How to Reduce the Risk of Dementia and Alzheimer's Disease

Interview with Dr. Vonetta Dotson

(Podcast #028)

Please forgive typos. Transcripts are created by an automated service.



Dr. Regina Koepp  0:00 
How valid is the fear that because my parent gets dementia, I'm going to get it, too?

Dr. Vonetta Dotson  0:07 
it's valid in the sense that it is based on some degree of truth. Because there is a tendency for dementia to run in families. I think that sometimes that fear goes too far. Because if people start to see that, if they start to think that genes equal destiny, then that can lead to a lot of distress that might not be warranted, because having an increased risk for dementia doesn't mean that you're going to get it. And again, I like to focus on empowering people to say, "Okay, if I do have this information, what can I do to minimize my risk?" So rather than saying, "Okay, my life is over, because my parent has dementia, that means I'm going to get it." Instead, see it as "Okay, I have this risk factor potentially. So let's do all the things that I can do to minimize that risk."

Dr. Regina Koepp  0:57 
I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and family. I created the psychology of aging podcast to answer some of the most common questions I get about aging, questions about mental health and wellness, changes in the brain like with dementia, relationships, and sex, caregiving, and even end of life. Like I say in my therapy group, no topic is off topic. We just have to have a healthy way of talking about it. So if you're an older adult, or caring for one, you're in the right place. Let's get started.

Dr. Regina Koepp  1:37 
Today, our favorite neuropsychologist Dr. Vonetta, Dotson is back. You might remember her from Episode Number 12, where she shared about dementia health disparities for African American families, and gave us tips for promoting equitable care for African American families. I'll link to that episode if you're interested. Today, Dr. Dotson is back to share with us about genetic risk for dementia. And she'll answer the question that I am often asked. And this question goes something like this. "My aging parent has dementia. Does that mean that I'll get it to?" What I love about this episode is that Dr. Dotson explains that even if you do have an increased risk for developing dementia, there is a lot that you can do to prevent it. So, what I want you to do is listen all the way through the episode and you will learn several strategies, easy to use strategies, to prevent dementia, even if your risk is higher.

Okay, as we get started, I want to share with you a memory loss guide that I made just for you. In this guide, you'll get a checklist of memory loss warning signs, you'll learn more about the benefits of early diagnosis of dementia. Dr. Dotson talks a little bit about that in this episode today. And you'll get so many other tips. So, i'll link to this guide in the show notes. So, take some time to download it. It will really help you out. All right now let me tell you about our esteemed guest, Dr. Vonetta Dotson.

Dr. Vonetta Dotson is an associate professor of psychology and gerontology at Georgia State University. She's a senior project scientist for behavioral health at NASA. That's right, NASA. And in this episode, she's gonna tell us a little bit about that. And she's founder and president of CerebroFit, integrated brain health. Dr. Dodson completed her doctoral training in Clinical Psychology at the University of Florida with a specialization in neuropsychology and a certificate in gerontology. She completed her postdoc training at the National Institute on Aging intramural research program, she is one of my favorite guests. And I'm delighted to have her back today talking about genetic risk factors and what we can do to protect our brains from developing dementia, even if we have increased risk. So let's jump into the interview.

Dr. Regina Koepp  4:19 
Have you heard that Vonetta? Do hear that a lot...

Dr. Vonetta Dotson  4:24 
A lot of people who come into my clinic come in because they haven't noticed any signs yet, but they know that their parents had dementia. And so they just want to get a checkup because they're concerned that they'll develop it as well.

Dr. Regina Koepp  4:36 
And it makes sense we have an existential expectation that we're going to sort of age like our parents or die like our parents. When they come to your clinic, then what do you do? So if they come in and they say, "Dr. Dodson, I'm really scared that I might be getting dementia because my parent has dementia," how do you address that with them?

