Maria Shriver and Patrick Schwarzenegger's Mission to Spread Brain Health Awareness

Episode Transcript

Dr. Daniel Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa. This is the Brain & Life podcast.
We're hearing it everywhere. Wellness, wellness and wellness. Whether it's things you buy online, advertisements, even some fast food commercials seem to mention wellness for some reason. But wellness isn't just the lack of hypertension, diabetes, or other medical conditions. But it's also the active goal of improving and maintaining your health.
If you're joining us today and have enjoyed the Brain & Life podcast and the Brain & Life magazine, I'm sure you're also interested in learning how to live better with the conditions you have. Actively improving your health and preventing new medical conditions, for just overall body health. But we're also here thinking about brain health and at the top of many of our minds is the prevention of dementia for ourselves and our family members.
Our guest today has taken this on as both a personal and a community mission after learning the disparities in healthcare and the increased dementia risk for women. Many of you know Maria Shriver from TV, journalism and media. She's also the founder of the Women's Alzheimer's Movement and has joined the Cleveland Clinic as a strategic partner on women's health and Alzheimer's.
This initiative has the goal of bringing a preventative approach for dementia to many different communities. She's joining us at the start of this episode with her son and business partner, Patrick Schwarzenegger. Later in the episode, you'll hear Maria join us as we start our conversation in approaching and understanding more prevention of dementia and women's health with dementia expert Dr. Jessica Caldwell. Make sure to subscribe and follow the podcast so you don't miss some of our coming episodes.
In a few weeks, we'll have an episode with Cory Lee, a travel blogger who travels the world in his wheelchair. And advocates for everyone to have better accessibility around cities and to all the wonders of the world. Also, coming up in recognition of Myasthenia Gravis Month, we have a blogger who shares her experience with chronic illness. Including myasthenia gravis and advocates for the community living with neuromuscular disorders, Ashley Brooks, who talks about her experience of being diagnosed with myasthenia gravis while working as a respiratory therapist. Stay tuned for this episode and for many great episodes coming up
Today I'm joined by Emmy and Peabody Award-winning journalist TV and media personality, author, producer... I'm running out of things, but importantly also mother, Maria Shriver. She has been working as an advocate for dementia and Alzheimer's prevention and research since her father Robert Sargent Shriver also was diagnosed with the disease in 2003. She shared some of her family's experiences in his journey in a segment in the four-part HBO documentary series, the Alzheimer's Project.
And these inspired her to found the nonprofit organization, the Women's Alzheimer's movement, and dedicate her journalism and talents and skills to discovering why Alzheimer's disease disproportionately impacts women and communities of color. Along with that, Maria has also joined us with her son, Patrick Schwarzenegger, who has worked as a actor, model and entrepreneur. And during the pandemic, they brought their energies and passions together to co-found MOSH, a food and products brand that also has a mission to support brain health awareness. Thank you both for joining us and talking with us.

Maria Shriver:
Thank you. Thank you. It's nice to be here.

Patrick Schwarzenegger:
Yes. Thank you so much for having us. We're excited.

Dr. Daniel Correa:
So I wanted to start at that beginning for you guys. And Maria, I was hoping you could remind us about Robert Sergeant Shriver, his legacy and your memories of him.

Maria Shriver:
Well, you'd need an hour and we don't have time for that.
So we'd have to dedicate a whole show to Daddy because he's worthy of that. But I think really quickly, Daddy started the Peace Corps, conceived of it, created it. Behalf of my uncle, president Kennedy, he created the Job Corps, foster grandparents, Headstart, legal services for the poor, news director of the War on Poverty. He was ambassador to France. He ran for vice president and President. He was the father of five, and he was married to my mom for over a half a century. Worked in Special Olympics and was diagnosed, as you said, in 2003 with all Alzheimer's. Which set off this kind of 20 year odyssey for me of trying to understand the brain. Understand the webs, the tangles, the plaques, how it changes, how it ages, how all of our brains are different, what we can do to feed our brains, keep our brains healthy. And then it has led me all the way to MOSH and this incredible partnership I now have with my son, Patrick,

Dr. Daniel Correa:
As a part of this whole path. As you said, over the last 20 years working on this effort, you've been advocating and supporting many researchers and nonprofit efforts, including the Women's Alzheimer's movement. And part of that started with your work in developing the Shriver Report. What were some of the things that you learned in that initial work as to what we knew about Alzheimer's and where do you see things now?

