Transcription of interview with Douglas Scharre on February 24, 2014.
Douglas Goldstein, CFPÆ, Financial Planner & Investment Advisor
Douglas Sharre is a board certified neurologist at Ohio State University with special interest
in dementia-related behaviors and degenerative dementias.
Douglas Goldstein, financial planner & investment advisor, interviewed Scharre on Arutz Sheva
Radio.
Douglas Goldstein: Could you just tell us whatís the trend that weíre seeing now in
the United States?
Douglas Scharre: As you know there was a large baby boom population some years back and these
individuals are all just the tip getting past 65 and so Alzheimerís and dementias are much
more common in the older age group and so this is going to increase dramatically the
number of patients that we see over the next ten years that are going to develop these
degenerative conditions.
Douglas Goldstein: Is there something in terms of percentages greater in this generation
than there was in the previous generation, or is it similar?
Douglas Scharre: I think itís similar in terms of numbers percentage-wise, but the
fact that thereís just a lot more people that are getting to become older.
Doctors are treating people better, theyíre living longer, and so since dementia is a
disease of older age, weíre seeing many more patients with the condition, but thereís
no sense that Alzheimerís is like a environment from an environmental toxin or something like
that.
It seems to be more than not genetic more than anything.
Douglas Goldstein: Is it there a general definition?
Is it also just people forgetting or a little more careless or are you really kind of talking
about the more severe instances that we might witness?
Douglas Scharre: Itís a very sneaky disease because what happens with most of these degenerative
conditions and Alzheimerís is just one form of that, but the most common form and that
is that thereís these abnormal proteins that accumulate in your brain and theyíre toxic
and they start killing nerve cells and where they happen to start bothering the brain earliest
in Alzheimerís disease is in the memory circuits.
Memory is usually one of the first symptoms people have trouble with and then it tends
to drift into some language areas, so word finding and some visual spacial areas, maybe
youíll get turned around more easily in terms of directions.
Douglas Goldstein: How can you tell the difference between just becoming perhaps a little forgetful
and actually suffering from a real disorder?
Douglas Scharre: As we age, things happen over 60, 70, 80 years, however old we are,
to the brain and doesnít work as well.
Normally aging usually causes just slower processing speed so weíre slowed down maybe
at figuring things out, but we still have good judgment and get to the right answer.
We become a little bit more forgetful and that could be normal aging.
Whatís not normal is more profound memory loss where we donít even know that we forgot.
Weíre asking the same question, forgetting that we even just talked about it five minutes
earlier.
That would not be a normal aging process.
As you age normally you donít lose your language skills.
You keep your vocabulary skills, basically to the end of life.
So you donít start having a lot of trouble finding words and if you were ever good at
directions you usually maintain your directional capabilities to the end of life.
So these things are things that change if youíre developing something like Alzheimerís.
Douglas Goldstein: Tell us a little bit about what seems to be groundbreaking research youíve
done regarding a special test that people can do to see if theyíre beginning to suffer
from cognitive impairment.
Douglas Scharre: Iím a clinical neurologist and Iíll see people with dementia and it
was very frustrating to me that people would come in three or four years after they started
having problems that were obvious to family members.
We were just seeing them too late and so I decided that we need to do better and the
best way to do that would be perhaps a screening test and the most practical screening test
I could figure out was a self-administered one, so that it would not take physicianís
time or caregiverís time.
The patient would just do it on their own, usually at a doctorís office, but it could
be done virtually anywhere.
We developed this self-administered screening test and recently we published a study that
looked at over a thousand patients that we tested with this self-administered screening
test, and we published on the results of the test how good it was and how we felt that
it was fairly affected in identifying cognitive impairment
at
an early state.
Douglas Goldstein: Letís say youíre afraid or
you have a history in the family that you think you really might suffer from this one
day.
If you find out early, does that somehow help you to either protect yourself or delay the
onset?
Douglas Scharre: Even if it turns out, and thereís many causes of cognitive issues,
and just wanted to say upfront that this test is not diagnostic of any particular or specific
condition.
