A new drug is giving hope to millions of Americans with Alzheimer's.

We look at why it's a game changer in fighting the progression of this debilitating disease.

And we get an inside look at the latest study helping South Florida researchers better understand how the brain ages and ways to improve brain health.

That and more.

Stay with us as we dive into "Your South Florida".

Hello, and welcome to "Your South Florida".

I'm Pam Gigante, thank you so much for joining us.

Alzheimer's, it's a terrible, debilitating disease that robs people of their independence and puts a huge strain on families and caregivers.

It is the most common form of dementia, affecting memory, thinking, and behavior.

Unlike typical signs of aging, it's a progressive disease that eventually becomes so severe it affects daily life and self-care.

More than 6 million people in the United States live with Alzheimer's, many of them right here in Florida.

Of our 65 and older population, nearly 600,000 seniors are suffering from Alzheimer's, one of the largest populations in the country.

And treating these patients comes with a huge price tag.

According to the Alzheimer's Association, the cost of care for those with Alzheimer's and other forms of dementia is expected to be a whopping $345 billion this year, growing to nearly $1 trillion by the year 2050.

This financial burden leads many to rely on family members to step in as caregivers.

In 2022 alone, unpaid Florida caregivers work more than a billion hours, a value of over $23 billion.

The stress brought on by being an unpaid caregiver has health impacts as well, with many experiencing a decline in their own health, including depression.

Fortunately, there is some help on the horizon, with both the federal government and Florida announcing new initiatives to provide resources and support.

And in July, for the first time, the FDA approved a new Alzheimer's drug meant to slow the progression of the disease for those in early stages.

Joining me now to talk more about all of this is Jennifer Braisted, director of government affairs for the Alzheimer's Association Southeast Florida Chapter.

Jennifer, thank you so much for joining me.

Really appreciate it.

Thank you for having me.

Yeah, so kind of walk us through the difference between dementia and Alzheimer's.

People age, and we all start to kind of forget things.

Sure.

But there's a difference, so talk to us about that.

Absolutely, so Alzheimer's is the most common form of dementia.

And when you're talking about dementia, it's an umbrella term, and there's different types of dementia, but dementia really covers a bunch of different symptoms that affect memory and thinking.

But Alzheimer's, it's not a normal part of aging.

Sometimes people think, oh, you get old, you get Alzheimer's, or you get another type of dementia.

That is not true, it is not a normal part of aging.

But like you said, there are some things that are part of the normal aging process.

So when looking at Alzheimer's, you really look at the warning signs.

And so, for instance, one of the main warning signs is difficulty completing familiar task.

So if you are someone who makes a recipe, and that is something that you do on a weekly basis, but all of a sudden you start having issues with that.

You're putting in the wrong ingredients, your family members notice different taste, that's something to look out for.

That really, that ability, when it affects your normal everyday life.

You're forgetting appointments, you're needing post-it notes everywhere you go.

But a instance of normal aging would be forgetting a person's name but then remembering it later.

[Pam] Right.

That would be normal.

[Pam] That's normal.

But if it's something that's-- Or forgetting your keys or something like that, you left your cell phone at home.

[Jennifer] Right.

That's normal.

If you're able to find your keys, and backtrack and be like, "Okay, well I was in this room and I was in that room."

Right.

Really, if you're able to do that comprehension and go through your steps, that's normal.

But, and then a lot of times, we'll say if you're putting your keys in the fridge, that's an...

But people misplace things and put 'em there.

But really, unless you forget what the key does, that's a real concern.

So what we're also seeing is, according to the CDC, Alzheimer's is on the rise.

Yes.

Especially in certain populations, like the Latino population and the African-American population.

What's going on here?

Yes.

So we are seeing that rise in numbers, but the big thing is, with the African-American population, they are twice as likely to develop Alzheimer's.

And Hispanics are one and a half times more likely to develop Alzheimer's disease, as opposed to Caucasian Americans.

And there's also the reality that many in the Hispanic and African-American populations are also having more difficulties and barriers to access healthcare.

We also see that they are being diagnosed later in life, and they also have a higher risk of chronic conditions like hypertension, other cardiovascular diseases, and diabetes, which have a strong correlation of also developing a form of dementia.

Let's talk a little bit about, obviously when somebody gets to that stage, they need care.

Yes.

They need a caregiver, a caretaker.

Correct.

