,680 --> 00:10:53,800 PASSED IN 2011. 273 00:10:53,800 --> 00:10:55,080 NATURAL PLAN DESCRIBES THE WORK 274 00:10:55,080 --> 00:10:58,040 THAT IS UNDERTAKEN BY HHS 275 00:10:58,040 --> 00:10:59,240 AGENCIES AND SELECT FEDERAL 276 00:10:59,240 --> 00:11:00,280 PARTNERS INCLUDING THE 277 00:11:00,280 --> 00:11:02,080 DEPARTMENT OF DEFENSE, 278 00:11:02,080 --> 00:11:03,280 DEPARTMENT OF VETERANS AFFAIRS 279 00:11:03,280 --> 00:11:05,160 AND NATIONAL SCIENCE FOUNDATION, 280 00:11:05,160 --> 00:11:07,080 TO ADVANCE RESEARCH PUBLIC 281 00:11:07,080 --> 00:11:08,280 UNDERSTANDING AND EFFECTIVE 282 00:11:08,280 --> 00:11:09,960 CLINICAL INTERVENTIONS AND OTHER 283 00:11:09,960 --> 00:11:12,760 SERVICES AND SUPPORTS TARGETING 284 00:11:12,760 --> 00:11:15,680 ALZHEIMER'S DISEASE AND RELATED 285 00:11:15,680 --> 00:11:15,920 DEMENTIAS. 286 00:11:15,920 --> 00:11:16,960 NAPA ESTABLISHED AN ADVISORY 287 00:11:16,960 --> 00:11:18,640 COUNCIL TO REVIEW AND COMMENT ON 288 00:11:18,640 --> 00:11:20,160 THE NATIONAL PLAN AND ITS 289 00:11:20,160 --> 00:11:21,880 IMPLEMENTATION AND TO MAKE 290 00:11:21,880 --> 00:11:24,040 ANNUAL RECOMMENDATIONS TO THE 291 00:11:24,040 --> 00:11:25,600 SECRETARY OF HEALTH AND HUMAN 292 00:11:25,600 --> 00:11:26,760 SERVICES AND TO CONGRESS ON 293 00:11:26,760 --> 00:11:29,760 PRIORITY ACTIONS. 294 00:11:29,760 --> 00:11:30,800 IMPORTANTLY THE ADVISORY COUNCIL 295 00:11:30,800 --> 00:11:32,680 INCLUDES BOTH FEDERAL AND PUBLIC 296 00:11:32,680 --> 00:11:34,200 MEMBERS TO ENSURE THAT THE 297 00:11:34,200 --> 00:11:36,080 NATIONAL PLAN IS INFORMED BY 298 00:11:36,080 --> 00:11:43,480 BROAD STAKEHOLDER PERSPECTIVES. 299 00:11:43,480 --> 00:11:45,480 WHEN IT WAS ESTABLISHED THE PLAN 300 00:11:45,480 --> 00:11:48,360 HAD FIVE AMBITIOUS GOALS. 301 00:11:48,360 --> 00:11:50,280 GOAL 1, STRATEGIES TO IDENTIFY 302 00:11:50,280 --> 00:11:54,320 AND EXPAND RESEARCH ON ALZHEIMER 303 00:11:54,320 --> 00:11:55,400 EAST DISEASE. 304 00:11:55,400 --> 00:11:56,640 GOAL 2 INCLUDE STRATEGIES TO 305 00:11:56,640 --> 00:11:59,080 IMPROVE CLINICAL CARE, 3, 306 00:11:59,080 --> 00:12:00,080 STRENGTHEN LONG TERM CARE AND 307 00:12:00,080 --> 00:12:01,760 CARE GIVING FOR PEOPLE WITH 308 00:12:01,760 --> 00:12:02,320 ALZHEIMER'S DISEASE. 309 00:12:02,320 --> 00:12:03,680 4 INCLUDES STRATEGIES TO EDUCATE 310 00:12:03,680 --> 00:12:06,240 THE PUBLIC ABOUT ALZHEIMER'S 311 00:12:06,240 --> 00:12:07,480 DISEASE AND GOAL 5 INCLUDES 312 00:12:07,480 --> 00:12:09,120 STRATEGIES TO ENHANCE FEDERAL 313 00:12:09,120 --> 00:12:10,720 GOVERNMENT ABILITY TO TRACK 314 00:12:10,720 --> 00:12:11,600 PROGRESS ON NATIONAL PLAN. 315 00:12:11,600 --> 00:12:23,080 A IN 2020 THE COUNCIL 316 00:12:23,080 --> 00:12:24,920 BEGAN TO CONSIDER THE 317 00:12:24,920 --> 00:12:26,680 POSSIBILITY OF SIX GOAL FOCUSED 318 00:12:26,680 --> 00:12:28,600 ON DEMENTIA RISK REDUCTION. 319 00:12:28,600 --> 00:12:30,080 ONE CONSIDER A RISK REDUCTION 320 00:12:30,080 --> 00:12:30,520 GOAL. 321 00:12:30,520 --> 00:12:31,920 WHILE NOT YET IDENTIFIED 322 00:12:31,920 --> 00:12:33,080 EFFECTIVE INTERVENTIONS TO 323 00:12:33,080 --> 00:12:36,240 PREVENT PEOPLE FROM GETTING 324 00:12:36,240 --> 00:12:36,880 DEMENTIA ALTOGETHER WE HAVE BEEN 325 00:12:36,880 --> 00:12:38,400 LEARN MORGUE ABOUT RISK FACTORS 326 00:12:38,400 --> 00:12:39,920 FOR DEMENTIA AND WAYS TO REDUCE 327 00:12:39,920 --> 00:12:41,960 THE CHANCES OF DEVELOPING THIS 328 00:12:41,960 --> 00:12:44,480 DISEASE BY ADDRESSING RISK 329 00:12:44,480 --> 00:12:45,640 FACTORS, IN PARTICULAR THERE'S 330 00:12:45,640 --> 00:12:47,080 GROWING EVIDENCE THAT 331 00:12:47,080 --> 00:12:47,880 EFFECTIVELY MANAGING 332 00:12:47,880 --> 00:12:48,840 HYPERTENSION AND BEING MORE 333 00:12:48,840 --> 00:12:50,400 PHYSICALLY AND COGNITIVELY 334 00:12:50,400 --> 00:12:53,600 ACTIVE MAY REDUCE THE RISK OF 335 00:12:53,600 --> 00:12:54,680 DEVELOPING DEMENTIA. 336 00:12:54,680 --> 00:12:56,880 MORE STUDIES UNDERWAY TO 337 00:12:56,880 --> 00:12:58,360 INVESTIGATE HOW RISK OF DEMENTIA 338 00:12:58,360 --> 00:12:59,480 CHANGES WHEN WE ADDRESS OTHER 339 00:12:59,480 --> 00:13:02,680 RISK FACTORS LIKE DIABETES 340 00:13:02,680 --> 00:13:03,680 INADEQUATE SLEEP, POOR 341 00:13:03,680 --> 00:13:04,680 NUTRITION, DEPRESSION, SUBSTANCE 342 00:13:04,680 --> 00:13:06,480 USE DISORDERS, HEARING 343 00:13:06,480 --> 00:13:08,120 DIFFICULTIES AND POOR DENTAL 344 00:13:08,120 --> 00:13:08,680 HEALTH. 345 00:13:08,680 --> 00:13:11,520 IN FALL 2021 AS DR. MACGUIRE 346 00:13:11,520 --> 00:13:12,760 MENTIONED BASED ONLY GROWING 347 00:13:12,760 --> 00:13:14,080 RESEARCH LITERATURE ON RISK 348 00:13:14,080 --> 00:13:15,920 REDUCTION THE ADVISORY COUNCIL 349 00:13:15,920 --> 00:13:17,480 AGREED ENOUGH POSITIVE EVIDENCE 350 00:13:17,480 --> 00:13:19,160 TO WARRANT BROADER MORE 351 00:13:19,160 --> 00:13:21,200 DELIBERATE EFFORTS BY HHS TO 352 00:13:21,200 --> 00:13:22,440 ADDRESS RISK FACTORS FOR 353 00:13:22,440 --> 00:13:25,520 DEMENTIA. 354 00:13:25,520 --> 00:13:28,200 SO IN DECEMBER HHS ADDED A 6TH 355 00:13:28,200 --> 00:13:30,640 GOAL TO THE NATIONAL PLAN. 356 00:13:30,640 --> 00:13:32,560 TO ACCELERATE ACTION AND PROMET 357 00:13:32,560 --> 00:13:35,280 HEALTHY AGING TO REDUCE RISK 358 00:13:35,280 --> 00:13:36,040 FACTORS FOR ALZHEIMER'S DISEASE 359 00:13:36,040 --> 00:13:37,520 AND RELATED DEMENTIAS. 360 00:13:37,520 --> 00:13:39,080 AS THIS DIAGRAM FROM THE 361 00:13:39,080 --> 00:13:41,120 NATIONAL PLAN SHOWS, COMPARE TO 362 00:13:41,120 --> 00:13:42,880 PREVIOUS GOALS, THE NEW GOAL 363 00:13:42,880 --> 00:13:44,120 PRIMARILY TARGETS INDIVIDUALS 364 00:13:44,120 --> 00:13:46,800 WHO DO NOT YET HAVE ANY SYMPTOMS 365 00:13:46,800 --> 00:13:49,840 OF DEMENTIA BUT MAYBE ELEVATED 366 00:13:49,840 --> 00:13:55,080 RISK. 367 00:13:55,080 --> 00:13:56,960 EVIDENCE ON RISK FACTORS FOR 368 00:13:56,960 --> 00:13:58,320 ALZHEIMER'S DISEASE IS GROWING 369 00:13:58,320 --> 00:13:59,480 AND STILL EVOLVING. 370 00:13:59,480 --> 00:14:01,680 AS IS EVIDENCE ON THE IMPACTS OF 371 00:14:01,680 --> 00:14:04,920 INTERVENTIONS THAT TARGET RISK 372 00:14:04,920 --> 00:14:05,160 FACTORS. 373 00:14:05,160 --> 00:14:05,800 STILL DEPARTMENT OF HEALTH AND 374 00:14:05,800 --> 00:14:07,840 HUMAN SERVICES DECIDED TO ADD 375 00:14:07,840 --> 00:14:09,680 THIS NEW GOAL FOR SEVERAL 376 00:14:09,680 --> 00:14:10,040 REASONS. 377 00:14:10,040 --> 00:14:11,680 FIRST HEALTHY AGING IS A KEY 378 00:14:11,680 --> 00:14:13,560 PRIORITY FOR THE DEPARTMENT. 379 00:14:13,560 --> 00:14:14,920 AND ADDRESSING THE RISK FACTORS 380 00:14:14,920 --> 00:14:16,920 FOR DEMENTIA ALIGNS WITH 381 00:14:16,920 --> 00:14:18,280 PROMOTING BRAIN HEALTH AND 382 00:14:18,280 --> 00:14:19,800 HEALTHIER AGING OVERALL. 383 00:14:19,800 --> 00:14:21,280 THERE ARE NO APPARENT DOWN SIDES 384 00:14:21,280 --> 00:14:25,040 TO ADDRESSING RISK FACTORS BY 385 00:14:25,040 --> 00:14:26,240 IDENTIFYING MANAGING CHRONIC 386 00:14:26,240 --> 00:14:27,760 CONDITIONS OR PROMOTING IMPROVED 387 00:14:27,760 --> 00:14:28,920 NUTRITION AND INCREASE PHYSICAL 388 00:14:28,920 --> 00:14:29,960 ACTIVITY, THESE ARE THINGS WE 389 00:14:29,960 --> 00:14:32,640 WANT TO DO ANYWAYS. 390 00:14:32,640 --> 00:14:35,360 AS THE EVIDENCE BASE ON RISK 391 00:14:35,360 --> 00:14:35,960 REDUCTION GROWS WE WANT TO BE 392 00:14:35,960 --> 00:14:37,360 ABLE TO TRANSLATE OUR FINDINGS 393 00:14:37,360 --> 00:14:39,600 INTO EFFECTIVE RISK REDUCTION 394 00:14:39,600 --> 00:14:41,280 INTERVENTION AS QUICK AS 395 00:14:41,280 --> 00:14:41,840 POSSIBLE. 396 00:14:41,840 --> 00:14:44,480 THROUGH THIS NEW GOAL, WE WILL 397 00:14:44,480 --> 00:14:46,440 BUILD INFRASTRUCTURE WE NEED TO 398 00:14:46,440 --> 00:14:48,320 IDENTIFY AND RESEARCH RISK 399 00:14:48,320 --> 00:14:49,080 REDUCTION INTERVENTION AND 400 00:14:49,080 --> 00:14:50,640 TRANSLATE THOSE INTERVENTION TO 401 00:14:50,640 --> 00:14:53,240 HEALTHCARE AND PUBLIC HEALTH 402 00:14:53,240 --> 00:14:54,400 PRACTICES AS QUICKLY AS 403 00:14:54,400 --> 00:14:55,120 POSSIBLE. 404 00:14:55,120 --> 00:14:57,160 THE THIRD REASON RELATES TO 405 00:14:57,160 --> 00:14:59,360 ACHIEVING HEALTH EQUITY WHICH IS 406 00:14:59,360 --> 00:15:01,360 AMONG HHS HIGHEST PRIORITIES. 407 00:15:01,360 --> 00:15:02,480 THE CHANCE OF DEVELOPING 408 00:15:02,480 --> 00:15:03,680 ALZHEIMER'S DISEASE AN RELATED 409 00:15:03,680 --> 00:15:04,760 DEMENTIA IS NOT EQUAL. 410 00:15:04,760 --> 00:15:07,280 BLACK AND LATINO KNOW AMERICANS 411 00:15:07,280 --> 00:15:08,840 ARE MORE LIKELY TO DEVELOP THE 412 00:15:08,840 --> 00:15:09,800 CONDITION AS ARE WOMEN AND 413 00:15:09,800 --> 00:15:11,440 PEOPLE WITH CHRONIC DISEASES. 414 00:15:11,440 --> 00:15:12,800 AND THESE DISPARITIES ARE 415 00:15:12,800 --> 00:15:15,480 PROJECTED TO WIDEN OVER TIME. 416 00:15:15,480 --> 00:15:17,240 THERE IS ALSO EVIDENCE 417 00:15:17,240 --> 00:15:18,480 COMMUNITIES OF COLOR EXPERIENCE 418 00:15:18,480 --> 00:15:20,280 INEQUITIES AT EVERY STAGE OF 419 00:15:20,280 --> 00:15:20,880 DEMENTIA CARE. 420 00:15:20,880 --> 00:15:23,800 BLACK LATINO AND NATIVE AMERICAN 421 00:15:23,800 --> 00:15:25,040 POPULATIONS LESS LIKELY TO 422 00:15:25,040 --> 00:15:27,240 RECEIVE A TIMELY DIAGNOSIS OF 423 00:15:27,240 --> 00:15:29,160 DEMENTIA, LESS LIKELY TO RECEIVE 424 00:15:29,160 --> 00:15:29,960 EVIDENCE BASED TREATMENT AND 425 00:15:29,960 --> 00:15:31,200 HAVE MORE DIFFICULTY ACCESSING 426 00:15:31,200 --> 00:15:33,480 LONG TERM CARE AND SUPPORTS. 427 00:15:33,480 --> 00:15:35,400 AS A RESULT EQUITY IN ADDRESSING 428 00:15:35,400 --> 00:15:36,920 INTERRELATED SOCIAL DETERMINANTS 429 00:15:36,920 --> 00:15:38,600 OF HEALTH ARE CORE PRINCIPLES OF 430 00:15:38,600 --> 00:15:40,160 THE NATIONAL AND LONG BEEN 431 00:15:40,160 --> 00:15:41,520 REFLECTED IN ACTIVITIES UNDER 432 00:15:41,520 --> 00:15:43,520 ALL THE PLAN GOALS. 433 00:15:43,520 --> 00:15:45,440 BUT KNOWING THE COMPREHENSIVELY 434 00:15:45,440 --> 00:15:47,560 ADDRESS INEQUITIES IN DEMENTIA, 435 00:15:47,560 --> 00:15:51,880 AND IN PARTICULAR, THE BURDEN 436 00:15:51,880 --> 00:15:53,680 PLACED ON BLACK LATINO AND 437 00:15:53,680 --> 00:15:55,240 NATIVE AMERICAN COMMUNITIES, WE 438 00:15:55,240 --> 00:15:56,760 HAVE TO ALSO ADDRESS THE RISK 439 00:15:56,760 --> 00:15:58,200 FACTORS THAT LEAD TO A HIGHER 440 00:15:58,200 --> 00:16:00,280 PREVALENCE OF DEMENTIA IN THESE 441 00:16:00,280 --> 00:16:02,200 COMMUNITIES IN THE FIRST PLACE. 442 00:16:02,200 --> 00:16:03,280 THAT'S ANOTHER REASON HHS FELT 443 00:16:03,280 --> 00:16:04,680 IT WAS IMPORTANT TO INCLUDE THIS 444 00:16:04,680 --> 00:16:06,480 NEW GOAL ON RISK REDUCTION AND 445 00:16:06,480 --> 00:16:09,360 TO EXPLICITLY EMPHASIZE 446 00:16:09,360 --> 00:16:11,800 ELIMINATING DISPARITIES AND RISK 447 00:16:11,800 --> 00:16:12,040 FACTORS. 448 00:16:12,040 --> 00:16:13,880 BLACK LATINO AND NATIVE AMERICAN 449 00:16:13,880 --> 00:16:15,080 POPULATIONS EXPERIENCE HIGHER 450 00:16:15,080 --> 00:16:17,520 BURDEN OF RISK FACTORS FOR 451 00:16:17,520 --> 00:16:18,880 DEMENTIA AND GREATER DIFFICULTY 452 00:16:18,880 --> 00:16:21,280 ACCESSING HEALTHCARE TO ADDRESS 453 00:16:21,280 --> 00:16:22,640 THESE RISK FACTORS. THESE 454 00:16:22,640 --> 00:16:23,960 DIFFERENCES IN BURDEN OF RISK 455 00:16:23,960 --> 00:16:24,480 FACTORS CONTRIBUTE TO 456 00:16:24,480 --> 00:16:26,440 DIFFERENCES IN THE INCIDENCE OF 457 00:16:26,440 --> 00:16:28,800 DEMENTIA IN THESE COMMUNITIES. 458 00:16:28,800 --> 00:16:31,440 FOURTH AND FINALLY, HHS 459 00:16:31,440 --> 00:16:33,080 RECOGNIZES THAT MANY OF THESE 460 00:16:33,080 --> 00:16:35,000 RISK FACTORS ARE EITHER CAUSED 461 00:16:35,000 --> 00:16:38,400 BY OR EXACERBATED BY SYSTEMIC 462 00:16:38,400 --> 00:16:39,520 COMMUNITY AND STRUCTURAL 463 00:16:39,520 --> 00:16:41,120 INEQUITIES. 464 00:16:41,120 --> 00:16:42,920 SO THIS NEW 6TH GOAL PROVIDES AN 465 00:16:42,920 --> 00:16:44,680 OPPORTUNITY TO ADDRESS NOT JUST 466 00:16:44,680 --> 00:16:46,200 WHAT INDIVIDUALS CAN DO TO 467 00:16:46,200 --> 00:16:47,400 PROTECT THEIR BRAIN HEALTH BUT 468 00:16:47,400 --> 00:16:49,800 ALSO TO CREATE COMMUNITIES AND 469 00:16:49,800 --> 00:16:50,680 INSTITUTIONS THAT SUPPORT 470 00:16:50,680 --> 00:16:52,480 HEALTHY AGING FOR EVERYONE AND 471 00:16:52,480 --> 00:16:54,080 THAT MAKE IT EASIER FOR PEOPLE 472 00:16:54,080 --> 00:17:00,400 TO MAKE THESE CHANGES. 473 00:17:00,400 --> 00:17:05,480 D THESE ARE REFLECTED IN 474 00:17:05,480 --> 00:17:07,520 EACH STRATEGY UNDER THE GOAL. 475 00:17:07,520 --> 00:17:08,880 6A WILL SUPPORT RESEARCH THAT 476 00:17:08,880 --> 00:17:09,800 ENHANCE UNDERSTANDING OF 477 00:17:09,800 --> 00:17:12,080 DEMENTIA RISK FACTORS AND THE 478 00:17:12,080 --> 00:17:13,200 IMPACTS OF INTERVENTIONS THAT 479 00:17:13,200 --> 00:17:15,480 ADDRESS RISK FACTORS. 480 00:17:15,480 --> 00:17:16,920 STRATEGY 6B WILL RAPIDLY 481 00:17:16,920 --> 00:17:19,960 TRANSLATE RESEARCH FINDINGS INTO 482 00:17:19,960 --> 00:17:21,360 CLINICAL PRACTICE, STRATEGY 6C 483 00:17:21,360 --> 00:17:24,080 INTO PUBLIC HEALTH ACTION AND 484 00:17:24,080 --> 00:17:25,720 STRATEGY 6D INTO INTERVENTIONS 485 00:17:25,720 --> 00:17:27,960 THROUGH AGING NETWORK. 486 00:17:27,960 --> 00:17:29,160 STRATEGY 6E WILL ADDRESS 487 00:17:29,160 --> 00:17:31,280 INEQUITIES IN RISK FACTORS AND 488 00:17:31,280 --> 00:17:33,160 FINALLY THROUGH STRATEGY 6F WE 489 00:17:33,160 --> 00:17:35,560 WILL WORK TO EDUCATE AND ENGAGE 490 00:17:35,560 --> 00:17:36,880 THE PUBLIC AT LARGE ABOUT WAYS 491 00:17:36,880 --> 00:17:39,600 TO REDUCE RISK FACTORS FOR 492 00:17:39,600 --> 00:17:40,280 ALZHEIMER'S DISEASE AND RELATED 493 00:17:40,280 --> 00:17:44,920 DYSTROPHIES. 494 00:17:44,920 --> 00:17:45,680 DEMENTIA. 495 00:17:45,680 --> 00:17:48,720 I WILL SHARE EXAMPLES TO GIVE 496 00:17:48,720 --> 00:17:50,360 YOU CONCRETE ACTION STEPS WE ARE 497 00:17:50,360 --> 00:17:52,680 PURSUING UNDER THE REDUCTION 498 00:17:52,680 --> 00:17:53,800 GOAL. 499 00:17:53,800 --> 00:17:55,920 IS 6A EXPAND RESEARCH ON RISK 500 00:17:55,920 --> 00:17:57,120 FACTORS THE NATIONAL INSTITUTE 501 00:17:57,120 --> 00:17:59,120 ON AGING AND NEUROLOGIC DISEASE 502 00:17:59,120 --> 00:18:00,280 AND STROKE ARE SUPPORTING A 503 00:18:00,280 --> 00:18:02,680 NUMBER OF STUDIES THAT EXAMINE 504 00:18:02,680 --> 00:18:04,080 DIFFERENCES IN PREVALENCE OF 505 00:18:04,080 --> 00:18:05,720 DEMENTIA RISK FACTORS ACROSS 506 00:18:05,720 --> 00:18:07,080 DIFFERENT RACIAL AND ETHNIC 507 00:18:07,080 --> 00:18:08,920 GROUPS, AND THE IMPACT THESE 508 00:18:08,920 --> 00:18:11,160 DIFFERENTOR DIFFERENCE VERSUS ON 509 00:18:11,160 --> 00:18:12,040 DISPARITIES IN ALZHEIMER'S 510 00:18:12,040 --> 00:18:13,640 DISEASE AND RELATED DEMENTIA IN 511 00:18:13,640 --> 00:18:16,880 THESE POPULATIONS. UNDER 512 00:18:16,880 --> 00:18:18,480 STRATEGY 6B, TRANSLATE RESEARCH 513 00:18:18,480 --> 00:18:20,200 FINDINGS TO CLINICAL PRACTICE, 514 00:18:20,200 --> 00:18:22,360 HRSA IS USING GERIATRICS WORK 515 00:18:22,360 --> 00:18:24,600 FORCE EDUCATION PROGRAM TO 516 00:18:24,600 --> 00:18:26,040 DISSEMINATE CURRICULA TO TRAIN 517 00:18:26,040 --> 00:18:27,080 HEALTHCARE WORK FORCE IN 518 00:18:27,080 --> 00:18:29,600 ADDRESSING BRAIN HEALTH AND CDC 519 00:18:29,600 --> 00:18:30,200 SUPPORTED THE AMERICAN COLLEGE 520 00:18:30,200 --> 00:18:32,120 OF PREVENTIVE MEDICINE TO 521 00:18:32,120 --> 00:18:33,880 DEVELOP A BRAIN HEALTH 522 00:18:33,880 --> 00:18:34,680 CONTINUING EDUCATION AND 523 00:18:34,680 --> 00:18:36,120 RESOURCE WEBSITE TO INCREASE 524 00:18:36,120 --> 00:18:38,080 HEALTHCARE PROVIDERS AWARENESS 525 00:18:38,080 --> 00:18:39,080 OF BRAIN HEALTH. 526 00:18:39,080 --> 00:18:41,240 UNDER STRATEGY 6C TRANSLATE 527 00:18:41,240 --> 00:18:42,880 RESEARCH FINDINGS TO PUBLIC 528 00:18:42,880 --> 00:18:44,600 HEALTH PRACTICE, CDC IS 529 00:18:44,600 --> 00:18:46,280 CONVENING A NATIONAL SUMMIT ON 530 00:18:46,280 --> 00:18:48,880 RISK REDUCTION THIS YEAR. 531 00:18:48,880 --> 00:18:50,160 UNDER STRATEGY 6D TRANSLATE 532 00:18:50,160 --> 00:18:51,280 RESEARCH FINDINGS INTO 533 00:18:51,280 --> 00:18:52,600 INTERVENTIONS THROUGH THE AGING 534 00:18:52,600 --> 00:18:54,480 NETWORK, THE ADMINISTRATION ON 535 00:18:54,480 --> 00:18:55,640 COMMUNITY LIVING IS DELIVERING 536 00:18:55,640 --> 00:18:56,760 HEALTH AND WELLNESS PROGRAMS TO 537 00:18:56,760 --> 00:18:58,440 OLDER ADULTS THROUGH THEIR 538 00:18:58,440 --> 00:19:00,680 CAPACITY BUILDING AND 539 00:19:00,680 --> 00:19:02,280 SUSTAINABLE SYSTEMS INITIATIVE 540 00:19:02,280 --> 00:19:04,480 WITH SPECIAL FOCUS ON REACHING 541 00:19:04,480 --> 00:19:05,000 HISTORICALLY UNDERSERVED 542 00:19:05,000 --> 00:19:05,480 COMMUNITIES. 543 00:19:05,480 --> 00:19:08,680 AND UNDER STRATEGY 6F ENGAGE 544 00:19:08,680 --> 00:19:10,640 PUBLIC ON RISK REDUCTION IF 545 00:19:10,640 --> 00:19:12,160 NATIONAL INSTITUTE NEUROLOGIC 546 00:19:12,160 --> 00:19:13,240 DISEASE AND STROKE THROUGH MINE 547 00:19:13,240 --> 00:19:16,120 YOUR RISKS CAMPAIGN AN CDC 548 00:19:16,120 --> 00:19:17,560 THROUGH MILLION HEARTS KNISH 549 00:19:17,560 --> 00:19:19,120 FIEF SUPPORT PUBLIC AWARENESS 550 00:19:19,120 --> 00:19:20,600 CAMPAIGNS TO EDUCATE ABOUT THE 551 00:19:20,600 --> 00:19:22,600 LINK BETWEEN HIGH BLOOD PRESSURE 552 00:19:22,600 --> 00:19:27,000 AND DEMENTIA RISK. 553 00:19:27,000 --> 00:19:29,320 OUR NEXT STEPS, FIRST, WE ARE 554 00:19:29,320 --> 00:19:30,480 COMMITTED TO SUCCESSFULLY 555 00:19:30,480 --> 00:19:32,400 IMPLEMENTING ALL OF THE RISK 556 00:19:32,400 --> 00:19:33,640 REDUCTION ACTION STEPS 557 00:19:33,640 --> 00:19:35,600 IDENTIFIED IN THE 2021 PLAN 558 00:19:35,600 --> 00:19:39,440 UPDATE. AT THE SAME TIME WE 559 00:19:39,440 --> 00:19:40,520 VIEW THESE AS THE BEGINNING OF 560 00:19:40,520 --> 00:19:41,560 OUR EFFORTS ON RISK REDUCTION. 