Podcast – AAIC 2024 – Day Two

Caitlyn Fastenau:

Hello, and welcome to our second AAIC Highlight Podcast, located onsite in Philadelphia, sharing news from the world's largest dementia conference. Hi, I'm Caitlyn Fastenau, and I'm very excited to speak with guests today about AAIC 2024, so stick with us. Joining me today are three brilliant researchers working on very different areas of dementia discovery. I'm pleased to introduce Dr. Balogun Wasiu from the University of Pittsburgh, Dr. Jessica Caldwell from the Cleveland Clinic, and Sophia Krix. Hi everyone. Hi.

Sophia Krix:

Hi.

Caitlyn Fastenau:

So I should introduce myself first. I'm Caitlyn. I'm a fifth-year PhD candidate at the University of Texas Health Science Centre in San Antonio, and I study innate immunity in Alzheimer's and other related dementias, and specifically how microglial changes interact with brain pathology. So I'd love to hear a little bit about what you all do. We can start with Sophia.

Sophia Krix:

Yeah. For sure. Hi.

Caitlyn Fastenau:

Hi.

Sophia Krix:

So I'm a third-year PhD candidate at the Fraunhofer Institute in Bonn, Germany, and my PhD is in computational life sciences. So I work with a lot of AI, so artificial intelligence, and machine learning methods for precision and systems medicine to discover, especially now, early biomarkers for the identification of Alzheimer's patients.

Caitlyn Fastenau:

Awesome. Wow. That's really cool, and especially very topical with the AI and-

Sophia Krix:

Absolutely.

Caitlyn Fastenau:

... the discussions of AI at the conference today. Yeah.

Sophia Krix:

Yeah. That's true.

Caitlyn Fastenau:

Nice to meet you.

Sophia Krix:

Nice to meet you. Excited to be here.

Caitlyn Fastenau:

Definitely. Yeah.

Dr Jessica Caldwell:

Yeah. I direct and run a women's Alzheimer's prevention centre in Cleveland Clinic, Las Vegas, and I also do research. So my research topics are on prevention, both intervention and lifestyle changes, as well as sex and gender in Alzheimer's disease.

Caitlyn Fastenau:

Awesome. Again, it was nice to meet Jessica. We did the podcast together earlier. I did get a comment from somebody that they were very curious how Cleveland Clinic ended up in Las Vegas. How did that happen?

Dr Jessica Caldwell:

It happened because there is a philanthropist who brought us there, and his father had Alzheimer's disease. And so we are the Lou Ruvo Centre for Brain Health, named after Larry Ruvo's father. He approached a number of hospital systems and found really a good match with the Cleveland Clinic, and so we have outpatient neurology in Las Vegas.

Caitlyn Fastenau:

Very cool. Yeah.

Dr Balogun Wasiu:

Yeah. I was going to actually ask also because I was at Case before, I did my first postdoc at Case and at the Cleveland ADLC, and Cleveland Clinic was a major partner there. So I was surprised when you mentioned Las Vegas. I thought you were going to mention Cleveland in Ohio, but yeah, so we keep learning every day. Yeah.

Caitlyn Fastenau:

Definitely.

Dr Balogun Wasiu:

So my name is Wasiu, I'm a postdoc at Karikari Lab at the University of Pittsburgh. I'm working on blood biomarkers, and I'm developing and assessing novel neuro inflammatory biomarkers for tests in fluid, human fluid, especially plasma, serum, CSF, and everything that you could think of, fluid in human.

Sophia Krix:

That's really interesting. That's basically the data I'm working with. So we're [inaudible 00:03:47].

Dr Balogun Wasiu:

Oh, interesting. Yeah. And I saw that a lot of the things or discussion at the conference has been around blood biomarkers. In fact, I'm excited and feeling like, "Oh, maybe the FDA should just come here and listen to how we [inaudible 00:04:02] just talking about blood biomarkers."

Caitlyn Fastenau:

Yeah, definitely.

Sophia Krix:

I mean, there's been so much research going on in this domain.

