[00:00:02] Speaker A: We see a couple things. One, the more air pollution you're exposed to prior to death, the more amyloid and tau you have in the brain, so that you have more Alzheimer's disease pathology. We also saw that the more air pollution you're exposed to, the worse your cognitive function. I think it's a pretty strong argument that air pollution is related to brain health and dementia.
[00:00:35] Speaker B: Welcome to the Age of Aging, a show about living well with an aging brain produced by the Penn Memory center and the Michael Nadoff Communications Hub. I'm Terrence Casey.
[00:00:44] Speaker C: And I'm Jake Johnson.
[00:00:46] Speaker B: Jake, how are you feeling? We had a pretty big weekend. We had Broad street run and our annual research partner thank you lunch.
[00:00:52] Speaker C: I'm still recovering. It was a huge weekend. So Saturday we had our thank you lunch where we welcome in all the research participants from the studies here at the Penn Memory Center. And then on Sunday, both of us Woke up at 5am and went up to North Philly to start the Broad street run, which, if you don't know, goes through the center of the city. It goes straight through City hall, north to south, and ends in the Navy Yard in South Philly. So it was a pretty epic weekend.
[00:01:22] Speaker B: Yeah, we talked about that in our make way for the Masters episode. I didn't see you. I didn't see Emily. But you said you wanted to talk about the thank lunch.
[00:01:30] Speaker C: Yeah. So there was just this moment during the thank you lunch that has. Has really stuck with me. Co director of the center, Dr. Dave Wolk, was giving his presentation and cited some recently published research by Dr. Eddie Lee, who is a neuropathologist here at Penn, which found a link between the pollution a person was exposed to in their lifetime and the amount of physical evidence of Alzheimer's disease in their brain.
So as someone who has lived in two major urban areas my entire life, I've been somewhat anxiously thinking about this and wanting to know more both about this relationship between Alzheimer's and air pollution and then just how bad Philadelphia air pollution is.
[00:02:09] Speaker B: I don't think of Philly as a highly polluted place, but is it?
[00:02:14] Speaker C: Yeah, that's exactly the question I wanted to answer. So in addition to talking with Dr. Lee, as well as some experts in toxicology and air pollution, I also spoke with a local clean air advocate about Philly's current air pollution status.
[00:02:27] Speaker B: All right. Well, with mild anxiety, I am looking forward to hearing the results of all those conversations. So I appreciate you going out and doing that. We'll get to those interviews in just a moment. But first A Word from our Sponsors
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Before today's episode, I want to tell our listeners about a new book, Dementia Care's Radical New Era, published by stat.
As you may know, for the past several months I've been writing my neurotransmissions essays for Statistics and was honored to be asked to write the introduction and contribute a selection of my essays, along with reporting from my STAT colleagues.
Dementia Care's Radical New Era is a comprehensive STAT special report that examines the breakthroughs, tensions, and emerging strategies reshaping the diagnosis, treatment, and care of persons with the diseases that cause dementia and the future of cognitive health.
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Okay, then, back to the show.
[00:05:45] Speaker C: Air Pollution. It's something you've probably heard a lot about, especially if you live in an urban area, but aren't exactly sure how much you should worry about it. So on today's episode, we're exploring what air pollution is, how we can reduce its potentially harmful effects, and for the purposes of this podcast, what exactly it has to do with aging. Let's start with that last part.
[00:06:06] Speaker A: So my name is Eddie Lee. I'm a professor here at University of Pennsylvania. I wear a lot of hats, one of them being the director of our brain bank. I'm also part of our Alzheimer's center and also co director, Institute on Aging.
[00:06:19] Speaker C: For a long time in the field, it was thought that neurodegenerative diseases like Alzheimer's were purely genetic. Dr. Lee said your likelihood for getting them was predetermined from birth.
However, he said, if you look at the cases of Alzheimer's disease over time, they're actually decreasing, particularly in more developed countries.
