Angeleta: I think the fact that she gave so much, honestly, she gave probably too much. I remember one of my cousins in Jamaica needed something and my mom was like, "Don't worry about it. I'll pick up a few shifts." And she was off and she would work and she would make sure that she kept on going. For her, I believe she had no limit when it came to her stress. I don't think she recognized the burnout factor or that she could possibly be exhausted. I think she didn't take time for herself as much as she should have, and that eventually impacted her health. Jay: That's Angeleta Cox. She believes that her mom may have developed Alzheimer's disease because of poor brain health arising from burnout. Angeleta is here to share her mom's story and to spread the word about the Alzheimer's risk faced by women. Allison: Welcome to Defy Dementia, the 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 of dementia, because dementia is not predestined by our genes. Genetics plays a role, but lifestyle risk factors such as unhealthy eating or loneliness are also very important. Allison: And scientists are saying 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, we're exploring why women may face a higher risk of Alzheimer's disease than men. We're going to take a look at the latest research exploring how we might be able to reduce that risk. 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 journalist. I've been writing and speaking about dementia for more than a quarter-century. Allison: Join us as we Defy Dementia because you're never too young or too old to take care of your brain. Jay: On today's show, we're focusing on women's Alzheimer's risk, and we're looking at Alzheimer's in particular because it's the dementia that affects women disproportionately. Allison: And the stats are sobering. Almost 2/3 of people living with Alzheimer's disease are women. And while breast cancer is seen as a serious health risk for women, women in their 60s are twice as likely to develop Alzheimer's disease as they are to develop breast cancer. Jay: At first glance, the fact that 2/3 of people living with Alzheimer's are women may not seem too shocking. After all, women on average live longer than men. The 10 oldest people in the world are women, and the greatest risk factor for Alzheimer's is age. The older you are, the more likely you are to develop Alzheimer's. Allison: But as you'll hear today, stress, reproductive history and a decline in estrogen brought about by menopause may all play a role in the onset of Alzheimer's disease in women. Jay: We're going to be speaking to a Canadian researcher who is a world leader, exploring some of the biological and social risk factors for Alzheimer's that affect women. Allison: But first, a personal story about a woman who burned brightly and maybe burned out. Jay: Angeleta Cox is a 49-year-old mother of three from Mississauga, Ontario. She grew up in a Jamaican-Canadian family who first came to Canada in 1985. At school, she majored in sociology. Now her day job is at Correctional Services Ontario where she is a programs officer, teaching life and job skills to inmates. Angeleta is also part owner of three Jamaican restaurants in Toronto and Brampton, Ontario. Angeleta's mom, Sonia Elizabeth Cox, worked as a personal support worker for older people for 28 years. She was diagnosed with early onset Alzheimer's disease at the age of 61. That happened in 2017. And since then, Angeleta has been her main caregiver in the family. Angeleta is the founder of the Pan-African Dementia Association. She's also a member of the Black community working group at the Alzheimer's Society of Canada. She's also served on advisory panels and as a public speaker for the Alzheimer's Society. Angeleta is here with us to talk about women's risk for dementia through her mom's story and her own. Angeleta, welcome to Defy Dementia. Angeleta: Thank you so much for having me. Jay: You're sharing a lot of information with us about you and your family. Why are you doing this? Angeleta: Well, I think for me, the main reason why I speak so openly about our experience is that I believe in sharing specifically my mom's experience. There are so many lessons that we can learn. I think in telling a story, others can hear it, relate to it, and also learn from it. And the hope is that my mom's story and my own lived experience can help them in some way or the other. Allison: So can you tell us a little bit about your mom Sonia, before the diagnosis, what kind of person was she? Angeleta: My mom was, I would say, an amazing woman. I would say she definitely was a force to reckon with. She was powerful. She was unstoppable. Really and truly, she had standards, high standards. She was a hard worker. She had great ethical principles. She was devoted to her family and to her friends. You could call on her for anything anytime and it would be done. There isn't anything I could tell you that my mom cannot do. She baked, she sewed, she crocheted, she gardened. And even till today, [her generosity is evident in the garden she tended]. So along our neighborhood, right now if you go houses to the left and to the right of us, have flowers still planted that bloom year after year that my mom planted in our neighbor's yards. My mom's garden was so big that even when you pulled up Google Map, you could see my mom's garden. Allison: Amazing. Angeleta: So she's an amazing woman in