Evo Terra (Host): Dementia, it runs in my family. So, I have questions, as I'm not getting any younger. Today, I'll speak with Dr. Morteza Modaber, Director of Neurology with Jamaica Hospital Medical Center. This is Jamaica Hospital Med Talk from Jamaica Hospital Medical Center. I'm Evo Terra. Dr. Modaber, thank you very much for joining me today. 

Morteza Modaber, MD: Thank you for having me.

Host: So as a neurologist, what types of conditions do you treat?

Morteza Modaber, MD: My team and I recently joined this hospital, bringing like expertise across a wide range of neurological conditions. Each of us specializes in different aspects of nervous system's health. We do provide a comprehensive care.

The common conditions that people know would be headaches, stroke, epilepsy, neuromuscular disorders, and neurodegenerative diseases. And obviously, our goal is to offer specialized and patient-centered care and treatment for both acute and chronic neurological conditions.

Host: I know today our main topic is dementia. So, can you explain what dementia is and why we get it?

Morteza Modaber, MD: Well, dementia isn't just a memory loss. It's a condition that affects a person's thinking, how they remember things, and how they interact with the world. Imagine your brain like a city, where streets connect memories, skills, emotions. Over time, some of these roads start breaking down, traffic gets slower, detours appear, and eventually some routes become completely blocked, and some neighborhoods completely inaccessible. This makes it harder to recall names, follow conversations, and even recognize familiar places or people.

Host: So at what age do individuals typically begin to exhibit the first signs of dementia?

Morteza Modaber, MD: Yeah. Well, dementia doesn't have a set start date. But for most people, the first signs show up after age of 65. Think of it like a dimmer switch. At first, it's just a little harder to remember names, follow conversations, or to multitask. For some, especially, some specific types of dementia, the early-onset forms, this kind of starts in their 40s or 50s. Certain types, like frontotemporal dementia, it can hit even earlier. But this is the key takeaway. Dementia isn't just getting older. It's a disease, and spotting the signs early can make a difference.

Host: As I said at the beginning of the episode, dementia runs in my family, and I'm now closer to 60 than I am 50. So, what are the early symptoms I should be looking out for?

Morteza Modaber, MD: Dementia doesn't start with forgetting everything overnight. As basically everyone knows, it sneaks in. I'm going to give you some early signs. Memory slips. Not just forgetting where you put your keys, these are common things, but asking the same questions over and over again. Confusion with time or place. Losing track of dates, forgetting where they are, or getting lost in familiar places. Struggling with the words, pausing in mid-sentence, calling objects by the wrong name, or having trouble following conversations. Poor judgment or mood or personality changes, this is very important in my opinion. Becoming unusually anxious, irritable, or withdrawn, but sometimes we just associate it with someone, "Well, they don't want to hang out with us." But I think at that moment that's the time that we need to understand that these could be early signs of dementia and they do need our support. They do need our presence.

So, when you start noticing some of these changes in yourself or someone you love, don't ignore them. It's not just getting older. Everyone can benefit from digging deeper and talking to a doctor.

Host: Speaking of talking to a doctor, is there a screening test for dementia? Can I do a blood test and say, "Oh, dementia, here"?

Morteza Modaber, MD: There's no single yes or no test for dementia, right? But there are screening tools that can help us spot early, especially the early warning signs. Physicians can ask the cognitive tests. We have some cognitive tests, like we ask someone to remember the short list of some words, draw a clock, follow some simple instructions.

These are not perfect by any means, but they can show us some red flags. In general, when there are signs needed with the history and physical examination, we can get closer to diagnosis. So when should someone get screened? I would say when very, very early sign if anyone is concerned, if they're getting lost in familiar places, I would say don't wait. Don't wait to see what's going to end up. Just get checked.

Host: And is that something that my general practitioner could do?

Morteza Modaber, MD: Exactly. The first steps would be general practitioner, and if they have any concerns, they can refer to us neurologists.

Host: Do most people experience-- I mean, I'm assuming that most of us, and I think you said this, most of us are going to experience memory loss as they age. I know I started losing my memory at around seven years old, I think. But, regardless, as we're going to get worse as we get older, we just know that, but dementia is different, right? How is it different?