561 00:19:41,560 --> 00:19:43,640 OUR WORK IS NOT DONE. 562 00:19:43,640 --> 00:19:45,760 SO TO BUILD ON AND IMPROVE THE 563 00:19:45,760 --> 00:19:47,280 WORK THROUGH THE RISK REDUCTION 564 00:19:47,280 --> 00:19:49,160 SUBCOMMITTEE OF THE ADVISORY 565 00:19:49,160 --> 00:19:50,240 COUNCIL ON ALZHEIMER'S RESEARCH 566 00:19:50,240 --> 00:19:52,240 CARE AND SERVICES, WE WILL 567 00:19:52,240 --> 00:19:54,040 IDENTIFY ADDITIONAL 568 00:19:54,040 --> 00:19:55,360 OPPORTUNITIES TO ADVANCE THIS 569 00:19:55,360 --> 00:19:56,520 IMPORTANT AGENDA. 570 00:19:56,520 --> 00:19:58,480 THIS WILL INCLUDE CONNECTING 571 00:19:58,480 --> 00:19:59,800 WITH BROADER HEALTH PROMOTION 572 00:19:59,800 --> 00:20:01,680 AND DISEASE PREVENTION EFFORTS 573 00:20:01,680 --> 00:20:02,800 WITH RELEVANCE TO BRAIN HEALTH 574 00:20:02,800 --> 00:20:05,120 TO ENSURE WE ARE WORKING 575 00:20:05,120 --> 00:20:06,480 COLLABORATIVELY AND 576 00:20:06,480 --> 00:20:07,560 SYNERGISTICALLY TO SUPPORT 577 00:20:07,560 --> 00:20:08,080 HEALTHY AGING. 578 00:20:08,080 --> 00:20:09,720 AND AS DISCUSSED EARLIER, WE 579 00:20:09,720 --> 00:20:11,640 WANT TO CONTINUE TO FOCUS ON 580 00:20:11,640 --> 00:20:14,160 COMMUNITY RISK REDUCTION AND 581 00:20:14,160 --> 00:20:15,640 SUPPORTING INTERVENTIONS THAT 582 00:20:15,640 --> 00:20:17,760 HELP INDIVIDUALS TO MAKE HEALTHY 583 00:20:17,760 --> 00:20:19,520 CHANGES RATHER THAN PLACING THE 584 00:20:19,520 --> 00:20:22,280 ONUS ENTIRELY ON THEM 585 00:20:22,280 --> 00:20:24,200 PARTICULARLY IN A HEALTH SOCIAL 586 00:20:24,200 --> 00:20:25,680 SERVICES SYSTEM THAT CAN BE VERY 587 00:20:25,680 --> 00:20:28,560 CHALLENGING TO NAVIGATE. 588 00:20:28,560 --> 00:20:30,080 FINALLY, WE WANTS THIS TO BE A 589 00:20:30,080 --> 00:20:31,480 TRULY NATIONAL PLAN, NOT JUST A 590 00:20:31,480 --> 00:20:31,960 FEDERAL PLAN. 591 00:20:31,960 --> 00:20:33,680 SO WE ARE EAGER TO ENGAGE WITH 592 00:20:33,680 --> 00:20:36,080 STATE AND LOCAL GOVERNMENTS AND 593 00:20:36,080 --> 00:20:37,320 NON-GOVERNMENTAL ORGANIZATIONS 594 00:20:37,320 --> 00:20:38,920 TO UNDERSTAND HOW WE CAN WORK 595 00:20:38,920 --> 00:20:39,840 TOGETHER TO IMPLEMENT AND 596 00:20:39,840 --> 00:20:47,360 STRENGTHEN THE NATIONAL PLAN. 597 00:20:47,360 --> 00:20:49,560 I WANT TO RECOGNIZE MY ASPE 598 00:20:49,560 --> 00:20:50,960 COLLEAGUES WHO HAVE BEEN 599 00:20:50,960 --> 00:20:52,480 COORDINATING ALL THIS WORK, IN 600 00:20:52,480 --> 00:20:55,240 PARTICULAR LAUREN ANDERSON AND 601 00:20:55,240 --> 00:20:57,400 GAAP KENNEDY AND BILL MARTIN AND 602 00:20:57,400 --> 00:20:59,280 ESPECIALLY DR. HELEN LAMONT WHO 603 00:20:59,280 --> 00:21:00,480 FOR HER LEADERSHIP. 604 00:21:00,480 --> 00:21:02,560 I ALSO WANT TO THANK FEDERAL 605 00:21:02,560 --> 00:21:03,840 PARTNERS FOR DOING ACTUAL WORK 606 00:21:03,840 --> 00:21:05,720 OF IMPLEMENTING THIS REALLY 607 00:21:05,720 --> 00:21:09,560 AMBITIOUS STRATEGY. 608 00:21:09,560 --> 00:21:12,400 AND I WANT TO THANK SECRETARY 609 00:21:12,400 --> 00:21:15,640 BECERRA FOR HIS SUPPORT OF THIS 610 00:21:15,640 --> 00:21:16,880 INITIATIVE AS WELL AS REST OF 611 00:21:16,880 --> 00:21:18,800 HHS LEADER EPISHIP. 612 00:21:18,800 --> 00:21:19,720 FOR MORE INFORMATION I INCLUDED 613 00:21:19,720 --> 00:21:21,200 A LINK TO THE NATIONAL PLAN 614 00:21:21,200 --> 00:21:23,400 ITSELF IN THE 2021 UPDATE AS WE 615 00:21:23,400 --> 00:21:24,720 AS REPORTING OF STAKEHOLDER 616 00:21:24,720 --> 00:21:26,400 BRIEFING THAT WE DID WHICH 617 00:21:26,400 --> 00:21:27,720 ENGAGED A NUMBER OF OUR PARTNERS 618 00:21:27,720 --> 00:21:30,120 WHO ARE IMPLEMENTING THIS PLAN. 619 00:21:30,120 --> 00:21:31,680 WE BELIEVE THIS NEW GOAL 620 00:21:31,680 --> 00:21:33,480 REPRESENTS AN IMPORTANT STEP 621 00:21:33,480 --> 00:21:34,400 TOWARD EPIIMPROVING HEALTH 622 00:21:34,400 --> 00:21:35,920 OUTCOMES FOR OLDER AMERICAN AND 623 00:21:35,920 --> 00:21:37,400 WE ARE VERY EXCITED TO WORK WITH 624 00:21:37,400 --> 00:21:38,880 ALL OF YOU TO IMPLEMENT THIS 625 00:21:38,880 --> 00:21:40,680 BOLD VISION FOR HEALTHY AGING 626 00:21:40,680 --> 00:21:41,320 AND BRAIN HEALTH. 627 00:21:41,320 --> 00:21:42,640 THANK YOU. 628 00:21:42,640 --> 00:21:44,760 >> WE WILL TURN IT OVER TO DR. 629 00:21:44,760 --> 00:21:48,800 BAKER. 630 00:21:48,800 --> 00:21:50,560 >> THANK YOU EVERYONE FOR TAKING 631 00:21:50,560 --> 00:21:54,080 YOUR TIME TODAY TO JOIN US. 632 00:21:54,080 --> 00:21:57,440 MY JOB IS TO TAKE YOU THROUGH 633 00:21:57,440 --> 00:22:02,280 WHAT IT MIGHT MEAN TO LOOK AT A 634 00:22:02,280 --> 00:22:03,560 PARTICULAR RISK -- PARTICULAR 635 00:22:03,560 --> 00:22:06,440 ELEMENT OF -- THAT WE CAN CHANGE 636 00:22:06,440 --> 00:22:08,280 WHERE WE CAN MODIFY RISK AND 637 00:22:08,280 --> 00:22:12,840 TALK TO YOU ABOUT WHAT ARE THE 638 00:22:12,840 --> 00:22:13,760 STEPS FROM THE BEGINNING TO 639 00:22:13,760 --> 00:22:15,280 IDENTIFYING A RISK MODIFIER TO 640 00:22:15,280 --> 00:22:17,400 THE END OF PUSHING IT OUT AND 641 00:22:17,400 --> 00:22:18,280 HOPEFULLY CHANGING POLICY DOWN 642 00:22:18,280 --> 00:22:20,400 THE ROAD. 643 00:22:20,400 --> 00:22:21,840 SO MY PARTICULAR AREA NOW THAT I 644 00:22:21,840 --> 00:22:25,400 WILL FOCUS ON IS EXERCISE. 645 00:22:25,400 --> 00:22:28,760 SO FIRST OF ALL I'M GOING TO 646 00:22:28,760 --> 00:22:30,520 TALK TO YOU ABOUT HOW EXERCISE 647 00:22:30,520 --> 00:22:31,560 PHYSICAL ACTIVITY IN PARTICULAR 648 00:22:31,560 --> 00:22:34,240 IS GAINING MOMENTUM AS A 649 00:22:34,240 --> 00:22:36,720 THERAPEUTIC STRATEGY TO PROTECT 650 00:22:36,720 --> 00:22:38,280 BRAIN HEALTH AND REDUCE THE RISK 651 00:22:38,280 --> 00:22:39,880 FOR COGNITIVE DECLINE AND 652 00:22:39,880 --> 00:22:41,560 DEMENTIA. 653 00:22:41,560 --> 00:22:43,920 I'M ALSO GOING TO SHARE RESEARCH 654 00:22:43,920 --> 00:22:46,360 RESOURCES THAT ARE AVAILABLE TO 655 00:22:46,360 --> 00:22:49,720 TEST WHETHER EXERCISE MIGHT BE A 656 00:22:49,720 --> 00:22:52,760 POTENT RISK REDUCER FOR 657 00:22:52,760 --> 00:22:54,360 DEMENTIA. 658 00:22:54,360 --> 00:22:55,440 AND DESCRIBE SOME EVIDENCE 659 00:22:55,440 --> 00:22:57,680 SHOWING THAT EXERCISE MIGHT 660 00:22:57,680 --> 00:22:59,040 INDEED SERVE AS MEDICINE, COULD 661 00:22:59,040 --> 00:23:01,160 BE MEDICINE. 662 00:23:01,160 --> 00:23:03,520 WHAT ARE OUR OPTICALS SO FAR 663 00:23:03,520 --> 00:23:04,880 MAKING PROGRESS AND LASTLY, 664 00:23:04,880 --> 00:23:08,320 GOING FORWARD, WHAT ARE THE 665 00:23:08,320 --> 00:23:11,760 ACTION ITEMS NEEDED TO DEVELOP A 666 00:23:11,760 --> 00:23:12,240 SUSTAINABLE ACCESSIBLE 667 00:23:12,240 --> 00:23:15,600 INTERVENTION PROGRAM. 668 00:23:15,600 --> 00:23:18,360 AS TISA DESCRIBED A MOMENT AGO 669 00:23:18,360 --> 00:23:20,240 NEW GOAL FOR THE NATIONAL PLAN 670 00:23:20,240 --> 00:23:21,480 IS ACCELERATE ACTION TO PROMOTE 671 00:23:21,480 --> 00:23:23,560 HEALTHY AGING AND REDUCE RISK 672 00:23:23,560 --> 00:23:25,120 FACTORS FOR ALZHEIMER'S DISEASE 673 00:23:25,120 --> 00:23:25,760 AN RELATED DEMENTIA. 674 00:23:25,760 --> 00:23:28,040 AND THE GOAL IS TO REDUCE 675 00:23:28,040 --> 00:23:32,360 PREVALENCE OF MODIFIABLE RISKS 676 00:23:32,360 --> 00:23:36,880 BY 15%, BY 2030 WHICH WILL HAVE 677 00:23:36,880 --> 00:23:39,960 TREMENDOUS IMACT ON DISEASE 678 00:23:39,960 --> 00:23:42,280 ONSET AND PROGRESSION. 679 00:23:42,280 --> 00:23:43,760 HERE ARE RISK FACTORS WE ARE 680 00:23:43,760 --> 00:23:46,080 TARGETING HERE, THIS IS IN LINE 681 00:23:46,080 --> 00:23:51,160 WITH GLOBAL INITIATIVES AS WELL, 682 00:23:51,160 --> 00:23:52,560 FOR EXAMPLE, WORLD HEALTH 683 00:23:52,560 --> 00:23:53,240 ORGANIZATION. 684 00:23:53,240 --> 00:23:54,120 WE ARE ON THE SAME PAGE WHICH 685 00:23:54,120 --> 00:24:03,400 RISK FACTORS TO TARGET. 686 00:24:03,400 --> 00:24:09,480 NEXT SLIDE PLEASE. 687 00:24:09,480 --> 00:24:10,440 RESOURCES AVAILABLE RIGHT NOW 688 00:24:10,440 --> 00:24:12,880 THROUGH THE GOVERNMENT, THROUGH 689 00:24:12,880 --> 00:24:14,960 NIH, YOU CAN SEE I WILL FOCUS MY 690 00:24:14,960 --> 00:24:16,840 TALK RIGHT NOW ON 691 00:24:16,840 --> 00:24:17,960 NON-PHARMACOLOGIC INTERVENTION, 692 00:24:17,960 --> 00:24:19,440 THOSE INTERVENTIONS THAT ARE 693 00:24:19,440 --> 00:24:21,920 FOCUSED ON REDUCING RISK. 694 00:24:21,920 --> 00:24:22,720 MODIFIABLE RISK. 695 00:24:22,720 --> 00:24:25,480 YOU CAN SEE THAT RIGHT NOW THE 696 00:24:25,480 --> 00:24:27,560 NUMBER OF GRANTS NIH GRANTS 697 00:24:27,560 --> 00:24:29,280 AVAILABLE TO STUDY 698 00:24:29,280 --> 00:24:30,160 NON-PHARMACOLOGICAL 699 00:24:30,160 --> 00:24:32,840 INTERVENTIONS IS GREATER THAN 700 00:24:32,840 --> 00:24:35,320 THOSE GRANTS THAT ARE EARMARKED 701 00:24:35,320 --> 00:24:37,560 FOR EARLY STAGE CLINICAL DRUG 702 00:24:37,560 --> 00:24:38,360 DEVELOPMENT, LATE STAGE CLINICAL 703 00:24:38,360 --> 00:24:40,600 DRUG DEVELOPMENT AND ONLINE IN 704 00:24:40,600 --> 00:24:43,040 LINE WITH PRE-CLINICAL DRUG 705 00:24:43,040 --> 00:24:44,160 DEVELOPMENT SO 706 00:24:44,160 --> 00:24:44,840 NON-PHARMACOLOGICAL 707 00:24:44,840 --> 00:24:46,000 INTERVENTIONS THAT WILL HELP 708 00:24:46,000 --> 00:24:50,040 IDENTIFY THOSE RISKS THAT COULD 709 00:24:50,040 --> 00:24:51,680 BE MODIFIED WE DO HAVE RESOURCES 710 00:24:51,680 --> 00:24:55,520 TO DO THIS THROUGH NIH. 711 00:24:55,520 --> 00:24:59,960 I WANT TO SHOW THAT OVER SINCE 712 00:24:59,960 --> 00:25:01,640 2009, TO 2019, JUST WANT TO SHOW 713 00:25:01,640 --> 00:25:03,400 YOU HOW THIS IS CHANGED. 714 00:25:03,400 --> 00:25:06,560 THE NUMBER OF GRANTS FOCUSED ON 715 00:25:06,560 --> 00:25:08,200 THESE MODIFIABLE RISK FACTORS 716 00:25:08,200 --> 00:25:11,160 CHANGED OVER TIME. 717 00:25:11,160 --> 00:25:13,200 WITHIN THE NON-PHARMACOLOGIC 718 00:25:13,200 --> 00:25:15,920 INTERVENTION SHOWING A PIE CHART 719 00:25:15,920 --> 00:25:18,040 HERE, DIVIDING DIFFERENT GRANTS 720 00:25:18,040 --> 00:25:19,920 AVAILABLE SO WILL IS A LOT OF 721 00:25:19,920 --> 00:25:22,120 BLUES LARGE SECTION DEVOTED TO 722 00:25:22,120 --> 00:25:23,280 PHYSICAL ACTIVITY AND EXERCISE 723 00:25:23,280 --> 00:25:24,840 AND THERE IS ANOTHER THAT GREEN, 724 00:25:24,840 --> 00:25:26,160 I WILL BRING YOUR ATTENTION TO 725 00:25:26,160 --> 00:25:27,280 THAT, COMBINATION THERAPY. 726 00:25:27,280 --> 00:25:30,840 THAT IS WHERE THE FIELD IS MOVED 727 00:25:30,840 --> 00:25:32,120 INTO COMBINING WHAT ARE THE 728 00:25:32,120 --> 00:25:33,880 BENEFITS ON BRAIN IF ETIANE 729 00:25:33,880 --> 00:25:35,400 PHYSICAL ACTIVITY, DIET, IF WE 730 00:25:35,400 --> 00:25:37,880 CHANGE COGNITIVE ACTIVITY, 731 00:25:37,880 --> 00:25:38,800 SOCIAL ENGAGEMENT. 732 00:25:38,800 --> 00:25:40,680 THAT IS REALLY A HOT TOPIC RIGHT 733 00:25:40,680 --> 00:25:47,920 NOW. 734 00:25:47,920 --> 00:25:50,160 WHAT ACTION DESCRIBE WE WANT TO 735 00:25:50,160 --> 00:25:51,160 ACCOMPLISH WITH GOAL 6 IS 736 00:25:51,160 --> 00:25:52,720 EDUCATE PUBLIC AND HEALTHCARE 737 00:25:52,720 --> 00:25:54,360 WORK FORCE ABOUT RISK REDUCTION. 738 00:25:54,360 --> 00:25:56,920 SO WE CAN DO THIS, WE HAVE TO 739 00:25:56,920 --> 00:25:59,360 THE MESSAGES HAS TO BE INTENSE, 740 00:25:59,360 --> 00:26:00,440 HAS TO BE UBIQUITOUS. 741 00:26:00,440 --> 00:26:02,520 SO IN 2019 THE "WALL STREET 742 00:26:02,520 --> 00:26:04,080 JOURNAL" PUBLISHED THIS 743 00:26:04,080 --> 00:26:06,320 PARTICULAR -- THIS IS A FRONT 744 00:26:06,320 --> 00:26:09,000 PAGE FEATURE ARTICLE ALL ABOUT 745 00:26:09,000 --> 00:26:11,000 WHAT IS TELLING US ABOUT 746 00:26:11,000 --> 00:26:12,480 PREVENTING DEMENTIA WHERE THESE 747 00:26:12,480 --> 00:26:14,280 PARTICULAR MODIFIABLE RISKS WERE 748 00:26:14,280 --> 00:26:14,560 LISTED. 749 00:26:14,560 --> 00:26:17,080 IT WAS A BEAUTIFUL ARTICLE, BUT 750 00:26:17,080 --> 00:26:18,760 I -- IT WAS A MILESTONE BECAUSE 751 00:26:18,760 --> 00:26:20,920 WE HAD NOT YET SEEN IN THE 752 00:26:20,920 --> 00:26:22,840 PUBLIC DOPE MAIN AN ARTICLE WITH 753 00:26:22,840 --> 00:26:25,160 THIS KIND OF A FOCUS ON 754 00:26:25,160 --> 00:26:26,200 LIFESTYLE MODIFICATION AS A 755 00:26:26,200 --> 00:26:29,600 MECHANISM TO PROTECT BRAIN 756 00:26:29,600 --> 00:26:33,680 HEALTH. 757 00:26:33,680 --> 00:26:36,080 COMMISSION, LANSETT COMMISSION 758 00:26:36,080 --> 00:26:38,760 OF 2020, PUBLICKED THEIR 759 00:26:38,760 --> 00:26:40,040 RECOMMENDATIONS, THEY -- 760 00:26:40,040 --> 00:26:42,640 ACCORDING TO LANSETT UP TO 35% 761 00:26:42,640 --> 00:26:44,960 OF ALL DEMENTIA CASES COULD BE 762 00:26:44,960 --> 00:26:47,280 PREVENTED BY TACKLING THESE RISK 763 00:26:47,280 --> 00:26:47,520 FACTORS. 764 00:26:47,520 --> 00:26:55,880 AND THAT WE REALLY NEED LONGER 765 00:26:55,880 --> 00:26:56,920 TERM LIFESTYLE INTERVENTIONS. 766 00:26:56,920 --> 00:26:58,520 THE CDC AND AMERICAN COLLEGE OF 767 00:26:58,520 --> 00:26:59,960 MEDICINE HAD A PUBLICATION 768 00:26:59,960 --> 00:27:01,680 CALLED PROMOTING HEALTHY 769 00:27:01,680 --> 00:27:03,040 LIFESTYLES AND BLOOD PRESSURE 770 00:27:03,040 --> 00:27:04,160 CONTROL AND DESCRIBES HOW 771 00:27:04,160 --> 00:27:06,040 HEALTHY CHOICES CAN REDUCE RISK 772 00:27:06,040 --> 00:27:07,720 OF COGNITIVE DECLINE. 773 00:27:07,720 --> 00:27:10,000 THIS ARTICLE AND OTHER RESOURCE 774 00:27:10,000 --> 00:27:10,560 HAVE BEEN WIDELY DECEMBER 775 00:27:10,560 --> 00:27:12,880 SIMILARNATED SO THIS STARTS -- 776 00:27:12,880 --> 00:27:13,240 DISSEMINATED. 777 00:27:13,240 --> 00:27:16,680 WE NEED TO GET OUT THE MESSAGE, 778 00:27:16,680 --> 00:27:20,080 PHYSICAL ACTIVITY CAN HELP 779 00:27:20,080 --> 00:27:21,240 REDUCE RISK OF COGNITIVE 780 00:27:21,240 --> 00:27:33,520 DECLINE. I'M GOING TO ASK YOU 781 00:27:33,520 --> 00:27:35,600 THE TAKE CONTROL AGAIN BECAUSE 782 00:27:35,600 --> 00:27:37,160 IT IS NOT -- NEXT SLIDE. 783 00:27:37,160 --> 00:27:37,800 THANK YOU. 784 00:27:37,800 --> 00:27:40,160 SO EXERCISE IS MY FOCUS FOR A 785 00:27:40,160 --> 00:27:41,200 MOMENT AS AN EXAMPLE. 786 00:27:41,200 --> 00:27:43,880 WE KNOW THAT EXERCISE IS A 787 00:27:43,880 --> 00:27:47,200 POTENT ANTI-AGING MECHANISM. 788 00:27:47,200 --> 00:27:49,960 THAT EXERCISE REDUCES STRESS AND 789 00:27:49,960 --> 00:27:52,400 IMPROVES MOOD, IMPROVES 790 00:27:52,400 --> 00:27:53,560 CARDIOVASCULAR FUNCTION, 791 00:27:53,560 --> 00:27:54,360 IMPROVES THE HEALTH OFS ARE 792 00:27:54,360 --> 00:27:56,280 SELLS IN THE BODY AND THE BRAIN. 793 00:27:56,280 --> 00:27:58,080 REDUCES YOUR RISK OF TYPE 2 794 00:27:58,080 --> 00:28:00,160 DIABETES, IT REDUCES YOUR 795 00:28:00,160 --> 00:28:02,760 OBESITY, IT TOUCHES ALL OF THESE 796 00:28:02,760 --> 00:28:03,920 DISEASES THAT NATURALLY AT LEAST 797 00:28:03,920 --> 00:28:06,760 IN OUR CULTURE, DO INCREASE IN 798 00:28:06,760 --> 00:28:09,040 PREVALENCE WITH ADVANCING AGE. 799 00:28:09,040 --> 00:28:11,160 IN THE LAST 15 YEARS WE ARE 800 00:28:11,160 --> 00:28:12,720 LEARNING EXERCISE ALSO HAS 801 00:28:12,720 --> 00:28:14,480 PROTECTION FOR BRAIN HEALTH AND 802 00:28:14,480 --> 00:28:16,240 MAY IN FACT HEALTH PREVENT OR 803 00:28:16,240 --> 00:28:17,840 SLOW OR PREVENT THAT COGNITIVE 804 00:28:17,840 --> 00:28:19,320 DECLINE ASSOCIATED WITH 805 00:28:19,320 --> 00:28:21,640 ALZHEIMER'S DISEASE AND RELATED 806 00:28:21,640 --> 00:28:24,320 DEMENTIA. 807 00:28:24,320 --> 00:28:25,920 THIS SLIDE IS A BUSY SLIDE, ONLY 808 00:28:25,920 --> 00:28:27,000 TO SHOW YOU THIS IS WHAT WE HAVE 809 00:28:27,000 --> 00:28:28,560 TO GO THROUGH, WHEN WE TRYING TO 810 00:28:28,560 --> 00:28:31,760 IDENTIFY A RISK REDUCTION 811 00:28:31,760 --> 00:28:33,040 STRATEGY, THE SCIENCE HAS TO BE 812 00:28:33,040 --> 00:28:33,280 STRONG. 813 00:28:33,280 --> 00:28:36,400 WE HAVE TO KNOW THIS IS A VIABLE 814 00:28:36,400 --> 00:28:38,200 CANDIDATE IN ORDER FOR US TO 815 00:28:38,200 --> 00:28:40,880 INVEST OUR RESOURCES BOTH IN 816 00:28:40,880 --> 00:28:44,160 TERMS OF ROLLING THIS OUT NOT 817 00:28:44,160 --> 00:28:46,320 ONLY IN SCIENCE BUT FOR CHANGING 818 00:28:46,320 --> 00:28:49,320 HEALTH POLICY. 819 00:28:49,320 --> 00:28:50,680 EXERCISE HAS MULTIPLE MECHANISMS 820 00:28:50,680 --> 00:28:55,360 OF RESTORATION, BODY, BRAIN, IT 821 00:28:55,360 --> 00:28:56,960 IMPROVES BRAIN CELL HEALTH; 822 00:28:56,960 --> 00:28:59,440 REDUCES OXIDATIVE STRESS, 823 00:28:59,440 --> 00:29:00,480 IMPROVES GLUCOSE METABOLISM, SO 824 00:29:00,480 --> 00:29:01,040 FORTH. 825 00:29:01,040 --> 00:29:03,960 THERE IS A LOT OF EVIDENCE TO 826 00:29:03,960 --> 00:29:07,240 SUGGEST EXERCISE IS A PRIME 827 00:29:07,240 --> 00:29:08,520 CANDIDATE FOR SLOPE REVERSING 828 00:29:08,520 --> 00:29:10,960 AGING EFFECTS ON THE BODY BUT 829 00:29:10,960 --> 00:29:13,520 ALSO SLOWING COGNITIVE DECLINE. 830 00:29:13,520 --> 00:29:15,200 I WANT O SHOW YOU THREE 831 00:29:15,200 --> 00:29:16,480 DIFFERENT EXAMPLES OF THREE 832 00:29:16,480 --> 00:29:17,760 STUDIES TO MAKE MY POINT HERE. 833 00:29:17,760 --> 00:29:19,960 THIS IS A STUDY, SHOWING BRAIN 834 00:29:19,960 --> 00:29:22,760 IMAGES OF AN OLDER ADULT, THESE 835 00:29:22,760 --> 00:29:24,280 ARE COGNITIVELY NORMAL OLDER 836 00:29:24,280 --> 00:29:24,640 ADULTS. 837 00:29:24,640 --> 00:29:26,880 THIS IS SIX MONTHS OF AEROBIC 838 00:29:26,880 --> 00:29:28,440 EXERCISE INTERVENTION VERSUS 839 00:29:28,440 --> 00:29:29,560 VETCHING AND BALANCE CONTROL. 840 00:29:29,560 --> 00:29:31,480 WHAT YOU SEE IN THE COLORED 841 00:29:31,480 --> 00:29:33,480 AREAS IN THE BLUE AREAS AND 842 00:29:33,480 --> 00:29:35,360 ORANGE YELLOW, AREAS WITH BRAIN 843 00:29:35,360 --> 00:29:37,320 VOLUME WAS INCREASED. 844 00:29:37,320 --> 00:29:39,200 WITH SIX MONTHS OF EXERCISE. 845 00:29:39,200 --> 00:29:43,040 NO MEDICATION ON BOARD. 