Jane: It was traumatic. It was devastating. It was a volleyball that struck me, smack in the face. Allison: That's our first guest, Jane Enright. She took an unexpected blow to the head. It changed her life forever. And the science is saying that such impacts can significantly increase our risk of dementia. Jay: Welcome to Defy Dementia. The podcast for anyone who has a brain. Allison: Defy Dementia is all about living in ways that keep your brain healthy and reduce your risk of dementia. Because dementia is not predestined by our genes. Genetics can play a role, but lifestyle risk factors like social isolation, lack of sleep, and air pollution may also have a significant impact. Jay: And according to the latest and best evidence, scientists are now saying that if we make healthy changes to those lifestyle risk factors, we could reduce dementia cases worldwide by more than 45%. Allison: Today on the show, the impact of traumatic brain injury on the brain. We're going to explore how blows to the head, both major and minor, might affect our cognitive health and ratchet up our dementia risk. Jay: I'm Jay Ingram. I'm a science journalist. I have a long time interest in dementia. Allison: And I'm Alison Sekuler, President and Chief Scientist at the Baycrest Academy for Research and Education, and at the Center for Aging and Brain Health Innovation. Jay: Join us as we defy Dementia. Because, you're never too young or too old to take care of your brain. Allison: On the show today, we are focusing on something that affects many, many people. Blows to the head that injure the brain. It's called traumatic brain injury or TBI for short. Jay: On average, more than 130,000 Canadians visit hospital emergency rooms every year because of a TBI. And worldwide, every year, nearly 70 million individuals experience a traumatic brain injury. Allison: Blows to the head can impact the brain in many different ways, and here are just a few. The brain can be subjected to huge G-forces during an impact. It can twist and rebound inside the skull, or an impact can cause it to bleed. Those injuries and others, may affect a person's cognitive abilities like learning and thinking. Jay: TBIs are caused mostly by falls, being struck by an object or by vehicle crashes. Doctors classify traumatic brain injuries as mild, moderate, or severe. For instance, concussion is at the mild end of that spectrum. Allison: But mild, moderate, or severe, researchers have shown that TBI is a risk factor for dementia. Jay: As you will hear later in this show, many of the effects of TBI are not understood, and scientists are sleuthing away trying to unlock multiple mysteries. But one thing's for sure, a blow to the head can have devastating consequences. Allison: That's just what happened to our first guest. In 2017, Jane Enright was the mother of two and a busy focus group facilitator for corporate executives. But then a traumatic brain injury while attending a volleyball game, changed her life. Just several months after her traumatic brain injury, her partner at the time also suffered a severe traumatic brain injury and nearly died. Jane's here to tell us about all of this and to share some insights on rebuilding life after such life-changing events. But skipping ahead a bit, today, Jane is an award-winning author and motivational speaker. She is a director on the board of Governors for the Brain Canada Foundation, and her partner is now her spouse. Jane Enright joins us from Victoria, British Columbia. Jane, thank you for helping us defy dementia. Jane: Thank you, Alison. Thank you for having me. It's a pleasure to be here. Allison: So there's a lot more to you and your story than the injury that you survived. But can you share with us just a little bit about what happened at that volleyball game? Jane: Well, it was traumatic. It was devastating. It was a volleyball that struck me, smack in the face. Allison: [When you were playing?] Jane: No, I wasn't playing. I was watching. I was a spectator. I was sitting in the spectator seating area. Jay: And what happened as a result, Jane? Jane: Basically, a lot of trauma, a lot of blood loss, but a lot of speech aphasia and memory issues. It was like I was Dory in Finding Nemo. I couldn't remember what had happened before and what was going to happen next. And I couldn't articulate myself. I couldn't express myself the way I had before that injury occurred. Allison: You made your living before by talking. Can you describe what your sensations and feelings were when you tried to find words after this incident? Jane: Basically, frustration. I think frustration is probably the best word to describe it or articulate my feelings at the time. And for a person that spoke for a living, [you know i was] facilitating conversations. It was a sense of disbelief, but also fear about the future. What happens next? Am I ever going to be able to remember what I should say and wanted to say? [Well], it wasn't so much that I couldn't remember what I wanted to say, but I [could] formulate the words in my mind,I could see the words in my mind, but the signal from my brain to my mouth wasn't functioning properly. I could not articulate what I wanted to say. For example, if I saw the search magnifier on a computer screen, my brain said, "Oh, that's a mule." And I said to myself, "No, that's not a mule. That's a magnifying glass." It was still very much in the here and now and still very much thinking about what I wanted to say. But it was like all the files in the filing cabinet of my mind had spilled