Dr. Lee said that this suggests that environmental factors play a role in whether or not you get the disease, because genetics don't change that quickly.
All this is to say that it's these external environmental factors that Dr. Lee and his team are interested in. When they examine the brains of deceased people who had Alzheimer's, they want to know what experiences from a person's life might correlate with Alzheimer's pathology in their brain.
You may remember Dr. Lee from our season two episode Building Trust, where he spoke about his research on the way socioeconomic status of a person's community correlates with their likelihood to experience cognitive decline.
[00:07:15] Speaker A: A couple years ago, we looked at something called Area Deprivation Index. So that's a measure of the socioeconomic status of your neighborhood.
And we were trying to see does that affect your cognitive function and what does that mean in terms of brain neuropathology? Do you have more pathology? And there, it turns out the the more deprived your neighborhood, the worse your cognitive function, suggesting that it's contributing to dementia. But they actually didn't have more Alzheimer's pathology in the brain. If anything, they had less.
So there's something about the stressor of living in a challenging environment that contributes to cognitive decline.
We published that study and then fast forward a little bit later, we were impressed by many studies that look at very large epidemiologic cohorts showing a relationship between air pollution and dementia and cognitive risk. The great thing about epidemiologic cohorts is that they're, they're very large. We're talking about millions and millions of people. The Downside is you can't do an autopsy study with millions of people. It's just not technically feasible. On the flip side, we have a brain bank which has thousands of cases.
And so we were able to look at air pollution in our cases, trying to see, you know, does air pollution relate to brain pathology and how does that affect cognitive function?
[00:08:32] Speaker C: Dr. Lee and his team looked at around 600 brains from their brain bank with common causes of dementia, such as Alzheimer's disease and Lewy body disease. And using statistical models that take into account factors like weather, traffic patterns, and satellite imaging, we're able to reasonably determine how much air pollution a person was exposed to when they were alive.
[00:08:52] Speaker A: So now we have their autopsy. We have an estimate of how much air pollution they've been exposed to, and we also have. There are clinical notes. So we have their clinical records and some measures of cognitive function in those individuals. So when we do that, we see a couple things. One, the more air pollution you're exposed to prior to death, the more amyloid and tau you have in the brain, so that you have more Alzheimer's disease pathology. We also saw that the more air pollution you're exposed to, the worse your cognitive function. I think it's a pretty strong argument that air pollution is related to brain health and dementia.
[00:09:27] Speaker C: So that's a pretty scary finding. But for as much as we've heard about air pollution, what actually is it and why is it so bad for us?
Dr. Trevor Penning is the director for the center of Excellence in Environmental Toxicology at the University of Pennsylvania School of Medicine.
[00:09:45] Speaker G: Pollutant is any substance that's in the environment that can actually be considered a hazard, and a certain dose will cause a toxic effect.
So air pollution is a complex mixture. We have to understand that first of all. And the second of all is it has different phases. There's a particulate phase and a gaseous phase.
The particulate phase consists of a particulate matter of different sizes. It can be PM1, PM2.5, and PM10, where the number refers to the micron size of the particle.
And the particle size is important in terms of how it actually enters the body and how it gets into the lungs.
[00:10:32] Speaker C: Dr. Lee's study looked specifically at particulate matter 2.5 micrometers or less, because at that size, particles are able to penetrate directly into our bloodstream.
Dr. Penning explained that the small size of the particles are the reason they're so associated with lung disease and heart disease.
Particulate matter can also absorb other toxic chemicals in the air. He said, which can cause inflammation and promote cancer.
[00:10:57] Speaker G: We also breathe through our nose, and the olfactory system is direct entry into the brain. And so you have a direct entry room of this particular matter into regions of the brain, and they can actually cause inflammation.
[00:11:11] Speaker C: So while Dr. Lee's research looked solely at particle air pollution, as Dr. Penney explained, there's also the gaseous phase of air pollution.
