🧠 The Modifiable and Non-Modifiable Risk Factors for Alzheimer's & Dementia | Lisa Skinner Webinar 🧠

Hi everybody!

Hello!

Wow, we have an amazing turnout this morning. This is really Delightful. I'm so excited to have you all here. So I am presenting a brand new topic today for my monthly informational workshop, and I wanted to share with you—

here you go—

that I recently came from Northwestern University. I was there a couple weeks ago. And I gave this same talk. And when I was trying to think of what topic I wanted to present today, I decided to do this one because I had so many people come to me after I gave this talk. Now, this is an extended version because I only had 20 minutes at Northwestern University, so I'm even providing more information today. But I had so many people approach me after I gave this talk on risk factors and how to minimize your risk up to as much as 40%. And so many people said that they were just so moved by the information and they had no idea. So I decided that this is the topic I wanted to share with all of you today. So Without further ado, let's get started. So once again, welcome to this informational webinar on risk factors that are known to increase a person's risk of developing Alzheimer's disease and related dementia. So I'm going to start off with a rather peculiar question that I want to pose to you. And it doesn't matter how old you are, but I'm curious, and you don't have to answer, just answer in your head. Has the thought ever crossed your mind, or have you ever been concerned that you might develop Alzheimer's disease and dementia later in life? Now, for some people, the thought weighs heavily on their minds. For others, it's not something that they think about or worry about, especially since it's always been considered a stereotypical old person's disease, right? Did you know, and this is really, this is a true statistic, did you know that it is the most feared condition to get in people over the age of 55? That's a fact. And I'm over the age of 55, and I have a familial history of family members who have developed Alzheimer's disease and dementia. So yes, it is something that I am concerned about, and I do—

What the hell was that?