Dr Balogun Wasiu:

Yeah, I agree.

Sophia Krix:

I mean, we now see finally revised criteria that actually take up the efforts and the evidence that's now there.

Dr Balogun Wasiu:

I was even surprised with Dr. Alladi's presentation today. Even though she was talking about being bilingual, and she was even talking about doing the blood biomarkers in their studies. So it shows that people are now looking towards the blood biomarkers.

Sophia Krix:

I mean, it's just such a great option because we are going away from this entire very invasive testing, over to something that could actually be applied at a GP visit in all of the countries basically, because you can just take a blood sample and then ship it to a lab, of course, but you don't need a special memory clinic to do this blood testing and blood sampling for you. So that has huge potential, I think, and I really hope there's going to be more being done with our efforts.

Dr Balogun Wasiu:

Yeah. And because it's cost-effective.

Sophia Krix:

Absolutely.

Dr Balogun Wasiu:

Using MRI or PET is expensive. And in fact many clinic or memory centres don't even have those imaging techniques. But just to take the blood and send it to a centre or even you could run it yourself because I've seen that there are some companies at the product theatre that are saying that you can own the kits to run the blood test by yourself. So I think that exciting things are coming and it's a good time to be in this field.

Sophia Krix:

That is really great, because we also see these changes happening. Of course, the AD pathology in the brain, but now more and more the changes that are actually happening 10 to 15, maybe 20 years earlier to the onset of the disease happening with the immune system, with metabolism, everything that's measurable in the blood.

Dr Balogun Wasiu:

I agree.

Sophia Krix:

And that's something we really have to pick up on.

Caitlyn Fastenau:

And I would just also echo when we think about accessibility to different types of screenings, a blood test or a biofluid would be more accessible to members across the world and also in rural communities. So I think that is something that I'm also very hopeful for.

Sophia Krix:

Yeah, absolutely.

Caitlyn Fastenau:

Awesome. Well, now that we've done some introductions, great to meet you all. I think we should get into the meat and potatoes of today's podcast. So for anyone that's new to this podcast, let's explain the format a little bit. It's pretty simple. I'm just going to go kind of down the line to each of you guys, and talk about the best bits of the conference for the last 24 hours approximately, and any exciting things that you think relate to your research or are particularly impactful to our audience members. Happy to go first if anybody is particularly passionate about anything.

Sophia Krix:

I'm happy to start.

Caitlyn Fastenau:

Yeah, absolutely.

Sophia Krix:

Well, I found the talk really interesting by David Bennett from the Rush University. Yesterday he did a talk on multiomic approaches to define disease heterogeneity and subtypes. So it was all based on multiomics data, so various levels of proteomics, epigenomics, et cetera. And basically they have data from thousands of patients, and they were trying to identify subtypes on a molecular basis. And so basically going away from this ATN framework and actually identifying, it was called pseudo time trajectories. That means you can basically see how a patient evolves from a normal state to an AD state, a progressed state via a certain trajectory, so a path onto that.

And they could actually explain these subtypes. So there were different paths emerging via the molecular underlying mechanisms. And that was something that I found amazing because he's basically trying to bridge this gap between the blood omics data to the molecular trajectories. And what I found amazing was that what we just said, you can take that blood from living persons, not after they've died, but while they're still alive, while you can still actually intervene, do the test sampling, and identify potential therapeutic targets that are different.

Because when we look at AD or any other disease now from another point of view, from this molecular point of view, we can actually identify different mechanisms, underlying mechanisms, that are different from the established ATN framework identification of the subtypes, and that is actually where we could tackle and identify potential targets that have not been focused on before. I think that has a huge potential.

Dr Balogun Wasiu:

Yeah, I agree with you, and I think the multiplex approach is the best way to go, and that's why to go back to what we started with, the biomarker issue appear like a great thing because, so one of the things our lab is looking at is that many years before people are even diagnosed with having this disease, let them know so that they can start preparing for it so that people don't get to their advanced age and they're just getting to know and it bog down their family. Someone was telling me today that the mother has dementia and the father has to go and stay with her.

