David's Alzheimer's Fight
Hosted by David Uhlfelder, who is facing early-stage Alzheimer’s with resilience and humor, alongside co-host Dr. Karen Gilbert, this podcast shines a light on living well with the disease. Together, they share personal stories, expert insights, and practical tips to help others navigate the journey with strength, knowledge, and hope.
David's Alzheimer's Fight
Rewiring the Brain: Non-Pharmaceutical Approaches to Fighting Dementia with Dr. Conde
What if fighting dementia isn’t about drugs, but unlocking the brain’s natural ability to heal? Dr. John Conde, a chiropractic physician specializing in neurology, explains how functional neurology uses neuroplasticity, exercise, and innovative therapies to strengthen brain health. From the limits of current medications to practical steps like cardiovascular exercise and proactive assessments, this episode explores science-backed ways to protect memory, improve cognition, and change the future of dementia care.
This podcast shares insights, not medical advice. Please consult a professional for your care. Hi everybody, I'm David Ufelder and this is David's Alzheimer's Fight. Today we have also Karen Gilbert, who's our co-host. She'll be introducing our latest guest.
Speaker 2:Thank you, David, and we are so excited today to bring you Dr John Kandi. Dr Kandi is a chiropractic physician with a specialty in neurology and specific approaches for those who are having symptoms of dementia or symptoms of cognitive impairment. So so thrilled to introduce Dr Kandi and tell us about your background as a chiropractic physician and this special interest in neurology.
Speaker 3:Wonderful. Thank you so much for having me, karen and David. I'm thrilled to be here and especially talking about something that's very dear to my heart. My father has a mild cognitive impairment and he's kind of on the kind, you know, the kind of spectrum as we say. So he's so.
Speaker 3:This is something that's been a passion for me as well, but my training is my foundational training is in chiropractic medicine. However, we have specialty routes and not many people know this, but we just like medicine, we have specialty routes and different specialties. So I chose to do a. My path was in neurology and typically how our system works is that when we finish, we do a three-year post-doctorate in the field of specialization, and so what's great about our field and different than traditional medical neurology is that we really are experts in understanding neuroscience and neurophysiology. That's what we're really good at understanding kind of the latest research and literature regarding pathways and lesions and areas in brain that become deficient with different pathologies, neurodegenerative diseases. We're great at diagnosing those because of this training, and then, besides that, we also get a heavy emphasis on rehab, neurological rehabilitation, right Understanding how we can leverage some of the powers of neuroplasticity to make the brain more efficient, much more robust and dense in terms of connections, right synapses, to make the highways just more fluid and more efficient. So that's really what we're great at we really don't dive too much into the pharmaceutical realm.
Speaker 3:I work routinely with other medical neurologists to co-treat patients. You know, for example, patients that have been diagnosed with any type of dementia. You know we'll get referrals to really perform high-level cognitive rehabilitation to really try to activate and stimulate certain pathways that we know from testing that are somewhat deficient with these patients. And we do it in a cooperative manner, meaning that we're working together to utilize some of the medication but also some of the functional type of work. So our field now is actually being termed and coined more functional neurology. That's kind of the new term that they use for what we do, because there's functional medicine people understand that concept.
Speaker 2:I think it's fascinating. Research is still struggling. We have Aricept and Nemendo, which have been around for a little over 20 years. Their effectiveness is really questionable. The newest medications, the Kisunla Lekembe, the monoclonal antibodies, can only help a limited population, those who are fortunate enough to get diagnosed in early stage. Many are not eligible to take them because certain other conditions put them at risk for brain swelling or brain bleeds. So we haven't really developed a lot in the pharmaceutical category, and so it's wonderful to hear that there are alternatives. As a nurse, I've always favored non-drug approaches that do not have potentially scary side effects side effects and where the worst that could happen is you might not improve. I think this is incredibly important and so so pleased that we can bring this to an audience today to hear about these alternatives. So what types of disorders do you address that can result in symptoms of dementia? Because there are many, Alzheimer's said to be the most common. But what other dementia-causing disorders might you be addressing?
Speaker 3:The other big ones that we see. In our practice we really don't get into frontal lobe dementias very often. It's so progressive and so rapid that unfortunately there hasn't been much research from a rehab perspective. So besides Alzheimer's, lewy body dementia is one that we really have. We see quite a bit and so we'll work routinely with medical practitioners to get these you know, skin testing done to see if we can confirm Lewy body.
Speaker 3:We also work pretty heavily with patients post-TBI, post-brain injury that eventually can trigger these types of accelerated dementias, especially when in older age.
