-With Nevada's primaries over, the focus now shifts to November.

Veteran political journalist Jon Ralston joins us.

And... -Alzheimer's is not only a brain disease, and it has been recognized increasingly as the women's health issue.

-Why Alzheimer's disease impacts women more than men and why researchers are taking a new look at women's brain health during menopause, that's this week on Nevada Week.

♪♪ Support for Nevada Week is provided by Senator William H. Hernstadt and other supporters.

-Welcome to Nevada Week.

I'm Amber Renee Dixon.

In November, Nevadans will select their Governor.

The June 9th primary confirmed that Republican incumbent Joe Lombardo will face Democrat Attorney General Aaron Ford.

The Governor's race is one of several notable contests.

Our guest this week is following closely.

Jon Ralston, prominent political pundit and CEO of the nonprofit, nonpartisan news and opinion website The Nevada Independent, thank you for joining Nevada Week.

-"Prominent political pundit," that's hard to say, but I'm going to use it.

-I love the illiteration.

-Thanks for having me again, Amber.

-Okay.

So Democrat Aaron Ford will face Republican Governor Joe Lombardo in November.

No real surprise there.

"The Cook Political Report" considers this race a tossup.

What do you think?

(Jon Ralston) I don't think it's a tossup.

I think that Lombardo, who is an incumbent Governor with no obvious scandals or missteps, has to be the favorite, especially in Nevada, where a Governor has so much power.

You know, the legislature only meets 4 months out of 24.

So Lombardo, or any Governor, can pretty much do what he wants and raise as much money as he wants.

So having said all that, you know, Ford is the Attorney General.

It's a familiar springboard for people to run for Governor, and he has some issues.

Lombardo is already going after him on his out-of-state travel.

We're going to see that incessantly for the next, I think it's 146 days or so.

The problem for Lombardo, and his team knows this, isn't so much that anyone with a D has a chance, including Ford, it's that Donald Trump's numbers are terrible here.

And even though Lombardo has been close to Trump when he needed to be and distanced himself when he came, that's not going to last.

And the economy, if it doesn't turn around and become really robust, it's an issue for them.

So you know, Ford put out, immediately put out a poll that showed him within the margin of error.

I don't think it's quite that close, but it's close.

-Last year, Fox News said the Governor is widely considered to be the most at-risk GOP Governor seeking another term.

Does that sway your opinion?

-You know, that's just-- that has to do with the matrix of Governors who are up across the country.

But also, here's the thing, Amber, and you know this, we're a purple state.

We're very evenly divided among Republicans and Democrats, and then you have all these Independent voters.

So anyone, as I said, with a D next to his or her name, if they're--especially if they're the Attorney General--get a reasonable amount of money, is going to be competitive.

So, relatively speaking, to other Republican Governors, Lombardo is vulnerable.

I think he's a slight favorite--not a prohibitive favorite, not a landslide favorite, just a slight favorite.

-Okay.

And then when you say that the President's numbers are bad here, are you referring to, what, his polling numbers?

-His approval rating is terrible across the country.

The average now is in the mid to high 30s.

That's about where he is here.

His numbers here have been a little bit higher than nationally, but not so much anymore.

And so it'll be really interesting to see if Trump comes out and campaigns for Lombardo, because I think they want to try to distance themselves from Trump as much as you can if you're a Republican.

-Okay.

But then at the same time you have Trump endorsed candidates who won this primary over, well, at least in Congressional District 2.

The President endorsed David Flippo.

The Governor endorsed his opponent, James Settelmeyer.

What does that say to you?

-What's really interesting about that, Amber, is that it happened in the reverse order that you said, which makes it even more stunning.

Lombardo and the incumbent, Mark Amodei, immediately embraced James Settelmeyer, former State Senator, former Executive Branch staffer, right after he announced.

And then Trump, out of nowhere, endorsed Flippo, which was kind of a Pearl Harbor maneuver on the Governor and the incumbent Congressman.

Amodei has been speaking out for the last few weeks against Flippo and for Settelmeyer.

