Part 1 of the Alzheimer's Journey – The New Perspective

– – Welcome to the Alzheimer’s Journey I’m William A. Van Horn, MD a medical doctor who specializes in Alzheimer’s disease The Alzheimer’s Association estimates that 5.2 million Americans currently are disabled by Alzheimer’s disease Another 15 million Americans take care of people who are disabled by Alzheimer’s disease And another five to 10 million Americans have the memory loss associated with Alzheimer’s disease That’s 25 to 30 million Americans right now directly impacted by Alzheimer’s disease Another study estimates that by the year 2050, one billion people worldwide will have Alzheimer’s disease One billion people, imagine that Now what does that mean for you? For me? For your family? For my family? What it means is we are in a war with Alzheimer’s disease A war that most people don’t know anything about A war that many doctors don’t know how to treat And a war most people don’t realize they’re in it till they’ve significantly lost the war The Alzheimer’s Journey is the battle plan to help you and your family win the war with Alzheimer’s disease Does winning the war mean that if you take everything you learn in Alzheimer’s Journey and apply to your life you won’t get Alzheimer’s disease? No, I can’t guarantee that Winning the war means that if you apply what you learn in Alzheimer’s Journey you will significantly reduce your risk of Alzheimer’s disease Does winning the war mean that if you have lost memory that you can bring your memory back? No, as I tell my patients you can’t bring back brain cells We lose memory because we lose brain cells But what the Alzheimer’s Journey will do for you to help you win the war is help you slow down the progression of the memory loss Does winning the war mean that if you have a family member in the later stages who’s depressed, anxious, agitated, out-of-control that you can get them like they were 10 years before? No, at that stage of the disease winning the war means that with the help of the Alzheimer’s Journey you can restore dignity and relationship to that person This is an area of passion for me I am the medical director of one of the only hospital units in the state of South Carolina that takes demented, agitated, depressed, screaming, yelling, paranoid patients I love the transformation when these very miserable people come in, but 10 days, 14 days later they walk out smiling, holding the hand of the person they were hitting two weeks before That these people often don’t get the care they need and at the end of life I emphasize to families that Alzheimer’s disease is not a disease of the heart or the soul Alzheimer’s disease is a disease of the cortex of the brain, the part we think with The person you love is still there experiencing you two, three, four, five years after they’ve forgotten your name And you can maintain, with proper medication, a deep loving valuing relationship with that person long after they’ve stopped thinking So in your war with Alzheimer’s disease what will the Alzheimer’s Journey do for you? Alzheimer’s Journey will arm you with the information, the understanding, and the treatment protocols to first significantly reduce your risk of Alzheimer’s disease Secondly, if you’ve lost some memory, to substantially slow down that memory loss And finally, if you have a loved one with later stage Alzheimer’s disease, Alzheimer’s Journey will enable you to restore dignity and relationship to the person you love It’s important to understand that the Alzheimer’s Journey is not an esoteric, philosophical discussion about Alzheimer’s disease It’s not about hoping for future research It’s about what you can do now The Alzheimer’s Journey is a practical, directive battle plan to help you and your family win the war with Alzheimer’s disease I am not a researcher, I’m a clinician I treat people and families The Alzheimer’s Journey is the information and data in my mind transferred to your home I’m excited about the Alzheimer’s Journey, because I know it will help you and millions of other families Today you’re gonna learn the new perspective about Alzheimer’s disease The perspective is practical, understandable and will empower you to win the war with Alzheimer’s disease It is a perspective that most people have no idea about It is a perspective that most doctors have no idea about And it’s a perspective that I personally, as a physician, had no idea about 15 years ago before I became an Alzheimer’s specialist I was treating patients and I had some Alzheimer’s patients, not the hundreds like I have now,

