 Today, we're taking your health bills of Think Tech Hawaii in downtown Honolulu and from my home office in Makiki. Today, I'd like to introduce you to L.J. Duanas, the executive director for the Alzheimer's and Dementia Association. I just need to add that whatever L.J. gets involved with, along comes his passion. And that's what drives him to success. Before we start, L.J., please tell us a little bit about yourself. First of all, Wendy, thank you for allowing me to be here and join you in taking our health back here in Hawaii. As you had mentioned, the executive director for the Alzheimer's Association and I'm very passionate about nonprofit work and all aspects in the community. So really appreciate all that you do to raise awareness about our work, not only the Alzheimer's Association but the other nonprofits that are making Hawaii a better place to live. Well, thank you. Thank you for having such passion to making a difference to many, many families and lives, individual lives. So keep on going. So I want you to just share with us a little bit, L.J., can you tell us a little bit about the Alzheimer's Association, mainly the work that you do here in Hawaii? Oh, yes, definitely. So the Alzheimer's Association was founded a little over 40 years ago in 1980 and we're fairly a young organization when compared to other organizations like the American Heart Association, which was founded in the early 1920s and the American Diabetes Association that was founded in the 1940s. The association was founded by volunteers who were also caregivers, caregivers for loved ones that were living with dementia. Today, the association has presence throughout the United States and its territories as well as influence worldwide in our work in science. So in Hawaii, what we do, Wendy, is we ensure that those who are living with dementia and their caregivers have the support that they need to thrive as caregivers. And we also work to improve their lives through our work in public policy and raising awareness so that those who have any concerns of cognitive health conditions that they get the help that they need and early. You've nailed it because not only the patient with the Alzheimer's and dementia, but the other half people really forget sometimes is the caregiver. And so being the support system for the caregiver is as important as supporting the patient because without the caregiver, I don't think the patient could survive and thrive. So to shave for nailing that aspect of it. So I want to ask you, L.J., where does the term Alzheimer's come from? So the term Alzheimer's actually comes from a doctor who first found out about this disease in one of his patients. His name is Dr. Aloysius Alzheimer. He's a German doctor and he found this disease in a patient that he's been treating but has died since he did an autopsy in her brain. And in her brain, he found changes that showed the shrinkage of the brain and also the presence of what we call plaques and tangles, which we also called amyloid and tau. And this has now has been the hallmarks of what we consider to be Alzheimer's disease. So this patient of his, her name is Miss August Dieter. And so she till this day has provided us with so much of what we have been using to elevate and excite the field to continue their work in science. So when we look at the slide with the picture of the brain, can you explain a little bit about the normal brain cells, let's say? Yes, so you can see on the normal brain cell section, healthy neurons and healthy brain cells. Now on the section about Alzheimer's disease, you see that there are tangles inside the brain cells and then these amyloid plaques that are outside of the brain cells. And what these two culprits do is that they disrupt the connectivity of these brain cells, which causes brain cells to die, which is why the brain starts to shrink. And this is common or this happens to everyone who's living with Alzheimer's dementia. Wow. And so is there something like, as you know, like I heard in one time that Alzheimer's and dementia actually starts from the time a kid is like five years old or could be even younger. And a lot has to do with their childhood and their dietary intake. Is there any truth to that? You know, Wendy, we still don't know what causes Alzheimer's and dementia. And I want to emphasize that this is a brain disease. So the brain is dying and it's not the patient with dementia symptoms. It's the brain that is dying because the brain cells are being disrupted by these plaques and tangles. So we have some folks, Wendy, that as young as 32, who developed early onset and as old as, you know, 90 or 100. However, there's many people that are well over 100 years old that still are cognitively healthy. So we know that there's still a lot of work that we need to do in science to really understand what's causing this, you know, with what's causing Alzheimer's and dementia. And I think we're getting closer. Wow. And I think what it is to, you know, it's a silent disease, I want to say. And people didn't talk about it so much, especially here in Hawaii. It was they just had to deal with it with their parents or their loved ones. And so they would just keep on the low down on the disease and not even refer to it as a disease. It was just growing old. But I know that with a lot of education and research that you guys are doing, it really helps people to come forward to seek help and, you know, even as far as the caregivers. So, you know, as time goes on, we all hear of loved ones that are caregiver or caregiving for Alzheimer's patients and family members. Can you tell me a little about that and what people with Alzheimer's may be experiencing? Sure. So let me let me just share, you know, what what we we can maybe put into words, what a person with dementia may be