Morteza Modaber, MD: See, some memory slips are totally normal. We all forget where we put our phone or struggle to remember the name every now and then. The brain slows down. These are these things are completely normal, like a computer taking an extra second to load.

Dementia is different, though. It's not just forgetting a name. It's forgetting the entire conversation. It's not just misplacing the keys, but putting them in a fridge and not knowing why. It disrupts daily life, changes personality. It gets worse over time. So, the key difference, normal aging make things slower. Dementia makes things stop working.

Host: Got it. My grandfather on my mother's side was diagnosed with dementia, and my grandfather on my father's side was diagnosed with Alzheimer's disease. Those are two different things, yes?

Morteza Modaber, MD: Yes. People usually mix up, and even physicians, they usually use these terms interchangeably. But they're not the same thing. Think of dementia as an umbrella term. It just means someone's brain is not functioning as they should for their age, in terms of memory, thinking, problem-solving.

Under that umbrella, there are different types of dementia, and Alzheimer's is the most common, but it's not the only type. So, all Alzheimer's is dementia, but not all dementia is Alzheimer's. There are other types, too. We have vascular dementia from multiple strokes. We have frontotemporal dementia, which we discussed, it usually happens early, which can affect personality first. Key difference, dementia is a big picture, and Alzheimer's is one specific type.

Host: So, are there things we can do, or specifically things I can do to prevent or minimize the chance of me developing one or both?

Morteza Modaber, MD: Well, find a partner and dance together. There are no guarantees that we can stop dementia, right? There are no guarantees we can stop it. The research shows that we can stack the odds in our favor. Think of your brain like a muscle. The more you challenge it, the stronger it stays. Dancing with a partner is shown to have a significant impact on slowing down the brain's aging process or even dementia. Move your body. Regular exercise. Keep blood flowing to your brain. That's also shown that it can improve and decrease dementia risks. Eat smart. Mediterranean diet. Full of leafy greens, fish, nuts, and healthy fat can protect the brain cells.

Stay social. Staying social can actually help our brain to stay sharp. Isolation speeds up the cognitive decline. Protect your heart. If you protect your heart, you protect your brain. High blood pressure is bad for your heart. Thus, it's bad for your brain. Diabetes is the same thing. And sleep well. Again, sleeping well over time, we've just seen that the eight hours is probably not sufficient or not good enough for some people, or maybe too much for some people, but as long as you're feeling well rested, your sleep is well.

It's never too early, we should keep that in mind. If anyone is listening to this podcast are 20-years-old, you've got to start now. If you're 70, you're going to start now. Never too early, never too late.

Host: Speaking of not too late, if someone does have dementia or someone in their life has dementia, are there things that we can do to slow down or treat the disease?

Morteza Modaber, MD: So, the same things that we discussed that how we can minimize the risk of having dementia, they can also slow down the process. But from a medical aspect, if you want to discuss, there are medications. We have medications like the donepezil, we have medications like memantine, which can give a slight boost to the brain function and also slow down the process of dementia.

There are new studies, basically 2024, 2023, there are newer medications, there are infusions, which they show they can slow down even more the process of dementia. So, yes, there are some new studies and there are research ongoing, a significant amount of research. Every day, we hear something new, but we need to give time for these medications and treatments to be commercially available.

Host: That is encouraging news. How can someone contact the Neurology Department there at JHMC for more information or even to schedule an appointment?

Morteza Modaber, MD: They can look at jamaicahospital.org. That would be a Neurology Division. They can look up all the information we have on our website. And also, if they want to have any appointment, they can email to neuro@jhmc.org. We'll be more than happy to see anyone who has any questions.

Host: Dr. Modaber, thank you very much for all the information today.

Thank you for having me.

Once again, that was Dr. Morteza Modaber, Director of Neurology at Jamaica Hospital Medical Center.

Host: For more information about the services Jamaica Hospital offers, visit our website at jamaicahospital.org. And if you found this podcast episode helpful, please share it on your social channels, and check out the full podcast library for topics of interest to you. I'm Evo Terra. And this has been another episode of Jamaica Hospital Med Talk from Jamaica Hospital Medical Center. Thanks for listening.