but I really didn’t know what I was treating The problem is, is that most people and most doctors perceive Alzheimer’s disease as a disease that attacks old people As if we’re just powerless victims hoping not to get Alzheimer’s disease I was in a meeting with a neurologist and he was presenting information on an Alzheimer’s drug My wife and I went there, we went to dinner And we’re sitting there and a family doctor asked this neurologist, who was an Alzheimer’s expert, “Is there anything that you can do “To keep from getting Alzheimer’s disease?” The neurologist laughed and said, “Just don’t get your head hit.” I whispered to my wife, are you kidding me? Here’s an expert on Alzheimer’s disease and all he says is, “Don’t get your head hit.” In the Alzheimer’s Journey you’re gonna learn over 50 things you can do to impact your risk of Alzheimer’s disease And all he said was, “Don’t get your head hit.” That’s the old perspective I gave a talk in Charleston at an Alzheimer’s Association meeting, and there were about 100 people there I gave a 45-minute discussion about the new perspective And it’s about 10% of what is in the Alzheimer’s Journey series A lady came up to me after the talk and she said, “Dr. Van Horn I loved your talk.” She said, “I’ve been coming here for 25 years “I’m the head of the Alzheimer’s Association Chapter “in Charleston and I’ve never heard 80% of what you said.” She’d been following this for 25 years and she hadn’t heard 80% of the 10% that I have in Alzheimer’s Journey In another case one of my inspirations for the Alzheimer’s Journey was a man named John up in New York My wife and I were up in Saratoga Springs at the Saratoga National Race Park That’s where they run the Travers race, which is the fourth biggest race after the Triple Crown, horse racing And at the end of the racing my wife and I sat down to have a glass of wine and a man walks up, introduces himself, his name was John, his wife was Susie And he just starts talking to me and he says, “What do you do?” I said I’m an Alzheimer’s doctor And he said, “You are?” He said, “Wow, my mom has Alzheimer’s “and my sister has Alzheimer’s.” And I said to him, how old are you John? He said, “65.” I said what are you doing to decrease your risk of Alzheimer’s disease? He looked at me astonished, “What do you mean what am I doing? “Of course there’s nothing you can do, right?” Now the kicker to the story, the amazing thing is John flew in from his vineyard in California that he owned on his private jet with his private pilot to watch his million-dollar horse run What does that mean? John had unlimited resources and he had no idea whatsoever that he was going to get Alzheimer’s and he was doing nothing about it That is the old perspective All these people have the same thing in common They perceived Alzheimer’s disease as a disease that attacks old people and that they were powerless victims and could do nothing about it That is simply not true The new perspective is the Alzheimer’s disease is not a disease that attacks old people and there’s a lot you can do about it and you are certainly not powerless and you don’t have to be a victim To understand the new perspective, you have to understand the aging body The simplest way to understand the aging body is to look in the mirror and look at your skin We all know that our skin ages Why does it age? It ages because of cellular changes, cellular loss One of my wife’s friends tells my wife that she has porcelain skin Well one of the reasons she has porcelain skin was she grew up in upstate New York where the sun doesn’t come out very much She didn’t get a lot of sun exposure, so at 42 her skin still looks really good On the other hand, I go to this piano bar where the average age is probably about 60 and I’ll see some women walk in who are from South Carolina who look, if you look at them, their body could look 35 or 40 Everything about them looks young, they turn around and look at their face and the skin damage is so apparent, they look 70 So everyone knows that their skin ages What most people don’t realize is as your skin is aging also are your internal organs aging Your liver’s aging Your heart’s aging Your lungs are aging And your brain is aging There’s a reservoir of cells that each of our organs can lose before we start losing functioning So the liver can lose whatever, 40% or so, before you have liver failure You can lose part of your kidneys before you get kidney failure Obviously, you can smoke long time and lose a lot of your lung before you actually have lung failure Well the same thing’s true about the brain There’s a reservoir of brain cells that you can lose before you actually lose thinking ability and that’s estimated to be as much as 20 to 30% of your brain So therefore, the brain is aging just like the rest of the body is aging because of cellular loss and cellular change

Now if you think about your physical organs being in a race, a race to see which one can live the longest, if you go back to 1900 there was hardly any Alzheimer’s disease Do you know why? The brain was winning the race People were maintaining their reservoir, they were losing cells as they age, but they were maintaining their reservoir to the point that they never lost thinking ability, why? Because people died at an average age of 50 in 1900 Now people live to an average age of 80 and they are losing their reservoir, because we lose our reservoir over decades So people are dying at an average age of 80 or so now and what’s happening is now the heart and lungs and the kidneys are winning the race and the brain is losing the race The brain is dying faster than the rest of the organs We have a much better understanding of how to keep the heart alive and the lungs alive then we do the brain alive If you keep your brain energized, healthy, and alive longer than your heart and your lungs you’ll never get Alzheimer’s