TIA IS GOING TO BRING US UP TO DATE ON THE IOM REPORT ON COGNITIVE AGING.
IOM REPORT ON COGNITIVE AGING.
>> I'M HERE TODAY TO GIVE YOU A BRIEF REPORT ON THE RECENTLY RELEASED IOM REPORT ON COGNITIVE
AGING.
I WON'T READ YOU THE WHOLE TITLE.
IT'S THERE IN FRONT OF YOU.
I THINK IT'S VIRTUALLY A FIGURE OF SPEECH TO SAY ONE IS HONORED TO BE PART OF A GROUP
BUT IT
SO IT WAS ACTUALLY FOR ME TO BE PART OF THIS GROUP.
AND ONE OF THE AUTHORS OF THE REPORT.
I WAS� YOU KNOW, OVER THE COURSE OF MY CAREER I'VE BEEN PART OF QUITE A FEW COLLABORATIVE
EFFORTS AND CONSENSUS GROUPS BUT WITH THIS GROUP IN PARTICULAR I GENUINELY WAS IMPRESSED
BY
THE DEPTH AND BREADTH OF KNOWLEDGE AND BY THE REFLECTIVE THOUGHTFUL NATURE OF THE
CONVERSATION THAT MANY� AT MANY OF THE MEETINGS.
IT REALLY WAS A GREAT PLEASURE TO BE PART OF THIS PARTICULAR PROJECT.
THE CHARGE TO THE COMMITTEE WAS VARIOUS, AS IS USUALLY THE CASE.
ONE WAS TO COME UP WITH A DEFINITION OF COGNITIVE AGING.
SUCH A BASIC TASK BUT IN FACT THERE IS NOT A CLEAR AND WIDELY AGREED UPON DEFINITION
OF IT.
SO THAT WAS ONE OF THE INTERESTING THINGS.
HERE IS A SUMMARY OF THAT DEFINITION.
OBVIOUSLY IT REFERS TO COGNITION, BUT THE KEY POINT HERE IS THAT THIS IS A LIFELONG
PROCESS
THAT IS EXTREMELY VARIABLE IN TERMS OF THE WAY CHANGE OCCURS WITHIN ANY PERSON AND ACROSS
PEOPLE.
IT'S NOT AN ILLNESS.
IT'S JUST AGING.
RIGHT?
SO IF YOU ARE AN ATHLETE, IF YOU'RE A SWIMMER OR RUNNER, YOU'RE LIKELY TO FIND THAT OVER
A
CERTAIN AGE YOU WILL NOT SWIM OR RUN AS SWIFTLY AS ONCE YOU DID.
THAT DOESN'T MEAN YOU'RE ILL.
IT MEANS THAT YOUR BODY CHANGES AND YOUR BRAIN IS SCHEDULER HOUSE SECURELY HOUSED IN YOUR
BRAIN AND BODY.
IT IS IN FACT A PHYSICAL ORGAN AND SUFFERS PHYSICAL CHANGES AND DEVELOPS OVER TIME LIKE
EVERY OTHER PART OF YOU.
SO JUST TO DISTINGUISH SINCE WE'RE HERE THINKING ABOUT DEMENTIA IN PARTICULAR AND CERTAINLY
ALZHEIMER'S DISEASE, HERE HAD SOME OF THE QUICK WAYS TO DIFFERENTIATE BETWEEN DEMENTIA
AND
NORMAL COGNITIVE AGING.
ONE IS THAT OBVIOUSLY DEMENTIA IS AN ILLNESS, COGNITIVE AGING IS JUST NORMAL, NORMAL CHANGE.
IT IS STILL OCCURRING IN SOME CIRCLES, EVEN AMONG DISTINGUISHED RESEARCHERS FOR PEOPLE
TO
DIMINISH THE EXISTENCE OF DEMENTIA AND SUGGEST THERE'S NO SUCH THING, THAT THIS ISN'T REAL.
THERE REALLY IS A DEMENTIA, ACTUALLY.
I WISH IT WERE OTHERWISE, BUT IT IS VERY MUCH A REAL ENTITY THAT CAUSES THE ACTUAL DEATH
OF
NEURONS.
