Alzheimers is the sixth leading cause of death in the u. S. That disease and other forms of dementia take a devastating toll on patients, families and care give givers. It is dock meanted in this short film. My name is mary helen. Im the mother of 12 children and i loved each one of them. I was born august 19, 1924, in north carolina. The south was always hard on blacks. They didnt want to feel that you were equal with them. But i always felt like i was as good as anybody else. I had no inferior complex at all. In fact i was a little arrogant. I thought i could do anything. In high school, we were i think we were in the what was it the tenth grade. She was so kind and so nice, you know. I proposed to her in a letter. I wrote her a letter. I was in new york and asked her if she would marry me and she wrote me back and said yes. This one here, this is when we lived in lived on paris street and everyone was very, very young. Thats george, carla, quinn. It started about ten years ago. I try not to show it, but i take it very hard. What are we doing today honey . Were going to church today. Well be at church. Why should a person like her, you know, have to go through that . Knowing the type of person she was, she [ crying ] she was always a person that tried to do right. Tried so hard to do everything right. I think ive had a good life. I was fortunate to marry a good man. Everybody talked about me, shes crazy. She keeps having those children. But i didnt pay them a bit of attention. I loved my children. I was determined that each one of them should have an education. And i cant remember how many years my husband would pick me up in the morning from work and drop me off at the home and he would go to work so i got very little sleep. In fact people told me i was going to die and leave my children but it hasnt happened. Im still alive. Shell ask me what do i do next . I dont mind it, you know. Why . Because i love her that much. I would do anything that she wants me to do. Well, i just see me living to a ripe old age and enjoying my children, my grandchildren and my great grandchildren. And joining me now are two researchers who were investigating different aspects of dementia. Dr. Leonard muki is the director of the Gladstone Institute of neurological disease. Also joining me is dr. Delores gal lar gallagher. You get a clear idea of the difficulties and challenges of dementia. I wanted to ask you, first of all, what are some of the stressors for caregivers . I think one of the biggest stressors are the changes that keep happening to their loved ones, changes that you dont have control over, changes that are not totally predictable and usually changes going into a negative direction so the person isnt able to do what they could do before they dont remember things, current things. She remembered very well things from her past but currently im sure shes quite forgetful. So thats a real stretch for families. But another aspect of it is the families themselves get overburn overburdened. They say, what else is happening . Can i cope with it . Will i be able to really manage or am i not going to be able to continue in this world . And most families want to continue. So part of what we try to do is help families learn that they have skills within themselves. They have coping strategies and they can learn more about what to do when they are confronted with these challenges. What are some of the coping strategies that you recommend to families . Well, one that works really well is something that what they did show on the video and that is the idea of sharing pleasant activities. Doing positive things together. When youre very stressed, caring for the loved one, thats a hard thing to do because most of your time is spent taking care of them in ways that are often unpleasant. You may have to help them eat, bathe go to the bathroom and dress themselves. This is hard on families, especially when theres a big age difference like a daughter taking care of a parent. Its a real role reversal, right . But we find that by doing things together things that they both enjoy that this can really improve the quality of life for both people and it takes some of that stress away. Dr. Muki, what differentiates alzheimers from different forms of dementia . Im asked that quite often, what is the difference between dementia and alzheimers disease. Aum alzheimers disease the most popular. But there are others. Behavioral abnormalities more than the memory and there are other forms that present with episodes of unresponsiveness or visual hallucinations and things of that sort and importantly there are a number of democrat dementias that are treatable due to vitamin defic ichlt eechlt niency and are treatable if they havent gone too far down the line. Its my understanding that the only one on the list is not preventible you cant slow it down and theres no cure for alzheimers. Youre right. Theres no treatment available today that can either prevent or halt the disease. That is what we must achieve. Its very important to realize that alzheimers is not just sort of an inevitable byproduct of the natural aging process. Its a true, ferocious disease like aids or Heart Disease and must be tackled in the same manner. We needy affective medicines for these conditions that we currently do not have. Dr. Gallagher thompson, you know, you deal a lot with minority caregivers as well. What are some of the differences that youve observed . What are the different needs . Well one big difference is really seeing this whole thing as part of normal aging for a long time, often until it gets to the point where there is significant behavior problems and thats when the family reaches out for help. But up until that time they may go to culturally relevant and traditional healers for example in the Latino Community they may go to the may go to church and believe that prayer is going to reverse this. And some of the chinese communities, the herbalists. So traditional forms of help are sought, oftentimes these people have other ailments that the family has so they think it will help here with dementia. But its really not efficient. So thats one issue is understanding, learning about learning about learning that there are resources that are culturally tailored and its also learning that within the family theres a great deal that one can do to support one another. So its true that there is no cure at the present time and its certainly true that the scientific world is trying very hard to find that. But in the meantime, we have millions of people globally who are struggling and they need to have some help. So one of the big sources of help is right there its the family. If you know