[00:00:00] Pete Waggoner: This is Neurology Now, the podcast that explores the fascinating and complex world of neurology. Join us as we explore the human brain and beyond, with expert guests who share their knowledge and insights. Welcome to the Neurology Now podcast. And on today’s show, we welcome in Dr. Dong from the Minneapolis Clinic of Neurology.
[00:00:20] Pete Waggoner: And November? It is Alzheimer’s Awareness Month and Dr. Dong is an expert in the world of Alzheimer’s and we’re going to get into that very deeply. So I know you’re busy and you’re helping a lot of patients along the way, doctor. So thanks for joining us here today.
[00:00:36] Xiaoming Dong: Thank you. It’s nice to be here. We’re talking about a very important topic.
[00:00:41] Pete Waggoner: I’m sure it’s one that affects a lot of people globally. And as we age, there’s more and more people that are experiencing this. And there’s so many things that we’re going to get into with this, including things that you’re doing to help people now and the whole process of diagnosis and everything from there.
[00:00:58] Pete Waggoner: So let’s just start with you [00:01:00] first. I mean, you have a rich background in neurology and a specialization in neuromuscular disorders. What drove you down the path to be interested into the topic of Alzheimer’s?
[00:01:11] Xiaoming Dong: Well, because there’s a huge need. During the second decade of my practice, I noticed that more and more patients are getting sent to the neurology clinic for consultation because of memory loss and dementia.
[00:01:25] Xiaoming Dong: I realized that that as the baby boomer generation getting older and the medical intervention keeps advancing, people are living longer. Issues like a cognitive decline and the dementia become a big challenge for seniors. So in the clinic, you can sense the fear in those patients when they start forgetting things.
[00:01:45] Xiaoming Dong: Some of them even ask, am I losing the marble in my brain? Others tell me they’re scared, saying, I don’t want to end up like my mom, who had Alzheimer’s disease. So for the patient with advanced Alzheimer’s disease, [00:02:00] it really turned their world upside down. They can’t recognize their loved ones, get lost in their own home, struggle with managing finance and daily life, and deal with confusion, disorientation, hallucination, and paranoia.
[00:02:16] Xiaoming Dong: It’s a tough road for both the patient and their families.
[00:02:19] Pete Waggoner: I agree. If you have loved ones that have had it, and it can be hereditary, I would assume, you kind of see the path that has been laid before you by them. And that’s a scary thing, knowing what it could be. That’s a lot of the fear that you’re hearing along the way.
[00:02:36] Xiaoming Dong: Peter, let me tell you, the help is on the way. Back then, I struggled too. I was not trained as a behavioral neurologist. I don’t have a set of plans to evaluate and treat a dementia patient. The diagnosis tools and the treatment options were also limited. So leaving the patient and the family desperate for help, plus managing a dementia patient is very complicated and [00:03:00] a time consuming process, putting a real strain on the healthcare workers.
[00:03:04] Xiaoming Dong: Still, our responsibility remains unwavering in caring for individuals living with Alzheimer’s disease. So I was thinking, although at the time there’s no effective treatment to stop dementia, our goal is to help people understand what’s going on, maintain their daily function and dignity as much as possible.
[00:03:24] Xiaoming Dong: Using the medication we have, try to slow down the progression of disease. and control the mental confusion and some behavior problem. So in response to the growing need, I developed a clinical algorithm tailoring our approach to the patient, varying from symptoms, which can range from mild forgetfulness to severe dementia.
[00:03:47] Xiaoming Dong: So we outlined how to evaluate, diagnose, and craft care plans that provide essential support for both the patient and their families.
[00:03:57] Pete Waggoner: What, to you, is [00:04:00] Alzheimer’s disease, and how does it affect the brain as you get to the diagnosis? So, what does it actually do, what happens there?
[00:04:07] Xiaoming Dong: Actually, the Alzheimer’s disease is a neurodegenerative disorder.
