Core Contents: Welcome and Context (Dan Janowick & Kris Lonsway) Dan Janowick opened by introducing The Community House, an 85-year-old nonprofit serving the western Chicago suburbs through mental health counseling, community recreation, and programming across social, emotional, and physical health dimensions. Kris Lonsway, Optwell's founder (organization launched January 2025), shared her personal motivation: both her mother and grandmother developed Alzheimer's in their 60s, and Kris herself carries one copy of the APOE4 gene. She framed the evening around hope, citing the Lancet Commission's finding that up to 45% of dementia cases may be preventable through healthy habits. Optwell's five core healthy habits were introduced: eat well, get moving, mental wellness (including cognitive fitness), quality sleep (7 to 9 hours nightly), and manage health.

Clinical Overview: Alzheimer's Disease, Biomarkers, and Emerging Treatments (Dr. Agarwal) Dr. Agarwal provided a comprehensive neurological perspective. Key areas covered:

Terminology and disease framing: She distinguished dementia as an umbrella term from specific types including Alzheimer's, Lewy body, frontotemporal (as raised by Bruce Willis's diagnosis), vascular, and mixed dementia. She emphasized the Alzheimer's continuum, noting that brain changes can begin up to 20 years before symptoms appear -- reframing this not as cause for fear but as a 20-year window for prevention.

Mild Cognitive Impairment (MCI): She defined MCI as the important transitional zone between normal cognition and dementia, and stressed the value of early detection and diagnosis for medical, emotional, social, and financial planning reasons.

Diagnosis: She was emphatic that no single test diagnoses Alzheimer's. A full clinical picture requires a physical exam, neurological exam, cognitive/memory testing, neuroimaging (MRI and/or PET), and biomarkers together.

Biomarkers: She explained biomarkers as reliable predictors of disease presence or progression, using glucose and cholesterol as familiar analogies. She covered amyloid PET imaging (which moved from research-only to insurance-billable when anti-amyloid drugs emerged), MRI (which shows brain structure, not function), tau protein measurement, blood-based biomarkers, and emerging markers including voice-based digital biomarkers. She cautioned that predictive biomarker use without a full clinical picture risks harm.

New Drug Treatments: She described the two approved anti-amyloid drugs (lecanemab and donanemab), explaining their mechanism (IV infusion, moving toward subcutaneous injection), efficacy in plaque removal, and significant side effect risks, particularly brain microhemorrhages and swelling (ARIA). Higher risk groups for ARIA include those with APOE4, women, and those on blood thinners. She stressed that existing medications (donepezil, memantine) remain in use for those who do not qualify for the new drugs, and that combination therapy -- drugs plus lifestyle -- is the future direction the field is pursuing.

U.S. POINTER Study Results and Alzheimer's Association Initiatives (Olivia Montango) Olivia provided an overview of the U.S. POINTER Study, the American adaptation of Finland's FINGER study. Key points:

The study enrolled over 2,000 participants aged 60 to 79 across five U.S. sites (Chicago, Houston, North Carolina, New England, and Northern California), with 30% from diverse racial and ethnic backgrounds. Participants were at elevated risk due to sedentary lifestyle, poor diet, family history of cognitive impairment, or cardiovascular concerns.

Two groups were compared: a structured group (meeting ~38 times over two years, with coached physical activity, MIND Diet adherence, Brain HQ cognitive training, and regular medical advisor visits) and a self-guided group (meeting ~6 times, given tools to self-direct).

Results: Both groups improved cognitively over two years. The structured group outperformed the self-guided group. Improvements were observed regardless of age, racial background, or cardiovascular history -- a notably inclusive finding.

Following these results, the Alzheimer's Association committed $40 million to implement the POINTER approach through two initiatives: Brain Health at Work (an organizational program with a recognition component) and a personalized Habit Builder on their website (alz.org).

Locally in Illinois, Olivia highlighted the 10 Healthy Habits initiative and a partnership with the Illinois Department of Public Health through the YourBrainWillThankYou.com project.

Participant Testimony (Phyllis Jones) Phyllis offered a deeply personal account of her journey as a U.S. POINTER Study participant (structured group). She described her state before the study -- "Phyllis BP, Before Pointer" -- as someone living on the standard American diet, rarely exercising, and coping with compounding stressors: job loss after 28 years, her mother's 8.5-year battle with dementia, pandemic isolation, and a toxic workplace that resulted in a panic attack and ER visit.

