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To Your Health With Dr. Jim Morrow: Episode 19, Dementia, An Interview with Dr. Peter Futrell, Lakeside Neurology

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To Your Health With Dr. Jim Morrow: Episode 19, Dementia, An Interview with Dr. Peter Futrell, Lakeside Neurology

On this episode of “To Your Health with Dr. Jim Morrow,” Dr. Jim Morrow interviews neurologist Dr. Peter Futrell of Lakeside Neurology on the causes, risk factors, and symptoms of dementia. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE  back to healthcare.

Dr. Peter Futrell, Lakeside Neurology

Dr. Peter Futrell is a neurologist at Lakeside Neurology in Cumming, GA. Lakeside Neurology is dedicated to serving the neurological needs of Forsyth County, GA, and the surrounding communities. Experience has taught the physicians to treat each patient as an individual and a partner in his or her medical care. The medical practice strives to provide state-of-the-art diagnosis and treatment using the latest neurological innovations. Sub-specialties include electrodiagnostic medicine and sleep disorders. 

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

Show Transcript

Intro: [00:00:06] Broadcasting live from the North Fulton Business RadioX Studio, it’s time for To Your Health with Dr. Jim Morrow. To Your Health is brought to you by Morrow Family Medicine, an award-winning primary care practice which brings the care back to health care.

Jim Morrow: [00:00:24] Hello. This is Dr. Jim Morrow with Morrow Family Medicine Offices in Cumming and Milton, Georgia. We’re here today for another episode of To Your Health. And I think it’s gonna be a great episode today. We’re here in the North Fulton Business RadioX Studio on Windward Parkway. I’m here with John Ray. John’s running the board and taking tweets and e-mails and we’ll talk about that in a second. How are you doing, John?

John Ray: [00:00:46] I’m doing great. How are you?

Jim Morrow: [00:00:47] Good. You’re getting over that cold?

John Ray: [00:00:49] I am. Thanks to early office hours from my family care physician.

Jim Morrow: [00:00:56] Great. That’s good to know. I’m glad to hear that.

John Ray: [00:00:58] That’s how I started coming to your place.

Jim Morrow: [00:01:00] Well, it’s one of the best reasons.

John Ray: [00:01:01] Well, absolutely, because I couldn’t get into the—the one I had wanted me to wait three days until I died. Then, they would see me.

Jim Morrow: [00:01:08] It drives me crazy.

John Ray: [00:01:09] I know. And then—and that’s how I got to you.

Jim Morrow: [00:01:11] So, at Morrow Family Medicine, we do have a walk-in hour every morning. We open at 7:30 for the first hour the day. You don’t need an appointment. If you just walk in, we will take care of whatever’s going on with you right then and there. We see walk-ins every day, Monday through Friday in that hour from 7:30 to 8:30 in the Cumming and the Milton office. And that way, there’s never a weekday you can’t be seen in one of our offices. And we like to say that we’re bringing care back to health care, and that’s one of the ways that we’re doing it.

Jim Morrow: [00:01:39] So this is our 19th episode of the podcast and radio show, and we’re excited to be here again. We do have a couple of ways you can get in touch with us if you want to. You can e-mail us at drjim@toyourhealth.md or you can tweet us @toyourhealthmd. So, that’s two ways you can get to us if you have recommendations for a show, or suggestions, or comments about the show you’re listening to at the moment. We try to gather some questions during the show and present those to you and come up with some answers at the end of the show every time.

Jim Morrow: [00:02:13] So, today we’re going to be talking about dementia, dementia in multiple forms. People think about dementia, they immediately think Alzheimer’s. But Alzheimer’s is a form of dementia. It’s not the only form. And we’re lucky today to have with us a neurologist from Cumming, Dr. Peter Futrell. Pete is the neurologist, one of the two with Lakeside Neurology and Cumming, Georgia. I’ve known Pete for about 20 years. Pete, how you are doing?

Peter Futrell: [00:02:39] I’m great. Glad to be here with you, guys, today.