[00:04:11] Xiaoming Dong: It’s named after Dr. Alois Alzheimer’s. He’s a German psychiatrist and a neuropathologist at the time. He’s credited for identifying the first published case. For which was initially termed as a personnel dementia. In 1906 later recognized as Alzheimer’s disease. So the pathologist pretty well understood the hallmark neuropathological change in Alzheimer’s disease, including of a true distinctive type of abnormality.
[00:04:43] Xiaoming Dong: I don’t know if you have heard about that. The first is amyloid plaques and neurofibrillary tangles. Amyloid plaque are characterized by deposition of amyloid plaque protein outside of a neuron cell. Why neurofibrillary [00:05:00] tangle consists of the accumulation of a hyperphosphorylated tau, or we call the p tau protein inside of nerve cell.
[00:05:08] Xiaoming Dong: The formation of those plaque and the tangle is essential for the disease pathology. So as accumulation of amyloid plaque. And the neurofibrillary tangles gradually destroy neurons. Connection between the network of a neuron can break down. The function can be lost. Many brain regions begin to shrink. So among the area often damaged first at the hippocampus and also its connected structure, it’s much harder for a patient to form new information and form new memories.
[00:05:42] Xiaoming Dong: So one significant aspect of Alzheimer’s disease is the existence of a prolonged pre symptomatic period. So the patient can have the physiological process in their brain for many years before they appear to have clinical symptoms, kind of the very challenge [00:06:00] for early diagnosis and the intervention in the disease.
[00:06:03] Xiaoming Dong: As the brain change associated with Alzheimer’s disease may begin years before noticeable. Cognitive decline occurs.
[00:06:11] Pete Waggoner: So, along those lines, is there a difference between Alzheimer’s and dementia? Do they interact together? Can you have both at the same time? How does that all function?
[00:06:23] Xiaoming Dong: It is one of the most asked questions I encounter in my clinic.
[00:06:27] Xiaoming Dong: Many people say, Doctor, what is the difference between dementia and Alzheimer’s disease? First, Dementia refer to a category of disease that cause a loss of a cognitive function. Many cases of dementia are caused by the neurodegenerative disease and why? They may all share some similarity. Each one have their own unique features.
[00:06:50] Xiaoming Dong: Here are some of the most common neurodegenerative condition, last level dementia. First is Alzheimer’s is account for 60 to 80% of the [00:07:00] dementia patient. The second is dementia with a Lewy body, and the frontal temporal dementia, also we call it FTD, or Parkinson’s disease dementia. There are also some less common ones, like progressive supraneuropathy, called PSP, corticobasal degeneration, or CBD, or multisystem atrophy and Huntington’s disease.
[00:07:21] Xiaoming Dong: However, there’s another group of dementia, Which is not caused by the neurodegenerative disease, and they can sometimes be reversible or slow down if we identify and treat underlying causes, such as normal pressure hydrocephalus, also called NPH, vitamin B12 deficiency, or alcohol related. Dementia, also called vertical Kusakoff syndrome, the condition caused by excessive alcohol drinking.
[00:07:48] Xiaoming Dong: Among them, one of the most common one is the vascular dementia. It’s caused by the stroke. So, besides other medical conditions, have also worse cognitive [00:08:00] ability, such as a congestive heart failure, kidney or liver problem, some side effects of certain medication which affected the brain. and head injury or the brain infection.
[00:08:12] Xiaoming Dong: Sometimes people can have a mixed different dementia, such as a combined Alzheimer’s and vascular dementia and some other medical conditions.
[00:08:20] Pete Waggoner: So when we take it to the next step of the differences between those two, we’re going to dip back into the Alzheimer’s discussion. And one of the things that you mentioned on your profile is how important it is for patients to take an active role in their care and planning.
[00:08:37] Pete Waggoner: The question is, How can patients and their families be proactive when it comes to Alzheimer’s? How can you get out front of it?
[00:08:44] Xiaoming Dong: Yeah, well, this question is very important, but also quite complex. So most dementia occur in older people, but it’s beyond the urine consequence of a biological aging process.
