Should There Be An Age Limit For Elected Politicians? - Encore

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Hello to all of you who have tuned in for another episode of the Truth, Lies Alzheimer's Show. I am Lisa Skinner, your host, and I'd like to shout out a very warm welcome to all of you who have taken the time to join us today. Thanks so much for being here. As I have told you many, many times, the purpose of this show is to talk about every aspect of Alzheimer's disease and dementia. That's going to include the good, the bad, and yes, the ugly. My goal is to get to the truth despite to dispel the lies and myths and unveil what I call the secret faces of Alzheimer's disease so you have a better understanding of what it's truly like for people to live with this brain disease. My hope is to zoom outside the paradigm of it exclusively being a memory loss condition and to shift people's understanding of just how dramatically this disease impacts the lives of those who have it as well as their caregivers, the family members, friends, neighbors— well, for that matter, anybody who is involved in the life of a person living with dementia. So, on our episode today, trending. Quite a bit in the news because we have an election coming up in, gosh, about 13, 14 months. So I wanted to give you something to really think about. Do you think the age of our current politicians, our world leaders, and/or the candidates that are currently running for office for the 2024 election should come into consideration now that people are living much longer than ever before in our history. This really in the past had not been an issue, but because people are living so much longer, It's a valid concern, and I'm going to share with you the extensive research that I have done on this subject to support whether or not this is a real and valid issue for us to take into consideration. So, it's food for thought. It is based on facts that I've researched. So, I'm going to share this with you and then you can decide if you think that this topic is a realistic concern moving forward. So, to understand dementia and its related behaviors, it's also important to understand what is happening to the brain of the person with dementia. Now, remember, dementia is not mental illness, nor is the person afflicted crazy. This is brain disease. But the bottom line is it's damaging the brain of the person living with it. So, that said, let's start from the beginning. Dementia is not a specific illness. It's actually a broad term used to describe a specific set of symptoms that are caused by other illnesses. There are actually over 100 known causes of dementia, and most of them are irreversible. Now, Alzheimer's disease, which most of us are familiar with that term, is the number one cause of dementia. Affecting today more than 6.7 million Americans. According to the Alzheimer's Association, this number is expected to significantly rise now that the baby boomer generation has begun to reach the age of 65. There are approximately 500,000 people dying each year from Alzheimer's disease in the U.S. It's the 6th leading cause of death in the U.S., but it's the number 1 leading cause of death in the UK, in the Netherlands, and in Finland. It's also the only cause of death among the top 10 in America that cannot be prevented, cured, or slowed down. Additionally, 1 in 3 seniors die with Alzheimer's disease or a related dementia, And currently, every 66 seconds someone in the U.S. develops Alzheimer's disease. In the world right now, every 3 seconds somebody is developing Alzheimer's disease. Now, don't you think these numbers are compelling? Unfortunately, the facts are the same and they will increasingly become worse unless a cure or a treatment is found. So, think of dementia like this: it is the failure of an organ just like any other major organ in our body, kind of like our heart or our kidneys. The affected organ with dementia happens to be our brain. However, because we cannot see our brain shrinking, which is what happens with Alzheimer's disease, it's often difficult for people to relate to it in the same way as the other organs that are failing. Alzheimer's disease, like most other illnesses that cause dementia, is progressive, with the symptoms growing worse over time. However, the symptoms progress at different rates and stages, and they do vary from person to person. Make a note of that in your mind because it's an important consideration to this topic. There are what is considered mild symptoms, moderate symptoms, and severe symptoms, but again, not everyone displays all the symptoms at any one stage. Dementia is also a persistent loss of intellectual functions due to a brain disorder. The decline in cognitive function in irreversible dementia is related to the destruction of the cells that transmit messages in our brains called neurons. These cells are attacked, they are destroyed, and they lose their ability to transmit messages which enable normal, healthy function. Alzheimer's disease, for example, begins in the part of the brain that houses memory formation, and the short-term memory begins to be affected. It then gradually spreads to other regions which affect functions such as— and take a mental note of this— which affect other functions such as thinking, learning, language, perception, orientation, judgment, reasoning, emotion, concentration, task sequencing, and learned behaviors. The person with dementia loses the most recent part of their life first. For example, he or she cannot