Jim Morrow: [00:02:41] I appreciate you doing this for us. So-

Peter Futrell: [00:02:45] I was inadequate because I don’t have walk-in hours from 7:30 to 8:30 every weekday and-

Jim Morrow: [00:02:51] But you can start anytime.

Peter Futrell: [00:02:52] I still see a patient but-

Jim Morrow: [00:02:54] You can do that any time you want to. I bet your people would be tickled to death. But I will say I’ve been referring people to Pete Futrell for 20 plus years and getting in to see him when they need somebody to take care of you from a neurological standpoint. It’s never been a problem. And I do appreciate the care you take of the people in North Georgia.

Jim Morrow: [00:03:13] So, I started researching dementia a little bit because, honestly, it’s something that family doctors are probably a little bit weak in. I know I’m a little bit weak in that particular area. And that’s why I’m thankful that you’re around. But what I read says that during the age—in the 70s and people’s ages of 71 to 79, 1 in about 20 people will have dementia of some sort. In 80 to 89, 1 in 4. And over 90, 1 in 3. And so, with the population aging like it is, this is an, obviously, increasing problem for everybody out there.

Peter Futrell: [00:03:46] It keeps us busy in the office. That’s for sure.

Jim Morrow: [00:03:49] I know it does. So-

Peter Futrell: [00:03:51] You refer patients to us all the time, including for dementia, and much appreciate that. But sorry to see the patients with it. But, of course, try to help others. And yeah, there’s no shortage of them out there as you’re suggesting with those numbers.

Jim Morrow: [00:04:06] So, Pete, tell me, in your words, what exactly is dementia?

Peter Futrell: [00:04:12] Well, the term dementia just refers to a progressive decline in cognition. So, people can have chronic issues or maybe just isolated memory issues for any number of reasons. But if it’s not kind of a progressive thing. So, for example, somebody who had a brain injury, and they had some cognitive issues from that, that’s not dementia. That’s a one-time event that happened to the brain. It can affect them. It can be residual through their entire life, but it’s not something that necessarily will get worse.

Jim Morrow: [00:04:43] Right.

Peter Futrell: [00:04:43] Dementia, on the other hand, is progressive. As you said earlier, several different forms. People always equate dementia and Alzheimer’s, but that’s not always the case. That’s, usually, the case but not always.

Jim Morrow: [00:04:58] And what are some of the other things that might go on in your body that can make you have dementia?

Peter Futrell: [00:05:07] Well, that’s probably a long list. When we see somebody who we, at least, suspect dementia, we, of course, always start looking for the basic things first. As you know, some of the simple metabolic issues. Thyroid disease is a common one that can cause cognitive issues. There’s some undiagnosed kidney or liver problems. Those could, at least, mimic dementia. Of course, medications. Also confusion because that can be hard to discern if it’s medication effect or it is dementia.

Peter Futrell: [00:05:43] There’s four different forms of dementia. So, there’s the Alzheimer’s, which is by far the most common. But things like vascular dementia, which occurs from being in multiple strokes. There’s frontal dementia. People with Parkinson’s have a form of dementia that’s not technically Alzheimer’s but very close to it. So, a lot of different things to consider.

Jim Morrow: [00:06:09] Right, right. So, if you suspect that a patient has dementia, other than what you would do in the office, are there other ancillary tests that you do? Do you order CAT scans, MRIs, that kind of thing?

Peter Futrell: [00:06:22] Of course, yeah. And it depends on—as you were saying, it depends on the patient, all the different variables, whether it’s age, or medications, or other medical issues they might be having. Obviously, in the office, we can examine the patient, we can test their cognition. And probably most important actually is having a family member or someone else who can provide history. Obviously, if you a patient is having kinds of issues, they’re not always the best historians sometimes because, of course, they don’t remember. And other times, they just don’t have the insight, and they’re not aware of even having a problem. So, that’s what we’ll do in the office is the exam and history, of course.