her fullness, you know? Allison: Yeah. And what was a day in the life of Sonia like? Angeleta: It was full. My mom started working four days after we came to Canada. That was her first job, and that was job number one. And then job number two came shortly behind that. Eventually, at one point I do remember my mom having three jobs. That's how hard she was. Allison: Wow. What sort of jobs did she have? Angeleta: She's a factory worker. I don't remember if people remember consumers distributing, she was a staker. She would move boxes. And eventually, she said she wanted more for herself. So she went back to school and she did her first upgrading. I remember seeing her at the kitchen table at night doing her homework. And then in the morning I would get up and she'd be gone to work. So consumers distributing was her first job. And then she started to work as a cleaner in a hotel. And then from there she went back to school and became a PSW. Allison: A personal support worker? Angeleta: Right. And so she worked at several homes. Eventually, she got full-time position at a private home in Etobicoke, and full-time position at another home in Toronto, which was run by the city of Toronto. Allison: When you say home, you mean a long-term care home, not an individual's home? Angeleta: A long-term care home. Right. She worked there for 28 years. That was her full-time job, so she went between the two. So if she wasn't going from one job to the other, she was at home. She was taking baking lessons. She was taking sewing lessons. She baked and she hosted parties. If someone was retiring at work, don't worry, mom was on that. She was baking something, making something. She did it from her heart, free. She didn't want anything back. And she did it to the fullest. She didn't just do it half, she just gave her all in whatever she did. Jay: That's an incredible, fascinating and wonderful life. But Angeleta, what factors or events in that life of your mother do you suspect may have contributed to her early onset Alzheimer's? Angeleta: Well, I think the fact that she gave so much, honestly, she gave probably too much and she never stopped. She just kept on going. There wasn't a cause for which she did not champion. I remember one of my cousins in Jamaica needed something and my mom was like, "Don't worry about it. I'll pick up a few shifts." And she was off and she would work and she would make sure that she kept on going. For her, I believe she had no limit when it came to her stress. I don't think she recognized the burnout factor or that she could possibly be exhausted. She just kept on going. She never complained. I think she didn't take time for herself as much as she should have. And that eventually impacted her health, I believe. I remember [when] she had a brain tumor. And shortly thereafter, there were other issues she faced as well, including when she had a hysterectomy. She rebounded quickly from that. She never really took the time to take care of herself, I think, not because she neglected herself, but because she had so much to do for others. I think because we come from a culture where women take on so much, and I think also because of the fact we came as immigrants in this country. She really wanted a lot for us. She understood the struggle we would have in this country as immigrants, as Black kids growing up, so she wanted the best for us. So she understood the struggle and she tried her best to make sure that we would not face that. And whatever hurdles or obstacles she thought that would impact us, she took it upon herself. And I think whether she was stressed out, whether she was overworked, whether she was burned out, we didn't feel it. Her body felt it. Allison: Yeah. And we have seen in other episodes this idea that people are sometimes so focused on taking care of others, doing so much for others, that they're not taking care of themselves as much as they could to decrease their dementia risk. You mentioned your mom was a force to be reckoned with. Are you also a force to be reckoned with? How much are you like your mom? Angeleta: When I was growing up, I would say I would never be like my mom, but I feel like I'm very much like her. And I'm not saddened by that. I'm actually proud to say that. I feel though that I take from my mom many lessons. As the introduction was being read and I'm hearing all these things I'm doing, I'm thinking, "Wow, that's a lot." We grew up as Christians. In the Bible they talk about a woman of Proverbs. She takes care of her household and everyone, and my mom was that way. And when my mom became sick, I became angry with God. Why should this happen to a person as good as her? [And for me, I feel], the lesson I'm learning from my mom is the take away from her sickness. And comparing myself to my mom in so many ways in terms of our characteristics, our lifestyle, the stress we take on, the battles we fight, and even down to my own physical manifestation, I think that my kids would say that I am also a force I reckon with. But differently than my mom. I'm very cognizant of the stress I take on. I check myself. I make sure that I'm not exhausted and depleted. I'm very careful in terms of the lifestyle that I live. I take care of myself. I am a student of meditation and mindfulness, and I pull myself back. I understand that there are limits, and I think that's a lesson I'm taking from my mom. I live every day to the fullest