[00:08:57] Xiaoming Dong: So previously, we talked about a pathological [00:09:00] change in Alzheimer’s disease, but exactly underlying ideology, which caused Alzheimer’s disease are not yet fully understood. So far, the extensive research have associated with both genetics. And the lifestyle factors. First, let’s talk about what we can do, the lifestyle.
[00:09:19] Xiaoming Dong: And so the common factors can increase developing Alzheimer’s. Of course, aging, which nothing we can do about it. High blood pressure, diabetes, obesity, smoking or drinking too much alcohol. And be physically inactive or socially isolated. So far, many studies have showed that the vascular disease risk factor, such as hypertension, obesity, diabetes, increased risk of Alzheimer’s dementia, especially when those factors present in the midlife.
[00:09:52] Xiaoming Dong: Accumulated data also suggests now that engaging the active social cognitive and physical activity inversely [00:10:00] correlate with the risk of Alzheimer’s and any form of dementia. Like I mentioned earlier, there’s a substantial interest in those activity. As a potential preventive strategies. Second, let’s talk about the family history of dementia.
[00:10:16] Xiaoming Dong: So that’s a very important topic. So for patient with the first degree relative with dementia, there is a 10 to 30 percent increased risk. So Peter, you’re at a risk and the individual with a familial with a two or three affected siblings with a later onset of Alzheimer’s dementia have a threefold increased risk of Alzheimer’s compared to the general population. Highlight the impact of genetic and familial factors.
[00:10:44] Xiaoming Dong: The genetic basis of later onset Alzheimer’s is complex. The most well established genetic risk factor of later onset is APOE4 gene. If your carrier of APOE4 alleles The two to three fold increase the [00:11:00] risk, but if you are, you carry the two gene, that’s also called a homozygote, you will have approximately eight to 12 fold increase the risk.
[00:11:09] Xiaoming Dong: The good news is that we’re now able to check the A4E gene regularly in clinic. Since September, the test is available. I personally have checked more than 80 patients. For the genotype, and the family are very, very interested. You identify their, the patient gene and how they affect them.
[00:11:29] Pete Waggoner: How does that work, that test? What happens there?
[00:11:32] Xiaoming Dong: Blood test! Very simple.
[00:11:34] Pete Waggoner: Really?
[00:11:35] Xiaoming Dong: Yeah, when I check the, the regular test, check people’s thyroid function, vitamin B12 level, and some other tests, I just added APOE gene. The test will be back within a week.
[00:11:47] Pete Waggoner: So would you suggest it would be a good idea for a person like me with family history of this to schedule an appointment to come in and have a test to see where I fit?
[00:11:55] Pete Waggoner: Or do I need to wait a little bit? What are your thoughts there?
[00:11:58] Xiaoming Dong: Here is my [00:12:00] suggestion. If you have a no symptom and your function highly. I don’t think you need to make a special trip to my clinic. If you do have some concerns, you should. And the early diagnosis is very important. We can talk more about it.
[00:12:16] Pete Waggoner: Well, and concerns for those that are, we’re talking about would be, I’m not leaving stoves on and I’m, you know, turning off lights and I know how to get to directions and normal functionality. I have a very busy job with, you know, we only have so much RAM of hard drive like a computer up here. Where if you’re overloading with work and things, there are things that can be missed.
[00:12:38] Pete Waggoner: There’s a difference, I think, from day to day functionality versus overly worrying about, oh, I forgot that because you have so much on your mind. There’s a difference, right?
[00:12:49] Xiaoming Dong: Correct. And I think as we grow older, the most thing we notice is when we multitask and some of the memory can be missed.
[00:12:58] Pete Waggoner: One of the interesting things that [00:13:00] I was telling Shelly who put this podcast together, our producer, my mother, I am convinced, existed with it for longer than I would imagine because she was, Dr. Dong, a big list writer. So she’d be transposing lists constantly and she’d function that way because she’d always go check her list. Is that possible to be a trick that allowed her to go longer without us knowing?
[00:13:26] Xiaoming Dong: I think so. And as I mentioned earlier, you know, the, I mean, with the plague. And the neurofibrillary tangle can exist for a prolonged period of time before the patient has any clinical symptoms.