846 00:29:43,040 --> 00:29:46,960 SO THAT WAS IN COGNITIVELY 847 00:29:46,960 --> 00:29:47,920 NORMAL FOLKS BUT SINCE THEN WE 848 00:29:47,920 --> 00:29:50,360 HAVE SHOWN THERE ARE BENEFITS 849 00:29:50,360 --> 00:29:52,160 WITH EXERCISE FOR PEOPLE WITH 850 00:29:52,160 --> 00:29:54,040 MILD COGNITIVE IMPAIRMENT, 851 00:29:54,040 --> 00:29:54,800 EARLIEST STAGES OF ALZHEIMER'S 852 00:29:54,800 --> 00:29:58,080 DISEASE. 853 00:29:58,080 --> 00:29:59,560 HERE IS ANOTHER EXAMPLE, ONE OF 854 00:29:59,560 --> 00:30:00,960 OUR STUDIES. 855 00:30:00,960 --> 00:30:02,760 WITH SIX MONTHS AEROBIC EXERCISE 856 00:30:02,760 --> 00:30:04,640 IN PEOPLE WITH MILD COGNITIVE 857 00:30:04,640 --> 00:30:06,560 IMPAIRMENT, THAT IS EARLY STAGE 858 00:30:06,560 --> 00:30:08,360 OF ALZHEIMER'S DISEASE, WE SAW 859 00:30:08,360 --> 00:30:10,800 CHANGES IN THEIR WHOLE BRAIN 860 00:30:10,800 --> 00:30:11,840 BLOOD FLOW, THE BLOOD FLOW TO 861 00:30:11,840 --> 00:30:15,120 THE WHOLE BRAIN. 862 00:30:15,120 --> 00:30:18,000 AND WE ALSO SAW IMPORTANTLY 863 00:30:18,000 --> 00:30:19,360 CHANGES IN SPECIFIC AREAS THAT 864 00:30:19,360 --> 00:30:23,760 ARE ASSOCIATED WITH AGING. 865 00:30:23,760 --> 00:30:24,960 THESE ARE RED AREAINGS, THE 866 00:30:24,960 --> 00:30:26,880 AREAS THAT NATURALLY DECREASE 867 00:30:26,880 --> 00:30:29,560 BLOOD FLOW WITH ADVANCING AGE 868 00:30:29,560 --> 00:30:33,080 BUT OTHER AREAS THAT DECREASE 869 00:30:33,080 --> 00:30:34,120 BLOOD FLOW WITH ALZHEIMER'S 870 00:30:34,120 --> 00:30:35,280 DISEASE, IN THE BLUE AREA. 871 00:30:35,280 --> 00:30:37,520 SO SIX MONTHS OF EXERCISE 872 00:30:37,520 --> 00:30:39,320 CHANGED INCREASE BLOOD FLOW IN 873 00:30:39,320 --> 00:30:40,920 THESE CRITICAL AREAS THAT HAVE 874 00:30:40,920 --> 00:30:43,960 TO DO WITH AGING AND ALZHEIMER'S 875 00:30:43,960 --> 00:30:45,560 DISEASE. 876 00:30:45,560 --> 00:30:48,760 SO IS IT WORTH THE TROUBLE? 877 00:30:48,760 --> 00:30:50,360 SO WHAT I'M SHOWING YOU HERE IS 878 00:30:50,360 --> 00:30:52,080 A SUN ROOM OF MANY -- SEVERAL 879 00:30:52,080 --> 00:30:54,080 DIFFERENT STUDIES CONDUCTED 880 00:30:54,080 --> 00:30:54,640 SINCE 2010. 881 00:30:54,640 --> 00:30:57,080 QUITE SOME FOR THE LAST 12 882 00:30:57,080 --> 00:30:58,840 YEARS, THE LINE DOWN THE CENTER 883 00:30:58,840 --> 00:31:01,840 KIND OF DIVIDES STUDIES THAT 884 00:31:01,840 --> 00:31:02,760 INDICATE THAT IT IS NOT 885 00:31:02,760 --> 00:31:04,360 EFFECTIVE, IT FAVORS CONTROL 886 00:31:04,360 --> 00:31:06,560 VERSUS RESULTS FAVOR THAT 887 00:31:06,560 --> 00:31:08,840 BENEFITS OF EXERCISE. 888 00:31:08,840 --> 00:31:11,080 ALL OF SPOKES YOU SEE ON THE 889 00:31:11,080 --> 00:31:14,000 RIGHT SIDE OF THE LINE FAVORED 890 00:31:14,000 --> 00:31:15,560 EXERCISE, GIVES YOU THE OVERALL 891 00:31:15,560 --> 00:31:16,960 IMPRESSION MAJORITY OF STUDIES 892 00:31:16,960 --> 00:31:18,960 REVIEWED IN THE LAST 12 YEARS 893 00:31:18,960 --> 00:31:24,120 ALL FAVOR THE BENEFITS OF 894 00:31:24,120 --> 00:31:25,560 EXERCISE ON COGNITION WITH 895 00:31:25,560 --> 00:31:27,880 PEOPLE WITH MILD COGNITIVE 896 00:31:27,880 --> 00:31:31,360 IMPAIRMENT. 897 00:31:31,360 --> 00:31:33,080 IN ORDER TO EVALUATE IS THIS A 898 00:31:33,080 --> 00:31:34,240 VIABLE RISK REDUCTION STRATEGY, 899 00:31:34,240 --> 00:31:37,400 WE HAVE TO REALLY PIECE APART, 900 00:31:37,400 --> 00:31:39,360 DIVE IN AND TAKE A LOOK AT 901 00:31:39,360 --> 00:31:40,160 EXERCISE WHAT ABOUT IT COULD BE 902 00:31:40,160 --> 00:31:45,800 RISK REDUCING. 903 00:31:45,800 --> 00:31:47,560 SO ONE PART WE HAVE LEARNED FROM 904 00:31:47,560 --> 00:31:50,760 THAT IS EXERCISE IS ACTIVITY 905 00:31:50,760 --> 00:31:51,360 MATTERS. 906 00:31:51,360 --> 00:31:52,920 AS WITH ANY MEDICATION, IF THE 907 00:31:52,920 --> 00:31:55,240 DOSE IS TOO LOW, YOU CANNOT 908 00:31:55,240 --> 00:31:56,520 EXPECT THE SAME BENEFIT SO WHEN 909 00:31:56,520 --> 00:31:58,120 I'M THINKING ABOUT ROLLING OUT A 910 00:31:58,120 --> 00:31:59,360 PROGRAM FOR RISK REDUCTION, WE 911 00:31:59,360 --> 00:32:00,920 HAVE TO PAY ATTENTION TO 912 00:32:00,920 --> 00:32:02,800 INTENSITY. 913 00:32:02,800 --> 00:32:04,960 WE ALSO KNOW THAT DURATION 914 00:32:04,960 --> 00:32:06,080 MATTERS. 915 00:32:06,080 --> 00:32:08,560 IF WE ARE -- IF ONE OF THE GOALS 916 00:32:08,560 --> 00:32:10,480 OF RISK REDUCTION IS TO RESTORE 917 00:32:10,480 --> 00:32:13,280 HEALTH TO THE BODY, IN ORDER TO 918 00:32:13,280 --> 00:32:16,720 RESTORE HEALTH TO THE BRAIN, IT 919 00:32:16,720 --> 00:32:17,560 CANNOT HAPPEN OVER NIGHT. 920 00:32:17,560 --> 00:32:18,920 IT TAKES TIME TO RESTORE THIS 921 00:32:18,920 --> 00:32:21,000 TYPE OF HEALTH. 922 00:32:21,000 --> 00:32:22,880 SO SHORT, SHORT DURATIONS OF 923 00:32:22,880 --> 00:32:24,560 EXERCISE, COUPLE OF MONTHS IS 924 00:32:24,560 --> 00:32:29,160 NOT SUFFICIENT TO PROVIDE 925 00:32:29,160 --> 00:32:31,360 PROTECTION AGAINST RISK. 926 00:32:31,360 --> 00:32:32,920 THE LEVEL LEARNED FROM ALL 927 00:32:32,920 --> 00:32:35,240 STUDIES THAT SUPPORT MATTERS. 928 00:32:35,240 --> 00:32:37,080 YOU CAN'T JUST GO TO YOUR DOCTOR 929 00:32:37,080 --> 00:32:38,560 AND SAY -- HAVE THE DOCTOR SAID 930 00:32:38,560 --> 00:32:41,320 YOU NEED THE START EXERCISING. 931 00:32:41,320 --> 00:32:43,080 -IS NOT HELPFUL. 932 00:32:43,080 --> 00:32:45,120 THIS WILL NOT SUCCEED IN A 933 00:32:45,120 --> 00:32:47,200 POPULATION WHO IS NOT USED TO 934 00:32:47,200 --> 00:32:47,840 DOING EXERCISE. 935 00:32:47,840 --> 00:32:49,960 SO IF WE ARE GOING TO SUCCESS IN 936 00:32:49,960 --> 00:32:51,880 THIS PROGRAM WE HAVE TO PROVIDE 937 00:32:51,880 --> 00:32:52,160 SUPPORT. 938 00:32:52,160 --> 00:32:53,760 SOME OF OUR STUDIES WE HAVE 939 00:32:53,760 --> 00:32:55,920 COMPLETED SO FAR HAVE SHOWN WITH 940 00:32:55,920 --> 00:32:56,600 ADEQUATE SUPPORT WE CAN GET 941 00:32:56,600 --> 00:32:58,800 PEOPLE TO STAY IN THE STUDY AND 942 00:32:58,800 --> 00:32:59,920 KEEP EXERCISING AT THE 943 00:32:59,920 --> 00:33:03,480 PRESCRIBED DOSE. 944 00:33:03,480 --> 00:33:04,760 WE ALSO KNOW THAT RESOURCES 945 00:33:04,760 --> 00:33:07,000 MATTER. 946 00:33:07,000 --> 00:33:07,960 THE QUALITY OF THE NEIGHBORHOOD 947 00:33:07,960 --> 00:33:08,360 FACILITIES. 948 00:33:08,360 --> 00:33:09,640 THE PUBLIC MESSAGING. 949 00:33:09,640 --> 00:33:11,760 HOW MUCH TIME DOES A PERSON HAVE 950 00:33:11,760 --> 00:33:14,320 TO EXERCISE, ARE THEY BUSY DOING 951 00:33:14,320 --> 00:33:15,560 CARETAKING SO THEY DON'T HAVE 952 00:33:15,560 --> 00:33:17,080 SUFFICIENT TIME THE TAKE CARE OF 953 00:33:17,080 --> 00:33:17,480 THEMSELVES. 954 00:33:17,480 --> 00:33:18,640 ARE THERE TRANSPORTATION ISSUES. 955 00:33:18,640 --> 00:33:19,320 COST ISSUES. 956 00:33:19,320 --> 00:33:22,160 SO THE HEALTH EQUITY, HEALTH 957 00:33:22,160 --> 00:33:23,560 DISPARITIES REALLY COME THE PLAY 958 00:33:23,560 --> 00:33:25,240 WHEN TRYING TO ROLL OUT A 959 00:33:25,240 --> 00:33:27,400 PROGRAM THAT IS EQUAL TO ALL 960 00:33:27,400 --> 00:33:30,960 WHEN THERE ARE UNEQUAL BARRIERS. 961 00:33:30,960 --> 00:33:33,600 SO I WANT TO SHOW YOU YOU CAN GO 962 00:33:33,600 --> 00:33:36,400 AHEAD AN CLICK ON COUPLE. 963 00:33:36,400 --> 00:33:41,760 ONE MORE. 964 00:33:41,760 --> 00:33:44,160 SO I WANT TO GIVE AN EXAMPLE OF 965 00:33:44,160 --> 00:33:45,640 A STUDY TRYING TO MEET THOSE 966 00:33:45,640 --> 00:33:46,360 DIFFERENT QUESTIONS THAT I 967 00:33:46,360 --> 00:33:48,920 PRESENTED IN A PREVIOUS PAGE. 968 00:33:48,920 --> 00:33:50,720 THE EXCERPT TRIAL IS ONE WE JUST 969 00:33:50,720 --> 00:33:52,080 FINISHED, IT IS A NATIONAL 970 00:33:52,080 --> 00:33:53,560 TRIAL, WE HAVE ENGAGED WE HAVE 971 00:33:53,560 --> 00:33:55,600 REALLY TRIED -- WORKING WITH A 972 00:33:55,600 --> 00:33:57,080 COMMUNITY PARTNER WHICH IS KEY 973 00:33:57,080 --> 00:33:58,880 FOR THE SUCCESS OF GOALS 6. 974 00:33:58,880 --> 00:34:02,200 WE ARE WORKING WITH YMCA, THEY 975 00:34:02,200 --> 00:34:03,800 HAVE BEEN AT TABLE SINCE DAY 976 00:34:03,800 --> 00:34:05,360 ONE, WE KNOW IF WE ARE 977 00:34:05,360 --> 00:34:06,880 SUCCESSFUL IT IS THE YMCA THAT 978 00:34:06,880 --> 00:34:08,360 WILL ROLL OUT THIS PROGRAM OR 979 00:34:08,360 --> 00:34:10,560 SOMEONE LIKE THE YMCA, NOT 980 00:34:10,560 --> 00:34:10,960 ACADEMIC. 981 00:34:10,960 --> 00:34:13,520 SO THIS PARTNERSHIP HAS BEEN 982 00:34:13,520 --> 00:34:13,960 KEY. 983 00:34:13,960 --> 00:34:15,600 WE ENGAGE THE COMMUNITIES, ALSO 984 00:34:15,600 --> 00:34:19,760 PART OF OUR GOAL FOR PART OF THE 985 00:34:19,760 --> 00:34:21,200 CHARGE FOR GOAL 6 TO WORK WITHIN 986 00:34:21,200 --> 00:34:24,840 COMMUNITIES TO HEAL A COMMUNITY. 987 00:34:24,840 --> 00:34:26,320 IN THIS STUDY WE HAVE GONE OUT 988 00:34:26,320 --> 00:34:28,560 AND WORKED WITH THE COMMUNITY TO 989 00:34:28,560 --> 00:34:29,840 GET PARTICIPANTS INTO THE STUDY 990 00:34:29,840 --> 00:34:30,880 AND FIND COMMUNITY RESOURCES 991 00:34:30,880 --> 00:34:32,160 THEY CAN USE TO COMPLETE THEIR 992 00:34:32,160 --> 00:34:35,080 PHYSICAL ACTIVITY. 993 00:34:35,080 --> 00:34:36,160 WE'LL REPORT TOP LINE RESULTS 994 00:34:36,160 --> 00:34:37,280 THIS SUMMER. 995 00:34:37,280 --> 00:34:40,960 AND NEXT. 996 00:34:40,960 --> 00:34:42,360 FUTURE DIRECTIONS FOR 997 00:34:42,360 --> 00:34:42,760 SUSTAINABILITY. 998 00:34:42,760 --> 00:34:43,760 THIS IS OUR NEXT STEP. 999 00:34:43,760 --> 00:34:44,760 WE GOT THE SCIENCE TO SAY IT 1000 00:34:44,760 --> 00:34:46,280 COULD BE A RISK REDUCTION. 1001 00:34:46,280 --> 00:34:49,400 SO HOW DO WE ROLL THIS OUT SO IT 1002 00:34:49,400 --> 00:34:51,960 COULD BE A VIABLE SUSTAINABLE 1003 00:34:51,960 --> 00:34:53,520 INTERVENTION TO REDUCE RISK FOR 1004 00:34:53,520 --> 00:34:54,240 ALL PEOPLE. 1005 00:34:54,240 --> 00:34:57,360 IF YOU CAN CLICK AROUND HERE, 1006 00:34:57,360 --> 00:34:58,200 THAT -- FOUR COLLISION. 1007 00:34:58,200 --> 00:35:00,760 SO WHAT YOU CAN SEE HERE IS WE 1008 00:35:00,760 --> 00:35:02,080 NEED -- WE HAVE NEEDS, IN ORDER 1009 00:35:02,080 --> 00:35:03,400 TO BUILD COMMUNITY PROGRAM, WE 1010 00:35:03,400 --> 00:35:06,120 HAVE TO HAVE READY ACCESS TO 1011 00:35:06,120 --> 00:35:07,960 FACILITIES, WE HAVE TO HAVE 1012 00:35:07,960 --> 00:35:09,120 UBIQUITOUS MESSAGING ENCOURAGING 1013 00:35:09,120 --> 00:35:10,120 PHYSICAL ACTIVITY, BASICALLY 1014 00:35:10,120 --> 00:35:13,000 CREATE A MOVEMENT WHERE THIS IS 1015 00:35:13,000 --> 00:35:14,440 THE STANDARD. 1016 00:35:14,440 --> 00:35:16,720 THIS HAS BEEN DONE AT OTHER 1017 00:35:16,720 --> 00:35:19,440 COUNTRIES NORWAY FOR EXAMPLE, 1018 00:35:19,440 --> 00:35:21,280 CHINA, WHERE EXERCISE FACILITIES 1019 00:35:21,280 --> 00:35:22,560 ARE WELL FUND AND AVAILABLE 1020 00:35:22,560 --> 00:35:23,760 WITHIN THE COMMUNITY. 1021 00:35:23,760 --> 00:35:26,880 IT CHANGES HOW PEOPLE BEHAVE. 1022 00:35:26,880 --> 00:35:30,560 WE HAVE TO HAVE LOW OR NO COST 1023 00:35:30,560 --> 00:35:32,800 ACCESS, WE NEED ADEQUATE 1024 00:35:32,800 --> 00:35:33,800 RESOURCES, SUPPORT FOR THESE 1025 00:35:33,800 --> 00:35:34,760 INDIVIDUALS YOU NEED COACHING 1026 00:35:34,760 --> 00:35:36,120 SUPPORT, THAT WHAT WE LEARNED 1027 00:35:36,120 --> 00:35:37,960 OVER AND OVER, LIFESTYLE 1028 00:35:37,960 --> 00:35:38,600 COACHING SUPPORT. 1029 00:35:38,600 --> 00:35:40,800 WE NEED PARTNERSHIP WITH 1030 00:35:40,800 --> 00:35:41,640 ORGANIZATIONS, WE NEED 1031 00:35:41,640 --> 00:35:43,200 HEALTHCARE TO WEIGH IN AND BE 1032 00:35:43,200 --> 00:35:44,240 PART OF THIS PROGRAM, 1033 00:35:44,240 --> 00:35:46,200 PRESCRIPTION IS PROVIDED WITH 1034 00:35:46,200 --> 00:35:48,560 REFERRALS TO A PROGRAM AND ALSO 1035 00:35:48,560 --> 00:35:51,200 OTHER LOGISTIC SUPPORT LIKE 1036 00:35:51,200 --> 00:35:52,360 TRANSPORTATION COMMUNITY FAMILY 1037 00:35:52,360 --> 00:35:53,960 SUPPORT AND ALSO IT HAS TO 1038 00:35:53,960 --> 00:35:55,800 CONTINUE TO BE EVIDENCE BASED. 1039 00:35:55,800 --> 00:35:58,760 SO HA IS THE IMPORTANCE OF 1040 00:35:58,760 --> 00:36:00,280 SCIENCE ALL THE NIH PROVIDED TO 1041 00:36:00,280 --> 00:36:02,160 PROVIDE THE RESOURCES FOR US TO 1042 00:36:02,160 --> 00:36:06,680 CONTINUE THESE INVESTIGATIONS. 1043 00:36:06,680 --> 00:36:07,560 MY LAST SLIDE PLEASE. 1044 00:36:07,560 --> 00:36:11,920 HOW DO WE TRANSITION FROM THIS 1045 00:36:11,920 --> 00:36:13,120 SCIENCE TO POLICY THIS IS WHAT 1046 00:36:13,120 --> 00:36:15,360 WE ARE WORKING ON, IT IS A WORK 1047 00:36:15,360 --> 00:36:18,760 IN PROGRESS BUT IT IS 1048 00:36:18,760 --> 00:36:20,760 IMPERATIVE, WE NEED ROBUST 1049 00:36:20,760 --> 00:36:22,720 RESULTS FROM SCIENCE, FROM 1050 00:36:22,720 --> 00:36:25,640 RIGOROUS TRIALS TO MOTIVATE 1051 00:36:25,640 --> 00:36:27,200 ACTION WE NEED A SENTENCE FOR 1052 00:36:27,200 --> 00:36:29,840 HEALTHCARE TO PROMOTE EXERCISE 1053 00:36:29,840 --> 00:36:31,560 AS MEDICINE PROGRAMS. 1054 00:36:31,560 --> 00:36:34,560 WE NEED PATIENCE INCENTIVES TO 1055 00:36:34,560 --> 00:36:35,360 PARTICIPATE. 1056 00:36:35,360 --> 00:36:37,360 WE NEED COMMUNITY BASED 1057 00:36:37,360 --> 00:36:38,920 INFRASTRUCTURE EQUAL, THERE'S 1058 00:36:38,920 --> 00:36:41,360 EQUITY FOR ALL COMMUNITIES, WHEN 1059 00:36:41,360 --> 00:36:42,720 WE ROLL THEM OUT ONE 1060 00:36:42,720 --> 00:36:45,760 NEIGHBORHOOD CANNOT BE -- EQUAL 1061 00:36:45,760 --> 00:36:46,960 ACCESS FOR ALL NEIGHBORHOODS 1062 00:36:46,960 --> 00:36:49,600 OTHERWISE THIS IS NOT GOING TO 1063 00:36:49,600 --> 00:36:50,760 ADDRESS OUR HEALTH EQUITY 1064 00:36:50,760 --> 00:36:55,360 PRIORITIES. 1065 00:36:55,360 --> 00:36:59,360 THANK YOU. 1066 00:36:59,360 --> 00:37:00,800 >> THANK YOU SO MUCH. 1067 00:37:00,800 --> 00:37:05,080 NEXT WE WILL HEAR FROM MATTHEW 1068 00:37:05,080 --> 00:37:05,920 BOMBART IN THE ALZHEIMER'S 1069 00:37:05,920 --> 00:37:06,560 ASSOCIATION. 1070 00:37:06,560 --> 00:37:07,600 >> THANK YOU VERY MUCH, LISA. 1071 00:37:07,600 --> 00:37:08,200 HELLO EVERYBODY. 1072 00:37:08,200 --> 00:37:11,360 GLAD TO BE WITH YOU TODAY. 1073 00:37:11,360 --> 00:37:13,480 AS THE SCIENCE ON DEMENTIA RISK 1074 00:37:13,480 --> 00:37:17,240 FACTORS INCREASES AND AS OUR 1075 00:37:17,240 --> 00:37:18,480 UNDERSTANDING GROWS, IT IS 1076 00:37:18,480 --> 00:37:19,960 REALLY RIPE FOR PUBLIC HEALTH TO 1077 00:37:19,960 --> 00:37:22,760 TAKE ACTION TO ADDRESS RISK 1078 00:37:22,760 --> 00:37:24,560 FACTORS FROM A COMMUNITY 1079 00:37:24,560 --> 00:37:24,840 PERSPECTIVE. 1080 00:37:24,840 --> 00:37:28,160 THAT IS PART OF WHAT THE NEW 1081 00:37:28,160 --> 00:37:30,720 GOAL SIX INCLUDES AND THAT IS 1082 00:37:30,720 --> 00:37:32,280 REALLY WHERE PUBLIC HEALTH 1083 00:37:32,280 --> 00:37:33,560 CENTER OF EXCELLENCE COMES IN 1084 00:37:33,560 --> 00:37:34,880 AND WHAT I WILL TALK TO YOU 1085 00:37:34,880 --> 00:37:35,400 ABOUT TODAY. 1086 00:37:35,400 --> 00:37:38,320 NEXT SLIDE. 1087 00:37:38,320 --> 00:37:41,760 BEFORE I GET TO THE CENTER OF 1088 00:37:41,760 --> 00:37:43,360 EXCELLENCE I WANT TO TALK TO YOU 1089 00:37:43,360 --> 00:37:45,440 ABOUT HOW BRIEFLY ABOUT HOW WE 1090 00:37:45,440 --> 00:37:47,160 GOT HERE. 1091 00:37:47,160 --> 00:37:50,760 AND MANY OF YOU ARE AWARE OF THE 1092 00:37:50,760 --> 00:37:53,200 BOLD ACT BUT JUST REVIEW IT FOR 1093 00:37:53,200 --> 00:37:58,360 THOSE NOT FAMILIAR, IN 2018 1094 00:37:58,360 --> 00:38:00,600 CONGRESS PASSED BUILDING LARGEST 1095 00:38:00,600 --> 00:38:01,920 DEMENTIA INFRASTRUCTURE FOR 1096 00:38:01,920 --> 00:38:03,720 ALZHEIMER'S ACT OR BOLD ACT TO 1097 00:38:03,720 --> 00:38:06,800 EXPAND THE NATION'S PUBLIC 1098 00:38:06,800 --> 00:38:08,040 HEALTH INFRASTRUCTURE TO ADDRESS 1099 00:38:08,040 --> 00:38:09,840 ALZHEIMER'S AND TO INCREASE THE 1100 00:38:09,840 --> 00:38:13,560 CAPACITY OF PUBLIC HEALTH TO 1101 00:38:13,560 --> 00:38:14,360 ADDRESS ALZHEIMER'S DISEASE 1102 00:38:14,360 --> 00:38:16,600 THERE ARE THREE MAIN COMPONENTS 1103 00:38:16,600 --> 00:38:19,400 OF THE LEGISLATION, THE FIRST IS 1104 00:38:19,400 --> 00:38:21,160 TO ESTABLISH CENTERS OF 1105 00:38:21,160 --> 00:38:22,560 EXCELLENCE, SECOND TO PROVIDE 1106 00:38:22,560 --> 00:38:24,160 GRANTS TO STATE LOCAL AND TRIBAL 1107 00:38:24,160 --> 00:38:26,080 PUBLIC HEALTH AGENCIES ACROSS 1108 00:38:26,080 --> 00:38:28,800 THE COUNTRY AND THE THIRD IS TO 1109 00:38:28,800 --> 00:38:30,040 INCREASE DATA ANALYSIS AND 1110 00:38:30,040 --> 00:38:37,160 TIMELY REPORTING. 1111 00:38:37,160 --> 00:38:38,960 IN 2020 AFTER CONGRESS PASSED 1112 00:38:38,960 --> 00:38:42,120 AND SUBS CAN'TLY FUNDED THE BOLD 1113 00:38:42,120 --> 00:38:45,600 ACT CDC FUNDED THREE CENTERS OF 1114 00:38:45,600 --> 00:38:46,760 EXCELLENCE INCLUDING THE 1115 00:38:46,760 --> 00:38:48,080 DEMENTIA RISK REDUCTION CENTER 1116 00:38:48,080 --> 00:38:49,520 AT THE ALZHEIMER'S ASSOCIATION, 1117 00:38:49,520 --> 00:38:51,760 THE OTHER TWO CENTERS FOCUS ON 1118 00:38:51,760 --> 00:38:53,120 CARE GIVING, OUT OF THE 1119 00:38:53,120 --> 00:38:56,000 UNIVERSITY OF MINNESOTA AND THE 1120 00:38:56,000 --> 00:38:58,760 THIRD IS EARLY DETECTION 1121 00:38:58,760 --> 00:39:00,000 DIAGNOSIS AFTER NEW YORK 1122 00:39:00,000 --> 00:39:00,320 UNIVERSITY. 1123 00:39:00,320 --> 00:39:03,040 NEXT SLIDE. 1124 00:39:03,040 --> 00:39:07,200 SO LET ME ILLUSTRATE WHY THE 1125 00:39:07,200 --> 00:39:09,360 RISK REDUCTION CENTER IS REALLY 1126 00:39:09,360 --> 00:39:12,720 IMPORTANT AND WHY ADDRESSING AT 1127 00:39:12,720 --> 00:39:13,800 THIS PARTICULAR TIME DEMENTIA 1128 00:39:13,800 --> 00:39:16,280 RISK FACTORS IS SO IMPORTANT 1129 00:39:16,280 --> 00:39:17,600 FROM A POPULATION LEVEL 1130 00:39:17,600 --> 00:39:20,960 PERSPECTIVE. 