disease The goal of the Alzheimer’s Journey is to help your brain win the race, so that your brain outlives your heart and your lungs So what exactly is this new perspective? The new perspective is that Alzheimer’s disease is not a disease that attacks old people Alzheimer’s disease is the end product of your brain aging and dying over decades and most importantly, you can intervene in that aging death process Let me say it again, your brain ages and dies over decades, from time in your 20s somewhere in there to whatever 70, over 50 to 60 years And there are many factors that promote the health and the lifespan of the brain There are many factors that accelerate the death of the brain What we are calling Alzheimer’s disease is simply the loss of thinking and functioning because of brain death The Alzheimer’s Journey gives you the battle plan to maximize the life factors and minimize the death factors You are not powerless, and you don’t have to be a victim Now if you know much about Alzheimer’s disease if you’ve studied anything about it you might ask about: What about the pathology in the brain? That means what’s wrong in the brain when they do an autopsy after someone has died from Alzheimer’s disease If you go in the brain you will see some pathology, one being amyloid plaques another being neurofibrillary tangles The amyloid plaques are the hallmark of disease This is what they’ve been calling the disease for 100 years, where they’ve been doing research, millions and millions of dollars of research to try to get rid of the amyloid plaques Because what happens is there is a cascade of events that happens that as your brain dies and the cells die there’s some inflammation, there’s neurofibrillary tangles and there’s amyloid plaques So they’ve been trying to find a drug to get rid of the amyloid plaques Well guess what? All amyloid plaques are is dead brain They’re the garbage left over after the cell has died Now what evidence supports this? They actually came up with an antibody, would go into the brain and attack the amyloid plaque and wipe it out They gave it to a group of Alzheimer’s patients who had significant cognitive loss, their thinking ability was way down, it worked It wiped out the amyloid plaques But guess what happened after they came out of the treatment? Their thinking ability was no better Their cognitive loss was just as great All that happened was the amyloid was gone, the brain shrunk, because amyloid plaques are not the disease Recently a neurologist has been talking about the concept that amyloid beta protein, which form together to make the amyloid plaques, that amyloid beta protein is the toxic substance in Alzheimer’s disease And he’s arguing that amyloid plaques are actually neuroprotective Now if you caught what I just said, after 50 years they’re calling the amyloid plaques neuroprotective, saying the amyloid beta protein, ’cause the amyloid plaques form to get rid of the amyloid beta proteins I don’t agree with him either I think, as I said, there’s a cascade of events that take place Inflammation, neurofibrillary tangles, amyloid beta proteins, amyloid plaques That’s what’s happening when your brain cell is dying That is not what’s causing your brain cell to die There are a multitude of factors that you’re going to learn about that cause your brain cell to die Our current approach to treatment of Alzheimer’s disease is like you taking your car, drive it over cliff and in the middle of the air you try to keep it from crashing and dying What we will teach you with the Alzheimer’s Journey is to keep your car from going over the cliff In other words, if you keep your brain cell healthy, you keep your brain healthy it doesn’t

enter into the death process Does that mean if you apply what you learn in the Alzheimer’s Journey your brain won’t die? No, your brain’s can die anyway Your brain is dying if you’re over 30 years old The question is how fast it dies Remember the race If your brain stays alive, healthy and energized longer than the rest of your body then you never get Alzheimer’s disease The key to treating Alzheimer’s disease is to keep your reservoir around, keep your brain around, and keep it as healthy as possible To better understand this new perspective come with me to Albuquerque, New Mexico I grew up in Albuquerque, New Mexico, the home of the New Mexico Lobo basketball team The University of New Mexico has this arena that’s underground, so they call it The Pit His seats about 20,000 people and it packs out for every single game It’s the big sport in Albuquerque and in New Mexico And my dad was fortunate enough to get front row seats in this 20,000 seat arena So I spent many nights at the bottom of the floor yelling at the refs, cheering and enjoying the games Well imagine that you and I are in the arena on the floor, but everything’s gone You have the ceiling, you have the floor, and you have the walls, that’s all Now very slowly you see some light bulbs start coming on and then gradually the arena starts filling up with light bulbs That’s your brain at conception slowly developing cells And so over development from the time you’re conceived somewhere into 25 or 30 you develop more and more brain cells and more and more