Peter Futrell: [00:07:04] After, the office is checking lab work. Like, for example, the thyroid we talked about. Vitamin B12 deficiency is a common one that can cause kinds of issues. Imaging, almost always either CAT scan or MRI, and depends on the patient’s age, and what else is going on with them, how we decide if we choose one or the other. We may do an EEG, electroencephalogram, looking at electrical activity in the brain. It’s, at least, possible for some types of seizures to go undiagnosed and to manifest as cognitive issues. So, that’s always worth screening for.

Peter Futrell: [00:07:46] Other than that, one test I use a lot, and I think most urologist would agree with me, is sending the patient for formal neuropsych or neuropsychological testing, which is a battery of tests. As I tell patients, it’s kind of putting your brain through the ringers, kind of a stress test for your brain, looking at all forms of cognition, whether it’s language, memory, concentration. And using your psychologist is pretty good about, sort of, teasing out what might be causing the cognitive issues, whether it’s dementia, mood issues. That can certainly fool you and look like dementia when it present. It might just be bad depression. So, we use all those things and kind of put them in the pot, mix them up, and see what it looks like when we’ve got them all together.

Jim Morrow: [00:08:34] Right. So, in the office, I see people every day, seems like. I saw one this morning who was concerned about their memory. And he was having trouble, like everybody I know, I think, having trouble remembering why he went into the kitchen, and why he walked in the room, and sometimes with people’s names. And I think is important for people to understand that that’s not necessarily dementia. And can you tell me a little bit about how you delineate the two?

Peter Futrell: [00:09:05] Well, those two examples you gave are the names in particular is, far and away, the most common complaint that I get also for older folks. And their memory complaint is forgetting names, And then, the classic, I went upstairs or I went to the kitchen to get something, I don’t remember why. That’s probably number two or three on the list as far as memory complaints. But you’re right, just because you have a little trouble with those things does not mean that it’s dementia. Depending on age, there’s a certain amount of falling off that we kind of allow.

John Ray: [00:09:40] After that, there’s a kind of stage of cognitive issues called mild cognitive impairment, which essentially just means you’re having more trouble with your memory than you should for your age, but it’s not to an extent of being dementia. Those folks are important keep an eye on though because that can, within time, sort of, switch into dementia. But no, just because you can’t remember names, definitely not that simple as being diagnosed with dementia right there.

Jim Morrow: [00:10:10] Right. And when someone is diagnosed with dementia, I know it’s important to get them on medication as quickly as possible. You know, if you start losing brain cells, which is what we’re talking about, you’re not gonna get them back. So, it’s important to protect the ones you have. Medications, it seems like we’ve been using the same medications for this for a very long time.

Peter Futrell: [00:10:34] You’re right. There has been nothing new for dementia. I have to—I could probably look it up quickly, but the most new thing we have for dementia has been out for, gosh, I’d bet 12 or 15 years. Here it is. You’re right. We really have—it, essentially, comes down to four medications that we use for dementia. Three of them are very similar, and you don’t use one at a time with a patient. And then, there’s another one, Memantine or Namenda is the brand name that can be used in conjunction with one of those other three. And that’s about what we have in our hard material right now.

Jim Morrow: [00:11:18] And I’m sure—exactly, it is sad. And I’m sure there’s a great deal of research going into that, but I think if you think about the brain and how difficult it is to understand what’s going up there, it makes it a bit little easier to understand why that’s not something that’s easy to figure out. What about—as far as meds and things, though, what about things that you hear about on the radio? I hear the advertisement for meds all the time on the radio, help your memory, prevent memory loss. Anything to that at all?

Peter Futrell: [00:11:47] Not that I’ve seen. Nothing that has been proven sufficiently, at least, for me, to recommend, as I’m sure you do. I got plenty patients asking about it. I hear it on the radio or see an advertisement on the Internet all the time. Kind of amazing what someone purports to do, but I have not seen any of the supplements that has have, you know, a reasonable study had been proven to have any benefit. So, when patients ask me about it, I caution against because of just the lack of proven efficacy. And I mean, quite simply, some are of them are pretty expensive and it’s-

Jim Morrow: [00:12:29] They are.