Maria Shriver:
Well, when I got involved in trying to understand Alzheimer's, because my father was the smartest human being I'd ever met. His recall of facts was unprecedented. He knew everything that had happened throughout history. So to watch somebody with that kind of finely tuned mind, someone who read several books a week who was a really deep intellectual and a thinker, not know what a fork or a spoon is, it's a mind blowing thing to behold. And as a journalist, you're like, how does that happen? When does that start happening? What is the cause of that? How could somebody that smart lose everything that they had accumulated over time?
And so when I got involved in learning about Alzheimer's, it was all just about plaques and tangles. People thought it was just kind of a normal part of aging. There was no mention of women at all. And it was just kind of this dark, scary, shameful place.
So when I was first Lady of California, I was doing a women's conference and I started to program conversations about caregiving because I found myself in this place. My mother was having strokes and breaking her hip, and my dad had Alzheimer's. So I was caregiving two elderly parents, and that's incredibly emotionally taxing, financially taxing, et cetera. And I had four young children. So I thought, "Well, there must be a lot of other women out there like me." And more and more women started to come to me and say, "My mother is diagnosed. My mother's diagnosed." And so I went to researchers and said, "I think this disproportionately impacts women. And everybody told me, "Oh no, that wasn't the case." So I spent a year and a half out in the field and partnered with the Alzheimer's Association and went out to disprove the theory that it didn't impact women. And I'm really proud of the Shriver Report because it was a report to the nation, to all 50 governors, to the president. And to every Alzheimer's researcher and doctor that it did impact women. It did disproportionately impact women. Two out of every three brains diagnosed do belong to women. And it wasn't just because women lived longer. And it did disproportionately impact people of color, and that was a sea change in the world of Alzheimer's.
And another sea change has been kind of the introduction of lifestyle changes in this space. Which is when I got involved, everybody said, "There's nothing you can do. It's a normal part of aging. It doesn't impact women." Now, it impacts women. There's a lot you can do. It's not a normal part of aging. You're in the driver's seat. The earlier you get involved... Patrick's age in your twenties and thirties and forties. You can have agency over your brain. You can do things that impact your brain because what you eat impacts your brain. How you live your life impacts your brain. How you sleep, how you exercise, how you engage.
So this has been a passion and a mission of mine because there is so much misinformation about Alzheimer's and dementia. People think, "Oh, that's something I that will naturally happen to me when I'm 80 or 90 and I shouldn't think about it when I'm Patrick's age. And I shouldn't think about it when I'm 30. And maybe I'll start thinking about it when I'm 60."
And we now talk across generations to families, to people who are like Patrick in their twenties, people who are in their thirties, people who are in their forties caring for parents with Alzheimer's, dementia, ALS, Parkinson's, you name it. And it gives them power to understand that there are things that they can do.
There's nothing that we know as you well know, that can 100% prevent any of these neurological diseases. But if you can buy a year, two years, three years, five years, that's a benefit to you, to your family overall. And to the American public and to the economy as we know it. So we are on a mission to educate people, to give them alternatives as to what they can eat, how they can think about their brain. And first and foremost, just to get them to think about their brain is a huge advocacy on our part. And Patrick speaks to one generation and I try to speak to a different one.