experiencing. So just if you want to close your eyes or just take a step back and just hear me hear me out here is. So you awake in the morning, not feeling rested. And you don't know what day of the week it is, what the date is, what the month is, or even what year it is. So you start your day pretty frustrated and confused. You don't remember what you had planned for the day. You get dressed in one of the three shirts or dresses that you wear regularly, ignoring everything else that's in your closet. You go into the kitchen to make coffee, but you can't remember where the coffee is. You feed the dog, you feed Gracie, or did you already? You take the clean dishes out of the dish rack too, but you're not sure where to put them. And then you open the dishes in your hand and you kind of wonder, you know, are these dishes clean? You're left, you're left frustrated and confused, right? And so you sit down with your cup of coffee that maybe your son made for you because you didn't know where the coffee was to begin with. And then you start to read the Star Advertiser. You read the same article about the rail or maybe the eruption going on several times. You eat the breakfast your son made, but you're kind of not really thrilled about what you're eating. And you kind of wonder, are you even hungry? Why are you eating the food that you have in front of you? So, you know, you get ready, maybe your husband, your wife, or your son is going to take you to the doctor's appointment at Queens. And during the 20-minute drive, you ask him or her, where you're going four times? The appointment, you answer all the questions your doctor asked of you. But then when the drive home, you ask your husband, your wife or your son, where have you been? And they respond, we were just at the doctor's office. And you ask, what did he say? And then your loved one maybe reminds you that the doctor is a female. And so once again, you're frustrated and you're confused. You stop for lunch, maybe at Zip B's, your favorite. You look over the menu a number of times and you eventually decide on what you want to order. The Korean chicken and chili mixed plate, maybe. The server comes and you eat half of your meal because it's really not what you wanted. So you're left frustrated and confused again. When it's time for dinner, your son, Ben, maybe prepares the meal for you and your spouse. And you say, thank you, Jason, you mentioned. Then Ben says, I'm not Jason. I'm Ben, your son. You apologize and you're left frustrated and confused. After dinner, maybe you watch the news and something on the news disturbs you. And when the news is over, you can't remember what it was, but that feeling still lingers. So you're left angry, frustrated and confused. You wake, you go to bed and you wake the next morning, not feeling rested. And you don't know what day it is. You don't know what the date is, what the month is, or even what the year is. So people with dementia, people with Alzheimer's, Wendy, they go through this cycle of just so much unknown and so much confusion and so much frustration. And that in itself can cause all of those feelings for the caregiver. So it's a very challenging disease to have and a very challenging disease to care for. And again, this is a brain disease. This person with Alzheimer's or dementia is not doing this to cause frustration or to stress out their loved one. Their brain is dying and we need to recognize that. Wow. Wow, LJ. You painted a really clear, vivid picture of what it could or me or is like for the patient. And how sad is that? And how frustrating is that? And you know, when we say, when we joke about those things, I think after hearing this explanation, I think we better stop joking about it. Because it could be any one of us at any one time. And so we must be more careful of what we say and how we say these things. Because, well, you really impacted my heart with just that. And yeah, so thank you for sharing with me and for the folks out there who are watching this video. I hope that you will become more compassionate of being that caregiver with that patient. With the patient, of course, thinking, wow, that man LJ on the screen. He really hit how I feel. I hope people can be more compassionate and understand me. So, wow. So, you know, many people think memory issues, LJ, are a part of the aging process. Is that true? And what are some of the signs that someone may have Alzheimer's or another dementia? What are the signs, LJ? You're right, Wendy. There are some age-related memory changes just as we age, just as we will have with some of the organs that are in our body, our heart, our anxious, our willingness to get out there and go for a run or a bike ride. We get a bit tired a lot faster. But memory loss that disrupts daily life is a sign. And so what I could share is perhaps for getting important dates or events, you know, maybe for getting the dates of your daughter's birthdays or the date of your wedding or maybe asking the same questions over and over again in just a matter of minutes where you've asked those questions or you've answered those questions. Also, the inability to retrace steps. So maybe you lost your, you can't find where your car keys are and the inability to think back on what room you came out of the past few minutes or the past few hours or where you were, that's a sign of Alzheimer's or dementia. It doesn't mean you have it. It just means, hey, it's probably time to go see a doctor. Also, losing track of time and dates. Some people, you know, can't tell if it's, you know, what day it is or, you know, what time it may be. And so that's certainly a concern. And so we always will recommend that someone takes the time to go see their doctor or at least talk to someone about these issues. But from what I've heard, Wendy, it's those