It was the cup. And I do, I do put myself into the high-risk category. So it's, it's definitely something that I personally pay attention to. I don't know if you're aware of this, but Alzheimer's disease, the common form of Alzheimer's disease, does not typically show up in people until they reach the age of 65 and beyond, unless they develop the less common version of Alzheimer's disease called early onset Alzheimer's. And this is the less common type. It's a rarer type of Alzheimer's disease, and it shows up under the age of 65, even as young as 30, and in between. But what if I told you that there are things we can all do to decrease our risk of developing Alzheimer's disease by as much as 40%, starting at any age, at any stage of your life, regardless of how old you are this minute. Would you pay attention once you learned that you could lower your risk significantly by implementing certain lifestyle choices into your daily routine? Well, this is what I'm here to share with you today. Because guess what? It's absolutely true and absolutely possible to accomplish this. Sadly, there is currently no proven way to prevent Alzheimer's disease. So these things I'm sharing with you are not going to prevent it, but they have been determined to lower a person's risk So I'm going to do a deep dive into how all that works and what it all means with you in this informational webinar today. There are characteristic changes to the brain that are seen in Alzheimer's disease, but what causes those changes is not fully determined. It's still a huge mystery disease. It is likely due to a combination of genetics, lifestyle, and environmental risk factors. However, as we get older, our risk of developing Alzheimer's disease and related dementia increases. There are currently almost 7 million Americans— this is just in the US— living with Alzheimer's disease in America today. Most of them age 65 or older that may have dementia caused by Alzheimer's disease. And the reason why I make that statement is because there are actually over 200 known brain diseases that cause dementia. Alzheimer's is the one that most of us think about. It is the most common, and it's, it's the one that most of us will end up getting, although there are so many others. There are also more than 50 million people worldwide living with dementia. And it is projected by the Alzheimer's Association and the World Health Organization that the number of people who are expected to develop Alzheimer's disease by the year 2050, and if you do the math, That's only 21 short years away. That number is expected to triple to 152 million cases globally in 21 years if a cure or a treatment is not found. And right now, as of this workshop, we're not even close. Think about that for a quick second. Think about the past 20 years. It went by in the blink of an eye. So the year 2050 is really right around the corner. I look at it as the tidal wave of Alzheimer's disease on its way. So that's one of the reasons why I want to bring this information to you, because the things that I'm going to talk about today, you can start today or tomorrow or next week. But the point is, don't wait until you're over 65. Although if you are over 65, it's not too late. You can still make lifestyle choices, and hopefully it will reduce your risk of developing Alzheimer's disease. Now, I also want to share with you that In the United States, Alzheimer's disease is the 6th leading cause of death in our seniors, but it is such a chronic problem in the UK, in the Netherlands, and in Finland that it's the number 1 leading cause of death in seniors in those 3 countries. So this is not to be taken lightly. It is, You know, on the verge of being an epidemic in the world. Surprise! And I already told you this. Experts in a recent report say 2 in 5 dementia cases could potentially be delayed or even prevented just by making these certain lifestyle choices. These various risk factors from early life to midlife to old age are linked to people's risk of developing dementia. For example, less education before the age of 45 is associated with 7% of dementia cases because the more we learn in early life, the more cognitive reserve we build up from that learning process, and our cognitive reserve protects our brains. All throughout our life. The leading risk factor from the age of 45 to 65, surprisingly, is hearing loss, which is linked to 8% of dementia cases. However, using hearing aids can help offset that risk, followed by traumatic brain injury, hypertension, alcohol, and obesity. Smoking in ages older than 65 is linked to 5% of dementia cases, followed by depression, social isolation, physical inactivity, air pollution, and diabetes. Many conditions have been found to increase the risk of dementia. Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimer's disease. And it seems likely that these changes in the brain may begin a decade or more before memory and other cognitive problems begin to emerge. During this preclinical stage of Alzheimer's disease, people seem to be symptom-free. However, the toxic changes are already taking place in the brain. Abnormal deposits of proteins form amyloid plaques and tau tangles throughout the brain. Most of you have probably heard that. Once healthy neurons stop functioning, lose connections with other neurons, they begin to die. Most people— this is another fact— are not typically diagnosed with dementia until they are already in, well into the mid-stage of the disease, because it's almost impossible to differentiate between the normal aging forgetfulness that we all experience when we reach certain ages, mild cognitive impairment, which in some people will progress to Alzheimer's disease, but not in everybody. And then full-blown dementia. Most people, they don't— the signs and the symptoms don't become blatantly obvious until they're well into the mid-stage, and that's when most people