Dr. Daniel Correa:
And I want to build on that. Empowering people and understanding that we can prevent various of these neurodegenerative processes dementias like Alzheimer's. And learn from what each of you are doing and incorporating in your life. Along the list of things that we educate people on to try to work towards preventing is exercising with some level of high intensity. Trying to work up to at least those 7.5 hours of sleep at night. Yearly screening for blood pressure and diabetes, eating right and eating less. And then building purpose and community and connection. So how have each of you incorporated some of this learning that we now know about helping prevent some of these conditions and living better in your life now?

Patrick Schwarzenegger:
Well, I think that one of the sayings that really woke me up and allowed me to try to help my mother spread her mission is that we are in the driver's seat. There are things that you can do today that will help your brain or impact your brain tomorrow or in a year from now or five years from now or in 10 years from now. And I think that the whole idea of COVID really sprung upon, especially to my generation and to people that are my age, this idea of mental health, of brain health, of cognitive functionality, tropics, all these different things to enhance the cognitive functionality of being attentive or focused. Or how do you optimize?
And my mom has been, like I said, doing this for decades. She's done coloring books, she's done normal books, she's done documentaries, she's done movies, she's done TV shows. All to spread the awareness and the mission of educating people about brain health And my background, part of it is in is CPG food and beverage. And food is one of the top pillars of things that contribute to someone's overall health, their body health, but also their brain health.
And this topic of brain and body health was gaining so much steam that that's when I kind of went to my mom and said, "Why don't you continue your mission and educate people about brain health, but through food?" That's something that I'm passionate about, but I also think can actually make a difference. Because I know so many people today my age or just in America as a whole are really starting to look at the food landscape in a different way than they were 10 years ago or 20 or 50 years ago. I mean, people are really starting to pay attention more and more so to the transparency of the ingredients or what is all this sugar doing in my soda. Or in my sports drink or in my energy bar that I thought was a snack but is really turning out to be a sugar bar that's 30 grams of sugar. All these different things. My mom can talk for a couple hours about what she does to push this mission, but that's how I get involved.

Maria Shriver:
Well, I think to Patrick's point, and I think young people look at labels differently. I didn't grow up reading labels, right? And so many people in my generation didn't have that. We didn't have that knowledge. We didn't feel that power when it came to what we were eating. But I think certainly through my work, I now meditate. I never used to meditate. I prioritize my sleep. And everything I'm talking about I have talked to my kids about. I tell them to prioritize them, their sleep. I talk to them about the benefits of meditation. When you sleep, your brain has a chance to relax and get out the trash, so to speak. I talk to them about exercise. Obviously, they grew up with a father who emphasized exercise tremendously. Talk a lot about purpose and meaning, keeping yourself engaged. All the kids do Wordle games and try to keep their minds going.
I think it used to be my generation, you went to school and that was that. Right? Now we know you need a long life of learning. Your podcast is called Brain & Life. I have always been surprised how people don't think of their brain as being connected to their body. And then they don't think about their brain as really how they rely on their brain to live their life. Your brain, as I always say, is your most valuable asset.
And so you can't just leave it sitting there on the side of the shelf and expect it to work well for you and don't nurture it or engage it or give it food and water. And so we know so much more now about the Mediterranean diet. We know about hydration. We know about the impact of sugar. We know what happens when you have no love or no purpose in your life. We know what happens when you're lonely. And as people age, that loneliness increases. And there is exciting things going on trying to bring two generations together.
And that Patrick's generation are the caregivers on deck for this country and this obviously Alzheimer's and dementia is a global issue, right? But it will be his generation that will have to care for my generation and others. How will they do that? So it is important for me to stay as healthy cognitively and physically as I am and as I can be so as not to become a burden to my children.

Dr. Daniel Correa:
You mentioned what we've learned about food and reducing added sugars and reducing ultra highly processed foods. You talked about incorporating the Mediterranean diet. So that people have just a better understanding of that is just increasing whole grains and whole vegetables and reducing ultra-high processed foods. A lot of people also advocate something that's a combination of the Mediterranean diet and the Dash diet, which is basically decreasing salt intake if it's appropriate for you.

