Memories and Milestones: Celebrating Six Years of ‘Dementia Matters’

Transcript

Intro: I’m Dr. Nathaniel Chin, and you’re listening to Dementia Matters, a podcast about Alzheimer's disease. Dementia Matters is a production of the Wisconsin Alzheimer's Disease Research Center. Our goal is to educate listeners on the latest news in Alzheimer's disease research and caregiver strategies. Thanks for joining us.

Amy Lambright Murphy: Hello, and welcome back to Dementia Matters. You might be wondering who this is behind the mic today. This is clearly not the voice our listeners are used to hearing. As we celebrate our sixth year in production and the publication of our 172nd episode, we decided to do something different for today's podcast installment. I'm Amy Lambright Murphy, a communication specialist for the Wisconsin Alzheimer's Disease Research Center (ADRC) and a producer of this podcast.

Caoilfhinn Rauwerdink: I'm Caoilfhinn Rauwerdink, also a communication specialist for the Wisconsin ADRC and a producer of Dementia Matters. Today, we are turning the tables on our host Dr. Nathaniel Chin, or Nate as we call him. Amy and I will alternate asking him questions, and give our listeners a glimpse into the person behind the podcast. Nate was born and raised in Watertown, Wisconsin, a small town between Milwaukee and Madison. He's a geriatrician, memory clinic doctor, and the medical director for the Wisconsin Alzheimer's Disease Research Center and WRAP study. His father's diagnosis of Alzheimer's disease inspired him to pursue a career as a geriatrician and scientist focused on dementia prevention, especially in regard to Alzheimer's disease. Nate, welcome to Dementia Matters.

Chin: Thank you both for having me, and I will say I, too, am nervous about being on this end of the microphones. You guys are not alone. I also want to say really I am so thankful for the two of you, and for the people who have been in your position prior to you joining. This podcast is not the podcast without your involvement. Thank you for getting us to the 172nd episode, and I very much appreciate the work that you all do to create these episodes.

Lambright Murphy: Thanks, Nate.

Rauwerdink: Aw, thanks Nate. To start, can you tell our listeners why you decided to create a podcast? What inspired you?

Chin: Well, the truth of it is I don't know that it was really my idea. It was in the middle of my fellowship, and this was a second fellowship in dementia care specifically, or it was right when I became a faculty member. Hanna Blazel, who was our center administrator, and our communication specialist at the time, Rebecca Wasieleski , met with me in their office to say, “Nate, you've been doing a lot of community talks,” and I certainly was doing tons. About two or three a month, and I loved it. I loved being in the community. They said, “Well with that, we need to have a way of connecting with our research participants. We need to be able to share with them the work that we're doing. We need to talk to the community possibly because we would love to get some more people involved in research, and perhaps a podcast is one of the ways that we can do this.” I remember thinking, “What exactly is a podcast again? Is this like the radio but without commercials?” I wasn't really listening to podcasts. I did a lot of books on tape, and so it wasn't something I was super familiar with. Granted this was six years ago, so I don't think podcasting was as big then. I did some research on it. I really enjoyed podcast episodes. I thought it made a lot of sense. We could keep it really short, and so I was fully in it. I remember meeting in this dark office within our program, and kind of hashing out the name, hashing out our mission. It really did come down to how we wanted to connect with participants. We wanted them to know what our research was about. We wanted to connect with the public, so that they knew what our program was doing and hopefully maybe they'd be interested in participating. We also wanted to put a voice to our scientists. We have such great scientists, and it isn't inherent in their training and or research to communicate with the public. We really wanted to force that in some ways. We really wanted to get them out there. For me, I think what ultimately pushed me to do it is that I was so tired of the myths and the misinformation that was out there. If science doesn't communicate that space exists, and other individuals and other agencies can come in and do what they want with it. It leads to people's suffering. It leads to a lot of poor decision making, just lack of the right information. I wanted to get in that space, and fight the good fight as I like to think of it. Share what research is really about, who it impacts and the things that institutions – great institutions like ours, but others across the country – what they're doing and how we are actually trying to help people.

Lambright Murphy: Thank you for that, Nate. I'm glad you decided to forge ahead with the podcast. Now we know the podcast has dedicated listeners from all over the world, and some might say, “Don't change a thing.” That being said, is there anything you would change about the podcast?