Dr. Vonetta Dotson  4:55 
So, I do a combination of giving them information and then also doing an assessment. So on the assessment side of things, I give them a neuropsychological assessment that includes an interview to get information about them and their backgrounds, what kind of educational history, medical history, psychiatric history, and then I do a series of mostly paper and pencil test to see what their skills are like in terms of their memory, their attention, their language, multitasking, those types of skills. And so I can put all that information together with their medical records, if I have any of that, and see if there's any strengths or weaknesses in their thinking skills and their cognitive abilities. And if that matches a pattern for dementia, in most cases, people come in early enough that they don't have dementia, they might have something called mild cognitive impairment, which is that sort of middle zone where your memory or other skills are not quite as strong as we would expect, but you have not progressed to having problems with day to day living. And so I will give them information about whether or not they meet any kind of diagnosis. But then also talk to them about what we know about dementia risk and families. And so basically, the information there is that there is some degree to which dementia can run in families. But it's more complicated than some people might think. Anytime we have a risk for something like dementia, there is going to be a combination of genes and environment at play. On the genetic side, we know the most about Alzheimer's disease, which is the most common type of dementia. Some people mistake what dementia means. And dementia just means the person has progressive problems with their thinking, but it starts to interfere with their functional abilities, meaning their day to day living, can they manage their medications and finances and cook or shop without getting confused and drive and those sorts of things. So when it comes to genes, we know that there are some genes that can increase your risk for dementia, but it's not guaranteed. And in a small percentage of people, about 5% of people with dementia, there is an actual causative gene, a gene where if you have it, then you are pretty much going to develop dementia. So it's going to be stronger than just the risk gene.

Dr. Regina Koepp  7:22 
Yeah, is that gene implicated in early onset dementia?

Dr. Vonetta Dotson  7:27 
So, early onset dementia is the one that has the strongest genetic risk. And there are actually three genes that sort of work together to cause dementia in those cases. So early onset means someone develops the symptoms, usually between ages 30 and 60. So much earlier than we typically think of, with 65 and older being more typical for 95% of cases. So in that early onset dementia, there are three genes, one that's called the amyloid precursor protein, and then Presenilin 1 and Presenilin 2. So those three genes are the ones that we consider to be causative. And in those situations, people do develop the early onset type of dementia.

Dr. Regina Koepp  8:10 
Correct me, but that tends to be particularly progressive, like quickly advancing?

Dr. Vonetta Dotson  8:16 
Right, so it's earlier onset and more quickly progressing, which is heartbreaking, you know, when you have to give someone that diagnosis, because that is the kind people are most worried about. But again, I tried to show people that, that is very rare. 5% is not that common, so not that I can guarantee they don't have it, but they oftentimes, if anything, have the risk gene, but there are things they can do about that. And so, you know, genes are not destiny in that regard when it comes to the rescue team.

Dr. Regina Koepp  8:47 
Mm hmm. Do recommend people get genetic testing?

Dr. Vonetta Dotson  8:51 
So at this point, I don't necessarily recommend that because the research shows that there really, oftentimes can be more harm than good done with that. If someone has early onset symptoms, and they do have a strong family history, if I have enough concerned in that case, I might think they're part of that 5%, and that knowing might be helpful for them. But when you consider this, the small prevalence of that type, people are more likely to have the APOE gene, which is the risk gene, certain variants of that can put you at risk. But what happens is that if someone finds out they have the risk gene that can actually be more distressing and do more harm than good. And so unless they're already starting to have symptoms, or have other reasons for concern, I recommend that people instead get some baseline cognitive testing. So, come in and get the assessment so that you can have comparisons to track you over time. And then that they start to implement some of those lifestyle behaviors that we know can be protective, even if you have a risk gene or things that you can do to minimize your risk of developing it and I prefer to focus on that, as opposed to focusing on, oh, I have this gene, now I need to start worrying.

Dr. Regina Koepp  10:05 
Mm hmm. And then there are so many variables that could influence how the person advances with dementia. Absolutely. So what is the risk of a person developing dementia if their parent has it?

