The Critical Decades: How Daily Habits in Midlife Can Actively Delay Cognitive Decline

Summary

Podcast Summary: The Dan Buettner Podcast

Episode: The Critical Decades: How Daily Habits in Midlife Can Actively Delay Cognitive Decline
Host: Dan Buettner
Guests: Dr. Dean Sherzai & Dr. Aisha Sherzai
Date: July 16, 2026

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Episode Overview

This episode dives deep into cognitive health, focusing on prevention of dementia through lifestyle changes—especially during midlife. Dan Buettner interviews renowned neurologists Drs. Dean and Aisha Sherzai, who share actionable strategies, discuss misconceptions, and provide an optimistic, science-backed perspective on delaying or preventing cognitive decline. The conversation flows from diagnosis and risk factors to everyday tips on diet, exercise, sleep, stress, and social engagement, punctuated with personal stories and practical examples.

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Key Discussion Points & Insights

1. When Does Dementia Start, and How Preventable Is It?

• Early Onset of Damage
  • Cognitive decline begins decades before symptoms:

    “The damage starts earlier. We have evidence that it starts 20 to 30 years before the first signs of dementia ever appear.”
    —Dean Sherzai [00:34]

• Empowering Prevention
  • About 60% of dementias are preventable:

    “Up to 60 north of 60% of dementias can be prevented.”
    —Aisha Sherzai [00:43]

• Misconceptions About Genes
  • Most dementia is influenced more by environment than genetics:

    “Genes play a role, but they're not the dominant determinant. Only 3% of Alzheimer's is 100% penetrant … The rest is an interplay between genes and environment. And guess what? The environment is the dominant factor.”
    —Dean Sherzai [03:12]

2. Early Detection and Testing

• Blood biomarkers can now detect seeds of dementia (amyloid and tau) decades before symptoms, but mainstream early testing is rare and mostly used for high-risk or symptomatic individuals. [02:31]

3. Symptoms and When to Seek Help

• Common forgetfulness (losing keys, forgetting why you went to the kitchen) is not necessarily a red flag.
• Concerning signs:
  • Repeatedly forgetting close family member names.
  • Difficulty with familiar tasks or routes.
  • Noticed behavioral changes by others.

  “If family members notice that there's a pattern... where you're forgetting more often than you used to... Those are things that shouldn't worry you, but should mobilize you to go and see a neurologist.”
  —Dean Sherzai [09:39]

4. Diagnosis & Brain Health Basics

• Diagnosis involves history-taking, blood work (checking for reversible conditions), cognitive testing, and brain imaging.
• Types of Dementia:
  • Alzheimer’s (most common), vascular, frontotemporal (often genetic), Lewy Body, Huntington’s, etc.
  • Brain atrophy patterns differ by type.

    “In Alzheimer's dementia, you have the parietal lobe, the temporal lobe, and the hippocampi... In vascular dementia, you tend to see damage of the subcortical areas.”
    —Aisha Sherzai [13:09]

5. The Value of Age and Accumulated Experience

• Older adults have more robust mental scaffolding, giving them broader contextual and emotional understanding:

  “A 70 year old can see anything in a context that's way vaster... the act of living has created a scaffolding that gives you a better perspective.”
  —Dean Sherzai [19:30]

6. NEURO+ Framework for Preventing Cognitive Decline

• Nutrition
• Exercise
• Unwind (Stress management)
• Restorative sleep
• Optimize mental/social activity
• Plus: Watch blood pressure, cholesterol, and diabetes risk. [25:29]

Nutrition [25:54–32:45]

• Predominantly or exclusively plant-based diets are best: vegetables, leafy greens, legumes/beans, whole grains, nuts, seeds, olive oil.
• Reduce: red meat, saturated fats, and ultra-processed foods.

  “Every degree of increase in red meat consumption could potentially increase the risk of Alzheimer’s disease and dementia... In the mind dietary pattern, reducing meat consumption to maybe two servings per week is beneficial.”
  —Aisha Sherzai [27:34]

• Fish (especially fatty fish) up to 2x/week may be protective, but omega-3s can be sourced from algae, flaxseed, chia.
• All amino acids are available from plants; “there’s nothing in meat that you couldn’t get from plant sources.”
• Added sugars and excess salt are concerning; focus more on adding “good” foods than strictly cutting things out.

Exercise [36:45–39:41]

• Daily activity—even five minutes—helps.

  “Studies show that a 25 minute brisk walk, so start with five minutes and work your way to 25 minutes, consistently reduces your chance of Alzheimer’s by 45%.”
  —Dean Sherzai [37:53]

• Optimal: 300 minutes of aerobic exercise per week. Doesn’t need to be intense—gardening, stair climbing, etc. count.
• Strengthening (especially leg muscles) increases brain growth factors (BDNF).

Sleep [40:31–44:18]

• Seven to eight hours per night, with good “sleep hygiene.”
• Deep sleep is critical: it’s when the brain does its “janitorial work,” clearing toxins like amyloid proteins.
• REM sleep consolidates memory.

  “The best detox we have is sleep.”
  —Aisha Sherzai [44:16]

Mental & Social Engagement (Optimize Cognitive Activity)[44:45–49:07]

• The brain craves challenge—purposeful, complex, and changing activities: learning music, languages, dancing, writing, playing games.
• Consistency and enjoyment are key, not just difficulty.

  “The activity should make you want to do it more. The activity should be complex, meaning it's involving multiple domains of your brain. And the activity should change and push you more.”
  —Dean Sherzai [46:36]

Stress Management

• Some stress is “good,” especially if tied to purpose and growth.
• Chronic negative stress is harmful.
• Social connections reduce stress and support cognitive health.

7. Treating Mild Cognitive Impairment & Full-Blown Dementia

• Mild impairment: Major focus on aggressive management of risk factors and lifestyle.

  “They are at a very important stage in their life where they can slow down the progression, maybe perhaps even reverse some of the damage that has already been done…”
  —Aisha Sherzai [49:25]

• Full dementia: Quality of life and reduction of anxiety are paramount; lifestyle overhaul is often not realistic.

  “Instituting a completely different lifestyle ... could itself be incredibly difficult, taxing, almost torture... more important is making sure that where this person is, they are living a vibrant life.”
  —Dean Sherzai [57:21]

  • Music and cherished activities can surface memories and bring joy, even late in the disease.

  “You play that music in the background and you see them waking up and then you see them singing the words where they haven't spoken for months. They're there, they're there. Our job is to make sure that that joy comes to the surface.”
  —Dean Sherzai [60:13]

8. Social and Environmental Factors

• Disparities in dementia rates between ethnic groups often reflect differences in access to resources (not genetics). [56:43]
• Remedies include better access to healthy food, safe spaces for activity, healthcare, and information. [40:08]

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Notable Quotes & Memorable Moments

• On hope and prevention:

  "That's not a disempowering statement. That's an empowering statement. Because if you know that what you do at any point in your life can build your brain or break your brain, then you have the power to build the brain."
  —Dean Sherzai [01:36]

• On the myth of reversal:

  "Alzheimer's, when it's fulminant Alzheimer's, cannot be reversed … There's no evidence of that. And it's not real. And it's dangerous because you're playing with people's hopes..."
  —Dean Sherzai [05:54]

• On public health vs. medicine:

  “The idea that 80% of it was just treatment and less than 20% was prevention didn’t make any sense. We wanted it to be the other way around.”
  —Aisha Sherzai [35:44]

• On small daily actions:

  “A walk and some squats. Free. And sleep. A good sleep … Free.”
  —Dean Sherzai [44:24]

• On lifelong self-improvement:

  "As you get older, if you could avoid the pathology, your brain gets better. That's what we're doing."
  —Dean Sherzai [52:07]

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Timestamps for Key Segments

• Dementia onset & prevention statistics: [00:34]–[04:52]
• Genetics vs. lifestyle discussion: [03:12]–[04:32]
• Early symptoms & when to see a doctor: [07:59]–[09:39]
• Types of dementia & diagnosis approach: [10:15]–[14:03]
• Value of aging and brain ‘scaffolding’: [17:38]–[19:30]
• NEURO+ introduction: [25:29]
• Nutrition specifics (meat, fish, beans): [25:54]–[32:45]
• Exercise recommendations: [36:45]–[39:41]
• Restorative sleep & sleep’s function: [40:31]–[44:18]
• Mental/social engagement: [44:45]–[49:07]
• Hearing, sensory issues, and cognitive health: [50:31]–[51:48]
• Disparities in dementia rates: [56:43]
• Approaching advanced dementia in loved ones: [57:02]–[60:13]

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Practical Takeaways (“Top 5” for Brain Health)

1. Eat mostly plants: Vegetables, leafy greens, beans, whole grains, nuts, minimal processed food, occasional fatty fish optional.
2. Move daily: Even short walks matter; aim for at least 25 minutes brisk walking or total 300 minutes per week.
3. Get good sleep: Prioritize 7-8 hours/night, practice sleep hygiene, avoid substances that disrupt deep sleep.
4. Keep your mind challenged: Learn new things, pursue hobbies, and engage socially.
5. Manage stress and health factors: Find meaningful purpose, control blood pressure, cholesterol, and blood sugar.

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How to Follow the Sherzais

• Social Media:
  • Instagram: @thebraindocs
• Website:
  • thebraindocs.com
• Community program:
  • inspireprogram.org
• Podcast:
  • "Your Brain On"

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Tone & Style

The conversation is warm, optimistic, and actionable, with frequent bursts of humor and humility from the Sherzais. Scientific information is communicated without jargon, and advice is consistently grounded in both the literature and their clinical experience.

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In Summary

This episode is a comprehensive guide for anyone interested in proactively delaying cognitive decline. By making small, sustainable changes in daily habits—especially during midlife—you can dramatically reduce your risk for dementia and enjoy a richer, more connected life well into old age. The Sherzais’ message: it's never too early (or too late) to start, and the most powerful tools are free, accessible, and already within your reach.

Transcript

[Dean Sherzai]

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[Dean Sherzai]

The damage starts earlier. We have evidence that it starts 20 to 30 years before the first signs of dementia ever appear.

[Aisha Sherzai]

Up to 60 north of 60% of dementias can be prevented.

[Dan Buettner]

What do you do?

[Dean Sherzai]

There's a lot to do. Not necessarily reversing the disease, but the person is living a beautiful life. There's a lot to do.

[Dan Buettner]

Hi, you guys.

[Aisha Sherzai]

Hi, Dan.

[Dean Sherzai]

How are you doing?

[Dan Buettner]

So, you know, living to 100 isn't much good unless you have a brain to enjoy it. And when people ask me who I think the top brain docs are in America, if not the world, I always point to YouTube. Dean and Aisha Sharezai. We've been friends for better than a decade, and you've really taught me that so much of dementia is preventable. I think so many people think, I got the gene, I'm gonna get it. There's nothing I can do about it. But I would ask you, when it comes to dementia, what do most people get wrong?

[Dean Sherzai]

What they get wrong is that they think that dementia started the moment they started forgetting. Dementia doesn't start there. It starts decades earlier. And that's not a disempowering statement. That's an empowering statement. Because if you know that what you do at any point in your life can build your brain or break your brain, then you have the power to build the brain. And by the way, the brain is incredibly resilient. So that point is critical that people don't say, oh, I'm fine, I can do whatever I want. I can have head traumas, I can have nights without sleep. I can just eat anything. Yes, you can. Your brain is resilient, your body's resilient, but the damage starts earlier. Now we know we have evidence that it starts 20 to 30 years before the first signs of dementia ever appear.

[Dan Buettner]

Is there any way to detect that? Dementia as it's first occurring?

[Dean Sherzai]

We now can. Not so much dementia, but the seeds for dementia. Seeds of dementia. Yes. There was a time that you had to do lumbar puncture, which Means this needle that goes into the spine draws the fluid. Now, you can do that through blood now. So you can draw the blood, look at the blood, and look for evidence of the beginnings of that dementia, such as amyloid and tau, these two proteins that are very strongly associated with specifically Alzheimer's dementia.

[Dan Buettner]

So if I'm 30 years old and maybe I don't have the best lifestyle, and I want to see if the dementia is growing in my brain or it's starting anyway, what do I ask my doctor for? What test do I ask for?

[Dean Sherzai]

If you're 30 years old, the doctor's not gonna do much. There are no protocols out there. So what you will do is ask them for, is there any evidence or any risks of developing dementia? So one of the risks that you probably have to pay out of pocket, but is looking at your genetics. Now, this is interesting because everything in us is genetic in some way or another, even behavior. We know that how people traveled throughout history had to do with certain genes. But genes are not absolute. They're very rarely absolute. What I mean by absolute is what they call 100% penetrance, means that if you have this gene, you're going to get the disease. There are diseases like that. There are genes like that for Huntington's disease. If they have this gene on chromosome 4, it's a sad story. They know they're gonna get the disease, a horrible disease, in their 30s and early 40s. But for many of the other chronic diseases, including Alzheimer's and vascular dementia and others, genes play a role, but they're not the dominant determinant. Only 3% of Alzheimer's is 100% penetrant, meaning that if you have these three genes, you will get the disease. But that's only 3% of Alzheimer's. The rest is an interplay between genes and environment. And guess what? The environment is the dominant factor.

[Dan Buettner]

There it is. I always turn to you for the hard science. And when it comes to the hard science, what does science tell us now about how preventable dementia is? Of all the factors of determining whether or not we get dementia, what percentage of it is in our control?

[Aisha Sherzai]

So the numbers are wonderful. They're very empowering. Different series have shown different numbers, but the ones that stand out have shown us that up to 60 north of 60% of dementias can be prevented. Obviously, there are multiple different factors that come into play. Vascular risk factors like blood pressure, cholesterol, diabetes or pre diabetes, even insulin resistance. But we can control it mostly absolutely. And then lifestyle, including diet and exercise and Stress management. All of this play a major role in prevention of dementia. And, you know, when you look at the interventions that were tested in these research programs, they're kind of the same thing. But we believe in our work, in our community and in our research that if they're actually done better and if the adherence is higher, people can actually do better than just 60%. So it's really empowering to see that number.

[Dean Sherzai]

We're a little rigid about the science. Two things that we want to make sure that people get out of this. We've done this for 20 years. In fact, our first conversation, 8,000 miles away in Afghanistan, where I went back with the World bank and our forces in 2002, and she had gone with Doctors Without Borders, was around our grandparents dying from Alzheimer's, two on her side and two on my side, and it was devastating. Her grandfather was a prime minister, trained in Columbia University, surgeon and then Johns Hopkins, and seeing him lose bits of himself. And my grandfather was Secretary of Education, brilliant poet, philosopher. And while sitting in our house in, well, the family gathering place in Virginia, there's a farm that we gathered from different cities. And this brilliant man all of a sudden didn't know how to move a piece, a chess piece. The night everybody recognized what was happening, it was the most shocking moment. Our first conversation was about that. And for the last 22 years now, we've been focused. It's been about this. And that's why we're very adamant about people not betraying the sufferers of this disease. Those that are experiencing, the families, 7 million in America, suffer from this. The one very important thing at a time like this is to say that Alzheimer's, when it's fulminant Alzheimer's, cannot be reversed. I know people are saying this. Even people who claim to be scientists are making papers in public. There is no evidence of that. And it's not real. And it's dangerous because you're playing with people's hopes, people's dreams, and also changing their pathway and journey that they should have, instead of going for the next lifestyle, the next pill, the next vitamin, and that's important. But here's the incredible fact. Short of Alzheimer's, short of dementia, which is a lot of people, including at the pre Alzheimer's stage, mild cognitive impairment stage, and that's tens of millions of people, they can prevent or slow the disease down significantly. And that's what we should focus on. We're talking about tens of millions of people.