It was at this session today. So she said that the family could only afford to pay for the care home for two years. So after two years, if the woman is still alive, they don't know, maybe they will be able to afford the care home. So you can imagine if she had been told 20 years before so it will have been a work in progress, they will have worked towards, "Okay, what do we do from now to the 20 years?" So I think that it's a good idea that we're able to approach this disease from different angles so that we can get therapeutic solutions on time before people reach the age whereby they're just getting to know and they're no more productive.

Dr Jessica Caldwell:

As you're talking about that though, so I work in a clinic for women at risk for Alzheimer's disease. And they're 30 to 60 years old. They are those people who are 20 years earlier. And we don't yet have a social system, at least in the US, that will support those folks if they're biomarker positive 20 years earlier. They could be discriminated against in terms of their life insurance, long-term care insurance. And we also just don't have enough support for caregivers.

I hear what you're saying in terms of preparation, and we talk about lots of risks. And knowing your risks is a powerful thing, especially if you can change some of them, but I think that as a society, we need to figure out how can we better support people when we know there's this baseline risk and that we have 20 years to do something. It shouldn't all just be on the families.

Dr Balogun Wasiu:

Yeah, but the good thing is that now we now know that, okay, this person now knows that in the next 20 years there's potential for them to have this disease, so they need to start working. And when we know then we can now get the policymakers to let them know that, okay, people are now getting to know that they will have a disease some years to come, what do we do? Do we get the Medicaid improved? Do we get some things ahead of time so that when they get to that stage, they are prepared like the boy scout?

Sophia Krix:

And we know already that a lot of lifestyle interventions actually have a massive impact on the risk for the disease and the progression also. So when a person actually gets to know of their diagnosis, then they can actually do something against it. So it's in their own power to some aspect or to some proportion.

Dr Jessica Caldwell:

Yes. And I think that you can get some of that work done just by knowing risk based on lifestyle, the genetic access that we have at this point, just APOE kind of risk as well as knowing your family history, whether or not dementia runs in the family. In my intervention clinic, I find that most women, the biggest thing that they take away is that they can do something. And it's really hope and trying a direction, like you were saying.

Caitlyn Fastenau:

Yeah, absolutely. It kind of goes back to all of transparency in medicine, being able to make informative decisions that you feel will impact you and your family moving forward.

Dr Jessica Caldwell:

Exactly. And I mean, just thinking of what you were saying, people 20 years earlier, we know just there was a study about five or six years ago that showed that most doctors don't even disclose the diagnosis of Alzheimer's at the point of diagnosis because there's a stigma and there's also a fear, "Well, what am I going to do? How will this affect the treatment plan?" Now that's changing these days, but I think even across the board, it's really an education issue for not just families and the public, but for physicians as well.

Caitlyn Fastenau:

Yeah. Awesome. Any other, do you want to talk about some sessions that you liked?

Dr Jessica Caldwell:

Sure. So I've really endeavored to try to see a number of different things, including things related to my own work and things that are really not. But one that I wanted to mention was I went to a session late yesterday on neuroimaging across the lifespan, and one of the presenters was Gagan Wig, and he's at UT Dallas. And what he was arguing was that when you think about the ATN framework and the Jack curves, there's a big gap between the N and the cognitive change.

And he's arguing that there may be other ways, more sensitive ways to get at staging closer to cognition. And so what he and his group are looking at is functional MRI, resting state MRI, and they look at measures of networks integration and segregation. And so basically the more defined segregated hubs your network has, the more specialised, and when folks enter into dementia states, we see lack of that segregation indicating had a lack of specialisation, more entropy. And so in this study, what they did was they looked at adults with amyloid and tau and cognitively healthy adults.