remember what happened earlier that day. They first lose hours, days, weeks, and months of their lives, then years, as the brain progressively shrinks and becomes more damaged. Older memories do stay intact the longest. As the brain continues to shrink and the cells continually become destroyed, symptoms and behaviors become more obvious and more prominent. Eventually, the disease destroys one's ability to recognize themself, their family members, and to communicate in any way. The individual becomes completely dependent on others for care. From the onset of symptoms, this process can take an average of anywhere from about 4 to 12 years, although many people go undiagnosed for years even after the most subtle symptoms begin to show. As a person loses various functions because of the different areas of their brains being destroyed, they must adapt new ways to communicate. It is in many of the behaviors that we see in people afflicted with dementia that the root of these behaviors is actually their way of trying to tell us something, and then it's up to us to interpret what that meaning is. So, what are the most prevalent differences between normal aging and something more serious such as a brain disease that causes dementia? Well, as we continue to live longer— take a mental note of that— our brains are aging right along with us. For this reason, forgetfulness as a part of the normal aging process is often mistaken for early signs of dementia. However, just because you are aging does not mean you will develop dementia. Forgetfulness, as well as lapses in memory, happen in both the normal aging process and dementia. So, how do you distinguish one from the other? That's kind of tough in the beginning because there are Similarities in the way a person forgets things with normal aging and with dementia, such as not being able to recall information or details, not remembering the name of a relative or acquaintance, forgetting events, occasionally having difficulty finding the right words to say, one's ability to operate appliances and learn new school— skills, start experiencing mood changes and changes in interest. The most obvious distinction is that with dementia, these symptoms and behaviors become more blatant and start to occur more frequently as the disease progresses. Also, with dementia, at some point, you will no longer be able to learn and retain new information or be able to perform normal activities of daily living without assistance. They will eventually need someone to perform these tasks for them. So, this is all a segue into why this is a trending concern in today's society. So, let me start with my research on a history of past presidents. This is really, really interesting. So there was a study done by Jonathan Davidson of the Duke University Medical Center and colleagues who reviewed biographical sources for the first 37 presidents who served from 1776 to 1974. The study found that half of those men had been afflicted by mental illness. And again, mental illness, different from brain disease. And 27% met those criteria while in office, which clearly could have impacted their ability to perform their jobs. The authors of this study concluded that 24% of the presidents met the diagnostic criteria for depression, which included James Madison, John Quincy Adams, Franklin Pierce, Abraham Lincoln, and Calvin Coolidge. Davidson and his team also found evidence of anxiety disorders ranging from social phobia to generalized anxiety disorder among 8% of the presidents, which included Thomas Jefferson, Ulysses S. Grant, Calvin Coolidge, and Woodrow Wilson. Now, more seriously, the team concluded that 8% had signs of bipolar disorder. Again, another mental illness. Lyndon Johnson had signs of bipolar disorder and Theodore Roosevelt were among them. Finally, according to this study, 8% of the presidents studied exhibited evidence of alcohol abuse or dependence. Of course, that can cause dementia. President Pierce died of cirrhosis of the liver. Ulysses S. Grant was known for hitting the bottle hard and was once allegedly so drunk that he fell off his horse during a military parade in New Orleans. And don't forget, he was the one who not only led the entire Union Army during the Civil War, but he also became the 18th President of the United States. Additionally, Nixon was once unable to take a rather important phone call from the British Prime Minister because he was, quote unquote, loaded. So, How does this play into all of this being a concern of a president developing dementia and being, being so insidious today? Well, in the study cited by Jonathan Davidson of the Duke University Medical Center, there is no mention of any former president having shown any signs of dementia or senility, although President Taft did suffer from sleep apnea, which has been associated with declines in cognitive functioning. So until Ronald Reagan, presidents in their 70s who are at greater risk for developing dementia were not a concern. Now, Donald Trump at the time of his inauguration was older than half of our least former presidents when they died, says Dr. Jacob Appel, a Mount Sinai School of Medicine psychiatrist who has studied the health of politicians and presidents. Only a generation ago, our political leaders, like the rest of us, were likely to die of heart disease or cancer in their 60s and 70s, what we now think of as late middle age. So at 70 years old, Donald Trump was the oldest American president to ever take office. His father Fred developed Alzheimer's