California’s aging population is placing growing pressure on families, caregivers, and a long-term care system already struggling to meet demand. In some cases, families face care costs of up to $20,000 per month, often after years of supporting a loved one through progressive cognitive and physical decline.
In a new interview with California Insider hosted by Siyamak Khorrami, Dayan Goodenowe, PhD, discusses the human and economic consequences of dementia and explains why the conversation must begin long before a family reaches a crisis.
“Dementia doesn’t just steal your life. It actually steals your death.”
Rethinking Dementia as a Loss of Function
A central theme of the conversation is the need to distinguish dementia, the loss of cognitive function, from the various pathologies that may accompany it.
Rather than asking only which disease a person has, Dr. Goodenowe encourages families and health professionals to ask a more fundamental question: What biological functions have been lost, and what does the body need to support their restoration?
This shifts the focus from waiting for symptoms to appear to identifying biochemical changes that may occur years earlier. Dr. Goodenowe describes this period as the prodrome: a measurable deviation from health that precedes overt disease.
He also discusses his research into plasmalogens, specialized lipids that are important components of brain cell membranes. His work has explored the relationship between declining plasmalogen levels, brain aging, and cognitive health, and how biochemical testing may help identify changes before they become a crisis.
The Four M’s of Maintaining Health
During the interview, Dr. Goodenowe introduces four foundational areas he believes are essential to preserving health and resilience throughout life:
- Membranes: Supporting the structural integrity and communication of cells, including through plasmalogens and phosphocholines.
- Mitochondria: Maintaining the cellular systems responsible for producing the energy the brain and body need to function.
- Methyltransferase: Supporting biochemical pathways involved in cell membranes, muscle energy, neurotransmission, and other essential processes.
- Muscles: Preserving strength, mobility, metabolic capacity, and the physical independence needed for a full life.
Together, these “four M’s” offer a practical framework for thinking about aging, not simply as the passage of time, but as a process influenced by cellular structure, energy production, nutrition, activity, and adaptability.
Why Purpose and Community Matter
Biochemistry is only part of the picture.
Dr. Goodenowe emphasizes that people also need connection, stimulation, love, and a reason to participate in life. Older adults should not be viewed merely as recipients of care. They possess decades of knowledge and experience that can continue to benefit their families and communities.
The conversation stresses the importance of helping people remain active, challenged, and engaged. Just as muscles require use to maintain strength, the brain benefits from meaningful activity and an environment that encourages participation.
This philosophy is reflected in Dr. Goodenowe’s community work in Moose Jaw, Saskatchewan, where programs bring older adults together for meals, activities, and social connection. He also discusses plans to expand aspects of this restorative health model in Temecula, California.
From Managing Decline to Measuring Health
Modern medicine is exceptionally effective at responding to acute illness and injury. However, as Dr. Goodenowe explains, it was not originally designed around the long-term biological challenges created by extended lifespans.
For dementia, diabetes, cardiovascular disease, and other age-associated conditions, waiting for symptoms may mean waiting until substantial function has already been lost.
A restorative approach begins earlier. It seeks to measure health, identify biochemical deficiencies, build physical and cognitive reserve, and create the conditions in which the body can perform the work it was designed to do.
The result is a different vision for longevity, one that is not simply about adding years to life, but preserving the health, independence, relationships, and purpose that make those years meaningful.
Watch the Full Interview
This candid conversation explores dementia, caregiving, long-term care costs, plasmalogen science, proactive health, community programs, and the deeper importance of recognizing the preciousness of every life.
Watch “California’s Aging Wave Is Testing Its Care System“ on California Insider.
The information in this article is provided for educational purposes only and reflects the views expressed by Dayan Goodenowe, PhD, during the interview. It is not intended as medical advice. These statements have not been evaluated by the U.S. Food and Drug Administration or Health Canada and are not intended to diagnose, treat, cure, or prevent any disease. Dr. Goodenowe holds a PhD and is not a medical doctor. Always consult a qualified health professional before making changes to your diet, supplement, or wellness routine.