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Health // Doctor in the House
Rasa Fournier

Keeping The Brain Healthy

DR. TOM HARDING, Director of Neuropsychology at Hawaii Pacific Neuroscience

Interviewed By Rasa Fournier

Where did you receive your schooling/training?

I studied neuroscience at the University of Hawaii and then entered a neuropsychology program at Argosy University here in Honolulu. Then I went to a hospital in Omaha, Neb., and worked with traumatic brain injury for internship residency training.

How long have you been practicing?

I started on Maui doing forensic neuropsychological assessments for the judicial system with the Department of Health. Then I moved to Oahu and worked at the State Hospital for a couple of years. I wanted to focus on dementia and traumatic brain injury with the rising senior population, so I joined the Hawaii Pacific Neuroscience clinic in May of last year.

What is your primary focus?

AT HPN, we’re trying to develop a model that can be replicated statewide and provides services for early dementia detection in Hawaii’s senior population.

When working with geriatrics, we’re mainly dealing with Medicaid and Medicare insurance. Any clinician will tell you the reimbursement rate is very low. So we decided to get graduate students involved. They need training, and they can help keep costs down in providing much-needed services to a population that Hawaii, for the most part, is not prepared for.

I am also a member of the state Dementia Task Force that lots of agencies are involved in. One of the things we’re trying to figure out is how to provide services to our seniors. The number of baby boomers who will be seniors is approximately three times the level we have now. We don’t have enough resources; we don’t have a network in place. For every person who becomes demented, the Medicaid bill rises 600 percent compared to a senior who doesn’t have dementia. For the dementia cases we can prevent or delay, we can save billions of dollars across the years.

Master of social work Dhira DiBiase, Dr. Tom Harding and researcher Brandon McNichols

Early detection and prevention is what we believe in. If you can catch it early, when it’s a little bit more than a senior moment when memory is failing on a regular basis it’s time to come in to see if it can be reversed. Not everyone who has memory problems becomes demented. It could be a mood disorder. It’s quite common for a senior who loses a spouse to become depressed, isolated and then they start looking like they’re demented because depression can make you forgetful and your mind becomes slow. Or the cause of the memory loss could be because of a thyroid disorder, or an interaction of the many medications that seniors sometimes take. It’s important to see a specialist who can ferret out these potential issues.

Quite often we see vascular dementia. In Hawaii, we like our fatty foods and plate lunches that can clog up the capillaries in the brain. Research done locally shows that about a third of the cases of dementia are vascular related, and these are preventable. You need to stimulate your brain, get proper nutrition and enough physical exercise and rest. Walking around the block is great for the heart and it’s also great for the brain. You also need to avoid the many risk factors associated with dementia.

You also do seminars.

My book, You CAN Prevent Alzheimer’s!: A Neuropsychologist’s Secrets to Better Brain Health is in the Hawaii Public Library system. I get out in the community and preach, “Use it or lose it,” feed the brain, exercise the brain with physical activities, avoid risk factors, and then I show the audience some brain games. My mentor developed the first TBI (traumatic brain injury) rehabilitation program in the U.S. In the ’70s, it wasn’t an accepted idea that you could grow new brain connections. But we know today it can be done. He developed these brain games.

I also have a website: Be-Dementia-Free.com. If someone’s concerned about their memory, or that of a parent or loved one, they can go there and take a visual memory test to see how they’re doing.

You received an award in May.

Mental Health America selected me for Outstanding Community Mental Health Leader for 2012. I think it will bring attention to what we’re trying to do here in Hawaii, which is increasing people’s awareness that we need to start looking at our seniors and their memory and brain health, and how are we going to prevent these cases. If we don’t prevent them, research shows by the time people are in their 80s, they have a 50 percent chance of having some form of dementia.

Can you talk more about risk factors?

My basic mantra is: “In with the good, out with the bad.” In with the good habits such as eat the right diet, form the right habits. Out with the bad habits: Smoking is terrible for the heart and brain. Eating a diet filled with junk food, trans-fat, saturated fats that is a risk factor for not only heart disease, but also vascular dementia. Another risk factor is diabetes. If you have diabetes, you’re at three times the risk for dementia. Type II Diabetes is tied to bad diet and lack of exercise. A risk factor would be “couch potatoism.” This is something that affects all of us to some degree. You come home from work and it’s just too easy to say, “I’ll get up in a little bit,” or “I’ll do it tomorrow.” Before you know it, weeks go by and you haven’t done anything. This catches up with us over time.

These are behaviors, routines and habits we created. That means it’s within our control. Some of the deadly ones are hypertension or high blood pressure, and stress. If you have high blood pressure, you are at an elevated risk for a stroke, a transient ischemic attack, and vascular disease that builds up over time and becomes dementia. We see that a lot here. In Honolulu we have some incredible traffic. It’s very stressful, and if you don’t manage your stress adequately, stress can lead to anxiety and depression. Stressful situations (relationships, work pressures, etc.) can work on certain areas of our brain where our memory centers are and it starts taking its toll, which can lead to decreased memory and brain function. Most of the avoidable risk factors are habits. Eating french fries and burgers everyone knows that’s not good for us. I can put the information in your hands, but you have to be proactive and take control of your life.

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