Mary: It's frustrating to fall asleep. You're exhausted. Can't wait to get into bed. Tumble into bed, go to sleep, and you're wide awake an hour later or half an hour later or two hours later. It's horrible. Jay: That's Mary Hynes. She's a health conscious 80-year-old, but she's worried that poor sleep is increasing her risk for dementia, and the science is saying there's good reason for that worry for Mary and anyone else who's struggling with sleep. You'll meet Mary in a few moments. Allison: Welcome to Defy Dementia. A podcast for anyone who has a brain. Jay: Defy Dementia is all about living in ways that keep your brain healthy and reduce your risk for dementia because dementia is not predestined by our genes. Your genes do play a role, but so do lifestyle risk factors like social isolation or a lack of exercise. Allison: And research suggests that if we make healthy changes to those lifestyle risk factors, we could reduce dementia cases worldwide by at least 40%. Jay: Today on the show, the inside scoop on why good sleep is key to brain health and some strategies for hitting the hay in a healthy way. Allison: I'm Allison Sekuler, president and chief scientist at the Baycrest Academy for Research and Education and the Center for Aging and Brain Health Innovation. Jay: I'm Jay Ingram. I'm a science writer and broadcaster. I have both a scientific and personal interest in dementia. Allison: Join us as we defy dementia, because you're never too young or too old to take care of your brain. Jay: It is a wake-up call that many of us have heard before. A good night's sleep is crucial to good health for our bodies and our brains. But now some scientists are sounding the alarm that poor sleep may also be a risk factor for dementia. Allison: And they're sounding that alarm even though they're still trying to answer some fundamental questions. Questions like, does poor sleep actually cause dementia? Or on the other hand, is poor sleep an early symptom of dementia? But even though more research needs to be done, there's some evidence that trying to get a good night's sleep is probably a good idea for everyone. Jay: Recently, researchers at the Harvard Medical School compiled health data from nearly 3000 people, 65 and older. These people were surveyed on how they were sleeping. And then five years later, scientists compared the survey data to what had actually happened to those people. Their findings were ominous. Compared to subjects who slept the normal amount, which was defined as between six and eight hours. People who slept less than five hours a night were twice as likely to develop dementia and twice as likely to die. I think of that study every time I have a poor night's sleep. Allison: And I'm not a great sleeper either, so it definitely raises concerns for me too. But one possible criticism that you could raise about that Harvard study is that people aren't always accurate when they respond to surveys. Jay: That's true, but there's more. In a widely cited study from 2021, European researchers went the extra mile. They examined sleep survey data from nearly 8,000 people from Britain. Six different times over 20 years those people answered survey questions about their sleep. The difference with this study is about half of those people also wore accelerometers while they slept, those measure body movements. The less movement, the more likely someone is sleeping. So these devices enabled scientists to confirm what people had claimed in surveys. And again, the results revealed that older test subjects who consistently slept less than six hours a night had a 30% increase in dementia risk compared to people who slept seven hours. Allison: Overall then, both studies show that poor sleep is associated with dementia risk in a big way, but that's really where they stop. Neither study definitively shows whether one causes the other. Jay: So where does this leave everyone who's tossing and turning late at night trying to get to sleep? To what extent should we be worried about dementia risk? Allison: In a few moments, we're going to get some answers from a top flight sleep researcher, but first we've got an all too common real life bedtime story for you. Jay: Mary Hynes is 80 years old. She's a retired special ed teacher from Toronto, and she's no relation to the Canadian radio broadcaster with the same name. Mary was a grad student at the University of Toronto, but recently as she puts it, she dropped out. We're going to ask her about that decision in a moment. But what you really need to know about Mary is, as an older student she was studying how older adults can manage their own health and lower their risk of diseases like dementia. She tries to use everything she's learned to manage her own health, but there's still one risk factor for dementia she's struggling with, sleep. Mary, welcome to Defy Dementia. Mary: Hi. Thank you for having me. Jay: We're very happy to have you. Mary. We're going to talk about your sleep in a second. But first, tell us more about your interest in managing health risk factors. That's what you were studying at the University of Toronto. Mary: Well, when I turned 65, I decided to go back to school to keep my brain from shriveling, and so I started taking undergraduate courses, a non-degree student. And I got interested in the idea that for older adults to successfully age, they're supposed to only have at most one health condition. And I thought, well, all my friends have way more. I have more. I want to successfully age. It could not possibly be that once you have some kind of medical condition, you can't successfully age. It's