for me as well. As much as I'm making time for others, I try to make time for myself too. Allison: [And when you say you've learned the lessons from your mum and that you have changed the way you're dealing with your lifestyle, is it intentional for you?] You sort of have that in the back of your mind that your mom was doing so much, which often women do for so many other people. Angeleta: Oh, it's 100% intentional. It has to be intentional. I am aware of what I am doing. I am aware of the changes I need to make. I compare myself to my mom very much because I understand that there's so many similarities between her and I. [But] I understand [that] if I continue to follow her exact path, the ultimate consequence could be very similar if not the same as hers. So the idea is from this point on, what I do is I make a change now for myself and even for my daughter. I have two boys and a girl. And even for my daughter, I make sure that there's an example set so that she knows and sees what I'm doing so that it's not repeated again. Jay: Angeleta, how is your mom doing these days? Angeleta: Now, mom is quiet. So unfortunately she no longer speaks. She no longer communicates [and] no longer moves around. So she's quiet. She's quiet, but the one thing that those who are caring for her will say is [that] you [can] still feel her energy and that she's still a pleasant person. [In] the long-term home where she currently resides, some of the people who are caring for her are actually individuals who she has trained. And so because these people are familiar with her in the fullness of her life, they actually treat her differently right now because they remember Sonia when Sonia was smiling. They remember Sonia when Sonia was at her fullest. Jay: Angeleta, you're taking steps to make sure that your kids don't take the same life path that may not have been completely good for your mother. But if you were to talk to the people listening to this, what would be the one thing that you'd want listeners to take home from your mom's story, and your story too? Angeleta: I think the one thing I would say is live your life to the fullest, but live it in balance. That's the one thing I would say to people, [to] understand how precious life is and how valuable time is. Understand that you can do all you can do, but do it within limits. Allison: Thank you so much for sharing such a personal story with us, Angeleta. Angeleta: My pleasure. Thank you. Allison: Angeleta Cox is a restaurant owner, corrections officer, mother and caregiver. She's also the founder of the Pan-African Dementia Association and a volunteer at the Alzheimer's Society of Canada. She's from Mississauga, Ontario. Our next guest has been listening to Angeleta. Dr. Natasha Rajah is a professor in the department of psychology at Toronto Metropolitan University and also a Tier 1 Canada research chair. That's a title given to Canadian scientists in recognition of their innovation and world-class status. She's also an adjunct scientist at Baycrest's Rotman Research Institute. Natasha researches how sex, gender, and diversity affect brain health and aging. And right now she and her team are working on a study that explores how biological factors like hormones contribute to women's risk for Alzheimer's disease, and they're also looking at social factors. Today, Natasha joins us from Montreal. Natasha, thank you for helping us defy dementia. Natasha: Thank you for having me. Happy to be here. Allison: First, let me ask you, what struck you about Angeleta's story and the story of her mom Sonia? Natasha: So one of the things that struck me was just how similar it is to my story in many ways. My family is also an immigrant family. I was born in Sri Lanka, and then we moved to Zambia where my dad passed away. And so my mom was a single mom with three daughters and we emigrated to Canada. Once she got to Canada, she then learned how to drive. She went back to school to get a bit of education so she [could] get a job. And so I could relate to a lot of what Angeleta was saying about her mom being a powerhouse and really working hard to make the best for her children. Allison: And you're a powerhouse as well, correct? Natasha: I like to think so. I'm probably the softer one between my husband and I, but yes, [My daughter] does like to listen to me talk about science. And I think I'm a powerhouse, sure. Jay: And Natasha, how did you get into studying people's brain health? Natasha: So I was interested in neuroscience for a long time when I was an undergraduate in psychology at University of Toronto, but it really was, again, life experiences [that made me decide]. So my grandmother, my mom's mom, who lived with us when I was a child, became really ill. They didn't know at that time what it was because this was back in the '90s and diagnoses weren't as clear at that time. So she was diagnosed with Parkinsonian type disorder. But later on as I've become educated, I realized it probably was Lewy body disease. And so just seeing her age and seeing how my family had to pivot and accommodate our life to take care of her and things like that really made me more and more interested in understanding aging. And with age and more experience, understanding how different cultures experience aging, how different cultures and backgrounds experience cognitive and brain aging. So that's where my current research is focused on, because it's