get their diagnosis. For this reason, It is so difficult to diagnose. And this is also part of the reason why these new drugs that have been approved by the FDA, Donanemab and Lecanemab, are difficult because they've shown to be more effective in the earlier stages of the disease. But it's a double-edged sword because it's very difficult to make a diagnosis or suspect that it's something other than normal aging forgetfulness or mild cognitive impairment because the signs are so subtle in the beginning. One of the great mysteries of Alzheimer's disease is why it largely strikes older adults. Scientists are learning how age-related changes in the brain may harm our neurons and affect other types of brain cells to contribute to Alzheimer's damage. These age-related changes include atrophy, which means the brain is shrinking, of certain parts of the brain, inflammation, vascular damage, production of unstable molecules, called free radicals, and mitochondrial dysfunction, which is a breakdown of energy production within a cell. Now, research does suggest that a host of factors beyond genetics may play a role in the development and course of Alzheimer's disease. There is evidence that there is a relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as metabolic conditions such as diabetes and obesity. Alzheimer's disease and diabetes share the genetic risk factor, which is called the APOE4 gene. Type 2 diabetes is caused by the pancreas not producing enough insulin. A hormone that regulates how sugar is distributed throughout the body. When the brain doesn't get enough sugar, fatigue and cognitive impairment happen in the short term while metabolism changes and cellular damage occurs in the long run. Type 2 diabetes is believed to double a person's risk developing dementia and may also lead to developing it years earlier than someone who does not have diabetes. Diabetes and dementia also share a subset of modifiable risk factors in which regular exercise and healthy eating are a few of the important lifestyle changes that reduce the risk of both conditions. And I'm going to really get into specific details about what I've just kind of summarized for you. So a nutritious diet, physical activity, social engagement, and mentally— excuse me— mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors may also help reduce the risk of cognitive incline— decline and Alzheimer's disease. Clinical trials are continuously testing some of these possibilities. All right, now we're going to get into it deep. Let's take a look at some of these known risk factors, and I want to say there are a lot of them. And the point being, the bottom line is, the more of these risk factors that I tell you about that apply to any one individual, the higher your risk becomes of developing Alzheimer's disease after the age of 65. However, some of these risk factors are modifiable, which means they can be managed or treated. Not every risk factor for Alzheimer's disease and related dementia is within our control. So we will take a closer look at which ones are and which ones are not. However, it is known that a person can reduce their risk for dementia by about a third if they address the modifiable risk factors, especially since we cannot alter the non-modifiable ones. But I do want to emphasize, keep in mind that there is no way to determine a person's exact risk level. And no matter how many of these risk factors apply to any of you, it still does not mean that you will definitely develop Alzheimer's disease. And I just really want to drive that home here because you could theoretically have every single one of these risk factors stacked against you. Does that mean you're going to develop Alzheimer's disease? No, it means that your risk for developing Alzheimer's disease is higher than somebody who does not have as many of these risk factors that apply to them. So let's start with the non-modifiable risk factors. And this means that they cannot be altered and they cannot be changed. And there's 4 of those. The number 1 non-modifiable risk factor that contributes to a person's risk of developing Alzheimer's disease comes down to our age. And there's absolutely nothing we can do to stop that process, right? 1 out of 3 people over the age of 85 currently have Alzheimer's disease. The probability of being diagnosed with Alzheimer's disease nearly doubles every 5 years beginning at age 65. So between the age of 65 and 70, your risk doubles, and so on and so forth, progressing to right now, 1 in 3 people at the age of 85 have Alzheimer's disease. The second non-modifiable risk factor is our gender. And we know that females do develop Alzheimer's disease more than males. And women actually represent two-thirds of Alzheimer's cases, making them more likely to develop dementia. Well, women also have risk factors that are unique to them and therefore do not affect the male population. For instance, estrogen has a positive effect on brain health, and when estrogen decreases during our change of life, the brain becomes more susceptible to dementia. Also, high blood pressure during pregnancy may also raise the risk of developing dementia later in life. And then the other theory is that women outlive men by several years, and that may have contributed to why there are more women who live with Alzheimer's disease versus men. The third nonmodifiable risk factor is our ethnic background. Within the older population, Latinos have 1.5 times the risk as those of the Caucasian population, while African Americans have twice the risk of developing Alzheimer's disease than those of Caucasians. These groups have a higher rate of cardiovascular disease compared to whites, which does increase the risk of Alzheimer's disease. The race factor is further complicated by socioeconomic status, resulting in more inequality when it comes to access to quality healthcare, higher education, and to healthy