[00:13:39] Xiaoming Dong: And then if they notice they’re a little forgetful, they manage, they write the list, and they have a planner, and they try to limit the things they need to do every day. So there is a coping mechanism, everybody develop in their own way. But the pathology, already started, we just don’t know.
[00:13:58] Pete Waggoner: It was impressive [00:14:00] though.
[00:14:00] Pete Waggoner: When I looked back when she was diagnosed, I’m like, Oh, like I didn’t know this. And one of the things that’s interesting to me, the earliest signs of how I noticed it, both in my grandmother and my mother was the repetitive stories. Like they would tell you the same story. All the time and you’d be like, okay, well, you’re not talking to a ton of people and you can’t remember who you told the story to.
[00:14:22] Pete Waggoner: I think for those listening, that’s a telltale sign. I’m kind of getting into the symptoms. Part of this discussion too as well. But is it fair to say that if people repeat the same story a lot? That’s the same. That could be another way of.
[00:14:36] Xiaoming Dong: Absolutely. Actually, that’s frequently you will hear people say, Hey, mom, you already told me this.
[00:14:41] Xiaoming Dong: And then they ask her, can I tell you a story of my patient? For example, I have a gentleman. He’s come from Ireland. He said, doctor, I come from Ireland. He told me 10 times. In the clinical visit, I said, I know you come from Ireland. Then he was so surprised. He said, how do you know? The family just laughed.[00:15:00]
[00:15:00] Xiaoming Dong: And then he said, doctor, now you’ll see what happened at home. He repeated the same thing over and over again, but he just cannot remember.
[00:15:07] Pete Waggoner: So then he’s pretty far advanced if he is doing that in one visit that much in my opinion.
[00:15:13] Xiaoming Dong: Yeah, that’s pretty advanced.
[00:15:14] Pete Waggoner: How do you deal with loved ones that don’t want to hear that maybe they’re cognitively not the same?
[00:15:23] Pete Waggoner: Because I think we all know that’s tricky to do.
[00:15:25] Xiaoming Dong: It is very tricky to do actually. There’s a battle in the family and in my clinic almost every day, if the spouse or the children brought their mom or dad here, they said, why you’re here? This, I don’t know. You don’t remember? So what do you mean? I don’t not remember? I don’t have a memory problem.
[00:15:44] Xiaoming Dong: Yeah. There is a very much lack of insight. And it’s not, they didn’t do it on purpose, they truly do not remember. And they struggle with that too. And sometimes they’re very surprised. They say, what do you mean I don’t remember? I remember and I don’t have a memory [00:16:00] loss. So I think that that’s the most challenging part.
[00:16:03] Xiaoming Dong: And sometimes I tell patients, if I tell you, you have a shoulder problem, you have a kidney problem, you accept it. You know what’s going on. But if I tell you, you have a memory problem, which you do not know, the acting is surprised and the people says do not remember you’re the last way in the world to know that.
[00:16:21] Pete Waggoner: How could you know? And that’s what makes it so tricky. So back to what we were talking about a bit. How does the clinical neurophysiology role play a role in understanding and managing the disease?
[00:16:33] Xiaoming Dong: Well, the neuro physiology, usually we have a three part. The EMG is also called a electromyography. EEG is electron and the sleep study.
[00:16:46] Xiaoming Dong: So normally it’s not typically needed for every patient who have Alzheimer’s disease. They’re generally reserved for the specific cases or when specific symptom or issue arise. [00:17:00] For example, the EMG or nerve conduction which assess the peripheral nerve function and the muscle function, and it can be used to evaluate any patient who has anomalies tingling in the arm or leg.
[00:17:12] Xiaoming Dong: And those symptoms are quite common in elderly patients who could have peripheral neural outputs from diabetes or nerve rules get pinched from the neck or the back. So it’s called a radiculopathy. So the EEG is a critical tool used to study seizure disorder and assessing mental confusion, or we call it encephalopathy.