on the floor. Jay: And yet, Jane, your now spouse, had a serious brain injury himself while you were dealing with what you've just described. That must have been incredibly difficult. Jane: It was. It was, Jay. And thank you for acknowledging that. And so I've had the unique experience of being both a TBI survivor [and a caregiver]. I was healing, and I was coming along and doing all the right things: working with a speech pathologist and a neurologist to really get my speech patterns back and articulate myself. Then of course, you think that would be enough to handle in life. And my partner at the time, and now my spouse had his own catastrophic head injury from a car accident, and it changed his life forever. Jay: And yet, we're talking to you now. You have no apparent shortcoming in formulating thoughts and speaking. So there must've been some significant turnaround during your recovery and rehab. What was the most important thing about that? What was the key? Jane: First of all, it was the belief that things could get better. Second of all, it was really listening and having the necessary healthcare support in place, with knowledgeable people like a speech pathologist, who not only focuses on what we say, but the inner workings of your brain. [The speech pathologist] said to me: "Jane, you really need to rest your voice. You really need to give that signal and processor in your brain enough time to heal. And I think you should focus on writing rather than talking". [This] led me in a beautiful new direction. And it is really a gift. It's the silver lining of the terrible event. I've [now] written about my experiences and I'm sharing my experiences with others, so they too can better understand how to handle [TBI] and become more resilient, but also move forward. I think there's a lot of misunderstanding sometimes about TBIs. This is not a cookie-cutter. One person's experience with a traumatic brain injury can be totally different; the area [where] you were hit, [where] you had your physical injury, whether it's a slip and fall [or] some sort of accident…[etc]. My goodness. And our brains change. They have the ability to regenerate and develop new neural pathways. And that's I think [is] what happened to me. My brain responded really well to writing more than speaking, but it is not without hard work. And there's an intentionality, a purposefulness about it. Allison: And on that purposefulness, in the book and in the speeches that you've given about the recovery, one of the things you focused on is the way that mindfulness was really key to your recovery. I wonder if you can share a little bit more about how you think mindfulness played a role? Jane: Yes. Mindfulness is one of the six pillars of brain health, which I didn't know at the time. I think in my life, I was a very busy executive before this injury happened to me. I didn't necessarily have time to research. "Well, what's good for your brain? What can I do now?" I really relied on the healthcare team that I had around me. But later on, I learned from Brain Canada and other organizations such as Brain Changes, which are two very important organizations in Canada, that mindfulness is one of the six pillars of brain health. True mindfulness is really how we define ourselves and how we see the world around us. It keeps us out of the weeds of overthinking. Because, a lot of times when you've suffered a traumatic brain injury or any type of injury or any type of loss such as COVID, we [go] through sudden rapid change [and then] we tend to dwell on the past. If you dwell on the past, a lot of people can get very depressed. If you're worried and anxious about the future, that can create a lot of fear and anxiety. Mindfulness is really being in the here and the now and saying, "I accept that this has happened. I'm not happy about it." You don't have to be happy that you got hit in the head. I wasn't. Mindfulness is really like emergency preparedness for your mind. Preparing [you for the] day. People spend billions of dollars on mindfulness. Yoga and meditation, but really not knowing what it does. It really helps your brain. It calms your brain. It helps you deal with whatever comes your way that day, but in a more positive, calm, purposeful way. And that's what happened to me. Allison: So traumatic brain injury is widely recognized as a significant risk factor for dementia. To what extent is that on your radar right now? Jane: Well, thankfully, I don't have any indicators of that in my life, but it is obviously a very, very important factor [that should be] on everybody's radar. TBIs don't discriminate; children, the elderly people in midlife like myself, teenagers, [during] sports [or not]. People that are at sporting events playing or in the stands, anywhere. Combine that with 15 Canadians being diagnosed with dementia each hour in Canada, that's huge. Couple that with people that have a higher risk factor, it needs to be on everybody's radar. I had a wonderful neurologist and it was really a gift. And he said, "Jane, I describe your injury as somebody who your gas tank is not..." We all start with a healthy brain [reserve]. If you have a TBI, those reserves go down. You're at risk for other things. You're at risk for another TBI. You're at risk for dementia”. But thankfully he [added] "How you manage your life and how you manage yourself are going to predict your outcome." I'm a good news story after a very horrific, horrific, traumatic incident in my life. But it takes work. It takes purposefulness. It takes