1131 00:39:20,960 --> 00:39:23,920 MANY OF YOU HAVE SEEN THESE 1132 00:39:23,920 --> 00:39:25,200 STATISTICS BEFORE BUT CURRENTLY 1133 00:39:25,200 --> 00:39:27,960 THERE ARE MORE THAN 6 MILLION 1134 00:39:27,960 --> 00:39:28,960 OLDER ADULTS IN THE UNITED 1135 00:39:28,960 --> 00:39:30,320 STATES LIVING WITH ALZHEIMER'S 1136 00:39:30,320 --> 00:39:32,760 DEMENTIA AND WITH THE AGING OF 1137 00:39:32,760 --> 00:39:35,160 POPULATION THAT IS PROJECTED TO 1138 00:39:35,160 --> 00:39:39,920 INCREASE TO NEARLY 14 MILLION IN 1139 00:39:39,920 --> 00:39:42,160 2060. 1140 00:39:42,160 --> 00:39:42,560 NEXT SLIDE. 1141 00:39:42,560 --> 00:39:46,040 IN LOOKING AT WHAT I CALL THE 1142 00:39:46,040 --> 00:39:48,400 FIVE -- THE BIG FIVE RISK 1143 00:39:48,400 --> 00:39:50,480 FACTORS. 1144 00:39:50,480 --> 00:39:53,840 THESE ARE RISK FACTORS THAT ARE 1145 00:39:53,840 --> 00:39:55,680 COMMONLY CITED AS RISK FACTORS 1146 00:39:55,680 --> 00:39:59,000 FOR COGNITIVE DECLINE AND 1147 00:39:59,000 --> 00:39:59,920 DEMENTIA, THEY ARE ALSO HAVE 1148 00:39:59,920 --> 00:40:02,200 SOME OF THE STRONGEST EVIDENCE 1149 00:40:02,200 --> 00:40:02,760 BEHIND THEM. 1150 00:40:02,760 --> 00:40:05,760 YOU CAN SEE THE PREVALENCE OF 1151 00:40:05,760 --> 00:40:08,880 THESE RISK FACTORS AMONG THE 1152 00:40:08,880 --> 00:40:10,760 U.S. POPULATION. 1153 00:40:10,760 --> 00:40:13,000 THE HYPERTENSION AMONG THOSE IN 1154 00:40:13,000 --> 00:40:18,280 MIDDLE AGE IS OVER 40%, OBESITY 1155 00:40:18,280 --> 00:40:20,440 IS NEARLY 40%, PHYSICAL 1156 00:40:20,440 --> 00:40:21,960 INACTIVITY YOU HEARD LAURA 1157 00:40:21,960 --> 00:40:24,760 TALKING ABOUT THAT, THAT'S WELL 1158 00:40:24,760 --> 00:40:29,080 OVER 40% CLOSING IN ON HALF OF 1159 00:40:29,080 --> 00:40:33,160 THE ADULT POPULATION WHO DO NOT 1160 00:40:33,160 --> 00:40:34,360 MEET PHYSICAL ACTIVITY 1161 00:40:34,360 --> 00:40:36,920 GUIDELINES. 1162 00:40:36,920 --> 00:40:39,360 WHEN YOU LOOK ACROSS ALL FIVE OF 1163 00:40:39,360 --> 00:40:41,160 THESE OVER 63% OF ADULTS IN THE 1164 00:40:41,160 --> 00:40:42,920 UNITED STATES HAVE ONE OR MORE 1165 00:40:42,920 --> 00:40:44,960 OF THESE RISK FACTORS FOR 1166 00:40:44,960 --> 00:40:46,160 DEMENTIA AND MORE THAN 1167 00:40:46,160 --> 00:40:47,520 TWO-THIRDS OF BLACKS AND 1168 00:40:47,520 --> 00:40:49,520 HISPANICS AND NATIVE AMERICANS 1169 00:40:49,520 --> 00:40:51,080 HAVE AT LEAST ONE OF THESE FIVE 1170 00:40:51,080 --> 00:40:55,360 RISK FACTORS. 1171 00:40:55,360 --> 00:40:57,120 SO ACCORDING TO THE LANSETT 1172 00:40:57,120 --> 00:40:59,560 COMMISSION AS MANY AS 40% OF 1173 00:40:59,560 --> 00:41:02,280 DEMENTIA CASES WORLDWIDE MIGHT 1174 00:41:02,280 --> 00:41:03,800 BE ATTRIBUTABLE TO 12 SUSPECTED 1175 00:41:03,800 --> 00:41:06,880 RISK FACTORS, MORE -- THEY 1176 00:41:06,880 --> 00:41:07,960 LOOKED AT MORE THAN THE FIVE I 1177 00:41:07,960 --> 00:41:09,920 SHOWED ON THE PREVIOUS SCREEN, 1178 00:41:09,920 --> 00:41:11,960 LOOKING AT THE 12 CITED BY THE 1179 00:41:11,960 --> 00:41:14,280 LANSETT COMMISSION, THEY 1180 00:41:14,280 --> 00:41:15,960 INDICATED THAT WORLD AS MANY AS 1181 00:41:15,960 --> 00:41:17,440 FOUR IN TEN DEMENTIA CASES COULD 1182 00:41:17,440 --> 00:41:19,320 BE ACONTRIBUTABLE TO THOSE 12 1183 00:41:19,320 --> 00:41:21,200 RISK FACTORS, GIVEN THAT AND 1184 00:41:21,200 --> 00:41:24,120 GIVEN THE HIGH PREVALENCE OF 1185 00:41:24,120 --> 00:41:26,560 RATES OF SOMEBODY'S RISK FACTORS 1186 00:41:26,560 --> 00:41:28,960 AS I SHOWED YOU ON THE PREVIOUS 1187 00:41:28,960 --> 00:41:29,840 SLIDE THERE A GREAT OPPORTUNITY 1188 00:41:29,840 --> 00:41:32,560 FOR PUBLIC HEALTH TO ACT. 1189 00:41:32,560 --> 00:41:36,640 AND THERE IS A POSSIBILITY FOR A 1190 00:41:36,640 --> 00:41:38,720 SIGNIFICANT IMPACT WITH AN 1191 00:41:38,720 --> 00:41:39,520 AGGRESSIVE ACTION. 1192 00:41:39,520 --> 00:41:41,960 I PUT ON THIS SCREEN THREE 1193 00:41:41,960 --> 00:41:43,480 POPULATION ATTRIBUTABLE RISK 1194 00:41:43,480 --> 00:41:45,200 ANALYSES, TWO OF THEM WERE 1195 00:41:45,200 --> 00:41:46,160 UNPUBLISHED BUT ONE WAS 1196 00:41:46,160 --> 00:41:47,800 PUBLISHED IN LANSETT NEUROLOGY 1197 00:41:47,800 --> 00:41:51,320 BACK IN 2014 THAT LOOKED AT WHAT 1198 00:41:51,320 --> 00:41:52,960 WOULD HAPPEN IF YOU COULD 1199 00:41:52,960 --> 00:41:55,080 AGGRESSIVELY ADDRESS RISK 1200 00:41:55,080 --> 00:41:59,000 FACTORS AND AGGRESSIVELY WAS A 1201 00:41:59,000 --> 00:42:01,160 10%, OR 15% PER DECADE 1202 00:42:01,160 --> 00:42:04,920 IMPROVEMENT IN THE BIG FIVE AS I 1203 00:42:04,920 --> 00:42:07,080 CALL THEM OR AS IN THE CASE OF 1204 00:42:07,080 --> 00:42:08,440 LANSETT NEUROLOGY ARTICLE THE 1205 00:42:08,440 --> 00:42:09,920 BIG 5 PLUS DEPRESSION AND 1206 00:42:09,920 --> 00:42:12,120 EDUCATION, YOU CAN SEE THERE 1207 00:42:12,120 --> 00:42:14,360 THAT WITH AN AGGRESSIVE EFFORT 1208 00:42:14,360 --> 00:42:15,560 TO IMPROVE THE PREVALENCE OF THE 1209 00:42:15,560 --> 00:42:18,840 RISK FACTORS IT COULD RESULT IN 1210 00:42:18,840 --> 00:42:21,960 AS MANY AS A MILLION OR MORE 1211 00:42:21,960 --> 00:42:23,160 FEWER CASES OF ALZHEIMER'S 1212 00:42:23,160 --> 00:42:27,120 DEMENTIA IN 2050. 1213 00:42:27,120 --> 00:42:28,920 SO THIS IS REALLY WHERE THE 1214 00:42:28,920 --> 00:42:31,960 CENTER OF EXCELLENCE COMES IN. 1215 00:42:31,960 --> 00:42:34,040 SO THE CENTERS OF EXCELLENCE AS 1216 00:42:34,040 --> 00:42:36,800 I MENTIONED THERE ARE THREE, ARE 1217 00:42:36,800 --> 00:42:38,360 REALLY DESIGNED TO GIVE PUBLIC 1218 00:42:38,360 --> 00:42:41,320 HEALTH AGENCIES AT THE STATE 1219 00:42:41,320 --> 00:42:43,360 LOCAL AND TRIBAL LEVEL TOOLS AND 1220 00:42:43,360 --> 00:42:47,480 RESOURCES AND NEEDED TO ACT IN 1221 00:42:47,480 --> 00:42:47,960 THEIR COMMUNITIES. 1222 00:42:47,960 --> 00:42:49,520 AND FOR CENTER OF EXCELLENCE ON 1223 00:42:49,520 --> 00:42:52,560 RISK REDUCTION I PUT ON THIS 1224 00:42:52,560 --> 00:42:55,400 SLIDE OUR GENERAL WORK FLOW. 1225 00:42:55,400 --> 00:42:57,760 WE -- PART OF OUR TASK IS 1226 00:42:57,760 --> 00:42:59,160 UNDERSTANDING THE SCIENCE AND 1227 00:42:59,160 --> 00:43:00,240 HELPING PUBLIC HEALTH AGENCIES 1228 00:43:00,240 --> 00:43:01,960 IN THE PUBLIC IN GENERAL 1229 00:43:01,960 --> 00:43:03,200 UNDERSTAND THE CURRENT STATE OF 1230 00:43:03,200 --> 00:43:03,640 THE SCIENCE. 1231 00:43:03,640 --> 00:43:05,880 THEN IDENTIFYING WHAT CAN BE 1232 00:43:05,880 --> 00:43:07,440 DONE ABOUT IT FROM A PUBLIC 1233 00:43:07,440 --> 00:43:08,960 HEALTH PERSPECTIVE, BUILDING 1234 00:43:08,960 --> 00:43:10,880 THOSE TOOLS AND RESOURCES FOR 1235 00:43:10,880 --> 00:43:12,760 PUBLIC HEALTH AND THEN REALLY 1236 00:43:12,760 --> 00:43:13,880 HELPING TO DRIVE ACTION BY 1237 00:43:13,880 --> 00:43:16,560 PUBLIC HEALTH AGENCIES. 1238 00:43:16,560 --> 00:43:19,200 I HAVE SHOWN THESE IN A LINEAR 1239 00:43:19,200 --> 00:43:21,200 FORMAT BECAUSE MY BRAIN WORKS 1240 00:43:21,200 --> 00:43:24,000 SEQUENTIALLY AND LITERALLY BUT 1241 00:43:24,000 --> 00:43:27,360 THERE ARE ACTIVITIES ON ALL OF 1242 00:43:27,360 --> 00:43:30,040 THESE STEPS OR MANY OF THESE 1243 00:43:30,040 --> 00:43:30,800 STEPS GOING ON AT THE SAME TIME. 1244 00:43:30,800 --> 00:43:33,400 THAT IS WHAT I WANT TO SHARE 1245 00:43:33,400 --> 00:43:34,040 WITH YOU NOW. 1246 00:43:34,040 --> 00:43:36,120 SOME OF THE THINGS BOLD CENTER 1247 00:43:36,120 --> 00:43:37,520 PUBLIC HEALTH CENTER ON RISK 1248 00:43:37,520 --> 00:43:38,680 REDUCTION HAS BEEN DOING. 1249 00:43:38,680 --> 00:43:42,440 NEXT SLIDE. 1250 00:43:42,440 --> 00:43:44,040 SO WE SPENT A GOOD CHUNK OF LAST 1251 00:43:44,040 --> 00:43:46,720 YEAR WORKING WITH OUR ACADEMIC 1252 00:43:46,720 --> 00:43:47,720 SCIENTIFIC PARTNER WAKE FOREST 1253 00:43:47,720 --> 00:43:49,760 SCHOOL OF MEDICINE JEFF 1254 00:43:49,760 --> 00:43:51,560 WILLIAMSON, LEADING THE EFFORT 1255 00:43:51,560 --> 00:43:52,160 THERE. 1256 00:43:52,160 --> 00:43:54,400 LAURA BAKER WHO YOU JUST HEARD 1257 00:43:54,400 --> 00:43:57,320 FROM WAS MEMBER OF THE RESEARCH 1258 00:43:57,320 --> 00:43:58,840 ROUND TABLE JEFF PUT TOGETHER 1259 00:43:58,840 --> 00:44:00,800 AND LED A REVIEW AND SAID THIS 1260 00:44:00,800 --> 00:44:03,040 IS THE STATE OF EVIDENCE ON 1261 00:44:03,040 --> 00:44:05,640 MODIFIABLE RISK FACTORS FOR 1262 00:44:05,640 --> 00:44:06,400 COGNITIVE DYCLONE AND DEMENTIA. 1263 00:44:06,400 --> 00:44:08,360 WE PUBLISHED ONE TO TWO PAGE 1264 00:44:08,360 --> 00:44:11,360 SUMMARIES ON 11 RISK FACTORS, 1265 00:44:11,360 --> 00:44:12,720 THEY TALK ABOUT THE CURRENT 1266 00:44:12,720 --> 00:44:14,240 STATE OF THE SCIENCE AS WELL AS 1267 00:44:14,240 --> 00:44:16,560 PUBLIC HEALTH IMPLICATIONS FOR 1268 00:44:16,560 --> 00:44:19,320 THOSE RISK FACTORS. 1269 00:44:19,320 --> 00:44:21,840 YOU CAN DOWNLOAD THOSE READ 1270 00:44:21,840 --> 00:44:28,440 THOSE ON WEBSITE AT ALZ.ORG/ 1271 00:44:28,440 --> 00:44:29,160 ALZ.ORG/PUBLICHEALTH. 1272 00:44:29,160 --> 00:44:30,760 FOLLOWING REVIEW AN SYNTHESIS 1273 00:44:30,760 --> 00:44:32,600 LAST AUGUST WE HELD FIRST PUBLIC 1274 00:44:32,600 --> 00:44:33,960 HEALTH ROUND TABLE WITH PUBLIC 1275 00:44:33,960 --> 00:44:35,400 HEALTH ACADEMIC AND ON THE 1276 00:44:35,400 --> 00:44:36,960 GROUND PUBLIC HEALTH OFFICIALS 1277 00:44:36,960 --> 00:44:40,160 TO BEGIN IDENTIFYING AND 1278 00:44:40,160 --> 00:44:41,320 PRIORITIZING PUBLIC HEALTH 1279 00:44:41,320 --> 00:44:43,960 ACTIONS TO ADDRESS THESE RISK 1280 00:44:43,960 --> 00:44:44,480 FACTORS. 1281 00:44:44,480 --> 00:44:46,560 FOLLOWING THAT, WE HAVE BEGUN TO 1282 00:44:46,560 --> 00:44:49,040 PREPARE TOOL KITS AND OTHER 1283 00:44:49,040 --> 00:44:50,960 RESOURCES HOW PUBLIC HEALTH 1284 00:44:50,960 --> 00:44:52,600 ADDRESS RISK FACTORS COMMUNITY 1285 00:44:52,600 --> 00:44:54,880 LEVEL AND ANALYZING STATE AND 1286 00:44:54,880 --> 00:44:56,200 LOCAL LEVEL DATA ON VARY USE 1287 00:44:56,200 --> 00:44:59,440 RISK FACTORS AND THE LOCAL LEVEL 1288 00:44:59,440 --> 00:45:03,920 DATA IS PARTICULARLY INTRIGUING 1289 00:45:03,920 --> 00:45:05,360 AND HELPFUL BECAUSE IT WILL 1290 00:45:05,360 --> 00:45:07,040 IDENTIFY FOR STATE PUBLIC HEALTH 1291 00:45:07,040 --> 00:45:08,560 OFFICIALS AND LOCAL PUBLIC 1292 00:45:08,560 --> 00:45:10,440 HEALTH OFFICIALS WHERE THE 1293 00:45:10,440 --> 00:45:12,960 PARTICULAR HOT SPOTS MAYBE FOR 1294 00:45:12,960 --> 00:45:15,360 THE VARIOUS RISK FACTORS. 1295 00:45:15,360 --> 00:45:18,960 FOR MANY PUBLIC HEALTH AGENCIES, 1296 00:45:18,960 --> 00:45:22,360 EVEN IF COVID WERE NOT A FACTOR, 1297 00:45:22,360 --> 00:45:23,920 THE CAPACITY TO TAKE ON THIS 1298 00:45:23,920 --> 00:45:24,960 ISSUE IS VERY LIMITED. 1299 00:45:24,960 --> 00:45:27,440 A LOT OF PUBLIC HEALTH AGENCIES 1300 00:45:27,440 --> 00:45:29,280 ARE VERY SMALL AND DON'T HAVE A 1301 00:45:29,280 --> 00:45:31,000 LOT OF FUNDING. 1302 00:45:31,000 --> 00:45:33,720 SO IN RECOGNITION OF THIS, ONE 1303 00:45:33,720 --> 00:45:35,360 OF THE ACTIVITIES WE ARE DOING 1304 00:45:35,360 --> 00:45:37,160 AT THE BOLD CENTER IS WORKING 1305 00:45:37,160 --> 00:45:38,720 WITH PUBLIC HEALTH AGENCIES ON 1306 00:45:38,720 --> 00:45:40,760 COMMUNITY CONVENINGS. 1307 00:45:40,760 --> 00:45:45,160 IT IS TO USE THE PUBLIC HEALTH 1308 00:45:45,160 --> 00:45:46,960 CONVENER ROLE TO BRING COMMUNITY 1309 00:45:46,960 --> 00:45:48,800 STAKEHOLDERS AND COMMUNITY 1310 00:45:48,800 --> 00:45:51,160 ACTORS TOGETHER IN A STRUCTURED 1311 00:45:51,160 --> 00:45:53,560 THREE STEP PROCESS IN WHICH THEY 1312 00:45:53,560 --> 00:45:55,960 DECIDE HOW COLLECTIVELY AS A 1313 00:45:55,960 --> 00:45:59,960 COMMUNITY THEY CAN ADDRESS RISK 1314 00:45:59,960 --> 00:46:00,840 FACTORS. 1315 00:46:00,840 --> 00:46:02,160 THAT TAKES SOME OF THE LOAD OFF 1316 00:46:02,160 --> 00:46:04,720 PUBLIC HEALTH BUT HELPS TO DRIVE 1317 00:46:04,720 --> 00:46:08,240 ACTION TO IMPROVE THE PREVALENCE 1318 00:46:08,240 --> 00:46:09,880 OF THE RISK FACTORS. 1319 00:46:09,880 --> 00:46:14,400 NEXT SLIDE. 1320 00:46:14,400 --> 00:46:16,920 WE AT THE CENTER PUBLISHED 1321 00:46:16,920 --> 00:46:19,560 SUGGESTIONS ON RISK REDUCTION 1322 00:46:19,560 --> 00:46:20,560 RECOMMENDATIONS THAT CAN BE 1323 00:46:20,560 --> 00:46:22,040 INCLUDED IN STATE AND LOCAL 1324 00:46:22,040 --> 00:46:22,760 ALZHEIMER'S PLANS. 1325 00:46:22,760 --> 00:46:25,200 WE HAVE SEEN OVER THE LAST 1326 00:46:25,200 --> 00:46:27,840 DECADE AS ALL BUT ONE STATE 1327 00:46:27,840 --> 00:46:29,600 PUBLISHED A STATE ALZHEIMER'S 1328 00:46:29,600 --> 00:46:31,480 PLAN THAT THESE PLANS CAN REALLY 1329 00:46:31,480 --> 00:46:32,120 HELP DRIVE ACTION. 1330 00:46:32,120 --> 00:46:35,840 SO IF WE ARE GOING TO ADDRESS 1331 00:46:35,840 --> 00:46:36,920 RISK REDUCTION AND IF STATES ARE 1332 00:46:36,920 --> 00:46:38,920 GOING TO ADDRESS RISK REDUCTION 1333 00:46:38,920 --> 00:46:40,640 IT IS IMPORTANT THEY ARE 1334 00:46:40,640 --> 00:46:42,880 INCLUDED IN STATE'S PLANS AS 1335 00:46:42,880 --> 00:46:44,160 WRITTEN AND AS THEY ARE UPDATED 1336 00:46:44,160 --> 00:46:47,120 SO WE PUBLISHED A DOCUMENT ON 1337 00:46:47,120 --> 00:46:49,760 THINGS INCLUDED IN THAT -- IN 1338 00:46:49,760 --> 00:46:52,360 THOSE PLANS TO DRIVE ACTION. 1339 00:46:52,360 --> 00:46:54,560 AND WE ARE NOW CIRCLING BACK TO 1340 00:46:54,560 --> 00:46:57,960 THE BEGINNING OF LINEAR SPREAD 1341 00:46:57,960 --> 00:47:00,760 BACK TO RESEARCH ROUND TABLE, WE 1342 00:47:00,760 --> 00:47:02,120 ARE NOW GIN WORKING WITH 1343 00:47:02,120 --> 00:47:03,960 PARTNERS AT WAKE FOREST TO DO A 1344 00:47:03,960 --> 00:47:05,600 REVIEW AND SYNTHESIS OF THE 1345 00:47:05,600 --> 00:47:06,560 EVIDENCE ON SOCIAL DETERMINANTS 1346 00:47:06,560 --> 00:47:09,720 OF HEALTH RELATED TO DEMENTIA. 1347 00:47:09,720 --> 00:47:11,800 THAT IS FROM TWO PERSPECTIVES. 1348 00:47:11,800 --> 00:47:13,480 FIRST WHAT ARE THE SOCIAL 1349 00:47:13,480 --> 00:47:15,440 DETERMINANTS OF HEALTH THAT NAY 1350 00:47:15,440 --> 00:47:17,920 AND OF THEMSELVES BE RISK 1351 00:47:17,920 --> 00:47:20,080 FACTORS FOR DEMENTIA. 1352 00:47:20,080 --> 00:47:21,640 POVERTY, QUALITY OF EARLY 1353 00:47:21,640 --> 00:47:23,720 CHILDHOOD EDUCATION OR AIR 1354 00:47:23,720 --> 00:47:25,360 POLLUTION, AND TO LOOK AT SOCIAL 1355 00:47:25,360 --> 00:47:27,120 DETERMINANTS OF HEALTH THAT ARE 1356 00:47:27,120 --> 00:47:29,400 BARRIERS TO ADDRESSING SOME OF 1357 00:47:29,400 --> 00:47:31,680 THE MODIFIABLE RISK FACTORS FOR 1358 00:47:31,680 --> 00:47:32,280 DEMENTIA. 1359 00:47:32,280 --> 00:47:34,520 FOR EXAMPLE, CONTINUING ON THE 1360 00:47:34,520 --> 00:47:39,440 THEME OF PHYSICAL ACTIVITY, 1361 00:47:39,440 --> 00:47:40,560 ENCOURAGING PHYSICAL ACTIVITY TO 1362 00:47:40,560 --> 00:47:43,760 HELP REDUCE THE RISK IS A GREAT 1363 00:47:43,760 --> 00:47:44,840 GOAL BUT IT IS DIFFICULT IF 1364 00:47:44,840 --> 00:47:46,640 PEOPLE DON'T LIVE IN A SAFE 1365 00:47:46,640 --> 00:47:47,760 NEIGHBORHOOD. 1366 00:47:47,760 --> 00:47:49,160 IF THERE AREN'T PARTS IF PEOPLE 1367 00:47:49,160 --> 00:47:51,960 CAN'T AFFORD JIM MEMBERSHIPS SO 1368 00:47:51,960 --> 00:47:53,040 WHAT ARE SOCIAL DETERMINANTS OF 1369 00:47:53,040 --> 00:47:55,880 HEALTH THAT PLAY A ROLE IN 1370 00:47:55,880 --> 00:48:00,040 ADDRESSING DEMENTIA RISK. 1371 00:48:00,040 --> 00:48:00,880 SO NEXT SLIDE. 1372 00:48:00,880 --> 00:48:02,800 THAT IS BRINGING YOU UP TO DATE 1373 00:48:02,800 --> 00:48:07,640 ON WHERE WE HAVE BEEN IN THE 1374 00:48:07,640 --> 00:48:10,560 PAST ALMOST 18 MONTHS AS THE 1375 00:48:10,560 --> 00:48:12,360 RISK REDUCTION CENTER OF 1376 00:48:12,360 --> 00:48:12,960 EXCELLENCE. 1377 00:48:12,960 --> 00:48:14,240 BUT HERE ARE SOME OF THE OTHER 1378 00:48:14,240 --> 00:48:15,560 ACTIVITIES THAT WE HAVE IN THE 1379 00:48:15,560 --> 00:48:18,960 PIPELINE COMING UP. 1380 00:48:18,960 --> 00:48:20,560 BUILDING ON THE REVIEW AND 1381 00:48:20,560 --> 00:48:23,360 SYNTHESIS OF THE EVIDENCE ON 1382 00:48:23,360 --> 00:48:24,840 SOCIAL DETERMINANTS OF HEALTH WE 1383 00:48:24,840 --> 00:48:26,760 WILL BE HOLDING A WORKSHOP AT 1384 00:48:26,760 --> 00:48:28,960 THE ALZHEIMER'S ASSOCIATION 1385 00:48:28,960 --> 00:48:29,720 INTERNATIONAL CONFERENCE IN SAN 1386 00:48:29,720 --> 00:48:31,920 DIEGO THIS SUMMER. 1387 00:48:31,920 --> 00:48:33,880 TO REVIEW THE SCIENCE AND BEGIN 1388 00:48:33,880 --> 00:48:35,560 TRANSLATING THAT TO PUBLIC 1389 00:48:35,560 --> 00:48:36,760 HEALTH ACTION WILL BE BRINGING 1390 00:48:36,760 --> 00:48:38,000 TOGETHER BOTH DEMENTIA 1391 00:48:38,000 --> 00:48:39,920 RESEARCHERS AND PUBLIC HEALTH 1392 00:48:39,920 --> 00:48:42,080 COMMUNITY TO HAVE THIS 1393 00:48:42,080 --> 00:48:44,600 CONVERSATION THIS IS AN OPEN 1394 00:48:44,600 --> 00:48:44,960 MEETING. 1395 00:48:44,960 --> 00:48:50,240 YOU DON'T NEED TO ATTEND THE 1396 00:48:50,240 --> 00:48:51,400 AAIC ITSELF TO ATTEND THE 1397 00:48:51,400 --> 00:48:52,160 WORKSHOP SO MORE INFORMATION 1398 00:48:52,160 --> 00:48:53,760 WILL BE COMING BUT SAVE THE 1399 00:48:53,760 --> 00:48:54,600 DATE, IF YOU ARE INTERESTED IN 1400 00:48:54,600 --> 00:48:56,280 THAT. 1401 00:48:56,280 --> 00:48:57,320 FOLLOWING THAT WORKSHOP WE WILL 1402 00:48:57,320 --> 00:48:59,400 BE HAVING OUR SECOND ANNUAL 1403 00:48:59,400 --> 00:49:00,760 PUBLIC HEALTH ROUND TABLE TO 1404 00:49:00,760 --> 00:49:02,680 BEGIN IDENTIFYING AND 1405 00:49:02,680 --> 00:49:04,600 PRIORITIZING WHAT PUBLIC HEALTH 1406 00:49:04,600 --> 00:49:07,680 CAN DO ON SOCIAL DETERMINANTS OF 1407 00:49:07,680 --> 00:49:07,920 HEALTH. 1408 00:49:07,920 --> 00:49:09,840 WE ARE ALSO WORKING ON PUTTING 1409 00:49:09,840 --> 00:49:11,200 TOGETHER A DEMENTIA RISK 1410 00:49:11,200 --> 00:49:14,080 REDUCTION SUMMIT. 1411 00:49:14,080 --> 00:49:15,400 IN ATLANTA WORKING CLOSELY WITH 1412 00:49:15,400 --> 00:49:18,920 OUR PARTNERS AND FUNDERS AT CDC. 1413 00:49:18,920 --> 00:49:21,720 THIS IS BROADLY TO INCREASE 1414 00:49:21,720 --> 00:49:23,520 UNDERSTANDING OF DEMENTIA RISK 1415 00:49:23,520 --> 00:49:25,840 FACTORS AND REALLY TO PROMOTE 1416 00:49:25,840 --> 00:49:27,760 TRANSLATION OF SCIENCE IN TO 1417 00:49:27,760 --> 00:49:28,960 PUBLIC HEALTH ACTION. 