connections between those brain cells So imagine the arena completely full of light bulbs and connections It’s estimated at maximum brain develop, again some are 25, 30in there where you reach your maximum number cells that you have approximately 100 billion brain cells and one trillion connections So just think about that The brain is an electric chemical factory just full of electricity flowing Now I’m gonna use this analogy to help you understand the four stages of the war on Alzheimer’s Stage number one is preparation, the development of your brain As you’re gonna learn, if you don’t develop as many brain cells, you have less to lose If you don’t develop as many connections, you have less to lose Stage two, protecting your reservoir Remember that reservoir? The number of cells you can actually lose before you lose memory, before you lose thinking ability Protecting the reservoir is stage two of the war Stage three of the war, battling memory loss Now you’ve lost enough brain cells, it’s actually affecting your thinking That’s an aggressive time to battle the war on Alzheimer’s And stage four, restoring dignity and relationship This is when someone’s lost so much of their brain they’re out-of-control, they can’t relate to you anymore That’s the time you can restore dignity and relationship Let’s talk about stage one of the war with Alzheimer’s disease Preparation, the stage of opportunity Why is it the stage of opportunity? Well think about your brain cell as being a soldier Think about your connections as being weapons Obviously if you’re going to war the more soldiers and weapons you have the more you are likely to win the war Well the same thing is true about Alzheimer’s disease Remember the new perspective is Alzheimer’s disease is a function of your brain aging and cells dying over decades, over 40, 50, 60 years So consequently, the more cells you have when it starts dying at maximum brain development the more you have to lose And there’s a lot of evidence to support this The other thing that’s important to recognize about preparation, stage one of the war with Alzheimer’s, I’m talking about in the womb, childhood development, young adult development I’m talking about fighting the war before you’re 20 Now think about how crazy that concept is compared to what most people think which is that it starts when you’re 80 or when you’re 70 Well the reality is it starts with the development of your brain I have a patient named Sally who her mother was very old when she gave birth to her and before she was born they did a amniocentesis An amniocentesis is a big needle, put in the womb, get out some amniotic fluid and they test it Well when they were doing the test they stabbed Sally’s brain Sally lost a significant number of brain cells So maybe she came out with 60 million or 60 billion instead of 100 billion, I don’t know What I do know is that she has a lot less to lose She’s already getting some of the memory loss of a 70-year-old person and she’s 31 years old I have another patient who’s 35 He has cerebral palsy and his brain was damaged during the birth process Now he’s 35 and according to his mother over the last four years he’s showed the exact memory loss of an Alzheimer’s patient who’s 70 So we’re gonna be treating him for Alzheimer’s disease

There’s a nun study, where they looked at nuns and they looked at their language skills in their 20s And the nuns with good language skills, approximately 11% of them end up with Alzheimer’s disease at 65 The nuns with bad language skills, approximately 80 something percent of them ended up with Alzheimer’s disease at 85 Why? The nuns who did not develop the language skills did not develop as much brain mass They didn’t have as many soldiers or weapons to start the war, consequently they lost the war earlier They couldn’t protect their reservoir, because their reservoir wasn’t as big There’s also a lot of evidence that people who get more education and maintain a lot of mental activity keep their brain alive longer and at the very least if they don’t get less Alzheimer’s, which appears they may, they certainly get the disease later on Again why? Well let’s say you’re losing 10 billion cells every 10 years Well obviously, if you have 120 billion, takes longer to lose your reservoir If you have 80 billion, you lose your reservoir sooner So stage one is preparation Go tell a family member that the war on Alzheimer’s disease starts in childhood Nobody will believe you Let’s move on to stage two of the war, protecting your reservoir Protecting your reservoir is the most important stage in the war on Alzheimer’s and it’s also the longest Remember you have a reservoir of cells that you can lose before you start losing memory and that’s estimated to be 20 or 30% of your brain Again, 100 billion cells, a trillion connections at the time of maximum brain development That means you can lose like 20 billion cells and 200 billion connections, maybe even 30 billion and 300 billion before you start losing thinking ability Now again, it starts in young adulthood Let’s go back to The Pit Now look at the arena now As you see it’s still really, really bright However, you’ll notice maybe 5% of the cells are gone Maybe 5% of the connections