 Think tech away, civil engagement lives here. Okay, we're back, we're live in the one o'clock clock today with Warren Wong, MD, he's a geriatric doctor and he's retired, may I say that on the air? Yeah, retired and reworking myself, yeah. Reworking himself and he's got into technology, but before we get to the technology, I just want to ask Warren, as I told you I would, Warren. Can you, for our audience, define yourself? Can you tell them who you think you are? What kind of person is Warren Wong? Okay, I think I'd say that a big part of my life has been taking care of older people and I just really love taking care of older people and that's part of the reason why even when I retired from directly taking care of patients, I kept on thinking, well, what would I really want to do and got into more of the techie world and I'd like to say that I have love in my life and love people and I want to do something with that. That's great. So, and while you were practicing actively, you were getting gratification out of that and the Lord knows that a doctor can get lots of gratification out of helping people. It's all about helping people. But then, you know, you retire and you're not doing it anymore and you have to find a way, find a new chapter, find a new identity to make that work for you and to get gratification out of that. Yeah, I mean, I'd turn to your audience and say, you know, how many of you are retired and, you know, what are you doing? Are you excited with life? And when I retired, I actually was kind of anxious when I retired. I said, well, what's next? Because, you know, in your career, you go from school to medical school to training to being a doctor. And then the what's next is kind of not really well-defined if you've been busy, you know. I kind of went into this zone of what's next and had a while trying to figure it out. And then a lot of different things popped up that actually make my life now more interesting than ever. And that's about making enough money to bring home the bread and more about what makes you warm, what are the things that you always wanted to do that you never did and make it fun, make it exciting, and also, you know, have a little more time to do it. It's like a bucket list. It was a primary bucket list. So tell us about your life now, you know, how you're sculpting it, how you're making it into a next chapter that works for you, that realizes all the dreams, whether you had conscious or unconscious dreams, and what are the parameters of that? Well, I think, for one thing, you know, I have more fun time than I used to. So do more traveling. And I think it's important to have fun time. I mean, you worked all your life. Why don't you have some fun? On the flip side of that, I've talked with some people that say, oh, you know, after a while, just traveling, traveling, traveling, after a while I say, well, what else is there? So I do, you know, I do have more fun than I do. I spend more time reading than I do on non-medical things and everything. I have my own book club that I have a lot of fun with. But I also spend more time taking care of my body because it actually requires more time than it ever did. And I think that as I'm getting older, it's not always about being strong, you know, in terms of how much can I lift or whatever. It's a lot about coordination, balance, things that are, and flexibility that are, you know, things that really get people in the problems as they get older. But there's still a big sense of purpose in my life, you know. What am I good for in my years? And I've got three big projects we can talk about any one of those. Yeah, but you've got to have that. You've got to have a sense of purpose. And I think, correct me if you feel otherwise, but I think a sense of purpose also means that you're in a community of some kind, that there are people who appreciate your sense of purpose. They appreciate what you're doing. You're talking to them. They're talking to you. You have connections. You need to be connected. Yeah, and everybody's different that way, Jay. I think you're the kind of person that needs a lot of connections. But there's some people who just need a little bit of connection, you know. I need a certain amount of connection a day. I mean, I probably, 20 or 30 minutes of talking with people outside my immediate family is enough in a day. But everybody is a little bit different. But I have to tell you that during my career, a lot of retired women would complain about their husbands who, you know, they didn't go to work anymore, and they dropped out of their circle of friends, and they just stuck on to their wife, you know. So wherever the wife goes, you know, they want to be where the wife is. And, you know. You lose something if you do that. That's not good, you know. I mean, you need your tight relationships. But I think that, you know, we're social animals. We should be involved with other people to a greater or lesser extent. But, you know, we just can't be klingons. Like, they were just clinging on to their wives all the time. And women are much better. Women seem to be able to socialize a lot more. There's so many men, it's, oh, you know, they're with their wife, and they're watching TV, and, you know, it's not the best path. So you've been