paying attention to what you eat, [to how] your sleep and exercises and mindfulness. That's how I defy dementia every day and other things in my life. I want the rest of my life to be the best of my life. Jay: Jane, how are you doing these days? Does that traumatic brain injury you suffered still affect you? Jane: I would say, I'm at the top end of the scale of really doing well. But I manage my day probably very differently than others. I take time every day to prepare [myself] with mindfulness and exercise. I limit alcohol, and there's a lot of positive self-talk in my brain saying, "Okay, you've come this far. Keep going. You can do this.?" Yes, there can be some days where your energy isn't what it could be. Or oftentimes, Jay, I'll readily admit, it takes me longer to do a task than someone else. Not because I can't do it or because I can't think or I'm not intelligent or my mind is mixed up. It's not that at all. It's just my brain. It's just the way my brain works. Allison: Well, you certainly gave us a tremendous amount of hope, and it was really amazing and inspirational to hear your story. So thank you so much for joining us and for helping us defy dementia. Jane: Thank you so much. It's been a pleasure. Allison: Jane Enright is an author, content creator and speaker. Her latest books are Jane's Jam, Inspiration to Create Your Super Awesome Life, and a book for children and their grownups to learn about the super power of mindfulness called, "Hi, I'm Cher. I go everywhere." Jane joined us from Victoria, British Columbia. Jay: Our next guest has been listening to Jane Enright. Dr. Carmela Tartaglia is an expert on traumatic brain injuries and concussions and their impact on dementia risk. Carmela is a professor at the University of Toronto, and a clinician scientist at the Canadian Concussion Center at the University Health Network. That means, on top of being a researcher, she's also a hands-on doctor who sees people who've experienced head injuries, daily. Carmela Tartaglia joins us from Toronto. Carmela, thank you for helping us defy dementia. Carmela: Thank you for inviting me. It's a pleasure to be here. Jay: What struck you about Jane Enright's story about her traumatic brain injury? Carmela: Yeah, it's very striking. We call these injuries, mild traumatic brain injury or concussion. But you can see it's not mild at all. That's because the injury is to the brain and the brain defines you. So, of course, any injury to your brain can have significant consequences even if it's not a moderate or severe brain injury. [And for] those ones, if you looked at an MRI, you would see blood on the brain. You would see a big bruise on the brain. You would see pieces of the brain missing. But even [with] a mild injury where the brain looks completely fine, doesn't mean that the brain is fine. It does not mean the person is fine. Because you can [see] all the symptoms that she struggled with. They come about because of the changes in the brain. It doesn't mean the brain can't recover, though. Allison: Yeah. And have you ever yourself experienced a traumatic brain injury or another kind of head injury? Carmela: Yeah, actually, I was hit by a car when I was 15 years old and spent the night in the emergency. Ended up with 17 stitches, and I remember I lost consciousness. I woke up in somebody's car. They were actually a drunk driver who drove me to the hospital. Allison: Oh my gosh. Jay: Oh, no kidding. Carmela: Yeah. I spent the night in the [emergency room], and then the next day I had a math exam. And I remember thinking, if I don't do well on this math exam, I'm going to tell them I spent the whole night in the emergency. But I was fortunate enough to not have any symptoms that day. I don't even remember having a headache or anything. Allison: And as a scientist, what did you learn from that injury and that experience? Carmela: Well, actually when I remembered this [incident] - because for many years I said, "No, I've never had a head injury." - I thought, wow, the reaction to a head injury is so variable. And that's because we're all unique. We have a different genetic makeup, we have a different environment. And so I always say to people, "If you've seen one person with a concussion, well, you've seen one person with a concussion." Jay: So that variability, Carmela, makes the question I was going to ask [more] difficult. But what happens to the brain during a traumatic brain injury? Carmela: I guess the honest answer is, we don't actually know, but many things happen to the brain. Because, remember that the symptoms that come about after a concussion or a mild traumatic brain injury like headache, confusion, trouble concentrating, sleep issues, all those come from the brain. The brain defines you. And if there's a hit to your head, well, there's going to be consequences to that. And so in terms of the mechanisms, in terms of the molecular, what happens at the cell level? We know that there can be inflammation. We know that there are changes in the mitochondria, which is the furnace of the brain. We know that there are changes in the way the cells talk to each other. There's changes in your serotonin level. That's the neurotransmitter, the chemical, that's associated with depression. [There are changes in] the epinephrine level, which is associated with attention. All those things come about. It doesn't mean they're going to be permanent, but something happens to the brain and that's why you end up with the symptoms that you get. Allison: So there's a lot going on in the