diets, and therefore are more likely to develop dementia later on. And then the fourth nonmodifiable risk factor And I mentioned this a little earlier, our genetics. People who have a parent or a sibling who develop Alzheimer's disease are 2 to 3 times more likely to develop the disease than those with no family history because our parents can pass down the APOE4 gene that increases the risk of developing Alzheimer's disease. So in other words, a person can inherit the APOE4 gene from one or even both parents. And if more than one close relative has been affected, the risk increases even more. Now let's look at the biggest risk factors that we refer to as being modifiable. In other words, they can be treated, managed, and even changed. Addressing modifiable risk factors such as diet throughout one's life offers our best opportunity to reduce our risk of cognitive decline. The number one modifiable risk factor is cardiovascular disease. There's a strong link between heart health and brain health. This we know. Those who are free of heart disease and related conditions are at a lower risk of developing Alzheimer's disease or another kind of dementia than those who live with cardiovascular disease. Conditions that damage the heart and blood vessels reduce the blood flow. This is the explanation for it. To the brain, and it is believed that this magnifies the cognitive problems that are caused by the buildup of protein plaques and tangles. Coronary artery disease, atrial fibrillation, valve disease, and heart failure raise the risk of developing dementia. However, treating or managing high blood pressure High cholesterol, diabetes, and heart disease may in turn lower the risk of Alzheimer's disease, as all of these can lead to damaging the blood vessels or the heart. High blood pressure can cause blood clots in our arteries, which block blood flow to the brain. Stroke and loss of brain cells may follow, and the brain could subsequently shrink. People with high blood pressure in midlife are more likely to develop dementia later in life, and some researchers suggest high blood pressure as early as our 30s increase dementia later on. Too much cholesterol. Builds up into plaques in the arteries and clogs the arteries, which can lead to heart attacks and stroke. Cholesterol can also build up in the brain, triggering beta amyloid buildup, which again is a protein found in the brains of Alzheimer's patients. There is some evidence that these conditions in and of themselves can raise your risk of dementia.. And when combined, it can greatly increase your risk. For example, having diabetes along with some of these other risk factors do raise your risk threefold. A 2012 study found that people with mild cognitive impairment were more likely to progress to dementia if they had cardiovascular problems. So that's significant. Now the second modifiable risk factor is our lifestyle. Although age and family history are out of our control, several modifiable factors can influence your chances of developing Alzheimer's disease. The evidence is mounting for the promotion of exercise, and healthy diet in order to reduce Alzheimer's risk. And these facts that I'm sharing with you are based on decades of research studies. They've been studying this for a long time. Hi, Sam! How are you? I just saw your picture pop up. So good to see you. Sam was one of the speakers at the summit that we had back in January. So I'm so appreciative that you've taken the time to come here today. Anyway, where was I? Okay, so as well as avoiding tobacco, the statistic on that is 14% of Alzheimer's cases worldwide may be attributed to smoking tobacco. According to the World Health Organization, even secondhand smoke may increase your dementia risk. Also, limiting alcohol consumption, poor sleep habits such as sleep apnea— that one surprised me— that result in less deep sleep or daytime drowsiness also reduces— increases your risk of developing Alzheimer's disease. But let's take sleep apnea, for example. It's modifiable because it can be managed and treated with CPAP machine, which will enable you to get that REM sleep and get more oxygen to your brain cells. Studies have been conducted on several types of activity, include running, weight resistance training, and yoga, all of which showed the potential to reduce our risk of dementia because physical workouts are proven to enhance the development of new brain cells in the brain. Exercise lowers the risk of age-related brain impairment and protects the brain against degenerative conditions like Alzheimer's disease, and/or mild cognitive impairment. Even reducing your sedentary time has been connected with dementia prevention, such as dancing and gardening. And we've been, had this adage just hammered into our heads all our lives long, that you are what you eat, right? Well, studies are showing more and more that what you put in your mouth does have a significant connection to the health of our brain. We've heard that adage, "You are what you eat," and it's so proving to be true. A healthy diet that helps reduce the risk of Alzheimer's disease includes whole grains, nuts, legumes, fruits, and leafy green vegetables, among other foods, as well as limiting our sugar intake. A strong connection between higher blood sugar and dementia risk exists. The link is so profound that Alzheimer's disease has been nicknamed Type 3 diabetes. I don't know if y'all have heard that before, but it's true. So maintaining good control of your blood sugar, whether you have diabetes or not, can be thought of as preventive medicine for your brain. Research does show that a high-calorie diet can impair memory. If it causes inflammation in certain parts of the brain, there's that word inflammation. There, there are correlations to inflammation in our body, inflammation in our brain that increases a person's risk of developing Alzheimer's disease and related