Patrick Schwarzenegger:
Yes, the Mediterranean diet, some people call it the mind diet, a brain healthy diet. Those are all forms of diets that are proven to be beneficial for long-term brain health. And that is whole foods, that is fruits, that is avocados, olive oil, healthy nutrient fats.

Maria Shriver:
I don't like to use the word diet because it's such a trigger, particularly for women, but a lifestyle. We are advocating a brain healthy lifestyle. This is an alternative to you eating sugar in the afternoon, M&M's at your desk, reaching for a can of soda. We are here so that you don't do that instead of something that gives you a high and then a crash. And it's part of a overall lifestyle, as you said.

Dr. Daniel Correa:
Helping people reach those goals of increasing the different components of the mind and Mediterranean diet. Unfortunately though some things that are consumer based though not everyone necessarily has the financial access to get them. You also, as you said, have been contributing to awareness about diet so that other people have tools. Can you share with us a little bit more about what you're doing within the Women's Alzheimer's movement to increase awareness and understanding?

Maria Shriver:
We do a lot of advocacy. I just completed a big year and a half long project for the governor of California about how states can better prepare for the Alzheimer's epidemic, which is upon us. How do we help families? How do we help caregivers? The Women's Alzheimer's movement funds research into trying to understand what's happening in women's brains, particularly at midlife. And I'm really proud that it's been a leader in that space. It's the preeminent organization for women in Alzheimer's. We merged with the Cleveland Clinic about a year and a half ago.
We started a women's Alzheimer's prevention center with the Cleveland Clinic two and a half years ago, offering to people at their different campuses and then also online. And so we partnered with the Cleveland Clinic to be able to bring our message to a larger audience, a global audience. They are doing the largest neurological study of its kind in the world to track people for 20 years. And track their brains and begin to see where does the brain and when does the brain begin to show the signs of aging, signs of changing?
So that eventually, maybe when Patrick is in his mid-forties, there will be some kind of a pill, like a statin is for heart disease. Perhaps there will be something like that that somebody at 45 can take. So I'm hopeful that there won't be a magic bullet for Alzheimer's. There might be several things that, some things you can take, some things that you must do. And that collectively we will be able to slow down these neurological diseases that do increase as one ages.
It's a challenge to get people to think about something they take for granted that they can't see. So Patrick's generation, they're 20 to 30, their brains are firing on all cylinders. They're processing, they're multitasking, they're on their phones and the computers. And so they just take that this works for granted. It's just like that, right? And so people, particularly people get to midlife and then maybe so like, wow, they can't remember someone's name or they forget a phone number the first time and then they panic and then they're like, "Oh my God."
But I think the goal is to try to begin to get people of all ages to think about the beauty of the brain, how all of our brains are different, how all of our brains learn differently. I think any parent who's really in tune with their child will be able to know, this child learns this way, or this child learns that way and begin a lifelong journey with your brain. I have found that in the 20 some years that I've been working in this space, I find more people interested in it. People are interested in define age. They're interested in longevity. They're interested in their bodies and their brains, and I think we're in a new era, and so I'm hopeful.

Dr. Daniel Correa:
Well, thank you both so much for taking the time to talk to our listeners and share your energy and everything that you're doing, both to work in the space of advocacy, increasing awareness. And now trying to help increase options for healthy diet alternatives.

Maria Shriver:
Well, I had-

Patrick Schwarzenegger:
Thank you.

Maria Shriver:
Thank you-

Patrick Schwarzenegger:
Thank you so much.

Maria Shriver:
... for having us. And I think it's great for all the doctors out there in neurology and researchers. They are our unsung heroes. So I just want to shout out all of you, too. It's extraordinary work that everybody's doing to try to understand this thing we cannot see.