And so they had already seen that in folks with Alzheimer's disease, there's less segregation. But now they also saw that adults who have greater segregation, they resist amyloid and tau in terms of their cognitive performance. So there's something about almost like a reserve based function in that network segregation. And kind of adding to that idea that this could be a proxy for cognitive reserve, they also found that environmental exposures like getting more education. And this time it was a college degree.

So lots of people talk about high school is the critical point, but here it was college. And those folks who had gone to college maintain that segregation longer. So I'm excited about trying to connect things that you can help people to modify in day-to-day life with underlying proxies that we can measure to see if these measures or these interventions we're doing on a lifestyle basis are impacting the brain in a meaningful way.

Dr Balogun Wasiu:

Yeah, yeah. I think on what you just discussed on a general note, education is actually a good destine for later life. I don't have enough knowledge about the study you just talked about. So there's a study on physician PHS, the code of the studies, PHS, whether they were studying. So what happens to actually the medical graduate? So do they develop Alzheimer's later in life and what happened to their cognition?

And so they found out that even those who later have predisposing potential to develop cognitive impairment, because they had early education, because you spent the first 20 years of their life studying, so it really helped them. It helped them later in life. They were able to pick up things earlier compared to people who didn't have those university form of education. So I agree with the fact that education can actually help.

But I don't know what they were trying to do, but I think that looking at AD from the angle of ATN alone is actually not so correct because there are issues with the classification of the disease. There's the inflammation, alpha-synuclein. So if you're just looking at T and N, if you saying that because they're not close, so I think that we need to look away from those just three things and move further and look at other problem or other reasons that contribute to the pathology of the disease.

Dr Jessica Caldwell:

Absolutely. Yeah, that's really important.

Sophia Krix:

I mean, it's just been integrated in the revised criteria. So we have the inflammation now as the new ATNI or ATNX actually called then.

Caitlyn Fastenau:

Oh, interesting. I didn't know that.

Sophia Krix:

Yeah. [inaudible 00:18:31]

Dr Balogun Wasiu:

Yeah. Someone presented on that on Monday or on Sunday, I think. Yeah, she presented on that on Sunday.

Sophia Krix:

Very exciting.

Dr Balogun Wasiu:

Yeah, for me, one of the sessions I like, so it's not a scientific session, it's the ask session with the AAIC awardees. So I feel like it is social event, so to say. It's not a scientific event. But it's an event where you learn lesson and you learn from experience because majority of those of us here are under the age of 40. Even though they say 35, but I feel like I'm older than 35 so I put myself in 40. So I feel like early career such as we need one or two things to learn from those who've been in this field before us.

So listening to Ricardo, Goldie, Eduardo, and the fourth person, we ask them, "Okay, so what are the things that have changed in this field over the time?" And the first thing they mentioned was that, "You guys have things that we don't have." 30 years ago, there was no technology. Nobody was even talking about markers like 20 years ago, but now we are excited about the fact that we have these biomarkers that we can manipulate and use it to get some desired results. So it's an event that I feel like for early career researchers we need to listen to people who have been in this field before us, what they have learned, because aside the fact that they've learned what to do, they've also learned what not to do.

So we can actually get one or two things from that. So that's a lesson that okay. Like Nitrini was saying that initially it was in neurosyphilis and he just felt that, okay, what is he going to do? Because the disease was starting to have treatment. And I did mean he's in neurosyphilis by now nobody will know him because the disease doesn't really exist anymore, so to say. So it shows that we should know when to move on or when to diversify. So I feel like those kind of sessions also matters aside the scientific session whereby people discuss their work. We also have those kind of sessions as a session to attend.

Caitlyn Fastenau:

Yeah, I certainly agree. I also attended several ask sessions, and I think for me it is nice because it's a little less formal. You're not in the big lecture hall. So I think you can have maybe some of those more informal questions like career development or even just more innate technical questions that are more kind of approachable in that way. But I guess that's a good segue. If each of you wanted to talk a little bit about any kind of presentations that you're participating in, any scientific sessions or posters, just so we can maybe reach out and watch some of your groups. Yeah, go ahead.

Sophia Krix:

Definitely. Okay, I can start.