1418 00:49:28,960 --> 00:49:30,560 THE OTHER THING WE HAVE BEGUN 1419 00:49:30,560 --> 00:49:31,800 WORKING ON IS DEVELOPMENT AND 1420 00:49:31,800 --> 00:49:33,560 TESTING OF RISK REDUCTION 1421 00:49:33,560 --> 00:49:34,800 MESSAGING THAT CAN BE USED FROM 1422 00:49:34,800 --> 00:49:36,920 A PUBLIC HEALTH PERSPECTIVE TO 1423 00:49:36,920 --> 00:49:41,640 REACH THE PUBLIC. 1424 00:49:41,640 --> 00:49:44,320 AND FINALLY, SOME HIGHLIGHTS OF 1425 00:49:44,320 --> 00:49:45,960 SOME OF OUR FUTURE ACTIVITIES 1426 00:49:45,960 --> 00:49:47,440 DOWN THE ROAD, THEY ARE NOT 1427 00:49:47,440 --> 00:49:48,680 QUITE YET IN THE PIPELINE. 1428 00:49:48,680 --> 00:49:52,200 BUT WE ARE PLANNING THEM DOWN 1429 00:49:52,200 --> 00:49:53,000 THE ROAD. 1430 00:49:53,000 --> 00:49:54,560 REGIONAL LEARNING 1431 00:49:54,560 --> 00:49:55,040 COLLABORATIVES. THIS IS 1432 00:49:55,040 --> 00:49:58,520 SOMETHING WE FOUND DOES NOT WORK 1433 00:49:58,520 --> 00:50:01,760 WELL OVER ZOOM. 1434 00:50:01,760 --> 00:50:03,440 SO WITH HOPEFULLY AS WE COME OUT 1435 00:50:03,440 --> 00:50:05,400 OF COVID WE WILL BE ABLE TO MOVE 1436 00:50:05,400 --> 00:50:07,800 FORWARD ON REGIONAL LEARNING 1437 00:50:07,800 --> 00:50:08,560 COLLABORATIVES TO BRING TOGETHER 1438 00:50:08,560 --> 00:50:10,880 STATE AND LOCAL AND TRIBAL 1439 00:50:10,880 --> 00:50:13,160 PUBLIC HEALTH OFFICIALS TO 1440 00:50:13,160 --> 00:50:14,120 INCREASE THEIR UNDERSTANDING 1441 00:50:14,120 --> 00:50:16,640 ABOUT DEMENTIA RISK FACTORS AND 1442 00:50:16,640 --> 00:50:20,520 WORK WITH THEM TO DEVELOP WORK 1443 00:50:20,520 --> 00:50:21,680 PLANS THANK YOU THEIR 1444 00:50:21,680 --> 00:50:21,960 COMMUNITIES. 1445 00:50:21,960 --> 00:50:24,560 WE ARE ALSO WORKING IN THE 1446 00:50:24,560 --> 00:50:26,000 FUTURE TO DEVELOP TOOLS FOR 1447 00:50:26,000 --> 00:50:28,960 PUBLIC HEALTH AGENCIES TO WORK 1448 00:50:28,960 --> 00:50:30,360 WITH LOCAL HEALTH SYSTEMS TO 1449 00:50:30,360 --> 00:50:32,120 ADDRESS DEMENTIA RISK FACTORS. 1450 00:50:32,120 --> 00:50:34,440 HEALTH SYSTEMS WHETHER HMO OR 1451 00:50:34,440 --> 00:50:36,720 HOSPITAL SYSTEM OR LARGE 1452 00:50:36,720 --> 00:50:38,560 POSITION PRACTICE THEY ARE 1453 00:50:38,560 --> 00:50:41,800 REALLY KEY IN THE LONG TERM TO 1454 00:50:41,800 --> 00:50:43,480 ADDRESSING DEMENTIA RISK 1455 00:50:43,480 --> 00:50:44,480 FACTORS, SO WE WILL BE 1456 00:50:44,480 --> 00:50:46,000 DEVELOPING TOOLS FOR HOW PUBLIC 1457 00:50:46,000 --> 00:50:47,480 HEALTH CAN WORK WITH THESE 1458 00:50:47,480 --> 00:50:49,480 HEALTH SYSTEMS TO COLLECTIVELY 1459 00:50:49,480 --> 00:50:51,560 PARTNER TO ADDRESS THE RISK 1460 00:50:51,560 --> 00:50:52,680 FACTORS AND WE WILL BE WORKING 1461 00:50:52,680 --> 00:50:56,560 TO EXPAND PARTNERSHIPS WITH 1462 00:50:56,560 --> 00:50:57,560 ORGANIZATIONS INVOLVED MANY THE 1463 00:50:57,560 --> 00:50:59,560 RISK FACTORS BOTH NATIONAL LEVEL 1464 00:50:59,560 --> 00:51:01,040 AND WORKING WITH LOCAL PUBLIC 1465 00:51:01,040 --> 00:51:03,000 HEALTH AGENCIES ON HOW THEY CAN 1466 00:51:03,000 --> 00:51:05,000 EXPAND PARTNERSHIPS IN THEIR 1467 00:51:05,000 --> 00:51:09,320 COMMUNITIES. 1468 00:51:09,320 --> 00:51:11,560 PLEASE FEEL FREE TO REACH OUT TO 1469 00:51:11,560 --> 00:51:13,760 US WITH ANY QUESTIONS THAT YOU 1470 00:51:13,760 --> 00:51:17,160 MIGHT HAVE, HAPPY TO TALK TO ANY 1471 00:51:17,160 --> 00:51:20,560 OF YOU WE CAN BE REACHED AT 1472 00:51:20,560 --> 00:51:23,280 CENTER OF EXCELLENCE AT ALZ.ORG, 1473 00:51:23,280 --> 00:51:25,160 OUR EMAIL ADDRESS AND FEEL FREE 1474 00:51:25,160 --> 00:51:29,920 TO GO TO ALZ.ORG PUBLICHEALTH. 1475 00:51:29,920 --> 00:51:31,240 THERE'S MATERIALS BROADLY ON THE 1476 00:51:31,240 --> 00:51:34,640 ALZHEIMER'S ISSUE, BUT THERE IS 1477 00:51:34,640 --> 00:51:36,160 ALSO SPECIFIC INFORMATION ON 1478 00:51:36,160 --> 00:51:38,160 RISK REDUCTION AND RISK FACTORS 1479 00:51:38,160 --> 00:51:39,760 INCLUDING MATERIALS I MENTIONED 1480 00:51:39,760 --> 00:51:40,560 TO YOU PREVIOUSLY. 1481 00:51:40,560 --> 00:51:42,960 LISA. 1482 00:51:42,960 --> 00:51:44,400 >> THANK YOU SO MUCH. 1483 00:51:44,400 --> 00:51:46,680 WE WILL TURN IT OVER TO DR. 1484 00:51:46,680 --> 00:51:50,920 NAVARRE. 1485 00:51:50,920 --> 00:51:55,680 >> THANK YOU SO MUCH. 1486 00:51:55,680 --> 00:51:58,880 I'M A PREVENTIVE CARDIOLOGIST AT 1487 00:51:58,880 --> 00:51:59,920 THE UNIVERSITY TEXAS SOUTH 1488 00:51:59,920 --> 00:52:01,560 WESTERN MEDICAL CENTER. 1489 00:52:01,560 --> 00:52:04,240 TODAY I WILL BE TALKING ABOUT 1490 00:52:04,240 --> 00:52:07,560 SOME WAYS THAT WE CAN BOTH LOWER 1491 00:52:07,560 --> 00:52:09,760 RISK OF DEMENTIA AND LOWER THE 1492 00:52:09,760 --> 00:52:10,720 RISK OF HEART DISEASE AND 1493 00:52:10,720 --> 00:52:11,240 STROKE. 1494 00:52:11,240 --> 00:52:12,360 THERE IS A LOT OF OVERLAP 1495 00:52:12,360 --> 00:52:15,000 BETWEEN WHAT I DO IN CLINIC AND 1496 00:52:15,000 --> 00:52:19,360 WHAT WE ARE ABLE TO DO FOR 1497 00:52:19,360 --> 00:52:21,920 PREVENTIVE INFECTION AS WELL. 1498 00:52:21,920 --> 00:52:25,800 THESE ARE MY DISCLOSURES. 1499 00:52:25,800 --> 00:52:28,080 JUST WANTED TO PAUSE A NOTE I 1500 00:52:28,080 --> 00:52:29,760 DID RECEIVE RESEARCH AND 1501 00:52:29,760 --> 00:52:31,000 CONSULTING FROM NUMBER OF 1502 00:52:31,000 --> 00:52:32,480 COMPANIES WHO MAKE THERAPIES IN 1503 00:52:32,480 --> 00:52:34,160 THESE AREAS, WANT TO BE 1504 00:52:34,160 --> 00:52:36,560 TRANSPARENT ABOUT THAT. 1505 00:52:36,560 --> 00:52:38,520 SO THIS SLIDE COMES FROM 1506 00:52:38,520 --> 00:52:41,480 SOMEBODY REFERENCED EARLIER 2020 1507 00:52:41,480 --> 00:52:43,880 LANSETT COMMISSION LOOKED AT 1508 00:52:43,880 --> 00:52:47,160 RISK FACTORS FOR DEMENTIA. 1509 00:52:47,160 --> 00:52:50,440 AND WE SEE A LOT OF THESE RISK 1510 00:52:50,440 --> 00:52:51,920 FACTORS ARE ALSO RISK FACTORS 1511 00:52:51,920 --> 00:52:52,720 FOR HEART DISEASE. 1512 00:52:52,720 --> 00:52:54,560 BEFORE WE GO INTO THAT, I JUST 1513 00:52:54,560 --> 00:52:57,560 HAVE TO PAUSE AND AS FORMAL 1514 00:52:57,560 --> 00:52:58,560 PHYSICIAN POINT OUT ONE OF THE 1515 00:52:58,560 --> 00:53:00,280 CHALLENGES FOR ONE O THESE RISK 1516 00:53:00,280 --> 00:53:03,160 FACTORS WHICH IS ACTUALLY QUITE 1517 00:53:03,160 --> 00:53:04,840 EASY TO TREAT FROM A MEDICAL 1518 00:53:04,840 --> 00:53:05,960 STANDPOINT BUT VERY HARD TO 1519 00:53:05,960 --> 00:53:08,120 TREAT FROM A POLICY STANDPOINT. 1520 00:53:08,120 --> 00:53:11,240 THAT'S HEARING IMPAIRMENT. 1521 00:53:11,240 --> 00:53:14,640 FROM A NUMBER OF PEOPLE WITH 1522 00:53:14,640 --> 00:53:16,840 HEARING -- WITHOUT ACCESS TO 1523 00:53:16,840 --> 00:53:19,200 HEARING RATES OR ASSISTIVE 1524 00:53:19,200 --> 00:53:21,560 DEVICE ARE AT INCREASE RISK OF 1525 00:53:21,560 --> 00:53:21,800 DEMENTIA. 1526 00:53:21,800 --> 00:53:25,160 CURRENT MEDICARE AND MEDICAID 1527 00:53:25,160 --> 00:53:26,920 INSURANCE POLICIES DON'T COVER 1528 00:53:26,920 --> 00:53:27,560 HEARING AIDS. 1529 00:53:27,560 --> 00:53:30,480 THERE IS ONGOING EFFORTS IN 1530 00:53:30,480 --> 00:53:31,360 CONGRESS TO MOVE FORWARD 1531 00:53:31,360 --> 00:53:33,560 LEGISLATION FROM THIS AREA. 1532 00:53:33,560 --> 00:53:35,720 SO IT IS FRUSTRATING AS A 1533 00:53:35,720 --> 00:53:36,720 CLINICIAN THAT SOME OF THESE 1534 00:53:36,720 --> 00:53:39,360 RISK FACTORS ARE ACTUALLY 1535 00:53:39,360 --> 00:53:41,720 POTENTIALLY MODIFIABLE BUT WE 1536 00:53:41,720 --> 00:53:44,600 FACE BARRIERS ON REIMBURSEMENT 1537 00:53:44,600 --> 00:53:47,480 AND COST RATHER THAN BARRIERS ON 1538 00:53:47,480 --> 00:53:48,320 THE ACTUAL SCIENCE. 1539 00:53:48,320 --> 00:53:50,640 THE OTHER SIDE I'M PREVENTIVE 1540 00:53:50,640 --> 00:53:51,760 CARDIOLOGIST AND I SPEND TIME 1541 00:53:51,760 --> 00:53:53,960 THINKING ABOUT WAYS TO PREVENT 1542 00:53:53,960 --> 00:53:55,320 CARDIOVASCULAR DISEASE INCLUDING 1543 00:53:55,320 --> 00:53:57,360 HEART FAILURE, CORONARY DISEASE, 1544 00:53:57,360 --> 00:53:59,080 HEART ATTACK AND STROKE. 1545 00:53:59,080 --> 00:54:00,680 AND THE NICE THING WHEN WE ARE 1546 00:54:00,680 --> 00:54:02,800 THINKING HOW TO PREVENT DEMENTIA 1547 00:54:02,800 --> 00:54:04,440 IS THAT OUT OF THESE 12 RISK 1548 00:54:04,440 --> 00:54:06,800 FACTORS, TEN OF THEM ARE 1549 00:54:06,800 --> 00:54:08,280 ACTUALLY STRONGLY ASSOCIATED 1550 00:54:08,280 --> 00:54:10,840 WITH HEART DISEASE AS WELL. 1551 00:54:10,840 --> 00:54:12,160 THOSE RISK FACTORS ARE LISTED 1552 00:54:12,160 --> 00:54:13,800 HERE OBJECT SLIDE. 1553 00:54:13,800 --> 00:54:15,600 SO WHILE WE STILL HAVE A NUMBER 1554 00:54:15,600 --> 00:54:17,760 OF RESEARCH NEEDS IN TERMS OF 1555 00:54:17,760 --> 00:54:19,080 UNDERSTANDING HOW TO MODIFY 1556 00:54:19,080 --> 00:54:21,040 THESE DIFFERENT RISK FACTORS IN 1557 00:54:21,040 --> 00:54:22,960 THE DEGREE TO WHICH MODIFYING 1558 00:54:22,960 --> 00:54:24,440 RISK FACTORS CAN IMPROVE 1559 00:54:24,440 --> 00:54:25,800 COGNITION AND COGNITIVE FUNCTION 1560 00:54:25,800 --> 00:54:26,840 OVER TIME. 1561 00:54:26,840 --> 00:54:29,360 WE HAVE REALLY STRONG EVIDENCE 1562 00:54:29,360 --> 00:54:30,760 WHILE WAITING FOR THAT, THAT 1563 00:54:30,760 --> 00:54:32,400 THERE IS SIGNIFICANT BENEFIT IN 1564 00:54:32,400 --> 00:54:34,200 TERMS OF CARDIOVASCULAR DISEASE 1565 00:54:34,200 --> 00:54:36,040 PROTECTION TO MODIFY THOSE RISK 1566 00:54:36,040 --> 00:54:37,520 FACTORS EARLY AND SUSTAINED OVER 1567 00:54:37,520 --> 00:54:39,800 THE LIFE COURSE. 1568 00:54:39,800 --> 00:54:41,600 TODAY WE WILL TALK ABOUT FIVE OF 1569 00:54:41,600 --> 00:54:42,120 THESE. 1570 00:54:42,120 --> 00:54:43,920 AND THESE ARE RISK FACTORS THAT 1571 00:54:43,920 --> 00:54:45,920 I THINK ARE ONES THAT WE 1572 00:54:45,920 --> 00:54:47,080 COMMONLY ADDRESS IN CLINIC AND 1573 00:54:47,080 --> 00:54:49,360 THERE ARE RISK FACTORS THAT 1574 00:54:49,360 --> 00:54:50,840 PEOPLE WHO ARE INTERESTED IN 1575 00:54:50,840 --> 00:54:52,720 LOWERING RISK OF HEART DISEASE 1576 00:54:52,720 --> 00:54:54,160 AND DEMENTIA CAN WORK WITH THEIR 1577 00:54:54,160 --> 00:54:56,600 HEALTHCARE PROVIDER TO RECEIVE 1578 00:54:56,600 --> 00:54:57,960 MEDICATION AND OTHER BEHAVIORAL 1579 00:54:57,960 --> 00:54:59,120 SUPPORT TO HELP ADDRESS THESE 1580 00:54:59,120 --> 00:55:01,240 RISK FACTORS. 1581 00:55:01,240 --> 00:55:04,440 WE WILL START WITH TWO, SMOKING 1582 00:55:04,440 --> 00:55:05,400 AND OBESITY. 1583 00:55:05,400 --> 00:55:06,440 I THINK IT IS IMPORTANT FOR US 1584 00:55:06,440 --> 00:55:09,520 TO POINT OUT FROM A PHYSICIAN 1585 00:55:09,520 --> 00:55:11,960 STANDPOINT THESE ARE RISK 1586 00:55:11,960 --> 00:55:13,240 FACTORS TO TO BE CONSIDERING MED 1587 00:55:13,240 --> 00:55:15,800 CAP CONDITIONS AND ARE MEDICALLY 1588 00:55:15,800 --> 00:55:16,080 TREATABLE. 1589 00:55:16,080 --> 00:55:17,520 WE OFTEN USE -- THERE IS STIGMA 1590 00:55:17,520 --> 00:55:20,840 AROUND OBESITY AND SMOKING AS 1591 00:55:20,840 --> 00:55:22,000 LIFESTYLE PROBLEM AND WHILE 1592 00:55:22,000 --> 00:55:24,440 LIFESTYLE MODIFICATIONS ARE 1593 00:55:24,440 --> 00:55:26,320 CRITICAL COMBATING BOTH OBESITY 1594 00:55:26,320 --> 00:55:28,280 AND SMOKING, THERE ARE NUMBER OF 1595 00:55:28,280 --> 00:55:29,680 WAYS THAT PATIENTS WITH WORK 1596 00:55:29,680 --> 00:55:31,400 WITH THEIR HEALTHCARE PROVIDERS 1597 00:55:31,400 --> 00:55:33,240 FOR MEDICAL SUPPORT IN THESE 1598 00:55:33,240 --> 00:55:33,960 INTERVENTIONS. 1599 00:55:33,960 --> 00:55:36,960 FOR OBESITY WE KNOW THAT HEALTHY 1600 00:55:36,960 --> 00:55:38,560 DIET IRRESPECTIVE OF WEIGHT LOSS 1601 00:55:38,560 --> 00:55:40,920 CAN LOWER THE RISK OF 1602 00:55:40,920 --> 00:55:42,040 CARDIOVASCULAR DISEASE. 1603 00:55:42,040 --> 00:55:43,960 AND REFERRALS TO 1604 00:55:43,960 --> 00:55:46,080 NUTRITIONALLISTS AND REGISTERED 1605 00:55:46,080 --> 00:55:47,880 DIETITIANS ARE WAYS TO ENGAGE 1606 00:55:47,880 --> 00:55:49,640 COLLEAGUES WHO CAN HELP GUIDE 1607 00:55:49,640 --> 00:55:51,160 PATIENTS TO CHANGES IN THEIR 1608 00:55:51,160 --> 00:55:53,040 DIET, TO BOTH HELP WEIGHT LOSS 1609 00:55:53,040 --> 00:55:55,000 BUT MORE IMPORTANTLY HEART 1610 00:55:55,000 --> 00:55:57,200 HEALTHY FOODS TO PROMOTE 1611 00:55:57,200 --> 00:55:58,800 CARDIOVASCULAR HEALTH OVER THE 1612 00:55:58,800 --> 00:55:59,200 LIFE SPAN. 1613 00:55:59,200 --> 00:56:02,240 FOR PEOPLE WITH SEVERE OBESITY, 1614 00:56:02,240 --> 00:56:04,800 BARIATRIC SURGERY, HAS NOT ONLY 1615 00:56:04,800 --> 00:56:07,040 SHOWN TO LEAD THE WEIGH LOSS BUT 1616 00:56:07,040 --> 00:56:08,720 IN FACT LOWERS THE COMPLICATIONS 1617 00:56:08,720 --> 00:56:13,200 OF OBESITY LIKE HYPERTENSION AND 1618 00:56:13,200 --> 00:56:14,680 DIABETES AND LOWERS THE RISK OF 1619 00:56:14,680 --> 00:56:17,200 LONG TERM CARDIOVASCULAR 1620 00:56:17,200 --> 00:56:17,440 DISEASE. 1621 00:56:17,440 --> 00:56:19,120 FINALLY IT IS AN EXCITING AREA 1622 00:56:19,120 --> 00:56:20,800 FOR MEDICAL TREATMENT OF OBESITY 1623 00:56:20,800 --> 00:56:22,600 AS A NUMBER OF FDA APPROVED 1624 00:56:22,600 --> 00:56:26,560 MEDICATIONS NOW TO TREAT 1625 00:56:26,560 --> 00:56:27,320 DIABETES THAT (INAUDIBLE) WEIGHT 1626 00:56:27,320 --> 00:56:27,720 LOSS. 1627 00:56:27,720 --> 00:56:29,280 ONE OF THESE CLASSES OF 1628 00:56:29,280 --> 00:56:31,920 MEDICATION THE GOP 1 RECEPTOR 1629 00:56:31,920 --> 00:56:34,160 AGONIST CLASS AND ONE OF THOSE 1630 00:56:34,160 --> 00:56:38,240 AT HIGHER DOSES IS NOW APPROVED 1631 00:56:38,240 --> 00:56:39,880 FOR WEIGHT LOSS. 1632 00:56:39,880 --> 00:56:41,160 SO WE HAVE NOW MEDICATION TO 1633 00:56:41,160 --> 00:56:43,040 HELP LOWER CARDIOVASCULAR 1634 00:56:43,040 --> 00:56:44,480 DISEASE RISK AND TREAT OBESITY 1635 00:56:44,480 --> 00:56:47,160 AT SAME TIME. 1636 00:56:47,160 --> 00:56:48,640 OBVIOUSLY WE HAVE CHALLENGES IN 1637 00:56:48,640 --> 00:56:50,760 BOTH UTILIZATION OF MEDICATIONS, 1638 00:56:50,760 --> 00:56:52,120 THEY OFTEN ARE EXPENSIVE AND WE 1639 00:56:52,120 --> 00:56:54,480 ARE GOING TO NEED TO PAY 1640 00:56:54,480 --> 00:56:57,160 ATTENTION TO OUT OF POCKET COST 1641 00:56:57,160 --> 00:56:58,520 FOR PATIENTS FOR THESE THERAPIES 1642 00:56:58,520 --> 00:57:03,680 AN WORK TO PROMOTE PRICING FOR 1643 00:57:03,680 --> 00:57:05,080 EQUAL ACCESS FOR ALL. 1644 00:57:05,080 --> 00:57:06,520 SMOKING IS ANOTHER MEDICAL 1645 00:57:06,520 --> 00:57:08,080 PROBLEM WE CAN TREAT OR HELP 1646 00:57:08,080 --> 00:57:10,400 SUPPORT PATIENTS WITH. 1647 00:57:10,400 --> 00:57:13,040 WITH BOTH FDA APPROVED 1648 00:57:13,040 --> 00:57:14,320 MEDICATION AS WELL AS PROVEN 1649 00:57:14,320 --> 00:57:17,800 EFFECT OF BEHAVIORAL COUNSELING. 1650 00:57:17,800 --> 00:57:19,200 NUMEROUS STUDIES HAVE SHOWN 1651 00:57:19,200 --> 00:57:22,760 MEDICATION PHARMACO THERAPIES 1652 00:57:22,760 --> 00:57:24,760 WORKS BETTER WHEN PAIRED WITH 1653 00:57:24,760 --> 00:57:26,320 REFERRAL THE BEHAVIORAL 1654 00:57:26,320 --> 00:57:26,600 COUNSELING. 1655 00:57:26,600 --> 00:57:27,240 EVERYBODY IN THE UNITED STATES 1656 00:57:27,240 --> 00:57:28,960 HAS ACCESS TO EITHER PHONE BASED 1657 00:57:28,960 --> 00:57:31,720 OR WEB-BASED BEHAVIORAL HEALTH 1658 00:57:31,720 --> 00:57:34,280 SUPPORT FOR SMOKING CESSATION 1659 00:57:34,280 --> 00:57:36,600 LIEU THE QUIT LINE OR SMOKE 1660 00:57:36,600 --> 00:57:37,400 FREE.GOV. 1661 00:57:37,400 --> 00:57:39,600 ALSO HAVE REFERENCES FOR OTHER 1662 00:57:39,600 --> 00:57:40,800 LANGUAGES SO IT IS NOT FOR THOSE 1663 00:57:40,800 --> 00:57:43,200 WHO SPEAK ENGLISH. 1664 00:57:43,200 --> 00:57:46,440 WE ALSO KNOW MEDICATION THERAPY 1665 00:57:46,440 --> 00:57:50,640 AND NICOTINE REPLACEMENT THERAPY 1666 00:57:50,640 --> 00:57:52,960 CHAN TAX AND WELLBUTRIN, HAVE 1667 00:57:52,960 --> 00:57:54,840 BEEN SHOWN TO HELP PEOPLE ABOUT 1668 00:57:54,840 --> 00:57:56,240 SANE FROM SMOKING. 1669 00:57:56,240 --> 00:57:58,440 THE CHALLENGES THAT PROVIDERS 1670 00:57:58,440 --> 00:57:59,560 DON'T ALWAYS RECOMMEND FOR 1671 00:57:59,560 --> 00:58:00,840 PATIENTS WHO SEEK TO QUIT 1672 00:58:00,840 --> 00:58:02,520 SMOKING SO WE NEED TO DO A 1673 00:58:02,520 --> 00:58:03,960 BETTER JOB ON OUR END AS 1674 00:58:03,960 --> 00:58:06,160 HEALTHCARE PROVIDERS AND LEARN 1675 00:58:06,160 --> 00:58:07,960 UTILIZATION OF THESE THERAPIES, 1676 00:58:07,960 --> 00:58:09,760 IDENTIFYING PATIENTS WHO MAY 1677 00:58:09,760 --> 00:58:12,920 BENEFIT FROM THEM AND HELPING 1678 00:58:12,920 --> 00:58:14,760 PROVIDE ACCESS TO THERAPY FOR 1679 00:58:14,760 --> 00:58:16,360 PATIENTS AS THEY SEEK TO PUT 1680 00:58:16,360 --> 00:58:18,480 CIGARETTE SMOKING AND USE OF 1681 00:58:18,480 --> 00:58:21,920 OTHER TOBACCO PRODUCTS. 1682 00:58:21,920 --> 00:58:23,960 BEHEARD FROM DR. BAKER ABOUT 1683 00:58:23,960 --> 00:58:25,840 PHYSICAL ACTIVITY TELLING US THE 1684 00:58:25,840 --> 00:58:26,960 IMPORTANT LENGTH BETWEEN 1685 00:58:26,960 --> 00:58:30,480 MOVEMENT EXERCISE AND PROMOTING 1686 00:58:30,480 --> 00:58:30,880 LONG (INAUDIBLE). 1687 00:58:30,880 --> 00:58:32,000 I WANT TO POINT OUT ONE THING 1688 00:58:32,000 --> 00:58:33,440 FROM A PHYSICIAN STANDPOINT THAT 1689 00:58:33,440 --> 00:58:36,360 IS HELPFUL FOR PATIENTS AS THEY 1690 00:58:36,360 --> 00:58:37,520 THINK ABOUT HOW THEY CAN 1691 00:58:37,520 --> 00:58:39,040 INCREASE PHYSICAL ACTIVITY. 1692 00:58:39,040 --> 00:58:40,960 IT CAN BE DAUNTING TO GO FROM NO 1693 00:58:40,960 --> 00:58:42,760 PHYSICAL ACTIVITY TO HAVING TO 1694 00:58:42,760 --> 00:58:44,080 RUN A MARATHON BUT THAT IS NOT 1695 00:58:44,080 --> 00:58:47,600 WHAT WE ARE ASKING PEOPLE TO DO. 1696 00:58:47,600 --> 00:58:49,160 IN FACT THOUGH DR. BAKER 1697 00:58:49,160 --> 00:58:51,360 EMPHASIZES THE IMPORTANCE OF 1698 00:58:51,360 --> 00:58:53,280 SUSTAINED CARD -- FITNESS OVER 1699 00:58:53,280 --> 00:58:54,840 THE LIFE SPAN, IN FACT EVEN 1700 00:58:54,840 --> 00:58:57,560 SMALL INCREASES IN THE AMOUNT OF 1701 00:58:57,560 --> 00:58:58,160 REGULAR PHYSICAL ACTIVITY HAVE 1702 00:58:58,160 --> 00:59:00,440 BEEN SHOWN TO LOWER THE RISK OF 1703 00:59:00,440 --> 00:59:02,080 ALZHEIMER'S DISEASE AS WELL AS 1704 00:59:02,080 --> 00:59:04,600 COGNITIVE IMPAIRMENT COMPARED TO 1705 00:59:04,600 --> 00:59:05,400 NO ACTIVITY. 