July 8, 2026
The truth about dementia: Myths, facts, and early warning signs
Dementia affects millions of individuals and families, yet misinformation and stigma continue to create confusion about the condition. In this episode, co-hosts Carmenn Miles and Dr. Rajay Seudath sit down with Dr. Jeremy Smith to separate fact from fiction and explore what everyone should know about dementia.
Docs in a Pod focuses on health issues affecting adults. Clinicians and partners discuss stories, topics and tips to help you live healthier.
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Show transcript
Podcast transcript
INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Rajay Seudath.
CARMENN MILES
Hello, everyone, and thank you so much for joining us today on the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles and I'm excited to jump into another great conversation centered around health and wellness topics that really matter, especially for our seniors. If you're listening in for the first time, you can find this podcast on any podcast listening platform. We're also available on the radio in several Texas markets. Each week, we share practical health information that hopefully helps all of us live healthier, happier lives. We're thrilled that you're tuning in. We have a great topic for discussion today, but before we go there, I want to introduce our co-host for today, Dr. Rajay Seudath. He's no stranger to the show. He's a part time native, and is board certified in family medicine and the lead physician at the University location for Optum. He brings great passion to primary care. He's a wealth of information and knowledge and makes health issues simple and easy to understand. And that, my friends, is precisely why we love having him as a resident co-host on the show. What's happening, Dr. Seudath.
DR. RAJAY SEUDATH
Hello, hello. So happy to be here again.
CARMENN MILES
Absolutely. We're glad that you could join us today. Let's take just a moment to introduce our guests to the show for the first time, actually. Dr. Jeremy Smith is a graduate of Western University of Health Sciences. He proudly served as a physician at the United States Military Academy and with the 10th Mountain Division. Though born and raised in Southern California, he is now a resident of Texas. Welcome to Texas, Dr. Smith.
DR. JEREMY SMITH
IÕm happy to be here.
CARMENN MILES
He currently lives in San Antonio with his wife and two children. In his free time, he enjoys hiking, canoeing and exploring the great outdoors. Dr. Smith enjoys the daily challenges. His internal medicine career presents and embraces each opportunity to help patients navigate their wellness journey. So, he helps patients learn to keep themselves healthy and live fuller lives through his patient-centered approach. Welcome, Dr. Smith. I'm wondering where you are canoeing. You're not canoeing in San Antonio I know.
DR. JEREMY SMITH
I have a canoe in my backyard. I've been living here for two years, and it's sat there and hasn't moved an inch. So, yeah, the canoeing, I'm afraid, might be in my past, but I am happy to be here, happy to be a part of the podcast. So, thank you for having me.
CARMENN MILES
Thanks for joining us. I know that you guys are always so busy caring for your patients. Today we're talking about the minutia. What it is, why it happens and what we can do to reduce our risk. Dementia affects millions globally. Exactly over 50 million people worldwide. And even in the US, millions of older adults are living with Alzheimer's, which I understand is the most common type of dementia. Prior to doing a bit of research for our discussion today, I understood dementia and Alzheimer's to be two separate conditions and that is not the case. Later in the show we'll get into the different types of dementia. In addition, Dr. Smith, I believe that dementia was a disease but have learned that two is not the case, and you'll correct me if I'm wrong. So, we're going to debunk several myths today as it pertains to dementia. But for starters, tell us, Dr. Smith, what exactly is dementia and what does it affect? How does it affect us?
DR. JEREMY SMITH
That's a that's a great question, and that's a great intro. This is a good a good place to start. First of all, thanks for having me here because this is a very important topic. You already pointed out that this affects tons of people. There are a lot of myths surrounding dementia. What it is, what it isn't, the different types of dementia. So yeah, this is a great topic and certainly a topic that needs to be talked about more in my opinion. Great place to start. What is dementia? Dementia is basically a syndrome or a disorder that affects your cognitive abilities like your ability to remember things, think, process information, communicate, things like that. That is a pretty good description of it, but because there are a lot of other things that can affect that, there is a lot of confusion regarding what dementia is and what it isn't. So, that's kind of the nutshell version of dementia. I will just take a moment to just sort of describe for you what I see in a day to day practice. I see patients and family members come in and say, hey, doc, I couldn't remember somebody's name the other day. Do I have dementia? So, they'll ask me questions like that. Sometimes I'll get a patient who is discharged from a hospital and they were really sick, and then they were kind of not really themselves for a little while, and then they got better, and now they want to know if they have dementia, too. So, when we actually diagnose someone with dementia, we have to say that it's not really due to anything else. People can have dementia, changes in their cognitive abilities because of sickness, because of infection, because of thyroid issues, all sorts of other things that we have to kind of take off the table before we say somebody has dementia. Even when we do that, we have to kind of decide what kind of dementia do they have? You already pointed out that dementia, has a lot of different varieties. You mentioned that Alzheimer's dementia is the most common dementia and yes, that is correct. It's about over half, maybe like 65 or so percent of folks with dementia have Alzheimer's dementia, but there are other dementias out there too.