are gone That’s the brain of a 35-year-old Now let’s go back again About 10% of the cells are gone, about 10% of the connections are gone Now you’re looking at the brain of about a 50-year-old Now think about that, so from early adulthood to 50 possibly as much as 10 billion brain cells are gone and 100 billion connections Now look at this brain Now you can see there’s about 20% missing, maybe 20% connections 20% cells Again, this is about a 65-year-old Now the three of these people have in common: The 35-year-old, the 50 and the 65 is that they have not lost thinking But as you can see with the 65-year-old quite a bit of the brain is gone Now look at this brain, about 30% is gone Now this is a 75-year-old with Alzheimer’s disease, early to middle Alzheimer’s disease The importance of this is that if you look chronologically he did not get attacked when he hit 75 His brain started dying way back here Protecting your reservoir is those four to six decades of your brain dying and there’s a lot that you can do about it The amazing thing, just imagine if I went out and asked a 100 30-year-olds, what are you doing to protect against Alzheimer’s disease? They’d laugh at me What if I asked a 100 45-year-olds, what are you doing to protect against Alzheimer’s disease? They’d probably laugh too If I ask a 100 55-year-olds, well they would say, probably be thinking a little bit about it, but obviously not be doing anything about it They’d probably say, well I’ve been worried, but is there something I can do? I actually went to dinner with my wife here in Myrtle Beach We’re sitting here at the bar, guy comes up with his wife he sits down He’s 55 years old, he has eight siblings All eight of them had Alzheimer’s disease Now his risk? He’s getting Alzheimer’s disease What was he doing to protect his reservoir? Zero 55 years old doing nothing That’s how lacking the information and the understanding is when it comes to protecting your reservoir If you remember nothing else about protecting your reservoir remember this: A brain cell that dies in your 30s is just as critical as a brain cell that dies in your 70s A brain cell that dies in your 40s, your 50s, your 60s are just as critical to your ultimate possibility of having Alzheimer’s as a brain cell that dies in your 70s Again, this is the new perspective It’s not like you hit 70 and something enters your brain and start killing it It’s been dying for 50 years

If you don’t believe that, go on Google and Google a name by the name of Ben Utecht Ben Utecht played for the Indianapolis Colts when they won the world championship He now has Alzheimer’s disease at 35 years old His many years of football killed so many cells that he has the same brain as the 75-year-old with 30% missing of bulbs and 30% of connections Now let’s move on to stage three, battling memory loss Now understand, if you win the war in stage two, if you protect your reservoir, if you keep at least 90% of your brain around, say 85, 80, you never lose memory You never lose thinking You only get into stage three, battling memory loss after you’ve lost your reservoir Now how do you know if you’ve lost your reservoir? Well there’s a simple test that you’re gonna learn in the Alzheimer’s Journey that will identify 90% sensitive and 90% specific for early Alzheimer’s disease That’s when I start medications And at that point the medications make a big difference Why do they make a big difference? They make a big difference because what the medications do is protect living cells The problem with the old perspective is we spent 50 years trying to bring back dead brain, can’t do it Maybe one day we’ll talk about stem cell research Or maybe one day they will have stem cells they put in and bring back brain But let me tell you right now, we have medications that help the brain stay around longer They already exist And most people in stage three, most people are not on those medications I could walk into any, say a club with ages 50 to 65 and screen for Alzheimer’s, I’d probably find 10 to 20% to have early memory loss that should be on medication I refer to this stage as the stage of neglect, denial, and ignorance Neglect by the medical community to screen for early memory loss Denial by families and individuals who don’t wanna admit they’re losing their memory Now it makes sense why you wouldn’t want to admit it Why do you want to admit you have something that’s going to take your life away? Because when people think of memory loss they think of Alzheimer’s and they think there’s nothing you can do Well the new perspective is you want to know you’re losing your memory as soon as you start losing it, in fact I think one day, maybe 10 or 20 years from now we’re going to start memory medicines It’s the same medicines I use right now on the 75-year-old, we’re gonna start on 40-year-olds with high risk factors Because they’re losing their brain cells faster That’s not the standard now Even in fact what I do, the standard I use, which is having a positive test showing early Alzheimer’s, I aggressively attack the memory loss And most of my patients are on at least four medications to help protect their memory And in the Alzheimer’s Journey I’m going to give you the exact treatment