Dr. Vonetta Dotson  10:18 
So again, it's gonna depend on whether or not the family has that early onset type, versus just having the increased risk that comes with certain genes. So if someone is in a family, one of those small groups of families that actually has those three causative genes that I mentioned before, then their risk is really pretty high, it's almost inevitable that they will then develop dementia. So again, that's going to be about 5% of cases where if you have that gene, you can feel fairly certain that you will start to develop those symptoms. However, in people who have one of the risk genes, and again, there's more than one of them, but the most researched risk gene is a APOE. There are basically three different variants of that gene and you can get a copy of the gene, if not, you do get a copy of a gene from your mother and your father. So you have two copies. One variant is the most common variant called A3 and A3, people who have that variant, particularly if those copies are A3, are kind of the comparison group, they tend to not have high risk. However, if they have the e4 variant, then for each copy, they have that variant, they have about a three fold increase in dementia risk. So if you have one copy, then your chances are three times higher than someone who has both A3 copies. If you have two copies of e4, then you multiply again. So you end up having a much higher risk when you have one or more of that e4 variants. If you have the e2 variant, you actually have a lower risk. So it's actually considered a protective gene. So getting back to the question about running in families, if you're a family and someone in your family has dementia, really the most useful information is whether or not their dementia is based on one of those variants, versus whether it's based on one of those causative genes.

Dr. Regina Koepp  12:26 
Okay, and so just explain real quick the difference between the variant and the causative gene.

Dr. Vonetta Dotson  12:33 
Mm hmm. So the causative gene is one that if you have it, then you are pretty much guaranteed to develop dementia, the particular genes that are involved really have to do with the buildup of amyloid in the brain. And that's the main marker that we use, biomarker to identify dementia. So there seems to be less environmental influence on that. And so it's considered causative because the gene ends up kind of equaling a certain outcome. In contrast, the variant that I mentioned, is considered a risk gene, meaning that it makes you more likely to develop dementia, but then you have more of an influence from environmental factors, lifestyle behaviors, medical conditions, things like that, that can shift your risk one way or the other. So, even though you're at higher risk, there's more you can do about it, which is the good thing that most people have this version that can be changed by the choices that you make throughout your lifetime.

Dr. Regina Koepp  13:34 
Yeah, so 95% of the time, right? So if you're saying 5% have a genetic component that's strongly implicated in dementia diagnosis. And so 95% of dementia has some variability. Right? You're saying? Then can you share some of the environmental factors, some of the things that shape a person's risk for developing dementia?

Dr. Vonetta Dotson  13:59 
Absolutely. That's one of my favorite topics. So, first, let me say that people in the past I think would focus on what you do in later life, trying to minimize your risk. And we realize now that what you do your entire life affects how you age and affects your dementia risk. And so there's a lot of lifelong lifestyle variables and factors to consider. So, on a very basic level, medical conditions, so having earlier life high blood pressure, that's uncontrolled, obesity, other vascular conditions can definitely make you at risk for dementia. And that's going to be true if that's present earlier in life as well as later in life. There are things like psychological conditions that can make you more at risk. So a big part of my research is on the link between depression and dementia. And so having particularly untreated depression, recurrent depression that occurs repeatedly throughout your life can put you at risk as well. But then there are things that can also protect you. So there are healthy lifestyle things. And so things like exercise, physical exercise is a huge one, we know that being more fit and exercising regularly can actually alter your brain, which I find very exciting. People who exercise more have larger size of different parts of their brains, their brain functions more efficiently, they have more of the healthy chemicals in the brain that promote the health of the neurons and the functioning of the brain. And it also can lead to improvements in memory, and multitasking, inhibition, other sorts of cognitive or thinking skills that are important. So exercise is a huge one. And again, that's going to be earlier life as well as as you're growing older. Things like keeping your mind active, use it or lose, it really does apply. So the more that you are, throughout your lifetime, doing activities that require you to sort of think and learn new things. So having a job that is more cognitively complex, is associated with reduced risk for dementia, higher education levels, and can reduce your risk of dementia. And then even just doing things in your leisure activities that require more thinking and less sort of pass it on. So that can range from reading books to traveling, doing crossword puzzles. And then also related to that is being social. People who have more social connections have lower risk for dementia. And that's particularly true as you get older, because oftentimes, as people age, they might become more socially isolated. And that is the worst thing that they can do. Because being around people has such a profound effect on your brain, and in and of itself can help to reduce the risk of dementia. And part of that might be because when you're around people, you're using your mind more. And because you're having conversations, you're listening, you're asking questions, you're trying to take in what they're saying. So, by definition, when you're social, then you're sort of keeping your mind active as well. So there are things that can both increase your risk and decrease your risk throughout your life. And, of course, I try to promote those things that are going to be ranked healthy. For the people who I, you know, I see in my clinic.

Dr. Regina Koepp  17:22 
Talk a little bit about your new clinic called Cerebral Fit.