[00:17:33] Xiaoming Dong: So in patients with Alzheimer’s disease, they can increase risk of seizure. In one study, they showed one in eight patients with dementia described episodic mental confusion. We believe could be caused by the epileptic seizure. So EEG can be very helpful to identify those cases and treat accordingly. And the last sleep study can help diagnose the untreated obstructive sleep [00:18:00] apnea can cause daytime sleepiness and increase mental confusion.
[00:18:04] Xiaoming Dong: So the proper diagnosis and adequate treatment for sleep apnea are very important.
[00:18:10] Pete Waggoner: Okay, that’s fascinating. So now you emphasize improving the quality of life for patients with chronical neurological conditions on your profile and how you are as a doctor. What are your best strategies? We’ve kind of like weaved in and out and discussed that throughout this discussion.
[00:18:27] Pete Waggoner: But if you were to give a best practice type of recommendation for Alzheimer’s patients, what would that be to improve their situation?
[00:18:36] Xiaoming Dong: Well, living with any chronic neurological condition is challenging. And Alzheimer’s disease can be particularly demanding for both the patient and the families. If it’s a chronic condition, patient can live many years after diagnosis.
[00:18:50] Xiaoming Dong: So as the disease progress, different stage face a different set of challenges. There are many good suggestions and recommendations you can get from Alzheimer’s [00:19:00] Association or some published books or pamphlets talking about how to deal with memory loss or maintain daily living and tasks, how to keep a healthy and active life.
[00:19:11] Xiaoming Dong: And here is my suggestion. I want to emphasize a couple of points. Number one, planning. Consider the big picture and a plan for the future. Well, if the patient is still able to make a decision, start an early discussion with your family. Several areas require consideration, such as the healthcare decision, legal and financial matter, and options for in home or long term care.
[00:19:38] Xiaoming Dong: If the patient becomes unable to make a decision, the family members should step in. It’s common to encounter resistance and denial. Number two, safety. Prioritize safety when planning, including financial management, driving safety living environment, and reducing health hazard like a fall [00:20:00] risk.
[00:20:00] Xiaoming Dong: Number three, find joy in life. Seek enjoyable activity and maintain existing hobbies. So if you like, she do any activities such as like reading, writing, drawing, singing, playing piano, and listen to music, any artwork, play cards or puzzles, keep doing them. I have a patient send me the drawing, their sewing work regularly, and I encourage them to keep doing those.
[00:20:28] Xiaoming Dong: And also engage active social activities, avoid isolation. Number four, caregiver well being. I regularly ask her the well being about a caregiver. I ask the patient’s spouse, the children, How are you doing? Taking care of a dementia patient is very challenging. And the many spouse provide 24/ 7 care. So the caregiver physical and the mental health are equally important.
[00:20:57] Xiaoming Dong: So establish a strong care [00:21:00] network and explore community care resources are important. The number 5. The most important is diagnosed earlier. I’d like to talk a little more about a new advancement in the Alzheimer’s field. So we now have a more diagnosed truth and a treatment option of Alzheimer’s disease.
[00:21:19] Xiaoming Dong: You know, this year, the FDA have approved like cannabinoid treatment and some other future treatment option. I’ll target a patient who have a diagnosis with a mild cognitive impairment and early stage of Alzheimer’s disease. There are no more excitement about Alzheimer’s evaluation and treatment in neurology field this year than any other year.
[00:21:43] Xiaoming Dong: There is many encouraging news in the field of Alzheimer’s. evaluation and treatment. It’s not just confined to the research paper. It’s also making its way to our daily clinical practice. benefiting patients with improved [00:22:00] diagnosis and access of new treatment. So, first, I want to talk now for the diagnosis.
[00:22:06] Xiaoming Dong: We can now check Alzheimer’s marker in the patient’s cerebral spinal fluid. I don’t know if you have heard anything about it. Now we can measure the spinal fluid, total tau, phosphor tau, along with the amyloid plaque called a beta 42 and a beta 40 ratio, which can help us identify the patient with Alzheimer’s pathology in the brain and the support diagnosis.