[00:11:19] Speaker G: Then in the gaseous phase, we're concerned about a whole host of different chemicals that actually are also carcinogens. Benzene, formaldehyde, acetaldehyde, acrylic, all of these are in the gaseous phase.
So it's a combination of both these entities that are endangering human health.
[00:11:40] Speaker C: In addition to these gases being toxic to humans on their own, when you add heat from the sun, some of these gases will form ozone.
In the upper levels of the Earth's atmosphere, ozone forms a protective layer against the sun's UV rays. But down on ground level, ozone is a major contributor to smog. Breathing in ozone can cause irritation and inflammation in your lungs.
[00:12:03] Speaker E: It actually causes a little bit like a sunburn inside your lungs.
[00:12:07] Speaker C: Bev Stewart is the senior director of lung disease education programming at the American Lung Association.
[00:12:14] Speaker E: It's oftentimes worse when it's really hot out, and so you'll see air pollution alerts during like, extreme heat days. And oftentimes that's tied to ozone because the air is stagnant and it's hot. And it's kind of just a breeding ground for this air pollution.
[00:12:32] Speaker C: Older adults are particularly at risk to experiencing the harmful effects of air pollution.
[00:12:36] Speaker E: Stewart said older adults over the age of 65 would fall into that category of being a sensitive population.
So there's recognition that your immune system doesn't work quite as well as it used to. And air contaminants and air pollutants, they can increase your susceptibility to getting a respiratory infection like the flu. It can also increase your risk of pneumonia and other things because it's making your lungs not operate as well as they otherwise could be.
[00:13:07] Speaker C: Now that we know why air pollution is so bad for us, just how much of it am I and my fellow Philadelphians exposed to on a daily basis?
[00:13:15] Speaker H: Freely's air quality is not great.
[00:13:18] Speaker C: Russell Zerbo has worked as an advocate for Clean Air Council in Philadelphia for 13 years.
[00:13:24] Speaker H: The city, much like most major urban areas in the US it doesn't attain the 2015 ground level ozone standard, and it also is not projected to attain the EPA updated 2024 particulate matter 2.5 standard. The absolute largest source is transportation, but that in and of itself is very broad. It includes the Philadelphia International Airport. It includes the region's marine traffic, which is fairly significant. And obviously cars and trucks, with an emphasis on trucks. Like, you know, your regular automobiles produce a certain amount of air pollution, but your larger diesel vehicles produce much more. And that's all just transportation. We also have a. A very significant amount of industrial pollution sources in this area. We still use fuel oil to heat a lot of our larger buildings, even some residences.
[00:14:30] Speaker C: Zerbo explained that what makes Philadelphia and many other major US Cities particularly bad for air pollution is the combination of a dense urban area with a lot of car and truck traffic in, like
[00:14:41] Speaker H: the Philadelphia and its suburbs and in New Jersey, you sort of have everything. You have a lot of cars, a lot of industry, a lot of people close together, a lot of highways. Yeah, but it's. It can be very shocking to see that, you know, New Jersey and Philadelphia having worse air pollution than New York City.
[00:15:02] Speaker C: Now that I've successfully scared all our listeners for 10 minutes straight, what can we actually do to reduce air pollution on a systematic and individual level?
Starting big picture, Zorbo said that he and his team at Clean Air Council are major proponents of walkable communities and public transit to reduce the amount of cars on the road.
[00:15:22] Speaker H: Our biggest thing that we always talk about a lot is really supporting public transportation to reduce automobile traffic and just having safer streets, safer neighborhoods, you know, letting people feel comfortable not being in the secure confines of their automobile, giving people stuff to do locally, is really underestimated in terms of its impact on transportation pollution. You know, if. If the places you need to go are right around you, you simply, you know, don't need to get into a car or hopefully public transit is accessible to get you where you need to go. But a lot of people feel reliant on their cars in the city of Philadelphia for public safety reasons because their school or work is far away from them, because they can't rely on public transit.