1706 00:59:05,400 --> 00:59:07,160 IN FACT EVEN MODERATE ACTIVITY 1707 00:59:07,160 --> 00:59:09,760 DEFINED AS WALKING ACTIVITY 1708 00:59:09,760 --> 00:59:12,480 THREE OR MARITIMES A WEEK IN 1709 00:59:12,480 --> 00:59:14,280 WOMEN WAS SHOWN OVER THE AGE OF 1710 00:59:14,280 --> 00:59:17,720 65 AS SHOWN TO LOWER THE RISK OF 1711 00:59:17,720 --> 00:59:19,560 COGNITIVE IMPAIRMENT BY ALMOST 1712 00:59:19,560 --> 00:59:19,720 58%. 1713 00:59:19,720 --> 00:59:21,720 SO FOR THOSE OF YOU WHO MAY BE 1714 00:59:21,720 --> 00:59:23,960 OVERWHELMED OR FEEL LIKE YOU 1715 00:59:23,960 --> 00:59:25,160 CAN'T REACH THE MINIMUM 1716 00:59:25,160 --> 00:59:27,600 RECOMMENDED PHYSICAL ACTIVITY 1717 00:59:27,600 --> 00:59:28,960 TARGET, HOWEVER CLOSE YOU CAN 1718 00:59:28,960 --> 00:59:31,160 GET THERE EVEN INCREMENTAL 1719 00:59:31,160 --> 00:59:33,320 INCREASES IN SUSTAINED PHYSICAL 1720 00:59:33,320 --> 00:59:34,760 ACTIVITY OVER YEARS IS LIKELY TO 1721 00:59:34,760 --> 00:59:36,360 DECREASE LONG TERM RISK OF 1722 00:59:36,360 --> 00:59:37,280 DEMENTIA AND COGNITIVE 1723 00:59:37,280 --> 00:59:39,280 IMPAIRMENT. 1724 00:59:39,280 --> 00:59:41,160 WE ALSO KNOW THAT PHYSICAL 1725 00:59:41,160 --> 00:59:44,040 ACTIVITY IS A KEY WAY TO HELP 1726 00:59:44,040 --> 00:59:45,960 PREVENT CARDIOVASCULAR DISEASE 1727 00:59:45,960 --> 00:59:47,520 INCLUDING HEART ATTACK AND 1728 00:59:47,520 --> 00:59:47,960 STROKE. 1729 00:59:47,960 --> 00:59:49,080 THESE ARE THE RECOMMENDATIONS 1730 00:59:49,080 --> 00:59:50,760 FROM THE AMERICAN HEART 1731 00:59:50,760 --> 00:59:52,120 ASSOCIATION FOR PHYSICAL 1732 00:59:52,120 --> 00:59:55,920 ACTIVITY IN ADULTS. 1733 00:59:55,920 --> 00:59:57,480 THE RECOMMENDATIONS ARE 150 1734 00:59:57,480 --> 00:59:59,520 MINUTE AS WEEK OF MODERATE 1735 00:59:59,520 --> 01:00:01,480 ACTIVITY OR 75 MINUTE AS WEEK OF 1736 01:00:01,480 --> 01:00:03,000 HIGH INTENSITY ACTIVITY. 1737 01:00:03,000 --> 01:00:05,440 AND THE EASIEST WAY I TALK TO MY 1738 01:00:05,440 --> 01:00:08,160 PATIENTS HOW TO KNOW IF WHAT YOU 1739 01:00:08,160 --> 01:00:10,200 KNOW IS MISDEMEANOR RAT OR 1740 01:00:10,200 --> 01:00:10,480 RIGOROUS. 1741 01:00:10,480 --> 01:00:11,960 WITH MODERATE I CAN E YOU SHOULD 1742 01:00:11,960 --> 01:00:14,320 BE, WHOING HARD ENOUGH TO SPEAK 1743 01:00:14,320 --> 01:00:15,840 IN COMPLETE SENTENCES BUT 1744 01:00:15,840 --> 01:00:17,720 COULDN'T SING A SONG. 1745 01:00:17,720 --> 01:00:18,720 HIGH INTENSITY ACTIVITY IS 1746 01:00:18,720 --> 01:00:20,080 SOMETHING LIKE RUNNING OR 1747 01:00:20,080 --> 01:00:21,320 SINGLES TENNIS WHERE YOU CAN 1748 01:00:21,320 --> 01:00:22,800 SPEAK BUT ONLY IN VERY SHORT 1749 01:00:22,800 --> 01:00:23,800 SENTENCES BECAUSE YOU ARE TRYING 1750 01:00:23,800 --> 01:00:25,840 TO CATCH YOUR BREATH. 1751 01:00:25,840 --> 01:00:27,680 WE ALSO RECOMMEND THE HEART 1752 01:00:27,680 --> 01:00:29,760 ASSOCIATION AT LEAST TWO DAYS A 1753 01:00:29,760 --> 01:00:31,240 WEEK OF STRENGTH FROM MUSCLE 1754 01:00:31,240 --> 01:00:33,200 BUILDING BECAUSE THAT CAN 1755 01:00:33,200 --> 01:00:35,400 PROMOTE ADDITIONAL METABOLIC 1756 01:00:35,400 --> 01:00:36,240 STABILITY AND DECREASE FURTHER 1757 01:00:36,240 --> 01:00:37,720 RISK OF HEART DISEASE IN HEART 1758 01:00:37,720 --> 01:00:39,160 DISEASE RISK FACTORS LIKE 1759 01:00:39,160 --> 01:00:42,080 DIABETES. 1760 01:00:42,080 --> 01:00:44,160 BLOOD PRESSURE IS A KEY 1761 01:00:44,160 --> 01:00:46,720 MODIFIABLE RISK FACTOR DEMENTIA 1762 01:00:46,720 --> 01:00:49,280 AND CARDIOVASCULAR DISEASE. 1763 01:00:49,280 --> 01:00:51,240 ONE STUDY SHOWING THE IMPORTANCE 1764 01:00:51,240 --> 01:00:52,200 OF SUSTAINED CONTROL AND BLOOD 1765 01:00:52,200 --> 01:00:55,480 PRESSURE OVER TIME, COMING FROM 1766 01:00:55,480 --> 01:00:58,080 FRAMINGHAM COHORT STUDY. 1767 01:00:58,080 --> 01:01:00,720 THIS TOOK PEOPLE IN THE 70s AN 1768 01:01:00,720 --> 01:01:02,320 FOLLOWED THYMICAE KIDS HOW RISK 1769 01:01:02,320 --> 01:01:03,840 FACTORS IN MIDDLE OF YOUR LIFE 1770 01:01:03,840 --> 01:01:05,520 IMPACT YOUR LONG TERM RISK OF 1771 01:01:05,520 --> 01:01:07,960 THINGS LIKE DEMENTIA AND 1772 01:01:07,960 --> 01:01:09,000 CARDIOVASCULAR DISEASE. 1773 01:01:09,000 --> 01:01:11,360 THIS PARTICULAR STUDY PEOPLE 1774 01:01:11,360 --> 01:01:13,280 WERE FOLLOWED FOR SEVERAL 1775 01:01:13,280 --> 01:01:17,360 DECADES AND WERE FOUND -- THEY 1776 01:01:17,360 --> 01:01:18,640 FOUND FOR EVERY TEN POINT 1777 01:01:18,640 --> 01:01:20,160 INCREASE IN BLOOD PRESSURE IN 1778 01:01:20,160 --> 01:01:22,080 MID LIFE, YOUR LONG TERM RISK OF 1779 01:01:22,080 --> 01:01:25,840 DEMENTIA WAS INCREASED BY 20%. 1780 01:01:25,840 --> 01:01:27,200 EMPHASIZING THE IMPORTANCE OF 1781 01:01:27,200 --> 01:01:28,600 THINKING EARLY ABOUT MODIFYING 1782 01:01:28,600 --> 01:01:31,680 RISK FACTORS TO HELP PROMOTE 1783 01:01:31,680 --> 01:01:33,560 LONG TERM BRAIN HEALTH. 1784 01:01:33,560 --> 01:01:35,760 WHAT DO WE KNOW ABOUT BLOOD 1785 01:01:35,760 --> 01:01:36,800 PRESSURE AND DEMENTIA FROM 1786 01:01:36,800 --> 01:01:38,160 CLINICAL TRIALS? 1787 01:01:38,160 --> 01:01:41,040 THIS META ANALYSIS PUBLISHED IN 1788 01:01:41,040 --> 01:01:43,720 JAMA TOOK 14 RANDOMIZED TRIALS 1789 01:01:43,720 --> 01:01:45,440 PEOPLE WHO RANDOMIZE DIFFERENT 1790 01:01:45,440 --> 01:01:46,320 BLOOD PRESSURE THERAPY AND 1791 01:01:46,320 --> 01:01:49,920 POOLED THE DATA TOGETHER FOR 1792 01:01:49,920 --> 01:01:50,400 100,000. 1793 01:01:50,400 --> 01:01:52,160 THE FOLLOW-UP TIME WAS ABOUT 1794 01:01:52,160 --> 01:01:53,520 FOUR YEARS. 1795 01:01:53,520 --> 01:01:55,880 AND POOLED TOGETHER THE AUTHORS 1796 01:01:55,880 --> 01:01:57,560 FOUND A SMALL BUT REAL DECREASE 1797 01:01:57,560 --> 01:01:59,440 MANY THE RISK OF DEMENTIA AS 1798 01:01:59,440 --> 01:02:00,720 WELL AS COGNITIVE DECLINE AND 1799 01:02:00,720 --> 01:02:02,400 THE GROUPS OF PEOPLE WHO WERE 1800 01:02:02,400 --> 01:02:03,920 RANDOMIZED TO BLOOD PRESSURE 1801 01:02:03,920 --> 01:02:05,000 LOWERING COMPARED TO PEOPLE WHO 1802 01:02:05,000 --> 01:02:06,720 WERE NOT. 1803 01:02:06,720 --> 01:02:08,360 YOU MIGHT ASK THIS LOOKS REALLY 1804 01:02:08,360 --> 01:02:10,160 SMALL COMPARED TO DATA YOU 1805 01:02:10,160 --> 01:02:12,160 SHOWED ON THE LAST SLIDE. 1806 01:02:12,160 --> 01:02:14,800 I WILL POINT OUT THAT MOST OF 1807 01:02:14,800 --> 01:02:15,960 THESE TRIALS DON'T FOLLOW PEOPLE 1808 01:02:15,960 --> 01:02:17,160 A LONG TIME. 1809 01:02:17,160 --> 01:02:18,720 WE ARE LOOKING AT THE BENEFIT OF 1810 01:02:18,720 --> 01:02:20,800 BLOOD PRESSURE LOWERING ABOUT 1811 01:02:20,800 --> 01:02:22,960 FOUR YEARS ON AVERAGE WITH THESE 1812 01:02:22,960 --> 01:02:23,480 STUDIES. 1813 01:02:23,480 --> 01:02:25,320 WE KNOW THAT THE BIOLOGY OF 1814 01:02:25,320 --> 01:02:26,480 DEMENTIA IS SOMETHING THAT TAKES 1815 01:02:26,480 --> 01:02:28,480 A LONG TIME TO ACCUMULATE RISK 1816 01:02:28,480 --> 01:02:33,360 AND A LONG TIME TO START TO 1817 01:02:33,360 --> 01:02:34,120 ACCUMULATE RISK WHICH MEANS WE 1818 01:02:34,120 --> 01:02:36,160 HAVE A LONG TIME TO ACCUMULATE 1819 01:02:36,160 --> 01:02:36,360 BENEFIT. 1820 01:02:36,360 --> 01:02:38,360 SO WHEN I LOOK AT THESE DATA IN 1821 01:02:38,360 --> 01:02:40,040 CONTEXT WITH OBSERVATIONAL DATA 1822 01:02:40,040 --> 01:02:42,760 FOR FRAMINGHAM, IT EMPHASIZES 1823 01:02:42,760 --> 01:02:44,160 THE IMPORTANT OF NOT WAITING 1824 01:02:44,160 --> 01:02:46,200 LATER IN LIFE FOR BLOOD PRESSURE 1825 01:02:46,200 --> 01:02:48,320 CONTROL TO MAXIMIZE POTENTIAL 1826 01:02:48,320 --> 01:02:49,960 BENEFIT OF BLOOD PRESSURE 1827 01:02:49,960 --> 01:02:51,760 LOWERING ON OVERALL RISK OF 1828 01:02:51,760 --> 01:02:55,400 DEMENTIA AND COGNITIVE DECLINE. 1829 01:02:55,400 --> 01:02:56,960 THIS RANDOMIZED TRIAL GAVE 1830 01:02:56,960 --> 01:02:58,440 ADDITIONAL INFORMATION FOR US. 1831 01:02:58,440 --> 01:03:00,560 ABOUT WHAT THE OPTIMAL BLOOD 1832 01:03:00,560 --> 01:03:03,560 PRESSURE SHOULD BE TO HELP 1833 01:03:03,560 --> 01:03:04,960 PREVENT DEMENTIA AND PROMOTE 1834 01:03:04,960 --> 01:03:06,320 LONG TERM BRAIN HEALTH. 1835 01:03:06,320 --> 01:03:07,640 THIS IS DEFINED TO SHOW WHETHER 1836 01:03:07,640 --> 01:03:09,640 OR NOT A LOWER TARGET BLOOD 1837 01:03:09,640 --> 01:03:11,080 PRESSURE IN THIS CASE SOLID 1838 01:03:11,080 --> 01:03:14,120 BLOOD PRESSURE LESS THAN 120 WAS 1839 01:03:14,120 --> 01:03:15,920 BETTER THAN TARGET SYSTOLIC 1840 01:03:15,920 --> 01:03:17,760 BLOOD PRESSURE LESS THAN 140. 1841 01:03:17,760 --> 01:03:21,440 THE OVERALL STUDY WE SAW 1842 01:03:21,440 --> 01:03:22,160 DRAMATICALLY (INAUDIBLE) STROKE 1843 01:03:22,160 --> 01:03:23,760 AND HEART ATTACK AND RANDOMIZED 1844 01:03:23,760 --> 01:03:24,800 LOWER VERSUS HIGHER BLOOD 1845 01:03:24,800 --> 01:03:27,680 PRESSURE. 1846 01:03:27,680 --> 01:03:29,520 FOLLOW-UP SUBSET OF PEE P L HAD 1847 01:03:29,520 --> 01:03:31,880 COGNITIVE ASSESSMENT AND WHAT WE 1848 01:03:31,880 --> 01:03:34,560 FOUND IS 17% DECREASE IN RISK OF 1849 01:03:34,560 --> 01:03:38,360 DEMENTIA AS WELL AS 19% DECREASE 1850 01:03:38,360 --> 01:03:39,760 IN MILD CONTROLOR COGNITIVE 1851 01:03:39,760 --> 01:03:43,240 IMPAIRMENT IN RANDOMIZED 1852 01:03:43,240 --> 01:03:44,800 (INAUDIBLE) IT IS IMPORTANT TO 1853 01:03:44,800 --> 01:03:47,440 ASK THAT PROBABLY DUE TO SAMPLE 1854 01:03:47,440 --> 01:03:49,360 SIZE IS RELATIVE RISK REDUCTION 1855 01:03:49,360 --> 01:03:51,600 WAS NOT STATISTICALLY 1856 01:03:51,600 --> 01:03:51,920 SIGNIFICANT. 1857 01:03:51,920 --> 01:03:53,320 COMBINED WITH WHAT WE KNOW ABOUT 1858 01:03:53,320 --> 01:03:55,360 -- FROM OBSERVATIONAL STUDIES 1859 01:03:55,360 --> 01:03:57,400 ABOUT RISK OF HYPERTENSION AND 1860 01:03:57,400 --> 01:04:00,600 DEMENTIA RISK IT IS BIOLOGICALLY 1861 01:04:00,600 --> 01:04:02,360 PLAUSIBLE LOWERING BLOOD 1862 01:04:02,360 --> 01:04:04,560 PRESSURE WILL HELP PROMOTE -- 1863 01:04:04,560 --> 01:04:05,960 PREVENT DIABETES COGNITIVE 1864 01:04:05,960 --> 01:04:08,840 IMPAIRMENT OVER TIME. 1865 01:04:08,840 --> 01:04:10,760 DIABETES IS ANOTHER RISK FACTOR 1866 01:04:10,760 --> 01:04:11,920 THAT WE CAN TREAT MEDICALLY TO 1867 01:04:11,920 --> 01:04:14,360 HELP PREVENT RISK OF DEMENTIA. 1868 01:04:14,360 --> 01:04:16,760 THIS GRAPH COMES FROM A NICE 1869 01:04:16,760 --> 01:04:19,920 REVIEW ARTICLE OF THE -- 1870 01:04:19,920 --> 01:04:21,560 DIABETES AND HOW IT INTERPLAYS 1871 01:04:21,560 --> 01:04:23,360 WITH RISK OF DEMENTIA, BOTH 1872 01:04:23,360 --> 01:04:27,840 THROUGH PROMOTING 1873 01:04:27,840 --> 01:04:28,440 ATHEROSCLEROSIS, MICROVASCULAR 1874 01:04:28,440 --> 01:04:29,280 DISEASE DIRECT TOXICITY IN THE 1875 01:04:29,280 --> 01:04:30,800 BRAIN AND INSULIN. 1876 01:04:30,800 --> 01:04:33,080 WE KNOW THAT DURATION OF 1877 01:04:33,080 --> 01:04:36,320 DIABETES HAVING UNCONTROLLED 1878 01:04:36,320 --> 01:04:38,560 DIABETES HYPOGLYCEMIC CREASE 1879 01:04:38,560 --> 01:04:39,720 RISK OF DEMENTIA. 1880 01:04:39,720 --> 01:04:41,160 ALL THESE THINGS INCREASE THE 1881 01:04:41,160 --> 01:04:43,040 RISK OF MYOCARDIAL INFARCTION 1882 01:04:43,040 --> 01:04:45,880 AND STROKE OVER TIME. 1883 01:04:45,880 --> 01:04:47,360 THE LAST WE HAVE HAD TWO CLASSES 1884 01:04:47,360 --> 01:04:50,440 OF THERAPIES THAT ARE ABSOLUTELY 1885 01:04:50,440 --> 01:04:51,440 BREAK THROUGH TREATMENT TO HELP 1886 01:04:51,440 --> 01:04:53,120 US LOWER THE RISK OF 1887 01:04:53,120 --> 01:04:54,160 CARDIOVASCULAR DISEASE IN 1888 01:04:54,160 --> 01:04:55,680 PERSONS WITH DEUTSCHE. 1889 01:04:55,680 --> 01:04:56,960 THESE INCLUDE CLASS OF 1890 01:04:56,960 --> 01:05:00,560 MEDICATIONS CALLED STLT 2 1891 01:05:00,560 --> 01:05:03,200 INHIBITORS AND GLP, 1 RECEPTOR 1892 01:05:03,200 --> 01:05:05,360 AGONISTS WHICH NOT ONLY LOWER 1893 01:05:05,360 --> 01:05:07,480 BLOOD GLUCOSE CONTROL IN PEOPLE 1894 01:05:07,480 --> 01:05:08,040 WITH DIABETES THEY HAVE BEEN 1895 01:05:08,040 --> 01:05:10,480 SHOWN TO DECREASE RISK OF HEART 1896 01:05:10,480 --> 01:05:11,480 ATTACK, STROKE, HEART FAILURE 1897 01:05:11,480 --> 01:05:13,120 AND CARDIOVASCULAR DEATH. 1898 01:05:13,120 --> 01:05:15,560 AS SUCH THE AMERICAN DIABETES 1899 01:05:15,560 --> 01:05:16,520 ASSOCIATION NOW RECOMMENDS THAT 1900 01:05:16,520 --> 01:05:19,200 ALL PERSONS WITH DIABETES TYPE 2 1901 01:05:19,200 --> 01:05:21,960 DIABETES WHO ARE AT RISK FOR 1902 01:05:21,960 --> 01:05:23,320 CARDIOVASCULAR DISEASE OR 1903 01:05:23,320 --> 01:05:24,400 ESTABLISHED CARDIOVASCULAR 1904 01:05:24,400 --> 01:05:26,160 DISEASE USE AGENTS AS FIRST 1905 01:05:26,160 --> 01:05:27,280 VOLUME AFTER PERFORMING TO HELP 1906 01:05:27,280 --> 01:05:29,960 FURTHER PROMOTE CARDIOVASCULAR 1907 01:05:29,960 --> 01:05:30,160 HEALTH. 1908 01:05:30,160 --> 01:05:31,080 WE DON'T KNOW IF THESE WILL 1909 01:05:31,080 --> 01:05:32,440 DECREASE RISK OF DEMENTIA, BUT 1910 01:05:32,440 --> 01:05:34,560 WE DO KNOW THAT BY PREVENTING 1911 01:05:34,560 --> 01:05:36,240 STROKES WE CAN PROMOTE LONG TERM 1912 01:05:36,240 --> 01:05:40,280 BRAIN HEALTH. 1913 01:05:40,280 --> 01:05:43,480 I WOULD BE REMISS TO NOT TALK 1914 01:05:43,480 --> 01:05:45,080 ABOUT STROKE AND STROKE 1915 01:05:45,080 --> 01:05:46,480 PREVENTION AS PARTS OF THE 1916 01:05:46,480 --> 01:05:47,400 BROADER CONVERSATION ABOUT 1917 01:05:47,400 --> 01:05:48,840 PRESERVING FUNCTIONAL STATUS IN 1918 01:05:48,840 --> 01:05:49,760 BRAIN HEALTH OVER TIME. 1919 01:05:49,760 --> 01:05:50,920 I WILL POINT OUT TWO IMPORTANT 1920 01:05:50,920 --> 01:05:53,320 RISK FACTORS THAT ARE KEY TO 1921 01:05:53,320 --> 01:05:55,960 HELP PREVENTING STROKE OVER LIFE 1922 01:05:55,960 --> 01:05:56,280 COURSE. 1923 01:05:56,280 --> 01:05:57,840 FIRST TREATMENT OF LDL 1924 01:05:57,840 --> 01:05:58,720 CHOLESTEROL. 1925 01:05:58,720 --> 01:06:00,360 WE KNOW FROM CLINICAL TRIALS 1926 01:06:00,360 --> 01:06:02,960 TENS OF THOUSANDS OF PEOPLE, 1927 01:06:02,960 --> 01:06:04,760 LOWERING LDL CHOLESTEROL WITH 1928 01:06:04,760 --> 01:06:06,120 STATIN THERAPY DECREASE NOT ONLY 1929 01:06:06,120 --> 01:06:08,280 RISK OF HEART ATTACK AND HEART 1930 01:06:08,280 --> 01:06:10,120 DISEASE, BUT ALSO RISK OF 1931 01:06:10,120 --> 01:06:10,360 STROKE. 1932 01:06:10,360 --> 01:06:11,520 IN FACT STATINS HAVE BEEN SHOWN 1933 01:06:11,520 --> 01:06:15,360 TO LOWER THE RISK OF STROKE BY 1934 01:06:15,360 --> 01:06:18,120 17% WHEN COMPARED TO A PLACEBO. 1935 01:06:18,120 --> 01:06:19,640 THE OTHER TYPE OF STROKE THAT WE 1936 01:06:19,640 --> 01:06:22,400 CAN PREVENT ARE STROKES THAT ARE 1937 01:06:22,400 --> 01:06:23,960 FROM THE HEART RHYTHM PROBLEM 1938 01:06:23,960 --> 01:06:26,600 ATRIAL FIBRILLATION. 1939 01:06:26,600 --> 01:06:28,600 ATRIAL FIBRILLATION LEADS THE 1940 01:06:28,600 --> 01:06:30,160 BLOOD CLOTS IN THE HEART THAT 1941 01:06:30,160 --> 01:06:32,320 WHEN THEY BREAK THREE CAN GO TO 1942 01:06:32,320 --> 01:06:32,880 THE BRAIN. 1943 01:06:32,880 --> 01:06:34,920 THOUGH WE HAVE NUMBER OF SHEER 1944 01:06:34,920 --> 01:06:36,600 THERAPIES TO PREVENT STROKE IN 1945 01:06:36,600 --> 01:06:41,520 PEOPLE WITH ATRIAL FIBRILLATION, 1946 01:06:41,520 --> 01:06:44,880 ANTI-COAGULANTS, GOING GENERIC 1947 01:06:44,880 --> 01:06:46,760 SOON, WE STILL FIND ONE IN THREE 1948 01:06:46,760 --> 01:06:48,640 PEOPLE WITH ATRIAL FIBRILLATION 1949 01:06:48,640 --> 01:06:50,440 HIGH RISK FOR STROKE ARE NOT ON 1950 01:06:50,440 --> 01:06:52,200 A BLOOD THINNER. 1951 01:06:52,200 --> 01:06:53,520 THIS IS A MASSIVELY IMPORTANT 1952 01:06:53,520 --> 01:06:54,880 OPPORTUNITY FOR US TO DECREASE 1953 01:06:54,880 --> 01:06:58,840 THE RISK OF STROKE BUT INCRESSET 1954 01:06:58,840 --> 01:06:59,600 THROUGHIZATION OF 1955 01:06:59,600 --> 01:07:00,160 ANTI-COAGULATION THERAPY IN 1956 01:07:00,160 --> 01:07:02,560 PEOPLE WITH ATRIAL FIBRILLATION. 1957 01:07:02,560 --> 01:07:03,960 ALSO WE HAVE NEW TECHNOLOGIES 1958 01:07:03,960 --> 01:07:05,440 THAT ARE HELPING US BETTER 1959 01:07:05,440 --> 01:07:07,920 IDENTIFY PEOPLE WITH ATRIAL 1960 01:07:07,920 --> 01:07:09,480 FIBRILLATION FOR -- BEFORE THEY 1961 01:07:09,480 --> 01:07:10,360 PRESENT STROKE IN THE FIRST 1962 01:07:10,360 --> 01:07:11,640 PLACE. 1963 01:07:11,640 --> 01:07:14,440 THIS INCLUDES DETECTION 1964 01:07:14,440 --> 01:07:16,400 TECHNOLOGIES SHOWN TO BE 1965 01:07:16,400 --> 01:07:18,000 ACCURATE IN BOTH THE APPLE 1966 01:07:18,000 --> 01:07:20,840 IWATCH AS WELL AS THE FIT BIT. 1967 01:07:20,840 --> 01:07:23,960 THE NEXT ERA OF AFIB IS GOING TO 1968 01:07:23,960 --> 01:07:25,960 MOVE TO INCREASE ATRIAL 1969 01:07:25,960 --> 01:07:27,400 FIBRILLATION AN IMPROVE 1970 01:07:27,400 --> 01:07:29,760 POPULATION HEALTH WORK TOWARDS 1971 01:07:29,760 --> 01:07:32,120 INCREASING ANTI-COAGULATION TO 1972 01:07:32,120 --> 01:07:36,160 HELP PREVENT IN THIS POPULATION. 1973 01:07:36,160 --> 01:07:37,760 CLINIC WORRIED ABOUT DEMENTIA 1974 01:07:37,760 --> 01:07:39,640 RISK I TALK TO THEM ABOUT 1975 01:07:39,640 --> 01:07:41,640 MODIFIABLE RISK FACTOR BUS ALSO 1976 01:07:41,640 --> 01:07:44,400 MAKE SURE THAT'S BROADER 1977 01:07:44,400 --> 01:07:46,600 CONVERSATION AROUND PREVENTING 1978 01:07:46,600 --> 01:07:48,680 STROKE AND IMPLEMENTING OVERALL 1979 01:07:48,680 --> 01:07:49,160 BRAIN HEALTH. 1980 01:07:49,160 --> 01:07:55,400 WITH THAT HUE FOR YOUR TIME. 1981 01:07:55,400 --> 01:08:00,400 >> THANK YOU VERY MUCH DR. 1982 01:08:00,400 --> 01:08:00,640 HOBART. 