Dr. Vonetta Dotson  17:27 
Yes, so I'm very excited about this endeavor. Cerebral fit really came from two things. One is my experience as a neuropsychologist. When I give someone an assessment, I write a report for them. And then I have a feedback session where I recommend what things I think will help promote their their healthy brain. And it typically involves some of the things I just mentioned, physically active, cognitively active, socially active, healthy diet, which I didn't mention before. So when I mentioned all those things, I've always felt like, okay, I send them off and say, "Good luck with that," or "Here are a couple of links to places to try out." But then they're gone. And I really felt like I wanted to do something where I feel like I can have more of a hand in offering to them within the same place some of those services that are going to be helpful for them to have a healthy life. And so that's what cerebral fit is, we have this combination of neuropsychological assessments, which I provide. But we also have a team of really wonderful people who can help with some of these lifestyle behaviors. So right now we have a really wonderful personal trainer. He's actually my own personal trainer, so I can say for sure that he's great. And he's offering personal training online for the time being actually and so far, it's proven to be very helpful. People really love that. So we have online Personal Training, we have a nutritionist who can either in person or online or combination, have nutrition consultations, and help with having more of a healthy lifestyle. I have a health and wellness coach who is great for helping to identify the barriers to making lifestyle changes and doing motivational interviewing to help sort of get at some of the root causes for the barriers and overcoming them and then implementing these healthy changes. And then soon we will have someone who can provide psychotherapy as well, because we know that better sort of psychological and mental health also promotes brain health. So I'm trying to frame this as a one stop shop for brain health. And I'm super excited. We just started offering services last month and we will start offering more services and hopefully, in the near future, have an actual center where people can come physically and have all that done in one place.

Dr. Regina Koepp  19:46 
That is such a holistic and thoughtful model really supporting people in their health journey now and for their brain health later. That's a really great thing that you're doing. Yeah.

Dr. Vonetta Dotson  20:01 
Thank you. I'm excited. And I forgot to mention the second part when I said that it came from my clinical work, but everything is informed by research. And so, on the academic side of my career, the research I do is all about brain health. And I really believe in making sure we have evidence based treatment and evidence based assessment. And so the way that we frame all of our services is 100%, based on what the science tells us about what's best for brain health.

Dr. Regina Koepp  20:27 
Mm hmm. Yeah, I really value that, which is also why you're I invited you to talk here because I know that we're getting a feel of credibility and security and knowing that it's everything that you're sharing is backed by science to thank you today. Yeah, well, thank you for promoting education and access to information and resources for folks. And just kind of setting the record straight about some there are a lot of misconceptions about dementia, aging and brain health. I, I think also one of the keys throughout life is substance use and brain aging brain, like chronic alcohol use, or chronic illicit substance use, it can also affect how the brain ages.

Dr. Vonetta Dotson  21:12 
Abosultely. Actually on our social media pages for three books that we just had a post a couple days ago, that has to do with how daily alcohol use and daily tobacco use have been linked to a higher risk for dementia. And so again, it's one of those healthy behaviors that we know that we can change ourselves, and in that way, reduce our risk for dementia. Even if we have the risk gene, there's still something that you can do to live a healthier life and increase your chances of aging Well,

Dr. Regina Koepp  21:42 
well, and then there's this just to throw, an added layer of a person can have more than one type of dementia. And so you can be protecting yourself for multiple types of dementia, not just Alzheimer's disease or vascular disease.

Dr. Vonetta Dotson  21:58 
Exactly. And most of what I said, a plot the lifestyle, things I've mentioned really are helpful for any type of dementia, the information that I gave about risk factors, in terms of genes is more for Alzheimer's disease, because that's the most common type of dementia. But what we've seen more and more is that a lot of people have the pathology in the brain related to more than one type of dementia. And I think that's one reason why oftentimes the same lifestyle changes can help more than one type of dementia is because a lot of times there's this overlap, that someone can have more than one process happening in the brain at the same time. So it's great when you have these interventions that can help all of it. And again, the things that I've mentioned, have been shown to be effective, really, for all of them.

Dr. Regina Koepp  22:44 
Say my parent does have dementia, what's the benefit of you know, giving them any memory aids like Aricept?