[00:16:15] Speaker C: One local Philly initiative Zerbo discussed is a bill currently in City council that would stop the city's trash incineration, which he said is a big contributor to air pollution.
In February, Philadelphia installed 76 air quality sensors throughout the city, so that every city address is at most 1.5 miles away from one of these monitors.
The sensors measure particulate matter, nitrogen dioxide and ozone. You can check the air quality around each monitor on the Philadelphia Department of Health's website, which we will link in the show notes.
In addition, Zerbos Clean Air Council runs their own air monitoring program.
[00:16:53] Speaker H: We have a EPA funded air monitoring program. If you go to purpleair.com it's a crowdsourced website. Anybody can buy a purple air monitor and get on that website. But if you look at South Philly, Southwest Philly and Southern Delaware county, you will see a lot of monitors that myself and my coworkers have installed. They're all labeled cac. Anybody can buy one of those monitors, reach out to me, I'll help you install it.
And that's one of the ways sort of we look at purple air's running in New York City and purple air is running in Philly and ours are getting higher numbers. So yeah, we're always trying to encourage people to do this resident air pollution monitoring. And then we have this cool tool, Clean Air Council's Pollution Tracker where we post a lot of the engagement and advocacy that we do with industrial pollution sources.
[00:17:49] Speaker C: When it comes to reducing your risk from air pollution.
Bev Stewart said there are a few things you can do and the first and most important is track your local air quality.
[00:17:59] Speaker E: So the best thing to do is to just be aware that air pollution can cause harm and then where to look for that. I've got a couple things on my phone. I have the airnow.gov app and it sends me alerts because I've programmed it to when the air pollution in my area is actionable to me. And I'll talk about what I would do if there was an actionable alert that came to me. But it also moves around with me because my phone moves around with me. So if I'm on vacation I also can get pollution alerts from other places where it at and then you can make informed choices about what you're going to do. An informed choice if the air quality was unhealthy for me, I got kids is I might ask the kids to not play outside.
That doesn't mean that they can't go outside ever.
That just might mean wow, the air quality is unhealthy. Let's find an indoor activity to do. It might mean that we go outside briefly because we have to walk the dog or whatever, but that we're not exerting ourselves, we're not exercising outside, we're not running with the dog. But there are other things that you can do beyond awareness.
You can wear an N95 mask. And an N95 mask is like the best of the best masks. The mask that like loops over your head instead of behind Your ears, that's a good indicator.
And that tightly affixed your face is going to help prevent those particulates from coming in.
[00:19:30] Speaker C: Additionally, Stuart said that keeping your windows closed and running your air conditioner on recirculate in your house or car are both good practices on bad air quality days.
She said to also regularly replace the fan in your house's heat and air conditioning system.
You want to look for a fan with a rating of MERV or MERV 13, Stewart said, because these will help filter particle pollution.
[00:19:55] Speaker E: The other thing that people can do is purchase an air cleaner.
Sometimes people call them air purifiers or something like that, and that is outside of your H. Vacs, your heating system, but it's like a standalone. It looks like a fan, but often cases, just taking the air in, running it through a filter and taking it out, just cleaning that air in your home. And as long as that's not emitting ozone, because remember we talked about ozone bed and some of them do emit ozone, which would be like getting rid of one problem and creating another one. But air cleaners that do that could also be a useful tool for people.
[00:20:29] Speaker C: Stuart emphasized that everyone in the modern world will be impacted by air pollution. So the best thing you can do is be aware of your local air quality, make informed decisions, and not stress too much about it. Otherwise, we will link a variety of places where you can track local air quality in the show notes.