how to bring the family together to work collectively to help and in the minority communities, we see that the family is brought in more often. We make a great attempt to do that and we find that that helps to ease the burden considerably. The understanding of the needs of minority communities certainly are evolving but the research has certainly been evolving. What have you, dr. Muki, and other researchers learned about dementia and alzheimers and how has that approached how dealt with this . Weve understood that the disease has multiple causes. So different people get the disease probably for different reasons. We know that there are some very aggressive genetic changes, so mutations in genes that can cause alzheimers disease where everybody has that mutation is going to get the disease for sure and weve understood now through largescale Genetic Research that there are risk factors, just like there are risk factors for lung cancer and cardiovascular disease. There are genetic risk factors for alzheimers disease so we understand much more about the different causes. And i think an important realization for us is that this multifactoriality will have to be met with a multiprong approach. Its very unlikely, in my view that there will be a single blockbuster drug that will take care of all alzheimers patients. Well need a whole toolbox of drugs. Much like the aids epidemic. Multiple drugs. Absolutely. And just to refer back to something that you said. What we saw at the beginning of the aids epidemic is people tried all kinds of things, you know, chanting and herbs and Lifestyle Changes and, unfortunately, it didnt help. And then medicine cracked open this field and now nobody has to die, really and its in the combination of drugs that were rationally designed and focused on the hiv virus but that only has nine genes. Its a very simple organism. Here were dealing with the complexity of the human behind so its a much harder challenge. Youve talked about the genetic factors. Does that mean if you have the gene you will ultimately get alzheimers or if you have family members, you will get it . So, you know, there are different genetic factors. There are those that determined with 100 certainty that you will get the disease. They are very, very rare. They make up less than 1 of all cases of alzheimers disease. But then there are other genetic risk factors for example, good and bad cholesterol there is good and bad abu. If you got one of those genes from your mom and one from your dad, so you have two of them, your risk of getting alzheimers in your early 60s can go up. Its a huge leap. These are powerful risk factors but it doesnt mean if you have those risk factors its 100 sure youre going to get it. Just like somebody who smokes may or may not get lung cancer and somebody who has high Blood Pressure and cholesterol levels may or may not have strokes and heart attacks. Its clear that these are important risk factors. Are there some promising medical developments now on the horizon . Will we see an effective treatment or cure soon . So, you know, how soon i am not 100 sure. In the early 90s when all of this science from genetics emerged i think me and my colleagues thought we were five ten years away from cure. But i think that we now are beginning to develop treatments that aim at the root causes of the disease, not just at the sim symptoms. And theres very exciting new treatments in latestage Clinical Trials that i think make me very optimistic and there are many more coming into the pipeline, focusing on these different factors like chronic brain inflammation and i really think that in the next five to ten years we will hopefully see at least various of these new therapeutic strategies move into the clinic and into the bedside of patients. With that, we certainly hope so. Dr. Gallagher thompson what advice would you give to a newly diagnosed patient and their families . Well, first of all, dont give up hope. There are things that you can do. So just like we learned to adapt to other chronic illnesses, we all have them in different forms and we learn to live with them. So dementia is similar. Its a longterm, chronic illness. It does go through stages. Its true there is a downhill course but at each stage along the way there are things that we can do to mitigate the impact that it has on the patient and on the family. So, for example in the early stages where people are forgetful and they repeat their questions and they get lost easily and so forth theres specific strategies that you can use that will help to reduce the frequency of that behavior. And organizations like the Alzheimers Association and here in san francisco, the Family Caregiver alliance helped families learn what those particular strategies are. In the middle stage when you have other kinds of problems, wandering, disinhibition derobing in public, there are other techniques you might use. So the message is hope. And that is a godod message to end on because its certainly a devastating disease but optimism is what you pointed out, thank you both. Dr. Muki and dr. Delores gallagher thompson, thanks to you both. Last year, Antwan Wilson became superintendent of the School District and 30000 Students Attend School at that financially struggling district. The High School Graduation rate was less than 61 well below the state average of 80 . Mitchell wilson is joining me now. Welcome. Thank you for having me. I see youre wearing your open shirt there with pride. Absolutely. Lean back a little bit so we can see what it says. Oakland is. What does that mean . About pride in the city, the swagger the city has and being proud to represent the town. Im certainly excited to be a part of it and have an opportunity to represent oakland. It is certainly a city with much to celebrate, as we know with the recent warriors win and beautiful neighborhoods as well. You also have quite a few challenges and we talked about that in the introduction the low graduation rate. Given that its so low why should families want to be in the oakland Public Schools . Oakland is a tremendous district because its in a tremendous city of oakland. Were tremendously diverse district and were focused and we invite parents to participate in our process of becoming an outstanding School District. And you know our focus is on academic achievement. What i would tell parents when they are considering our district is to look at the fact that our student achievement is increasing look at the fact that we have more students at grade level and the more students from throughout the city and i would say look at our focus on college and Career Readiness and the fact that were seeing improved outcomes in