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so a year ago there was a study so weamp;#39;ve known for a long time probably at best half of the cases the people who with Alzheimeramp;#39;s disease or related disorder are actually diagnosed and there was a study about a year ago that said when doctors actually billed Medicare for Alzheimeramp;#39;s treatment over half of those cases they do not share the diagnosis with the patient of family you do this professionally done it for a long time why do you think thatamp;#39;s so far why are those numbers so I think thereamp;#39;s two reasons first is that the level of confidence of the primary care provider is not as strong as it is for those of us who do diagnosis and treatment on regular basis so theyamp;#39;re not so certain in a second of course is that the diagnosis carries with it I thought Iamp;#39;d say that this is you know this is like a brain cancer right itamp;#39;s not a good and abusive and people are fearful of that and the easiest thing that I hear over and over