CARMENN MILES
Absolutely. We'll break down the different types of dementias, but let's take a moment to welcome those who may have just joined us. You're listening to the award winning Docs in a Pod presented by WellMed. Our podcasts are available wherever you listen to your podcasts. We're also available on the radio in several Texas markets. I'm Carmenn Miles alongside Tampa native, Dr. Rajay Seudath, our co-host today and our guest today, Dr. Jeremy Smith from WellMed at Division in San Antonio, Texas. They are with us to help break down dementia, understanding the brain, the risk and prevention. There are so many myths around dementia in all of its forms. Dr. Smith, one myth is that dementia is a normal part of aging. I imagine that's because so many of our senior friends and family suffer from dementia, and it gets worse over time. But it's not part of the aging process, correct?
DR. JEREMY SMITH
That is correct. I mean, only about 10% of folks will ever develop dementia and even if you have a family member who has dementia, it doesn't mean you're going to have it or that that any of that is inevitable. It is common as we see it a lot, but yeah, only about 10% of the population will ever develop a form of dementia. It is not inevitable, and certainly there are things you can do to help mitigate your risk for dementia as well.
DR. RAJAY SEUDATH
One thing I want to make sure make our listeners are catching, when we say cognitive decline, we're thinking about memory. We're thinking about processing, like actual thinking, going through a problem. Behavior can also play into when we decide someone has or doesn't have dementia. So, sometimes we see that as a person's memory is getting worse, as they're not able to think and process through problems, they start to get behavioral issues as part of those memory changes. So, a guy who is a very sweet, mild mannered guy, suddenly, he is a very cranky person. Now he's snapping at everybody. He's always aggressive. So, those are some of the changes that we can kind of see moving into when we're thinking about a person maybe developing dementia.
CARMENN MILES
Very good. As we mentioned, there are several types of dementia, but let's just share with the listeners some of the common types of dementia that you see in dealing with your patients, Dr. Smith.
DR. JEREMY SMITH
You already mentioned Alzheimer's dementia. That is far away the most common. It actually boils down to a diagnosis of exclusion in a lot of ways, meaning once we say that you don't have any of the other forms of dementia, we give you the diagnosis of Alzheimer's. There are tests that are kind of emerging in terms of giving somebody that diagnosis and things that help you sort of nail down that diagnosis, but it comes down to a clinical diagnosis, meaning that it's done through conversation and patient interview and basically saying that they don't have all these other types of dementia. So, that's number one. That's the one that people know most frequently is the Alzheimer's dementia. Another rather common dementia is the vascular dementia. Basically, that is a result of blood vessel disease in the brain. So, either a patient's had a stroke in the past or even they've just had vascular disease in their brain. Not that that they've had a stroke, but it has affected their brain to the extent that it is causing them to have some amount of cognitive decline. That one's more in the 15 to 20% of all dementia. So, between those two, you're looking at like a very high percentage of dementia. There are some other kinds, we call it like Lewy body dementia. That's more associated with hallucinations and motor function tremors, things like that. I'm just kind of moving down the list here in terms of frequency. ThereÕs frontotemporal dementia. I believe there was a celebrity who was diagnosed with that pretty recently.
DR. RAJAY SEUDATH
Oh wow.
DR. JEREMY SMITH
Could be wrong about that. That so that one is kind of in the news. It does affect the personality, behavior, language. That's one where we see somebody, as we kind of mentioned, their personality kind of changes a little bit. They feel maybe disinhibited. They'll act out a little bit differently. So, those are the majority. People talk about Parkinson's dementia as well. That's something where folks have an issue with motor function early and then the dementia kind of comes later. So yeah, those are the main types. Again, the thing we see most frequently is the Alzheimer's dementia.
DR. RAJAY SEUDATH
Making that diagnosis, like you said, it's a diagnosis of exclusion oftentimes. So, we're looking for things that could cause you to have memory issues. Are your liver enzymes having a problem? Were you a long time alcoholic and you've pretty much pickled your brain kind of deal? Are you having vitamin B deficiencies? Dr. Smith said earlier about thyroid. I had a patient and they were profoundly hypothyroid. They never wanted to take blood work. Their thyroid was so under producing their thyroid hormones, it caused them to have memory changes replacement. Their memory came back. So, that's one of the things that can happen.