Speaker 3:So, seeing some of those, I just recently had a patient that came in with chronic, prolonged, chronic, prolonged dizziness from an old brain injury that now kind of has fallen into a pretty significant dementia pattern. So these types of other aspects are really the ones we see, of course, alzheimer's being the greatest, but we do a lot of mild cognitive impairments. Those are really our bread and butter. If we can take a patient that's scoring a 20 out of 30 on a mini mental status exam, we have a greater probability of making some positive change than a patient that's scoring a 10. It's a little bit, as you can imagine, at that point in the progression of the process of the disease, it's a little harder to make change. We've made change with those patients before in the past. I typically don't really take them on as patients just because I don't want to kind of waste people's time or rather than do other things that can be strategic for them to help them at this point in their process. But yeah, typically around the 20 range is what we like to see.
Speaker 2:As is true for virtually any disease you could name, the earlier you intervene the better, so you might get improvement with later patients, but probably less improvement. So another reason we would love for everyone to follow David's example in getting an evaluation as soon as he perceived he was having some issues, hitting those interventions as early as possible. Now you talked about traumatic brain injury, or TBI, and I think David has a question for you, based on his own experience early in life. David, why don't you explain what happened to you to see if this could still be addressed now?
Speaker 1:The first thing that happened was before seatbelts and we had an accident and I flew into the windshield and broke the windshield with my head. Okay, and this was I, was. I had to be less than six, maybe, maybe less. It was before seatbelts and you know, the old thing was they put parents used to put their hand out.
Speaker 3:Yeah, yeah, right Right.
Speaker 2:Right, right.
Speaker 1:The human seatbelt. I grew up in Florida. We had these mango trees and we used to take a baseball bat and hit the mangoes and splatter them all over. You know it was really. It was a lot of fun. You know it was like so. But I was standing behind my brother and he hit me in the head on a backswing. I still have the lump. It's still there. I didn't lose consciousness. From what I know, I remember sitting on my father's lap and saying am I going to die? You know so nothing really ever became. The next time I got hit in the head with a baseball bat again, this was really stupid. I was at a party and we were playing baseball. I was maybe in the early teens and we were playing baseball with a basketball. I hauled off and hit that thing as hard as I could and hit me right back in the head. You know equal and opposite reaction. So I've been hit twice with a baseball bat and broke a windshield once. I mean, could that be a problem?
Speaker 2:Well, my question would be we now know that a head injury early in life can turn up decades later. So I guess our question would be if you know, as David does, that he had this history of a couple of significant knocks on the head, could he come to your program in a preventive posture?
Speaker 3:Oh, absolutely Absolutely. So. We know, with any type of traumatic or mild traumatic brain injury or concussion, right, which is just a milder blow, no matter what, no matter what, there will be cellular change that occurs, it happens. There's what we call oxidative stress. There is kind of a hyper excitability of the brain. There's inflammation that occurs, and you don't have to have a brain bleed to have this happen. Okay, these things occur with mild to moderate hits to the head. And so what happens is in a more significant pattern here, with individuals like football players that have chronic head injuries, right, there's something called chronic traumatic encephalomyopathy. So when you look at what these CTEs that are occurring, where they're having these individuals that are high impact players, whether it's football, whether it's hockey, we're finding that these individuals post-mortem are having signs of an Alzheimer's type brain. And so we know, obviously that's that's an extreme example, but head injuries, especially with multiple head injuries early on, can absolutely change the trajectory of the brain and nervous system function for the rest of life.
Speaker 2:Are there interventions that you can offer to someone who says to you look, you know I'm now 70, but as a 10-year-old and then a 20-year-old I had these head injuries. Is there something I could do proactively?
Speaker 3:Absolutely. We do it all the time Patients come in. I had you know I'm reading now about, you know multiple head injuries over time and what it can happen. You know what this can lead to in terms of you know my ability to have thought processes and memory and dementia. I want to try to do something now. Yes, the answer is yes. We can put you through a battery of tests. Look at how areas of brain are doing from a statistical perspective. We can look at numbers, we can look at different aspects and then get a gauge as to hey, where should you be in comparison to your peers at this moment? And if we start to see some deficits in some areas, there are ways to strengthen those pathways. Those connections, and really the main connections are going to be in the very front part of the brain. That's the area that we see that there's the greatest detriment.