THAT'S NOT TRUE IN NORMAL AGING.
YOUR NEURONS, YOUR BRAIN WILL CHANGE, BUT PIECES OF IT DON'T IN SIGNIFICANT NUMBERS
DIE.
THAT'S THE REALLY CRUCIAL DIFFERENCE BETWEEN NORMAL AGING AND ACTUAL DEMENTIA.
A SMALL PERCENTAGE OR LARGER THAN IT SHOULD BE, A�PERCENT OF PEOPLE ARE AFFECTED BY
DEMENTIA.
EVERYBODY AGES.
IF YOU LIVE LONG ENOUGH.
DECLINES TEND TO BE MUCH MORE INCREMENTAL AND SUBTLE WITH NORMAL AGING.
HERE IS A LITTLE BIT MORE ON A FEW FACTS, MISCONCEPTIONS AND FACTS.
COGNITIVE HEALTH IS OBVIOUSLY MUCH MORE THAN SIMPLY MEMORY IT ALSO HAD A TO DO WITH
EXECUTIVE FUNCTION WITH A NUMBER OF OTHER DIFFERENT THINGS.
NOT ALL CHANGING WITH AGE IS NEGATIVE.
WE HAD TO KEEP REMINDING OURSELVES BECAUSE WHENEVER WE WOULD BRING IN RESEARCHERS THEY
WOULD
TALK ABOUT SLOW PROCESSING SPEED AND DIFFERENT NEGATIVE CHANGES WITH AGING BUT IN FACT THERE
ARE SOME POSITIVE CHANGES.
AND DURING THE LUNCHTIME BREAK A NUMBER OF THE PEOPLE HERE WERE JOKING AND TALKING ABOUT
WHAT KIND OF PHYSICIAN DO YOU WANT?
DO YOU WANT ONE THAT JUST GRADUATED THAT HAS THE NEWEST INFORMATION?
YOU PROBABLY DON'T WANT THE ONE THAT'S BEEN AROUND A REALLY, REALLY LONG TIME BUT HOW
DO YOU
BALANCE THOSE TWO?
THERE IS SOMETHING TO DO WITH WISDOM THAT WE ACCRUE AS WE AGE.
YOU NEED SOME JUDGMENT, SOME EXPERIENCE, CERTAINLY NEED TO STAY ON TOP OF YOUR BODY OF
KNOWLEDGE, BUT THERE IS SOME POSITIVE CHANGE THAT HAS TO DO WITH BEING MORE SOBER, MORE
REFLECTIVE IN JUDGMENT AND ACQUIRING SOMETHING THAT LOOKS LIKE WISDOM, ALSO VERY HARD TO
DEFINE.
THERE'S A MISCONCEPTION THAT THERE'S NOTHING YOU CAN DO TO IMPROVE COGNITIVE HEALTH.
ABSOLUTELY NOT THE CASE.
THERE CERTAINLY ARE ACTIONS PEOPLE CAN TAKE AND LAST JUST TALKS ABOUT NEURON DEATH AGAIN.
SO IN THE REPORT HERE A FEW OF THE KEY MESSAGES.
AGE AFFECTS EVERY PART OF YOU, I'M SORRY TO SAY.
THIS IS OUR NEWS BULLETIN FOR THE DAY.
COGNITIVE AGING IS NOT MERELY ABOUT MEMORY.
BUT IS REALLY ABOUT A NUMBER OF OTHER ASPECTS OF YOU.
OUR UNDERSTANDING OF COGNITIVE AGING IS NOT ALL THAT WE WOULD WISH, ACTUALLY.
THAT'S TRUE ACROSS MEDICINE, OFTEN VERY DIFFICULT TO DRAW A BRIGHT LINE BETWEEN NORMAL AGING
FOR ANY ORGAN, WHETHER IT'S YOUR KIDNEY, LIVER, HEART, AND WHEN THAT REALLY STARTS TO SHADE
INTO ACTUALLY DISEASE.
THE SAME IS TRUE FOR THE BRAIN.