[Dan Buettner]

So what is the first sign that I might notice that Would trigger I need to do something.

[Dean Sherzai]

Forgetting your keys or no, no, we all forget. I forgot the keys.

[Aisha Sherzai]

We would do no.

[Dean Sherzai]

Or when you go to the kitchen and you forgot what you were trying to do, that happens. And that happens more when you're older. Not because necessarily because you have memory issues, it's because there are many more distractors. Focus is the gatekeeper and currency of memory. Focus is the gatekeeper and currency of consciousness. So if focus is affected, memory is not gonna work. And of course an 18 year old has focus on a couple of things, right? If it's a boy, we know what that's about. But when you're 50 years old or 40 years old, it's the pain in the knee, it's the work, it's the job, it's the in laws, it's the mother, it's the father, all these subconscious things that affect memory and focus. So no, forgetting what you were doing, getting to the kitchen is not a thing.

[Dan Buettner]

I'll bet you. Social media and our handheld devices are eroding our focus as well.

[Dean Sherzai]

And their profoundly, in fact, their job is to affect your focus so that then you are at a lower state of emotion so that then you can be plugged. That's a different subject that we will talk about. But the reality is to start mobilizing resources is now, even if you don't have any symptoms, because at any stage in your life, if you take the right steps, which we'll talk about, you'll significantly reduce your risk. But if this happens, then you should definitely start seeing a neurologist and others, which is if you start forgetting closer family members on a repeated basis.

[Dan Buettner]

Their name.

[Dean Sherzai]

Their names, yes, Paul. Oh yeah. Or if family members notice that there's a pattern that's different from the past, where you're losing, you're forgetting more often than you used to. If you're going to the same place over and over again, driving there, but now you're having a little bit trepidation on a more common basis, on more regular basis. Those are things that shouldn't worry you, but should mobilize you to go and see a neurologist. And that's a good place to start.

[Dan Buettner]

And okay, let's just say that I go to a neurologist. Obviously dementia is creeping in. What can they do?

[Aisha Sherzai]

So there are specific guidelines. You know, when someone goes to a

[Dan Buettner]

neurologist, just to be clear, this is what you do, this is your Monday job, right? Yeah.

[Aisha Sherzai]

Yes, it is actually a Monday job. And so when a patient comes in and they're complaining of things like, I forget, you know, so many friends names, or I am repeating my questions. It's typically not the person themselves. It's always a loved one or a proxy bringing them in to get checked. And the story is they're not themselves anymore. They lose their way driving back home, for example, or they're asking the same question over and over again. Or, for example, some of the things that were very easy for them are not easy anymore. They're struggling with tasks that come. That would come very easily for them. And so a lot, a majority of our work is actually listening and getting a good history. The history helps us understand the pattern of the disease because dementia is an umbrella category, right? There's Alzheimer's dementia, which is about 60 to 70% of all dementias, is the most common one. As a matter of fact, Alzheimer's and dementia sometimes is used synonymously because it's a good representation of that disease. Then you have vascular dementia, which is as a result of damage to the arteries in the brain because of vascular risk factors like little strokes or something. Little strokes, minor little strokes, white matter disease. And then you have frontotemporal lobe dementia that manifests as personality changes.

[Dan Buettner]

What causes that?

[Aisha Sherzai]

So that is a degeneration of the part of the brain that is mostly responsible for making decisions and personality, and

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it just auto decides to degenerate, or it's mostly.

[Aisha Sherzai]

So most of the frontotemporal lobes have a very strong genetic background to them, and we are not very sure. At least we don't have the data to show how much of lifestyle impacts it. And then there are some smaller ones like Huntington's dementia, Lewy Body dementia, et cetera, et cetera. And then comes laboratory tests. We check their cholesterol and blood sugar and thyroid hormone, B12, other vitamins and minerals that could potentially be related to a reversible type of dementia. Then we send them to a neuropsychologist who's a person who does memory testing with them. Now, with technology, you can do it on an iPad, on a computer as well. But. But there's also a person who sits down with them and does an extensive memory test. And then we do neuroimaging, which is either a CT scan or an mri. And there are different variations or sequences of MRI that we do to look at volumetrics. What's the size of the temporal lobe? What's the size of the frontal lobe? How do the, you know, the occipital lobes look like? What is the hippocampus which is part

[Dan Buettner]

of the brain, tell us what a brain suffering from dementia looks like. I know there's probably a couple variations here, but what does a brain suffering from Alzheimer's look like compared to a brain suffering from vascular dementia look like?

[Aisha Sherzai]

So, generally speaking, because there are some situations where the brain actually looks just fine and a person has dementia, and Dean's gonna talk about what actually causes that later. Typically there is shrinking or atrophy of specific areas of the brain proportional to others. In Alzheimer's dementia, you have the parietal lobe, the temporal lobe, and the hippocampi, which are tiny little parts of the brain responsible for memory shrinks and atrophies. In vascular dementia, you tend to see damage of the subcortical areas, which are supplied by very, very tiny blood vessels. And when they collapse on themselves and they die, oxygen and nutrients don't go in there, so you get to see small little spots. And there's a general shrinking of the brain. So different patterns actually tell you different things. And then the Parkinson's dementia shows another pattern. Lewy Body shows another pattern. Frontotemporal lobe shows another pattern.

[Dean Sherzai]

And the name of the frontotemporal lobe is in itself, Frontal lobe is shrunken. And you can see it distinctly for. And then temporal lobe. And the reason for these are a little different.

[Dan Buettner]

For the audience, though, you mostly do brain research as opposed to treating patients.

[Dean Sherzai]

I do patients as well. I treat patients as well. But now I've moved much more towards research.

[Dan Buettner]

Yeah. So you guys are married?

[Aisha Sherzai]

Yes.

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Are we?

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Yes.

[Aisha Sherzai]

22 years old.

[Dean Sherzai]

22 years, yes. Yes.

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Just interstitially, did you guys get together over the brain?

[Dean Sherzai]

We did. We did, yes.

[Aisha Sherzai]

So, yeah, Our first conversation was about the brain. It was about our grandparents.

[Dean Sherzai]

We were sitting in Afghanistan, 2003. You know, military everywhere. We were with the expats. The expats in a war zone. And you get really isolated and insulated, and you get gathered together with all these people from Norway and Sweden and everybody and the Americans. And I was sitting there talking with a bunch of people. I was actually with the Ministry of Health and World bank, and I was talking with somebody, and then I saw this young lady pick up a chair and sit next to me, and that's my story. And she knew me, and I knew a little bit about her as well.

[Aisha Sherzai]

So he was amazing. So he was here from. He had just gotten out of nih, and he was with World bank, and he was doing amazing work. He actually created one of the most successful women's empowerment program in the country and he trained 20,000 midwives. And so it was incredible. We all heard about him. And I found an opportunity and I grabbed one of those dinky folding chairs, sat next to him. I was like, dean, I admire you so much. When I get to where you are, I want to be just like you. I said that to him.