Dr. Daniel Correa:
Want to learn more about the conditions discussed in this episode and other factors that could impact your brain health? For the latest on causes, symptoms, diagnosis, treatment, and management of more than 250 of some of the most common and rare neurologic conditions, please visit brainandlife.org/disorders.
Welcome back. We are joined by the director of the Women's Alzheimer's Movement Prevention Center at Cleveland Clinic. Dr. Jessica Caldwell, she is a neuropsychologist and assistant professor of medicine at Cleveland Clinic's Department of Neurology and a researcher in their department of neurosciences. Her clinical psychology work and research work focuses on assessing women at risk for dementia, helping adults and geriatric patients with their concerns of memory loss. And investigating really what are the differences between the types of predictors or biomarkers between women and men. And developing methods for diagnosis and prevention of dementia. Thank you so much, Dr. Caldwell for joining us.

Dr. Jessica Caldwell:
Thank you for having me.

Dr. Daniel Correa:
Now this episode will build on our discussions from past episodes and their medical expert interviews and dementia and Alzheimer's. Including a discussion with Lauren Miller Rogan and journalist, Greg O'Brien about Alzheimer's dementia. Caregiving episodes where we talk to Kitty Eisele and documentarian, Michelle Boyaner. And then we talk about how the memory works with Dr. Craig Stark. So really encourage our listeners to listen to some of those. What are some of the normal signs of aging, if there are any? When is memory loss really a concern or possibly a sign of dementia?

Dr. Jessica Caldwell:
Most of us as we age, do lose a little bit of what I would call cognitive sharpness. So there is a natural tendency for us to have a little bit of a longer delay when we're trying to come up with a word or a name. And it becomes a bit more frequent for us to forget. At the same time, there is a point at which that forgetting can actually become problematic and a pathology related type of forgetting.
The way that I ask people to think about how to know what's normal versus what could signal a problem like dementia is to really think about first frequency. So at any age, we all could forget something. But when you notice that you are forgetting something over and over... For example, in the same day, if you need reminders several times about a conversation that happened that morning, that's frequent and that could show a problem. On the other hand, severity is also important. So most of us might forget things one time like where we put our keys. But on the other hand, if you forget where your car is, what your car looks like, that could signal a more severe type of forgetting and a problem.

Dr. Daniel Correa:
So part of your work has focused on looking for risk factors for Alzheimer's and other dementias. Can you tell us a little bit about what we understand now and how you're trying to build on that?

Dr. Jessica Caldwell:
Sure. So we know now that it's not just that women live longer than men. That's why we have higher rates of Alzheimer's than men. Everything from our genetics to our lifestyle and our medical conditions play into why women and men look different in terms of whether or not we get dementia and what our dementia path looks like after we're diagnosed. So a couple of examples would be, we know in terms of lifestyle, women are twice as likely to not be physically active compared to men, and that'll increase our risk.
When it comes to genetics, some studies have shown that a woman having a common risk gene for Alzheimer's might impact us up to four times greater in terms of our likelihood of getting the disease than it does for a man. So it comes across both those factors that are related to our family history and genetics, but also our lifestyle or our environment are very important.
Some of the things that I'm currently focusing on are looking at ways in which women might have a set up at midlife in terms of their biology. Whether that's in their body and in their brain, that really kind of unfortunately welcomes Alzheimer's disease to take hold. And so specifically I'm looking at how estrogen loss across menopause and increasing stress across midlife might actually meet and create blood related and brain related environments that really can promote Alzheimer's proteins.

Dr. Daniel Correa:
And what are other aspects that actually have led to further disparities in health for women related to their aging?