disease in his 80s. Ronald Reagan was diagnosed with Alzheimer's disease 5 years after leaving his presidency. However, it has long been rumored that he suffered from the disease years before it was diagnosed in 1992. Therefore, a sitting president showing signs of cognitive decline is a relatively recent development. Yes, we are living longer. So, is there a solution? We do ask candidates for the presidency to disclose their medical histories. However, we currently have no mechanism to evaluate their ask and present mental health. Arthur Kaplan, a bioethnicist at New York University's Langone Medical Center, says there needs to be greater transparency when it comes to presidential health. I think we're about 50 years overdue for having some sort of annual physical for the president and vice president with the results of which should be reported publicly, and part of this should be psychiatric and cognitive testing, which today is not required. Chaplin says the exam should be conducted by an independent panel of external physicians selected by a major medical society, as any internal reports from the president's personal doctors are likely to be spun for political purposes. Mount Sinai's Appel questions how to objectively determine what level of impairment renders a candidate unfit for office. This isn't to say that Dr. Appel objects to steps to ensure mentally unfit politicians are removed from office, because we do have the 25th Amendment to the Constitution, which outlines the The succession of high office if a president dies, resigns, or becomes incapacitated provides a logical process from removing a dementia-stricken president. Yet, Dr. Appel asks, will anyone actually apply it? I think that's a great, great concern. Regrettably, He says, "Our current political climate makes it unlikely that such a measure will be invoked even when necessary until the system is fixed and the political culture changes. Medical information is rather useless. To one side, it'll be a smoking gun, and to the other side, it will be fake news or alternative facts." Like Appel, Kaplan does not hold out much hope that the public would be clued in if a president's cognition starts to meaningfully decline. What will they do if he or she starts to slip? Nothing, Kaplan declares. If that were to happen, he or she would be protected. They'll take over his or her Twitter feed, And this is always how it's been. Is this sounding all too familiar? Well, rumors often circulated about President Reagan's mental status. The media often reported instances of him being dazed and confused during his two terms in office. That speculation was then put to rest in 1994 when he was officially officially diagnosed with having Alzheimer's disease. But again, that was 5 years after he left office. So the debate then quickly pivoted to whether or not he had been exhibiting signs of dementia while occupying the White House. According to an article written by Lawrence K. Altman, MD, on March 30, 2015, which was published in the New York Times, Dr. Altman states that even before Ronald Reagan became the oldest elected president, his mental state was a political issue. His adversaries often suggested his penchant for contradictory statements, for forgetting names, and seeming absent-mindedness could be linked to dementia. In 1980, Mr. Reagan told this doctor that he would resign the presidency if White House doctors found him mentally unfit. But years later, those doctors, key aides, told me they had not detected any changes in his mental abilities while in office. Now a clever new analysis has found that during his two terms in office Subtle changes in Mr. Reagan's speaking patterns linked to the onset of dementia were apparent years before doctors diagnosed his Alzheimer's disease in 1994. The findings, which were published in the Journal of Alzheimer's Disease by researchers at Arizona State University, do not prove that Mr. Reagan exhibited signs of dementia that would have adversely affected his judgment and ability make decisions in office, but the research does suggest that alterations in his speech might be used to predict development of Alzheimer's and other neurological conditions years before symptoms are clinically perceptible. Detection of dementia at the earliest stages has become a high priority. Many experts now believe that yet-to-be-developed treatments are likely to be effective at preventing or slowing progression of dementia only if it is found before it significantly damages the brain. As of now, most people are not even diagnosed until the mid-stages of the disease because the signs and symptoms are so subtle in the early stages. The highly innovative methods used by the researchers may eventually help 'to further clarify the extent to which spoken word changes are associated with normal aging or predictive of subsequent progression to the clinical stages of Alzheimer's disease,' said Dr. Eric Reiman, the director of the Banner Alzheimer's Institute in Phoenix. He was not involved in the study. Visar Barischa and Julie Liss, professors of of Speech and Hearing at the university compared transcripts of all 46 new conferences that Mr. Reagan held to the 101 sessions President George H.W. Bush held in his teens. The researchers assessed changes in the president's speech patterns with a new algorithm based on a technique used by others to analyze changes in writing by Nawat. So, let us fast forward to today's concerns. Based on what we know with Alzheimer's disease with Ronald Reagan, we