Chin: Well, I'm a perfectionist yet I believe perfection is impossible to achieve. So yes, there's actually a lot of things I would like to change, and that has no reflection of the two of you just so you know. I would love to have multiple stories within a single episode. We do such a great job of interviewing scientists and health care providers and care partners, and I love doing that. I think that it's actually our forte, but when I listen to other professionally-done podcasts I like the story arc that they have within an episode. Sometimes you have two people in the beginning, and then you go to a different segment then you bring them back to the two people in the beginning. I like the idea of doing that. Having music in between these things to kind of jazz things up, but that takes a lot of bandwidth and a lot of human energy and finances and we just don't have that currently. I wish we had common segments that we could just repeat. For instance, write-in letters to us or emails, and I could get on the mic and answer those or have other scientists within our program answer those. I would like to engage more with our listeners. I do think all – I say this to you because I do believe we're heading in that direction, that we're going to be doing bigger and better things. I'm certainly proud of what we've done now, but we're not perfect. I think if we are given the support we need, I certainly think we can do more and make the show as engaging as possible, though I do feel like we're doing a wonderful job now.

Rauwerdink: Nice, yeah. There's definitely a lot of ways for the podcast to grow just overall, so I think those are going to be great ways that we can improve in the future. To move on a little bit, your 40th birthday is coming up pretty soon. In fact, it's the day that this episode is being released, so November 14th. [Happy Birthday Sound Effect] There's a saying that life begins at 40. With your experience in the field up until now, what do you think is the best brain health practice or the best brain health advice you'd like to share with listeners? Is there a brain health tip you wish you'd started following sooner?

Chin: Well thanks for outing me, Caoilfhinn. Yep, I'm turning 40. It's not something I'm super excited about. Like you said, I think of 40 as the new 20, or at least I hope so in that 50 will be the prime and maybe 60 would be the prime too. I don't have a single answer for you. I'm going to do what my guests have done to me, which is provide a little bit more than just one short answer. I do believe the top three things that matter when it comes to brain health are going to be sleep, exercise and food. I think sleep – as many people have heard me say – is a keystone habit, meaning if we sleep well it allows for us to do the other things that are important. So sleep allows for me to then exercise. I think exercise has the best evidence for brain health, but it also has so many other impacts on our body like lower blood pressure, weight management, improvements in mood, the natural endorphins. I think exercise is really important. I think we should do it on a daily basis, and sleep allows me to do that. I also just feel better when I have my proper restorative sleep. And then food is hard. I do believe food matters. I think food is either medicine or poison, and we just have to choose which one we're going to take in. I struggle with this. I think – like most of us – I think food also means a lot about our culture and our family habits and traditions. Our mood greatly impacts it, certainly our stress does. I do think food matters a great deal. Food science is really hard. For those that conduct it, I tip my hat off to you because I don't think it's an easy thing. I think a lot of people kind of dig in on food science and kind of show the weaknesses, but it's a really hard thing to do. I would say if there's anything else I would add to is that I don't think science – or maybe science is starting to show – is purpose. I think that's something I haven't covered on the podcast yet. I think purpose is what feeds our soul. It's what feeds our well-being. For me, this is one of the things that I think has happened in the past few years and since I've started this job. I love my work. I love the people that I work with, my colleagues. I love my patients and families, and so I feel like I have a lot of purpose. That is not something I think I've always had, and I think it makes a difference in my day-to-day. I think ultimately it's my wife, Erin, and our two boys, Auggie and Bennett, that are truly my purpose. That's really what drives me. Knowing that and recognizing that I think has been really helpful for me. My advice then for listeners – and I think frankly it's the listeners and the people I've interviewed that have given me this advice, certainly my patients have – is to really find the people that you love and don't let go of them, or really to try to find something that you love and do that as often as you can. That would be how I answer your straightforward question with a very roundabout answer, Caoilfhinn. As far as the brain health tip I wish I had been doing sooner, I don't socialize a ton. I mean, I am very social in that I get to communicate with you two and our great team here at the research center, but I don't socialize a lot outside of work. I think that's because of my two little boys, and I wish I meditated more. I think that's an intentional way of reducing stress, and I think all of us have a lot of stress. I wish I was doing more of that on a regular basis.

Lambright Murphy: Well thank you for sharing those thoughtful nuggets with our listeners, Nate. I’m sure people appreciate hearing your perspective. We’ve got another question to ask you. Because you get behind the scenes and you network at many national and international conferences like the Alzheimer's Association International Conference recently held in Amsterdam, I have to ask you – where do you see the field of Alzheimer's disease research in the next five years?