They consider Flippo who was running in the Congressional District 4 race down here before Amodei announced, and suddenly he's become a Northern Nevadan.

And so the Trump endorsement in primaries here and everywhere with very, very few exceptions is golden.

And so as soon as Trump endorsed Flippo and then all of MAGA world came in--Turning Point USA, the Freedom Caucus, the Speaker of the House endorsed him, it was a very uphill climb for Settelmeyer after that.

-What does this do for the general election then and the Democrats' chance of taking that seat, which has never been done?

-Exactly.

It's never been taken by a Democrat.

The closest any Democrat has come is about five percentage points, which is still a relatively decisive victory.

So Democrats have more hope now that Flippo won, because he's not as well known.

He ran a very vicious campaign against Settelmeyer, full of all kinds of distortions of Settelmeyer's legislative record.

A lot of bad feelings in Northern Nevada about that.

Is that enough to give Teresa Benitez-Thompson, the former Assembly Majority Leader, who was well known up there even before she became a legislator?

She was involved in the community.

She was a Miss Nevada winner.

She's, she's a good candidate.

In fact, she won her primary decisively on Tuesday, despite having spent almost no money against a multi-millionaire who spent a fortune against her in Greg Kidd.

So she's a strong candidate.

Having said that, it's a very Republican district, has been for a long time.

Republicans, especially in the rural parts of that district--and there's a lot of rural parts of that district--don't like voting for Democrats.

-That fundraising aspect, or is it more the spending aspect that you just brought up?

I mean, it's fascinating because there's an example of not spending much yet beating someone with a lot of money.

And then you have Governor Lombardo, who has a ton of money on hand.

Can anyone beat that?

-It's much more likely in a primary with a smaller universe of voters that you can run a grassroots-type campaign.

I think that's what Alexis Hill, the Washoe County Commissioner, thought she could do against Aaron Ford.

But it's still very difficult.

Money means a lot and especially in a general election.

And difference with Lombardo and anybody else is he has unlimited amounts of money.

You may remember when he first ran against an incumbent, Steve Sisolak.

He didn't-- He raised a decent amount of money, but he never would have been able to be competitive with Sisolak, except for third-party spending, including from Robert Bigelow, a local businessman who essentially funded that third-party effort for Lombardo.

I don't know if he's going to do that again, but Lombardo may not need that now that he's the Governor and can raise money from everywhere.

Everyone wants to be friends with the Governor or everyone fears the Governor, however you look at it.

So he's going to have fantastic amounts of money, both himself and coming in from third parties.

Aaron Ford's not gonna be able to raise a lot of money in states.

Some.

He's just gonna need third parties from outside the Democratic Governors Association and others to help him, but he'll never come close to matching Lombardo.

-Well, let's move to the Democratic Attorney General's race.

State Senate Majority Leader Nicole Cannizzaro pulled that one out.

That was a heated contest.

You moderated, along with Tabitha Mueller from The Nevada Independent, a debate between the two.

How would you describe that debate?

-It was one of the most contentious debates I've ever been a part of, and I've been a part of a few.

Those two really, really dislike each other for a variety of different reasons.

And it was palpable during that debate.

Now, I have to tell you, Zach Conine, who is the State Treasurer, I don't think most people gave him any chance at all in that race.

Most people don't even know he's a lawyer, right.

And Nicole Cannizzaro, as a Democratic woman on the ballot, that's an advantage in a Democratic primary, always has been, and she's a former prosecutor.

So it was an uphill battle from Zach Conine.

I thought he ran a good campaign, but I mean she won by a huge margin in that race, bigger than I think most people thought.

-What did that debate indicate about the Democratic Party in Nevada, if anything?

Or is that just, you know, par for the course within a primary?

-It's a great question, and I think it's emblematic of what's going on in the Democratic Party, not only at that level but in legislative races and across the country.

At a time when it's a midterm for a Republican President and Trump's numbers are terrible, it should be a big year for Democrats everywhere.

But they seem to have this circular firing squad going on in a bunch of these races.