Dr. Vonetta Dotson  22:53 
Yeah. So that really is gonna depend on the timing. So what the research shows us is that any possible benefit from something like NSF depend on a window of opportunity, that's going to be earlier in the disease course, which is why early detection is really important. And so once you have, once you have that early detection, for someone who is just beginning to decline, they are typically going to see it as a benefit if they can slow down the decline. And that's what the medicine does. Unfortunately, we don't know how to reverse dementia, we don't know how to cure dementia, but we certainly can slow it down. And so if someone's starting to have memory problems starting to have some difficulties in daily life, but they're still aware, they're still active to some degree, they're still involved in their life, for them the ability to say, Okay, I can stay where I am a little bit longer, before starting to decline that can be really powerful. And it can help as well with dealing with some of the depression and anxiety that can come with having a dementia diagnosis. If the person has some hope that at least for some time, they can sort of slow things down, still be able to enjoy time with their family, maybe they have a bucket list and some things that they can still do. And just basically buy some time that can be helpful. Mm hmm. in later stages, where the person maybe is more impaired. Number one, the medicine is less likely to help. And then number two, I can see how for some caregivers as well as the the patient themselves might feel like why prolong this because this is already sort of a bad a bad scene. This is not something good. But if it's at that stage, then that's already past the point of the medications effectiveness anyway. So I think the time when you will want to take the medication is earlier on when a person can still benefit from being able to enjoy life a little bit longer.

Dr. Regina Koepp  24:50 
And then to focus on life enjoyment.

Dr. Vonetta Dotson  24:52 
Focus on life enjoyment. People also like to have some time to set their affairs in order, if they're starting to have some memory problems. But are still able to make decisions in a way when, with the family's involvement, of course, it can be very empowering for the person to have a say in what's going to happen down the road. And again, you want to do that earlier than later. So they can still make some decisions.

Dr. Regina Koepp  25:18 
Dr. Dotson, how valid is the fear that because my parent gets dementia, I'm going to get it to

Dr. Vonetta Dotson  25:26 
It's valid in the sense that it is based on some degree of truth, because there is a tendency for dementia to run in families. I think that sometimes that fear goes too far. Because if people start to see that, if they start to think that genes equal destiny, then that can lead to a lot of distress that might not be warranted, because having an increased risk for dementia doesn't mean that you're going to get it. And again, I like to focus on empowering people to say, Okay, if I do have this information, what can I do to minimize my risk? So rather than saying, Okay, my life is over, and because my parent has dementia, that means I'm going to get it instead see it as Okay, I have this risk factor potentially. So let's do all the things that I can do to minimize that risk. But to some degree, the concern is valid. But I think it's just a matter of how you frame it, does it spur you to action to do more? Or does it sort of lead to this sense of knowing that it's inevitable, and that you can't do anything about it, despair? Thank you. Exactly. And that really does happen a lot. I've seen that a lot. And oftentimes, when I when I see, you know, clients, and I have feedback with their families, I'm not only talking to the client themselves, but I'm also talking to the family about a number of things, including whatever worries they're having and sense of despair they have about their future, as well as them thinking about the caregiving burden that comes with caring for their, their parent. Yeah.

Dr. Regina Koepp  27:01 
So just to restate what a person can do, if you were saying one is they can do get neuro psych testing, so that you can get a sense of a person's baseline and optimal functioning. And the baseline will help you over time, see, if there are changes in the brain, you can repeat tests at certain markers in time, and see if there are any changes of the diet, exercise, managing medical conditions (so if you have heart disease, or diabetes), kind of reducing substance use, in terms of drinking illicit substances, and smoking, am I missing anything,

Dr. Vonetta Dotson  27:40 
Those are the main ones I would add on to that, getting treatment for psychological conditions to and not just other medical conditions. So we know that depression, anxiety, other psychological illnesses, can also contribute to the increased risk. And so number one, I promote people to get treatment anyway, because you can do something about that and make your life better. But number two, that in and of itself can help to reduce your risk if you manage your mental health as well. Yes, and social activity, social activity. Another one I'll add is sleep. Sleep is really important. And I think that a lot of us go through periods in our life, such as grad school, or what have you, where we say, Oh, it's not a big deal, I'm only gonna have a few years of not getting sleep. But that then leads to these unhealthy habits of practically having insufficient sleep. And sleep is really important for for cognitive health and brain health as well. So trying to get adequate, adequate sleep throughout your life can also be powerful in terms of aging better and having less cognitive impairment and dementia.

