Resilience and Behavior Change with Dr. Reza Ghomi

An interview with Reza Ghomi, MD, on high impact behaviors post-diagnosis, and how families can stay resilient to do the things that they want to do.

Welcome to this special edition of the Simon Cares newsletter!

Daniel Brown, CEO and Founder of Simon, recently sat down with Dr. Reza Hosseini Ghomi, a neuropsychiatrist who bridges the gap between clinical care and engineering to improve the lives of those living with neurodegenerative disorders. Reza provides actionable, early-intervention strategies to help families navigate a dementia diagnosis with resilience and clarity.

Moving Past Anxiety: Focusing on Quality of Life

Daniel Brown (DB): Reza, thank you for sitting down with Simon today. I’m a huge fan of your work and we’ve been following your advice online for a while now. Lucky to have you here. Before we jump in to who you are and what you do, let’s get straight to some serious stuff:

When families are overwhelmed by a recent diagnosis, how do you help them move past that anxiety and focus on their quality of life? Are there small wins they can focus on?

Reza Hosseini Ghomi (RHG): I will ask, "What is it that you're no longer doing that you used to do that brought you joy?" When you dig, especially when it's cognitive related, you'll almost always find that something to do with something straightforward, whether it was hearing or just tracking information that made them withdraw.

Then I focus on small wins. If I get them on a CPAP or a hearing aid where they immediately will feel a difference, that is reinforcing. A significant win is organizing caregiver support paid for by insurance, which universally reduces family stress levels. I also try to use what's important for the patient as an anchor. Almost always it's important for them to keep driving, so I'll say, "If we work together on this I suspect you might still be able to drive a year, two years, three years longer than if you don't." We focus on the fact that there are so many things we can do that are going to drastically improve your lifestyle.

Background: Improving Longevity and Independence

DB: Incredible advice. Thank you. Now, how did you get into this work? Tell us a bit about who you are:

RHG: For me, the common thread has always been healthcare improvement. I really just fell in love with the field of dementia and neurodegeneration. I wanted to be able to treat patients at the same place, rather than passing them on. I never liked being in clinic and saying to a patient, oh, you know, you have Parkinson's disease and now you're at the point of the process where you're getting dementia, so you have to go to a different provider. All of my work is in service of how do you increase longevity in terms of quality of life years and independence, and how do you reduce the symptom burden of neurodegenerative diseases.

Proactive Care: Moving Earlier in the Timeline

DB: You've talked a lot about delivering care "in the way that it needs to be" and intervening earlier. What does that mean practically for a patient?

RHG: We know that if we do certain things with diet, exercise, sensory loss, caregiver support, and sleep, we have a massive impact. But with the health care system, we're very reactive. We shouldn't be treating dementia like an emergency waiting to happen.

Practically, it means moving earlier in the timeline. We now have the tools to detect illness earlier, like simple blood tests that measure the tau protein, which will show levels changing many years before you come to me as a patient saying your memory is going away. While it's a delicate balance, telling someone they have this marker increasing can be very motivating to say, "Oh, shoot. I need to do something right now.”

High-Impact Recommendations: Engagement and Purpose

DB: What are some of your favorite, high-impact recommendations for people recently diagnosed to keep them doing the things they want to do?

RHG: I love sending patients to dance lessons or dance practice. It's a very high yield activity because you're getting physical, mental, you're getting all kinds of stimulation and social stimulation. For Parkinson's, I love the Rock Steady Gym Network, which is basically boxing classes.

Another big one is that I will prescribe them volunteer work. It could be a 30-minute thing, or helping a church, but you have to have responsibility and show up to something every day. When people let that go, the cognitive decline will really speed up. You've got to feel a sense of accomplishment and a sense of belonging.

When you dig in, and it’s cognitive related, it’s often hearing or vision or something that makes tracking difficult, or making that activity difficult. So I try to do what I can to get that back for them. It’s rare that people say “I used to go skydiving every day”, normally I can find a way to get people back to that.

Equine therapy, water therapy, getting people grounded more quickly. Traditional psychotherapy isn’t always the best approach. Sometimes it’s in person, a faith based organization, some more movement. It’s really about finding more than one thing to address, community, exercise, stimulation. It can be hard, but it can also provide a sense of accomplishment. Giving people a purpose.

It’s one of those things where, particularly in America, retirement is an active transition. People don’t want to just stop working. I prescribe volunteer work, send people to places, greeters at Walmart, but getting people to show up to something every day gives people responsibility. As humans, we’re much more resilient than it sounds with these diseases.

Behavior Change and Building Trust

DB: Resilience is one thing, change is another. How do you get people to change behavior?

RHG: A lot of it comes down to knowing someone. I have some patients who want all the gadgets, they want all the data, they’ll adopt a new tool immediately. Then there are many more who have a justifiable degree of skepticism. They may need more trust first. So it is about building that relationship and figuring out “how do I get them to do the thing they need to do.”