dementia. We're hearing that more and more every day. And here is a statistic for you. In a 2009 study, women above the age of 60 who reduced their calorie intake by 30% showed significant improvement in their verbal memory scores. Eating the recommended foods that I just mentioned has been correlated with a host of health benefits. Including improved brain function and fewer changes that are seen in Alzheimer's disease. A diet that focuses on plant-based foods that are rich in potassium, calcium, and magnesium, including vegetables, fruits, whole grains, and lean protein, is the recommended diet choice. Also, Limiting the amount of saturated fats you take in. Cholesterol, sodium, and sugar have been found to reduce signs of memory loss and cognitive decline later in life. Dr. Yu Chen, who's a PhD and an MPH and professor in the Department of Population Health at NYU Grossman and he's also the senior authority of the study that I am sharing with you, said the findings indicated that observational studies consistently show that adhering to a healthy diet, such as the DASH diet or the Mediterranean diet, which are very similar, can help protect against cognitive decline over the long term. One of the benefits of adopting a healthy diet is due to lowering one's cholesterol. Well, that makes perfect sense. The concept is that adopting a healthy diet starting at a younger age, such as middle age, so in our 40s, is more beneficial than making short-term dietary changes in your older years. Women who followed the DASH diet during middle age, with the average age being 46, were about 17% less likely to experience memory loss and other cognitive decline issues later in life. Although it is never too late to make dietary changes in order to improve your health. And the earlier we begin making these dietary improvements, the better our health outcomes can be throughout our life. Many of the foods recommended in the DASH diet contain properties that may help reduce brain inflammation, which is another known contributor to cognitive decline. So maintaining a healthy weight, keeping your body mass index in a healthy range, especially in your middle years, has also been tied to dementia prevention. Further, staying socially active and engaging in intellectually stimulating activities have been shown to have a protective effect. This is the cognitive reserve that I spoke of in the beginning against Alzheimer's disease. And continued social interaction after an Alzheimer's diagnosis has been shown to slow down the progress of the dementia. Social engagement is believed to be equally important as other lifestyle factors in maintaining cognition. And we saw this during the COVID epidemic. People who were not allowed to visit their loved ones in assisted living and memory care neighborhoods, that isolation was a huge factor to their increased decline. So This has been proven to be true. Low education levels, and when I say low education, I mean specifically less than a high school education, has long been associated with increasing the risk of Alzheimer's disease. While it's your brain that has Alzheimer's disease or one of the other brain diseases that cause dementia, paying attention to your whole body is important. Deficits in vision and hearing can cause or increase confusion. Physical exercise has been associated with improved cognition with or without dementia. In addition to exercising regularly, Please pay attention to good nutrition. Certain foods have been tied to better cognitive functioning. As a matter of fact, a study that came out in July of 2022 by the American Academy of Neurology found that eating ultra-processed foods is associated with increasing your risk of dementia. The researchers took into consideration factors that could affect the risk of dementia. These included your age, your gender, family history of dementia, the heart disease or cardiovascular disease, as well as some of these other known factors. And once determined, the study concluded that on average, for every 10% increase in the daily intake of ultra-processed foods, people had a 25% higher risk of developing dementia. Some of the significantly high ultra-processed food intake worth mentioning include certain beverages like sugary beverages, sugary products, and ultra-processed dairy. Furthermore, the study shows an association between ultra-processed foods with the risk of dementia, and lower risk of dementia was associated with replacing these ultra-processed foods in a person's diet with unprocessed or minimally processed foods. Another risk factor to developing Alzheimer's disease later in life, and we're seeing this with a lot of former NFL players, is traumatic brain injury. That's become a huge risk factor. Several brain injuries increase— I mean, excuse me, severe brain injuries do increase the likelihood of developing dementia, even many years after sustaining the injury. And one study in this area estimated that it could increase a person's risk by up to 80%. And don't forget, we got to keep mentally active. Mental activity has been associated with increased cognitive reserve, which in turn has been connected with dementia prevention. Exercise your brain. To keep it sharp by doing crossword puzzles, Sudoku, jigsaw puzzles, playing card games. The number one thing that is known to be the best thing you can do to stimulate your brain activity is to learn a foreign language or learn a musical instrument or by taking classes. And the reason being is the parts of your brain that it takes to do these critical thinking activities really keeps those neurons alive and well. And then again, plenty of sleep is recommended by the National Institutes on Aging. If you have sleep apnea where you stop breathing multiple times when you're sleeping, It's critical to properly treat it. Sleep apnea does have many risks associated with it, including an increased risk of