One of the reasons we plan for retirement is that we know our health may not hold up. It’s an ugly thing to think about, but while we plan for our golden years, we also have to be aware that not everyone gets to be healthy in their retirement.
Broadcast Retirement News’ Jeffrey Snyder dug into this unpleasant topic with Dr. Manisha Parulakar of Hackensack University Medical Center on the May 23 edition of BRN.
And, while the topic is not roses and bubblegum, Dr. Parulakar shares a lot of useful advice and makes it clear that slowing down and serious illness are not the same thing.
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Retirement news: Highly-regarded doctor on Alzheimer’s warning signs (11:23)
BRN May 23, 2025 transcript
Jeffrey Snyder: This morning on BRN Science, it’s time to take your memory loss seriously and joining me now to discuss this and a lot more Dr. Manisha Parulakar of Hackensack University Medical Center. Dr. Parulakar, great to see you. Thanks for joining us in the program this morning.
Dr. Manisha Parulakar: Thank you for inviting me.
Snyder: Yeah, it’s great. We’re talking about memory and I guess my first question is, how do you figure out whether or not forgetfulness needs to be taken more serious and that it could lead to a potential Alzheimer’s or dementia diagnosis?
Parulakar: Before, I used to jokingly tell my patients that if you forget what you forgot, we have a problem and we need to get a formal assessment and formal evaluation. The topic has changed a little bit more now, especially because we do have the new treatment options available, which are for patients with mild cognitive impairment. So not necessarily the dementia diagnosis, the pre-pre-dementia stage of mild cognitive impairment.
And what that looks like is if you are having difficulty doing your day-to-day task, something that you’ve been doing for years and had no problems, but now all of a sudden, you need a much longer time to complete that task. Maybe that’s paying the bills, managing your calendar, managing a project. If you are having a harder time and you’re requiring much longer time and many more resources to finish it, maybe there is something going on and you should talk to your doctor about it.
Snyder: And so that takes some personal awareness. But what about a family member? I mean, is this something that a family member could check with their loved one to see if, hey, they’re just not completing the tasks the way they used to complete the task?
And also, doctor, we slow down a little bit as we age. I know I’m a lot slower than I was in my 20s.
Parulakar: Absolutely. And those are two important points. And one is that some slowing down does happen to all of us.
That’s the loss of brain plasticity. And all of us are going to have that as we age. Being said that, it still should not interfere with our activities that we were doing so well.
So we should still be able to pay our bills the same way that we were doing 10 years ago. I may have a difficult time figuring out setting up a new process. So if I was setting up a new account to do that, that may take a little bit longer.
But if I was doing something like handwriting my checkbook, I should be able to do that in a timely manner. So if I’m taking much longer and if I’m asking many more questions, and that’s something the family members can observe, is that the loved one, are they asking a lot of questions for their usual activity? Are they not able to do the cooking that they were doing without going back to the recipe or asking questions about recipe?
Are they just repeating questions that they’re forgetting the conversation that they had not that long ago? So those are all warning signs that, OK, there’s something going on.
Snyder: So, doctor, if you see something going on, what’s the first, and you’re a loved one, let’s just say, or an individual, you feel something’s not right. What’s the first step you should take? Should you call your internist, your general practitioner?
Or do you go directly to someone like yourself who’s a specialist in cognitive functions and Alzheimer’s and dementia?
Parulakar: I would say it depends on what access you have. So if you do have access to a memory center around you, reaching out to them and making an appointment is a great idea because they have all the resources. And they can really, especially when it comes to mild cognitive impairment, which is a very, it’s an accurate diagnosis.
It does require a lot of multiple steps to get there. So if you have access, that would be great. But unfortunately, we don’t have those many memory centers around.
So talking to your primary care physician is a great first step. And they could start with some of the basic testing and then decide whether further investigation is needed. Yeah.
Snyder: And then they would refer you to someone like yourself or someone else to help address and see what the root cause of it could be. Doctor, you mentioned as we age, the brain is not as elastic, I think is the term you use. But are there things that we can do to create better elasticity and improve the longevity of our thoughts, of our brains, of our memories?
Parulakar: Absolutely. And I think that’s the reason why it is so crucial for us to start thinking about our brain in our 40s and 50s. And not because we definitely know that Alzheimer’s is a very long process.