Speaker 2:You mentioned earlier Lewy body disease as being another that you can intervene for and you know. The theory now is that up to 50% of people diagnosed with Alzheimer's pathology also have Lewy body pathology and unfortunately, if they're being diagnosed in primary care, sometimes the Lewy body component is missed in favor of the more common Alzheimer's. And how you can intervene or even anticipate with your evaluation that somebody might be developing Lewy body pathology by the way they move.
Speaker 3:Alzheimer's seems to have a lot more and I'm pretty sure, in the literature and as well as funding and research, they're ahead of the game in comparison to Parkinson's, there's no doubt. Okay, I sit on a Parkinson's board as well American Parkinson's Disease Association, apde and so what we do there is we look to see, you know what's happening in the world of Parkinson's and you know, are we seeing a lot more Lewy body dementias? Are we seeing this increase? And the answer is absolutely. And what we're noticing is that if we can do a proper examination on these patients with early Parkinson's and start to detect if there's any cognitive aspects occurring early on, and we shift a lot of our treatment methodology, even some crossover treatment, you know, from a pharmaceutical perspective, these patients have a better prognosis of slowed progression of that dementia. So, yes, the answer is yes in terms of making changes in these patients early on, and this involves areas of activation in brain that involve the basal ganglia, the dopamine centers, the areas in brain that are more responsible for producing this Parkinson's type of presentation, and detecting that earlier on is a key. I mean it is a key.
Speaker 3:It's funny. It's not really funny, but in the last week I've had two Parkinson's patients, one really pretty advanced in their mid-40s. I haven't seen that in some time. We want to get on those immediately and start to look at hey, are there any? Are we seeing any cognitive deficits? If we are, should we, you know, do some things differently from a rehab perspective and also from a pharmaceutical perspective, start to work on trying to slow any progression down?
Speaker 2:So just to tie those two together, for those who may not know, the same type of pathology that causes Parkinson's can progress to the more diffuse Lewy body disease, affecting more areas of the brain than Parkinson's does. So not everyone with Parkinson's will develop the more advanced general Lewy body disease, but some do. So, being that those are largely movement disorders, are you able to identify someone who might be on their way to developing Parkinson's or Lewy body based on your observations of how they move?
Speaker 3:As a screening tool for patients that have had brain injuries, because we see quite often that there are triggers for Parkinson's disease. As for Alzheimer's too, to be honest with you, these triggers can be typically a kind of an impact to the head right, a head injury, a stressful event. It doesn't even have to be a physical event. It can be a physiological stressful event that can trigger the phenotypic expression of the gene that they. You know, especially with Alzheimer's, we know that there's a definite genetic component to it, especially with Alzheimer's. We know that there's a definite genetic component to it and we see these patients start to express these genes earlier on. So what we're doing is, as we're looking at these patients coming in, we are trying to be proactive, smell tests, things that we can do early on to, as you know, especially with Parkinson's, but even with Alzheimer's, these disease processes are starting 20, 30 years before the first symptom even appears. So we are trying really hard to start to look at this and trying to get a good idea how we can figure out what's happening earlier and then strategize ways to improve you know that functionality, but we're always getting new research I mean just last year and then strategize ways to improve, you know that functionality.
Speaker 3:But we're always getting new research. I mean just last year and then again they repeated it this year, there's a wonderful research study looking at increasing the size of the hippocampus with cardiovascular activity. Right, hippocampus, that's your memory centers, 30 minutes they're looking at three to five times a week. We actually have clinical data that shows that the hippocampus actually can double in size with this activity. Now we're finding that bicycling, recumbent bike bicycling, is actually wonderful for looking at patients with Parkinson's as well. Okay, so a wonderful association with reducing the bradykinesia or the slowing with recumbent biking, okay, and I'm sure, being that it's a neurodegenerative disorder pretty, I would say it's almost a kissing cousin to dementia, to Alzheimer's, just because of the protein aspects. There are probably some crossover there even for Alzheimer's. So you know, I think it's a wonderful thing that you know we're always, constantly getting good research and data.
Speaker 2:I'm very glad you mentioned what we call the preclinical period. So for 20 years or even more, you could be developing pathology that will ultimately result in symptoms. Now, on the one hand that sounds a little scary, but on the other hand, you could see that as opportunity. You have all of this time to do these other things, to improve your diet, to plan for that 30 minutes a day minimum, three to five days a week of aerobic exercise Walking is just fine, or biking, and this is where we're trying to get people we're trying to get them to a point where they don't necessarily wait for the symptom to show up Understand we are at risk just because of living to a certain age, environmental exposures, diet.