personal. Allison: Some of the work that you're doing, as we mentioned, is really focused on these sex and gender differences. Apart from accounting for women living longer, which we talked about at the top of the show, can you give us a bit of a thumbnail sketch about what [we] know about women's risk of Alzheimer's and to what extent is it greater than the risk that [is faced] by men? Natasha: So we do know that there's a higher prevalence rate. So there's more cases of Alzheimer's disease in women compared to men. This is after controlling for life expectancy. And we are starting to learn that there are certain risk factors for Alzheimer's disease. So non-modifiable risk factors such as the APOE gene, and its variant epsilon 4 allele, that really affects females more. So females with this genotype tend to have a greater burden of tau in their temporal cortex in addition to amyloid beta. And there's some literature coming out now that indicates that this risk factor has a greater effect in females compared to males. That's a really important discovery in the last decade. [For] incidence rates, that's the number of people diagnosed with Alzheimer's disease, there is a lot of debate on that. It seems as though males and females have a similar incidence rate, but there was a higher prevalence in women, 2/3 of Alzheimer's disease patients are female. Allison: So Angeleta mentioned that she thought that lifestyle risk factors were playing a role in her mother's Alzheimer's. [Given what you've just said], how important do you think it is for people, especially women, to institute lifestyle changes like better diet and more exercise? Natasha: There is a lot of interest right now about how sex and gender and our differential exposures to social determinants of health. Such as education, socioeconomic status, access to exercise environments and things like that, [and] how that could affect health and brain aging in females and males. And what we're noticing is that different types of exercise might be beneficial for females compared to males. So after menopause, strength training and building muscle mass and preventing frailty in females seems to be a very important difference between males and females. So really focusing more on maintaining bone health and strength in aging with females. Jay: Thinking back to Angeleta and her description of Sonia, her mother; hardworking, raising a family on her own, overcoming illness, are those factors that you see, Natasha, as playing a role in the risk for dementia? Natasha: There's a lot of growing evidence that stress and lifetime exposure to stress is a modifiable risk factor for Alzheimer's disease. So from the story that I heard, her mother was vibrant and was very engaged in helping others, but she highlighted that maybe she was taking on a lot, she had multiple jobs, and there might've been a lot of stress. In addition to that, one of the things that we know from data in [North] America is that there is evidence that individuals that are racialized minorities may experience racism or prejudice or some sort of bias against them, which is another type of social stress that can affect how we age. And so I don't know what the exposures were for Angeleta's mom, but given that she's an immigrant, she probably had a lot of stress moving to Canada and raising her children. And she seemed to be very extroverted in focusing her attention [on] other people. So I think there might've been a lot of hidden stress, and that might've affected her aging. Jay: One significant difference between aging men and aging women is that women go through menopause. Lots of people talk about a male menopause. It obviously isn't the same thing. Is there any evidence that menopause might have an influence on the development of dementia? Natasha: There is evidence that surgical menopause has detrimental long-term effects on the cognitive health of females. Females that had an oophorectomy. An oophorectomy is the removal of either one or both ovaries in a female. This is in contrast to a hysterectomy, which is the removal of the uterus [where often the ovaries are kept] in place. So if you do have an oophorectomy because you have a risk factor for ovarian cancer or breast cancer, there is evidence that this has detrimental long-term effects on the cognitive health of females. Now, in spontaneous or natural menopause, which is what females with ovaries experience roughly around the age of 51, they experience brain fog, lack of sleep, night sweats. There is evidence that for some females,things like that have cognitive effects in females at midlife. What I'm studying is actually to try to understand if those [symptoms] in midlife actually may be predictive or prognostic of later cognitive aging. Are the females who are experiencing brain fog and cognitive dysfunction at midlife during the menopause transition, [due to lack of sleep or night sweat], the ones that are more vulnerable to dementia later in life?That's an ongoing research study in my lab. We don't know the answer to that question yet, but we do know that menopause has effects on cognition and brain function at the time that females experience it. Whether or not that can predict risk for Alzheimer's disease and dementia, that's still unknown. Allison: So you mentioned the effect of an oophorectomy, the removal of the ovaries. Angeleta mentioned that her mom had a hysterectomy. I'm wondering