Dr. Jessica Caldwell:
I think this is a really important question. There are so many aspects where women are behind in terms of the care we get. And it really stems from the fact that research on women is behind when we compare what we know about men to what we know about women. This is everything from women not being included in research studies, female mice not being included in research studies. And even after we just pass a really critical anniversary, which is NIH's sex as a biological variable mandate, which said we have to include women and we have to look at that data carefully. That was seven years ago.
And even so, we still have studies that don't include both sexes and genders, or they don't correctly statistically look for differences. So we do have this major gap when it comes to research on women and it goes beyond research as well. So there are times when women have been shown to be less heard when they go into the doctor. And that pattern can then lead to kind of a self-fulfilling prophecy where women don't speak up when they go to the doctor. So there's multiple things going on in terms of why we're not as far ahead as we should be.

Dr. Daniel Correa:
Now, early in our discussion with Maria, we heard some about the founding of the Women's Alzheimer's movement, and over time has become to partner with the Cleveland Clinic. Can you tell us a little bit more about its effort and what the women's Alzheimer's movement and the Prevention Center is doing at Cleveland Clinic?

Dr. Jessica Caldwell:
Absolutely. So the Women's Alzheimer's movement has long been just a driving force in educating the public about women's Alzheimer's risks as well as an advocacy and supporting research. And I'm very thankful that I started some funding from the Women's Alzheimer's movement back in 2016 and started looking at sex differences in Alzheimer's disease.
And then in 2018, Maria Shriver, the Women's Alzheimer's movement founder approached us at Cleveland Clinic and said, "Can we go beyond research? Can we actually start a clinic where women can begin to make changes that we know could potentially reduce risks now?" I was really excited to lead the charge there and develop and now direct that clinic. And we are the first and only in the world. That is a place where women can come meet with doctors and learn how to reduce risks for Alzheimer's that we can control.
This has been a joy over the past three years. We're coming up on our third anniversary. Still receiving such positive feedback from women and such interest. And I would say that what I do primarily is help women to prioritize themselves and help women to see that they have hope when it comes to Alzheimer's. And the reason for that hope is that not only do we have these techniques that we think can we reduce risks? But the number of cases currently that we think could have been prevented by using these types of techniques is 40%. And most women have no idea that the number is that big. And so providing hope is a reality here.

Dr. Daniel Correa:
Now, a little bit different from some of our past medical expert interviews. We also have Maria here with us. She founded the Women's Alzheimer's Movement and has been helping move forward the strategic work. And we talked in our previous discussion about a lot of the efforts that she's done to investigate and report on these issues. Maria, can you tell us a little bit about how you and Dr. Caldwell met and your sense of the importance of moving this forward?

Maria Shriver:
Well, we met at the Cleveland Clinic where she is. And my great friends, Larry and Camille Ruvo had started the Ruvo Brain Center at the Cleveland Clinic in Vegas. And he and I had been working in this space for the last 20 some years. They had honored me when I had written a children's book about explaining the disease to children. And that began kind of a relationship a long time.
So when I wanted to start a center and a clinic on the ground for healthy women, I reached out to Larry and to Camille to see if they were interested in it. And they brought their whole team. They were obviously very interested in it. They brought all the best doctors and researchers from the Cleveland Clinic. We started there in Vegas, and we have moved on to main campus and we're hoping to move around the world. Because what I think is super important is that everybody, to step back for a moment and to realize that we all have a brain. And we're all susceptible to Alzheimer's and dementia. It's not something that, "Oh, it just runs in my family. Therefore, we're the only ones that should be concerned about it." We should all be concerned about our brains and how we age.
And we begin to age the day we're born. We begin to age our brain ages differently as women in midlife due to being per menopausal, menopausal, postmenopausal. And then as we move forward into our sixties and our seventies and our eighties, the goal is to not only understand why Alzheimer's disproportionately impacts women. But alongside that, parallel to that is to age as well as we can to age in independently and to age cognitively healthy. So what do we have to do to do that? And if you go to the center, you will learn tools, techniques, how to live a brain healthy lifestyle along with a heart healthy lifestyle. Now it's never too late. You are never too old to start implementing many of the changes that are advocated by Dr. Caldwell and the team that works with her and behind her at the center.
And that is our goal, to fund research, to be advocates on the ground, activists on the ground, turn dementia warriors into dementia warriors. To let people know that we should, all of us men, women, people my age, people who are my children's age, be thinking about what we put into our mouths. How we live and work. What are we doing to nurture and nourish our brains? So much of that is within our power, and it's something that you don't see every day. So therefore, sometimes we don't think about, "Oh, I need to care for my brain. I need to rest my brain."
So that is what the center does. That is what this partnership is all about. It's about elevating it to a global level. Cleveland Clinic is working at a global level. It's about empowering women in particular, who are the CEOs of most of their households who put themselves last. This is about saying you deserve to be recognized. You deserve to think about your own brain health and your own physical health, and we're here to help you in that process.