A lot of times, and we mentioned it at the top of the show, and there's so much money spent on billions of unpaid hours for people who start taking care of their loved ones.

[Jennifer] Yeah.

They quit their jobs in many instances.

[Jennifer] Yes.

How hard is this on caregivers?

It is incredibly difficult, because caregivers are devoting so much time and energy to caring for their loved ones.

It has a tremendous impact.

Alzheimer's is not just a disease that affects the individual, it affects the entire family.

It's systemic in the way it reaches.

But caregivers, they're, 66% of caregivers here in Florida have another chronic condition that they're dealing with while they care for someone.

And then also, over almost 30% of caregivers in Florida have been diagnosed with clinical depression.

So we need to be able to support caregivers, and not only support their physical, but their mental health as well.

Yeah, they need care as well, right?

[Jennifer] They do, absolutely.

And in fact, we were going to have a caregiver on the program, but her mother, who she cares for, had an issue.

And that's not uncommon, right?

No.

And you talked about the workplace.

And some people, they have to quit their jobs, they have to cut back on their hours to go to a part-time status.

But also, while they're working full-time, they may be having to come in late or leave early due to their demands as a caregiver.

And many also are, about 25% are part of that sandwich generation, where they're caring for a young child, and then also caring for a parent, a grandparent as well.

We know a lot of strides have been made as far as getting funding to help treat Alzheimer's and also support caregivers.

[Jennifer] Yes.

[Pam] In fact, the White House has something called the GUIDE Model.

[Jennifer] Yes.

And then also, the state of Florida has increased spending with over $50 million for what they call the Alzheimer's Disease Initiative Program.

Yes.

So talk about how important that is.

It's incredibly important.

It's really the highest funded Alzheimer's program in the country.

So when it comes to the Alzheimer's Disease Initiative, which is here in Florida, this provides funding in a few different facets.

The first one is actually for the memory disorder clinics, which there's 17 across the state, where people can go to get cognitive screenings and get a diagnosis.

So that's incredibly important for people if they have concerns about their loved one and the warning signs.

But then also another aspect that, is respite care, which is so critical for caregivers.

Because one of the big things that we always say to caregivers is, you have to take care of yourself.

Sure.

But as we were discussing, they're not going to doctor's appointments, they're dealing with chronic conditions, and then they also are dealing with their own mental decline, with their mental health.

But this respite funding gives them the opportunity to utilize either adult daycare for their loved one or have an in-home caregiver come in.

And we do have significant wait list in the state, but with these increases in funding, we're able to get more individuals off the wait list so they are able to take time to go to their doctor's appointments.

My goodness, go to the grocery store, maybe get a haircut.

[Pam] Take a break.

Take a break.

Just a little of a break, right?

Go to dinner with your spouse or something like that.

Absolutely.

Wow, let's talk about the drug, Leqembi.

[Jennifer] Yes.

[Pam] Which was just approved by the FDA over the summer.

[Jennifer] Yes.

Talk a little bit about how some people are calling this, really, a game changer, right?

Absolutely, so as you mentioned, the FDA traditionally approved the drug called Leqembi.

We really are entering an era of treatment now.

This drug is one of the first of its kind to actually slow the progression of its disease.

So in the past, when you said there were drugs for Alzheimer's, they really could help alleviate some of the symptoms of Alzheimer's, but they could do nothing for the actual disease.

So these were actually removing plaque from the brain.

And so, they've had an effective rate, but really gives the opportunity for loved ones, in consultation with their healthcare professional, but potentially to get more time.

that gives them the ability to maybe keep some of their independence.

They can drive a little longer, they can be able to go to their loved ones graduations and ballet recitals.

Right.

And just have their independence, and keep them at home longer.

But this is something for early stages.

Correct.

In consultation with your physician because there have been some side effects too that people need to know about, right?

There has been.

Yeah.

So, of course with anything, you have to talk to your doctor.

This may not be right for some people.

As you said, it's really for those who have mild cognitive impairment or in the very early stages of Alzheimer's disease.

Those are the only two groups where it is effective.

And as you mentioned, there have been some side effects of some brain swelling, brain bleeding.

There are individuals who, through their genetic makeup, are at a higher risk.

So if a doctor does think that you're eligible, they'll have to do some testing to make sure, just so you know what the potential risks are going in.

Sure, and this drug does come with a high cost.

I believe it's what, $26,500 for the year?

Yes, yes.

And you got to meet the deductible of 5,000 first.