protocols that I use so you can go to your doctor and request proper treatment And in battling the memory loss, if you do battle the memory loss at the early stages, I have hundreds of patients, hundreds, who came to me early in their memory loss I’ve been at Myrtle Beach for four years and their memories are just about as good as they were four years ago, and they’re not supposed to be Now contrast that with a patient I have by the name of Paul Paul came to my office and my office manager said to me, he’s upset about being here When I looked at his chart I saw that he was 64 years old So I’m thinking he doesn’t want to admit he has early memory loss I walk in the room and within 10 seconds I knew he had substantial memory loss He didn’t know what state he was in I asked his wife, when did you first notice is memory loss? She said five years ago She said he had cardiac surgery, came out of the surgery with some memory loss We talked to the cardiologist and he said, just forget about it don’t worry about it, it happens sometimes Now if I had seen Paul five years before he’d still know what state it is, odds are very, very high He had five years of brain cell loss without treatment after he’d already lost his reservoir And the very sad part of this story is his son is a doctor As I’ve said throughout this entire introduction in the new perspective, it’s not only laypeople, the public, that doesn’t understand the new perspective, it’s also physicians I have a lot of physicians when they see what I have my patients on, why do you have them on so much medicine? I have them on the medicine because this is the opportunity to keep them from getting disabled by a very severe disease of Alzheimer’s because of progression of the memory loss So I’m convinced and I see it every day, I see it every day that patient’s memory loss slows down significantly with proper treatment Now let’s move on to stage four, restoring dignity and relationship Now understand you won’t get to stage four if you protect your reservoir and you battle memory loss However, if you do get to stage four it’s important to understand, or if you have a family member at stage four, it’s important to understand that there are treatments This is an area in our country that is really, really lacking As I said earlier, I’m the medical director of one of the only units in the entire state of South Carolina Think about that, people have to come from 300 miles to our unit when they have severe dementia, the stage where you’re losing the front of your brain The person’s screaming, they’re yelling, they’re agitated, they’re paranoid So a lot of parts of the country there’s nowhere to go I was in upstate New York in an area and there were a million people with one 11-bed unit

for this group of patients And the number of people with severe Alzheimer’s is rapidly growing, rapidly growing The other thing that exists in stage four is the lack of knowledge that there actually is treatment The lack of understanding by physicians that there are things you can do Probably a third of our admissions to our hospital is because a physician put a patient on something they shouldn’t have been on that made them worse So when we get into Alzheimer’s Journey I’m gonna get specific about the treatment protocols and I’m gonna get specific about things the patient should not be on that actually makes their agitation worse But as I said earlier, with proper treatment probably in 90% of the time at least the vast majority of the patients come to me who are out of control, and again they may have lost all of their memory, but as I said earlier with proper medication you can restore dignity to their life and you can restore relationship to where they can actually maintain a deep loving relationship with you for many years Because stage four can actually go for some people five to 10 years I’ve walked into nursing homes, many different nursing homes, at 10 o’clock in the morning and half the patients are asleep What does that tell me? That tells me that they’re being improperly medicated A person doesn’t have to spend the last two to five years, five to 10 years of their Alzheimer’s disease sleeping most of the time They can be alert, awake, smiling, interactive, and calm And again, even though they’ve lost their memory they’re still there I’ll finish stage four with a real quick story Her name’s Millie Millie came to me, it was actually her daughter who goes to the country club with me referred her to me She came in the hospital because she was screaming, yelling, and hitting the staff at the assisted living She was 84 years old and she was beating up people in the hospital Now Millie 10 years before was the sweetest grandma you’d ever meet This is part of the disease I tell my staff all the time They see these agitated patients who are out-of-control and they start blaming them I say, listen that’s the disease, that’s not the person, that wasn’t Millie That was Millie without the front of her brain So anyway, I started putting her on medication and there are certain rules I follow which I’ll talk about And to make a long story short, I used to walk into the day room and Millie would be sitting there and she’d go, Dr. Van Horn, Dr. Van Horn, Dr. Van