those areas and know that they can help us get even more done. What else do you need to do, do you think, for Oakland Schools to succeed . I think our focus needs to be on supporting all children and focusing on building on our strength. You know oakland is a city where we have tremendous strength throughout Community Engagement a great deal of innovation and ingenuity in oakland, a number of people who have a great deal of pride being from the city. Having graduated from oakland unified School District and they are doing a lot of Amazing Things and a lot of different levels. Our students need to see that and learning from their example, they will be successful as well. One of the Biggest Challenges to that . I think some of the Biggest Challenges is some of the past perceptions, maybe some of the past mistakes. And then funding. You know, just making sure that we continue to do the work that we are doing to improve our fiscal situation which im quite proud of the fact that we have made tremendous progress in that regard. A lot of the challenges, though, also lie outside the classroom, as you know. You have a community where some oakland students have been victims of Violent Crimes or have been witnesses to very brutal crimes. How do you go about addressing all of that . Because that very much goes to the heart of how they perform in school. I appreciate the challenges that our students have in terms of what they are facing in their every day lives because those challenges, being around crime witnesses of crime, that was very much a part of my upbringing, very much a part of what i saw. The violence, the shootings, all of that was a part of my lived experience. You grew up in lincoln. I grew up in wichita and lincoln and had to deal with the fact that in lincoln excuse me in wichita a mother being shot and dealing with all of those different types of things. So, yes, i understand it. So what do we do with that . We work to make sure, first of all, that they know that the superintendent understands that. Thats part of the experience. Two, to recognize that we know that we have a School District that is there to meet the needs of our students regardless of what they are emotional and academic needs and then its part of the community to provide support to our students that they are going to need with a number one focus on making sure that they come to us with great assets and strength and they will be successful. There is a new director of education position. This is a policy job. How do you feel about the new hire, david steelberg. Im very excited about my collaboration with mayor shaft and had absolutely nothing but great thoughts about her pursuing an education agenda. Weve done this in collaboration. What i would say, ensuring that our students are successful in oakland, thats our job. In no way is this a threat to me as the superintendent in oakland. This is an opportunity to partner the city around the outcomes that we want to see for our children which is that they are all college and career ready. Last month the Oakland School board voted unanimously to end the use of willful defiance and this is a vaguely defined category for all types of misbehaviors. Have you set the grounds for transferring or suspending a student. What is the significance of that move . We recognize that its important that students are in school that the environment is safe, that they are respecting their teachers and we believe that we can get that done by lifting up practices, making sure that they understand their behaviors while inappropriate are not going to be an excuse to miss out on learning and that we will make sure that we address any inappropriate behavior that may come and ensure that we also continue to focus on their learning. And so by emphasizing our focus on the practice ending suspicion and willful defy nans and normalizing or standardizing this across the district which was also part of that vote, we think that we are on the path to ensure that all of our students get what they need to graduate from high school. I want to also talk about the relationship between Police Officers and students of color. Your district, what are you telling the officers about how to relate to the students and vice versa . We believe our Police Officers are an important part of uplifting School Safety and social learning speaking to the relationships that we establish with each other, including our students awe students and we hired a chief of police uplifting those same messages and were providing training for those officers. Charter schools, do you view them as a partner or competitor to the schools . We have 48,000 students in oakland and 11000 students are in Charter Schools and i see that Charter Schools are a partner. Now, its important that we recognize that while were partnering with charters, that were going to do everything that we can to uplift the schools that we directly run. Were going to do everything that we can to support them and help them be successful. You alluded to this earlier your background, your mother having seen her been shot, you were the son of a single teenage mother. Your family was poor. How did that experience shape you and how what lessons have you gotten from that that you are now taking and putting into practice in the oakland School District . Well, i had a great example you know, for me. My mother didnt allow me to make excuses. So we had a lot of things, as you just mentioned, that were extremely difficult. I watched her work extremely hard. We went through a number of challenges but i also saw a great deal of determination, pride and belief in agency. It was about being respected and demanding respect. One of the things that endears me to oakland. I see that same type of resiliency here. So what that does is it puts in me a desire to ensure the students get what they deserve and they get the opportunity that i got to be successful and i bring that in my leadership here in oakland that fight and determination that i saw modeled for me and i see reflected in so many in our students. I wish you much look and we look forward to hearing from you on year two to see how things are going, superintendent of schools in oakland, thank you so much. Thank you for having me. And that does it for us. Thanks for watching. For all of the news coverage, go to kqednews. Org. Im thuy vu. Have a good night. The following kqed production was produced in high definition. Every single bite needed to be great. Twinkies in there. Wow its like a great big hug in the whole city. That food is about all i can handle. My parents put chili powder in my baby food. French fries everywhere, all over the table and just a lot of chili