brain, once we hit our heads and have a traumatic brain injury or concussion. What do we know about how traumatic brain injuries might increase dementia risk? Carmela: Again, a great question that I have to say, I don't know. But, we have many hypotheses. I have a research program which is actually dedicated to this [question]. [We are] trying to understand what happens the day you got the concussion, the mild traumatic brain injury, and how did the changes that occur that day increase your risk of dementia? And the thing is, it actually doesn't happen in everybody. We know, everybody hits their head. When you think about it, all the children who learn how to walk, they fall. And some of them fall really hard and they can't tell you [if] they've had a concussion. Sometimes they get a little moody afterwards, but it's very hard to know. I think most of us have hit our heads in our lives if we're at all active. So what happens to people to say, "Hey, something so dramatic has happened that it increases your risk for something decades later?" And like I said, there's many things that happen on the day that you get a concussion. Allison: You've talked about concussion, and you've talked about traumatic brain injury. I wonder if you can just say a little bit about what's the difference? Are they the same thing, or is there a difference? Carmela: Yeah. Concussion and mild traumatic brain injury are often used interchangeably, [but] they're not exactly the same. A concussion is a milder form of a mild traumatic brain injury. And that usually means that if there's an episode of confusion, it's very short-lived. If there's an episode of loss of consciousness, it's very, very short. [In both] concussion and mild traumatic brain injury, we shouldn't see any changes on any of the classical imaging like MRI or CT scan. So yes, they're not exactly the same but because we don't have any markers they're difficult to differentiate. Now, between that moment in time where you had that injury, it could have been from a motor vehicle accident or [from] playing football, how do you end up with dementia decades later? That pathway is the subject of intense research, because we actually don't know. We know that in people who've had repetitive head injuries - there's been a focus on athletes who've had many, many concussions - as well as all sub concussive blows to the head, [it] puts them at risk of chronic traumatic encephalopathy that has been mostly [talked about] into the news. But those people don't just have chronic traumatic encephalopathy. A lot of them will have many other diseases also in the brain, like Alzheimer's or Parkinson's disease. We don't really understand how it happens, but we do know that, when you look at large studies, you can see that if you've had even a mild traumatic brain injury in your life, in your past, your chance of dementia is increased. Jay: And chronic traumatic encephalopathy, what is that? Carmela: That's that disease that has been described in many former professional athletes who have had repetitive head injuries. Some of the [injuries] concussive [but] sometimes even sub concussive. It's a disease of the brain, like Alzheimer's disease. It's a change in the brain that we can see. It means after a person dies, we can make a diagnosis of CTE. It is a change in the brain related to these repetitive head injuries. It's been seen in some military, as well as a few cases of women with intimate partner violence. Allison: So just to be clear that the traumatic brain injury doesn't necessarily have to be really severe. How severe does it have to be to have a negative impact on cognitive health or dementia risk? Carmela: We don't know how severe it has to be. We actually think that it may not have to be that severe at all. Because when you talk to these former athletes who've had repetitive head hits, many of them will tell you they've had very few concussions. They've had very few times where they've [had] loss of consciousness or had post-traumatic amnesia. But they've had many, many, many, many hits to the head. So we are worried now about subconcussive blows. Allison: Right. But just to be clear, if someone falls and hits their head once, it doesn't mean that they're going to get dementia. Carmela: No, of course not. And I think it's really important. That's a great point. Jay: Carmela, when somebody takes a blow to the head or somebody they know takes a blow to the head, what things might you look for to know whether you should seek medical help, go to the hospital or not? Carmela: I usually tell people that, if let's say, you hit your head and then you have symptoms, you have a headache, a really bad headache, or you get nauseous or you don't feel right, then you should get medical attention. And it might be that your threshold for seeking medical attention might be different than mine. But that's okay. If you're worried about your symptoms, you should seek medical attention. If you hit your head and you have no symptoms afterwards, it's probably okay to let it go, because that happens to a lot of us. Jay: So if somebody is suffering symptoms of one kind or another, what would you say are some of the best treatments or therapies that you suggest for your patients to try and restore normal brain function? Carmela: We really take a symptom focused approach. So that means, if you have a headache, I will try to get rid of your headaches. If you have a mood problem, we will try to fix that.The issue is that people sometimes come to me and are obviously very