It’s about, it’s going on for about 10, 15 years before it starts producing those memory symptoms. So it really is important for all of us to work on the plasticity and to maintain our function of the brain. And the big threats for our brain health are our chronic conditions.
So managing your high blood pressure, managing your diabetes, managing your cholesterol are really essential to maintain that brain health. The second big threat is our mobility. So not moving enough is an important risk factor.
So just having any mobility is better than none, but continuing to move. And newer data is suggesting that we want to be mobile throughout the day. So not just hitting the gym for one hour, but then staying sedentary for the rest of the day, that doesn’t help either.
So staying active and not sitting at one place for too long is helpful. Managing our sleep, which is something else that we don’t necessarily pay attention to. A lot of people will walk around saying, oh, I do fine with four hours of sleep.
We know that’s the time that our brain spends in managing our deep memories, creating new memories. So we need to have, that says, six to seven hours of sleep, ideally seven to eight hours of sleep to be able to recharge the brain for the next day. And then, of course, staying away from substances.
We are finding more and more evidence that alcohol is really not good for us. Even small amounts of smoking, some other substances like marijuana, they all have negative effects on your brain. So staying away from substance use is another great way to maintain your brain health and managing.
A lot of times the substance use is related to behavioral health issues. So managing the behavioral health issues by getting the right help. Meditation, yoga are great ways to help almost all behavioral health issues as a basic step.
So addressing all of them together, we can technically push the risk of dementia to a much, much later part of our life.
Snyder: And last question for you, doctor. In terms of treatment, are we further along in terms of the research and medications that maybe can delay or even reverse some of the effects of this disease?
Parulakar: So a lot of, yes, we do have new medications, especially for Alzheimer’s or mainly for Alzheimer’s, that can be used in that mild cognitive stage of the disease or very early dementia disease. And it does have potential of slowing down the progression to some extent. We don’t have anything right now that actually reverses the disease, so we’re still working on that.
And a lot of studies are showing that the non-pharmacological interventions that we just talked about, the exercise, the sleep, the brain exercises, can be equally helpful in slowing down the progression. And sometimes even maybe reverse it, especially if you’re in the mild cognitive phase. And if you address all of those, that can be potentially helpful.
Alzheimer doesn’t have to be inevitable
Snyder: Yeah, I mean, and Alzheimer’s, it sounds like, doctor, Alzheimer’s, if you take the right steps, Alzheimer’s doesn’t have to be the end result of aging. It doesn’t have to be the thing that ultimately we all get.
Parulakar: Absolutely. And there are people telling us that that’s true. If you look at the blue zone, where people are living to be 100, and a lot of them have their memory intact.
So that tells you that following those non-pharmacological interventions, socializing and having that support structure can protect our brain health and potentially help us prevent or at least push it to a much, much later part of our life.
Snyder: Well, doctor, you talked about treatment. And I want to ask you about maybe the, ask you about the blood test where we look at biomarkers. How successful is that blood test?
And should I go run out to the store and take it or to the doctor and take it and get it?
Parulakar: Okay. So yes to first question, no to the second question. So yes, we have done significant progress in helping in building biomarkers in Alzheimer’s.
And now we’re using similar knowledge to look at Lewy body and other types of dimensions as well. So we have much more, we have gotten much more sophisticated to have that accurate diagnosis. And yes, we have moved from doing the cerebrospinal fluid to now blood to able to help us with those, with the accurate diagnosis.
But those blood tests should be ordered in the context of if somebody has memory issues, has had some workup and there is a possible diagnosis of Alzheimer’s. So it’s not a screening test. We should not be just going and getting it.
And we should not definitely be asking our doctors to say that, hey, you’re doing my blood work. Can you add that screening test for Alzheimer’s as well?
Snyder: Yeah. It’s not going to be showing up on the LabCorp menu anytime soon, I guess.
Parulakar: It is on the LabCorp and Quest menu. And that’s the reason I’m making a point even further that please don’t ask for it just because it’s on the menu.
Snyder: Yeah. Very, very smart. Well, doctor, thank you so much again for joining us.
And we look forward to having you back on the program again very soon. Thank you so much.
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Until then, I’m Jeff Snyder. Stay safe, keep on saving, and don’t forget, roll with the changes.