I don't think it's going to affect the Attorney General's race as much as it will down-ballot races where we just had these special interest groups in labor, mostly, some progressive groups put up left-wing candidates against Democratic either incumbents or those essentially seen as establishment candidates.

Now, most of them didn't do very well, but still that is a sign of a fractured base.

You see it nationally, and you're seeing that here, too.

-Have you ever seen anything like that here in Nevada?

-Not, not to this degree.

There have been isolated instances, of course.

And you can say that in Nevada, the insurgent campaign of Bernie Sanders, when he was running for President, did very well here.

He won the caucus here against Joe Biden in the year that Biden actually won.

But to this extent, to have special interest groups who are critical, by the way, to the Democrats' potential successes in November, be so fractured right now, I've never seen that before.

-So the Harry Reid machine in its current form, how does it compare to the Joe Lombardo machine?

And you've used that terminology, right, "Joe Lombardo machine"?

-I have.

Guilty as charged.

I have to tell you, Amber, I don't think we're going to know.

The Lombardo people really think that they are better than the Reid machine.

Now, they've replicated a lot of what the Reid machine did.

A lot of people think that the Reid machine no longer exists because Harry Reid passed away in 2021.

But the same people running it are basically still there and are still very good at what they do.

But the proof is going to be in the pudding in November.

They're very confident that they can carry forward to victory with that machine, while Lombardo's team, and they are very, very good and very skillful and really adept at the modern age of politics, which involves much more than when I first started covering this, where you have to have good digital campaigns, good Spanish language.

Again, they just started running an ad on Spanish language TV this morning attacking Ford for his travel.

So it's going to be a real test.

Now, this is inside baseball to some extent, but it's going to set the tone, I think, going forward if Lombardo can not only be re-elected but help other candidates down the ballot that he has endorsed or that he wants to win in legislative races, because who wants to be Governor when you have such a huge near supermajority of Democrats in the legislature.

He wants to do something about that.

-And then, what would be fair?

You'd have to compare time spans, right?

I mean, Harry Reid machine, how long has that been powerful versus how long Joe Lombardo has been in power?

What would be a safe amount of time?

-Yeah.

I mean, that's exactly right.

I mean, once the Reid machine really formed in the mid 2000s, they didn't lose a Presidential race until 2024 when Trump took the state for consecutive Presidential cycles.

So we haven't even gotten to the Presidential cycle.

I mean, Lombardo had nothing to do with Trump's victory here in 2024, but can he help a Presidential candidate?

That's assuming he gets reelected.

Yeah, the time span is significant.

The Reid machine did that over a period of about two decades.

That's tough to match.

-And you are the expert in Harry Reid.

How are your book sales doing?

-You know, I never expected to be a best seller.

Most people don't know, even know who Harry Reid is, including some people in Nevada.

But it's selling fine.

What's really been gratifying have been the reviews.

I've gotten really good reviews, which meant-- because I thought I have to be sitting in a dark room fretting about the, about the reviews for weeks.

But they've been good.

And just getting random emails from people, people I don't know across the country saying they read it and they liked it.

So I doubt I'm going to eclipse Gone With the Wind anytime soon, but I'm happy with it.

-Any review that surprised you?

-The most surprising one was a publication that my dad used to read, called The Economist, which is an internationally known, really well-respected publication, a magazine.

I didn't think they were going to review the book, and they give it a glowing review.

And to be honest with you, what I thought about was my dad, who passed away about 10 years ago.

He would have been so proud to see that.

-Okay.

We have to talk about the Republican candidate for Attorney General.

And she was able to pull that off.

It's going to be two females going against each other.

And that was Adriana Guzman Fralick.

She got the endorsement from Trump as well, but where does she fit in with the Governor's endorsement and who he wants in power?

-So what happened in that race is that Danny Tarkanian, who's run, you know, I think since-- every election since I started covering politics, was in the race.

And Joe Lombardo and his team were very worried.

They care a lot about the Attorney General's spot, obviously.

They were worried that Danny Tarkanian was going to win that primary and then lose again, as he almost always does in the general election.