important to successfully... Well, whatever. To age well. And so I talked to some people who knew about this sort of stuff and I got sort of talked into going to grad school. So I became a grad student looking for a PhD. And I thought, I want to know what are the different factors that go into... What are the health conditions that affect us? What are some of the things we can do? How can we prevent as much as possible the conditions of aging? And so I started doing research. And so for four years I've been researching the various things that go into success, living healthy. And I sort of got tired. I thought I want to do other things. I want to look after my own health even more than just sitting at a desk all day working on research. And I thought about the fact that 20 years ago I had walked something called the Camino, and now it's 20 years later, I'm 80. Why not do it again? But I need to get myself fit enough to do it because certainly with COVID I've been doing an awful lot of sitting. So I thought, I can't do that and be a student. So I dropped out of school. Allison: And for people who don't know what the Camino is, can you explain what that is? Mary: The Camino is a walk that's well over 700 kilometers that goes across Spain from the French border all the way as far west as you can go in Spain. Allison: So when you were doing all of the research about how to stay healthy as you get older, obviously you learned a lot presumably about things like exercise and diet and so on. What is it that you've done yourself in terms of what you learned to be able to manage your own health, as you put it, and protect yourself from dementia and other conditions and diseases? Mary: Well, being a student certainly makes a difference. I do an awful lot of academic reading and talking to people who are academics, working on research. So there's the cognitive issues, the brain issues. I've also been exercising now, especially since COVID is over. I'm trying to walk at least 15,000 steps a day is my goal. Not always successful, but as much as possible. And I also subscribe to a food program where I get food deliveries every week. So I have vegetables and I have fruits in my home so I can eat more healthily. And by being around young students, people in their 20s and 30s, I guess, good social connections. So I've covered a whole lot of the areas, many of the areas that have to do with aging and successfully keeping your brain from turning to garbage. Allison: You've been doing almost everything it sounds like that we've been talking about in some of our previous episodes around cognitive engagement, social engagement, physical activity, diet and exercise. Is that right? Mary: As much as I can. I mean, not enough, but certainly more than most. And I'm trying to do as much as I can. I mean those are areas I'm doing rather well with, but I definitely have an issue with sleep. Jay: So what is your sleep like, Mary? Mary: Well, it varies. Some nights I tumble into bed completely exhausted, fall asleep and stay asleep through the whole night. Most nights I either fall asleep right away and then I'm awake maybe an hour later or maybe at 3:00 in the morning and then I can't get back to sleep no matter what I try to do. I find just lying, tossing and turning is the worst possible thing. Sometimes I might actually go to my computer and work on a jigsaw puzzle or do games of that sort. Sometimes I try to use, there's an app called Calm which has sleep stories, and sometimes they work. But I have to be calm enough for Calm to work. And I usually end up falling asleep before a story is finished, which is fine because then I can listen to the same story again and not be listening to the same thing over and over again. So those are things I try to do, but it doesn't always work. So I tend to not get enough sleep. I know we're supposed to get seven to eight hours sleep a night, and I usually end up at best with six. Jay: So you haven't settled on any of those methods as your go-to response to waking up? Mary: No. If I'm completely awake, I just can't sit calmly, just listen to a sleep story and fall asleep. If I start looking at my computer, I might end up starting to do some research. I look at something and it sends me off looking at something else, which sends me looking at something else, and then three hours have gone by. Allison: Yeah. Have you seen a doctor about the sleep to try to gain some insight into why you're wide awake at night and what you can do? Mary: I went to a sleep clinic a number of years ago and they suggested among other things to try to read a boring book. Get up and read a boring book. That definitely doesn't work. Allison: Are you tired in the morning when you wake up? You seem pretty wide awake right now. Mary: Not always, no. Sometimes I can wake right up and no problem at all, and I've only had four hours sleep. Allison: Yeah. I went to a sleep clinic myself ages ago because I was just always exhausted and after the worst night sleeping... If you've ever been to a sleep clinic, you know don't sleep well there. They stick all these wires on you and everything. But the diagnosis I had, Mary, was that I am a night person living in a day person's world. Not very helpful. Really frustrating. Jay: At least they didn't say you were living in a day person's body. But, still. I totally get this Mary because I have non sleeping experiences, and I think the thing that throws you off most is that when you don't have a go-to strategy and therefore you don't have confidence that you're going to fall back to sleep, and therefore most of the time you don't. Mary: It could