For real change I try to focus on the positive side, I have tons of cases of people changing behavior. I always use this example of the 70’s where no one wanted to talk about a cancer diagnosis. And that has changed massively. Cancer has tons of resources, people want to fight it together. If you go to a dementia clinic, it’s in a corner in a basement if it exists at all. But that’s now changing.

So I try to set up little wins first. The little wins along the way, like a CPAP or a hearing aid will allow them to immediately see benefits, rather than wait and wait.

The Characteristics of Resilience

DB: What are some of the other characteristics you see in helping people stay resilient?

RHG: I often take a gendered view here. Women tend to do better with the disease and I think that with age they stay more social, they move more, they invite more help. The men I know doing okay, they bring the community in around them, they allow for help.

But also people who have the type of personality where they have the ability to move on, to take action, instead of giving up. Making adjustments is necessary. We’ve all been there, but giving up isn’t right, the mentality to accept that things have changed but you can still do things, it works. I’m a big fan of helping people stay strong, get muscle on the body, and be healthier.

Diet, Exercise, and Practical Action

DB: And what are some of the best ways you see people doing that?

RHG: Dietary changes, resistance training, the classics. But I like to go into the weeds, see what people are eating. There tends to be way too many refined carbs, no one is ever eating as much protein as they should, and then a lot of unhealthy fats.

But the average medical provider, they aren’t trained on this. I’ve done this on my own, cooking classes, professional certificates, nutrition conferences. I don’t want to just talk about disease or biology i want to give clear actions people can take in their every day life.

Immediate Impact through Science and Data

DB: You really focus on immediate impact, that’s something that is difficult to do and I don’t hear often. Tell us more about the how and why.

RHG: The public is sick of waiting. 30 years of developing Alzheimer’s drugs, people lose patience. I want to show real results to my patients quickly.

How we use data, how we use science, that’s evolved over time. There’s a big shift happening in how the public perceives science, and their access to science. But behind that, we as scientists have to be better at communicating science and engineering, and that means showing real results.

In the past I’ve done remote cognitive testing, using voice, and getting quality of care equally across populations. The new tools are about both more immediate results, and expanding access, making it equitable. Those are real ways to get people to trust medicine and science and to change behavior.

Community and Peer Support

DB: Wrapping up here Reza, a few big questions for you. How do you make people feel not alone?

RHG: It’s a big question. I will really push people to start going to some of these groups. It’s sort of like the addiction world, AA has been a great success, the community really helps. We all need it.

As humans, when we’re going through something, you can have your family, but the camaraderie of people going through the same thing is different, it can be so helpful for an individual. Plenty of patients won’t go, they’re hesitant, and it’s understandable, new social groups are hard. But sometimes you gotta just shop around. If you don’t like one group, that’s okay, move on and try another. That peer support can be essential.

The "Gift" of a Diagnosis: Clarity over Confusion

DB: You've previously mentioned that getting a diagnosis can actually be a "gift." That can be hard for some to understand. Why is that diagnosis so important?

RHG: Replacing confusion with clarity is a big thing. Patients often have been through years or months of uncertainty. Getting a diagnosis can drastically improve a family's dynamic. Families stop blaming the person, saying "why aren't you listening?", and realize, "oh my god, this is different." It also opens the doors to all kinds of support. It gets caregiver support paid for, it triggers insurances to kick in, and helps get legal and financial planning figured out, which prevents a lot of pain down the road.

Final Advice: Starting the Response

DB: To wrap up, what final piece of advice would you give to someone who has just been diagnosed?

RHG: I would say, the diagnosis doesn't start the disease, it starts the response. Keep in mind whatever is going on has been going on for a long time. But now, the sooner we intervene, the more control you get, the more independence. We're going to be working towards the same goal.

DB: Thank you so much, Reza, for sitting down with us and sharing your expertise and perspective.

Readers can always respond with questions, comments, or feedback, or if you have a story you’d like to share, we are always open to work with our community at Simon.

Daniel Brown CEO and Founder of Simon

Reza Hosseini Ghomi, MD, MSE is a neuropsychiatrist and healthcare entrepreneur working at the intersection of clinical medicine, technology, and care system design. He trained at the University of Massachusetts Medical School, completed his psychiatry residency and neurology fellowship (movement disorders and behavioral neurology) at the University of Washington, and holds a master's in biomedical and electrical engineering from Johns Hopkins University.

Dr. Ghomi is currently CEO at MedFlow, a healthcare workflow automation company, and maintains an active clinical practice focused on neurodegenerative disorders. He previously founded Frontier Psychiatry, scaling it to 75 staff and 5,000 patient visits per month serving largely rural and underserved populations.

He holds a faculty appointment in the Department of Neurology at the University of Washington and has published over 35 peer-reviewed papers on topics including digital biomarkers, voice-based disease detection, cognitive assessment, and dementia care. He has delivered grand rounds and invited talks at Mass General Hospital, Brigham and Women's, Harvard CME, and multiple national conferences.

Website: rezahg.com | LinkedIn: linkedin.com/in/rezahg

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