a geriatric doctor for a long time, and you've seen this. You've seen it in your patients. And you've learned all these lessons about the risks of, you know, going out there in retirement and not doing the right thing. And then, you know, it's part of what you're doing now to take those lessons and help people, not necessarily in a medical context, but help those people in a real-life context avoid those problems and have an identity, have a community, have a purpose in life. And for this, you're developing technology. I love it. It's the perfect, it's the perfect evolution. So tell us about, tell us about your projects, your technology projects. My company that I founded is called Memories Connect, and we have a first product that we launched in the Apple Store. It's only available right now, only if you have an iPad and you need to have your Apple password and your PIN and your name and yeah. You don't have to pay anything and you don't have to sign up for anything as long as you have an Apple password. And then yeah, you just go to the Apple Store and you look up my app and it's called Memor C, M-E-M-O-R-C. And it's free. And the whole concept behind it is that, you know, I did Alzheimer's and dementia evaluation throughout my career and, you know, the medicines that we have available are really not that powerful at this point. And people end up, I realize that people end up with a disability. They end up not being able to remember things and not just thinking of it as a disease but also as a disability. How does it impair you? You know, if everybody's talking about their family and friends and what they're doing and then your friends are talking about and then you have a hard time remembering who your friends and family are, well, that's kind of a big cognitive loss. I mean, you can feel pretty alone that way. So the app, it's one of the primary features is that there's pictures of people that are important to you and you're asked to identify those people and their name, their relationship to you. It's just a very basic product right now. But it's gamified so that, you know, if a person has difficulty, it makes it easier. And if it's too easy, then we make it a little harder because it has to feel like a game. And when you get people to do it over and over again, they start to, you know, it's a reinforcement of memory. It's not improving the brain per se, but it's improving, you know, just like if I see you every day, Jay, I'm going to know you a lot better than if I see you once every two or three years. What's his name? What's his name? Sure. So that's one of the features. Another feature is just a little bit of a chat feature in which we ask people about their lives and very just general things like what do you like to eat for breakfast? Therapy. Is it therapy? Well, it's kind of like just telling them, you know, whatever, whatever, when you like aloha shirts, that's great. That's part of Jay. You're trying to draw me out and make me more self-aware. Well, let's say whatever you are is important and you're a human being and it's important. Right. And if I'm a human being, it's important that what I say to you or the app is important, it means I have a self-image. I have a place in the universe. I'm real. That's exactly it, you know, because, you know, we start to develop these deficits, you know. Who am I? You know, I'm useless, you know. Those are the kinds of feelings that creep up on people who start to have memory problems. Right. And I'm just guessing here, but isn't there, seems to me there must be a big connection between memory problems, isolation, and ultimately depression, which comes in that same continuum. Yeah. Depression is definitely more common in people who have Alzheimer's disease or the more generic term, you know, the broader term dementia. And they feed on each other, right? The isolation like people with memory problems are a little bit more hesitant to interact if they know that they can't remember things. They lose confidence. Yeah. They're afraid to have a conversation where they might be found to have forgotten things. Yeah. Yeah. Very interesting. I had an Italian teacher in my French class in junior high school. I can't tell you his name, but I can tell you what he taught me, okay, and it's this. It's not Italian and it's not French, it's Latin, and it means, it's funny how things stick with you. Yeah. You know, I can't remember what I had for lunch today, but I could remember things from 30 years ago, that kind of thing. This is more than 30 years ago. It means repetition is the mother of study. So it goes to what you were saying about trying to reinforce memory. If you find a way to reinforce it. If I can't remember a word or a person, and I make myself think of it and repeat it again and again and again, or if I see the person in the street, as you said, that will help me sort of build a structure around that symbol, that symbol will rise to the top of the stack, right? So we have a pretty basic product right now. It's free and we're just trying to build some awareness. And actually what we're really interested in is in people to download it and play with it and tell us what they love about it and what they hate about it. Because what I've learned is you have to get rid of