Dr. Daniel Correa:
And Maria mentioned the health for all of us. And Dr. Caldwell. I'd like to go back then to some of the research work and the efforts as you're looking towards risk factors and prevention. How does us understanding better risk factors for women with dementia and how prevention for dementia for women actually might help us understand things that could impact all of our brain health and new initiatives that could impact for everyone's health?

Dr. Jessica Caldwell:
That's exactly right. So when we're trying to study a really complicated disease that has risks that we can control as well as some that we can't. If we only study risks in one group, we will not solve the problem. And unfortunately right now, we know a whole lot about how these risks work in men, and we don't have the full story in women. And we're different biologically when it comes to hormones and critical periods for brain development, for example.
And so in taking a focus specifically on women, what we're doing is really adding half of the puzzle that's missing right now. And in order to really understand what risks are important, when we can act on those risks, when it's the most meaningful, we have to consider everyone. And I should say it too, we focus on women here, but this is exactly the same story. If we think about people from a diverse perspective when it comes to socioeconomic status, race, ethnicity, sex and gender diversity. We have to have everyone at the table if we want to understand what's really going wrong when it comes to Alzheimer's. But also to really understand resilience from a whole person perspective. One solution won't work for everyone when it comes to these lifestyle changes.

Maria Shriver:
The women that go to the prevention center, they've all agreed to be part of studying what's going on in women's lives. I think this is really important because for so long as Dr. Caldwell pointed out, women were not included in clinical trials. They were not deemed stable enough. They were not deemed reliable. And the women that have signed up to join the center, to join the clinic who have signed up for the larger Cleveland Clinic Brain Study, it's primarily women who are signing up because they want to solve this problem. They've seen it firsthand. They've seen it on the ground. Women are two thirds of the caregivers in our country as well. And they want to not only live a more healthy life themselves. Anything that comes out of this study, they want it to be used for the greater good. And I think that's something that's really important to reiterate,

Dr. Daniel Correa:
But not everyone necessarily is going to have physical access to your clinics and to the center. And you also have done work going into the community to bring this discussion directly to people. Can you tell us a little bit about the ways you're servicing the community at large, even if they can't make it into the clinic and the resources available through the Women's Alzheimer's movement?

Dr. Jessica Caldwell:
Absolutely. So the clinic from its inception was designed as a virtual and in-person hybrid. So while the current clinic in Las Vegas does require some visits to us, there are also visits that happen virtually. There's a lot of information gathering that happens online. And as we look to expand to the rest of Cleveland Clinic, especially focusing on main campus, we're looking first at efficient and accessible ways to do this. And that's virtual visits and group visits. So this is something we're actively developing right now.
And in terms of bringing prevention to the broader community, it is part of my passion and mission to speak, and I have spoken with scientific communities, but also Nevada Women in Trades. I want to bring this prevention message out at a broader level. And so I really appreciate this opportunity today.
Something else that we're working on is I got an award from Cleveland Clinic Catalyst Grant to develop a web application. We're focus group testing it with folks from Cleveland who are patients or have provided care for patients with memory issues. And this web application is designed to be free and accessible to communities who might otherwise be underserved. And we're really taking their opinions at the ground level so that hopefully we build something that folks are getting what they need and they want to use it.