[Dean Sherzai]

I took that as a. I was not hitting a beard.

[Dan Buettner]

Maybe not the beard, but you didn't

[Dean Sherzai]

have a beard back then.

[Aisha Sherzai]

But, you know, then we sat down and we talked about our grandparents and we realized they were very good friends. And my grandfather died of Alzheimer's disease and dementia. And we talked about how painful it was to see these incredible human beings who were changing healthcare systems. And they were incredibly smart and their words were just. You know, we would write them down in our diaries and we had pictures of them everywhere to see them get to a point in their dementia journey where they couldn't recognize us, they couldn't recognize their children, they would get scared of a random person walking by, they couldn't eat. And when you see something like that, it stays with you. So I wanted to go into neuroscience because of my grandfather and Dean wanted to go into neurology because of his grandfather. So we bonded on that.

[Dean Sherzai]

In fact, I'll send you a picture of her grandfather with Kennedy. So he had come here and Kennedy had. There's a picture of them together. And then my grandfather had done amazing stuff and the weight of that was amazing because it's not that they had done great things. Every human being has lived beautiful lives.

[Aisha Sherzai]

True.

[Dean Sherzai]

Every human being has stories and experiences and pains. And by the time you're 60, 70, you're a different species. I tell my kids, no matter how smart you are, any 70 year old is a different species compared to you.

[Dan Buettner]

I love this because people I find are afraid of getting older.

[Dean Sherzai]

We are different species as we get older, we get three dimensional, four dimensional, five dimensional. We're not talking about interstellar, we're talking about human capacities and human connections at levels that no 18 year old would have. And this is not putting down 18 year olds because they are going to go through this journey, but maybe with awareness.

[Dan Buettner]

Give me a good example because I think people are going to love hearing this.

[Dean Sherzai]

One example, which is going to be in our next book, is the fact that much of what your consciousness is is a tree of knowledge that's built upon itself. It's like that movie Avatar. It's a massive tree that's connected upon memory, upon memory, upon memory. In Fact, you can't memorize without connecting it to another memory. So a person that has a thousand stories, much of it they don't even remember consciously, but a subconscious, their tree of knowledge and experience and emotion that's connected to that is way vaster than a very strong linear tree.

[Aisha Sherzai]

A very quick and a simple example that I give to my patients, especially my patients who come into the clinic and they're very worried because they can't remember things or it takes them a very long time to remember something. And I'm saying, I tell them, I said, listen, okay, you cannot compare yourself to your 17 year old grandchild, right? Your 17 year old grandchild or 18 year old grandchild's brain is like a kindergarten library. All the books are stacked there and you can see each and every one of them. You wanted, you go get it and that's done, right? Yours is like a New York public library.

[Dean Sherzai]

By the way, when they say that you don't forget anything, you do, but the subconscious knowledge that still exists is massive. And all the memories that you're building are connecting emotionally and intellectually with all that scaffolding that's already built over 70 years or 60 years, that's different, that's a different species. Short of developing dementia, short of the pathology, vascular pathology, that we should fight, we are actually getting better as we get older.

[Dan Buettner]

So cognitively speaking, what does a 70 year old do better than a 20 year old?

[Dean Sherzai]

A 70 year old can see anything in a context that's way vaster than a 16 or 17 year old or 18 year old. And it's not wisdom alone. Wisdom is a soft concept that we think that, oh, they are emotionally controlled so they can see things. No, they can contextually actually see things better. Any aeo. Now, some do better than others because they've organized that scaffolding proactively, systematically. But just the act of living has created a scaffolding that gives you a better perspective.

[Dan Buettner]

How do you guys resolve conflict between each other?

[Dean Sherzai]

So our conflicts are about projects, right? It's about pace of projects, it's about organization of projects or how the project and then you talk it out.

[Aisha Sherzai]

We're very united with the kids too. Yes, conversation. We're best friends and we just talk.

[Dan Buettner]

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[Dan Buettner]

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[Dan Buettner]

One of those books called the Blue

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[Dan Buettner]

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[Dan Buettner]

just want to point out what professionals who go into brain health. Listen to the children that you produce. Tell them about your resigned. You can brag.

[Dean Sherzai]

Okay, so Sophie and Alex, they finished high school at age 10. They took SAT at 11, the amazing 90 percentile. And then they went to college. This special program called eep, early entrance program at Cal State. And they started at 13, they got done at 17, college at 17.

[Dan Buettner]

I was getting C's in high school.

[Dean Sherzai]

Same here. No. And Sophie after college, got into a program at the Mass General Brain Machine interface. Her college degree was in biomedical engineering, specifically Brain Machine. And she went to a brain machine interface lab in Mass General. And Alex finishes master's at UCLA and AI and brain health at what age? At 20. And he went to. Just got a job at Nvidia. And you'll be going to San Francisco starting Nvidia, specifically AI and health and brain health.

[Aisha Sherzai]

Most importantly. They're good people, they have good hearts, they are very passionate about making this world a better place. And I think that's the most important

[Dan Buettner]

thing that is true success. But let's bring it back to brain health because my audience is absolutely entranced by what they can do to keep their brain sharp. One of the delightful parts of your work is that you're not out touting a silver bullet. You have this sort of silver buckshot, so to speak. And what do you guys encapsulated in your neuro program, which of which is a acronym, but could you unpack that a little bit for us?

[Dean Sherzai]

Yeah, so neuro is an acronym, or we have it now as NeuroPlus, but Neuro is a self serving acronym with neurologists, but it stands for N for nutrition, E for exercise, U for unwind or stress management, R for restorative sleep, and O for optimizing mental and social activity. The plus that we've added is just be aware of your blood pressure, cholesterol at diabetes or pre diabetes.

[Dan Buettner]

Okay, how. How should we be eating if we want a sharp brain or want to stack the deck in favor of a sharp brain when we're 90 years old,

[Aisha Sherzai]

despite all the nutrition wars and the just the crazy rhetoric that you hear online, we know that when people adhere to a dietary pattern that is mostly plant based, plant predominant or exclusively plant based can be good for brain health. Whether it's the mind diet or the Mediterranean diet or the DASH diet, they have different Acronyms, these dietary patterns, when you look at them, the construct of these dietary patterns are essentially the same thing. It's a variation of the same theme. They're all high in vegetables, green leafy vegetables and other vegetables. They're high in legumes or beans. They're high in whole grain nuts and seeds for good fats, olive oil and you know, vegetable oils instead of sources of saturated fats like butter and cream cheese and things of that nature and making sure that you just eat a variety of those things. What do we reduce? Reduction of red meat, sources of saturated fat and ultra processed foods.

[Dan Buettner]

My listeners like specificity. So when it comes to meat, is there a safe level of meat eating? A maximum number? We can eat without amount, we can eat without worry.

[Dean Sherzai]

Just for transparency, we're plant based.

[Dan Buettner]

You're vegan.

[Dean Sherzai]

Yes, but we can't say that we know what the. If there's a lower level of good or bad, we can't say that if you eat any meat, it's bad. I can't. Even though I would like to say that, but as a scientist I can't make that claim.

[Dan Buettner]

Do we know I can't meat every day is bad or like what is the threshold at which after this we know it's bad.