what's the current scientific thinking on hysterectomies as a risk factor for Alzheimer's and other dementias? Natasha: There is some growing evidence that hysterectomies can also have negative consequences for cognition and well-being later in life in females, but it all comes down to the blood supply to the ovaries and how the hysterectomy was performed. If there is an impact to the blood supply and to the health of the ovaries, and so [to] the exposure to estrogens that females have throughout their lifespan, then there could be detrimental effects. Because inadvertently the hysterectomy might have reduced the amount of estrogen being produced. Allison: So then when you think about hormone replacement and other kinds of treatments, are those options available now and would they lower the risk of Alzheimer's? Natasha: That is a big debate in the field. Historically, the women's health study from the United States kind of highlighted how hormone therapies might be detrimental. But in retrospect, as new scientists have looked at that data, what we noticed is that that study was conducted in older females in their late 60s that had already gone through menopause [when] they were being introduced to hormone replacement therapy and therefore it really didn't speak to females experiencing menopause and being put on hormone replacement therapy at the time of perimenopause and the transition to menopause. Right now there seems to be some evidence that hormone therapy may be beneficial. It might mitigate some of the cognitive brain fog that females experience during menopause transition. Now, I want to give a caveat there though, because it really is an individual based kind of approach. So you really need to talk to your doctor. Look at your family history and risk factors for estrogen related cancers in your family, and then talk to your doctor about what type of hormone replacement is best suited. There's many variables. So there's estrogen. And if you take estrogen and you have a uterus, then you have to take progesterone as well to offset risk factors for cervical cancer. But if you don't have a uterus, you could just take estrogen on its own. And then there's also females that just take progesterone as well. So there's many, many kinds of formulations now that are available to females. So if you are seeking or interested in hormone replacement therapy, it's important to talk to your doctor about all the variations that are out there. Allison: So it's definitely not one size fits all. And there's so many interesting variations that we're starting to think about. For example, the role of hormones in trans women. Natasha: Yes, there's an interesting study that's being led by Dr. Jillian Einstein at University of Toronto and Baycrest that I'm collaborating on where she is exploring how hormone treatment in trans women may affect their cognition and aging. We really don't know. This is a brand new start in the field. Jay: Natasha, we've talked about a lot of different angles on this issue of women and their increased risk for dementia. Could you just kind of give us a sense of the main directions that you and your lab are heading in terms of trying to figure this whole puzzle out? Natasha: Sure. One thing we're very interested in is looking at how cardiovascular risk factors and biomarkers for vascular and inflammatory health in females as they transition through menopause, is related to brain function and cognition. Because inflammatory markers and vascular health are also risk factors for Alzheimer's disease. So we are trying to bring it all together about how females experience menopause, how that then relates to inflammation and vascular health, and then maybe [how that] affects brain and cognitive function. And also what differentiates the females that experienced this to a greater degree from others and how do they age. [We want] to follow them up longitudinally and see [whether] once they've gone through menopause transition, do they improve? Do they go back to having normative levels of cognitive function or are they still showing difficulties? So we really need that longitudinal study to understand how these females, once they transition, how do they progress. Because there's a lot of debate in the field right now about whether it's just a little blip. You go over the hump of menopause and then you kind of normalize. Or if some females, they go over the hump, but they don't normalize. So we need to identify those females in order to try and prevent them from getting Alzheimer's disease later in life. Allison: So just coming back to lifestyle risk factors, in the context of what you've just been talking about, do you think it is still important for people to institute changes to those lifestyles to reduce the risk factors? And might that be working differently with women versus men? Natasha: What type of exercise you do matters, if you're a female or a male. So [if you are]doing a lot of cardio as a female, maybe switch it up and do a bit more strength training, get that bone density up to help with frailty and help with general health. If you are a smoker, or if you drink more than seven to 14 glasses of wine a week, these are modifiable risk factors. If you stop smoking, if you reduce the amount of alcoholic units that you consume in a week, you will see benefits. I think vascular health is very important as we age. Keeping our vascular