Horn, Dr. Van Horn, Dr. Van horn, I mean literally said hundred times in the 15 minutes I was there when she first got there It was nonstop, nonstop And then when I leave the room she’d say to the nurse, I need this, I need this, I need this Basically, for some people with later stage Alzheimer’s they have what’s called a catastrophic reaction which they have very difficult time emotionally and psychologically transitioning from functional to the complete loss of awareness and functionality and those people are anxious all the time It’s so sad to see And she basically had no life if we could not get her brain right And she was there about two weeks and we’d gone in agitation from 100% of her waking day to about 20%, but she still had about 20% of her day where she was in this intense distressed state Just, Dr. Van Horn, Dr. Van Horn, Dr. Van Horn I sat down with the daughter I said, listen I’m gonna have to put her on higher doses of medications because these are working And there are some risks with higher doses, not a lot of risk, and we follow it very closely, start low and go slow, try to find out and make sure there’s no side effects, but I asked her daughter if I had her permission I had to add an antipsychotic medication And antipsychotics have an increased risk of stroke and heart attack with dementia patients But her daughter made the decision that small risk was not as great as the potential benefit Well at the end of three weeks, and it took three weeks, usually it takes 10 to 14 days, Millie left the hospital smiling, laughing, interacting with her daughter and she was on the highest dosages of medicine that I ever put an 84-year-old on But she was doing great And as I tell my families and our staff, if Millie walks out of here like this 20% miserable that’s the best she’ll ever be So my commitment when someone comes to my hospital is I don’t give up until I’m absolutely convinced that they can’t be fixed And in the vast majority of times they can So what have you learned today? You’ve learned that Alzheimer’s disease is not a disease that attacks old people You’ve learned that Alzheimer’s disease is actually the end product of your brain aging and dying over decades You’ve learned you’re not powerless You’re not a victim and there’s a lot that you can do to intervene with the aging dying process I wanna emphasize again, because this is really important, that the Alzheimer’s Journey is not an esoteric, philosophical discussion about a disease ‘Cause I’ve reviewed a lot of different programs before I did this and most of them talk about the misery of the disease I’m talking about the solution to the misery

As I said earlier, I treat people and families I want my patients, I don’t care what stage of Alzheimer’s they’re in, I want them to have the best care and I want them to have the best life I hope that the Alzheimer’s Journey inspires millions and millions of people and physicians to understand not only the end of the disease where the person’s still there, but the beginning of the disease, the development of the brain, the protecting the reservoir, the battling the memory loss Do you realize how this new perspective can impact the disease, the money that can be saved, the lives that can be improved? If you win the war before stage four you don’t end up in a nursing home I also want you to remember very clearly that this is not about research This is about things I’m doing right now with my patients The Alzheimer’s Journey again, is the information and data in my mind and understand that’s a lot of information I see hundreds and hundreds and hundreds of Alzheimer’s patients every week and every year over and over, so it’s the information and data in my mind transferred to your home so you can use it to benefit yourself and your family.Now I wanna talk about what you can expect for day two The misunderstood organ, the brain I started giving this talk about 25 years ago and some of the details have changed a little bit, but it’s still very similar And the reason I did that was because it was very clear to me back then that most people really don’t understand what their brain does, how it functions, and the significance of it And they certainly really don’t understand brain illness And that was true 25 years ago, that is still true now for the majority of people But day number two will give you a very clear understanding of what it means to have a brain I’m gonna talk about four brain basics: That is your brain is a living physical organ, your brain is like a tub, your brain is like a window, and your brain is like a computer And I’m gonna talk about the seven primary areas of the brain malfunction, so you can actually see if maybe you need to see a doctor and get your brain fixed At the end of day two you will have a better understanding of the brain than 95% of the people have right now.Day number three is understanding the war If I went out right now and asked 100 people, what is the difference between Alzheimer’s disease and dementia? Maybe one would know, but probably not Now think about this, this is a disease that is now affecting millions of people, it is headed for a billion people and most people don’t even know the answer to that basic question