repetitive question and asking that folks typically will, will experience. And that's also right. I mean, it'll frustrate caregivers or family members if loved one continues to ask the same question over and over again. Right. Well, and takes a very patient caregiver or family member to have to do with them because of repetitiveness of the questions. The same question that you answered a few times in the last few minutes. It gets frustrating for all, for the patient as well as the caregiver. So, but being more aware of it makes us more sensitive to it. So thank you, OJ. And I think, I think that's, you know, kind of the silver lining to all of this and for caregiving and it teaches us to be more patient and more kind. And, you know, my grandfather lives in vascular dementia and that's, you know, he was the most patient and kind man I know. And, you know, I'm glad that I, I hope I live up to what he has expected of me to be as patient and as kind as he was. Wow. So, OJ, I need to ask you about how many people live with this disease and what are some other impacts to our islands? So there's about 100,000 people in Hawaii who are impacted by this disease. 30,000 residents have diagnosed dementia that we know of and there's about 65,000 unfaith family caregivers that provide their care. You know, the burden on families, gosh, we can't even put a figure on what that number is. And these families are doing their very best to provide the best care for their loved ones with Alzheimer's or another dementia. And, you know, just financially, just so if we can put a number out this, you know, the average cost per month for dementia care in Hawaii is about six to $7,000. But in total, when we talk, we talk about care, we talk about caregiving. It costs about $2 billion annually and counting for Hawaii. So it's a very expensive disease to treat, manage and care for. Wow. That's a big price tag. And that's only the cost that they know of. You know, like you said, you know, sometimes are, hey, Johnny, you want to go out? Oh, no, I have to stay home with my mom, but she's your mom. How come you have to stay home with her while she has Alzheimer's? And we can't leave her alone. And so someone has to be there with her. So, you know, making the public more aware of these situations that they're experiencing also as friends of caregivers will allow us to be a little bit more compassionate and say, hey, Johnny, then why don't we come over to your place so we can hang out and watch TV and you can watch mom as well. So, you know, really getting out there. And I know you're doing a great job of all of this, LJ, but just really, yeah, not just the patient and the caregiver, but the people around them really need to be educated so that, as I said, we too can be more compassionate with this, the blend of patient and caregiver. So that's another, another focus for you. I'm sure you're already nailing that, but yeah, wow. So, LJ, there, that's a lot of people to provide services for over 100,000 people. Can you share with, can you share what your team in Hawaii has been able to do this past year and during the pandemic for these patients and families with Alzheimer's disease? Happy to, Wendy. And, you know, I'm so proud of my team because they were very quick to respond. And, you know, when the pandemic happened, we quickly transitioned all of our offerings to be done virtually or by phone. But not only our staff did this, our volunteers actually, you know, call our call to action to volunteers who stepped up to also help us in reaching more people. In the past year, we serve nearly 5,000 families across Hawaii and we hope to double that in the coming year. We continue to offer our support groups and our education programs. And, you know, the best thing a caregiver can do for the person that they care for is to stay physically and emotionally healthy and strong. Caregiving is hard. It's so hard. And our support groups offer comfort and reassurance. And, you know, it also can be a great source of advice and even humor. And we've been able to do this, you know, continue to do this virtually. But we are looking forward to offering this in-person in the new year in 2023. Our Ed programs, they do just that. They provide training and education to caregivers or just the general public who have an interest in Alzheimer's or dementia. And we also talk about legal and financial planning because we know that that's a big concern as people's cognitive health become a concern. We talk about the 10 warning signs. We talk about working with challenging behaviors and what to do. And, you know, we also do individualized care consultations. So we come up with action plans to ensure that the family has the best course of action or the best journey as they provide care for a loved one who are impacted by dementia. And so it's really just a lot of love and aloha, you know, and just really hearing people out so that we understand their challenges. Well, like I mentioned in the beginning of this talk, Ajay, your passion for this disease is infectious. And you have brought hope and inspiration to so many that are with this silent disease of dementia and Alzheimer's. So I just want to say mahalo and just keep doing the exemplary job that you are doing thus far. When I see you with the doctors and the teams, I'm very proud to call your friend and all that you're doing thus far. And I know even more great things will be coming. So share a little bit more about the Alzheimer's Association with this next slide. So, you know, Wendy, we, as I mentioned, we continue to provide care and support programs, but we are also the world's largest nonprofit founder of Alzheimer's research. We invest over three hundred million dollars in over a thousand projects, I believe, worldwide. But more importantly is we connect