Looking to the future, Dr. Lee said that there's still a lot to explore in the relationship between pollution and neurodegenerative diseases like Alzheimer's. He said he and his team are interested in studying the impact of gaseous pollutants on the brain, particle pollutants from different sources, to see if there's a different effect, like wildfire smoke versus car engines. And they're also interested in positive factors that could potentially protect the brain from pollution, like having more access to green spaces or having more trees in your neighborhood.
Dr. Lee said he hopes that this research can ultimately contribute to greater public policy around air pollution.
[00:21:25] Speaker A: Air pollution regulation is expensive, right? Because we're talking about putting limits on economic output and factories and cars. And so it's not as easy as just saying, hey, we just want better air quality, but we're adding to the evidence that it's actually contributing to disease, right? And so we have to consider, is it worth reducing air pollution, which could come at an economic cost, but we'll also have savings because if it has an effect on dementia, you know, dementia care is very Expensive as well.
So I think on a policy standpoint, we can make that argument. Now,
[00:22:08] Speaker B: I'm joined today by Dr. Holly Elser, a clinical fellow in cognitive neurology here at the Penn Memory Center. Holly earned her MD at Stanford and her PhD in epidemiology from UC Berkeley.
And her current research focuses on environmental drivers of neurological diseases, including the specific biological link between air pollution and dementia. She's also a Philly native who came back to do her residency here. So she's got a personal stake in just about everything Jake just reported.
Holly, thanks for being here.
[00:22:36] Speaker D: It's great to be here. Thanks for having me.
[00:22:38] Speaker B: Sure. First, I just have to ask, do you own an air purifier?
[00:22:44] Speaker D: Yeah, we have three in our home.
[00:22:46] Speaker G: Okay.
[00:22:47] Speaker B: So when Jake and I started this, that was how we had started it out. I don't have one. I don't have one at home. I don't have one in my office.
Before we get into all this, should I have three air purifiers in my home?
[00:23:00] Speaker D: Some of that is a function of my husband's allergies. So maybe you don't need three. But you can make a really affordable in home air filter using a box fan and just like one of the H vac filters affixed to it. So if you Google box fan air filtration system, you'll get like a nice how to guide.
[00:23:19] Speaker B: All right, that's good intel. And if we can find a good one, we'll put it in the show notes here.
So you've described yourself as broadly interested in social, environmental, and occupational health determinants. And I had to take a pause for this phrase here. Pattern the distribution of neuropsychiatric diseases in populations first. Can you translate that for me?
[00:23:39] Speaker D: Yeah, absolutely. So, as you mentioned, my academic training is in epidemiology. Epidemiology is the study of the determinants and distribution of diseases in populations. In other words, my scientific expertise is really in study design and the application of statistical tools to answer questions about, hopefully, modifiable drivers of diseases. And over the course of my career, which hasn't been that long, I've been fortunate enough to think about sort of a wide range of potential modifiable exposures. And that includes sort of social determinants and how disadvantage influences disease risk, how features of the workplace influence disease risk. And my most recent work is really focused on how the ambient environment influences disease risk. And in terms of the outcomes that I think about, I sort of span the continuum from neurologic to psychiatric. But my Real interest, as you can imagine, based on my clinical training, is in sort of the upstream determinants or drivers of dementia risk.
[00:24:45] Speaker B: And so tell me a little bit about, from your perspective, what it's like to hear Jake's reporting and some of Dr. Eddie Lee's research.
[00:24:52] Speaker D: Well, I have to say I'm a. I'm a huge fan of Eddie's and I think it's not every day you encounter a pathologist who wants to do an epidemiologic study. To answer what I think is still sort of a fundamental question in the air pollution, dementia space, what is happening under the hood? There is a tremendous amount, as Eddie said, of demonstrative work that shows that air pollution and dementia are associated and there's much less work that focuses on why. And I think that this was a really clever application of our postmortem or autopsy cohort to try to get at that question.
[00:25:25] Speaker B: And so you talked about having the allergy driven motivation to have these.
Did you have these air filters before learning about this research or was this a double down after hearing these types of.