Chin: That's a great question, Amy. I think people think of Alzheimer's disease research as, “Oh, you focus on Alzheimer's disease, try to come up with a treatment and a cure. That's what you do,” and it's such a huge enterprise. There's so many different ways of looking at it, and different and needed aspects to it. That diversity is important, but it also makes things very complex. I'm going to try to break it down into sort of the key categories that I think the field is moving in. The first is biomarkers, and you hear this frequently on this podcast. We need to identify the proteins in the brain, the processes that are occurring in the brain and the body that are leading to thinking change and ultimately to how we define Alzheimer's disease, or Lewy body disease, Parkinson's, vascular disease or frontotemporal disease. That's through blood, through fancy imaging like the PET scans and then spinal fluid. For those listeners that are participants, we are not getting rid of spinal fluid because of the great advancements in blood. We still need these things. We need to understand at different levels and in different ways what’s happening to the body and the brain, so I think biomarkers are going to be foundational. It improves access. It improves our understanding of disease and it helps us study all the populations of people and not just certain ones. I think that speaks to the second one, which is representation. We need to understand thinking change, Alzheimer's disease and related diseases and the impacts of life experience in this field, so we need to have people from all walks of life, improving diversity in our research, in our clinical care, in the data that we collect. The third thing I would say is clinical trials, which I think we hear a lot about in the media because that is really exciting for the general public. We need different therapies, different options of treatments to look at, “How can we modify – hopefully stop – the progression of disease?” But even “How do we prevent it?” Things like the AHEAD study I think are very exciting, and we need more of these trials. We certainly need trials that involve multiple medications or interventions. Ideally also trials that involve older drugs that we already know a lot about that we can repurpose and bring into the Alzheimer's disease space. Drugs aren't everything though, and so I certainly think research is looking at care. How can we provide better models of care? How can we support people? How can we support care partners? Care research I think needs – and will get – more of an emphasis, especially as clinical trials move more and more towards the clinic space. Then lastly, what's called implementation science. So we have science and research, but research – or as I like to say clinical trials – are not clinics. It's a different ballgame. It's a different world, and so we need to be able to apply or implement what we're learning in clinical trials and clinical research into the real world, into clinics, and some might even argue that what I do in a memory clinic isn't enough of the real world, that you need to get into primary care clinics. I certainly think memory programs are the place to start, and having the areas of excellence and specialists is a good place to see how the things that we learn in research actually work in the clinic. We need to understand that more, and I certainly think our program and I'm in a good position to help with that. That's where I see the field moving. It's certainly person-centered, and it's certainly about collecting the best and most thoughtful data and as much data on each individual as we can.

Rauwerdink: Yeah, it certainly sounds like the field is going to change a lot in the future. That'll be a lot of exciting changes to come.

Chin: And we're gonna cover all of it, Caoilfhinn. We're gonna meet with all of these people.

Rauwerdink: Exactly, we're going to cover it all on the podcast. Kind of jumping into some more fun questions in honor of like the six years of the show – you mentioned you're the father of two young boys, and so I imagine you do a lot of like play and role play with them from time to time. In the spirit of that, if you could have one superpower what would it be and why?

Chin: Caoilfhinn, I love this question because I don't share this – and I definitely didn't share this with the two of you – but there's a lot of role playing and there's a lot of discussion about superpowers. My son Auggie, who's four at the time of this recording, he's very much about superpowers. I don't know why because we're not letting him watch a lot of these shows yet, but he likes to talk about superpowers. Therefore that means I like to talk a lot about superpowers, and I think for me I would like to fly. I would like the ability to fly around at super speeds, and just be able to see the world differently and to do things very quickly. I also think that comes from the fact that I grew up in a time where Superman was a main character in all of this. I like the ability of going back in time because you go so fast, or being able to be invincible in that regard. If I had to be a superhero character I’d be Superman. Flying would be this at least the one power that I would choose. More realistically, I would say if I could have one super ability it would be to be able to live in the moment – in the present moment – all of the time. I know that's not really that possible, but this goes back to my wish for more meditation in my life. I think people who can appreciate the now end up feeling better about their life no matter the circumstances. I have learned this in my geriatric practice in meeting people who are 90 to 110 who have been through a lot, have lost a lot and still have this amazing disposition and appreciation for the world. I think when I talk to them one of the things that they're able to do is live in the present moment despite the things that have brought them to that moment, and appreciate that moment. I think that's a true superpower.