[Aisha Sherzai]

It's a very important and a good question. And when you again, relying on data and science, when you look at how dietary adherence is scored, it all depends on what that meat is consumed with, Right? So we don't eat one food in isolation. We eat different kinds of food every single day. Now if we just consumed meat, that would be something that would potentially be harmful. And they've shown that every degree of increase in red meat consumption could potentially increase the risk of Alzheimer's disease and dementia. I'm just going to stick to my own field here in the mind dietary pattern, reducing meat consumption to maybe 2 servings per week is beneficial. We know that people who were vegetarians and vegans, they actually had lower risk of a cognitive impairment and dementia. So we do have data supporting that. However, we don't have the data to say, like Dean was saying earlier, that you have to cut off all meat. We don't have that. So even if people are eating a little bit of red meat but eating a predominant diet, they can actually see the benefits.

[Dean Sherzai]

So even let, let's take fish. I rather people don't eat fish because we're destroying the oceans and all of that. But the data shows that fatty fish twice a week is actually maybe beneficial.

[Dan Buettner]

Fatty fish being salmon and mackerel and all of that?

[Dean Sherzai]

Yeah, absolutely. But why Omega 3? Can you get your Omega 3 in other sources? Absolutely. Where does fish get its omega 3? Algae. So you can get algae and algae sources. And we wrote two review papers, comprehensive review papers on importance of Omega 3. So be aware of your Omega 3 and you can get it from pills, from algae source, or from fish, or from flaxseed and chia and walnut and things of that nature. So the science is there. On the meat side, I would say the less the better, especially red meat. And the way we do it in communities is just increase your consumption of beans and greens and legumes and things of that nature and reduce your consumption of meat slowly to once a week or less.

[Dan Buettner]

But wait a minute, meat is a whole protein and easily absorbed biologically. Why should I be eating beans and greens if the proteins meet some much better protein source?

[Aisha Sherzai]

Well, fortunately we actually have data to show that, you know, all of the amino acids that are found in meat can be found in plants as well.

[Dan Buettner]

And we and our bodies can absorb them as well.

[Dean Sherzai]

There's no doubt. We just did basically five review papers with experts and we looked at all the data. The data on nutrition is very clear that there's nothing in meat that you couldn't get from plant based source of protein. In fact, without the saturated fat, without the carcinogenic effects and everything else as well.

[Aisha Sherzai]

And there's another piece of data and because we're researchers, we're always relying on these numbers. We have data that shows that when people swap meat for vegetables, they actually have lower risk of all cause mortality, lower risk of cardiovascular disease, lower risk of cancer and dementia as well. So the more plants you eat, the better.

[Dan Buettner]

How does sugar figure into dementia and its various forms?

[Aisha Sherzai]

So excess of sugar, especially added sugar, can be a problem. I mean, added sugar, I think it's important for us to cut down as much as possible. It's very important for us to take into consideration the kind of fats that we consume or the amount of calorie that is consumed with. Probably more important than any individual nutrient or food.

[Dean Sherzai]

We've really overdone the sugar, the processed sugar as well as salt. And then on the other side is saturated fat. So if we are aware of these three things, I think we're going to do much better. We are doing terribly because every time you get in a conversation with people they say, but look, we've been aware of this so much, but we're getting worse. We're aware of it, but we're not Living by the standards, we're just getting worse and worse. When it comes to salt consumption, when it comes to sugar comes diet consumption. And when it comes to saturated fat consumption, when we work in the communities, there's no way we can say go to zero. We say the optimal is this. Here's what the Mind Diet says. Here's what the seven, the Adventist study says. That's an aspiration. That's the direction, what you should do as add these things. If you start with adding, you've actually done a very important thing as far as behavioral change. When people add and not take away, they get empowered. And when you put the seed of empowerment, that's something you can build up. And two things we start with. Sorry, we gotta go there. Two very important things. One of them you love. You've lived all your life around that, which is exercise, which is a walk, a morning walk. The second thing is add greens. People who consume green leafy vegetables, at least one serving a day. Their brains are 11 years younger.

[Dan Buettner]

Wow. I mean, that, to me, sounds like a takeaway superfood. Instead of your handful of pills or supplements, steam up some spinach or some collard greens and eat that as your supplement.

[Dean Sherzai]

Yes. And imagine when I said, whatever you need is in your home. Everybody has some. Some form of greens.

[Dan Buettner]

But, you know, I pity anybody who's on Instagram or watches TV because we're so bombarded with contrary information, conflicting information, it's hard to know the right thing to eat and the right thing to do.

[Aisha Sherzai]

You know, I don't have a good answer for that. There's some really good science communicators that are doing a great job of making sure that people get the right kind of information. But it's difficult and sometimes it's exhausting too.

[Dean Sherzai]

I don't know if this is the right place, but I'm gonna say I think I'm the optimist. I think the floor of human consciousness and awareness is always moving. And I think that people hate social media. I think one of the positive sides of social media is this overwhelm of language. What happens is the truth comes to the surface. The meaningful language comes to the surface. Things like logical fallacies, things like anecdotes not being something to be relied upon as far as public health is concerned. Things like when people say, oh, my uncle smoked till 90, they always are there for smoking is good. No, that's an exception. An exception is not the norm. So I'm very optimistic and I want to say this to the audience. You're amazing audience is that language of science is something is the most important job of all of us as human beings going forward. Because that language of science is not just about science. That's reason and how to look at data across the board, whether it's science, whether it's social behavior or politics.

[Dan Buettner]

You know, I've known you guys for better than a decade and I've just seen like a meteor. You're, you're over a million followers on Instagram. Talk about your books. That 30 day Alzheimer's solution.

[Dean Sherzai]

So we asked to keep the credit low to you. Yeah. So we had just come back from Afghanistan. We looked for the top neuroscience program in the country. It was ucsd. It was number one in the country. It was Leonthal, like usual. I did a cold call. I set up coming and while there we got a little disillusioned because it was clinical trial after clinical trial after clinical trial. Fairly 400 drugs work on mice, but none of them translated to humans. And I don't mean that that shouldn't be, that it should be and it will be. And it will have results not on mice, but on humans. But we said there must be another path. So all of a sudden we saw this really lanky, unusual person talking about blue zones. That was huge. And I'm like, what is he talking about? And I called you, I remember that. And you spoke to me long time. And right after that I made a call to Loma Linda, Dr. Hart, the President, we said, we gotta come and build an Alzheimer's prevention program there. He said, absolutely, come over. And he said, why? Because we heard Dan talk about blue zones. And specifically the one blue zone in America, which is Loma Linda. And when we went there, the people, the study itself, the environment, it was just life changing.

[Aisha Sherzai]

It was. And now when you were in the medical system, the doctors and hospitals are necessary, but the idea that 80% of it was just treatment and less than 20% was prevention didn't make any sense. We wanted it to be the other way around. And we found ourselves more and more involved in conversation for the community and prevention. And that's when we decided that we were going to dedicate ourselves to that. So I went to Columbia University for my fellowship. And while I was there, I went to cooking school. I'd be in the ICU in the morning and then I took some cooking classes at night, got my degree because I saw it. When a person comes into my clinic, instead of saying, just eat healthy food and eat some oatmeal, it would be fantastic. If I could teach them how to cook. And so we would create recipes and all of that, you know, all of the conversations was culminated in our first book in 2017, the Alzheimer's Solution, which you kindly, you know, helped endorse. And I think it did really well. And then the second book was a cookbook. So that was, that's where, you know, I just wanted our recipes to shine. And it did really well.

[Dan Buettner]

I've often said that the entrance ramp to a healthier life is through your mouth. Offering people good recipes of maniacally delicious food that they can cook at home is one of the best delivery vehicles for greater health. And then right behind that food is the whole sort of philosophy behind it. You bring in your other neuro points as well.