Peter Futrell: [00:12:29] You know, especially the older folks who are already paying enough for medications, on and off medications, and other supplements, and throw more in the mix. And not only is it a cost issue, but then, you might have to worry about interactions. And just as you know, the more medications I think we’re on, the muddier the waters are.

Jim Morrow: [00:12:47] That’s right. Very true.

Peter Futrell: [00:12:48] And I’d love for it to be the case. I tell patients all the time, “Boy, if somebody proves to me that eating, or sleeping over here, or something will do the trick, I will be the first to not only recommended but take it myself.”

Jim Morrow: [00:12:59] Right, right.

Peter Futrell: [00:13:00] I just don’t see it yet. I wish I did.

Jim Morrow: [00:13:04] What about alcohol as far as bringing on dementia. Is there a relationship that you’ve seen there?

Peter Futrell: [00:13:12] Alcohol, a little bit of a funny one. Just with dementia, just like with other medical conditions, you always say, “Well, drinking in moderation helps. Drinking too much hurts.” And that’s probably the case for dementia that that little bit of alcohol may have some benefit actually in preserving. I guess, that’s the mixed results about that. I don’t think anybody would argue, though, that too much alcohol, and I’m not sure I can find too much alcohol, but too much alcohol absolutely can exacerbate dementia and even cause reform of dementia, that alcohol boost dementia that we occasionally see, and fortunately not too often but clearly can happen.

Jim Morrow: [00:14:00] One thing I get asked a good little bit in the office is about people that have a family history of dementia, and they’re concerned about that. Do you find that it runs in families? Do you find that is hereditary?

Peter Futrell: [00:14:13] There’s likely some genetic component. I’m not sure how strong that really is. My—when I’m asking about it from patients, I explain that if there’s family members, especially multiple family members, then just it seems to be borne out. I think common sense would tell you that, yeah, your risk is somewhat higher. But it’s not one—certainly not a slam dunk like, “Oh, gosh. Mom or dad had it. The rest of us are going to get it too.” That is not the case.

Jim Morrow: [00:14:41] Good, good. And once somebody is diagnosed with dementia, I know the progression can happen at all kinds of different rates. There’s no way to really predict most of that. But what would you tell or what do you tell caregivers to expect or that they need to understand about dealing with a patient that has dementia?

Peter Futrell: [00:15:06] Well, that’s a big question there. I think there’s probably a lot of aspects on that one. You know, everybody wants to know where it’s going from here. No question that that’s one of the most top concerns is, “All right. You just diagnosed my husband and my father with dementia. What can we expect in a year, or two years, whatever?” I dodge that question the best I can, usually, from patients, because it’s just so difficult. I have my own patients, some of them that clearly have dementia, but it’s been terribly slow, which is a good thing that I’ve been following for many years, and I’m not sure I’ve seen that. Well, a little bit decline over that time, but not anything terribly significant.

John Ray: [00:15:50] And then, I got patients, including, actually, ironically just one I saw yesterday, who just really began having problems earlier this year. And, now, it’s pretty well advanced. That’s certainly not your usual, but you see everything in between. As far as what to tell family otherwise, yeah, I guess the most important thing is explaining to them that it will get worse. Even though you can’t define over what time, this is something that is going to be worse at some point. Of course, this applies to any of us that you need to have your affairs in order, whether you’ve been diagnosed with dementia or not. That’s always a good idea, but even probably more so if you catch dementia early, and get to the attorneys, and get your power of attorneys, and health care, and all that. Then, you got to worry about issues with driving, and just safety, managing finances. There’s just so many things that come up.

Jim Morrow: [00:16:58] And I know one thing – people, a lot of times will want to, I guess, argue is the best way to put it, with a patient when they have dementia, and they will be insistent that something hasn’t happened or something has happened. And I’ve seen a lot of people go through the problems with that. And I think it always seems best if they just kind of go with the flow instead of trying to correct people every time. Is that a decent piece of advice for them?