Caitlyn Fastenau:

Yeah. [inaudible 00:21:57].

Sophia Krix:

So I'm presenting a poster on our recent work within our study. So we have our own study going on early identification of Alzheimer's patients via basically two paths. So one path is investigating in their sleep behaviour and sleep disturbances that are digitally assessed. So we have smartwatches, so smart device device-based monitoring of sleep, and also studies with a headband that we compare to.

So things that you can wear during your daily life that is not in a sleep lab, but that's actually realistic to monitor over a long time. And the other path of our study is about the immune system. So the characterization, deep characterization of immune cells that appear to be different in Alzheimer's, like natural killer cells, cytotoxic lymphocytes. And we're doing single cell sequencing and trying to integrate these two aspects of the disease together to find early biomarkers.

So the post I'm presenting today is about the sleep behaviour of the patients. So we actually see that with some watches you can identify patients not only at a late stage 80 progress stage, but actually prior to that earlier stage that is prodromal MCI. So it is an early identification of these patients. And it does improve or it does outperform these traditional sleep questionnaires if you've heard of them. So clinicians ask the patients, "How do you sleep? Do you sleep well?" Different aspects of the sleep behaviour, but they're just subjective or by the caregiver actually.

So there is nothing that is objectively measured. And if you have an objective measure of a person over time, that is very helpful. And what we saw is not just that the differences between the patients actually can lead you to a diagnosis, but what's more important sometimes is the difference within the person. So when you see that your personal sleep pattern changes, which can be totally different to the sleep pattern of another person, that can already tell you a lot about what's going on in the back.

Dr Jessica Caldwell:

I find that super interesting. I do a lot of work with women who are going through menopause, and that just makes me think, I wonder what you might be able to see with an objective measure of sleep like that because we know menopause disrupts sleep for so many women.

Dr Balogun Wasiu:

Yeah, I was going to say that there could be other factors that could affect sleep like hormonal imbalance, like stress. So how do you find a balance between trying to know that it's a potential cognitive impairment or other factors?

Sophia Krix:

Well, that's kind of where AI comes in. So as I said in the beginning, I am more on the artificial intelligence and machine learning data science side. And so we're trying to really investigate data from that perspective. Really, really look at the data, use it in our algorithms to identify the patterns that are there possibly links between the immune system that is dysregulated and changed and the sleep behaviour that is changed and see how it emerges, if it's actually a trigger of the disease that triggers the onset or if it's a consequence of the disease progression. I mean, right now the research that's going on this field suggests that it's both. So it actually does it-

Dr Balogun Wasiu:

Interesting.

Sophia Krix:

... from both sides. And we are trying to use various experimental, let's say, AI approaches that are very advanced in avant-garde to... Well, because otherwise you can't deal with that kind of data. You have vast amount of data. You have various data modalities and simple methods which sometimes don't suffice for the challenge at hand. So you've got to be really creative of how do I look at this data? How can I answer this question? And that's how we operate.

Caitlyn Fastenau:

Yeah. Very cool. And you said you're presenting that today?

Sophia Krix:

Tomorrow.

Caitlyn Fastenau:

Tomorrow. Wonderful.

Dr Balogun Wasiu:

Okay. Yeah, I was going to ask that the session for poster has ended today. So are you presenting your two posters-

Sophia Krix:

Tomorrow.

Dr Balogun Wasiu:

... tomorrow?

Sophia Krix:

Yes.

Dr Balogun Wasiu:

Oh, interesting. Yeah, I'm also presenting tomorrow. So for me, my work is on the p-tau217 and if you've been listening to people who talk about blood biomarkers that the p-tau217 is the top most of the biomarkers, even though I feel like the p-Tau 231 is better, but presently now everybody's talking about the p-tau217. So what I did was comparing these p-tau217 across different platform, comparing it on Quanterix, Platform, NULISA, Janssen, Lumipulse and our home in-house p-tau217 that we develop in our lab.