be. I mean, it's frustrating to fall asleep. You're exhausted. Tumble into bed. Go to sleep, and you're wide awake an hour later or half an hour later or two hours later. It's horrible. Jay: Mary, we are going to be talking to a scientist in this episode who studies sleep and dementia and the risk of dementia from not sleeping. What would you like to know from him? Mary: So I want to know if it possibly can be normal to be awake for a long period. I know waking up constantly, like sleep for an hour, wake up, sleep for another hour and wake up, is definitely not a normal sleep pattern. But maybe a wake time for several hours in the middle is a normal sleep pattern. Is that possible? Is anybody researching that? I don't know. I also want to know, my smartwatch tells me I've had enough sleep or my smartwatch says you've had enough sleep but it wasn't good quality. Can I do something about it? Is my smartwatch even telling me the truth or is it just some kind of statistical thing that it comes up with that may or may not apply to me? Allison: We'll pass those on because I'm sure a lot of other people are going to have those questions as well. My last question for you is do you have any plans that you've been thinking about, about ways that you might improve your sleep in the future? Mary: Well, I at one point used to sleep with a light on in the room, and I don't do that anymore. And I don't know that that's made any difference, but I don't sleep with a light on in the room anymore. So that may help. But I don't know, what can I do? Is it that I wait too long to go to sleep? Maybe I should be setting a bedtime, whether or not I am sleepy, maybe that makes a difference. Should I set an alarm and go to bed a certain time and get up a certain time, does that help? I have no idea. Allison: Well, whatever you're going to try to do to improve your sleep, we wish you the very best of luck. So many people, I think including me and Jay, share some of that frustration and we're really looking forward to getting the answers to the questions that you've posed from our next guest. Mary: Thank you. Jay: Mary Hynes is a retired special ed teacher and former grad student. She joined us from Toronto. Allison: Our next guest is Dr. Andrew Lim. He's an associate professor of neurology at the University of Toronto and a sleep neurologist at Sunnybrook Health Sciences Centre. That's where he treats people with sleep disorders. He's also a researcher who studies the link between sleep and dementia by scrutinizing the molecules and mechanisms in the brain that govern that relationship. His long-term goal is to use what he learns to develop treatments for dementia. Dr. Lim, Andrew, welcome to Defy Dementia. Andrew: Great to be here. Allison: First things first, our previous guest, Mary Hynes, had a question for you and her question is this, is it possible that as we get older maybe we're supposed to be awake in the middle of the night for a couple of hours? Andrew: So I get asked that all the time from patients and others, what constitutes normal sleep? And the answer is there's a huge variation in what is normal from a sleep perspective. What I'd like to say is this, that if you are sleeping anywhere between six and nine hours a night, that you fall asleep relatively easily, that you're waking up no more than a couple of times per night and that you feel fine during the day, that you are able to stay awake even in relatively sedentary or boring situations, then your sleep is probably okay. Jay: So Andrew, Mary also had a question about smart watches and other devices that supposedly measure how well we're sleeping. How accurate is that smartwatch sleep data? Andrew: Yeah, so what I'd like to say about the smartwatch is, is this, is that they can be helpful. One thing to bear in mind about the algorithms that underlie a lot of these commercial devices is that they were developed primarily for young, healthy people. So they tend to work quite well if you're 20 years old and have no medical conditions. And then as you get older and develop more medical conditions, they become less and less accurate. So I think we need to take, especially if you're somebody who's a little bit older and may have some medical problems, we need to take the output from the smartwatches with a bit of a grain of salt. Jay: What struck you most, Andrew, about Mary's sleep story? Andrew: First of all, her overall story was quite inspiring and remarkable that she's able to be so healthy and so active at this point in her life. And you can really hear the frustration in her voice at the difficulty she's having with sleep. Now, sleep problems are really common as we get older. They're common for a couple of reasons. One, as we get older, we're more likely to develop medical conditions that might lead to difficulties with sleep. For instance, you might develop difficulties with needing to urinate multiple times per night or back pain or itchiness or any one of a zillion other symptoms. So this makes it more difficult to sleep as we get a little bit older. Sleep disorders as well, things like sleep apnea and restless legs become more common as we get a little bit older. And then age itself is associated with some changes in sleep. So studies have taken a look at older folks who have no identifiable sleep disorders, no identifiable psychiatric disorders, the sort of rare super healthy, older adult. And even in individuals like this, when you compare their sleep to younger individuals, there are a few changes that are obvious. So, one, older folks' sleep tends to become a little bit more fragmented over time. So