and we convene. You know, we bring together the biggest ideas and the brightest scientists to connect across many disciplines to address common challenges, gaps in care and also share data. And you know, what's so exciting is that research is happening here in Hawaii. But we want to do more here. We want to make certain that people are people, you know, our Pacific Island people and our Asian Americans, our native Hawaiians are in trials so that we know that when a treatment is available, we know it will work for us. And we've seen in the past that there are some therapies that do not work for indigenous populations. Right. And so we need to ensure that we have representation. And so we're looking forward to funding more in Hawaii. And we're so, you know, we're so thrilled to be partnering with, you know, folks at UH and also at Hawai'i Pacific Neuroscience who are doing great work. Wow. So can you just share with us a little bit about the research that has been conducted thus far? Yes. So, well, nationally, you know, we are looking at anti-amyloid therapies and amyloid obviously is the plaques that I mentioned before. But here, Hawai'i Pacific Neuroscience has clinical trials that have folks on this therapy to see it. One, it will remove amyloid and help in delaying the onset of the dementia symptoms or the loss of cognition. And there are new drugs. There's new drugs that's coming to market that, you know, is doing the same. Just doing it a little bit better with less side effects. So we're hopeful that, you know, this is far from a cure, Wendy, very far from a cure, but it's the it's the next step we're taking so that we can get better treatments and ultimately a cure. And, you know, you give us hope. You give the families and patients hope and inspiration that you're diligently working towards the cure through this research and, of course, the education that you're giving to all of us as it comes out. So and I can see, you know, you're very busy traveling here and there to conferences and presentations. So I know you're not sitting back and just waiting for that cure to land on your desk. I know that you're out there and I was at the last walk, the walk to end Alzheimer's earlier this month, which was, I know, an ultra success with over 1500 participants. You mentioned there that there were new therapies that can help people with Alzheimer's. Can you talk a little bit about that? Yes, so there's there's like I mentioned earlier, there's two drugs that have shown to effectively remove amyloid plaques in the brain. And to have Alzheimer's, you have to have amyloid and you have to have tau and you have to have some cognitive issue. And so these two drugs have shown to effectively remove amyloid. And our belief is that when you remove amyloid, you can slow the progression of cognitive decline. So that's what's so exciting. Wendy is that we also know that if you cannot, if a drug does not remove amyloid, there is no effect or decline in cognitive decline. So we know that moving amyloid works. We just want to be able to remove it effectively and safely for people. So it's exciting because, you know, we've seen these types of therapies work for AIDS, cancer, diabetes, heart disease. And so Alzheimer's, as young as we are as an association and research, we're getting there. We're getting closer to to better treatments and a cure. I mean, people are living longer with cancer, with heart disease, with AIDS. And this disease is the only disease that has no survivors. But we will we will have that first survivor one day. And I know it's going to be very soon. Wow. And, you know, just with that strength in your voice, it gives us all hope and it inspires all to get more involved with what you're doing there. And I know so much work is being done on Alzheimer's and dementia. What is next on the horizon for the Alzheimer's Association? So, you know, these therapies that are becoming available, whether it's it's it's drugs that we take or it's lifestyle changes is it needs to be done early. And so we want to make sure that we're raising awareness about this disease so that people can make changes early in their life. Like you like what you do, Wendy, every day, you know, you talk about health. You help nonprofit organizations talk about their cause. And a lot of it is really on prevention and early intervention. And that's what we want to be able to do. So the next year, the next two years, we're focusing on raising awareness so people know that that they can do something about this. They can do something to delay or prevent the onset of dementia and not only dementia, other chronic conditions. So that's that's our next that's our, you know, our project is raising awareness. Wow. And, you know, I volunteered at your champions booth and we all know champions booth. Those are the people that go out and talk about dementia and Alzheimer's and raise a thousand dollars or more. And I know we had a massive list that we presented these acknowledgments to next year. I don't know the date yet, but when it does come out, people get out there and make more people aware of Alzheimer's and the effects of not just the patient, but for the caregivers, the families and friends around this patient. So I know that the walk was very successful. And I'm going to know that next year will be even greater and more successful because of the passion that you share, LJ, for finding the peer and supporting the team around the patient. So for now, LJ, we've we've run out of time. I just want to say mahalo to you, LJ Duenas, the executive director of the Alzheimer's and dementia association for your passion as you educate, inspire and need many to the awareness of this silent disease. We'll be back in two weeks with more of taking your health back with Wendy. Aloha and mahalo to LJ.