[00:25:37] Speaker D: We had them before, but I'm even more grateful for my air purifiers now than I was maybe a year ago.
[00:25:43] Speaker B: So you're not just a researcher though, you're also a clinician? Yeah, I imagine by default pollution doesn't typically come up in a clinical visit. Do you ever hear any conversations like this from your patients or do you ever bring it up?
[00:25:58] Speaker D: Yeah, it's a good question.
It doesn't come up that often and I think sometimes my academic work ends up being more separate from my clinical practice than I would like it to be because the goal is to sort of answer scientific questions that are rooted in the experiences of real patients. What I will say is that there is probably a role to counsel patients about something as simple as checking the air quality index or like some of the guests on this episode mentioned, sort of using various APP based measures to identify days where the air quality isn't as good and there should be sort of behavioral modifications. So maybe the sort of step forward for me to marry research and clinical practice is to talk about air quality and sort of environmental drivers of disease risk when I also talk about things like exercise, healthy diet and social interaction, all of which are things we routinely counsel our patients about.
[00:26:53] Speaker B: That's a good point. So we've talked a number of times on the show about the community outreach and engagement efforts of the Penn Memory center and we do run through how to increase your social engagement and how to improve your diet and up your exercise. And we have not been putting out any information about tracking your environment or managing your home. So your recommendation would be we start looking at that and include it as part of our healthy brain aging recommendations.
[00:27:18] Speaker D: Yeah, and I think it extends beyond air pollution. I mean, it is projected that ambient temperature will become on average warmer, but also more variable, sort of in tandem with man made climate change. And I think that there is some role to sort of make sure that our patients are taking adequate protections when the weather is unseasonably warm or unseasonably cold. Because we know from the epidemiologic literature that older adults, and especially persons with either comorbid memory or psychiatric illness, are particularly susceptible to the health effects of the extremes of temperature. So I think that there is maybe sort of an opportunity here to think about how place more broadly, which includes the environment, affects health and what are the steps that our patients need to be taking to sort of ensure their protection from those factors.
[00:28:09] Speaker B: In Jake's reporting, Russell Zerbo talked about Philly's air quality and said it was, quote, not great. We were just talking beforehand that you were someone who grew up in center city, Philadelphia. You've left, you've been literally across the country and then came back.
How do you react to that as a prodigal child of Philadelphia?
[00:28:27] Speaker D: Yeah, you know, it's interesting. When I was living in Northern California during med school, I lived through some of the sort of most historic wildfire seasons. So there, there were periods of time where the air quality was much, much worse than it usually ever is in Philadelphia. And when I made the decision to come back east for residency, in the back of my mind I was thinking, oh, how great. I'm not going to have to live through any more sort of smoky days. And then January of 2023 rolled around and the air quality in Philadelphia was terrible because of Canadian wildfires. So, you know, not only do we live in a place where sort of at baseline there are somewhat higher levels of place pollution than maybe in our sort of sister cities, but also we are not sort of exempt from the potential exposure to poor air quality from wildfire events, which are becoming more frequent, more intense, and are happening in more sort of ectopic locations. So I think, you know, in addition to our higher than average levels of baseline pollution, we also have to think about what are the sort of exogenous factors that can make that way way worse in a very short period of time.
[00:29:30] Speaker B: Sure.
I think as a fellow prodigal son of Philadelphia. Although I only made it as far as central Pennsylvania before I came back, I think a lot of my perspective on this has been dedicated to more of the personal responsibility of it and particularly vehicle traffic and so on.
Big public transit apologists. We've heard a lot of love stories and horror stories about SEPTA over the years here, but you're talking a lot about the environment, not just an individual's adjustment. So what kind of recommendations are you making besides just monitoring the air quality? And if it's bad, what would you recommend either family members or patients are doing?