1983 01:08:00,640 --> 01:08:02,360 NEXT WE'LL HAVE OUR FINAL 1984 01:08:02,360 --> 01:08:03,440 SPEAKER OF THE DAY. 1985 01:08:03,440 --> 01:08:04,320 >> THANKS. 1986 01:08:04,320 --> 01:08:08,320 LET ME BEGIN BY SAYING I'M 1987 01:08:08,320 --> 01:08:11,960 EXTREMELY GRATEFUL TO THE STAFF 1988 01:08:11,960 --> 01:08:14,880 AT THE AREA COUNTY HERE IN 1989 01:08:14,880 --> 01:08:16,280 FOURTH WORTH AND OTHER PARTNERS 1990 01:08:16,280 --> 01:08:18,760 WHO MADE MY WORK I WILL BE 1991 01:08:18,760 --> 01:08:20,440 TALKING ABOUT POSSIBLE OVER THE 1992 01:08:20,440 --> 01:08:21,040 PAST 15 YEARS. 1993 01:08:21,040 --> 01:08:24,960 NEXT SLIDE. 1994 01:08:24,960 --> 01:08:27,920 AREA AGENCIES WERE CREATED BY 1995 01:08:27,920 --> 01:08:32,240 THE OLDER AMERICANS ACT IN 1973. 1996 01:08:32,240 --> 01:08:37,200 FOR MOST OF THE 49 YEAR HISTORY, 1997 01:08:37,200 --> 01:08:38,680 TRIPLE A IS REQUIRED TO TARGET 1998 01:08:38,680 --> 01:08:40,880 SERVICES TO HIGH RISK 1999 01:08:40,880 --> 01:08:41,440 POPULATIONS. 2000 01:08:41,440 --> 01:08:43,400 I'M GOING TO BE SHARING THOSE 2001 01:08:43,400 --> 01:08:45,720 PROVISIONS WITH YOU FROM THE 2002 01:08:45,720 --> 01:08:48,920 ACT, TALK ABOUT SOME OF THE 2003 01:08:48,920 --> 01:08:49,640 TARGETED PROGRAMMING WE HAVE 2004 01:08:49,640 --> 01:08:52,320 DONE HERE IN TEAR RANT COUNTY, A 2005 01:08:52,320 --> 01:08:54,960 COUPLE OF OUR ACL FUNDED 2006 01:08:54,960 --> 01:08:57,360 DEMENTIA CAPABLE PROJECTS AND 2007 01:08:57,360 --> 01:08:59,560 ALSO SERVICES TO ADDRESS SOCIAL 2008 01:08:59,560 --> 01:09:00,440 DETERMINANTS OF HEALTH. 2009 01:09:00,440 --> 01:09:02,400 AND SOME OF THE BARRIERS THAT WE 2010 01:09:02,400 --> 01:09:03,720 HAVE FACED AND PROVIDING 2011 01:09:03,720 --> 01:09:05,000 COMMUNITY BASED SERVICES AND 2012 01:09:05,000 --> 01:09:05,720 SUPPORTS. 2013 01:09:05,720 --> 01:09:11,520 NEXT SLIDE. 2014 01:09:11,520 --> 01:09:14,360 THESE ARE THE TARGETING 2015 01:09:14,360 --> 01:09:15,640 PROVISIONS INCLUDED MISDEMEANOR 2016 01:09:15,640 --> 01:09:17,040 THE OLDER AMERICANS ACT. 2017 01:09:17,040 --> 01:09:20,960 THEY HAVE REMAINED RELATIVELY 2018 01:09:20,960 --> 01:09:26,000 THE SAME FOR ABOUT 40 YEARS. 2019 01:09:26,000 --> 01:09:28,160 IN THE '90s THERE WAS MORE 2020 01:09:28,160 --> 01:09:31,480 EMPHASIS AT IT ON LOW INCOME 2021 01:09:31,480 --> 01:09:34,080 MINORITY INDIVIDUALS AND ALSO IN 2022 01:09:34,080 --> 01:09:35,960 THE 2000 AMENDMENTS TARGETING TO 2023 01:09:35,960 --> 01:09:37,760 PEOPLE RESIDING IN RURAL AREAS 2024 01:09:37,760 --> 01:09:41,400 IN TEXAS WE ARE PARTICULARLY 2025 01:09:41,400 --> 01:09:44,840 CONCERNED ABOUT NUMBER 6 BECAUSE 2026 01:09:44,840 --> 01:09:47,360 ACCORDING TO CMS WE HAVE MORE 2027 01:09:47,360 --> 01:09:49,960 LOW PERFORMING ONE STAR NURSING 2028 01:09:49,960 --> 01:09:52,640 HOMES THAN ANY OTHER STATE IN 2029 01:09:52,640 --> 01:09:59,160 THE COUNTRY. 2030 01:09:59,160 --> 01:10:03,440 ONE OF MY FAVORITE WAYS THE 2031 01:10:03,440 --> 01:10:06,000 APPROACH ANY CONVERSATION ABOUT 2032 01:10:06,000 --> 01:10:08,240 HEALTH DISPARITIES IS BY LOOKING 2033 01:10:08,240 --> 01:10:10,600 AT ZIP CODE DATA. 2034 01:10:10,600 --> 01:10:12,360 FOR EXAMPLE WE HAVE A ZIP CODE 2035 01:10:12,360 --> 01:10:15,160 HERE IN TERRANT COUNTY WITH A 2036 01:10:15,160 --> 01:10:19,240 LIFE EXPECTANCY OF 66.7 YEARS. 2037 01:10:19,240 --> 01:10:22,000 WHAT YOU WILL FIND MANY THAT ZIP 2038 01:10:22,000 --> 01:10:25,040 CODE AND SIMILAR ZIP CODES ARE 2039 01:10:25,040 --> 01:10:30,000 HIGH RATES OF HEART DISEASE, 2040 01:10:30,000 --> 01:10:32,960 HYPERTENSION, DIABETES, 2041 01:10:32,960 --> 01:10:37,120 DEMENTIA, ALSO HIGH CRIME 2042 01:10:37,120 --> 01:10:39,000 NEIGHBORHOODS, BIG FOOD DESERTS 2043 01:10:39,000 --> 01:10:41,240 WITHOUT A LOT OF ACCESS TO 2044 01:10:41,240 --> 01:10:41,960 HEALTHY FOOD. 2045 01:10:41,960 --> 01:10:44,360 ALSO ONE RISK FACTOR I HAVEN'T 2046 01:10:44,360 --> 01:10:49,080 HEARD MENTIONED TODAY AND THAT'S 2047 01:10:49,080 --> 01:10:51,040 AVERAGE NUMBER OF REVERSE 2048 01:10:51,040 --> 01:10:52,320 CHILDHOOD -- ADVERSE CHILDHOOD 2049 01:10:52,320 --> 01:10:54,600 EXPERIENCES WHICH ARE ASSOCIATED 2050 01:10:54,600 --> 01:10:56,360 WITH A LOT OF OTHER RISK FACTORS 2051 01:10:56,360 --> 01:10:58,240 THAT WE DISCUSSED. 2052 01:10:58,240 --> 01:11:00,760 MY FAVORITE OUT OF ALL THE 2053 01:11:00,760 --> 01:11:04,800 OUTREACH STRATEGIES AS FAR AS 2054 01:11:04,800 --> 01:11:06,880 BEING MOST EFFECTIVE IS DOOR TO 2055 01:11:06,880 --> 01:11:09,320 DOOR STRATEGIES, THESE ARE VERY 2056 01:11:09,320 --> 01:11:12,600 LOW COST STRATEGIES FOR REACHING 2057 01:11:12,600 --> 01:11:14,280 PEOPLE. 2058 01:11:14,280 --> 01:11:14,960 REACHING UNSERVED AND 2059 01:11:14,960 --> 01:11:19,440 UNDERSERVED POPULATIONS. 2060 01:11:19,440 --> 01:11:21,600 NEXT SLIDE. 2061 01:11:21,600 --> 01:11:27,440 WE STARTED USING GEOGRAPHIC 2062 01:11:27,440 --> 01:11:30,200 INFORMATION SYSTEMS TO TARGET 2063 01:11:30,200 --> 01:11:31,640 SERVICES IN LOW INCOME AREAS 2064 01:11:31,640 --> 01:11:32,840 WITH HIGH CONCENTRATIONS OF 2065 01:11:32,840 --> 01:11:36,560 PEOPLE LIVING ALONE. 2066 01:11:36,560 --> 01:11:44,160 TO ADDRESS LONELINESS IN 2006. 2067 01:11:44,160 --> 01:11:46,560 IN 2008 WE REPLICATED DEMENTIA 2068 01:11:46,560 --> 01:11:48,600 CARE TRANSITIONS PROGRAM, THAT 2069 01:11:48,600 --> 01:11:51,000 WAS DEVELOPED BY BAILOR SCOTT 2070 01:11:51,000 --> 01:11:55,200 WHITE IN CENTRAL TEXAS THEN 2071 01:11:55,200 --> 01:11:58,200 UNITED WAY FUNDED A NINE YEAR 2072 01:11:58,200 --> 01:11:59,800 HEALTHY AGING INDEPENDENT LIVING 2073 01:11:59,800 --> 01:12:02,680 INITIATIVE THAT INCLUDED BOTH 2074 01:12:02,680 --> 01:12:04,360 PROGRAMS FOR CAREGIVERS AS WELL 2075 01:12:04,360 --> 01:12:09,640 AS WELLNESS PROGRAMS WE SERVED 2076 01:12:09,640 --> 01:12:10,680 OVER 63,000 PEOPLE. 2077 01:12:10,680 --> 01:12:14,680 THERE IS OUTCOME DATA ON 30,000, 2078 01:12:14,680 --> 01:12:16,760 ALMOST 30,000 OF THOSE PEOPLE. 2079 01:12:16,760 --> 01:12:19,400 WHAT WE HAVE LEARNED FROM ALL 2080 01:12:19,400 --> 01:12:21,880 THESE INITIATIVES IS THAT WE CAN 2081 01:12:21,880 --> 01:12:24,200 MAKE MUCH BIGGER DIFFERENCE IF 2082 01:12:24,200 --> 01:12:26,760 WE FOCUS ON POPULATIONS WITH LOW 2083 01:12:26,760 --> 01:12:27,880 TO MODERATE COGNITIVE 2084 01:12:27,880 --> 01:12:36,360 IMPAIRMENT. 2085 01:12:36,360 --> 01:12:38,560 AS A FAILED FUTURE FARMER OF 2086 01:12:38,560 --> 01:12:40,720 AMERICA FROM EAST TEXAS, I 2087 01:12:40,720 --> 01:12:41,960 ALWAYS TRIED TO SURROUND MYSELF 2088 01:12:41,960 --> 01:12:43,600 WITH MUCH SMARTER PEOPLE SO I 2089 01:12:43,600 --> 01:12:47,240 BRIEFLY WANT TO ACKNOWLEDGE A 2090 01:12:47,240 --> 01:12:50,680 FEW PARTNERS, ALLEN STEVENS AND 2091 01:12:50,680 --> 01:12:56,560 JIM YUNG CHO JIM BAILOR SCOTT, 2092 01:12:56,560 --> 01:13:02,240 THEY PROVIDED THE BULK OF THE DI 2093 01:13:02,240 --> 01:13:03,560 PROJECTS AND MATTHEW SMITH AT 2094 01:13:03,560 --> 01:13:06,320 TEXAS A AND M. 2095 01:13:06,320 --> 01:13:07,880 JANICE AND JENNIFER ARE PARTNERS 2096 01:13:07,880 --> 01:13:12,240 FOR EIGHT YEARS ON HRSA PROJECT. 2097 01:13:12,240 --> 01:13:12,960 MAR SERKSLLA AND KATHERINE 2098 01:13:12,960 --> 01:13:16,200 DANIEL AT UTA AND LAST BUT NOT 2099 01:13:16,200 --> 01:13:18,880 LEAST, MY TRUSTED ADVISOR FOR 2100 01:13:18,880 --> 01:13:20,760 OVER 30 YEARS ON ALL MATTERS 2101 01:13:20,760 --> 01:13:23,280 DEMENTIA AND CARE GIVING, NANCY 2102 01:13:23,280 --> 01:13:23,520 WILSON. 2103 01:13:23,520 --> 01:13:27,960 NEXT SLIDE. 2104 01:13:27,960 --> 01:13:33,160 SO IN 2016 WE DECIDED TO GO ALL 2105 01:13:33,160 --> 01:13:35,880 IN ON DEMENTIA HEALTH 2106 01:13:35,880 --> 01:13:36,400 DISPARITIES. 2107 01:13:36,400 --> 01:13:38,920 AND APPLY FOR FUNDING FROM 2108 01:13:38,920 --> 01:13:40,200 ADMINISTRATION FOR COMMUNITY 2109 01:13:40,200 --> 01:13:42,680 LIVING AND RECEIVE THAT FUNDING. 2110 01:13:42,680 --> 01:13:46,240 WHAT WE DISCOVERED OVER THE 2111 01:13:46,240 --> 01:13:49,000 FIRST THREE YEARS OF THE PROJECT 2112 01:13:49,000 --> 01:13:51,720 WAS THERE IS A LOT MORE PEOPLE 2113 01:13:51,720 --> 01:13:53,720 LIVING ALONE WITH DEMENTIA THAN 2114 01:13:53,720 --> 01:13:54,960 WE ANTICIPATED. 2115 01:13:54,960 --> 01:13:58,160 SO WE RECEIVED AN EXPANSION 2116 01:13:58,160 --> 01:14:01,640 GRANT TO SERVE THAT POPULATION 2117 01:14:01,640 --> 01:14:07,520 IN 2019. 2118 01:14:07,520 --> 01:14:10,720 ALL STATE UNITS ON AGING THAT 2119 01:14:10,720 --> 01:14:13,720 OVERSEE AREA DENSITIES ON AGING 2120 01:14:13,720 --> 01:14:17,200 NATIONWIDE OR MOST OF THEM, 2121 01:14:17,200 --> 01:14:18,720 REQUIRE THE USE OF SOME KIND OF 2122 01:14:18,720 --> 01:14:21,360 FUNCTIONAL ASSESSMENT TO 2123 01:14:21,360 --> 01:14:23,520 DETERMINE ELIGIBILITY FOR 2124 01:14:23,520 --> 01:14:24,200 UNDELIVERED MEALS AND OTHER 2125 01:14:24,200 --> 01:14:27,480 SERVICES WE USED THAT AS A 2126 01:14:27,480 --> 01:14:30,240 BASELINE, AND DOING SCREENING 2127 01:14:30,240 --> 01:14:33,760 FOR DEMENTIA AND USE THAT IN A 2128 01:14:33,760 --> 01:14:35,400 FEW QUESTIONS I WILL MENTION IN 2129 01:14:35,400 --> 01:14:37,040 A MOMENT TRIGGER ADMINISTRATION 2130 01:14:37,040 --> 01:14:40,520 OF THE ADA, WE USE THE QLAD IN 2131 01:14:40,520 --> 01:14:44,360 THIS BURDEN, AS OUTCOME MEASURES 2132 01:14:44,360 --> 01:14:45,440 AND ALSO THE (INAUDIBLE) FOR 2133 01:14:45,440 --> 01:14:46,760 PERSON CENTERED PLANNING. 2134 01:14:46,760 --> 01:14:52,680 NEXT SLIDE. 2135 01:14:52,680 --> 01:14:56,560 SO WE FOUND A FEW QUESTIONS ON 2136 01:14:56,560 --> 01:14:57,800 THE TEXAS CONSUMER NEEDS 2137 01:14:57,800 --> 01:15:00,560 EVALUATION FORM THAT WE THOUGHT 2138 01:15:00,560 --> 01:15:02,880 IF THEY ANSWER YES TO ANY ONE OF 2139 01:15:02,880 --> 01:15:04,040 THESE QUESTIONS MAYBE GO AHEAD 2140 01:15:04,040 --> 01:15:06,560 AND DO THE ADA. 2141 01:15:06,560 --> 01:15:07,200 WHICH WE DID. 2142 01:15:07,200 --> 01:15:10,960 I LIKE TO SAY THIS WOULD NOT 2143 01:15:10,960 --> 01:15:14,160 HAVE BEEN POSSIBLE WITHOUT THE 2144 01:15:14,160 --> 01:15:21,560 HELP OF MEALS ON WHEELS OF 2145 01:15:21,560 --> 01:15:23,480 TERRAN COUNTY, ONE OF THE BEST 2146 01:15:23,480 --> 01:15:24,320 IN THE UNITED STATES. 2147 01:15:24,320 --> 01:15:26,920 WE VIRTUALLY SCREEN ALL OF THE 2148 01:15:26,920 --> 01:15:28,560 PEOPLE GETTING MEALS ON WHEELS 2149 01:15:28,560 --> 01:15:33,160 IN TERRANT COUNTY, ACCORDING TO 2150 01:15:33,160 --> 01:15:41,360 THE ADA, 41% OF THOSE SCREENED 2151 01:15:41,360 --> 01:15:44,880 HAD AT LEAST SOME POSSIBLE 2152 01:15:44,880 --> 01:15:46,000 SYMPTOMS OF DEMENTIA. 2153 01:15:46,000 --> 01:15:50,520 ABOUT HALF OF THOSE, ABOUT 19% 2154 01:15:50,520 --> 01:15:52,920 OF THE TOTAL OVER 3,000 PEOPLE, 2155 01:15:52,920 --> 01:15:55,960 WERE PEOPLE LIVING ALONE WITH 2156 01:15:55,960 --> 01:15:56,200 DEMENTIA. 2157 01:15:56,200 --> 01:15:58,800 WE WERE REALLY PLEASED WITH THE 2158 01:15:58,800 --> 01:16:00,400 OUTCOMES AFTER WE PROVIDED 2159 01:16:00,400 --> 01:16:02,520 SERVICES PRIMARILY TO ADDRESS 2160 01:16:02,520 --> 01:16:05,960 SOCIAL DETERMINANTS OF HEALTH. 2161 01:16:05,960 --> 01:16:09,320 NEXT SLIDE. 2162 01:16:09,320 --> 01:16:11,640 I NEVER HEARD OF CULTURALLY 2163 01:16:11,640 --> 01:16:12,560 LINGUISTICALLY APPROPRIATE 2164 01:16:12,560 --> 01:16:15,880 SERVICES UNTIL 2015 WHEN WE WERE 2165 01:16:15,880 --> 01:16:17,840 PUTTING TOGETHER GRANT 2166 01:16:17,840 --> 01:16:19,760 APPLICATION AND I WAS TOLD ABOUT 2167 01:16:19,760 --> 01:16:23,440 STANDARDS BY MARSELLA NAVA AND I 2168 01:16:23,440 --> 01:16:24,680 THOUGHT BOY, THIS REALLY FITS 2169 01:16:24,680 --> 01:16:26,880 NICELY WITH WHAT WE ARE TRYING 2170 01:16:26,880 --> 01:16:29,880 TO ACCOMPLISH WITH THE 2171 01:16:29,880 --> 01:16:32,160 (INAUDIBLE) SO MARSELLA 2172 01:16:32,160 --> 01:16:34,120 CONDUCTED TWO HALF DAY TRAININGS 2173 01:16:34,120 --> 01:16:42,760 FOR ALL OF OUR PARTNERS. 2174 01:16:42,760 --> 01:16:45,320 AND WE RATED OURSELVES THE 2175 01:16:45,320 --> 01:16:48,760 LOWEST ON STANDARD 11. 2176 01:16:48,760 --> 01:16:51,280 SO WE DECIDED THAT AS A GROUP AS 2177 01:16:51,280 --> 01:16:53,920 A COMMUNITY THAT WE WOULD FOCUS 2178 01:16:53,920 --> 01:16:56,360 ON THAT ONE STANDARD WHICH IS TO 2179 01:16:56,360 --> 01:16:58,400 COLLECT AND MAINTAIN ACCURATE 2180 01:16:58,400 --> 01:17:00,680 RELIABLE DEMOGRAPHIC DATA BY 2181 01:17:00,680 --> 01:17:05,960 DOING SO WE WERE ABLE TO 2182 01:17:05,960 --> 01:17:07,880 INCREASE SERVICES TO AFRICAN 2183 01:17:07,880 --> 01:17:12,520 AMERICAN HISPANIC CAREGIVERS BY 2184 01:17:12,520 --> 01:17:13,160 17%. 2185 01:17:13,160 --> 01:17:18,480 SERVICES TO PEOPLE WITH 2186 01:17:18,480 --> 01:17:27,160 DEMENTIA, BY 21%. 2187 01:17:27,160 --> 01:17:29,160 WE PUT THIS LIST TOGETHER WITH 2188 01:17:29,160 --> 01:17:31,640 THE HELP OF ONE OF OUR DEMENTIA 2189 01:17:31,640 --> 01:17:35,400 CAPABLE PARTNERS IN HOUSTON. 2190 01:17:35,400 --> 01:17:36,360 BAKER RIPLY. 2191 01:17:36,360 --> 01:17:39,360 WE THINK THESE ARE THE MOST 2192 01:17:39,360 --> 01:17:43,320 NEEDED SERVICES FOR PEOPLE WITH 2193 01:17:43,320 --> 01:17:44,120 DEMENTIA. 2194 01:17:44,120 --> 01:17:47,560 IN MY OPINION I THINK ASSISTIVE 2195 01:17:47,560 --> 01:17:49,160 AND TRANSPORTATION AND IN HOME 2196 01:17:49,160 --> 01:17:51,120 VISITS BY PHYSICIANS IS 2197 01:17:51,120 --> 01:17:54,440 CRITICAL, IT IS A LITTLE 2198 01:17:54,440 --> 01:17:56,160 UNREALISTIC TO EXPECT A PERSON 2199 01:17:56,160 --> 01:17:59,280 LIVING ALONE WITHOUT FAMILY 2200 01:17:59,280 --> 01:18:00,280 CAREGIVER SUPPORT WHICH IS ABOUT 2201 01:18:00,280 --> 01:18:02,960 HALF THE PEOPLE WE SERVE, TO 2202 01:18:02,960 --> 01:18:06,640 SOMEHOW FIND THEIR WAY INTO A 2203 01:18:06,640 --> 01:18:08,480 DOCTOR'S OFFICE FOR A FORMAL 2204 01:18:08,480 --> 01:18:10,120 DIAGNOSIS WHICH IS NEEDED FOR 2205 01:18:10,120 --> 01:18:17,680 ACCESS TO SERVICES. 2206 01:18:17,680 --> 01:18:20,440 SO ONLY ABOUT 30% OF THE PEOPLE 2207 01:18:20,440 --> 01:18:24,120 WE IDENTIFIED WITH THE ADA AS 2208 01:18:24,120 --> 01:18:26,520 HAVING A POSSIBLE SYMPTOMS OF 2209 01:18:26,520 --> 01:18:30,640 DEMENTIA HAD A FORMAL DIAGNOSIS. 2210 01:18:30,640 --> 01:18:33,080 SO FIGURING OUT A WAY TO GET TO 2211 01:18:33,080 --> 01:18:34,560 THOSE PEOPLE, SINCE IT IS VERY 2212 01:18:34,560 --> 01:18:37,200 DIFFICULT FOR THEM TO ACCESS 2213 01:18:37,200 --> 01:18:42,040 MEDICAL SERVICES IS CRITICAL. 2214 01:18:42,040 --> 01:18:45,760 I HEARD JANICE KANABLE ONCE SAY 2215 01:18:45,760 --> 01:18:48,120 ONE AT ONE OF OUR HRSA MEETINGS 2216 01:18:48,120 --> 01:18:50,200 THAT THE FUTURE OF HEALTHCARE IS 2217 01:18:50,200 --> 01:18:54,120 IN THE COMMUNITY. 2218 01:18:54,120 --> 01:18:56,040 I COULDN'T AGREE MORE. 2219 01:18:56,040 --> 01:18:58,200 AND I THINK SOME FINANCIAL 2220 01:18:58,200 --> 01:19:00,560 INCENTIVES NEED TO BE PUT IN 2221 01:19:00,560 --> 01:19:06,080 PLACE TO ENSURE WE GET MORE 2222 01:19:06,080 --> 01:19:08,200 HEALTHCARE OUT TO PEOPLE, 2223 01:19:08,200 --> 01:19:09,120 PARTICULARLY THOSE LIVING WITH 2224 01:19:09,120 --> 01:19:09,960 DEMENTIA. 2225 01:19:09,960 --> 01:19:12,560 A COUPLE OF MACRO TRENDS THAT 2226 01:19:12,560 --> 01:19:14,360 KEEP ME AWAKE AT NIGHT THESE 2227 01:19:14,360 --> 01:19:15,440 DAYS. 2228 01:19:15,440 --> 01:19:17,040 ONE IS THERE ARE MORE OLDER 2229 01:19:17,040 --> 01:19:20,080 AMERICANS LIVING ALONE THAN ANY 2230 01:19:20,080 --> 01:19:21,360 OTHER COUNTRY. 2231 01:19:21,360 --> 01:19:24,720 THE OTHER TREND IS WITH EACH 2232 01:19:24,720 --> 01:19:28,000 UPCOMING COHORT, WE ARE SEEING 2233 01:19:28,000 --> 01:19:29,800 MORE JOBLESS AMERICANS. 2234 01:19:29,800 --> 01:19:32,360 WE REFER TO THEM AS ELDER 2235 01:19:32,360 --> 01:19:32,600 ORPHANS. 2236 01:19:32,600 --> 01:19:37,400 IN FACT IN A RECENT SURVEY, OF 2237 01:19:37,400 --> 01:19:44,560 AMERICANS AGES 18 TO 49, 44% 2238 01:19:44,560 --> 01:19:46,120 SAID HAY WOULD NOT LIKELY OR 2239 01:19:46,120 --> 01:19:47,840 DEFINITELY NOT HAVE CHILDREN. 2240 01:19:47,840 --> 01:19:49,760 SO SO THOSE DAYS OF US BEING 2241 01:19:49,760 --> 01:19:53,160 ABLE TO RELY ON FAMILY CARE 2242 01:19:53,160 --> 01:19:56,920 GIVERS TO PROVIDE THE BULK OF 2243 01:19:56,920 --> 01:19:58,760 CARE, FOR PEOPLE WITH DEMENTIA 2244 01:19:58,760 --> 01:20:03,360 ARE COMING TO AN END. 2245 01:20:03,360 --> 01:20:03,880 SO THANK YOU VERY MUCH. 2246 01:20:03,880 --> 01:20:04,960 IF YOU HAVE ANY QUESTIONS FEEL 2247 01:20:04,960 --> 01:20:09,640 FREE TO EMAIL ME. 2248 01:20:09,640 --> 01:20:10,960 >> GREAT. 2249 01:20:10,960 --> 01:20:12,920 THANK YOU TO ALL THE SPEAKERS 2250 01:20:12,920 --> 01:20:13,280 TODAY. 2251 01:20:13,280 --> 01:20:15,320 WE WILL WAIT A SECOND FOR THEM 2252 01:20:15,320 --> 01:20:19,280 TO ALL GET ON VIDEO AGAIN. 2253 01:20:19,280 --> 01:20:20,560 IT TAKES A COUPLE OF MINUTES TO 2254 01:20:20,560 --> 01:20:24,240 FIND NOSE BUTTONS. 2255 01:20:24,240 --> 01:20:27,880 SO SINCE YOU ARE AVAILABLE, 2256 01:20:27,880 --> 01:20:31,160 FIRST QUESTION I HAVE IS IS THE 2257 01:20:31,160 --> 01:20:33,840 DEIDENTIFY DATA COLLECTED ON THE 2258 01:20:33,840 --> 01:20:35,120 AD 8, IS THAT AVAILABLE TO 2259 01:20:35,120 --> 01:20:38,280 PEOPLE FOR RESEARCH PURPOSES? 2260 01:20:38,280 --> 01:20:42,960 >> I WOULD NEED TO CHECK WITH 2261 01:20:42,960 --> 01:20:46,400 ALLEN STEVENS AND JIM CHO AT 2262 01:20:46,400 --> 01:20:47,440 BAILOR SCOTT WHITE. 2263 01:20:47,440 --> 01:20:51,160 BUT JUST SHOOT ME AN EMAIL AND 2264 01:20:51,160 --> 01:20:53,280 THEN WE WILL SEE IF THAT IS 2265 01:20:53,280 --> 01:20:56,960 POSSIBLE. 