Peter Futrell: [00:17:28] Absolutely. Just—it wasn’t this week, but last week, a patient mine that I’ve been seeing for probably five or six years, his wife as well, and almost every time they’re in, we have this discussion about her getting frustrated with him over kind of same thing. And as much as I love her, I think she’s actually one of my favorite folks, but she just, sometimes, just can’t let it go. Just stirs that pot. And I told her what I tell people all the time, “You got to move on. You got to distract to do a different subject. You’re just asking for a whole lot more frustration.” It’s already bad enough. If you let that frustration level get even higher, that’s not good for anybody involved, patient or family. You know, I just remind people that it’s not their loved one, it’s not really the patient who’s trying to be frustrating.

Jim Morrow: [00:18:26] Yeah.

Peter Futrell: [00:18:26] They just don’t know they’re doing it. And sometime, people, they kind of have a hard time getting their head around that.

Jim Morrow: [00:18:35] Yeah, I can imagine.

Peter Futrell: [00:18:35] They had been with them for 50 years, and known them, and this is such a change. It’s hard to deal with. That, of course, is understood.

Jim Morrow: [00:18:45] Do you see more dementia in men or women? Is there a gender split?

Peter Futrell: [00:18:53] It seems, to me, in my practice, more women. And I believe the research would show that it’s more women than men as well.

Jim Morrow: [00:19:03] It makes you wonder if that has something to do with-

Peter Futrell: [00:19:04] I’m not sure I know why. I’ll probably know at some point why that might be, but off the top of my head, I don’t know.

Jim Morrow: [00:19:09] I know we could chat about why and guess about why for a long time. But the truth is, we just don’t know enough about this particular disease. That’s the bottom line.

Peter Futrell: [00:19:19] Well, that’s the bottom line. I’m sure that that’s, at least, somewhat limiting the treatment options that we have. We’re talking about medications earlier. Every now and then, you hear about something that sounds like it might be coming out, and it is promising. And I’ll be damned if not. Two months later, the studies dropped because there’s some safety concern.

Jim Morrow: [00:19:41] Right, right.

Peter Futrell: [00:19:42] And that’s just—with dementia, that is—it seems like that happens way too much, which is why, I guess, we’re stuck in this rut we are right now with the very limited options.

Jim Morrow: [00:19:52] Well, that’s actually something I was going to ask you about. I was going to ask you if there’s something on the horizon that you anticipate coming out the next three to five years.

Peter Futrell: [00:20:03] I’d love to be more optimistic, but I’m not sure I’ve seen anything here, at least, recently, that looks like it has the numbers or momentum behind it to be available to us at anytime real soon-

Jim Morrow: [00:20:18] Right.

Peter Futrell: [00:20:18] … which, obviously, is not what I’d like to say and not what people would like to hear but that’s, at least, my experience.

Jim Morrow: [00:20:27] Well, what about reducing your risk of developing dementia? And this is not really funny, but I thought I’d already ask that but I guess I forgot. But what can we do?

Peter Futrell: [00:20:41] I can’t see you between 7:30 and 8:30 tomorrow because we don’t have any walk-in hours, but I could probably get you in later in the morning.

Jim Morrow: [00:20:45] Because you’re still in the bed at 7:30 in the morning?

Peter Futrell: [00:20:49] I don’t think so.

Jim Morrow: [00:20:50] So, what can people do to help keep this from being a problem of theirs?

Peter Futrell: [00:20:57] Well, that’s another one that’s mixed. I’m not sure that a month or two goes by where somebody doesn’t come up with, “Well, there’s this diet,” or take an anti-inflammatory, or keeping your sugar under control. And not that all these things aren’t necessarily good things, but all the time, we seek them out that seem to maybe help the risk of dementia down the road. And the other one I see and have seen in the past is you keep using your mind as you get older and trying to stave off dementia.

Jim Morrow: [00:21:33] Use it or lose it.