[00:30:11] Speaker D: Yeah, so if the air quality is poor, it's important to take sort of steps to modify behavior, particularly if you have comorbidities like cardiopulmonary disease, so heart or lung disease that can make you particularly vulnerable to the effects of the extremes of temperature or poor air quality. So for air pollution in particular, whenever possible, it's important to minimize time spent outdoors. So if you're a jogger, maybe don't go for a jog that day.
If you were making plans outside, maybe sort of move them indoors, keep the windows closed, have your air filter running, one of your three trusty air filters if you need to go outside.
N95 masks, which we all got to know very well during the COVID 19 pandemic, actually filter out 95% of fine particulate matter. So having an N95 mask for those days, if it's really hazy or the air quality is particularly poor, can be helpful if you need to go outside.
And like we were talking about earlier, you know, there can be, there can be very affordable solutions to in home air filtration that don't involve buying a really pricey air filter for your home. So using a box fan and sort of retrofitting it to make sure that your air gets a little bit cleaned up. And then I think the same can be said for temperature. So if it's very hot outside or very cold outside, try to minimize time spent outdoors. If you're living in a place that doesn't have air conditioning, knowing where the nearest public space that has air conditioning can be really helpful, like going to a shopping center or mall where there is going to be good, nice, robust indoor air conditioning can be a way to make sure that you're staying cool. But I think I always feel guilty when I make these recommendations that really require people to make personal behavior changes. Because really the most effective way to protect people and communities from the potential adverse health effects of the environment is to have sort of a stronger regulatory landscape. So I really think the best thing you can do is vote for local officials who are going to take the quality of your environment seriously. And in particularly, you can vote down ballot. So not just the sort of congressional candidates or the gubernatorial candidates. You want to make sure that you're thinking about your entire ballot and voting for people who are going to take your health and the quality of the place that you live seriously.
[00:32:29] Speaker B: Sure. Even on a township level, you can have township policies that will focus on the commercial improvements of air quality.
[00:32:38] Speaker D: Exactly.
[00:32:39] Speaker B: One of the things that I immediately took as an action I needed to take at my own home is not just worrying about getting a new air purifier, but just checking that the air filters are up to date. I think I'm overdue. When Jake and I first started talking at the intro of the episode, I had that moment of panic like, oh, no, I didn't do it at the start of spring. So not all these changes have to be high cost. It just needs to be an intentionality.
[00:33:01] Speaker D: Yep, I think that's exactly right.
[00:33:03] Speaker B: So I'm sure a lot of what Jake was reporting in this episode was not entirely new to you. Was there anything that did stand out?
[00:33:11] Speaker D: You know, it's always, I sort of knew that the air quality in Center City Philadelphia wasn't great, but to hear it sort of like defined in absolute terms, it always sort of strikes a chord. So that moment I had to sort of stop and reflect on. Certainly.
[00:33:28] Speaker A: Yeah.
[00:33:29] Speaker B: And you'll be wrapping up your time as a clinical fellow and you'll be joining us as faculty. Right. So congratulations on that. Thank you. And hopefully we can start working this into our communications and outreach efforts. Maybe we could work together on that.
[00:33:43] Speaker D: I think that would be great.
[00:33:44] Speaker B: Great. Thank you so much for joining me today, Holly.
[00:33:46] Speaker D: It was a pleasure to be here.
[00:33:51] Speaker B: Thanks for listening to this episode of the Age of Aging. A special thanks to today's guests, Dr. Eddie Lee, Dr. Trevor Penning, Bev Stewart, and Russell Zerbo.
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[email protected] the Age of Aging is a Penn Memory center production made possible by the generous support of the Michael Nadoff Communications Hub Fund and Lena Chow and our sponsors, Rothkopf Law Group and the Salvation Army Philadelphia Croc Center. Our team includes Morgan Adams, Dahlia El Said, Jason Karlowish, Emily Largent, and Allison Lynn. I'm your host, Terrence Casey, joined today by my co host Jake Johnson and guest host Holly Else.