Lambright Murphy: On a related note, if you could solve one problem in the world what would that be?

Chin: Yeah, Amy this is a really good question, and a hard one to go from the superpower to then how do I solve a problem. I would say if I could do one thing it would be to eliminate hate. The reason I say that is because I think about the other things that we all have to face in life: stress, fear, and those things still have a purpose. You've heard podcasts about the value of stress and what it can do in the short term. Even fear has a purpose in motivating us for building courage and resilience, but I see no purpose in hate. I would welcome anyone to challenge that, or to provide some information to me about how we benefit from having hate. I don't see it. If I could do anything for the world it would be to eliminate having hate altogether, because I think that things would feel different in our – certainly in our current world – but even going forward and for our future generations, I don't see a place for it. If we all – and I know we all feel it, and so it's not that it's an unnatural thing – if we could get rid of it, I think we would all be better off.

Rauwerdink: That was a very thoughtful answer, Nate. I agree, I think that would just make a lot of people's lives a lot easier and happier. To wrap things up, could you share with our listeners a bit about what you're most proud of. This could be just your work as a geriatrician, could be with the podcast, could be general life stuff. What are you most proud of having accomplished?

Chin: Yeah, I appreciate the question, Caoilfhinn. I will try not to get emotional about it because I think it's a very intimate question. I'm going to reveal how I like to chunk things, because I can never just give one answer, right? There's many different aspects of my life as there is for everybody. I would say, clinically, I'm really proud of the patient care that our team provides. I'm proud to be a geriatrician. I certainly think that my team is the best: my social workers, the neuropsychologists, the medical assistants, the nurses and the schedulers. I just think they're really invested and they do a wonderful job. I think that ultimately leads to people coming into a scary visit and leaving feeling better. I'm really proud of that. I'm very proud of this podcast and the reach that we've had. We have many listeners across the world, and I'm frequently approached where people express gratitude for that. I don't actually take credit for it. I think it's really the two of you, I think our student editors, I think the people who approach us with ideas. I think it's this whole enterprise or organization that is Dementia Matters is really amazing. Then personally I think – and I'm going to speak for the children and spouses of those who have lived with a loved one – I'm proud that my father's disease didn't break me. I think seeing someone with Alzheimer's disease and seeing someone pass with any form of dementia can just be really traumatizing and really difficult. I think it's understandable if someone goes into a dark place because of that, but I also think it shows the incredible strength and resilience of human beings to be able to come out of that. I've met many people who have done more impressive things after their time as a care partner and I'm really proud that I was one of those people too. I think lastly – and I'm more on a heartfelt note – I'm really proud of the two boys that Erin and I are raising. They’re really something, and I say that with a smile because they're driving me crazy and I know they drive Erin crazy too. I think that that's the joy of the whole thing. As much as I would like some solitude in my life, I'm certainly glad that they're here and that we're doing this. I guess I'm proud that I'm still as invested as I thought I was going to be prior to Erin delivering the two of them.

Rauwerdink & Lambright Murphy: Awwww.

Rauwerdink: Well, that's a wonderful answer to wrap up this special episode. Thank you so much for switching things up with us today. We appreciate your time and you sharing a bit more about yourself with listeners of the show. We just appreciate all the work you do as a geriatrician and within the center as well. You do a lot of great collaborative work with everyone and all the different scientists as part of the team here, and so thank you.

Lambright Murphy: Thank you, Nate

Chin: [Laughter] Thank you both.

Outro: Thank you for listening to Dementia Matters. Follow us on Apple Podcasts, Spotify, Google Podcasts or wherever you listen or tell your smart speaker to play the Dementia Matters podcast. Please rate us on your favorite podcast app – it helps other people find our show and lets us know how we are doing. Dementia Matters is brought to you by the Wisconsin Alzheimer's Disease Research Center at the University of Wisconsin--Madison. It receives funding from private, university, state, and national sources, including a grant from the National Institutes on Aging for Alzheimer's Disease Research Centers. This episode of Dementia Matters was produced by Amy Lambright Murphy and Caoilfhinn Rauwerdink and edited by Haoming Meng. Our musical jingle is "Cases to Rest" by Blue Dot Sessions. To learn more about the Wisconsin Alzheimer's Disease Research Center, check out our website at adrc.wisc.edu, and follow us on Facebook and Twitter. If you have any questions or comments, email us at dementiamatters@medicine.wisc.edu. Thanks for listening