biased because I'm a cognitive neurologist. I see people who have cognitive issues, so they're complaining about their memory. They're complaining about their difficulty concentrating. But of course, you're going to have trouble concentrating if you have a terrible headache or if you don't sleep well anymore. If you're depressed or anxious. The important thing is to remember that if you don't concentrate on something and you don't register that information, then of course it's unfair to ask the brain to remember it. It didn't even get into the brain. So we try to fix the symptoms that are taking up some of your cognitive bandwidth. We all have bandwidth. And if your bandwidth is taken up by poor sleep and a headache and low mood and dizziness, and feeling generally unwell, [then] you just have very restricted bandwidth to pay attention and actually register information and process things. Allison: You talked about bandwidth. In previous episodes we've talked about things that people can do to enhance their bandwidth in different ways. So for example, exercise can actually improve people's cognitive function. So when you see people with these more serious injuries, are there specific things that you advise people to do? Carmela: Yes. We know that aerobic exercise is very important for the brain. It's probably [true] across all brain diseases. Exercise is important. But in concussion, there's very good data that aerobic exercise [is good]. That means things like running, cycling, swimming. Of course, sometimes people say, "Well, I have a really bad headache. I can't run." Fine. Don't run. Sit on a stationary bicycle, a recumbent bicycle, do whatever you can do. Dancing. Do whatever you can do, but get that heart rate up. We now recommend rest only for 24 to 48 hours. We no longer recommend rest, dark rooms, or staying away from your friends and people. [Only] the first 24, 48 hours. You can take a walk, you can do things, but take it easy. And then afterwards, start doing some exercise. And you may have to go up slowly. Allison: In the past, I've heard people who are recovering from traumatic brain injury or concussion, say that the doctors have told them to stay off the screens and don't watch TV. Is that still advice, or you're saying maybe that's only for the first 24, 48 hours now? Carmela: It's a personalized approach. If you tell me that you have computer screen intolerance, where the screen brings on headaches, I'm going to [tell you tp] limit your screen time as much as possible. TV actually is interesting because TV does not bring on headaches, as much as a screen. We don't know [exactly why], maybe it's the fact that most times when we're looking at our screens, we're concentrating on things. And so it may just be that cognitive load in addition to looking at the screen. Jay: If somebody has experienced a brain injury and that there is a chance that that might increase dementia risk, is that increased dementia risk there for the rest of their lives? Carmela: That's a great question. And I always tell people, "I don't actually know the answer to that." But what I do know is that, you cannot take away the fact you had that injury. We're not going to go back in time. So what I usually tell people is, do the things that can mitigate that risk. We know there are many things that you can do to improve your brain health. We also know that you have to think about your brain health [your] whole life. So if the brain injury has happened and that increases your risk of dementia, then do those good brain health things, like exercise. Lots of evidence that aerobic exercise can delay the onset of your dementia. Learning new things. We know that learning new things gives you cognitive reserves. Make sure your blood pressure is well controlled. Make sure you're not turning into a diabetic. Maybe you want to engage in activities where you socialize more. Alcohol has been shown to be very devastating to the brain. The new guidelines have shown that you really should not be drinking alcohol at all or restricting it to a maximum of two per week. Obviously no smoking. So there's many things that we can do to mitigate the risk of something that has happened to you and you cannot change. Allison: So we know that you can avoid putting yourself in dangerous situations to some extent, to mitigate some of the risks. But people are always going to be active, we hope. They're always going to play sports. They may have car accidents, they may fall and hit their head. But are there any particular steps that we all can take in those active ways of living our lives that can also decrease traumatic brain injury? Carmela: I think that's a great question. Because as you've mentioned, we want people to engage in sports. We'd rather they engage, not so much in contact sports. There are some sports where unfortunately, hitting the head is part of that sport. [But] do children really have to head the ball at young ages? Especially in soccer. Do they need to play contact sports at young ages? Maybe we need to think about some rules, some laws that change the age that you head the ball. This has happened in other countries, but Canada has not done that yet. In terms of other things, yes. Falls on the sidewalks are very, very common. So should we encourage measures that will decrease falls? Of course, we want people to walk. We want people to walk more than drive. In terms of car accidents, I have to say that I have so many people in my clinics who've had rear-ending accidents. Are the laws strict enough for