the sleep is a little bit lighter, you wake up a little bit more often. The sleep duration tends to be a little bit shorter, so you shouldn't expect to sleep the same 10 hours you did as a teenager when you're 65. And then the timing of sleep changes as well. Now, on average, the timing of people's sleep becomes a bit earlier as we get older. There's a lot of variation in this, and there are some older adults who remain night owls well into their later years. But on average, even those folks will be slightly less night owls than they were when they were relatively younger. Allison: My mother and I, my daughter, we're all in that night owl category. But it does worry me because I do have such bad sleep in general, and I know I'm worried, and I'm wondering, and I know that other people are also wondering, to what extent do we know that that kind of poor sleep is a risk factor for dementia? Andrew: So I mean, when we take a look at the sorts of sleep problems that are associated with dementia, I think the ones that are most prominent are people who have very short sleep time. So if you're sleeping five hours a night, that appears to be associated with an elevated risk of dementia. People who have bad sleep fragmentations, who are waking up a lot at night, have a higher risk of developing dementia and specific sleep disorders. Things like sleep apnea appear to be quite strongly associated with the risk of dementia. Now, sleep timing is, I think a complicated one. So people have taken a look at people's tendencies toward morning-ness and evening-ness as it relates to dementia risk, and there may be sort of subtle signals there. One of the complexities of that is that people who are strong evening types are, as you say, stuck in a world full of morning types. So although there may be a bit of an association between being an evening person and having dementia or a future of dementia, this is much weaker than some of these other factors. I think at least some of it is that folks that are evening folks are being forced to live on a morning schedule. And it's in fact that dyssynchrony between the internal clock and the external schedules that's the thing that's kind of bad for you. And I suspect that what would happen is we just let evening people live their evening schedules, then a lot of that problem would not be evident. Allison: Or if I become a stand-up comedian or a jazz musician, some sort of late night job might be better for me. Andrew: Well, that's exactly it. So I have a ton of patients in my practice that are evening people. So they're folks who well into their 50s and 60s prefer to sleep like teenagers, and there are a few of them that successfully do so by doing exactly that. I mean, they work in industries where that works great. So I have a bunch of folks in IT who will show up for work at noon and leave work at 10:00, and that kind of works from their perspective. Allison: Yeah, well, I'm stuck in my job. I love my job, so I shouldn't say that, but I'll live in the day world for a while longer. When I or others are having poor sleep what is it that's actually going on in the brain? Andrew: Sure. So our group and others have done a lot of work trying to understand why it is that people who have poor sleep appear to have a higher risk of having dementia. There are a couple of key mechanisms, a number of key mechanisms that we've identified. The first, number one, is that it appears that sleep is the physiological state in which the brain tries to clear its waste from itself. So there's a mechanism that goes by the fancy term lymphatics, but really what it is, is the flushing out of the brain substance of toxins and metabolites, toxic proteins like the amyloid that leads to Alzheimer's disease. So that's one important mechanism. We and others have shown that sleep plays an important role in damping down inflammation. For instance, when we took a look at older folks in whom we measured sleep using kind of like a fancier version of the Fitbits that you can get commercially. And then we took a look at the brain, so they agreed to donate their brains when they passed away. What we found was that adults who woke up very frequently had a much higher level of inflammation in their brains, and that this inflammation in turn was associated with poorer memory. So we think inflammation plays an important role. A third important mechanism appears to be the maintenance of brain blood flow and brain vessel health. So we know that, and we've shown this in our own studies, individuals who wake up frequently or individuals who have very irregular sleep will go to bed and wake up at different times every day when we looked at their brains, had evidence of worse brain vessel damage as well. Allison: What does brain vessel damage mean? Andrew: The blood vessels are of course what provide blood flow to the brain, and your brain needs healthy blood flow just like every other organ to function properly. So what we found there was hardening of the brain's arteries, so thickening of the artery wall. And we know that this hardening of the arteries is one of the things that can contribute to cognitive impairment and dementia. Allison: So normally you hear about thickening of the arteries in the heart, but this is thickening of the arteries in the brain. Andrew: Exactly. Exactly. And others have taken a look at sleep apnea in relation to these sorts of changes as well. So it appears as though thickening of arteries in the brain and resulting poor brain blood flow appears to be an important mechanism linking sleep and dementia. And then a final mechanism that people have