CARMENN MILES
Wow. That's interesting. The connection there. We need to take just a quick break, but please stay with us as we continue this great discussion on how to manage or just understanding dementia as a whole. You're listening to Docs in a Pod presented by WellMed. We'll be right back.
AD
For over 35 years, WellMed has redefined health care for older adults and people on Medicare. We're physician led and nationally recognized as an Age-Friendly Health System. Our doctors take time to listen and support your unique needs, working with Medicare and select Medicare Advantage plans to keep you healthy and independent. With 24/7 nurse support, telemedicine, in-home, and office visits, care is always within reach. WellMed. Compassionate care. Proven results. Visit wellemdhealthcare.com to learn more.
CARMENN MILES
We're back on Docs in a Pod. I'm your host, Carmenn Miles with co-host Dr. Rajay Seudath and our fantastic guest, Dr. Jeremy Smith, who is breaking down dementia for us today. Just before the break, we learned that there are several types of dementia. We also briefly touched on causes and risk, but let's give this just a bit more attention as it's important that we learn the causes and risk associated with dementia. What to look for and when to bring matters to a doctor's attention.
DR. JEREMY SMITH
That's great. Anytime you see in yourself or a family member any sort of cognitive change, ability to reason through things, function on a day to day basis. If you feel like your brain health is dilapidated or declining, I recommend getting in touch with your doctor for a more thorough assessment. While we're here, I really do want to just mention the important things that you can do to reduce your risk of dementia and also to prevent progression as well. You already mentioned earlier in our segment that it's such a profound illness. It's a life changing illness. It is also pretty ubiquitous. A lot of people have this. Everyone wants to know what they can do to prevent their risk and so on and so forth. So, I'm just going to kind of breeze through these and then if you'd like to comment on this or have any questions, I would I would love to hear your feedback. Staying physically active is really important. Strength training. Doing things that engage your mind. So, a lot of my patients like to do Sudoku puzzles. Those are those are great. Anything you can do to continue to stimulate yourself. Be social. Interact with your family and friends. Some people, if they're of the age, they like to do senior activities. Those are great. There's a lot of things that your doctor has to get involved with, too, in terms of helping you manage your blood pressure, your cholesterol, your blood sugar, things like that. But certainly, you as a patient or family member, can do things as well in terms of eating healthy fruits and vegetables and whole grains. Most of us in the medical community like to promote the Mediterranean diet. So, that's certainly something you can do as well. We kind of already touched on the puzzles and the staying mentally engaged. Part of that is making sure that you can see and hear. If you don't have that sensory input, you're not going to stimulate your brain and you're not going to really get that effects from the stimulation ultimately.
DR. RAJAY SEUDATH
I just wanted to add on that. A lot of times people think, I'm not going to get hearing aids until I need them. They have this idea that they're going to wait until they're completely deaf and then get hearing aids, and it's going to restore their hearing. That's absolutely not how it works. Hearing aids can preserve what you have and hopefully stop to stop the decline of your hearing. Dr. Smith is absolutely correct. Not being able to see, not being able to hear. When you don't have that stimulation, you that part of your brain can stop working and I think that's really what all of these things are, are making sure that we're keeping that type of mental stimulation, that social stimulation, the activity stimulation, the exercise stimulation, all of those things are basically the exercise for your brain. So, I definitely agree with that.
DR. JEREMY SMITH
I appreciate that comment. That's really important because like you said, a lot of people try to be reactive, but being proactive about these things, that's kind of the whole point. How do we prevent illness? How do we prevent disease? I mean, just in terms of brain health, part of having good brain health is having good sleep. Good sleep quality is important. Other things we've talked about is smoking, alcohol, things like that. They can definitely contribute to and have been shown to increase your risk of developing dementia later on. I will say, too, and this is kind of more for our younger folks. This is kind of coming to the the forefront, and you may have read about in the media with sports and things, but head injuries. Head injuries are a big deal, and they do contribute to a significant proportion of dementia later on. So, taking those steps to prevent things from happening in terms of head injury, wearing a helmet if you're riding a bike, whatever you can do to reduce your risk of head injury is going to be important as well.