Joining the POINTER study as a structured participant, she described what she gained: a sense of control over her health, the power to potentially break a generational cycle of dementia in her family, purpose, community, and a network of mentors and fellow advocates. And what she lost: her pre-diabetic status (A1C normalized), the threat of being put on statins (cholesterol normalized), 30 pounds and 11.5 inches off her waistline, chronic joint pain, and the belief that pain and decline are inevitable parts of aging.

Her closing message was both personal and community-oriented: citing that Black Americans face twice the dementia risk of white counterparts, she said this could no longer be "just her story" and she has begun sharing these practices with family and community. She closed with the line: "Hope without action doesn't change outcomes."

MIND Diet and Nutrition Strategies (Laura Morris) Laura provided an accessible overview of the MIND Diet and practical nutrition strategies, noting that slides were co-prepared with Jennifer Ventrelle. Key content included:

MIND Diet origins: Developed by Dr. Martha Clare Morris (Laura's mother) and colleagues at Rush University as a hybrid of the Mediterranean and DASH diets, with added emphasis on foods specifically neuroprotective based on the available evidence.

Foods to choose (9 categories): Leafy greens (daily, 1 cup; people consuming leafy greens 6x/week showed thinking abilities equivalent to someone 11 years younger), other colorful vegetables (at least 1 serving daily), berries (5x/week, ½ cup; the only fruit on the MIND Diet), extra virgin olive oil (2 tbsp daily, primary cooking oil), nuts and seeds (1 oz, 5x/week), fish/seafood (1+ serving/week), poultry (2 servings/week), whole grains (3 servings/day), and beans and legumes (½ cup, 3x/week).

Foods to limit (5 categories): Fried food, red and processed meats, full-fat cheese, sweets and sweet drinks, and butter. She noted that high saturated fat diets are associated with 2 to 3 times the risk for Alzheimer's, and high sugar intake is linked to double the dementia risk in observational studies.

Research outcomes: Highest MIND Diet adherents had a 53% reduced Alzheimer's risk; moderate adherents had a 35% reduction; even improving one's score by 3 points has shown benefit in more recent research.

Practical strategies: Add greens daily (start with 1 to 2 times per week if new to them), eat berries most days, choose lean proteins (swapping processed red meat for one serving of nuts or beans was associated with a 23% lower dementia risk in one study), cook with EVOO, include whole grains and legumes. She also covered snack building (protein + produce), simple healthy swaps (yogurt and berries instead of ice cream, side salad instead of fries), and the multi-domain brain health picture: nutrition, physical activity (the best workout is one you enjoy and will keep doing), 7 to 9 hours of uninterrupted sleep, social connection, and cognitively challenging activities.

Optwell Programs Overview (Kris Lonsway) Kris presented Optwell's current and upcoming programming: Mindful Movement (free exercise classes integrating cognitive challenges and mental wellness techniques, offered in multiple locations and in Spanish, funded by the Lions Township Mental Health Commission); a 30-day Employee Wellness Challenge (partnered with LifeHive Nutrition, including registered dietitian access at no cost to employers or employees); and upcoming programs including a Walk With a Doc initiative launching in La Grange and Countryside, a Women's Brain and Hormonal Health event planned for Hinsdale in October, and a pickleball fundraiser. More information is available at optwell.org.

Panel Q&A The event closed with a rapid-fire panel Q&A:

Alzheimer's Association helpline: Staffed by master's-level clinicians 24/7 at 1-800-272-3900, able to assist with diagnosis questions, resource navigation, caregiver support, and more.

Can you eat too many berries? No established limit; variety across the full dietary pattern is what matters most.

Tips for habit consistency (Phyllis): Notice and feel the changes -- physical improvements like no longer needing knee braces kept her motivated. Find movement you genuinely enjoy, not something you watch the clock through.

What should asymptomatic individuals with family history do? (Dr. Agarwal): Start by establishing a clear family history of what type of dementia was involved. Assess current cognitive function honestly. Conduct a thorough clinical workup to rule out reversible causes. She cautioned against ordering predictive blood biomarker tests without symptoms, since no approved drug exists for asymptomatic individuals at this time, and an ambiguous result can cause harm. Lifestyle optimization is her primary recommendation for asymptomatic high-risk individuals.

Where to start? (Audience question): Begin with your primary care physician, build the relationship over time, and come prepared with a concise, specific list of observations and concerns.