taken great interest in is the connections between nerve cells and how they're affected by sleep. So one of the mechanisms by which we form new memories, by which we're able to learn new things is by forming new connections between the neurons, the nerve cells of the brain, but also importantly getting rid of old less important connections. So as we learn new things, these connections between brain cells are always reforming, strengthening, less important connections or weakening. And this is an important part of being able to form new memories. And we know that a lot of this process, of strengthening the important connections and weakening the less important connections happens in sleep. Jay: So Andrew, I'd like to go back to the first factor you mentioned about clearing waste from the brain. And we also know that there's light sleep, deep sleep, dreaming sleep, REM sleep. Does that happen in certain of those phases and not in others? Andrew: Yeah, so it appears as though that mechanism happens most effectively in the deepest stage of sleep, which is slow wave sleep. So it's important to be able to get some amount of slow wave sleep. Now we don't know exactly what part or what aspect of slow wave sleep is important for that. There's still a lot that we don't understand. But the slow wave sleep itself appears to be important. And more broadly, it appears that the sleep stages play important roles in different aspects of sleep. For instance, REM sleep appears to play a role in consolidating certain types of memory. REM sleep is dreaming sleep, rapid eye movement sleep. Others have shown that slow wave sleep, and in particular, certain types of slow wave sleep or certain qualities of slow wave sleep are more associated with some of the abnormal proteins that build up in Alzheimer's disease, so amyloid plaques and neurofibrillary tangles. But it does appear that what you want to get is sufficient quantity and quality of slow wave sleep and of REM sleep. And together those two stages of sleep have been shown to be the most predictive of cognitive outcomes. Jay: Is there any way somebody could know that their intermittent waking during the night is interfering with deep sleep, slow wave sleep? Andrew: Yeah. So in general, because the way the sleep cycles work is we start off when we fall asleep, we start off in relatively light stages of sleep, and as we stay asleep, we fall into deeper and deeper stages of sleep. So that about 45 minutes to an hour after you initially fall asleep, you're finally hitting a slow wave sleep and then REM sleep. So in general, if you're waking up very frequently, then it makes it less likely that you're able to stay asleep long enough to hit those deepest stages of sleep. Allison: For people who want to know how do they get into the right stages of sleep at the right time and start to sleep better, what advice do you have about what we can do to improve the quality of our sleep so we can reduce our dementia risk? Andrew: Sure. So I think there's a bunch of things that we can do from a behavioral and lifestyle perspective that can be really helpful from a sleep health perspective. So one important thing is to have some degree of regularity in your sleep patterns and ideally regularity that fits in with your own biological sleep tendencies. So that if you're tend to be an evening person, you're going to regularly go to bed maybe a little bit later than everyone else and regularly wake up a little bit later than everyone else. So I think regularity is really important. Part of that regularity is having a regular routine in that pre-sleep period. So you have a regular relaxing routine that sets your body up psychologically and physically to fall asleep. That shouldn't include things like trying to do your taxes or get work done in the minutes before bed. Some people will read a book, some people will take a bath, having a cup of milk, other things, a little bit of a warm tea. These are all very helpful things. One thing that a lot of my patients, or at least some of my patients, find helpful is to do a little bit of meditation. And a lot of folks find this an important part of their regular pre-sleep routine. Having the right sleep environment is important. You want your sleep environment to be quiet, you want it to be dark. It's very hard to sleep in a noisy and bright environment there. And then in addition to that, I think a part of this that people often don't think about in relation to sleep but is actually really important is what happens during the daytime. So it's really, really important to get as much natural light exposure as you can during the day. This is relatively easier in the summer, it's relatively more difficult in the winter. It's difficult when you wake up at 7:00 in the morning and it's dark outside and by 8:00 or 9:00 it's brighter but gloomy. So it's hard to get enough daylight during the winter. But to try and do that is really important. And physical activity as well. Getting enough physical activity during the day, not in the hours immediately before bed, but before that point. It's just really important. It's really important in keeping the body clock on track and it's really important in getting the body in a shape that's ready for sleep. Allison: Those are all such great tips. And you mentioned it's good to have light, but there's always a question that comes up about having light right before you're going to bed. In other words, should you be having as part of your bedtime routine reading a book on your phone or your iPad or playing Sudoku or whatever on your phone or your iPad? Andrew: So the answer