DR. RAJAY SEUDATH
Absolutely. I have a patient who was an NFL player and he's actually part of the Alzheimer's program. In addition to his care that we have here at our clinic, he goes and he's participating in the Alzheimer's NFL program. So, they do scans, they do memory testing, all the lab work we do we forward to them as well. So, trying to reduce the head injuries. Competitive sport play, boxing, those kinds of things. We want to make sure that we're doing everything we can to prevent those types of injuries.
DR. JEREMY SMITH
Yeah. That's great. I know there's this other sort of we call it a phenotype or something, but it is this other type called chronic traumatic encephalopathy that a lot of NFL players suffer from. So, that's kind of a corollary, but there's a lot of overlap in terms of the symptoms and brain health and basically preserving brain health with reducing repetitive trauma. So, thank you for that. That's terrific. Those are the things that we can do to prevent and that's really what I want to key on today is that people kind of have a good sense for, well, what can I do to reduce my risk? Dr. Seudath, if you want to, we can go into some of the treatment stuff.
DR. RAJAY SEUDATH
Yeah. I think for a lot of our listeners, if you're possibly living with a person who has dementia, if you have a friend who's dealing with a person who has dementia, oftentimes, you can really get burned out. It's like dealing with a person who has cancer, dealing with a person's heart failure. Dementia is a little bit different from either of those. So, I think that's one of the things is making sure that you're getting as much support as possible. Whether it's from other families, friends, if you need to get a home health aide, oftentimes it's not paid for by insurance, but that can be something. Even if it's just twice a week if you're paying out of pocket, that could be helpful not only for the patient who we're trying to preserve their cognitive abilities, but for you, as the caregiver, to preserve your own cognitive abilities. We could talk about medicines, things that we typically prescribe for that. If you want to jump in on that.
DR. JEREMY SMITH
I appreciate you saying that, too. I mean, caregiver burnout is such a big deal. Depending upon the way your insurance works and health plan and the resources available to you, there is such a thing as respite care, where if you are caring with someone, a family member, etc., who has significant dementia, disease, then that might be something to look into. Certainly, you canÕt be at your best for them or yourself if you are just totally burnt out all the time. I'm glad you brought that up, Dr. Seudath. There are medications out there. I'll just tell you, it's hard for docs because the medications are not very good. In my opinion, I just never see somebody who says, oh yeah, I'm back to normal.
DR. RAJAY SEUDATH
This is a safe space.
DR. JEREMY SMITH
I appreciate it. I mean, some people will notice like, yeah, I've had a little bit of benefit. I'll hear that anecdotally here and there. Some medications you'll hear like donepezil, memantine, some of these medications in certain stages of Alzheimer's dementia are helpful. The data doesn't really support long term use of them. Honestly, once we get to this point with most folks developing dementia after the age of 65, pill burden is a huge problem. If they're going to take a medication that is not really helping them that much, I want to pull that medication off because I don't want to make their life that much more burdensome. I don't want to say don't try the medication because I want to extend every grain of hope I can to my patients. It's just kind of something that I think we should all be aware of and have kind of an appropriate expectation for what may or may not occur. Do you have any anecdotes in terms of using medications, Dr. Seudath?
DR. RAJAY SEUDATH
I think we should also bring up medicines that aren't good for dementia.
DR. JEREMY SMITH
Yes.
DR. RAJAY SEUDATH
We're talking about the medicines that we could try to use to treat it, but the beers list, which is a list of medicines that are bad for people over 65, a lot of those medicines are on there because they can cause confusion. They can worsen memory issues. We were just talking about having good sleep, good sleep hygiene. We want to make sure you're sleeping during the nighttime and you're awake during the daytime to try and reinforce that natural cycle. There are medicines, the sleep aids, right? The Benadryl, those kinds of things. Tylenol PM. Those kinds of things worsen memory. Same thing with some other sleep aids like Xanax or temazepam. Those are called benzo medicines. Those can actually make you more confused, which can worsen that. We could talk forever and ever and ever about this kind of stuff because it's just so much and gosh, this time just goes by so quickly.
CARMENN MILES
It does. It completely flies by and I'm so interested in what you just mentioned about other medications that really don't help with dementia. I hate to say this Dr. Smith and Dr. Seudath, but we're out of time for today. WeÕve got to come back and talk about it a little more. The great news is, while dementia is a growing global challenge, it is not inevitable. With awareness, early detection and healthy habits, we can reduce our risk and protect our brain health. Small lifestyle choices over time can help protect our brains. Thank you, listeners. Don't be a stranger. Subscribe to this podcast so you never miss an episode. And if today's show helped you, sharing is caring. Tell your friends and family where to find us on any podcast platform until we talk again. Thank you for listening. Stay well.
OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.
DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.
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