Speaker 2:I'm going to do as many of these lifestyle strategies as I can that are now believed to preserve and protect brain health. And, you know, with research really struggling to produce anything on the pharmaceutical side, this is so incredibly important. I have another question for you in that regard. Everybody should be aware of their family history and know that whatever's in the family history you just might be more vulnerable to. So if someone knows that they have a fairly strong history of Alzheimer's disease or Parkinson's, but they're feeling fine. Would it still be advisable that they come to be evaluated to see if they have any potential triggers there under the radar that you could detect and then work on?
Speaker 3:Absolutely. I am a big proponent of doing a simple. We have a wonderful software that we use in conjunction with the Cleveland Clinic and in 30 minutes it's pretty sensitive to pick up cognitive deficiencies and it's a wonderful tool. We're able to match you with 50th percentile of your demographic and do a good comparison. I'm able to look at several different domains quick and easy. We do a couple other tests associated with it but, you know, in an hour we can tell you. Hey, you know, you can either start doing some things here or, you know, right now we don't see much going on. Either way, there needs to be intervention, practical intervention. It doesn't have to be clinical if there's no symptoms, but something going on at home, as you talk, karen, very, very passionately about which I love biking, exercising, diet. If there's a family history, you better get on it. Just do it and do some of the precautionary things, get a baseline, those types of things. I can't harp on that enough.
Speaker 2:Well, one of the things that's so obvious to me is with other conditions. If you knew you had a strong history of skin cancer, for argument's sake you might be really diligent with sun protection, special clothing, sunscreen and so on. If you knew you had a strong family history of colon cancer, you'd probably be pretty diligent about your colonoscopies. Generally, though, we have not applied that logic to brain health, and this is where we are all trying to move people view it the same way and get to that proactive point. Frankly, I'm seeing the type of evaluation you do as part of an approved, covered preventive evaluation, even if you say by age 55 or 50, we will cover you insurance company, we will cover you to have this evaluation. We believe every adult should have a baseline hearing exam no later than age 50, but certainly sooner if they think they're having a problem. So we've not gotten there yet, and we really want to push for this type of advocacy, because preventing is always better than trying to treat or cure.
Speaker 3:The best medicine is how to teach people to be able to monitor themselves and take care of themselves, and to prevent disease.
Speaker 2:And we can have a lot of control. We really can Things again that do not involve medications, but I know David wants to ask you because you have this very space age looking equipment.
Speaker 1:One of the things I'm facing that's popped up, so to speak. I've had other situations where I've had in my neck, I've had neck surgery, because I've had when the vertebrae had to be changed, mainly because of arthritis, I guess. And I'm facing that right now where I'm having pains in my back that are that because my orthopedic said it's arthritis. You know, back that are that because my my orthopedic said it's arthritis. You know my curvature of my vein is happening. I really would like to get taken care of.
Speaker 1:Something like that looked at and absurd, and try to find result. You know it's something I can do to help relieve that because, as you probably know, I'm not the first person who's ever had this. It's, it's painful, it's annoying. I'm trying not to let that hinder my progress with the Alzheimer's, but now I'm basically have another fight that I'm trying, and so by you having you on the show and talking to you, I see, and it's remarkable that what you're doing and the innovative things that you're doing and that's what I'm asking is, I assume there's something I could come see you about. Yeah, for sure.
Speaker 3:In terms of. I don't personally do a lot of work in my clinical practice with spine, but I do have a sister practice. That's also kind of part of our practice that they're wonderful, they all do physical medicine. I have wonderful doctors in there and it's a good point that you're asking regarding the spine and those types of things, because if you are in pain, the problem there lies that you may not be as motivated to do your walking, do your biking.
Speaker 1:Right, exactly it happened with biking. I was I literally a week ago or less. I was riding my bike 15 miles. I went out the other day. I was able to do six, but it was tough.
Speaker 3:Any orthopedic conditions need to be seen, otherwise you're going to hamper your own ability to do the things you have to do to fire your brain. And what people don't realize is when you do exercise and you move, it's not just the blood flow that's making the change in your brain. And what people don't realize is, when you do exercise and you move, it's not just the blood flow that's making the change in your brain. What's really making the change in your brain is the movement of the joints. Your joints and your body are lined with little sensors on them and as we move these joints, it literally fires up neurological information to your brain. That's why this hippocampus grows. It's not because we're getting blood to the hippocampus, it's because we're as we move.
Speaker 3:All of this global activity of movement is stimulating brain and the. And talking about space age equipment, we use something called I think this is what you're referencing, but a multi-axis rotational chair. It's called the gyro, the gyro stem, and so and so patients come in and say what the heck am I getting on this thing for? Holy cow, you're going to be moving me around and turning me and possibly flipping me around in this. It looks like you're training for NASA to go to space.