So he recruited Adriana Guzman Fralick to run.

She's a very well-respected attorney from Northern Nevada.

Nobody knew who she is-- she was.

And so I-- It's kind of-- And someone else used this first, I think.

It was kind of a make-up call by Trump.

After kind of screwing the Governor on the Flippo endorsement, he decides to endorse her relatively late.

She was still doing very well, but Danny Tarkanian was running these old quotes from Trump on TV gushing about Danny.

But they weren't contemporaneous, and I think they used that to irk Trump and get him to endorse Adriana Fraylick in that race.

So she's a, she's a credible candidate.

Lombardo will be able to get her a lot of funding.

But I think Nicole Cannizzaro looks very strong coming out of that primary with how-- You know, we talked about the problems within the Democratic Party.

She won that by a sizable margin, and that's going to help her.

-What about any of the congressional races?

Do you think there are any Republicans who have a chance of taking those strongholds in Southern Nevada and Steven Horsford's seat?

-If it were a midterm election, I'd say maybe we should pay close attention to it with a Democratic President where they were going to be weaker.

But all the winds are blowing the Democrats' way.

And so unless something very strange happens, they don't have super high quality, well-known candidates in any of those races.

The Republicans, I mean.

Marty O'Donnell in the swing seat, which is Susie Lee's seat, the Halo composer, and he's a multimillionaire.

He's put in $3 million.

Doesn't mean he has to spend it.

But if he decides to spend that much money in that race, I think he has a chance.

But the other races I don't think are real races.

-Okay.

And then last topic, the Democrats in Nevada would like this state to be the first to have the Presidential primary in 2028.

I think Nevada is one of 12 states competing for that right.

What do you think about Nevada's chances, and does it make sense for Nevada?

-Well, it certainly makes sense.

And I've argued this for years.

We really, we-- It's so strange, Amber.

When I first moved here, you know, Vegas was an alien place, even to me.

This was in the mid 80s.

But now we're essentially a mirror of America, especially Las Vegas.

It's changed so much.

It looks like, especially the Democratic Party, writ large.

They just made a pitch, the Democratic Party here in Washington to the Democratic National Committee, what's called the Rules and Bylaws Committee.

We're going to know probably next month what their decision is.

People who are, who are in the know here tell me they think Nevada has a decent chance of being first.

At very worst, they think we'll be second.

And I think either is great for the state.

We'll get a ton of attention.

You will have Presidential candidates coming wanting to be on your program, which will be great for you.

It's great for journalists in Nevada, because they're just going to pay a lot of attention to us.

-And what about South Carolina, though?

They have the number one spot right now, and they've made a strong argument from what I've read.

What advantage does South Carolina have over Nevada?

-They have none.

And the only reason that South Carolina was first is because Biden was close to James Clyburn, who was a very entrenched House member from there, very influential.

And so he did that as a favor to Clyburn.

That doesn't exist anymore, obviously.

And so I don't think South Carolina has any chance to retain that.

I don't think there's any momentum for them, but, you know, internal party politics are weird.

No outcome would surprise me.

But I do think Nevada will be first or second and, at worst, somewhere in the first four.

-We are running out of time.

And I am upset that I did not find an opportunity to use "bureaucratic toupee," which was something that Zach Conine said about what?

About the legislative building?

-Yes.

I think that was it.

That was during the debate, right?

Yeah.

I forget what that was.

It was just-- The thing about that debate is he was just sending so many barbs out there that was difficult to keep track of all of them, and she kept interrupting Tabitha and myself, because she wanted, she had, she wanted to defend herself against every single one of those.

And so, but that was a, that was one of the most well-received debates that I've ever moderated.

People really liked it.

Tabitha and I just sat back and let them show who they really were, I think.

-Yeah.

I'm remembering it is about the dome on the legislative building.

He called it a bureaucratic toupee.

-Expensive, yes.

-Jon Ralston, CEO of The Nevada Independent, thank you for joining Nevada Week.

-Thanks for having me.

-And we move now to this month's "Your Brain Health Matters."

Alzheimer's disease affects women differently and more often.