So we compare it in two different community-based cohort. So if you are familiar with Pennsylvania, you know that there's two popular river in Pennsylvania, Monongahela and... Sorry. Yeah. It's a popular river. It used to be called the [inaudible 00:27:38] area. We got some cohort from people who live in this area who are economically deprived and who are not so educated, and they are non-Hispanic. And we got data from there and also from the Pittsburgh City, which is like a-

Dr Jessica Caldwell:

Urban area.

Dr Balogun Wasiu:

... urban area. We compared the resort from these two areas. What I found out was that, like I was saying before, we got two different findings. The first was that we saw that people can actually know that they won't have dementia many years before they develop the disease. So that's our NPV. Negative predictive value. So for our PPV, that's a positive predictive value shows that it might not be enough to use the p-tau217 as a test to show that people will have it. So it's showing that they need further confirmatory test.

However, we know that there are some group of people who won't have it, so you don't need to include them in, maybe you want to do a clinical trial or you want to do a therapeutic trial. So these ones won't have it. So you could probably use them as control, but not as a potential dementia group. So that's the message from that. And we got good specificity. The values are reproducible and the they are consistent, and we're planning to publish it soon. And I'm presenting it tomorrow. I think my poster number is 250, so anyone who is interested come out and see it.

Caitlyn Fastenau:

Awesome. Thank you so much.

Dr Jessica Caldwell:

Yeah. So I presented a talk this morning, and I want to say this is our first big push from my lab. We have data here in seven posters, and then my talk and my postdoc had a talk, and this is data coming from the women's clinic, which I'll say more about, as well as from a study of stress and oestrogen that we're running that's funded by NIA. So the Women's Alzheimer's Prevention and Research Centre is a place in Las Vegas, currently the only one in the world where you can come to get specific risk reduction personalised recommendations just for women.

And so I presented this morning on data from the baseline visits from 207 of these women. And what we're seeing is we essentially just wanted to characterise the risks that people are coming in with, compare those to other types of lifestyle risk lists, and then see if anything differed across the menopause transition. What we found was in hindsight, probably not surprising, the clinic opened in 2020. So right-

Dr Balogun Wasiu:

[inaudible 00:30:54].

Dr Jessica Caldwell:

... in the beginning of the pandemic. But what we found was the most frequent risk profile was a psychosocial profile. So three quarters of the women endorse using alcohol, almost half our chronic daily stressed endorsing, and then almost half again endorse a diagnosis of depression, and just below that risk factor is low cognitive engagement. And so we saw the medical risks as well, but it was really this psychosocial profile that really popped up.

And then in terms of whether or not it differed across menopause transition, it didn't. And it didn't matter if we based transition on women's self-reported transition or if we used in a subset of women FSH levels as a proxy for transition. And so I think the message that's really coming out of this talk is that there's a huge potential opportunity to intervene on a psychosocial level in women who are 30 to 60 with a family history. And I think that there's reducing risk, but then there's also just improving life to a level that would allow women to engage in healthy behaviours beyond treating their depression or something like that.

Dr Balogun Wasiu:

So is it a longitudinal study?

Dr Jessica Caldwell:

It is.

Dr Balogun Wasiu:

So how many years do you-

Dr Jessica Caldwell:

So the baseline data is here then we have one-year data that we're starting to analyse. Unfortunately, due to the fact that prevention isn't reimbursable, this is currently a one-year study. So women in the clinic can stay on for some time, but these are the only intensive visits we have. But yeah, absolutely. I would love to keep this going for a long time.

Dr Balogun Wasiu:

Yeah, it'd be nice to see what happens in few years to come maybe five years or a thereabout. Yeah.

Dr Jessica Caldwell:

Yes.

Dr Balogun Wasiu:

Nice. Nice study.