health. So go see your doctor, see what your blood pressure is like, what your cholesterol is like, and do what you can to keep it in a healthy range. Jay: And Natasha, are you constantly aware of all of these lifestyle issues? I'm not prying here. Are you trying to adopt them as much as you can? Allison: Do you practice what you preach is what he's asking. Natasha: Yes. I love yoga. And yoga has a lot of strength training in it. You use your own body weight to kind of build your strength. And it also provides you with the space to de-stress and kind of center yourself. So I think stress management is very important as we age. I do eat less meat. That's something I've been conscious about as I age to eat less meat and to eat a broader, more colorful diet. Jay: That sounds good. Thank you very much for doing this, Natasha. We really appreciate you joining us. Natasha: Thank you for having me. Jay: Dr. Natasha Rajah is a Tier 1 Canada research chair and professor of psychology at Toronto Metropolitan University. She joined us today from Montreal. Allison: Before we get into our reactions about what we heard from today's guests, there are some other factors women might face that might also increase the risk of Alzheimer's, and here's one. Of all the caregivers looking after people living with Alzheimer's and related dementias, about 60% are women. And as we heard on our caregiver episode, episode number 11, caregivers face up to six-fold risk of dementia because of the toll that caregiving takes. It affects many risk factors such as diet and sleep. Jay: There's another tentative possibility. Brain injury caused by intimate partner violence. Intimate partner violence can cause concussion, that's a form of traumatic brain injury. In fact, YWCA Canada estimates that for every concussion a national hockey league player suffers, 7,000 women in Canada suffer the same injury because of violence by an intimate partner. Allison: So there's an uncertain but possible sequence of events here. Traumatic brain injury is a known risk factor for dementia, but right now there's no strong evidence connecting brain trauma from domestic violence with dementia risk. But now there are some scientists at the University of British Columbia and Vancouver Island University who have begun research on exactly this topic. Jay: That's really striking to me Allison because the more episodes we do and the more risks for dementia we uncover and we talk about them, it seems to get more complicated all the time. Who would've thought about intimate partner violence as a possibility? So it does get more complicated. And I wonder if some people might be a little depressed by that. There are so many things to think about. But on the other hand, we're coming up all the time, as we've talked about, with many ways that you can lower these risks. So maybe I'm wondering, we're just at the first stage. And then suddenly the smoke will clear a bit, and we'll have a much clearer picture of dementia and what you can do to prevent it. And especially as we're talking about today, the risks that women face in particular. Allison: Yeah. Just don't breathe in the smoke because that's also bad for you. Jay: Right. Okay. Smoke was a bad analogy. I'm sorry. What do you think about what we've heard today? Allison: Well, interestingly, you're talking about how all the different factors interact with each other, and one of the things I found most interesting today was when Dr. Natasha Rajah was talking about the research on exercise and women and that the kind of exercise that might be best for women might be different from the kind of exercise that's best for men. I thought that was a really interesting sort of concept that it's not going to be one fits all for sure. What was interesting for you? Jay: I think just the idea there are new layers of complexity all the time of potential risk, actual risk, but also things we can do about those risks. And I think at some point it's going to become a much clearer picture, much better and more widely understood picture than it is now. But hey, on Defy Dementia, we're doing our bit. Allison: So it's just really clear that it's not one size fits all. You've got to figure out what works for you. To find out more about how you can reduce the risk of dementia or slow its progression, please visit us at defydementia.org. Jay: There you can check out other episodes of the podcast. There's 13 of them now, as well as our videos, infographics, and plenty of other resources. Allison: Our podcast production team is Rosanne Aleong and Sylvain Dubroqua. Our Chase producer is Ben Schaub. Production is by PodTechs. Music is by Steve Dodd. And our cover art is by Amanda Forbis and Wendy Tilby. Jay: And a big thank you to Jhnelle McLaren-Beato at the Alzheimer's Society of Canada, and the Center for Aging and Brain Health Innovation and Baycrest for supporting this podcast. Allison: Your support is greatly appreciated, so hit that subscribe button for Defy Dementia on Spotify, Apple Podcasts, or wherever you get your pods. And please don't forget to leave a like, a comment, or a 5-star review. Next time on Defy Dementia, stigma busting, how people living with dementia are fighting prejudice and asserting their human rights. I'm Allison Sekuler. Jay: And I'm Jay Ingram. Thanks for listening to Defy Dementia. And don't ever forget, you're never too young or too old to take care of your brain.