[Dean Sherzai]

Let me take your analogy. So I think the entrance way and the platform is the mouth and the walkway is the legs. Of all the body parts, none of them benefit from exercise more than the brain. Whereas nutrition and stress management and sleep create the environment, the healthy environment for the brain to grow. And exercise and mental activity literally grow the brain. So studies have shown that people who exercise in their 80s, started exercising in their 80s, actually grew their brain.

[Aisha Sherzai]

And it doesn't have to be intense, just morning walk, just five minutes.

[Dan Buettner]

I want people to hear that because I think people hear you have to go to the gym every day. But you're telling me that a five minute walk is going to improve your brain health.

[Dean Sherzai]

So let me give you numbers. So the studies show that a 25 minute risk walk, so start with 5 minutes and work your way to 25 minutes. Consistently reduce your chance of Alzheimer's by 45%. By the way, all those pills that they say sell at late night for brain, none of them do even zero percent. Look at the data, they can. There's nothing I'm saying that's false. Not even zero percent.

[Dan Buettner]

Snake oil?

[Dean Sherzai]

Snake oil.

[Dan Buettner]

Okay, if 25 minutes gives you 45% reduction, what's the optimal, can you extend that? If I run three marathons, it's even gonna be better.

[Dean Sherzai]

The optimal seems to be 300 minutes of aerobic exercise per week.

[Aisha Sherzai]

It doesn't necessarily have to be focused. Actually, it could be leisurely activities too. So say for example, you're, you know, you're jumping ropes for five minutes, but then you go into the garden and you pick up some weeds and you just walk out. That's considered activity as well.

[Dan Buettner]

So shoot from the hip. Yeah, I want to do the amount and kind of exercise optimal for my brain. I'm more Willing to carve all the time, shoot from the hip. What is that optimal exercise routine look like?

[Aisha Sherzai]

Honestly, anything that you absolutely love and you can consistently do.

[Dan Buettner]

Consistency is everything but pumping iron or Pilates or is there some big advantage?

[Aisha Sherzai]

There are some studies. So all that said is good. There are some studies that show that when people build muscle, especially legs, especially leg muscles, that results in growth hormones being secreted in your body, specifically called BD and a brain derived neurotrophic factor and that can actually create more connections between your brain cells.

[Dean Sherzai]

You don't need a gym. Many squats, going up the stairs, you know, walking, you know, up a hill or just at home, get a little stepper, do little steps there.

[Aisha Sherzai]

I know I sound like a broken record. That consistency so important.

[Dan Buettner]

My mantra always is if you want to live longer, don't try to change your behavior because you'll probably forget.

[Dean Sherzai]

Make food healthy, food accessible, real estate. It's location, location, location, public health. My background and Isha background is access, access, access, access to resources, access to information and access to healthcare, access to

[Dan Buettner]

sidewalks, access to parks, access to nature, access to healthy food, access to easy social interaction. These are tools we know work, but are not part of the quibber for most public health and certainly not for any of the to the healthcare system we're spending 18% of our GDP on.

[Aisha Sherzai]

Correct?

[Thrivent Sponsor]

Correct.

[Dan Buettner]

Let's move to the R in Murrow Rest. So you guys emphasize deep sleep especially. Can you talk about what deep sleep is and can you measure it and what happens during deep sleep?

[Aisha Sherzai]

So restorative sleep essentially means getting seven to eight hours of sleep where you're not waking up, at least not waking up too many times. And even if you're waking up, you go back to sleep right away and do it consistently every day. Now, as far as how deep, you know, one sleep should be, as long as people wake up and feel refreshed, I think that's a really good hallmark. And the reason I'm saying that is because we're all inundated with wearables and people have all of these charts and things to look at to see whether they hit the deeper stages of sleep. First of all, those wearables are not very accurate as of yet. Will they be accurate? I'm pretty sure they will be with technology moving so fast. But you know, we go through different stages of sleep and when you look at a sleep architecture which is done in a sleep lab, you are awake and then you go into the stage where it's superficial sleep and then there's N1, which is stage one, stage two, stage three. Stage three is the deepest stage. And we go through about four or five of these cycles every night. We spend about 90 minutes in each of these cycles. Most of the first half of our sleep is spent in deep sleep. And it's really important for us to reach there because two very important things happen. First of all, the brain cleanses itself. We have a very elegant cleansing system. And if your audience can just kind of imagine our brain being like a building that is packed with office, you know, people and employees and employers in the daytime, at nighttime, when they go home, a janitorial team comes in and they start cleaning that building.

[Dan Buettner]

What are they taking away?

[Aisha Sherzai]

They're taking all the trash and all the byproducts. So basically, our brain is very active, and it starts creating these byproducts, including amyloid protein, which has been associated with Alzheimer's disease, and they dump them in the lymphatic system, and it gets rid of it from the body. But if we don't go to the deeper stages of sleep, what happens is there is accumulation of that byproduct. And that's why when people have very poor quality sleep or they have a sleep disorder like sleep apnea or restless leg syndrome, these proteins and byproducts accumulate and they have a higher risk of developing Alzheimer's later. So studies show that you need to sleep about seven to eight hours every night for this system to get activated. And when people sleep less, or if they have a medical condition where they keep waking up, or if they have too much alcohol, which actually keeps you in the superficial stage of sleep and doesn't allow you to go to the deeper stages of sleep, or they have certain medications that they're taking, that kind of messes up that sleep cycle. People tend to have cognitive decline in the long run.

[Dan Buettner]

How about REM sleep, which is kind of that middle stage of sleep? Is that a cleanup happening there?

[Dean Sherzai]

That's the second function. The second function of the brain is memory consolidation. So it's back when we first started with computers, it was defragging. You remember defragging. That's what you do at night during REM is where information is gathered, put in the right file folder and cabinet so it can be drawn later. That's why people who sleep and go through these REM in the morning, their memory is much better of the things that they were supposed to memorize the day before. So that's what happens. In fact, the most important thing for you can do for memory is sleep.

[Aisha Sherzai]

Well, you know, people always talk about detox this and detox that.

[Dan Buettner]

Yeah.

[Aisha Sherzai]

The best detox that we have is sleep.

[Thrivent Sponsor]

Wow.

[Dean Sherzai]

So we've talked about three things. Greens and vegetables. Free. Well, not free, but easily accessible.

[Dan Buettner]

Yeah.

[Dean Sherzai]

A walk and some squats. Free. And sleep. A good sleep where you create the environment, do sleep hygiene, and all these things that actually help with better sleep. Free. And these are powerful factors.

[Dan Buettner]

Let's rake order the Top 5 Top 5 Things People should do to keep your brain sharp.

[Aisha Sherzai]

We forgot one of them. And I feel it's important for us to talk about that because that is also very, very important, which is optimizing your cognitive activity.

[Dean Sherzai]

So we skipped the middle one, U, which is stress. But that's okay because there's good stress and bad stress. Bad stress. We all know what that is. Good stress is when you're challenging your brain around purpose and with winnable, measurable outcomes. And your brain requires it. Why else would you need 87 billion neurons and 1, quadrillion connections to reproduce? Bacteria do that way better than you. To find food. So many viruses do better than you. No, it's because the brain wants to be challenged. The brain wants to be creative. The brain wants to seek. The brain wants to think. The brain wants to be pushed. And that's critical. And when you don't do that, those connections between neurons, by the way, each neuron can make two connections, or as many as 30,000 connections.

[Dan Buettner]

Wow.

[Dean Sherzai]

And guess what makes those connections?

[Dan Buettner]

Two things.