is in general, no. I mean there are exceptions, right? I think it depends on what your body's internal body clock tendencies are. But in general, I mean, what you want to think about is getting light at the time when natural light would normally occur. So I mean, through millions of years of evolution we evolved in an environment where light was available basically from dawn through dusk. This makes me actually think of one of my favorite studies that's been done in sleep medicine, was a study that was done by Ken Wright in Boulder. And what he did was he took a bunch of seemingly healthy young and middle-aged adults who had no sleep disorders, no psychiatric problems, no medical complaints, but they were just normal folks like you and I working our office jobs in the city. And what he did was he measured their sleep in their normal lives. So remember, these are people without sleep disorders or sleep complaints, and he did some EEGs, he did some wristwatch measurements, and the sleep wasn't terrible. So the sleep was pretty much what you would expect for healthy young people. Then what he did was this, he basically took them all on a week-long camping trip. So they went out into the Colorado Rockies and they went hiking all day long, at night there were no artificial light sources, no device, maybe a campfire at most. And he measured their sleep again using wearable devices, but now in the woods. And what he found was even folks who had seemingly normal sleep just slept better. They slept better when they were taken away from the city environment, taken away from all that nasty artificial light, exposed to natural daylight at the time you're supposed to be exposed to natural daylight and exposed to levels of physical activity that we were supposed to be exposed to. When we were all hunter-gatherers we didn't sit around in a chair all day staring at computers. We're supposed to be walking, tons. Outside all day long. Allison: So you're not suggesting that we all quit our jobs and move into the woods, though. I think what you're suggesting is maybe we turn off our screens before we go to bed. Andrew: A lot of us probably be pretty happy quitting our jobs, moving to Hawaii. But I think it just goes to show that the daytime environment especially is really important for getting healthy sleep. And what we do during the day and what we're exposed to during the day actually matters a lot. Jay: So the most important question, Andrew, how do you sleep? Does the sleep doctor practice what he preaches? Andrew: Right, right, right. So in addition to being a sleep doctor, I'm a clinical neurologist at Sunnybrook, and that involves its fair share of nighttime work. So in addition to that, I've got a couple of young kids. So between the on-call time and the kids, it's definitely a matter to some degree of doing as I say, not as I do. Jay: Thank you very much for this, Andrew. Andrew: Yeah. Thanks so much, Jay. Thanks so much, Allison. Jay: Dr. Andrew Lim is an associate professor of neurology at the University of Toronto and a sleep neurologist at the Sunnybrook Health Sciences Centre. He joined us from Toronto. Allison: So Jay, what did you think of that conversation? Jay: Well, it's complicated, right Allison? There seem to be so many factors that go into having a better sleep. If I had to pick one though, it's consistency. The idea of going to bed at roughly the same time every night, have a pretty set pre-bedtime routine, try and get up in the morning at roughly the same time. Now it's hard to do all of that, but try if you can and don't try to catch up, having a three-hour nap Saturday afternoon. So for me, consistency is one of the biggest things. What about you, Allison? Allison: I think for me, the fact that so many people have sleep problems really stood out, and I'm, as you know, one of them. And I think it's also really interesting that different kinds of solutions work in different ways for different people. So I've tried so many different kinds of things, whether it's trying not to use my screen before bed or trying different kinds of mindfulness meditation. Those may have worked for other people, but they haven't necessarily worked for me. So that variability in what kind of solutions are going to work for people, I think really stood out. I think it is also really important though, that people understand that if you're having any kind of sleep issues, the first thing that you should do is just go talk to your doctor. To find out more about how you can reduce the risk of dementia or slow its progression, please visit us at defydementia.org. There you can check out other episodes of this podcast as well as our videos and infographics. Jay: Our podcast production team is Rosanne Aleong, Monique Cheng, Sylvain Dubroqua. Our chase producer is Ben Schaub. Production is by PodText. Music by Steve Dodd. And cover art by Amanda Forbis and Wendy Tilby. Allison: We'd like to express a big thank you to the funder of this podcast series, the Public Health Agency of Canada. Please note that the views expressed here do not necessarily represent the views of the Public Health Agency of Canada. Jay: Your support is greatly appreciated too. So please hit that subscribe button for Defy Dementia on Spotify, Apple Podcasts, Google Podcasts, or wherever you get your podcasts. I'm Jay Ingram. Allison: And I'm Allison Sekuler. Don't miss the next episode of Defy Dementia. If you've been listening to all the lifestyle tips that we've shared over all the episodes so far and are wondering where the heck do I start? Well, that's a smart question, and this next episode is for you.