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Amanda Grant Smith is a geriatric psychiatrist with decades of experience treating patients with dementia and Alzheimer's disease. In this episode, Amanda shares how she developed a passion for geriatric psychiatry as a means to support dementia patients. She explains how to recognize, define, and diagnose dementia\u2014a process that still remains somewhat elusive. They also talk about the significance of ApoE genotype and compare the various forms of dementia including differentiating between Alzheimer\u2019s disease and Lewy body dementia. They discuss the current landscape of clinical trials, the drug pipeline, and talk about a very promising monoclonal antibody directed at amyloid beta that has the potential to be a disease-modifying drug. They conclude with a discussion about how to define \u201chealthy aging\u201d and reflect on how understanding dementia can shape one\u2019s life philosophy.

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We discuss:

• How Amanda developed a passion for geriatric psychiatry [3:15];
• Defining and diagnosing dementia and Alzheimer\u2019s disease [13:30];
• Medical tests for dementia and their relationship to clinical symptoms [22:45];
• The pathology of dementia, and the role of the tau and beta-amyloid protein in Alzheimer\u2019s disease [33:15];
• The significance of ApoE genotype, and differentiating Alzheimer\u2019s disease from Lewy body dementia [43:15];
• The evolution of Alzheimer\u2019s disease prevention, care, and medications over the last 20 years [52:45];
• Psychiatric support for dementia patients (and caregivers) with depression and anxiety [1:02:45];
• Drug pipeline, clinical trials, and major challenges to overcome [1:13:45];
• Redefining Alzheimer\u2019s disease and designing effective trials [1:23:00];
• The promise of monoclonal antibody treatments for Alzheimer\u2019s disease\xa0[1:34:15];
• How we should measure outcomes in dementia trials and define \u201chealthy aging\u201d [1:42:30];
• How understanding dementia can reshape our life philosophy [1:53:45]; and
• More.

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