Dr. Dylan Wint, director of the Cleveland Clinic Lou Ruvo Center for Brain Health, emphasizes the significance of the connections between neurology and psychiatry when treating Alzheimer's disease
Globally, 55 million people live with Alzheimer’s disease or another form of dementia. Alzheimer’s disease—a degenerative brain disease that affects a person’s memory, thinking, and behavior—still has no cure.
How does this affect Nevadans? The third-fastest rate of growth for the disease, according to the Alzheimer’s Association, is expected in Nevada. Calculations estimate, between now and 2025, the number of Nevadans with dementia will increase from 49,000 to 64,000 residents. However, it’s also worth noting that Las Vegas is home to one of the nation’s top neurology institutes—the Cleveland Clinic Lou Ruvo Center for Brain Health.
For World Alzheimer’s Day (September 21), Dr. Dylan Wint—director of the Cleveland Clinic Lou Ruvo Center for Brain Health—explains why our state has the third-fastest rate of growth for the disease, what isn’t receiving enough news coverage and what healthy habits may help prevent it.
How did your career journey lead you to becoming the director of the brain health clinic here in Las Vegas?
I did residency in neurology and psychiatry, because I was focused on this idea of brain health and trying to understand the brain from both anatomical aspects and cognitive aspects—which is neurology—and the emotional [aspects which are] more related to psychiatry.
Randy Schiffer was also a neurologist and psychiatrist. I actually contacted him to ask about how you do that in an academic environment. He had been very successful at Texas Tech. He united the neurology and psychiatry departments there. So I asked him, you know, how one goes about doing that in an academic environment? He invited me to come out here [and] after a while it turned more into a sort of recruitment.
People with degenerative brain disorders are really suffering and are often left to suffer because we can’t cure them. But there’s a lot we can do to improve their quality of life. So I decided to come out here as Director of Education, and from there became Director of Clinical Operations. When the previous director resigned, I was asked to serve as interim director, which I did that for about a year before agreeing to assume the role of director full time.
Are there any recent studies or findings, combining both neurology and psychiatry that you think people should keep an eye on?
That’s a really good question. I don’t know about articles combining the two. But there’s abundance of research about the fact that in people with brain disorders–whether it’s a stroke, multiple sclerosis, dementia, Parkinson’s disease–the biggest source of their suffering is actually from behavioral and psychiatric and mental health disorders like depression, and so forth.
So even in Parkinson’s disease, which we think of as a movement disorder, people who are doing well mentally, have much better quality of life, their caregivers have better quality of life. Alzheimer’s is another example. Even though it’s a cognitive disorder that affects memory and other cognitive functions, generally, people describe the suffering as originating from behavioral problems that can occur with Alzheimer’s disease.
So there’s a lot of evidence suggesting that if someone is treating neurological disorders, they really ought to know how to recognize and take care of psychiatric disorders. Because our job is to reduce suffering, and that’s where the suffering is.
“Every five years after age 60 your risk of having Alzheimer’s disease doubles.”
Dr. Dylan Wint, director of the Cleveland Clinic Lou Ruvo Center for Brain Health
What is something that isn’t discussed enough about Alzheimer’s disease that is important to know?
We still have close to 6 million people out there who are beyond the point where any sorts of curative treatments would work. Whatever treatment is developed, just like with any other condition, probably isn’t going to work for everybody and may not help with other types of dementia.
We haven’t really put in as much work as we need to, in terms of understanding how to maximally enhance, improve and protect quality of life, in people with Alzheimer’s disease. So I think the under reporting is really about what you can do on a daily basis to improve quality of life as opposed to just looking for the home run cure. Not that that’s not important. It is just that the importance of daily quality of life and making each day as good as it can be—I think is under-recognized.
How can families and caregivers help improve the quality of life for people living with Alzheimer’s disease?
Living with a brain disease is a journey and we know that as the disease progresses, so too will the needs of the person living with the disease and their caregiver. The most successful patients are those with the most engaged support system, which is why at the Lou Ruvo Center for Brain Health, we offer a full range of programs and services that individuals, families and caregivers can access at no cost during their quest to become more informed, connected and supported, thus improving coping skills and quality of life. These programs include but are not limited to music therapy, support groups and art making and are available to the community.
Why is Nevada projected to have the third fastest rate of growth of Alzheimer’s disease?
Now the primary reason, from my understanding, is that we are such a highly desirable retirement state. The way that Alzheimer’s disease in particular works is that the older you get, in general, the more likely you are to develop Alzheimer’s disease or another memory disorder. So if you have a state where older people are moving in at a very fast rate, perhaps at a faster rate than younger people, then your percentage of people with Alzheimer’s disease is [higher]. I believe that the biggest reason is simple demographics. Every five years after age 60 your risk of having Alzheimer’s disease doubles.
Are there any daily habits you can recommend to people in prevention of Alzheimer’s disease?
Yes, number one is exercise, aerobic exercise. We recommend an average of 30 minutes a day. Aerobic exercise can be walking, bicycling, swimming, anything where you’re constantly moving, and at a moderate pace, or moderate level of intensity. A moderate level of intensity means that it’s enough to get you breathing hard, but you could still have a conversation. You couldn’t sing a song, but you can still have a conversation.
Another daily habit to be mindful of is diet. Two diets in particular, Mediterranean diet the Mind Diet, seem to be associated with a lower risk of cognitive decline. There’s a variety of other lifestyle measures that can support brain health. A really good resource for those are is our Six Pillars of Brain Health. Science indicates those six foundational areas in which to improve your life can also reduce your risk of developing cognitive decline and incidentally, other conditions as well.
Is there anything else you wanted to elaborate on that I didn’t ask about?
In addition to Alzheimer’s disease, there are other memory disorders that can occur and sometimes they can look very different from Alzheimer’s disease. It can be confusing to people, “Why doesn’t this look like my mother’s Alzheimer’s disease? or “Why does my neighbor’s medication work for them, but it was a disaster for us?” Those are questions that people often have because they haven’t received a diagnosis or have been misdiagnosed. So just keep in mind there are other memory disorders beyond Alzheimer’s disease. Our center treats not just memory disorders, but also movement disorders like Parkinson’s disease and inflammation of the brain and spinal cord, like we see in multiple sclerosis.
Visit Cleveland Clinic Lou Ruvo Center for Brain Health to learn more about Alzheimer’s disease.