Caitlyn Fastenau:

I just love when you talk about the women's clinic because it's just such an interesting component because women are more likely to develop Alzheimer's disease and related dementias. And hearing about the psychosocial interaction has a lot of factors to reduce some of those stresses, but I think that's such a hopeful thing to hear, especially as women. So I think with that, I just wanted to say thank you guys for sharing your talks, kind of components of the conference that you've enjoyed so far. I wanted to highlight today's plenary sessions. I thought they were really exciting. If you had any maybe comments briefly, particularly the bilingualism by Dr. Suvarna-

Dr Balogun Wasiu:

Alladi.

Caitlyn Fastenau:

Alladi. She was amazing. I loved that.

Dr Balogun Wasiu:

Can I-

Caitlyn Fastenau:

Yeah, absolutely.

Dr Balogun Wasiu:

Yeah. For me, it's not even about the topic. It's about what Alzheimer's Association is doing with regards to low and middle income country. I'm originally from Nigeria and I feel like I could connect with a lot of people here. If this conference is an Olympic, I think that Brazil or Spain is going to win it because you could see the inclusion. And I was impressed when I saw Dr. Alladi on the podium in a saree.

She's a woman so she's an inspiration for many of us that okay, people can listen to us. We don't need to be an American or a person from England to be recognised here. It shows that the association is for everybody. It's not just for a group of people. So aside the science that she discussed for me, seeing that on that podium was a big take home for me, and I felt proud about that. But going to the science, it's unique because for those of us who are whose first language is not English, so we have to learn English with our local dialect.

And even if you are from countries whereby you have to learn more than one or two languages. Like in Nigeria, we have at least three languages, the national language that you have to learn. So I feel like, oh, does it mean that we are at an advantage? Yeah. So that's some of the takeaway from the session today.

Sophia Krix:

What you said in the talk, yes, I think that's the way it is.

Caitlyn Fastenau:

It's normal. Yeah, absolutely.

Sophia Krix:

I mean, she focuses especially on the kids in school and their education and the language that's being taught in school compared to the language they speak at home. And so I think that especially early on, learning a new language actually makes a much bigger difference compared to learning a language when you're in your 20s or 30s, which still might add or boost your cognitive resilience, and that would still be good, definitely. But actually recognising this importance of early bilingual, multilingual education is really important.

Dr Balogun Wasiu:

Yeah. I think that learning that an adult age is also not a bad thing. Now we have many software or platform whereby you can learn new language in a month. I've forgotten the name of the-

Caitlyn Fastenau:

Duolingo?

Dr Balogun Wasiu:

Duolingo. Yeah. Yeah. With Duolingo, you can learn another language in few... And there's also another one, I think it's Bella or something like that. Yeah. So I think platforms are common on web. Even Google Translate can help in learn because it has the voice and this thing. So it's a good thing to learn multiple language.

Dr Jessica Caldwell:

And I think encouraging that in the US is so needed. It's not just going to give us brain resilience, but it's going to improve the science and medicine because we need more people who speak multiple languages to be able to provide care and to conduct the research in folks that don't speak the same language.

Caitlyn Fastenau:

Exactly. Yeah. I think with that, I think we'll wrap up, but I wanted to agree with everything that you just mentioned, representation and support across the international spectrum of science. I think AAIC this year is trying to push really hard for that, and I very much see it, and I appreciate it. So thanks everybody for listening to today's podcast. If you couldn't make it to the conference, the full programme is online at aaic.alts.org. Thank you guys so much for talking. Had a great time.

Dr Balogun Wasiu:

Thank you for having us. [inaudible 00:37:42] nice time.

Sophia Krix:

Thank you.

Dr Jessica Caldwell:

Thank you.

Caitlyn Fastenau:

Yeah, absolutely.

Dr Balogun Wasiu:

Thank you.

Caitlyn Fastenau:

Thanks. Bye.

Sophia Krix:

Bye.

Voice Over:

The Dementia Researcher Podcast was brought to you by University College London, with generous funding from the UK National Institute for Health Research, Alzheimer's Research UK, Alzheimer's Society, Alzheimer's Association, and Race Against Dementia. Please subscribe, leave us a review, and register on our website for full access to all our great resources, dementiaresearcher.nihr.ac.uk.