Correct, about 20%, yeah.

Yeah, so talk about how that is covered for people who really need it.

Yeah, so one of the big things though is that Medicare did decide, with the traditional approval in July, to cover the drug 'cause...

So that's a real game changer.

Hopefully private insurers will step up as well, and begin to cover.

But again, as you said, it is that 20% deductible, which is about right now, $5,000, so.

Right.

The Alzheimer's Association, others really advocating to ensure that people do have access to these treatments.

And let's talk about the Alzheimer's Association for a moment.

[Jennifer] Sure.

And what an incredible resource it is for people.

[Jennifer] Yes.

I mean, I was navigating the website and saw it's quite user-friendly.

[Jennifer] It is.

Can easily find information on there.

So talk about the resources that you provide.

Absolutely, so one of our great things is our website, but also we have a 24/7 helpline.

That's 800-272-3900, that is available 365 days a year in over 200 different languages.

You can call at any time, and you're going to speak to a master's level dementia specialist.

[Pam] Wow.

Who's going to be able to answer any questions.

Maybe you have a neighbor, and they're doing some odd behaviors, and you think that there could be some signs.

You could find out information on that.

Could be your loved one.

A lot of times our calls will actually spike up during the holidays.

So people come home after Thanksgiving, they go home.

Maybe their loved one who is very tidy, things are messy, they don't know what's going on.

Yeah.

So people, we do see a lot of spike in calls during the holidays.

But people can call us with inquiries.

Also, if you're a caregiver, you are in the trenches in this journey dealing with someone.

And maybe it's in the evening and you can't get your loved one to go to sleep.

They're restless, they're acting out, there's behaviors.

You can call the helpline and we will walk you through to help you navigate that situation.

That's a great resource.

And talk real quick about The Brain Bus, what is that?

Yes, so The Brain Bus is a Florida specific initiative.

It is our mobile outreach unit.

We have two brain buses that go across the state, and they serve, going to underserved areas, to educate them on brain health, the warning signs of Alzheimer's, where they can get a diagnosis, like the memory disorder clinics.

[Pam] Right.

And also, if there's caregivers, we can provide caregiver consultations and support for them as well.

Jennifer, thank you so much.

Thank you.

It was great chatting with you.

We've learned a lot, and we know that the Alzheimer's Association is a great resource, so thank you.

Thank you.

Yeah.

Well, in 2021, the University of Miami Miller School of Medicine opened the Comprehensive Center for Brain Health in Boca Raton.

Led by neurologist, Dr. James Galvin, this research hub is helping to get a better understanding of people's risks for developing diseases like Alzheimer's and Lewy body dementia.

Recently, "Your South Florida" sat down with Dr. Galvin and his team to learn more about their research, and how their Healthy Brain Initiative is helping to better treat and prevent these diseases.

The Comprehensive Center for Brain Health was created to allow us to take what's called a transdisciplinary approach.

Taking specialists from many, many different fields and breaking down the usual walls or barriers that pigeonhole researchers.

And working as a team to understand what constitutes healthy brain aging, and what puts people from diverse backgrounds at different risk for developing diseases like Alzheimer's disease.

We developed a group of tools which we call the Brain Health Platform.

So this allows us to look at resilience factors, what makes the brain stronger.

Vulnerability factors, what makes the brain weaker.

And performance, which tells us how someone's doing at that moment in time.

Then we can look at an individual, look at those individual factors that are putting 'em at higher or lower risk, and develop a personalized plan to address it.

And I think that's really the key, because one size fits all really fits no one.

But if I know everything about that person, then I can tailor those recommendations specifically to that individual.

Everything okay, not too tight.

Walk at your normal pace, as you normally walk in the streets, to that blue line and then come back.

We created a study called the Healthy Brain Initiative.

We do a bunch of medical testing.

We share some of the results back with individuals, so they have feedback on this, and then we ask 'em to come back every year.

Our goal is to recruit about 500 people and follow them over time.

And we're really trying to focus on having a diverse sample.

We're trying to understand how women with certain genetic traits may progress faster than women without those traits, and faster than men.

We're trying to understand what are some of the underlying differences between how African Americans perform on test and other groups perform on test.

We are trying to develop some novel markers that can tell us what puts people at risk.

These include things like how people speak, their pattern of speech, how their eyes track objects in space, and how they stand and walk.

And we're using techniques called machine learning, which is sort of like artificial intelligence.