Peter Futrell: [00:21:34] Right. And that’s one where I would love to see better numbers on that too because as I explain to patients, it’s certainly not going to hurt to stay, obviously, physically active and mentally active. But I think someone seems to think that they can just do enough, they’ll be able to keep it away. And unfortunately, if it’s going to come, it’s going to come. You might delay it, you might make it slower, but not necessarily gonna stop it from coming.

Jim Morrow: [00:22:07] You mentioned the anti-inflammatory-

Peter Futrell: [00:22:08] I wish the brain was like the muscle where you can go to the physical therapist, and work on your balance, get you stronger, and do that for your brain.

Jim Morrow: [00:22:14] Exactly, yes.

Peter Futrell: [00:22:16] This comes down to it’s not that simple, currently.

Jim Morrow: [00:22:22] And I forgot the question I was going to ask. Again, there’s-

Peter Futrell: [00:22:28] So, we may need to advance it. We may need to move that-

Jim Morrow: [00:22:30] I’ll be there at 7:30 in the morning.

Peter Futrell: [00:22:33] How long is it gonna take you to get from Windward?

Jim Morrow: [00:22:35] Not long this time of day. So, what about the memory care units we’re blessed in the area to have? And I think across the country, there’s an assisted living place on every street corner, it seems like. And then, most of them have a memory care unit. Do you feel like society has handled the aging population and the increasing patients with dementia as well as they could? Is there something we could do better? This is not a medical question.

Peter Futrell: [00:23:03] Sure. Again, that’s one that I actually kind of had that discussion with a patient just this morning or the caregiver, actually, who was actually just more frustrated with her loved one staying home and having more resources there. These assisted living with the lock-down memory care units, so you don’t have to worry about patients wandering off, fantastic. As you pointed out, you can barely turn a corner now without there being one. And there are certainly things that seem to provide a service. But of course, a lot of people want to, for a lot of reasons, and expense being one of them, because assisted living for memory cares are not cheap-

Jim Morrow: [00:23:52] Right.

Peter Futrell: [00:23:53] … loved ones only want to keep their family member with them, not just for, obviously, the cost, but just because best to have family around. And it probably is for the patients, if it weren’t for safety issues, that it’s probably better to be in a familiar environment. Sometimes, that environment is just not safe if patients are wandering off, stairs and family finding them two miles down the road in the middle of the night. So, I’m not sure what the answer is as far as having some better in-home care that’s affordable, but a lot of people would appreciate that if it was more of an option.

Jim Morrow: [00:24:38] You’ll be glad to know that I remembered the other question. You were talking about anti-inflammatories and keeping sugar under control. Is there anything at all to be said for taking statins? Is there anything at all that has anything to do with dementia?

Peter Futrell: [00:24:52] Well, that’s—like all—I mean, yeah, it’s not like I’m saying things every time, but it’s just the way it is. You know, mixed things. I’ve seen studies indicating that, at least, some of the statins might help to prevent dementia and help prevent some of this buildup of the proteins in the brain that occurs with Alzheimer’s. But then, some of statins, in a very small number of patients, seem to actually cause some cognitive decline. Unfortunately, it seems like it probably resolves if they’re off the medication, but it’s just kind of interesting that it can cause some mental changes. But, on the other hand, it might long-term help to—it might help to prevent. I’m going to say might.

Jim Morrow: [00:25:38] Right, right.

Peter Futrell: [00:25:39] But, you know, I try not to let patients make decisions based on that because those numbers just aren’t solid enough. And the reason they’re taking statins is so that they can avoid having their stroke or their heart attack.

Jim Morrow: [00:25:50] Right.

Peter Futrell: [00:25:51] And those things are much more likely to happen. And they seem to have—they have patients stop the medicines to—for the medicine’s issue they’re concerned about cognition when you don’t want them having that heart attack or stroke.

Jim Morrow: [00:26:05] I gotcha. Well, that’s great, and that’s really all the things I had that I want to talk to you about. And out time’s about up. But John, I believe, have some questions that people have sent in that we’d like to run by you.