YET IT'S ACTUALLY VERY IMPORTANT FOR US TO CONTINUE TO LOOK AT THAT AS A MATTER OF RESEARCH
AND FIGURE OUT WHAT IS� HOW CAN WE DISCRIMINATE BETWEEN NORMAL AGING PROCESSES AND WHAT
ACTUALLY IS THE BEGINNING OF DISEASE?
COGNITIVE CHANGING EVEN IN THE ABSENCE OF DISEASE CAN MAKE A SUBTLE IMPACT ON YOUR FUNCTION.
SO THE PROCESSING SPEED, THE SPEED WITH WHICH YOUR BRAIN WORKS, CAN CHANGE NORMALLY WITH
AGE.
SO IF YOU'RE DRIVING IN VERY HEAVY TRAFFIC AND YOU'RE TRYING TO THINK ABOUT WHEN TO MAKE
A
LEFT TURN, YOU MAY HAVE ABSOLUTELY� YOU MAY� MEET NONE OF THE CRITERIA FOR MINIMAL
COGNITIVE
IMPAIRMENT OR DEMENTIA BUT IT MAY BE HARD FOR YOU TO JUDGE THE SPEED OF ONCOMING TRAFFIC,
TO
FIGURE OUT HOW LONG IT'S GOING TO TAKE YOU TO MAKE A LEFTHAND TURN.
THERE CAN BE SUBTLE WAYS IN WHICH COGNITIVE AGING CAN HAVE SOME IMPACT ON YOUR FUNCTION
EVEN
IN THE ABSENCE OF DISEASE.
AND IT'S VERY HARD FOR US TO FIGURE OUT WHAT A GOOD EXAMPLES OF THAT AND WHAT ACTUALLY
SHADE
OVER INTO SPECIFIC MANIFESTATIONS OF ILLNESS.
WE DON'T HAVE ALL THE INFORMATION WE NEED HERE.
FINALLY, THERE ARE OPPORTUNITIES FOR ACTION AT MANY LEVELS, CERTAINLY AT GOVERNMENTAL
LEVEL,
AT THE LEVEL OF HEALTH PROFESSIONALS AND CERTAINLY AT THE LEVEL OF CONSUMERS.
IF I CAN TAKE LAUREL COLEMAN'S COMMENT ABOUT THE KALE SMOOTHIE AND SUGGEST SHE'S GIVEN
US A
MEAN FOR IT TODAY,.
[ LAUGHTER ] >> I THINK LOTS OF PEOPLE ARE ACTUALLY THINKING
ABOUT I AM ENGAGED IN PROTECTING MY HEALTH,
COGNITIVE HEALTH TOO, I'D REALLY LIKE TO DO THE THINGS GOOD FOR THAT BUT WHICH ARE THOSE
THINGS?
SO IF PEOPLE ARE MAKING THEIR LIVING BY SELLING YOU SOMETHING, THEY MAY NOT BE THE BEST
SOURCE OF INFORMATION FOR YOU ABOUT NOT JUST THE POSITIVE BUT ALSO THE NEGATIVE EFFECTS
OF
ANY PARTICULAR INTERVENTION, WHETHER IT'S A DIET FAD, DIETARY SUPPLEMENT, WHETHER IT'S
A
FORM OF EXERCISE, WHETHER IT'S SOME OTHER INTERVENTION.
SO IT'S REALLY ACTUALLY QUITE IMPORTANT AND TWO OF THE RECOMMENDATIONS IN THE REPORT SPEAK
SPECIFICALLY FOR WAYS OF HELPING CONSUMERS VET INFORMATION.
EITHER SUPPORT FOR HOW WE REGULATE NEW INTERVENTIONS, NEW THINGS THAT COME IN, WHETHER IT'S
A DIETARY SUPPLEMENT, BRAIN GAME, HOW CAN WE REALLY REGULATE AND VET THOSE TO MAKE SURE
THAT
THE CLAIMS THAT ARE ATTACHED TO THEM ARE REASONABLY BASED IN RESEARCH?
SIMILARLY, HOW CAN WE PACKAGE INFORMATION ABOUT DATA FOR REGULAR CONSUMERS?
LIKE ANY OTHER HUMAN ACTIVITY, RESEARCH CAN VARY IN QUALITY.