should now be paying closer attention to what has been observed in the behaviors of some of our current leaders. What this all means is yet to be discovered. Currently, the only way to determine whether Alzheimer's disease is present is to look at the brain of a person after death or upon autopsy. For patients who are living, doctors use special cognitive tests which monitor memory and everyday skills such as dressing and bathing, but the results are often misleading or inaccurate. New findings presented at the Alzheimer's Association International Conference in London now show that positron emission tomography, or the PET scans, altered the diagnosis for more than two-thirds of the people. PET scans do show the buildup of sticky amyloid plaques in the brain, which prevent neurons from communicating and eventually kill areas of the brain. Wiping out memories and can help with definitive diagnosis. But guess what? They're not using PET scans other than in clinical trials because insurance doesn't pay for them. Additionally, there are other conditions that mimic the symptoms of dementia, and a perfect example of that is the singer-actor Kris Kristofferson. He struggled with memory problems and was told he had Alzheimer's disease and was subsequently treated with Alzheimer's medications for 3 years. But it turns out he was misdiagnosed and all along had actually been suffering from the tick-borne illness Lyme disease. So, based on some of these facts revealed about dementia, Age appears to be a definite factor in the development of it. That is a true fact. So, we have to ask ourselves, is 2024 on track for becoming the dementia campaign? Well, Reagan was 69 when he won his first presidential election. Trump was 70, making him the oldest person to be elected to the presidency. Well, then Biden, Ronald Reagan's reelection at 73. Joe Biden is currently 80, but if he wins the election in, uh, 2024, he'll be 82 when he enters office. And there is often speculation that some of our political leaders are demonstrating signs of cognitive decline. And I'm not just talking about presidential candidates, I'm talking about senators and, and other political leaders. Now, Trump was given a clean bill of health— of cognitive health— in January of 2018 by White House physician Dr. Ronny Jackson. Who had tested him for cognitive impairment and said he had no concerns about the president's mental fitness, although changes in his speech patterns and behaviors have been noted over the past 20 years. And that study did show a correlation between changes in speech patterns and cognitive decline. Reagan's doctors said much the same thing while he was in office, despite the former president's memory lapses and bouts of confusion in public, most visibly during the 1984 presidential debates and his 1990 Iran-Contra testimony. Incidents such as these led to speculation that he was undergoing gradual mental decline, and that those around him did not want to admit. A 1987 article in the New Republic posed the troubling questions outright: Is Reagan senile? Now, keep in mind that the physicians who directly attended Ronald Reagan while he was president agreed unanimously that he never displayed signs or symptoms the entire time he was in office. The New York Times reported that in 1997, which later became disputed. And then Ronald Reagan's son came forward and said he definitely was displaying signs of cognitive decline while he was in office. At 73, Ronald Reagan would be the oldest president ever reelected. And at the time, voters were beginning to imagine a grandpa who could never find his reading glasses in charge of a bristling nuclear arsenal, and it was making them nervous, as well as his floundering his way through his responses, fumbling with his notes, uncharacteristically lost for words, along with tired and bewildered. Well, fast forward now to 2023, and a lot of these people are even older than Ronald Reagan was back then. So today, this is what we're facing. The two people most likely to control the U.S. nuclear arsenal through January 2025 are both well into their 70s and 80s and facing continued public speculation that they may be coming senile. So, these are all very, very valid concerns. So, Alzheimer's disease can begin as much as 20 years before memory loss and other symptoms develop. So, at what point will it start having a substantial impact on a person's cognitive abilities? We don't know the answer to that question. It varies from person to person. When would we know if it's actually disrupting the leader's daily life or their decision-making ability? We don't know the answer to that question. Most people, again, are not even diagnosed until they are already well into the mid-stage. So, they could have it for years. And you also have to take into consideration the number one point that age is the greatest risk for developing Alzheimer's disease. The percentage of people increases dramatically with age. So, here are some Statistics. 