John Ray: [00:26:17] A couple for you, if we can. So, one is, for a person who has a parent, in this case, and they’re—they’re really—they don’t know. They think there may be a dementia issue, but they’re kind of concerned about maybe broaching that with the parent so—because they don’t want to be—they want to get them taken care of, but they don’t want to alarm them, right? So, how should that—how should they approach that issue? What do you suggest?

Peter Futrell: [00:26:59] Yeah, I’m not sure how—I’m not sure how Jim handles that one. I’m sure, he’d run into it too. From my standpoint, that’s a concern for patients. The families, all the time, are worried about how their loved one is going to take the news or is even willing to accept the news. You know what? Other than sitting down, and trying to explain that you have some concern, and that you think it needs to be checked out, and “Hey, if you see the doctor, and everything’s fine like you think it is, well, great. Nothing is lost. But can we, at least, go have it looked into.” I’m not sure I have a better way of handling it. but-

Jim Morrow: [00:27:40] I think that’s-.

Peter Futrell: [00:27:41] … that is definitely something—definitely something that can get to be an approaching point. I’ve seen it too many times with—and it’s the reason why, sometimes, I am seeing the patients and the family separate because it’s just the subject that follows a big risk.

Jim Morrow: [00:27:55] It is. And that’s something that I would encourage people to lay it on me, and bring them into the office, and let me bring up the point that I’m seeing some things about memory that I’m concerned about. And I think we need to try some medication, do some tests, and so forth. And invariably, they’re gonna end up in a neurologist’s office, but I think it’s just easier-

Peter Futrell: [00:28:17] Be the bad guy, ultimately.

Jim Morrow: [00:28:18] Ultimately, absolutely.

Peter Futrell: [00:28:20] Yeah.

Jim Morrow: [00:28:20] Absolutely. But at the same time, I think it’s something that the family needs to feel free to bring them to somewhere. And they’re usually gonna start with us. And that will start with you in those cases. And so, you know, to keep them from being the bad guy, I think it’s important that they just come in and let me broach the subject. The same way with driving. I get asked, and I know you do too, I get asked all the time to tell daddy that he can’t drive anymore. And usually, if you bring him in, and you can make a point of reflexes and so forth, you can make a good point with him and get him to not drive anymore. John?

Peter Futrell: [00:28:55] Well, you took the words right of my mouth. I was gonna say driving is the other big moment of tension that we have to be a bad guy about.

Jim Morrow: [00:29:02] It’s huge.

Peter Futrell: [00:29:04] Yeah, that’s huge. It impacts too many people.

Jim Morrow: [00:29:08] One other question here surrounds incidents at seemingly earlier ages. This person is citing the Pat Summitt case, the Tennessee women’s basketball coach. And I guess she had early onset Alzheimer’s in her 50s. Is it just coincidental or anecdotal? I mean, are we seeing more dementia and Alzheimer’s cases earlier in age and stage than we have used to see 10 or 20 years ago.

Peter Futrell: [00:29:52] Well, I mean I can speak for the last 20 years, I’ll be quick to point out Jim can talk a little bit longer than that. But I don’t—in my practice, I haven’t seen, I don’t think, an uptick in the earlier patients. I think patients I have in their late 50s with it now. I don’t think that numbers a whole lot different than it was 20 years ago when I started. That’s just—that’s my own experience. Others may see otherwise. But I’ve not seen an epidemic of a 52-year-old coming out with dementia.

Jim Morrow: [00:30:30] Well, good, good. So, we’ve been talking with Dr. Peter Futrell, neurologist with Lakeside Neurology in Cumming, Georgia. Pete, I want to thank you for taking the time to be with us today. I really appreciate this. I think this is the kind of thing that many, many families are dealing with and that might benefit them to listen to the podcast. And I appreciate you taking the time out of your day to do this with us.

Peter Futrell: [00:30:54] Well, not a problem. Sorry I couldn’t join you in the studio there but happy to help, of course.

Jim Morrow: [00:30:59] Good to have you anyway. Thanks very much. So, for now, this is To Your Health.