[Dean Sherzai]

Exercise. And especially mental activity challenging the brain. And if you do, imagine this. These are two neurons. They have one connection between them, or two connections. One night you have bad sleep, one of them suffer. The other night you just, you know, had bad food. Other ones suffer. These two cells are now separate, and they're gone. Now, if you have 30,000 connections, what's going to suffer? Death? Not much. That's why these connections are important. That's why exercise creates those connections. That's why you grow. You don't create new neurons. You do, but very few. It's the connections that make the growth. And exercise does that. But especially mental activity. Challenge yourself around creative endeavors. Creativity is not just a side bite. Creativity is the byproduct.

[Dan Buettner]

So I'm guessing learning a new instrument or learning a new foreign language. How about playing chess?

[Dean Sherzai]

Absolutely.

[Dan Buettner]

How about playing spades?

[Dean Sherzai]

A little less. The one that's the best is the one that you like and you're doing repeatedly. And it's challenging you and it's pushing you. We did a meta analysis and There are three Venn diagrams. Purpose, complexity, and challenge. What does that mean? The activity should make you want to do it more. The activity should be complex, meaning that it's involving multiple domains of your brain. And the activity should change and push you more. Let me give you an example. Let's say you're learning guitar. I'm terrible at guitar, but I still play it. I love it. When you're learning guitar or you're playing guitar, you're reading the music right? That's your left parietal lobe, language centers, you're processing it. That's your frontal lobe. You're visually processing that. It's occipital lobe. You're being creative. At your parietal low, you're dextrous. It's your motor cortex and your cerebellum. You're emotionally involved in that music. Well, for me, it's good. For everybody else, it's terrible. And that's your limbic system. That's your brain on fire. It's all of those systems and your purpose. That's the kind of activity I want people to be involved. And also pick up some other things that you're not comfortable with because that discomfort, slight discomfort, actually grows your brain as well.

[Aisha Sherzai]

Not painfully difficult, but a little difficult. That pushes them to the edge a little. And especially for women, sure, baking is great. Housework is fine. You can keep yourself busy in that. But something that is cognitively challenging, so, so important because it's like having a saving savings account in your bank. It's like you're really investing in your brain health.

[Dan Buettner]

Shooting from the hip. And I know you work with a lot of real people. You diagnose and treat people with cognitive decline. What is the optimal amount of challenging cognitive activity you should do every day?

[Dean Sherzai]

The more the better. But remember, good stress can become bad stress. Make sure that you don't push yourself to the point of bad stress, meaning that that activity is no longer serving your purpose. That activity is actually not now causing the stress and anxiety. Always push yourself at the edge of difficulty. That's where actually growth happens. By the way, if you see that an activity is getting a little boring or a little daunting, pick up another activity. That's why I usually tell people have two or three activities that challenge you, and the more varied, the better. If it's music, if it's dancing or writing, those are three different things. But at least you have different venues to go to, and that's important.

[Dan Buettner]

So let's talk about. I want to get back to your Clinic Aisha. The people come in, you listen to their histories. You send to the psychologist, you've diagnosed mild cognitive decline. What's the treatment? Other than what we've talked about, Is

[Aisha Sherzai]

there anything definitely understanding that they are at a very important stage in their life where they can slow down the progression, maybe perhaps even reverse some of the damage that has already been done, and really, really know their risk factors. Right. So it depends as far as some of the factors that don't necessarily get impacted by lifestyle. Let's just go there as well. Right. If someone has high LDL cholesterol and they're trying their best with diet to lower it, exercise doesn'. Do much, but diet does. And if it still doesn't go down to the level which is protective, then in that kind of situation, we actually start conversing about medication. So depending on their situation, or for example, send them for a hearing assessment or send them for their vision assessment, it just depends on the person. And we combine both lifestyle and medication and those kind of situations because it's a very, very urgent situation for them to reverse some of the risk factors.

[Dan Buettner]

The majority of older people in America are suffering from some hearing loss. It's very common, Very. What's interesting is sort of a dichotomy here is if you're suffering from hearing loss and you're in a restaurant and you really have to cognitively struggle, I would think this is almost the sort of push in your brain because you got to figure out, out of a six word sentence, you only heard word number two and word number five, and you got to quickly kind of put it together. Is that good cognitively or bad cognitively?

[Dean Sherzai]

But the reality is that that level of focus is not the baseline. When a person has hearing loss, they might do that once in a while, but what happens, you settle their baseline, which is I can't hear. You become more withdrawn. And what happens? Also, ambient noise, or any noise is a stimulator for the brain. So if that goes down and any form of noise goes down, you see the connection between neurons becoming less and less, more and more afraid.

[Dan Buettner]

So get a hearing aid.

[Dean Sherzai]

It's one of the most important things to do is especially as you get older, to first of all, check your hearing, because we don't. A lot of times you don't realize you're actually experiencing hearing loss.

[Dan Buettner]

What?

[Dean Sherzai]

That's right. So you should check it. If you see that there is loss of hearing, you should get a hearing aid.

[Aisha Sherzai]

So when people can't hear anything, all the energy of the Brain is spent on deciphering language. It's not spent on memorizing, it's not spent on thinking of how you're going to respond. Creativity goes away, joy goes away. And that kind of stress is actually really bad for the brain.

[Dean Sherzai]

I always say that none of us have ideal situations, but if we optimize the rest, that's an incredible positive that you wouldn't have otherwise or others compared to your baseline. So if you're eating healthy and you're exercising and you're getting good sleep and you're keeping your mind active, then that's fantastic, that's by themselves, they have significantly reduced your chance of dementia. But more important, not more important than that, but different, looking at it differently, you're actually increasing your cognitive capacity. That's what we started with, that as you get older, if you could avoid the pathology, your brain gets better. That's what we're doing.

[Dan Buettner]

So if you were to, you know, there's all kinds of talk about an anti aging drug, Rapamycin, Metformin, and from the guests I've had on the show who are true anti aging biologists, they'll tell you that the intervention most likely to slow aging down or to maybe even reverse aging would, would intervene with the pathway of cellular replication. Where you know, our cells, every time they replicate, there's a doubling of damage. So by the time they replicate, you know, 25 times, there's an exponential buildup. But brains don't work that way, do they?

[Dean Sherzai]

What you're talking about is the, the cell cycle. So there are cells that are frozen and non reproduction stage. The heart is one of those organs that cells are at one stage and they don't replicate. The same thing with the brain. And for the brain, a non aging brain's pill would mean that a pill that allows the connections to continue. This is actually very important for your audience to hear because it's not even the number of neurons. Let's say that you lose a billion, which if you live healthy, you're not going to. You still have 85 billion neurons. If those 85 billion neurons make two connections, that's one day, those 85 billion neurons make 30,000 connections. That's an order of difference, right? So that's what's important. So it's not so much losing cells that's important. These cells, if you keep them healthy, if you eat healthy and all that, we think that you could live multiple lives. It's the connections between them. And everything we've talked about is that pill eating greens not Eating ultra processed food, exercising. So that bdnf, gdnf, vgf, these growth factors are actually pumped into your brain. So the connections are kept healthier, the vessels are kept healthier through the ultimate pill, which is exercise. And then the other ultimate pill is sleep. Well, because all the cleansing, all these patches at the bottom of the feet and all these drops that they take for cleansing, none of them work. You have an incredible drug for cleansing. This drug is sleep. It widens the highways. Actually, the brain shrinks and the highways widen these cells actually actively. By the way, these gluteal cells outnumber neurons by 9 to 1. They go in like an army and clean it up. And then the flow is actually sped up. There is no cleansing that you could even imagine better than that. There's another pillar mental activity. When you play guitar for an hour or any music, or you dance or you're connecting at an order of millions of connections per minute. There's no pill that could ever do that. Those are your pills.