[00:22:34] Xiaoming Dong: Another piece of good news is that the biomarker test can also be done in the blood test. It’s already used in the research and the clinical trial. We hope it can be used in clinic in the near future, so the patient does not have to go through the vinyl tap. Another diagnosis tool is the PET scan. The amyloid PET tracer, which can measure amyloid lesion burden [00:23:00] in the brain, has been available for years.
[00:23:03] Xiaoming Dong: It can identify amyloid plaque before the patient develops any clinical symptoms. Head scan is very expensive. Recently, Centers for Medicare and Medicaid Services have now just opened up the door for wider coverage of a PET scan, which is great news. Well, the second one is the treatment. So, FDA has approved medication called lanocatamide, which is developed by the ELSA.
[00:23:31] Xiaoming Dong: The brand name is also called leqembi, it’s L E Q E M B I, it’s the anti amyloid. monoclonal antibody that the target is soluble amino beta protein. It has been used in individuals with early symptoms of Alzheimer’s disease, including those with a mild cognitive impairment or MCI or mild dementia due to Alzheimer’s.
[00:23:56] Xiaoming Dong: So, after 18 months of treatment, the group received the [00:24:00] lacanomab experienced a statistically significant 27 percent reduction in decline, based on the primary outcome measure. And remarkably, if you do the PET scan, it showed that lacanomab effectively reduced the brain amyloid beta burden.
[00:24:17] Pete Waggoner: Well, there’s so much there.
[00:24:19] Pete Waggoner: The one thing that stands out to me out of all of the information and the data that you shared was the authentic joy that you had moving out of this topic with how things have moved along. You’ve been doing this for two decades, correct? I mean, quite some time.
[00:24:37] Xiaoming Dong: I’ve been practicing neurology for 18 years.
[00:24:39] Pete Waggoner: I sense that you have a feeling of encouragement as baby high as ever. I mean, like, where are you at with that? Do you feel like all of these things that you just discussed are absolutely nice steps forward?
[00:24:52] Xiaoming Dong: Absolutely. You know, in the past, I feel the patient is in those like a black box. You know, we just watch them [00:25:00] go into that dark tunnel, but we have no way to help them.
[00:25:04] Xiaoming Dong: But now the diagnosis, will shine a light. We understand their genetic profile better and we also can check if they carried the marker, the pathology process in their brain and we can have those treatment options hopefully can help maintain their function. And then maybe prevent the progression of the disease.
[00:25:27] Pete Waggoner: That’s amazing. And that is the things that I think the public would like to hear. Those that are very familiar with it. And I just have one final question for you. And it’s one of interest for me because you obviously have a multibilingual background and I’m just curious to know if you’ve observed any differences in the experiences or understanding of Alzheimer’s among your Chinese speaking patients and others. From a global perspective, what you see is the knowledge base of alzheimer’s?
[00:25:55] Xiaoming Dong: Over the years. I have taken care quite a few Chinese [00:26:00] patient who develop Alzheimer’s or other type of a dementia. I didn’t notice those patient tend to visit a clinic in a fairly late stage of their conditions. So, typically, family become alarmed only when this patient have lost some basic self care functions, such as forgetting how to cook, how much Chinese grandma like to cook, being unable to dress themselves, getting lost, or experience some personality or behavior changes.
[00:26:30] Xiaoming Dong: So, there’s multiple factors. contributing to this trend. Firstly, many Chinese elders live with their children, and the family members handle most of the daily tasks, such as managing finance, driving, shopping, or cleaning. You know, if a grandma or grandpa become a little forgetful or repeat themselves, we know as a la la da da, like you mentioned, they repeat themselves all the time, telling the same story over and over again.
[00:26:57] Xiaoming Dong: Most times the family might consider it’s a [00:27:00] normal aging process. Another reason could be the language and the cultural barrier for patients who do not speak English. Obtaining their precise medical history and conducting clinic evaluation, particularly memory and cognitive assessment, could be very challenging.