SO THERE'S RESEARCH THAT'S BEAUTIFULLY DESIGNED, THAT'S ACTUALLY VERY COMPELLING AND IS A
GOOD REASON TO BASE YOUR ACTIONS ON IT OR EVEN TO USE AS A BASIS FOR SPENDING YOUR SCARCE
FINANCIAL RESOURCES.
THERE'S OTHER RESEARCH, THE KIND THAT TENDS TO BE QUOTED ON TV SAYING "RESEARCH SHOWS"
THAT
IS NOT WELLDESIGNED, NOT PUT FORWARD BY A NEUTRAL SOURCE AND IS NOT A GOOD BASIS ON
WHICH
CONSUMERS SHOULD BE MAKING THEIR DECISIONS ABOUT WHERE THEY WANT TO SPEND THEIR MONEY,
SHOULD I SPEND IT ON THIS SUPPLEMENT?
SHOULD I SPEND IT ON GETTING A PAIR OF SNEAKERS AND WALKING AROUND MY NEIGHBORHOOD?
SHOULD WE SPEND IT TO MAKE OUR NEIGHBORHOODS BETTER TO WALK AROUND IN?
SO THERE ARE LOTS OF CHOICE THAT'S PEOPLE NEED TO MAKE AND SOME OF THE RECOMMENDATIONS
IN
THE REPORT LOOK TO HELPING CONSUMERS FIGURE OUT WHAT'S THE GUIDANCE HERE?
HOW CAN I JUDGE WHICH OF THESE MANY CLAIMS THAT ARE MADE ARE ONES THAT WILL WORK FOR
ME AND
THAT I SHOULD SUPPORT?
HERE'S A LITTLE BIT MORE ABOUT KEY MESSAGING, AND I'VE PUT TOGETHER SOME SLIDES, SOME OF
THEM ARE DIRECTED AT HEALTH PROFESSIONALS, SOME AT CONSUMERS.
REALLY I JUST WANTED TO PUT THIS INTO NOTE THE COGNITIVE AGING IS EXTREMELY DIFFERENT
FOR
DIFFERENT PEOPLE, GOES AT DIFFERENT RATES.
AS WITH DEVELOPMENT, WHEN WE GROW UP AND ACQUIRE NEW SKILLS, WE DO THAT AT DIFFERENT RATES.
SO CLASSICALLY YOU CAN IMAGINE THE TEENAGE BOY LEARNING PHYSICS, INCREDIBLY BRILLIANT
BUT
CAN'T REMEMBER TO BRING HIS WALL WALLET TO SCHOOL.
WE'RE VERY UNEVEN IN THE WAY WE ACQUIRE SKILLS AND SIMILARLY IN THE WAY WE LOSE THEM.
AS WE START TO BE CHALLENGED WE MAY NOT LOSE OUR SKILLS IN SIMILAR WAYS.
THAT'S TRUE FOR ALL OF US.
WE'RE EXTREMELY VARIABLE IN THE WAY WE AGE, INCLUDING
COGNITIVELY.
THAT MAKES IT PARTICULARLY CHALLENGING TO FIGURE OUT WHAT'S A MANIFESTATION OF ILLNESS
AND
WHAT'S NORMAL COGNITIVE AGING?
WE REALLY NEED TO BE ABLE TO HELP PEOPLE WITH THAT.
THERE ARE SOME SPECIFIC THINGS THAT THE COMMITTEE REALLY FELT WERE AMPLY SUPPORTED BY
CURRENT EVIDENCE.
ONE IS JUST ABOUT PHYSICAL ACTIVITY.
IT'S HARD TO SAY WHICH FORM OF PHYSICAL ACTIVITY IS THE BEST, BUT SOME IS DEFINITELY BETTER
THAN NONE.
SO SITTING ON THE COUCH AND WATCHING TV PROBABLY NOT GOING TO STAND UP AGAINST EVEN THE MOST
MODEST FORM OF EXERCISE THAT YOU MAY TAKE ON.