people who rear-end other drivers? Are the cars designed well enough for rear-ending accidents? They're actually designed for no airbag deployment, if you get a rear-ending accident, it's all about the front end. We're also thinking about the way cars are designed and are they designed for all people? Women tend to be smaller. Many of them don't even reach the headrest very well. Is your car safe? We certainly have way more women in our clinics who are there with persisting symptoms of concussion from a rear-ending car accident. I think there's a lot of things, intimate partner violence also is an important reason for people getting repetitive head injuries. The laws need to change in regards to that. So there are many things we could do. Jay: Well, thank you very much, Dr. Tartaglia for this. It's been really eye-opening and I'm sure useful for our audience. Thank you. Carmela: Well, thank you for having me. Always happy to talk about the brain. Jay: Dr. Carmela Tartaglia is a professor at the University of Toronto. She's also a clinician scientist at the Canadian Concussion Centre at the University Health Network. She joined us from Toronto. Allison: So, Jay, once again, some really interesting discussions with our guests. What stood out for you? Jay: You know Allison, I think one of the striking things that Carmela told us was that, even though the effects of traumatic brain injury are pretty well catalogued by now, and we know that they can range from not serious to extremely serious, it's still pretty much a mystery as to what actually happens inside the brain as a result of a brain injury. [It is also unknown what exactly in the brain constitutes the difference between, a moderate and a severe brain injury]. Obviously, this is a high priority research area. The other thing that I was thinking about as we talked to our guests is that we've spent a lot of time on defy dementia, talking about the various dementia risk factors that have been identified [and ranked] by the Lancet Commission. I like to go [back to this ranking], and traumatic brain injury is less of a risk for dementia than hearing loss and social isolation. It's equivalent to depression and air pollution. But it's actually more significant than physical inactivity, tobacco smoking, alcohol, diabetes, and obesity. So this is not a trivial situation. Allison: The other thing I thought was really interesting [is that] the same kind of injury can affect different people in such different ways. So we heard Jane being hit in the head with a volleyball, have really, really long-lasting consequences. Carmela described her own events - being hit by a car and being hospitalized - and did just fine the next day [when] she took a math exam. That variability is, for me, a really interesting thing. And I think it really highlights that what's going on in the brain is going to be different from person to person. And that just because you have had one hit to the head, one traumatic brain injury, it doesn't necessarily mean that you will end up with dementia. It's going to affect your brain in very different ways. Jay: Could I just comment on that too, Allison? The variability even extends to the apparent severity of the blow to the head. I know a person who, having suffered a couple of concussions, was playing with her son in the backyard throwing a wiffle ball, one of those very light balls with holes in it. So it doesn't really travel very fast and threw it to him and he batted it back. It hit her in the head and she got another concussion. So, I think that's a message that even if you think it was a trivial incident, if you're feeling any symptoms, you should check it out. Allison: Absolutely. Go see your doctor. And I think the other thing to keep in mind, and Jane really exemplifies this, is that traumatic brain injury is potentially a risk for dementia, but it doesn't mean that there aren't things you can do to counteract that risk. And Jane was talking about how she herself is really engaged in taking care of herself, and she's recognized she can improve in things like exercise. And then Carmela really highlighted for us how important exercise is in helping to heal the brain. To find out more about how we all boost brain health and reduce the risk of dementia or slow its progression, please visit us at defydementia.org. There you can check out other episodes of our podcast, as well as our videos, infographics, and other resources. Jay: Our podcast production team is Rosanne Aleong and Sylvain Dubroqua, our writer and chase producer is Ben Schaub. Production is by Podtechs. Music by Steve Dodd, and our cover art is by Amanda Forbis and Wendy Tilby. Allison: We'd also like to thank the funders of this podcast. The Slaight Family Foundation, as well as the Center for Aging and Brain Health Innovation and Baycrest. Jay: We really appreciate your support too. So hit that subscribe button for Defy Dementia or wherever you get your podcasts. And don't forget to leave a like, comment, maybe even a five-star review. Allison: Next time on Defy Dementia, smoothing the transition to long-term care. We'll share some hard-won advice on how caregivers can ease the impact of moving family and friends living with dementia into long-term care. And we'll have tips for both caregivers and long-term care staff on how to make transitions work better for everyone. I'm Allison Sekuler. Jay: And I'm Jay Ingram. Thank you for listening to Defy Dementia. And don't ever forget, you're never too young or too old to take care of your brain.