things that people hate about it and you really have to work on the things that people love on it. So we need help actually, because whatever is in my head about what a good product is, we really need real users to help us with that. So what is it like? What is the user experience like? I go on it, I download it, I go on it, what does it say to me, what do I do with it? Well, I mean, so we've actually done a lot of what we call beta testing with older people and people with dementia and it is on a tablet, it's an iPad and a lot of people would say older people, especially people with dementia, are not going to be able to use this. And there's truth to it that there's a lot of fear around using it. We have some people that have no cognitive impairment at all who are actually afraid to touch an iPad or a tablet. But then when they showed how to use it, they actually saw it, they feel like they learned something, oh, no, I can use an iPad. Empowerment, yeah. And we found actually even people with moderately severe dementia that they can't interact. And really the original concept I developed with this was when I saw two and three-year-old children playing with the tablet, I said, you know, why can't we get these really important technical tools to people who could really benefit from it in the older population? So I mean, actually eventually we're going to get away from the tablet concept. Where it goes, I don't know. It could be on a laptop. It could be on a desktop. It could be on your phone. It could be in Google Glasses. Or it could be in something like a robotic dog. Because the second generation product we were going to develop, my dream of developing, is more interactive, where it's not just a person interacting with you, but other people can interact with you. And let's just say that a person, like your mother or somebody, was really feeling lonely at any given moment. They could just say, oh, I'm feeling lonely now. And it instantly goes to your Instagram circle of friends and sons and daughters and loved ones, mom saying she's lonely now, let's have someone give her a call. I mean, that's... It's very sophisticated actually. Well, yeah, but it's certainly not out of the realm of easy to understand. That as a computer coding matter, it's not hard to code that. It takes time, it takes time. It's time, it's time. It's time for a break, actually. That's Warren Warren. I do remember his name. M.D. Jay, take my doll. Be right back after this break. Hey, loha. My name is Andrew Lanning. I'm the host of Security Matters Hawaii, airing every Wednesday here on Think Tech Hawaii, live from the studios. I'll bring you guests. I'll bring you information about the things in security that matter to keeping you safe, your co-workers safe, your family safe, to keep our community safe. We want to teach you about those things in our industry that may be a little outside of your experience. So please join me, because Security Matters. Aloha. Aloha, I want to invite all of you to talk story with John Wahee every other Monday here at Think Tech Hawaii. And we have special guests, like Professor Colin Moore from the University of Hawaii, who joins us from time to time to talk about the political happenings in this state. Please join us every other Monday. Aloha. OK, we're back with Warren Warren M.D., a geriatric doctor who retired and has found another chapter in life that fills his need and gratifies his lifelong desire to help people. So he's created this technology that it's not a psychological reaction like what was the name, Eliza, years ago. You typed on the DOS line, and you would say hello, and she would say to you, all automated. She would say to you, why are you asking me that? Whatever it was. Anyway, it's more like a friend. And with certain powers that could help you, even when you don't realize how it could help you, it comes up with stuff to help you. I mean, the possibilities are enormous because you can apply artificial intelligence to this. You can come up with solutions that are sort of context-based, time of day, where you are, your life as opposed to all of the lives. You could make this your best friend. And I mean, that's one of the problems in the 21st century in the nuclear age. We don't have best friends so much like we used to have them, I think. So this could be the best friend for a lot of people who are in need of a best friend. Well, I'm a little hesitant, because I believe in real, live human beings. But it could be used to access, and then the whole thing about developing communities that are, some people have disabilities and can't get around. And how do they stay part of a community? There's a lot of tools out there now to connect people with people. And of course, there's all the concerns about privacy and things like that. And so distinguish it from social media, because social media, people want to have a community, and they can sign up and 10 minutes later be involved in a global community. That's not what you mean, though. It's something more personal than that, isn't it? Yeah, I think, well, in terms of the app that I'm, I think right now it's a very basic product. I think a second generation is interactive. And then the third generation, actually, like I was saying, a robotic dog or