[Dan Buettner]

Do you guys take supplements?

[Dean Sherzai]

We do.

[Aisha Sherzai]

Well, we're vegans, so I take a vitamin B12 and we take omega 3 fatty acids.

[Dan Buettner]

But these are really almost pharmaceutical. I mean, they're diagnosed deficiency. They're not. You don't take any supplement that promises some kind of a better cognitive outcome.

[Dean Sherzai]

They promise something. I promise them that it's not working.

[Dan Buettner]

That doesn't work. So you kind of started by telling us that once we get full blown dementia or Alzheimer's, there's not a lot we can do about it. First, what are the statistics in America right now? What are the chances an average American is going to be suffering from dementia?

[Dean Sherzai]

Pretty significant. Like I said, 7 million people in America suffer from dementia. We're talking about one in nine men and, sorry, one in 11 men and one in six women.

[Dan Buettner]

Right now.

[Dean Sherzai]

Right now. And in certain populations, like African Americans, two to three times more. Hispanics, two to three times more. But the good news is it's preventable. It's preventable.

[Aisha Sherzai]

And I think it's very important for us to say that the reason the numbers are higher in African Americans than Hispanics is because of lack of resources. It has nothing to do with the genetic part of it. Most of the communities don't have access to information to prevent dementia. And because of that disparity, you see the results.

[Dan Buettner]

That makes sense. So what if I show up to your clinic with my mother and she clearly has Alzheimer's disease? What can we do? And a lot of people listening now are struggling with A grandma or parent or even a spouse that's suffering from. What do you do?

[Dean Sherzai]

There's a lot to do. Not necessarily reversing the disease, but the person is living a beautiful life. There's a lot to do. Instituting a completely different lifestyle and a person that has dementia is itself. Could itself be incredibly difficult, taxing, almost torture. Is that something that this person would want? Just because we think that this person should become a runner or a walker and this and this at this age, which they were. They hadn't done this before. Is that cost benefit there? That's a conversation to be had between the family, with the person, if possible, but more importantly with what this person would have wanted. That's important. So we don't just put everybody in lifestyle just because it's not there. The second important thing, and probably even more, is making sure that where this person is, they are living a vibrant life. Because with dementia comes anxiety, with dementia comes fear. Dementia comes fear and anxiety that's often not communicated either because they can't communicate it or because they're ashamed to communicate. It's a quality of life issue. We are beings that care about each other's suffering. All of our journey suffering not just because now somebody has dementia. No, it's even more because they're suffering more. We must be aware, we must care for that. We shouldn't go from Charlotte and Charlotte and selling them a lifestyle and selling them a pill, selling them a vitamin concoction. I'm very aggressive about this because I care for my. Not my patients, my family, my communities. And that's where we must fight people who are making upsides.

[Dan Buettner]

My loved one has full blown Alzheimer's. What am I going to do to make them comfortable?

[Dean Sherzai]

So first of all, you gather with family, talk about their history, talk about what things make them happy. If you can talk to them and they are not, they are still able to communicate, talk to them. What makes them happy? What makes the anxieties go away even

[Dan Buettner]

if they can't respond. Are they probably hearing.

[Aisha Sherzai]

Yes, absolutely. Again, one of the things that we forget, they're still there. They're that beautiful person still there with tremendous amount of anxieties, with tremendous amount of fear because they can't finish their sentences or remember somebody's name. Are they feeling. Absolutely they are. They're right there sitting in front of you and highlighting those memories and highlighting that personality and making them understand that we see them and we hear them and we're going to be with them till the end of the journey. Is the most important thing, One of

[Dean Sherzai]

the most beautiful videos that you should watch is a ballerina. A world renowned ballerina who has advanced Alzheimer's, hasn't spoken, hasn't communicated. Her son comes and puts on swan

[Aisha Sherzai]

wake and they're sitting in a wheelchair

[Dean Sherzai]

and she starts dancing to this in the wheelchair.

[Dan Buettner]

Oh, wow.

[Dean Sherzai]

It is the most powerful thing you've ever seen, but to me, it's the most powerful thing I've ever seen. No painting can replace this flower that comes from the bottom, from the depth back to the surface. It's nothing like this. And with our own patients, we ask the children, do they like certain music? And you play that music in the background and you see them waking up and then you see them singing the words where they haven't spoken for months. They're there, they're there. Our job is to make sure that that joy comes to the surface. Our job is to quelch and quiet anxiety. Her job is not always to push the pill.

[Dan Buettner]

Let's talk a little bit about how to reach you, how to get your information.

[Aisha Sherzai]

Well, we have a cat. We chose a catchy name for ourselves on social media and we are the brain docs. Docs like doctors the brain docs. And our website is thebraindocs.com we're very proud of our community. We have a nice podcast called you'd Brain on where we invite scientists and community members and authors and artists who speak about the important elements of what brain health is all about. And our community is neuroworld, so it's neurodoct world. And we'd be happy to connect with anyone if they have any questions.

[Dean Sherzai]

And as an extension of that, I'm doing the research at the university. She's leading the largest brain op initiative in the country at the community level and then churches and faith centers. We the Inspire program. So if people want to learn about it, they can go to inspireprogram.org and hopefully within a year this will be a countrywide study. Nothing like this anywhere.

[Aisha Sherzai]

You know, we're very, very excited to see the impact of a comprehensive lifestyle intervention that had been created with a community. It's not just a pamphlet that we give them. We sit down and we create an intervention program with the community and see what the results are as far as brain health is concerned.

[Dan Buettner]

By the way, I'm an ardent follower of your study and you are such an articulate. You speak about the results of studies in a way that I'm leaning into it because most a lot of this academic gibberish you can't understand it. Vocabulary is arcane. But you have a gift too. But you really have a gift.

[Aisha Sherzai]

I've learned over the years to say things the way I would say it to someone who has no idea about science. Because I think scientific literacy is incredibly important right now. And science communication and health communication can save lives and miscommunication can alter lives and harm lives as well. So thank you for saying that. That means a lot.

[Dan Buettner]

Yeah, no, I mean, you have a way of delivering a message. It's entertaining and you retain it.

[Dean Sherzai]

I want to end by coming back to you, not to just in Gratiot, but what you have done, what you have shown in your work in these countries and cities and places is to show that it's in those communities, those basic things. So when we go to Filipino community or Hispanic community or to Cuban community or whatever, we realized that the reason that the unhealthy things have sneaked in is because of the fast food and this quick culture that has adulterated their own food. So when you sit down with the community, talk about how the food was before you realize, wait a second, they all had greens, they all had beans, they all had the healthy foods. So you find out that the original food, drinking your food, was incredibly healthy.

[Aisha Sherzai]

And not just that, you know, they all believed in rest as a very important pillar. They all believed in, believed in the idea of transferring and sharing stories with each other. What are stories? These are, you know, moments of creativity that literally, you know, makes those connections that we were talking about. So, you know, moving away from this fast paced life and trying to remind ourselves about the crucial pillars of what a healthy life is about is just that. And you're doing that.

[Dan Buettner]

We're always looking for answers with AI.

[Dean Sherzai]

Yes.

[Dan Buettner]

And really some of the best answers come from not looking forward but looking backwards. Exactly what our grandparents did. What your sharp grandparents did.

[Dean Sherzai]

Yeah.

[Dan Buettner]

Anyway, you're doing a great service, not only for science, but for humanity. And I'm honored to call you two friends. Thank you.

[Aisha Sherzai]

Thank you.