CERTAINLY LOOKING TO YOUR CARDIOVASCULAR RISK FACTORS, AS I BELIEVE THE CDC HAS PROMOTED
THE
NOTION WHAT'S GOOD FOR YOUR HEART IS GOOD FOR YOUR BRAIN AND THE COMMITTEE WAS SIMILARLY
IMPRESSED BY THE EVIDENCE FOR THAT.
SO DOING THOSE THINGS WE KNOW ARE GOOD FOR YOU GENERALLY WILL ALSO SUPPORT YOUR COGNITIVE
HEALTH, STOPPING SMOKING, MAKING SURE THAT YOUR DIABETES IS WELLMANAGED, LOOKING TO HIGH
BLOOD PRESSURE SINCE WE KNOW STROKE IS A MAJOR CONTRIBUTOR TO COGNITIVE RISK FACTORS.
ONE OF THE THING WE WANTED TO DRAW A LOT OF ATTENTION TO IS MEDICATION.
OUR ELDERS ARE ON AVERAGE TAKING 14 MEDICATIONS EACH.
I'LL TELL YOU RIGHT NOW THERE'S NO RESEARCH THAT TELLS YOU THE 14 MEDICATIONS THAT MY
GRANDMA IS ON, HOW ARE THEY INTERACTING WITH EACH OTHER?
IS SHE ON BALANCE AT GREATER RISK FOR TAKE THOSE 14 MEDICATIONS OR HAVE WE AS PHYSICIANS
ACTUALLY� HAVE WE HELPED HER OR HAVE WE HARMED HER ON BALANCE?
AND IT'S ACTUALLY AN� IT'S AN UNANSWERED QUESTION.
IN A FEW WEEKS THE AMERICAN GERIATRIC SOCIETY WILL HAVE ITS ANNUAL MEETING NEAR D.C. AND
I
WAS LOOKING OVER THE AGENDA AND THERE ARE SIGNIFICANT NUMBER OF SESSIONS FOCUSED ON
DEPRESCRIBING, GETTING PEOPLE OFF OF MEDICATIONS.
SO SOMETIMES IT IS NOT JUST WHAT CONSUMERS ARE DOING THAT ARE� THAT MAY NOT BE PERFECTLY
WELLINFORMED IT'S CERTAINLY ALSO MANY THINGS THAT PHYSICIANS DO THAT IS NOT PERFECTLY
WELLINFORMED.
THROWING MEDICATION AT EVERY SYMPTOM IS GOING TO BE A BAD IDEA AS WE GET OLDER AND HAVE
MORE
AND MORE ISSUES.
NOT SAY THAT YOU DON'T HAVE TO TREAT SOMEBODY'S DIABETES, HIGH BLOOD PRESSURE, OF COURSE YOU
DO BUT DOING THAT WITH THE GREAT PARSIMONY POSSIBLE.
SIMILARLY WE NEED TO ENGAGE THE PUBLIC IN PARTNERING WITH THEIR PHYSICIANS AND THINKING
ABOUT THEIR MEDICATIONS.
DO I STILL NEED TO BE ON THIS?
I KNOW I HAD SOME SYMPTOMS FOR DEPRESSION OR SOMETHING LIKE THAT FOR A PERIOD OF TIME.
SHOULD I STILL BE TABBING THAT NOW?
OR IS MY HEALTH BETTER SERVED BY COMING OFF THAT MEDICATION AT THIS TIME?
SO WE REALLY ENCOURAGE PEOPLE TO ENGAGE WITH THEIR PHYSICIAN IN THINKING ABOUT WHAT ARE
THE
ESSENTIAL THINGS I NEED TO BE HERE THERE ARE A FEW OTHER ACTIONS YOU CAN TAKE THAT HAVE
SOME
BASIS IN EVIDENCE, NOT QUITE AS STRONG AS THE OTHER ONES, THAT INCLUDES BEING SOCIALLY
AND
INTELLECTUALLY ACTIVE, ENGAGED ARE YOUR COMMUNITY.
SLEEP IS� ALMOST EVERY I SEE THAT RECOMMENDS GETTING MORE SLEEP DOES NOT THEMSELVES GET
ENOUGH SLEEP.
[ LAUGHTER ] >> IT'S ONE OF THOSE THINGS WHERE YOU SHOULD
DO AS PEOPLE SAY AND 23409 AS THEY DO.