Using the information, whether the machine can pick out who has disease and who doesn't.

And these markers appear to be very powerful early detectors of people at risk for disease.

[Medical Instructor] Place your chin here, yep.

Participants are invited to come to the center.

They're usually here for about four hours.

When they come, we go through the lab work.

Once labs are completed, then we begin with memory assessments.

Some are pen and paper, others are computer based.

Then they are met with a research clinician who will do a very thorough physical function assessment.

They have them walk in a digital mat.

And for example, one of the exercises that they do is they have to say the alphabet backwards as they're walking, so they're using their executive function.

We also have an InBody machine that not only tells us what their BMI is, but also can tell us a little bit more, if there's any muscle mass, things that we can maybe work on.

I think that one of the most exciting things about this program is all the tests that are conducted.

And the information that's given back to me, I find it very interesting, I like getting that information, and then I can share with my primary care physician if there's any concerns.

They're given the opportunity to get these assessments that typically they normally would not get.

We also have retina screening.

So the retina can actually tell us a lot of what might be going on in the brain in terms of amyloid plaque.

I think that what I've learned is it's helped me quell any fears that I have that I do have a significant memory loss.

I forget names, I forget things, but at my age, I think that's kind of normal.

So that's been good, that's been good, a positive thing.

At the end of the visit, everybody sits with a clinician who gives them feedback on how they did, what we think is going on with their brain health, and then recommendations to improve your brain health.

And what we find is the people who follow those recommendations, they tend to actually show a little bit of improvement from year to year.

That people who don't follow those recommendations tend not to show much improvement.

So clearly, these type of interventions can make a difference.

Start when you're ready, you ready?

Mhm.

I work in recruiting Latino communities, as well as African American communities, communities of color.

There's a stigma that lies around dementia, even the word dementia itself.

So my work is to educate, help them understand that there's nothing to be afraid of, that they're going to be contributing to something that's going to help them and eventually help other members in the community.

Friday, Thursday, Wednesday, Tuesday, Monday.

Our bodies are made to move.

We have a brain that we don't use half of.

So I try to read, I love reading, I love reading.

And I also write.

So you're going to use only this wheel, okay?

Mmh.

And then you're going to stay on the right dots first, if you can.

Geraldine has been active in our research studies for a number of years.

So there's a personal connection that's very important to Geraldine.

Her mom passed away from the disease, and her sister recently received a diagnosis of Alzheimer's.

So as a female and an African American, this is very important for her to participate and give back to the the research community.

And also, really to empower her own community, that it's important to get checked and find what the baseline is.

I'm hoping to learn anything that may signal where I need help.

No one wants Alzheimer's, I don't want it.

And I would do what I can to help them find a cure for it.

When we have conversations as physicians and healthcare providers, we often focus on disease, and disability, and death.

And we talk very little about health, and capability, and vitality, right?

So what we're trying to do is sort of change the topic of conversation.

Instead of talking reactively to a disease that's already happened, let's talk proactively to potentially prevent a disease from developing.

Let's not focus on things like life expectancy, that's life lived long.

Let's focus on health expectancy, which is life lived well.

And I think that's what makes our project very, very different than what most people are doing.

When you walk in, it doesn't say Alzheimer's clinic, it doesn't say memory disorder clinic.

It says brain health, and that's the focus.

We want to find out what your risk is, what we can do about it, 'cause we want to make you the best you that you can be.

As we've heard on today's program, early detection is key to fighting off the progressive symptoms of Alzheimer's.

And while certain factors such as age, genetics, and family history can increase a person's risk of Alzheimer's, there's growing evidence that lifestyle changes can help keep the brain active and healthy well into our later years.

Joining me now with more tips on all of that is Dr. Shaye Moskowitz.

Neuroscience medical director at Broward Health.

Doctor, great to see you, thanks for being with me.

Thank you very much, Pam.

Alright, so let's just dive right in.

According to the Alzheimer's Association's list on their website, they have 10 tips for brain health.

So let's go over some of them.

One of the biggies, obviously, physical activity, so talk about that.

What we've learned is that exercise is critical for maintaining brain health.

It does not involve running marathons, although it doesn't exclude it.

It does not involve very aggressive exercise, but even as short a walk as 30 minutes on a daily basis improves functional outcome and improves memory and brain health.

So it doesn't involve a lot, but it certainly requires a vested interest in being mobile, being active, being physical.