Dr. Regina Koepp  28:45 
Yeah, true. I can attest to that.

Dr. Vonetta Dotson  28:50 
Yeah. Well, a lot of us can see an immediate effect, obviously, for a day or two, then all of a sudden, our brain feels foggy, our memory's not as good, what have you. And people tend to think, Oh, I can catch up on sleep. And that's really not the case. It's not how the body works. So you really want to just try to as much as possible, have consistently good sleep, everyone's going to have a bad night of sleep here and there, that's fine. But as much as you can try to maximize good sleep, where you getting consecutive hours of sleep, as opposed to chopped up sleep, and that sort of thing can be good for your brain.

Dr. Regina Koepp  29:25 
Oh, you know, what just came to mind is caregiver stress.

Dr. Vonetta Dotson  29:29 

Dr. Regina Koepp  29:30 
So it's really important if you are at risk, and you're a caregiver to make time to manage your own stress and caregiving burden.

Dr. Vonetta Dotson  29:38 
That is a huge part of things. So one thing that caregivers often forget about, or the main thing they forget about is themselves. And so oftentimes, there's this feeling of guilt of taking time for themselves of feeling like everything needs to be about the loved one they're caring for. And that's actually one of the worst things that you can do for yourself and for the person you're caring for. Managing caregiver stress is so important. And so you can't forget to care for yourself. I was actually recently part of this intervention group. So at the University of Florida, and Dr. Glen Smith has this problem, this program called peace of mind, where they have a sort of multi component intervention for people with mild cognitive impairment and their family. And so one aspect of that is a group for the caregivers, a support group, which is actually really important. There are a lot of them throughout the country, and you can find them at the Alzheimer's Association website. But in this group, as he was going around asking people, what their biggest concerns were or what they worry about, it was very striking that no one brought up themselves. So everyone was concerned about some aspect related to who they were caring for, and no one brought up that Oh, on my priority list should be thinking about myself as well. But yet all of them were reporting a lot of stress. And so I think that really kind of hit home in a very direct way, to me how much we need to have more focus on making sure that caregivers care for themselves caring for it goes both ways. And I understand that the person who is impaired is not able to give that care. So that means the caregiver really needs to try to do both. So taking advantage of opportunities to, to unwind to have some time alone, to go to caregiver support groups, to take care of the of your own medical conditions, your own psychological distress, is really going to be incredibly important for both the individual person and for the person they're caring for.

Dr. Regina Koepp  31:48 
Yeah. And it will help the so the less stress you the more stress we have, the greater our risk for depression, if we're caregivers were less likely to engage in stress management techniques, we're more likely to have depression. And so with depression, you're more likely you have a greater risk for developing dementia. And if you're caring for a loved one with dementia, your risk is already higher. So it's so important for caregivers to prioritize their own health.

Dr. Vonetta Dotson  32:16 
Absolutely. And I think also, it's important for people to realize that there's no need to feel guilty about that. I think sometimes, particularly when someone with dementia is progressing. And they oftentimes can become more agitated and anxious, if they're in an environment that's unfamiliar, or if their primary caregiver is away from them. And it can really pull on the person feeling like, if I leave, they're going to be really upset, and they're going to be really stressed. And I don't want to do this to them. And I think starting that process of taking the time away early starts to sort of set habits and patterns for the person to make them maybe less likely to be distressed. But that doesn't guarantee that there's not going to be any distress. And in some ways, it's kind of like, you know, leaving your four or five year old and you know, pre K or kindergarten, there might be some tears and some Distress that happens. But ultimately, you know that this is a good thing. And so I think having that mindset of the reaction of distress does not mean that this is a bad thing. And that the person will be consolable eventually, and that you will be back and that you're ultimately taking better care of them by leaving, I think can help to deal with some of that. That comes from their distress.