Google glasses might just help a person as a tool. Let's just say you have some memory problem and you're walking to the store, and then you can't quite remember what you wanted to get at the store. That tool could help you. Or if you're walking home and you get a little bit lost, that tool could help you say, this is the way home. So it would help promote some degree of independence, which is another important issue. There's the need for community, and a lot of people's need for feeling independence as well. Now, I have another aspect to this, and that's the conversation you were telling me about where the device, the program, will ask you questions about what's on your mind and how are you feeling today, and it's a conversational thing. Is this part of the basic memorisee? Yeah, it's right now at a basic level of development for those kinds of things. Obviously, you know, it can reach a time where it could be a little bit like an Alexa or a Siri, but even more sophisticated. Getting back to issues such as, Jay, you told me this yesterday, but you're saying something different now. How do you really feel about things? And developing a little bit of a conversation, but I'm actually very leery of developing relationships that are not human to human. Human to humanoid even is, I'm a little bit leery of that. I think that whatever we do, and this is kind of a difficult area is that when we use tools that actually help hold people together. But one very interesting aspect of it that I've been thinking about is, how do you communicate with a person who has memory problems, perhaps significant ones? And this is a very simple example. The simple example I have is that when people have memory problems, it's a common tendency to ask them, do you know who I am? Well, what if I didn't know who you are? That's not a very good way to lead a conversation, right? It's very intimidating. This could be a tool for learning, telling a person who's a caregiver how to communicate with a person who has memory problems and also learning to understand what a person with memory problems, what they're trying to communicate, the basic message that they're trying to communicate. And sometimes that requires a certain level of communication that's a little bit different from just normal conversation. So are you teaching the other person to the conversation something? Are you communicating with that person? Well, I think we're, you know, I mean, it took us a long time to get to where we are. I think, you know, knock on wood, if the product becomes a successful product, then we'd have a lot more infrastructure to develop. A lot of the different things that I think would be really useful. And I think the bottom line is technology is so useful for people who have no need of technology. I mean, all these people who are 18, 20 years old, they know how to do everything, but they don't really need the tool as much as the person who could really use this tool. But the person who could really use it doesn't know much about the tool, so he's not inclined to use it. We need to make it much simpler. Yeah. And there are things we've learned about older people, you know, reflection off glass, how they touch things. We've learned all those things, so. Yeah. Well, how about getting around sounds very important to me. Especially Alzheimer's, you get lost. Now, you forget where you are. And then you sort of lose the ability to navigate where you want to go or how to get back to where you were. Yeah, and just a real small side hint on that, Jay. People always say, when I was practicing a lot, oh, that won't happen, their dementia's not that bad. It turns out that people have a lower level of dementia, less dementia, less Alzheimer's, have an equal, if not higher chance of getting lost because they're trying more things. And so it's not the severity of the Alzheimer's that helps determine, so you have a person who's driving and all of a sudden, you know, there's a road service being done or whatever and they have to take a different route. That's kind of a formula for not being able to find your way back home. Because things change and they weren't quick enough to recognize it. And I mean, I would not be a problem if somebody else was in the car, I like the spouse. But if the person is alone in the car or driving it, it's a real risk on that one. So I suppose, you know, this would be useful in a car, useful on a phone or as you have it now on an iPad, useful in a device like an Echo I guess you can set this up to talk to you. So it's not just writing it, you know, typing out a message or looking at the screen, you can have a conversation with it. Well, you're thinking way ahead, Jay, because you just told me you're a coder. So you've been a coder for a long time, but yeah, there's a lot of potential. Well, I just had a moment to talk about how things are working in geriatrics in general. When people are living longer, thank goodness for medical science. If they're aware of the possibilities of correcting medical problems as they get older, they can, in most cases, do that. And so they have a longer life. And it's no surprise to see somebody in the newspaper who died when he was 95 or 100 even. And so our lives are getting longer. But as our lives are getting