[00:27:18] Xiaoming Dong: In the future, you know, we should provide more public education to raise awareness about memory loss, the early signs of dementia, and encourage people to seek evaluation as soon as possible.
[00:27:30] Pete Waggoner: I think the most important thing to what you just said there is for individuals to have the ability to acknowledge that things might not be right, or if they forgot and didn’t know it was right, be able to know what’s potentially in their history.
[00:27:48] Pete Waggoner: And it could happen and to start doing the things that you said. I think education takes people a long ways. For instance, my mother didn’t really think that she would have it because her mother [00:28:00] had it. Well, now I’ve seen two patterns of it. Third generation. I’m clearly going to say to myself, okay, to my kids, my grown adult kids, I’ve said, Hey, if anything gets wacky or weird right away, let me know.
[00:28:12] Pete Waggoner: And so I think a lot of it goes a long way and really having your eyes open and understanding that. It’s very possible. But the things that you’ve outlined in here give a person hope in knowing that they don’t go down that black hole, that dark hole that you were speaking of, and that it can be a lot brighter.
[00:28:31] Pete Waggoner: And you gave a ton of great tips of what to do to not isolate and to continue to be social and to do the things you need to do and to. Do puzzles to read, listen to music. All of those things are incredibly helpful for those that are in the position of saying, what do I do next? And then along with the medical breakthroughs, I think all of it just blends together beautifully.
[00:28:54] Pete Waggoner: So I didn’t know the depth of what we were going to get here today. I go in with a open mind and just [00:29:00] say, Hey, what are we going to have? And doctor, I have to say, this is a very encouraging podcast I just heard from you. I think it’s been great. So thanks for your information. So good.
[00:29:10] Xiaoming Dong: You’re welcome. I think for today’s take home message, besides many things we already know, how to live in a healthy lifestyle and how to recognize the family history, the most important thing and the take home message is to get an early diagnosis.
[00:29:26] Xiaoming Dong: We have so many great tools now, as I mentioned. We can do the genetic testing, which most insurance cover. And we can do the neuropsych testing. And we have a great neuropsychology tools and identify very subtle sign of early memory loss. And we can check the Alzheimer’s markers. which is another huge breakthrough.
[00:29:49] Xiaoming Dong: Now we still have to do the spinal tap, but in the future, the blood test or the PET scan are available. The diagnosis will be much easier. And the last one is [00:30:00] we do have a specific targeted treatment. To, as my patient put it, go to the source, the treatment will go get, the amyloid, the plaque, and that’s very encouraging.
[00:30:13] Xiaoming Dong: That’s made me think in the future, we may able to prevent this happening. So that’s the future. There are many other breakthrough and the new treatment available, and we can update the next year. I have a patient drove four hours to come here after we had a discussion and they said oh my god doctor we get more than we asked for.
[00:30:34] Xiaoming Dong: This is so exciting.
[00:30:36] Pete Waggoner: That’s awesome and that’s the whole point of what we’re doing here on this podcast is everybody can get more than they ask for if they just ask. You’re carrying a doctor as is your whole team. And that’s what makes Minneapolis Clinic of Neurology special. And the fact that you take the time out to educate the masses this way through this podcast is really, really huge.
[00:30:57] Pete Waggoner: Dr. Dong, thank you for joining us here today. We really [00:31:00] appreciate your time.
[00:31:00] Xiaoming Dong: Thank you.
[00:31:01] Pete Waggoner: Thank you. This was the, one of our more exciting podcasts. The information was so deep. It was great. Thank you for joining us for this episode of Neurology Now, and we hope you found it informative, engaging. If you’ve enjoyed this episode, please subscribe to our podcast to stay up to date and help us educate our community and beyond.
[00:31:19] Pete Waggoner: We welcome your feedback, comments, and suggestions for future topics. So please feel free to reach out to us through our website or social media channels. That’s going to do it here, Dr. Dong. Have yourself a great weekend, and we really appreciate your time today.
[00:31:34] Xiaoming Dong: My pleasure.
[00:31:35] Pete Waggoner: I’m Pete Waggoner. So long, everybody.