Dr. Regina Koepp  33:31 
Yeah, it is complicated. The The challenge is that there's also the pressure cooker of time that the caregiver is also operating in, when you have a four year old you know, you have a lifetime, when you're caring for an aging parent with a chronic terminal illness, you have short time, and I hear a lot of caregivers kind of struggle with "the days are long, but the years are short, and my time with them isn't going to be forever" and and so then there's also this pressure cooker of limited time. And "this is a good day, and I want to spend time with them on their good day. Because tomorrow they're gonna have a bad day." And, and so it's the caregiver is in this constant bind. And I think what you're saying this strategy that you have of or recommending of starting this pattern early of implementing time for your own self will help you kind of pave a road down the road when caregiving has a higher burden and is harder and more complicated. And then you won't have to be dealing with these big transitions because you've already in terms of separation if you're going to go to a day program or something because you've already set those in place.

Dr. Vonetta Dotson  34:48 
Absolutely. And I think anytime you can set habits for yourself as well as for the person you're caring for, the more likely it is to continue and so it just becomes part of life as opposed to something that's been I've imposed later. And I think sometimes caregivers try to not take time try to always be there. And then at some point, they can't take it anymore. And that's when it becomes more of a abrupt change that can be harder to deal with. So just starting early is a good way of dealing with that.

Dr. Regina Koepp  35:18 
Yeah, that's great that you're setting the foundation for your caregiving journey, including your own health. Exactly. Okay. Is it right, Dr. Dotson that I heard that you're working with NASA?

Dr. Vonetta Dotson  35:31 
Yes, it is. So this is an exciting new part of my career. And that sort of happened unexpectedly, I gave a presentation at a conference. And someone approached me afterwards and said that he was made to complicate my life and had I ever thought about working with NASA. And so as a neuropsychologist, I had never thought about working with NASA, I didn't really see the link there. But it turns out that they have a really great Behavioral Medicine Research Program, where they try to, among other things, identify risk factors associated with space travel. And that can include things like radiation exposure, being in zero gravity, being in isolation, and confinement, that sort of thing. And there can be all kinds of effects on your brain, on your cognitive functioning on your mood, all the things that I studied in that I do in love. And so long story short, I had a very exciting trip out to Johnson Space Center and learned more about what they were doing and ended up being able to work out a way to sort of remotely work for them still living in Atlanta, still keeping my day job, but being able to work with them to help them develop that research program. So I'm really excited about applying what I do to a different population. The other part of it is using some of their longitudinal data, they've been falling over time astronauts as they get older. And so the idea of being able to see how the history of being on space missions affects the aging process is super exciting for me. So yeah.

Dr. Regina Koepp  37:12 
I mean, when you walked into NASA, the NASA building, were you like, Oh,

Dr. Vonetta Dotson  37:19 
yes, I was very cheesy. Okay. I will admit that as I was driving up to Johnson Space Center, and I saw the sign, I grabbed my phone and took a picture and texted my husband and said, Oh, my gosh, I'm here. So the whole process was kind of like being a kid in a candy store and trying to be cool about it and not give off your excitement when you're interviewing was kind of hard. So every now and then I would have to just like have a moment alone and kind of squeal to myself. So such an exciting thing and really important work they're doing I think it's exciting to be a part of something that could you know, ultimately make it safer for people to do different space missions. And just contributing to something that has this national interest is something I was not expecting, but I'm really happy to be doing.


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Dr. Regina Koepp  38:07   
After this episode, I think you can see why I love having Dr. Dotson on the podcast so much. All right. If you're concerned that your older loved one has memory loss, go and download my free memory loss guide. It has a checklist of memory loss warning signs. And it also shares some of the benefits of early diagnosis of dementia, and really touches on what Dr. Dotson was sharing with us today. Plus, there's so much more that you'll get out of this guide. I'll link to it in my show notes. To make it simple. So just go and download it. It will help and it's free. And wrapping up. I would love it if you would subscribe and leave a review wherever you listen to podcasts. And here's why. When you subscribe and leave a review, it helps people to find this show. And why do I want people to find this show. Older Adults are left out of the conversation when it comes to mental health and wellness. And my hope at this podcast is that we can begin to change that. By subscribing and leaving a review. You can help to change that too, because it will make this free public education program accessible to everyone and more easy to find. So there you have it, subscribe and leave a review. Now and wrapping up, it's important to remind you that information in this episode does not take the place of licensed medical or mental health care. I'll see you next week. Same time, same place. Lots of love to you and your family. Bye for now.


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