longer, we can't do all that much about the brain because the brain gets old, right? Am I right about this? How do you keep your brain functioning even when it might not otherwise function so well? Yeah, so regardless of whether a person has, there's a distinct Alzheimer's and dementia, but even very people like Warren Buffett, I'm sure, their brains are changing. And of course, Warren Buffett, who's one of the richest people in the world, still gives advice. And he gives a lot of wisdom, basically, from his years and decades and decades of experience. I think older people actually, the brain may not be the same, but they share a lot of wisdom. And I actually think that older people have a lot to share in terms of wisdom. And how to say, I mean, a lot of older people have been through divorce, been through loss of loved ones. They know how that feels much more than a much younger person. And it's to develop a meaning and context around that I think older people are really, really important to kind of see the big picture. Yeah, they have wisdom, don't they? They may not remember what they had for lunch today, but they can remember a lifetime of experience and wisdom. They'll say it's not that important what I had for lunch. True, there's a priority thing going on inside. But you know, one of the things I've heard my whole life is that you have to keep your mind active. You have to read. You have to think. You have to be engaged with people and ideas. And if you don't do that, you're taking a risk because then your brain isn't being exercised or something like that. So how important is that? And how can, maybe your app does some of this, how can a person who recognizes this risk keep his brain or her brain active to the point where he or she is making maximum use and minimizing the risk of losing it? It starts way, way earlier, I think. You know, I mean, HMSA has done a lot of work with the blue zones. And it does boils down to living a healthy style. There is a brain diet that you can eat now. It's greens and nuts and things like that. But I can tell you that things like supplements are not the answer. You know, I think the thing that you pointed out, remaining connected, exercising your brain a lot, keeping those neurosynapses working and not underused. And also, so there's the concern that connection with other people is really important and then staying physically active is very important. Just the usual things that people would say, what does it take to lead a healthy life that basically decreases, you know, there's clear evidence that decreases the probability of getting Alzheimer's. There's also a strong pathology that's very hard to get away from, but it does make a difference to exercise your brain earlier in life and stay connected. Warren, do you think there'll be drugs out to help people keep thinking straight as they get older, where otherwise they might not? Do you think there'll be drugs out that would, you know, deal with Alzheimer's? I think, yeah, eventually. I mean, there's like a lot of diseases that are major problems. The major problems are diabetes. That's common, but very common among seniors, aside from dementia, is Parkinson's disease. When you think about it, neither diabetes, nor Parkinson's, nor Alzheimer's, none of them have a cure. It's not like an infectious disease. You get a pneumonia, take an antibiotic and you're back to normal. These are chronic diseases. Will there ever get a point where there's a cure? We've been working at Parkinson's disease for longer than my career. And really, it's still more treatments for approaches to, rather than cures. I think these challenges are really long-term challenges. In the world of cancer care, actually, cancer care has made incredible advances in the last 10 or 20 years. People are not nearly dying as quickly from cancer. But I do believe in progress, but I also, I guess I'm giving you a little bit of a mixed message. It's also very challenging. Yeah. Well, it's challenging for the person. Yeah. Because the person, you know, I mean, while the person's sentient, the person who wants to deal with age, it should come to the realization that age is an adventure, just the way teenage life is an adventure. And the risks are different, the challenges are different. Maybe they're more difficult challenges. But that doesn't mean you can't and shouldn't address them. Well, two things I've learned from this discussion. One is, I think you have a soft spot for Warren Buffett. And I think it's probably because you and Warren have the same first name. There's gotta be a relationship there. The other thing I've learned is to have a conversation with you, Warren, and to have this discussion, it sort of clears my head. It probably helps me in terms of my mental process. Thank you for that. Yeah, I wanna say something to your audience. You know, it's really not about me. It's about everybody being themselves and making the most out of it. I mean, there's no success in comparing yourself with anybody else. There's gotta be the person you are and make the most of it. And I do think that society, it doesn't do justice to older people that way. Yeah. Thank you, Warren Wang, MD. Really appreciate the discussion. Thanks. Aloha and happy new year. Happy new year.