IT IS AN IMPORTANT ISSUE AND IT'S OFTEN IGNORED.
DELIRIUM IS A MAJOR SOURCE OF MORBIDITY AND EVEN MORTALITY FOR ELDERS.
SO THERE'S AN ENORMOUS RISK FOR PARTICULARLY PEOPLE WHEN THEY GO INTO THE HOSPITAL WITH
DELIRIUM.
OLDER PEOPLE ARE FAR MORE SENSITIVE TO GENERAL ANESTHESIA, CERTAINLY MORE SENSITIVE TO THE
ILLNESS THAT BRINGS THEM INTO THE HOSPITAL IN THE FIRST PLACE, AND ALL OF THE MEDICATIONS
THAT MAY BE PILED ON, PARTICULARLY SHORTTERM, CAN ACTUALLY REALLY EXACERBATE DELIRIUM, WHICH
MAY BE VERY SLOW IN CLEARING, WHICH MAY INCREASE THE RISK FOR A FALL, FOR SOME OTHER REALLY
SEVERE HEALTH CONSEQUENCE.
SO LOOKING AT DELIRIUM, RECOGNIZING IT, TREATING IT APPROPRIATELY, PREVENTING IT IF POSSIBLE
IS AN ENORMOUS PUBLIC HEALTH CHALLENGING.
A CHALLENGING BOTH TO� FOR FAMILY MEMBERS TO BE ALERT TO THAT POSSIBILITY AND PUSH YOUR
PHYSICIAN TO THINK ABOUT THAT AS A CAUSE FOR SOME OF THE SYMPTOMS YOU MAY BE SEEING.
AGAIN, ENCOURAGING PATIENTS TO REALLY ENGAGE WITH THEIR PHYSICIANS AND THINKING ABOUT WHAT'S
THE RIGHT MEDICATION REGIMENT AND NEVER LEAVE OUT THE OVERTHECOUNTER MEDICATIONS.
THAT'S BEEN RAISED EARLIER HERE TODAY, INCREDIBLY IMPORTANT.
I THINK MANY PEOPLE HAVE THE MISCONCEPTION THAT IF YOU CAN BUY SOMETHING OVER THE COUNTER
IT
MUST BE PERFECTLY SAFE.
I WISH THAT WERE TRUE.
IT REALLY IS NOT.
YOU CAN BUY LOTS OF THINGS OVER THE COUNTER THAT HAVE VERY POWERFUL EFFECTS AND CERTAINLY
THE MORE SO IF YOU ARE OLDER, IF YOU HAVE MULTIPLE COMORBIDITIES AND IF YOU'RE TAKING
14
MEDICINES.
SO THAT SLEEPING MEDS THAT YOU CAN GET OVER THE COUNTER, THE ANTIHISTAMINE, THE ALLERGY
MEDICATION, EVEN THE HERBAL SUPPLEMENT CAN HAVE VERY POWERFUL EFFECTS, INTERACT WITH
YOUR
MEDICATIONS AND EVEN IN ITS OWN RIGHT CAUSE SIGNIFICANT COGNITIVE EFFECTS FOR PEOPLE.
WE REALLY ENCOURAGE THINKING AND LEARNING ABOUT THOSE MEDICATIONS THAT ARE BOUGHT OVER
THE
COUNTER.
THERE WERE EVEN SOME COMMITTEE MEMBERS, I CAN'T REPORT WHO, WHO WERE REALLY CONCERNED
THAT
SOME OVERTHECOUNTER MEDICATIONS ARE WRONGLY CATEGORIZED PERHAPS SHOULD BE WITHDRAWN FROM
THAT, THAT HAVE ENOUGH OF AN IMPACT PARTICULARLY ON OLDER RESIDENTS THAT IT MAY BE THAT
THOSE NEED TO REVERT TO PRESCRIPTION STATUS.
POLITICALLY EXTREMELY CHALLENGING SUGGESTION BUT IT'S POSSIBLE THAT MAY NEED RELOOKING.
I WON'T SAY MUCH ABOUT THE FINANCIAL DECISION MAKING, JUST TO SAY THAT I SUPPORT THE MANY,
MANY COMMENTS THAT WERE MADE HERE TODAY.