2266 01:20:56,960 --> 01:20:58,120 >> THANK YOU VERY MUCH. 2267 01:20:58,120 --> 01:21:02,000 DR. NAVARRE, SO WHEN YOU SEE 2268 01:21:02,000 --> 01:21:03,600 PATIENTS IN CLINIC, AND YOU 2269 01:21:03,600 --> 01:21:05,360 TRYING TO HELP THEM REDUCE THE 2270 01:21:05,360 --> 01:21:08,280 RISK OF ALL THESE BAD THINGS 2271 01:21:08,280 --> 01:21:10,120 THAT COULD HAPPEN, WHAT DO YOU 2272 01:21:10,120 --> 01:21:13,240 WISH THEY WOULD TELL YOU, OR 2273 01:21:13,240 --> 01:21:14,600 WHAT THINGS WOULD BE HONEST WITH 2274 01:21:14,600 --> 01:21:15,000 YOU ABOUT? 2275 01:21:15,000 --> 01:21:18,400 THAT CAN HELP YOU HELP THEM? 2276 01:21:18,400 --> 01:21:20,000 >> I LIKE MY PATIENTS TO BE 2277 01:21:20,000 --> 01:21:22,960 HONEST WITH ME ABOUT EVERYTHING. 2278 01:21:22,960 --> 01:21:25,360 AND I THINK THAT PEOPLE OFTEN 2279 01:21:25,360 --> 01:21:28,000 FEEL LIKE RELUCTANT TO TELL ME 2280 01:21:28,000 --> 01:21:29,080 ALL THE THINGS THAT YOU THINK 2281 01:21:29,080 --> 01:21:31,520 YOU CAN DO BETTER WITH. 2282 01:21:31,520 --> 01:21:34,360 AND OUR JOB AS DOCTORS ISN'T TO 2283 01:21:34,360 --> 01:21:36,560 JUDGE OR GIVE YOU A REPORT CARD. 2284 01:21:36,560 --> 01:21:38,880 AND I THINK PEOPLE OFTEN FEEL 2285 01:21:38,880 --> 01:21:41,240 AFRAID TO BE FULLY TRANSPARENT 2286 01:21:41,240 --> 01:21:42,720 BECAUSE THEY DON'T WANT TO GET A 2287 01:21:42,720 --> 01:21:44,520 BAD GRADE FROM THEIR DOCTOR OR 2288 01:21:44,520 --> 01:21:46,600 HEAR ALL THE THINGS THEY ARE 2289 01:21:46,600 --> 01:21:47,560 DOING WRONG. 2290 01:21:47,560 --> 01:21:50,240 THE REALITY IS YES, I IN AN 2291 01:21:50,240 --> 01:21:51,840 IDEAL WORLD YOU DO EVERYTHING 2292 01:21:51,840 --> 01:21:52,400 RIGHT. 2293 01:21:52,400 --> 01:21:55,280 THE GOOD NEWS IS YOU CAN GET A 2294 01:21:55,280 --> 01:21:57,720 BENEFIT FROM EACH OF THESE 2295 01:21:57,720 --> 01:21:58,840 THINGS INDEPENDENT WITHOUT DOING 2296 01:21:58,840 --> 01:21:59,600 THEM ALL. 2297 01:21:59,600 --> 01:22:01,920 SO SAY YOU HAVE A PHYSICAL 2298 01:22:01,920 --> 01:22:03,480 IMPAIRMENT AND YOU CAN'T 2299 01:22:03,480 --> 01:22:05,360 EXERCISE OR YOU HAVE CHRONIC 2300 01:22:05,360 --> 01:22:06,520 ARTHRITIS AND JUST CAN'T 2301 01:22:06,520 --> 01:22:07,840 INCREASE PHYSICAL ACTIVITY 2302 01:22:07,840 --> 01:22:09,760 WITHOUT SUBSTANTIAL PAIN. 2303 01:22:09,760 --> 01:22:10,560 THAT IS OKAY. 2304 01:22:10,560 --> 01:22:13,000 WE CAN GIVE YOU SOME WAYS TO EAT 2305 01:22:13,000 --> 01:22:14,360 HEALTHIER, WE CAN HELP YOU QUIT 2306 01:22:14,360 --> 01:22:15,560 SMOKING AND CONTROL YOUR BLOOD 2307 01:22:15,560 --> 01:22:17,320 PRESSURE. 2308 01:22:17,320 --> 01:22:19,120 SO BOTH SHARING EVERYTHING THAT 2309 01:22:19,120 --> 01:22:23,120 YOU ARE DOING HONESTLY, BUT 2310 01:22:23,120 --> 01:22:24,520 MOSTLY BEING HONEST WITH YOUR 2311 01:22:24,520 --> 01:22:25,960 DOCTOR WHERE YOUR CHALLENGES 2312 01:22:25,960 --> 01:22:29,080 ARE, IT IS GREAT WHEN SOMEBODY 2313 01:22:29,080 --> 01:22:30,800 SAYS LOOK I WON'T QUIT SMOKING. 2314 01:22:30,800 --> 01:22:32,960 YOU CAN TALK ALL DAY AIN'T 2315 01:22:32,960 --> 01:22:33,320 HAPPENING. 2316 01:22:33,320 --> 01:22:35,000 I WILL STAKE A STATIN. 2317 01:22:35,000 --> 01:22:37,200 HELP ME FIGURE OUT WAYS TO WORK 2318 01:22:37,200 --> 01:22:39,000 TOGETHER AND FIND MODIFIABLE 2319 01:22:39,000 --> 01:22:41,360 RISK FACTORS RATHER THAN HAVE ME 2320 01:22:41,360 --> 01:22:42,800 SHOOTING IN THE DARK. 2321 01:22:42,800 --> 01:22:44,120 >> RIGHT. 2322 01:22:44,120 --> 01:22:46,240 THANK YOU, VERY MUCH. 2323 01:22:46,240 --> 01:22:51,600 DR. SHERRY, THE NEW GOAL FOR -- 2324 01:22:51,600 --> 01:22:53,160 FROM THE NATIONAL PLAN IS 2325 01:22:53,160 --> 01:22:56,160 TALKING ABOUT RISK REDUCTION. 2326 01:22:56,160 --> 01:22:58,000 CAN YOU GIVE A BRIEF -- WHAT IS 2327 01:22:58,000 --> 01:22:58,800 RISK REDUCTION VERSUS 2328 01:22:58,800 --> 01:23:01,920 PREVENTION? 2329 01:23:01,920 --> 01:23:03,440 ARE THEY THE SAME THING? 2330 01:23:03,440 --> 01:23:04,960 >> THANK YOU SO MUCH, DR. 2331 01:23:04,960 --> 01:23:05,440 MACGUIRE. 2332 01:23:05,440 --> 01:23:07,800 WHAT AN EXCELLENT QUESTION. 2333 01:23:07,800 --> 01:23:10,800 I CAN TELL YOU HOW WE ARE 2334 01:23:10,800 --> 01:23:11,600 CONCEPTUALIZING THE DIFFERENCE 2335 01:23:11,600 --> 01:23:13,080 BETWEEN RISK REDUCTION AND 2336 01:23:13,080 --> 01:23:14,760 PREVENTION IN THE CONTEXT OF 2337 01:23:14,760 --> 01:23:16,680 THIS NEW GOAL. 2338 01:23:16,680 --> 01:23:20,360 WE THINK OF RISK REDUCTION ON A 2339 01:23:20,360 --> 01:23:21,360 POPULATION LEVEL. 2340 01:23:21,360 --> 01:23:23,440 WHAT ARE THE THINGS WE CAN DO 2341 01:23:23,440 --> 01:23:25,920 THAT WOULD REDUCE THE LIKELIHOOD 2342 01:23:25,920 --> 01:23:28,480 OF THE GROUP OF PEOPLE OVERALL 2343 01:23:28,480 --> 01:23:29,760 DEVELOPING DEMENTIA? 2344 01:23:29,760 --> 01:23:32,120 WHEREAS WHEN WE THINK OF 2345 01:23:32,120 --> 01:23:34,560 PREVENTION IN THIS SPECIFIC 2346 01:23:34,560 --> 01:23:36,240 CONTEXT RECOGNIZING A LOT OF 2347 01:23:36,240 --> 01:23:38,920 PEOPLE USE THESE TERMS 2348 01:23:38,920 --> 01:23:41,160 INTERCHANGEABLY, WE THINK OF THE 2349 01:23:41,160 --> 01:23:43,960 DISTINCTION AS WHAT CAN WE DO TO 2350 01:23:43,960 --> 01:23:46,320 STOP A PERSON FROM GETTING 2351 01:23:46,320 --> 01:23:48,400 DEMENTIA ALL TOGETHER. 2352 01:23:48,400 --> 01:23:50,640 SO THAT IS THE DISTINCTION WE 2353 01:23:50,640 --> 01:23:52,640 DRAW AND WE DO IT IN PART 2354 01:23:52,640 --> 01:23:55,240 BECAUSE WE RECOGNIZE AS OUR 2355 01:23:55,240 --> 01:23:57,960 PRESENTERS HAVE SO ELOQUENTLY 2356 01:23:57,960 --> 01:23:59,560 DESCRIBED TODAY THE SCIENCE AND 2357 01:23:59,560 --> 01:24:02,600 UNDERSTANDING OF WHAT FACTORS 2358 01:24:02,600 --> 01:24:03,880 CONTRIBUTE TO DEVELOPING 2359 01:24:03,880 --> 01:24:05,960 ALZHEIMER'S DISEASE IS EVOLVING 2360 01:24:05,960 --> 01:24:09,360 AND IS COMPLEX, IT APPEARS A 2361 01:24:09,360 --> 01:24:11,320 MULTI-FACTORAL ILLNESS AND 2362 01:24:11,320 --> 01:24:11,560 CONDITION. 2363 01:24:11,560 --> 01:24:14,880 SO IT I CAN BE ADDRESSING ONE 2364 01:24:14,880 --> 01:24:18,440 RISK FACTOR SUCH AS HYPERTENSION 2365 01:24:18,440 --> 01:24:20,720 CAN REDUCE THE RISK BUT MAY NOT 2366 01:24:20,720 --> 01:24:21,960 PREVENT IT ALL TOGETHER BECAUSE 2367 01:24:21,960 --> 01:24:22,880 THERE ARE OTHER FACTORS THAT 2368 01:24:22,880 --> 01:24:24,800 CONTRIBUTE TO THIS. 2369 01:24:24,800 --> 01:24:27,080 SO IN OUR APPROACH WE HAVE TRIED 2370 01:24:27,080 --> 01:24:29,240 IN USING THE TERM RISK REDUCTION 2371 01:24:29,240 --> 01:24:30,880 TO ACKNOWLEDGE THE LIMITATIONS 2372 01:24:30,880 --> 01:24:32,600 OF WHAT THE RESEARCH TELLS US 2373 01:24:32,600 --> 01:24:33,200 RIGHT NOW. 2374 01:24:33,200 --> 01:24:35,880 AND WE HAVE UNFORTUNATELY NOT 2375 01:24:35,880 --> 01:24:37,280 DESPITE THROUGH GOAL ONE 2376 01:24:37,280 --> 01:24:38,840 NATIONAL PLAN REALLY DRIVING 2377 01:24:38,840 --> 01:24:40,760 TOWARDS AND WE HAVEN'T GIVEN UP 2378 01:24:40,760 --> 01:24:43,240 BUT WE HAVE NOT IDENTIFIED THAT 2379 01:24:43,240 --> 01:24:44,840 ONE SILVER BULLET INTERVENTION 2380 01:24:44,840 --> 01:24:45,360 JUST YET. 2381 01:24:45,360 --> 01:24:47,840 THAT CAN PREVENT A PERSON FROM 2382 01:24:47,840 --> 01:24:49,360 GETTING ALZHEIMER'S DISEASE. 2383 01:24:49,360 --> 01:24:50,880 IMPORTANTLY WE HAVE IDENTIFIED 2384 01:24:50,880 --> 01:24:53,960 ALL OF THESE OTHER RISK FACTORS 2385 01:24:53,960 --> 01:24:56,760 THAT WE CAN INTERVENE TO REDUCE 2386 01:24:56,760 --> 01:24:57,240 CHANCES. 2387 01:24:57,240 --> 01:24:58,560 WE WANT TO BE CLEAR WHEN WE 2388 01:24:58,560 --> 01:25:00,680 COMMUNICATE TO THE PUBLIC DOING 2389 01:25:00,680 --> 01:25:02,280 THINGS LIKE KEEPING BLOOD 2390 01:25:02,280 --> 01:25:03,520 PRESSURE UNDER CONTROL, 2391 01:25:03,520 --> 01:25:05,360 EXERCISING MORE, BEING MORE 2392 01:25:05,360 --> 01:25:07,080 COGNITIVELY ACTIVE, THESE ARE SO 2393 01:25:07,080 --> 01:25:07,920 IMPORTANT BECAUSE THEY CAN 2394 01:25:07,920 --> 01:25:09,440 REDUCE YOUR RISK BUT WE ALSO 2395 01:25:09,440 --> 01:25:11,480 WANT TO BE CLEAR WE DON'T GET -- 2396 01:25:11,480 --> 01:25:13,120 HAVE EVIDENCE THAT THEY WILL 2397 01:25:13,120 --> 01:25:16,000 STOP YOU AS AN INDIVIDUAL FOR 2398 01:25:16,000 --> 01:25:16,760 DEVELOPING ALZHEIMER'S DEMENTIA 2399 01:25:16,760 --> 01:25:17,160 ALL TOGETHER. 2400 01:25:17,160 --> 01:25:18,080 I HOPE THAT ADDRESSES YOUR 2401 01:25:18,080 --> 01:25:19,560 QUESTION. 2402 01:25:19,560 --> 01:25:20,560 >> IT DID. 2403 01:25:20,560 --> 01:25:24,560 THANK YOU, VERY MUCH. 2404 01:25:24,560 --> 01:25:27,720 >> MATTHEW, IS THERE ANY RISK 2405 01:25:27,720 --> 01:25:29,040 REDUCTION DATA RELATING TO 2406 01:25:29,040 --> 01:25:31,040 AMERICAN INDIAN ALASKA NATIVE 2407 01:25:31,040 --> 01:25:35,480 PEOPLE AND TRIBAL COMMUNITIES 2408 01:25:35,480 --> 01:25:36,600 WITH DEMENTIA? 2409 01:25:36,600 --> 01:25:38,640 >> DATA IN THAT POPULATION IS 2410 01:25:38,640 --> 01:25:39,920 VERY HARD TO COME BY. 2411 01:25:39,920 --> 01:25:43,760 THERE ARE COUPLE OF THINGS WE DO 2412 01:25:43,760 --> 01:25:44,320 KNOW. 2413 01:25:44,320 --> 01:25:46,120 AS I MENTIONED ON ONE OF MY 2414 01:25:46,120 --> 01:25:49,280 SLIDES MORE THAN TWO-THIRDS OF 2415 01:25:49,280 --> 01:25:51,360 NATIVE AMERICANS HAVE AT LEAST 2416 01:25:51,360 --> 01:25:53,840 ONE OF THOSE BIG FIVE RISK 2417 01:25:53,840 --> 01:25:55,480 FACTORS HYPERTENSION DIABETES 2418 01:25:55,480 --> 01:25:57,400 OBESITY SMOKING OR PHYSICAL 2419 01:25:57,400 --> 01:25:58,360 INACTIVITY. 2420 01:25:58,360 --> 01:26:03,000 WE ALSO KNOW THAT IN GENERAL THE 2421 01:26:03,000 --> 01:26:05,120 PREVALENCE OF A LOT OF RISK 2422 01:26:05,120 --> 01:26:07,480 KNACK TORRS IS MUCH HIGHER AMONG 2423 01:26:07,480 --> 01:26:09,520 NATIVE AMERICANS, A LOT OF THESE 2424 01:26:09,520 --> 01:26:12,160 -- A LOT OF THESE CONDITIONS ARE 2425 01:26:12,160 --> 01:26:13,680 MUCH HIGHER IN GENERAL AMONG 2426 01:26:13,680 --> 01:26:15,360 NATIVE AMERICANS WHEN COMPARED 2427 01:26:15,360 --> 01:26:15,840 WITH WHITES. 2428 01:26:15,840 --> 01:26:17,640 THE OTHER THING WE KNOW AND I 2429 01:26:17,640 --> 01:26:19,840 THINK YOU ARE INVOLVED IN THE 2430 01:26:19,840 --> 01:26:23,040 STUDY THAT LOOKED AT THIS -- 2431 01:26:23,040 --> 01:26:25,120 PUBLISHED A COUPLE OF YEARS AGO, 2432 01:26:25,120 --> 01:26:29,280 THAT BETWEEN 2014 AND 2060, SO 2433 01:26:29,280 --> 01:26:31,280 OVER THAT TIME SPAN, THE NUMBER 2434 01:26:31,280 --> 01:26:33,640 OF NATIVE AMERICANS WITH 2435 01:26:33,640 --> 01:26:36,480 DEMENTIA IS EXPECTED TO INCREASE 2436 01:26:36,480 --> 01:26:36,920 FIVE FOLD. 2437 01:26:36,920 --> 01:26:41,200 AND SO THAT IS A HUGE INCREASE 2438 01:26:41,200 --> 01:26:44,000 IN THE POPULATION AND PART OF 2439 01:26:44,000 --> 01:26:46,360 THAT IS IMPROVED HEALTHCARE IN 2440 01:26:46,360 --> 01:26:48,760 GENERAL SO PEOPLE ARE LIVING 2441 01:26:48,760 --> 01:26:50,680 LONGER. 2442 01:26:50,680 --> 01:26:52,960 BUT IT IS ALSO PROBABLY A FACTOR 2443 01:26:52,960 --> 01:26:54,840 OF THE HIGHER PREVALENCE OF SOME 2444 01:26:54,840 --> 01:26:58,120 OF THESE RISK FACTORS. 2445 01:26:58,120 --> 01:26:59,760 >> THANK YOU VERY MUCH. 2446 01:26:59,760 --> 01:27:02,400 DR. BAKER. 2447 01:27:02,400 --> 01:27:06,120 CAN YOU COMMENT ON THE EFFECT OF 2448 01:27:06,120 --> 01:27:07,960 CHRONIC SLEEP DEPRIVATION AND 2449 01:27:07,960 --> 01:27:11,320 POTENTIAL IMPACT ON DEMENTIA? 2450 01:27:11,320 --> 01:27:13,240 >> THIS IS A NEW AREA THAT IS 2451 01:27:13,240 --> 01:27:16,800 GETTING A LOT OF ATTENTION NOW, 2452 01:27:16,800 --> 01:27:20,760 SLEEP, QUALITY, AND COGNITIVE 2453 01:27:20,760 --> 01:27:22,680 HEALTH AND DECLINE. 2454 01:27:22,680 --> 01:27:25,560 THE LATEST SCIENCE THAT WE ARE 2455 01:27:25,560 --> 01:27:28,360 LEARNING ABOUT SUGGESTS THAT 2456 01:27:28,360 --> 01:27:30,040 DURING SLEEP A VERY IMPORTANT 2457 01:27:30,040 --> 01:27:30,960 PROCESS TAKES PLACE. 2458 01:27:30,960 --> 01:27:33,400 I ALWAYS LIKE TO THINK OF IT AS 2459 01:27:33,400 --> 01:27:35,560 BRAIN TAKES OUT TRASH. 2460 01:27:35,560 --> 01:27:36,440 AT NIGHT. 2461 01:27:36,440 --> 01:27:40,680 IF WE DO NOT GET GOOD QUALITY 2462 01:27:40,680 --> 01:27:41,760 SLEEP, WELL, WE MOW WHAT HAPPENS 2463 01:27:41,760 --> 01:27:44,360 IN OUR HOUSES WHEN THAT DOESN'T 2464 01:27:44,360 --> 01:27:45,760 HAPPEN, RIGHT? 2465 01:27:45,760 --> 01:27:47,760 SO WHY WOULD WE EXPECT ANYTHING 2466 01:27:47,760 --> 01:27:48,120 DIFFERENT. 2467 01:27:48,120 --> 01:27:51,240 IF WE CAN'T TAKE OUT THE TRASH, 2468 01:27:51,240 --> 01:27:54,400 AND -- JUST EVERY DAY WHEN WE 2469 01:27:54,400 --> 01:27:57,040 ARE THINKING -- EVERYTHING WE 2470 01:27:57,040 --> 01:27:57,800 DO, THERE ARE BY-PRODUCTS THAT 2471 01:27:57,800 --> 01:28:01,600 WE HAVE TO -- THERE'S EXTRA -- 2472 01:28:01,600 --> 01:28:02,760 THERE'S TRASH THAT NEEDS TO BE 2473 01:28:02,760 --> 01:28:04,640 DISPOSED OF AT THE END OF THE 2474 01:28:04,640 --> 01:28:04,800 DAY. 2475 01:28:04,800 --> 01:28:06,120 WHAT WE ARE LEARNING IS PEOPLE 2476 01:28:06,120 --> 01:28:08,400 WHO ARE NOT GETTING GOOD QUALITY 2477 01:28:08,400 --> 01:28:10,280 SLEEP HAVE HIGHER BUILD UP OF 2478 01:28:10,280 --> 01:28:11,160 THIS TRASH. 2479 01:28:11,160 --> 01:28:12,320 SO WHAT WE HAVE SEEN IN SCIENCE 2480 01:28:12,320 --> 01:28:14,640 IS THERE IS A HIGHER BUILD UP OF 2481 01:28:14,640 --> 01:28:16,400 AMYLOID PROTEIN MANY THE BRAIN 2482 01:28:16,400 --> 01:28:18,360 FOR PEOPLE WHO HAVE CHRONIC 2483 01:28:18,360 --> 01:28:20,440 PROBLEMS WITH SLEEP. 2484 01:28:20,440 --> 01:28:23,120 SLEEP COMES IN ALL SHAPES POOR 2485 01:28:23,120 --> 01:28:25,200 SLEEP IN ALL SHAPES AND SIZES SO 2486 01:28:25,200 --> 01:28:28,880 POOR QUALITY CAN RELATE TO NOT 2487 01:28:28,880 --> 01:28:30,720 HAVING ENOUGH SLEEP, IT COULD BE 2488 01:28:30,720 --> 01:28:33,720 RELATED TO SLEEP APNEA WHERE YOU 2489 01:28:33,720 --> 01:28:34,640 HAVE INSUFFICIENT OXYGEN 2490 01:28:34,640 --> 01:28:37,120 SUPPLIED TO THE BRAIN AT NIGHT. 2491 01:28:37,120 --> 01:28:38,960 IT COULD BE RELATED TO 2492 01:28:38,960 --> 01:28:42,120 DISTURBANCES THAT OCCUR OR 2493 01:28:42,120 --> 01:28:44,240 EXPOSURES, OTHER EXPOSURES 2494 01:28:44,240 --> 01:28:46,360 HAPPENED THAT DISTURB QUALITY OF 2495 01:28:46,360 --> 01:28:46,720 SLEEP. 2496 01:28:46,720 --> 01:28:49,400 SO ONE OF OUR RISK REDUCTION 2497 01:28:49,400 --> 01:28:51,400 MANTRAS THAT WE HAVE IS REALLY 2498 01:28:51,400 --> 01:28:56,160 PAY ATTENTION TO YOUR SLEEP. 2499 01:28:56,160 --> 01:28:58,600 THERE'S OHIO TRICKS WELL 2500 01:28:58,600 --> 01:29:01,800 ESTABLISHED WHO CAN FIND THEM IN 2501 01:29:01,800 --> 01:29:04,920 MANY DIFFERENT SITES, NIH HAS 2502 01:29:04,920 --> 01:29:07,160 STRATEGIES TO HELP BEHAVIORS 2503 01:29:07,160 --> 01:29:08,200 THAT YOU CAN DRAW THAT ARE 2504 01:29:08,200 --> 01:29:09,480 IMPORTANT TO TRY TO PROTECT 2505 01:29:09,480 --> 01:29:10,400 SLEEP. 2506 01:29:10,400 --> 01:29:13,840 I WANT TO SAY IF YOU HAVE OR 2507 01:29:13,840 --> 01:29:16,040 SUSPECT SLEEP APNEA, I STRONGLY 2508 01:29:16,040 --> 01:29:17,280 ENCOURAGE THAT YOU ENCOURAGE 2509 01:29:17,280 --> 01:29:19,360 YOUR PEOPLE THAT YOU WORK WITH 2510 01:29:19,360 --> 01:29:22,760 TO GET THAT CHECKED OUT. 2511 01:29:22,760 --> 01:29:25,400 WE ARE LEARNING THAT TREATMENT 2512 01:29:25,400 --> 01:29:27,720 OF SLEEP APNEA CAN HAVE 2513 01:29:27,720 --> 01:29:31,840 SIGNIFICANT IMPACT ON COGNITIVE 2514 01:29:31,840 --> 01:29:32,120 TRAJECTORY. 2515 01:29:32,120 --> 01:29:33,440 >> I HAVE TO JUMP IN AND MAKE A 2516 01:29:33,440 --> 01:29:35,880 PLUG HERE FOR THE HEART TOO ON 2517 01:29:35,880 --> 01:29:36,080 SLEEP. 2518 01:29:36,080 --> 01:29:38,120 WE HAVE A LOT OF DATA THAT SHOWS 2519 01:29:38,120 --> 01:29:40,320 THAT NOT JUST -- NOT ENOUGH 2520 01:29:40,320 --> 01:29:41,800 SLEEP POOR QUALITY SLEEP BUT 2521 01:29:41,800 --> 01:29:43,080 EVEN IRREGULAR SLEEP CAN 2522 01:29:43,080 --> 01:29:45,960 INCREASE RISK OF CARDIOVASCULAR 2523 01:29:45,960 --> 01:29:46,600 DISEASE. 2524 01:29:46,600 --> 01:29:48,560 SLEEP APNEA UNTREATED CAUSES 2525 01:29:48,560 --> 01:29:49,600 HYPERTENSION AND OTHER HEART 2526 01:29:49,600 --> 01:29:51,520 PROBLEMS. 2527 01:29:51,520 --> 01:29:53,040 THERE ARE THINGS YOU CAN DO 2528 01:29:53,040 --> 01:29:54,360 MEDICALLY TO HELP YOU SLEEP 2529 01:29:54,360 --> 01:29:55,720 BETTER INCLUDING REFERRING TO 2530 01:29:55,720 --> 01:29:58,280 SLEEP STUDY BUT ALSO SOME SIMPLE 2531 01:29:58,280 --> 01:30:00,800 THINGS MAYBE MEDICATIONS YOU ARE 2532 01:30:00,800 --> 01:30:02,040 TAKING, OR OTHER THINGS YOU ARE 2533 01:30:02,040 --> 01:30:03,720 DOING THAT MAYBE AFFECTING YOUR 2534 01:30:03,720 --> 01:30:06,720 SLEEP THAT WE CAN HELP WITH. 2535 01:30:06,720 --> 01:30:09,280 >> THANK YOU ALL VERY MUCH. 2536 01:30:09,280 --> 01:30:13,000 THIS WAS A VERY INFORMATIVE 2537 01:30:13,000 --> 01:30:13,240 SESSION. 2538 01:30:13,240 --> 01:30:14,880 I WANT TO LET YOU KNOW THAT THIS 2539 01:30:14,880 --> 01:30:18,560 IS A WEBINAR SERIES THAT HAPPENS 2540 01:30:18,560 --> 01:30:21,240 ABOUT QUARTERLY SO PLEASE CHECK 2541 01:30:21,240 --> 01:30:23,120 OUT THE WEBSITE, THAT IS SHOWN 2542 01:30:23,120 --> 01:30:24,920 HERE ON THIS SLIDE AND YOU WILL 2543 01:30:24,920 --> 01:30:28,600 SEE THE NEXT WEBINAR AND ALSO IF 2544 01:30:28,600 --> 01:30:31,560 YOU MISS THIS WEBINAR, IF YOU 2545 01:30:31,560 --> 01:30:32,880 MISSED WATCHING AND WANT TO MAKE 2546 01:30:32,880 --> 01:30:34,560 SURE YOUR FRIEND SEE IT AND 2547 01:30:34,560 --> 01:30:35,960 COLLEAGUES SEE IT YOU CAN SEND 2548 01:30:35,960 --> 01:30:37,000 THEM THE RECORDING WILL BE 2549 01:30:37,000 --> 01:30:38,320 POSTED AS WELL. 2550 01:30:38,320 --> 01:30:41,160 SO ONCE AGAIN, THANK YOU ALL, 2551 01:30:41,160 --> 01:30:43,560 EXCELLENT PRESENTATIONS. 2552 01:30:43,560 --> 01:38:48,960 AND THANK YOU FOR PARTICIPATING.