dementia. However, if you're being treated by using a CPAP machine, as I mentioned, it can help lower that risk. Finally, both early life and later life depression have been found to increase the risk of developing dementia. People with dementia have high rates of depression, and the two conditions are heavily linked. However, the why unfortunately is uncertain. A study in the Archives of General Psychology found that people who develop depression late in life have a 70% increased risk of dementia, while people who were consistently depressed since middle age have an 80% increased risk. And those numbers are, are stark, if you'll agree. So unfortunately, what we know Alzheimer's disease and related dementia does not discriminate in terms of who it picks on. Anyone can develop it regardless of the preventive measures you take. However, do know this: the more of these risk factors that are stacked against you, the greater your risk does become to develop Alzheimer's disease. But I want to just emphasize this to no end, that no matter how many of these risk factors that I've gone over today, and you say, oh my gosh, that applies to me, that one does, that one does, that one does, and they are all in your bucket, your personal bucket, it still does not mean that you will definitely develop Alzheimer's disease. What I'm saying is it increases your risk of developing it. And I want to be clear on that because I don't want any of you to leave today and, you know, oh my gosh, all these things that Lisa Skinner Skinner today, I'm definitely on the track to develop Alzheimer's disease. It may not strike you, and I hope it doesn't. Some of these risk factors cannot be changed. However, many of the risk factors that I discussed can be lowered by making certain lifestyle and diet changes, making better choices for yourself. And the earlier you start, the lower your risk becomes. And by implementing these lifestyle choices sooner than later, can mean the difference between living your later years with dementia and living the rest of your life with a completely healthy brain. So in conclusion, I want to just say, and that's, that's why I really wanted to present this information for those of you who had no idea that any of this was even a possibility for lowering your risk of developing Alzheimer's disease later in life. But my hope for all of you is that someday you might look back and say to yourself, I am so glad I listened to that Alzheimer's lady when I had the information. To minimize my risk of developing Alzheimer's disease, instead of the person, the 1 in 3 people at age 85 who will have it and wished they had listened to that Alzheimer's lady. And with that said, I'm going to conclude today's informational webinar. If you are open to it, I would love it if you would share in the chat if this has been a valuable workshop for you, that, you know, put a 1 in the chat if you are so glad you attended today. You didn't know a lot of this information. And now you're really glad you did listen and show up today. And put a 2 in the chat if, eh, it was okay, but I didn't really learn anything new. So anyway, we do have a little bit of time. So Marilyn, if you could take a look at people's comments in the chat and just kind of share with us some of the numbers that people are putting in. And if anybody wants to put any questions in the chat, I will certainly do my best to answer them for you in the remaining time we have. And I do appreciate everybody taking the time out of your valuable day today to be with us and to, um, hopefully that you've learned information that you will implement into your daily lifestyle choices. So we do have one question about recommendations that can be made about agencies that might be able to assist for people that already have an Alzheimer's diagnosis. Assist in what? Doesn't specify. Beverly, could you clarify that? Oh, Steve is caring for his mother with dementia and how the lack of sleep could increase his— will that increase his risk? Could you look at the chat? Yes, and the answer to your question is yes. The answer to your question is yes. It's— studies have shown that Lack of restful sleep is one of the modifiable risk factors. It does not have to be full-blown sleep apnea where you actually stop breathing while you're sleeping, but lack of restful sleep is a risk factor. So hopefully that answers your question. And was there a second part? Let me go into the chat. Second part. This is Beverly. I was concerned that Steve said that he's, you know, that he's, it seems like to me, maybe feeling overwhelmed. And I was just wondering, aren't there agencies, I don't know where he's located, but that can help give him respite care perhaps? So that. Yes, yes. There are many agencies throughout of the United States, and you just have to Google it, Steve, that do have connections with respite care. Respite care means that you have somebody come in and take over your caregiving role and caregiving duties, or you can take your loved one to a memory care facility if they're full-blown Alzheimer's disease dementia, and have them stay there under their care for a few days. Or you can have somebody come into your home. So what I would recommend, you could call the Alzheimer's Association. They have a toll-free 800 number and they could probably assist you with that. But if you Google respite care in your area, The resources will come up as to who you can call to get more information, but a lot of the memory care facilities and assisted living facilities, but if somebody really is, you know, mid-stage into the dementia, you would have to make arrangements in their memory care neighborhood and, you know, you can do it a day or a couple days, or I think some of them are up to 30 days, and give you a much-needed break in your caregiving role and to get caught up on your sleep. There are those resources out there. Yeah, definitely.