Dr. Daniel Correa:
As you brought up all walks of life. Thankfully, the Affordable Care Act and a lot of the opportunities for access to healthcare, health insurance has expanded to have many more people who have insurance. But in terms of the Women's Alzheimer's movement and the Prevention Center you have, are the services available to people regardless of their type of insurance or their access to insurance? Or are some of the services limited in that situation?

Dr. Jessica Caldwell:
I think to answer that question, I need to take one step back and just make a point that prevention of Alzheimer's disease is not covered by insurance. So we have a more basic issue, which is why the philanthropy is so critical, because that will give us the power to bring this to women now. But also to do that research that eventually we hope will really show to insurance providers that this is something that is more than useful to cover. It will save you money in the long run to work on your health now.
But in terms of our clinic here in Las Vegas, some of the time that we spend with women is fully covered by philanthropy. So for example, women get a cognitive screening assessment with one of our team members, and I speak with women for about an hour each, and all of that time is not billed to insurance. It's covered by our philanthropic donors.
On the other hand, there is a medical appointment, face-to-face. And there's also one virtual visit with a medical provider, and those are billed to insurance. So if a woman doesn't have insurance, it would involve a cost. Cleveland Clinic is very dedicated to working with individuals who might need either financial assistance or assistance with understanding how the finances might be impacted by a visit with us. So we're not free, but this is something that we're committed to improving in the future, whether that's through some of these online services that we can provide for free. Or whether that's this long game of really advocating for insurance coverage.

Dr. Daniel Correa:
Yeah, I think something that's needed throughout the whole world and initiatives and advocacy that's going to bring more brain health and discussion and prevention to everyone. We need preventative care, both for brain health and for all of our body. So Dr. Caldwell, on the pharmacy, grocery health, food shelves, there are a lot of non-prescription products out there for sleep, memory, stress, anxiety. You could pick pretty much any symptom or positive outcome that you want, and there's a product out there for it. How do you approach discussing these items with the community that you're working with and for the prevention and moving towards better healthy aging?

Dr. Jessica Caldwell:
So we strongly encourage our patients to get nutrition from their diet rather than seeking out supplements, but we do also test for deficiencies. So our women have blood work done. And we are specifically looking for things that folks are commonly deficient on, things like vitamin D, for example. And then if you need to supplement, supplement where you know you need it. I think there are many reasons not to really get your hopes up about a lot of these supplements that are freely available.
And one reason is because a lot of these things aren't tested by an organization like the FDA, which means that you can say a lot about what your product supposedly does. But if it's not been tested by scientists. If it's not been reviewed and really put to the test by people who don't have to have anything to benefit from the sales. It's really hard for me as a provider to recommend those types of products.
And the other piece is too, many of these supplements might have overlapping ingredients. And we have learned that many folks will take many supplements and unfortunately you can wind up with interactions between different ingredients. You can wind up with too much of a particular vitamin, even though that... Many people, that doesn't seem intuitive, but there's such thing as too much of many vitamins.
And so I would recommend that folks, if you think you need supplementation, work with a doctor, get your blood levels tested. And really take it that way instead of guessing based on what's available on the shelf or what is advertised on TV.

Dr. Daniel Correa:
Thank you again so much, Dr. Jessica Caldwell, for joining us. Thank you, Maria Shriver, for working with us together on this episode and for bringing forward the Women's Alzheimer's movement. Really, truly appreciate each of your time and the work that you are doing to move this research and this effort forward for prevention and healthy aging for all of us.

Maria Shriver:
Thank you so much. Appreciate it. Thank you.

Dr. Jessica Caldwell:
Great to be here.

Dr. Daniel Correa:
Thank you again for joining us today on the Brain & Life podcast. Follow and subscribe to this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life magazine for free at brainandlife.org and even get the Espanol version. For each episode, you can find out how to connect with our team and our guests along with great resources in our show notes.
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