Researchers at UNLV's Kirk Kekorian School of Medicine are trying to better understand why.

And for Amanda Osse, Assistant Professor in the Department of Brain Health, the work is personal.

-My grandpa had Alzheimer's disease, and then my husband's grandmother had Alzheimer's disease.

And we watched both of them go through this.

And what was interesting is that they both went through it very differently.

So especially being a man and a woman, it makes you wonder if that played a role in how they both progressed differently and presented some of the symptoms differently.

So the prevalence shows that about two-thirds of Alzheimer's disease cases are women, so we know that there's a difference that is happening in the prevalence.

Why?

There's some things that could be playing a role, but there's a lot of research that still needs to be done for us to fully understand why that is happening in women versus men.

-Could you start with some sort of explanation?

(Amanda Osse) Yeah.

There's social factors that can play a role.

So women tend to have more caretaking responsibilities and higher stress levels.

They tend to not have time to do things like exercise or eat healthy.

There's also biological differences.

So men and women have differences in their brain makeup that affects how the brain functions and also things like hormone changes that happen throughout the life, especially with women going through menopause.

And I think that's where the conversation is now starting to emerge about what we can do to be protecting our brain during this transition.

-One area of that conversation centers on hormone replacement therapy and what role it may play in women's brain health during menopause.

Nevada Week discussed that with Dr.

Kate Jhong, a research professor in UNLV's Department of Brain Health, who says the thinking around HRT is changing.

(Dr.

Kate Zhong) Menopause really is such a shift of our body, of our brain health.

And then this is where people have to be so vigilant about what you should be doing during that particular transitional period of time.

In the early 2000s, almost 20-some years ago, there were large studies really looking at the role of hormones and women's health.

And that study, or group of studies, have indicated that there are some risks associated with using of hormone replacement therapy, including higher incidence of stroke and potentially higher incidence of dementia.

Now fast forward.

Nowadays we understand looking at the data.

The design of the study were somewhat flawed, and then the data was at a certain level misinterpreted and, even more importantly, it was applied to a much broader population.

By that I mean the original study only looked at women who were older than 65 and who started the treatment much later after the onset of the menopause.

But then because of the study, then they apply broadly to all women and regardless of their age, regardless of the onset of their menopause.

So now with the understanding and research we have done, that has been shifted in a very significant and positive way.

So the key is timing really matters, so it's when the initiation of the hormonal therapy should be considered.

And the current recommendation is that it really should start as soon as possible and really should start ideally for those who are under 65 or if not younger.

It's a matter of when that is used, how is it used, and what kind of formulation?

Because the hormonal therapy also comes in different formulation.

It can be in the pill format, it can be in transdermal patch, and it can be in gels, so and so forth.

So then they-- we are really now moving from a mindset of a very broad range of caution, almost fear, to more individualized, more personalized, and more precise approach.

So I'm so pleased to see that we are making such a big change in the direction that will make the hormone treatment available for so many women who can potentially truly benefit from that.

-So women who are watching this and who have thought that hormone replacement therapy may be a bad thing, what would you tell them?

Go talk to your doctor about it?

-I would say, yes, go talk to a doctor is a very important step.

And also I think just find more information.

Go on FDS website.

Go on the public education website.

The key is that not two women are alike, right?

So I think you have to really think about you, Amber, for example, your age, your risk factors, and also your overall symptoms, because now the hormonal therapy is really indicated for people who have symptoms, for example, the hot flashes and, you know, all the menopause associated symptoms.

We need to be clear that estrogen or the hormonal therapy is not a treatment for Alzheimer's or dementia.

However, when people benefit from the treatment--that their cardiovascular condition improve, their sleep improve, their mood improve--that can all positively impact on the overall brain health.

-In 2024, the medical journal The Lancet reported that nearly half of dementia cases could be prevented or delayed by addressing certain health and lifestyle risk factors.

To learn more about those risk factors and to find any of the other resources discussed in this show, go to vegaspbs.org.

And I'll see you next week on Nevada Week.

♪♪♪