Episode 361 | Dr. Aaron Greenstein on Cognitive Health and Dementia Care

In this episode of Millennium Live, host Connor welcomes Dr. Aaron Greenstein, medical advisor at BrainCheck and medical director at Kitwood Health, to discuss the critical yet underappreciated challenge of cognitive health and dementia care. Dr. Greenstein defines dementia as an irreversible, progressive decline in cognition and function driven by underlying brain degeneration, emphasizing that it's an umbrella term encompassing Alzheimer's disease, vascular dementia, Lewy body disease, and others—much like cancer. He highlights the profound difficulty in early detection due to stigma, lack of standardized screening protocols, absence of blood tests for most dementias, and the fact that behavioral or personality changes often precede cognitive symptoms. With only 8% of mild cognitive impairment (MCI) cases detected, the majority of dementia is identified too late, missing crucial windows for intervention. Dr. Greenstein advocates for early detection through tools like BrainCheck—a digital, self-guided cognitive assessment platform—and the integrated care model of Kitwood Health, which provides longitudinal, co-managed dementia care within primary care settings. He stresses that early detection enables lifestyle interventions, access to disease-modifying therapies, and comprehensive care planning that supports both patients and caregivers. Looking ahead, he calls for systemic changes, including Medicare reimbursement for care management services, to make comprehensive cognitive care sustainable and accessible. The conversation also touches on the emotional and practical burdens of dementia on families, the importance of maintaining patient relationships and caregiver support, and the role of personal resilience in healthcare leadership. Dr. Greenstein shares his own wellness practices—physical activity, social connection, spirituality, and mindfulness—citing skiing as a meditative, present-moment activity. He recommends Viktor Frankl’s 'Man’s Search for Meaning' as a foundational text on finding purpose and control through attitude, especially in the face of aging and loss. The episode concludes with a heartfelt reflection on the importance of proactive self-care and meaningful human connection in both patient care and professional life.