5% of people have Alzheimer's disease between the age of 65 and 74. Then it jumps to 13.1% of people have it between the age of 75 and 84. Then it jumps again drastically By the time people are 85 years old or older, 33.3% of people have Alzheimer's disease. That's 1 in 3 people. So, there you have the facts as researched by me, and I think that definitely substantiate that there is now in today's society with the fact that people are living longer. You know, and the thing is we have so many treatments that, that treat medical conditions like cancer and heart disease and things like that, but as of this conversation, we have nothing that preserves our brains. So our brains are continuously aging and our bodies are staying somewhat healthy well into, for a lot of people, into their hundreds. But how do we deal with the aging, changing brain, especially when Alzheimer's disease or one of the other over 100 brain diseases that causes dementia plays into that role. So, just wanted to give you some food for thought. Take these facts into consideration, and then you decide if you think that maybe there needs to be some mandated changes to At what age is too old for somebody to be in office or to run for president? You know, I think this is one of the reasons why people are standing up and taking notice of this being a very valid concern in today's society. So, on to what's news. I came across this really interesting article that I thought I'd share with you, and the caption says, "A massive shift is happening in the senior care industry. Home care, once the go-to solution for many families, is seeing its prominence wane in favor of adult day services, and here are the top 4 reasons why home care is dead." And why Adult Day is the future of senior care. This actually was a post on LinkedIn by Chris Chana. So, the first reason is lack of socialization in home care. Yeah, we know loneliness and isolation, we know, does accelerate the progression of the disease. We learned that, especially during COVID One of the most significant drawbacks, she says, of home care is the limited social interaction that it offers. An aging individual might spend hours, if not days, without meaningful human interaction, save for the occasional visit from the caregiver. This isolation can lead to feelings of loneliness, and even precipitate mental health issues like depression. On the contrary, adult day services prioritize group activities, interaction, and camaraderie. Seniors have the opportunity to participate in group exercises, games, and discussions, forging new friendships and relishing the joys of community living. I agree with that totally. Number 2 is the rising cost of home care. Home care, especially when available round the clock, can be a hefty financial burden for families. Oh, yes, it can. Personalized one-on-one services at home demand a premium, and not every family can shoulder these costs over extended periods. The other thing you have to keep in mind is unless somebody just happens to have taken out a long-term care insurance policy or qualifies for veterans benefits, the cost of assisted living, memory care is all out-of-pocket expenses. Adult day services with their group— model often does turn out to be more economical. These centers can distribute costs across several participants, making the service more affordable without compromising the quality of care. Number 3, chronic staffing shortages in home care. The home care industry has been grappling with staffing shortages for some time now. I agree with that. Given the rising demand for elder care services and the challenging nature of home-based caregiving, recruiting and retaining talent has been an uphill task. Families sometimes find themselves in a bind, unable to secure reliable caregiver when they most need it. In contrast, adult day services often have a more Stable staffing situation. The group setting, regular hours, and team-oriented approach makes these centers more appealing for many professionals in the elder care sector. And then number 4, the multifaceted services of adult day centers. Home care in its traditional sense usually covers basic needs like meal preparation, shaving, and medication reminders. But what about the other aspects of well-being? Adult day centers often offer a slew of additional services that can greatly enhance the quality of life for seniors. This includes hair and nail services so participants can feel pampered and well-groomed. More crucially, many centers provide physical and occupational therapy ensuring that seniors maintain their mobility and dexterity. These services bundled together present a holistic approach to care that home-based solutions often miss. And while home care has its merits and can be the right choice for some, the shifting needs of our aging population are paving the way for the rise of adult day services. I think that, um, this was exceptionally well written and to the point of being important and true. I just wanted to mention that as a result of COVID we did see a lot of adult day centers and senior care centers closed down because of COVID And I think that they're slowly but surely starting to open up again. So, hopefully, you can look to see if there is one in your area that would be convenient. So, that is our show for today. In closing, I just want to thank you all again for listening today. There's so much to cover when it comes to Alzheimer's disease and related dementia, and I really sincerely want to provide you with information that you will find helpful and valuable and make this journey a little easier to bear. And remember, dementia awareness happens every day. Kindness is the ability to speak with love, listen with compassion, and act with patience, and these are all very necessary attributes to have in order to outlast Alzheimer's disease. Thanks again for being here with us, and we'll look forward to having you back for another new episode of the Truth, Lies Alzheimer's show with your host, Lisa Skinner. Bye for now.

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