It wonít tell you whether you have Alzheimerís or dementia.
Just says ìHey maybe thereís some problem with your thinking.î But if you do identify,
perhaps with this test, cognitive issues very early, you can start medications.
The medications that we have right now for things like Alzheimerís work better the earlier
you start them, and so we can help slow down the course if we can identify it early.
The other big advantage as well in identifying cognitive issues early, whether itís Alzheimerís
or for some other cause, is that if you know that mom or dad is struggling a little bit
more, theyíre doing poor on this self-administered test, maybe they need a little bit more supervision.
Perhaps you would maybe look over their shoulder at their finances, make sure theyíre not
getting taken advantage of or missing payments, or check their driving.
Make sure theyíre taking their medications.
People get on a number of different medications for chronic medical conditions as they get
older and what happens is if you start forgetting, youíll have poor compliance.
Youíll have worse problems with complications of your other chronic conditions and that
would mean more doctor visits and maybe more hospital stays if youíre not taking care
of your other conditions or not taking your other medications appropriately.
Just supervision would be tremendously helpful for the health and hopefully the quality of
life for the individual.
Douglas Goldstein: As a sandwiched generation kind of person might begin to see his parents
suffering.
At what point would you say youíve got to go and take over their finances and itís
because itís so delicate, how do you recommend that people bring up the topic with their
parents?
Douglas Scharre: If you take a self-administered test, you could take it, I recommend everyone
take it sort of as a baseline, maybe when youíre 65, perhaps youíre still thinking
pretty well at that time.
You have a baseline so that you can take it over time, every year, every two years, and
then you can see very early if there is a change.
Itís when we see a change in cognition, when people are doing worse from their usual baseline,
because everyone starts at different talent levels, that would be the time to say ìHey
letís evaluate a little bit more.
See what the cause of the cognitive issues are and maybe then if youíre noticing these
changes, looking over their shoulder at their finances and if theyíre still doing it fine
then you may just let them keep going with it, but if youíre noticing some changes that
theyíre making mistakes, that might be the point to try to help them with it and maybe
initially just over their shoulder come over, and then maybe eventually if they still have
a lot of cognitive loss you might have to take over everything.
Douglas Goldstein: Are
there certain phrases or terms that you could suggest to someone to say, ìHey mom and dad,
I think such and suchî so that you can find a respectful way to let them let you help?
Douglas Scharre: Sometimes if youíre a family member, itís very difficult if youíre a
spouse or a child that sometimes there are issues or they may not listen to what you
have to say and so our suggestion with these types of self-administered tests is to get
it to their physician, and sometimes the physician has a little bit different relationship with
the individual and can bring up these things easier and start talking to the patient and
caregivers and family a little bit easier than maybe a family member.
If youíre struggling, if theyíre not taking advice or suggestions from family member,
my suggestion would be to see if you can engage the physician to help out and you can always
call the physician on your own and provide information and ask them to help with these
different situations.
Douglas Goldstein: How can people find your test if they want to go ahead
and do this?
Douglas Scharre: You can go on the website and you just type in www.sagetest.osu.edu
and that will lead you to the test site.
You can take one of the four forms there and take it to your doctor after you finish it.
Itís about 10 to 15 minutes depending on how fast you are in terms of doing it.
You print it out and just do it with a pen.
Douglas Goldstein, CFPÆ, is the director of Profile Investment Services and the host
of the Goldstein on Gelt radio show (Monday nights at 7:00 PM on www.israelnationalradio.com.
He is a licensed financial professional both in the U.S. and Israel.
Securities offered through Portfolio Resources Group, Inc., Member FINRA, SIPC, MSRB, NFA,
SIFMA.
Accounts carried by National Financial Services LLC.
Member NYSE/SIPC, a Fidelity Investments company.
His book Building Wealth in Israel is available in bookstores, on the web, or can be ordered
at: www.profile-financial.com (02) 624-2788 or (03) 524-0942.
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