Speaker 3:But the wonderful part of this type of therapy is that it is vestibular stimulation. So what we're doing with this is that we are loading the vestibular system to apply a sensory load to the brain. Okay, just like when you walk, you're firing joints. Well, if you move in a robust spatial kind of dynamic in different axes of motion, you are firing heavily into the brainstem and then into your brain.
Speaker 3:Recently, looking at vestibular stimulation and how it enhances the neuropathways and the connections within multiple areas of the limbic system and the cognitive system, these activation, these movement parameters as they activate the brain, we're getting hippocampal activation, we're getting what we call anterior cingulate activation, we're getting amygdala activation, frontal lobe activation, we're getting thalamus activation, parts of the brain that just fire up your cortex. So one of our secret sauce that we do is we for not everybody, but for patients that are candidates we will do full body rotational activities to activate and patients come out of that thing and after doing it for a little period of time, there's so much more aroused, alert, focus, attention and of course it's a buildup process. But that's how that works and of course we use it for a multitude of things brain injuries, concussions, alzheimer's. We use it for Parkinson's patients because we're getting activation into these areas of brain.
Speaker 2:I love all of these proactive approaches Again. Love things that use the body's own potential restorative functions that people may not be aware of. We don't always need a pill. We don't always need an infusion of some new monoclonal antibody. Each of us has potential restorative power accessing this type of intervention. Everyone learn from David's experience. You get the best outcomes when you intervene early. But again, I would urge people, if you know you have this family history that may point to emerging cognitive impairment, get some evaluation while you're cognitively intact so you can make decisions. So we really do need to let people know how to find you and your practice.
Speaker 3:Thank you, yeah, so my practice is Functional Neurology Brain Center of Florida and we've been here 20 years. We're in Delray Beach. I've been blessed to grow over the years so we have a nice large home base here. So we have a multitude of technologies and really we take pride in elite level training for our team and our doctors. Delray Beach, right off of Atlantic Avenue in Delray Beach, our website is it's kind of long so I'm working with my tech people on this, but it's wwwfunctionalneurologybraincentercom. It's wwwfunctionalneurologybraincentercom. Functionalneurologybraincentercom. You can reach us there and we'd love to take a look at you and work with you and see what we can do to help you.
Speaker 2:I have one remaining question for you. I have known many chiropractors in my life and I work out a lot, so I sometimes get injured, so they have helped me tremendously a lot. So I sometimes get injured, so they have helped me tremendously. But what percentage of chiropractic physicians have actually taken on this specialty in neurology?
Speaker 3:It's a very small percentage. So we are a small discipline in general chiropractic medicine. So when you look at that and then you say that maybe about 10% of our profession is that it's actually I think about that or a little bit under go on to have their three-year training and then sit for their we're called diplomates is what we're called Diplomate of the American Chiropractic Neurology Board, dacbn. It's about maybe a little under 10%. So there's not a whole lot of us. We are growing. It used to be a lot less 5%, it's growing. There's a huge demand for functional medicine. Patients want to do things. Now that there's a lot more data, research, they want to do things naturally as much as they can. Of course, there's a wonderful place for pharmaceuticals and surgical aspects, but they could want to do things as functional as they can, as long as they can, to get the best outcome.
Speaker 2:Right and we think that's really the best approach. Dr John Condie, thank you so much for taking this time with us For those who are listening. If you have questions or comments, you can reach David. His email address is david at davidsalzheimersfightorg. You can reach me, Karen Gilbert. Again, I'm representing Alzheimer's Community Care, based in West Palm Beach and serving also Martin and St Lucie counties. You can reach me very simply at education at alzcareorg A-L-Z-C-A-R-Eorg, and our phone number at Alzheimer's Community Care is 561-683-2700. Yes, leave a message for me or for David. We will get back to you. Thank you again. This has been tremendous and really enlightening.
Speaker 3:This is wonderful. Thanks for having me. This is just a wonderful show that you guys do here so much information and wonderful for people to listen and hear.
Speaker 2:We want to inspire that proactive approach for everyone. All righty, thank you so much and we'll see you next time.
Speaker 1:We are here on this earth as humans to help others. That's what I believe. Please note this podcast provides information only. Podcasts should not be considered professional advice or a substitute for professional advice. Viewers of the speakers do not necessarily reflect those of Alzheimer's, Community Care or David Ufelder. Listeners and viewers are encouraged to consult with appropriate professionals and are responsible for how the information provided is used.