Thank you.

You're very welcome. Are you the only person that has the responsibility of taking care of your mom? You don't have any help at all?

I am her primary caregiver. Oh, okay. This is not— I do have an aide during the day, but at night it's me alone.

Is it possible to just have somebody come in at night so you can get a restful night's sleep and maybe just sit there for a couple hours or the entire night to allow you to get sleep and look after— is it your mother?

My mother.

Yeah, after your mother. I know that for a lot of people it's prohibitively expensive.

It is. I work full time. Oh, and the insurance is refusing to add more hours. Even after her dementia and her COPD, which we did not know about, occurred recently, she's much more needy, but insurance doesn't pay for that. No, they're not— they refuse to give any increased hours to care for her at night.

So is this a nightly thing with her that she— does she sleep a lot during the day and then she's up She naps. She naps. Okay. So one of the things that we know about dementia, regardless of what's causing it, is it throws off our circadian rhythms. And a lot of people living with dementia can't differentiate between day and night. Is, um, so if there's a way that you can reduce how much she's napping during the day, that would help her get more sleep at night. She wouldn't be, you know, quite as active at night. So, you know, we certainly can have a separate conversation about that and maybe some of the things that you could put in place that would help with that if you want to, you know, get together. And I'd be happy to talk to you over the phone. At no charge to give you some ideas since you are her primary caregiver of things that you might implement to maybe help prepare her to sleep more during the night. I'll put the email in the chat. Thanks, Marilyn.

I actually put my number.

Okay, Marilyn, if you could grab that for me. Yes, I will. And then, um, hopefully that's been helpful for you.

Yes.

You have a lot on your plate. I, there's no denying.

I do have a full-time job and thank God I have a job that is very understanding.

Oh, that's, you're very fortunate.

And compassionate. Very fortunate. Absolutely fortunate.

Yeah, but it still doesn't, uh, doesn't help relieve the stress that you are under. And I, you know, I'm well aware of how difficult that role is. So if there's anything I can do to make your life a little easier, I'd be more than happy to. That's why I'm here.

Absolutely. Thank you very much.

You're welcome, Steve. Have a great rest of your day.

You too.

Anybody else that has any questions for me or comments, that's what I'm here for. So Um, we still have about 5 minutes if anybody else wants to come forward. I'm happy to, uh, help if I can. There's nothing else in the chat. Okay, thanks again everybody for showing up today, for being here. It's been a pleasure. I, you know, there's— nothing would make me happier than to know that this has been helpful to at least some of you, if not all of you. So have a great rest of your day. And Steve, I will be in touch with you.

And thank you very much for this presentation. It's very informative.

Oh, thank you. Thank you. That means a lot to me. It really does.