So understanding the war is critical to winning the war, I will answer six questions on day three What is dementia? What is Alzheimer’s disease? What is the difference between dementia and Alzheimer’s disease? What are the risk factors? What is the prevalence? And what are the five most common types of dementia? At the end of day three you will have the understanding necessary to go into battle against Alzheimer’s disease.Day number four is an exciting day, protecting your reservoir Remember, this is the most important and the longest stage of the war with Alzheimer’s disease This is 40 to 60 years of making a significant impact on whether you ever lose your memory On day number four, protecting your reservoir, I’m gonna give you detailed information about what you can do that will definitely decrease your risk of Alzheimer’s disease We’re gonna talk about FEP; food, exercise and protection If you take 50% of what I give you on day number four and apply it to your life, your brain will live a lot longer and be a lot healthier.Day number five, conquering brain killing illness You may not realize, but there’s many illnesses of both the body and the brain that accelerate

brain cell death And again, when you talk about your brain dying over 40 to 60 years, many people have these illnesses for 40 to 60 years And when they’re properly treated it’s much healthier for your brain But if you don’t get treatment or you get improper treatment, then your brain dies a lot faster than it should I’m gonna talk about cardiovascular illness I’m gonna talk about diabetes Those are clearly associated with an increased risk of Alzheimer’s disease I’m also gonna talk about certain brain illnesses that cause the brain to die faster than it should One illness I’m gonna talk about is fibromyalgia I’m not only gonna talk about the illness, I’m gonna talk about the treatment for fibromyalgia And most people with fibromyalgia do not realize that their brain is shrinking much faster than it should It’s dying much faster than it should and it appears to be directly related to the fibromyalgia and the lack of proper treatment So the end of day five you will not only know what illnesses are killing your brain, you will understand how to go to your physician and ask for the same treatment protocols that I use that are effective for most of my patients.Say number six, battling memory loss Millions of people in the United States right now have the early memory loss of Alzheimer’s disease and are not getting treated Most of them are either denying they have the memory loss or don’t know it’s really Alzheimer’s disease And the vast majority of even the ones that do know are not getting treatment And some of who are getting treatment are getting inadequate treatment My patients who have early memory loss are on at least four medications and multiple supplements And I’m convinced, I’m convinced, that these medications and these supplements make a huge difference in the progression of their memory loss On day number six I’m gonna give you the exact treatment protocols I use so you can go to your doctor and say, this is what I wanna be on to slow down the progression of my memory loss.Day number seven, restoring dignity and relationship On day number seven you’re gonna join me to hear about one of the areas in my work that I’m the most passionate about, taking care of Alzheimer’s patients in the later stage of their disease Right now I have about 20 patients in the hospital who came in screaming, yelling, agitated, paranoid They couldn’t function at home They couldn’t function at a nursing home They couldn’t function at assisted living I went into the hospital last year 355 days to take care of these patients Why? Because I’m the only doctor in this area that does that . So if I miss every weekend, I miss half the days to treat them And I actually like going in I like taking the hands of my Alzheimer’s patients, rubbing their shoulder and saying: How are you doing today? And understand, half of them don’t understand what I’m saying, but all of them experience what I’m sharing with them and I love to see them leave at the end of their stay with restored dignity and being able to have a relationship with their family I will give you on day seven the seven steps that I go through with each patient to achieve the goal of restoring dignity and relationship.Day eight, family guide I work with hundreds of families who are dealing with a patient with Alzheimer’s disease I sincerely have a lot of respect and care for each of those families For many of them it’s a really hard journey and my job is to make it the best journey they can possibly have Not only by treating the patient, by advising the family And there’s a standard group of questions that I get asked on a regular basis and I’m gonna talk about those; such as driving When should a person be at home alone? When should a person be in assisted living? What about legal matters? But I’m going to go down the list and I’m also going to touch on making sure the family member, that you, the caretaker, takes care of yourself too The family guide is just my view of how you as a family member should handle the Alzheimer’s Journey that can go on for many, many years