And that can look like a lot of different things for a lot of different people.

The key is to move, that really is the take home message.

Not necessarily to focus on a specific sport.

Cardiac risk factors are improved by exercise too.

So is it really a surprise that brain functions in the same way?

Of course it's not.

That is the key piece.

And as we age, we have a tendency to become less active.

All the more reason to really remember that and maintain a healthy lifestyle.

So move the body, go for a walk, maybe get in the pool and just move around a little bit.

So that's a good one, that's easy to do.

Education, talk about that.

Are we talking about reading more books, maybe taking a class?

Elaborate a little bit on education for us.

Reality is, is that we exercise our body to maintain its stamina, its health, and its durability.

We exercise our brain to maintain its stamina, its strength, and its durability.

And in many ways, that really comes in many different flavors.

Education taxes the brain, keeps you thinking, keeps you focusing in different directions, besides the mood element and the interest that it creates for folks.

Just because you are at risk does not mean that you can't learn something.

In fact, the more you try, the better off you are.

So education is critical.

There are risk factors overall when you look at population spreads, that those who are in a lower socioeconomic state, those who have a lower educational degree all are at increased risk of developing neurocognitive disorders.

So independent of that, we're not talking about a population study, we're talking about a person, not a statistic.

So what can an individual person do?

The answer is be intellectually active.

Puzzles, games, books, television, classes, learn a new skill.

That doesn't mean necessarily you'll achieve a new educational degree, but that's not the point.

The whole point is to keep your brain working.

And by using your brain, education is just an expression of the same.

You strengthen it and you keep it healthy for as long as you possibly can.

Yeah, if you don't use it, you'll lose it.

Let's go back to playing games.

That's one of the things that's on the list, challenging games.

So what do you mean, do Sudoku do a crossword puzzle?

Elaborate for us a little bit.

Yes, exercise your brain.

Puzzles are easy, because in many ways, it's the kind of thing that you can do on our mini screen.

It's the kind of thing you can do, and I don't know if they print newspapers anymore, but maybe I remember--.

[Pam] On Sunday at least.

Maybe I remember the early age of crossword puzzles on the Sunday paper and then every day of the week.

I mean, games are games, exercising the brain is the key.

So any puzzle that strikes your fancy and really causes you to focus, to think, to process.

It could be math games and word games.

It could be processing skills that you're really taxing.

These are just obviously fun ways to do that.

[Pam] Yeah.

It's much easier and more pleasant to do a short puzzle than it is to sign up for a class.

Obviously, quitting smoking, that's goes without saying.

Heart health, we kind of talked about that earlier.

Talk about things like mental wellness, self-care, getting enough sleep.

The mental wellness part, and we hear so much about that, why is that so important?

Mental health, I'm going to bundle a bunch of things together because, I think for many people, it's easier to understand the concept than it is to remember a list of 10.

We're talking about the emotional social wellness that we really ought to have.

Everybody should have in every aspect of their life.

But we're talking about interaction, social interaction, meeting other people, talking to other people, having dialogue with other people.

We're talking about mental health, meaning addressing issues like depression, which are often very common in an older at-risk population, and also often come hand in hand with dementias and cognitive issues.

Easily you imagine someone keeps losing their keys.

After a while, you start to wonder, are you losing your mind?

It creates mood issues.

So there's a circular problem of cognitive decline coupled with mood issues, so all of it goes hand in hand.

Being outdoors, being connected with other people.

So put that in a basket in and of itself.

When you do that, you realize what we're talking about is not just exercising the brain and processing, we're talking about exercising our social interactive skills.

Having friends, people who go out, being engaged with other people, perhaps other ideas, being open to other ideas.

Essentially, that is really the same thing when you think about it.

In many ways, this is really critical for at-risk populations because they have a tendency to want to shy away.

They have the tendency to want to, "I'm afraid of X, Y, or Z."

Getting lost, forgetting things, forgetting people's names.

They become more socially reclusive.

And in the end, that unfortunately feeds the process.

[Pam] Right.

That has to be broken by allowing a social interaction.

In many ways, that is really the spirit of what we're getting at.

Be engaged in every which way.

Dr. Moskowitz, great tips.

Thank you so much, we really appreciate it.

Thank you very much, Pam.

For more on brain health and Alzheimer's awareness, follow us on Facebook, @YourSouthFL.

I'm Pam Giganti.

As always, thanks so much for watching.