THIS IS REALLY AN INCREDIBLY IMPORTANT ISSUE.
THERE ARE MANY PEOPLE WHO ARE IN THE PRIME OF LIFE AND ARE LACKING IN FINANCIAL LITERACY,
ARE NOT MAKING FULLY INFORMED AND CAREFUL CHOICES ABOUT THE USE OF CREDIT CARDS, ABOUT
COMPLICATED INSTRUMENTS LIKE REVERSE MORTGAGES.
SO AS PEOPLE GET OLDER AND HAVE MANY MORE CONCERNS AND MAY HAVE SOME ISSUES, EVEN WITHOUT
AN
ACTUAL ONSET OF FORMAL COGNITIVE ILLNESS THOSE DECISIONS CAN BE INCREDIBLY CHALLENGING AND
PEOPLE CAN CHOOSE IN A WAY THAT'S CLEARLY NOT IN THEIR SELFINTEREST.
THAT'S REALLY THE SUM OF THE REPORT.
YOU SEE THERE THE SUPPORTING FUNDERS FOR THE REPORT.
YOU CAN ORDER A COPY ON PAPER BUT I POINT OUT TO YOU THAT YOU CAN ALSO GET IT FOR FREE
AND
BE GREEN BY JUST DOWNLOADING IT FROM THE INTERNET.
SO UNLESS YOU WANT TO TAKE QUESTIONS, THAT'S IT.
>> THANKS VERY MUCH, TIA.
NICE CONCISE REPORT ON A COMPLICATED DOCUMENT I THINK WAS VERY WELL DONE.
VERY SCHOLARLY GROUP THAT PUT IT TOGETHER AND� OFFLINE.
[ LAUGHTER ] >> I MEAN YOU DID THE BEST JOB� THEY DID
THE BEST JOB YOU COULD DO WITH COGNITIVE AGING BUT
THAT STILL IS AN UNKNOWN ENTITY.
I MEAN, IS IT REALLY THE ABSENCE OF DISEASE OR IS IT THE DISEASES WE DON'T UNDERSTAND,
DON'T
KNOW ABOUT YET SO IT COULD BE MICROVASCULAR, THIS, THAT, THOSE KIND OF THINGS.
THE POINT IS THAT WHAT YOU'VE DONE IS VERY WELLTAKEN.
ONE OF MY FORMER MENTORS TALKED ABOUT THAT, YOUR EXAMPLE OF WISDOM AND THIS IS LOOSEY
GOOSEY
AS THAT IS, ON THE OTHER HAND WHEN YOU GET INTO A 747 AND YOU'RE FLYING TO JAPAN AND
YOU
LOOK AT THE COCKPIT DO YOU WANT THE 20YEAROLD IN THERE, WHO CAN THINK FASTER, JUMP HIGHER,
RUN FASTER OR DO YOU WANT THE 50, 55YEAROLD PERSON IN THERE WHO HAS BEEN OVER AND BACK
A FEW
TIMES.
THAT'S THE KIND OF THING YOU FEEL A LITTLE MORE COMFORTABLE WITH.
THE OTHER ISSUE THAT CAME UP OF AGING AND WHAT IS IT IF IT'S NOT A COMPILATION OF DISEASES,
AN ANALOGY IS LIKE RADIO ACTIVE DECAY, WHAT IS� RADIO ACTIVE DECAY, THE SUBSTANCE SORT
OF
LOSE ITS ESSENCE AND THAT MAY BE BUT STILL THAT PROBABLY HAS A BIOLOGIC EXPLANATION AS
WELL.
SO QUESTIONS?
ISSUES?
COMMENTS?
YEAH.
>> QUICK CLARIFYING COMMENT.
FOR THE RECORD, I PERSONALLY LOVE KALE.
[ LAUGHTER ] >> AND I DON'T WANT ANY CALLS FROM THE KALE
LOBBY OR ANYBODY LIKE THAT BECAUSE IT'S JUST AN
ILLUSTRATION.
>> DISCLOSURE.
>> I DON'T WANT TO BE THE MEME.