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The mindbodygreen Podcast
639: How to lower your Alzheimer’s risk at any age | Majid Fotuhi, M.D., Ph.D.
00:50:17
Today's guest is Majid Fotuhi, M.D., a Harvard and Johns Hopkins-trained neurologist, brain health researcher, and author of Invincible Brain. Dr. Fotuhi has spent his career studying one of the most pressing questions of our time: why do some people's brains deteriorate with age, while others stay sharp well into their eighties and nineties? His answer might surprise you.
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Welcome to the MyBodyGreen podcast. I'm Jason Wakab, founder and co CEO of MyBodyGreen and your host. Ugh.
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Nope. But I've got tonight's dinner paid for. Start selling on depop where taste recognizes taste list. Now with no selling fees, payment processing fees and boosting fees still apply. See website for details. This message is sponsored by Greenlight. With school out, summer is the perfect time to teach our kids real world money skills they'll use forever. Greenlight is a debit card in the number one family finance and safety app used by millions of families helping kids learn how to save, invest and spend wisely. Parents can send their kids money and track their spending and saving while kids build money, confidence and skills in fun ways. Start your risk free Greenlight trial today@greenlight.com Spotify that's greenlight.com Spotify this episode is brought to you by State Farm. Listening to this podcast Smart move. Being financially savvy Smart move. Another smart move having State Farm help you create a competitive price when you choose to bundle home and auto bundling. Just another way to save with a personal price plan. Like a good neighbor, State Farm is there. Prices are based on rating plans that vary by state. Coverage options are SEL availability, amount of discounts and savings and eligibility vary by State.
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On December 12, Disney invites you to
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go behind the scenes with Taylor Swift in an exclusive six episode docu series.
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I wanted to give something to the fans that they didn't expect. The only thing left is to close the book.
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The end of an era and don't miss Taylor Swift.
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The Eras Tour, the final show featuring for the first time the tortured poets department. Streaming December 12th only on Disney. What if most of what we fear about aging and memory loss is simply wrong? And what if the brain you have today doesn't have to be the brain you have tomorrow? Today's guest is Dr. Mahid Fatouhi, a Harvard and Johns Hopkins trained neurologist, brain health researcher and author of invincible brain. Dr. Fatouhi has spent his career studying one of the most pressing questions of our time why do some people's brains deteriorate with age while others stay sharp well into their 80s? And 90s. His answer might surprise you. Cognitive decline, he argues, is far more preventable and reversible than most of us have been led to believe. In fact, 45% of dementia cases may be preventable through modifiable lifestyle factors alone. In today's show, we explore what the latest biomarkers can and can't tell us about Alzheimer's risk and why testing tower amyloid in isolation can lead to unnecessary panic. We discussed the five pillars of brain health that can actually grow the size of your hippocampus in as little as 12 weeks. And why chronic stress may be the most underrated threat to your brain. And how lifestyle interventions outperform current Alzheimer's drugs by 2 to 400% in clinical trials. If you've ever worried about memory loss, been confused by brain health lab work, or simply want to show up sharper and more resilient as you age, this show is for you. You argue that 45% of dementia is preventable. What are the most surprising modifiable factors that people overlook here?
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I think that people don't appreciate how important it is to move their body sedentary. Lifestyle is a major risk factor for cognitive decline, as well as strokes and heart attacks. Also recently, we have come to appreciate that hearing loss and vision loss can contribute to cognitive decline and dementia. So I have been talking about how a dozen different medical conditions can contribute to the brain shrinkage that eventually causes cognitive decline and get people to get a diagnosis of Alzheimer's disease. And so I feel great to know that the international community and this recent paper in Lancet that showed 14 risk factors can reduce the load of dementia in the world by 45%. But they did not look at all the factors. It's not just there are only 14, there are 14 that they have already studied and established. There are other factors that, for example, they have not considered and are very important, such as insomnia, if you're sleeping fewer than six hours a night, or sleep apnea, which means you snore at night, and then you feel tired and groggy during the day. So the bottom line is that there are many different factors that can contribute to to the brain shrinkage with aging, which then causes cognitive cloning and Alzheimer's disease.
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You know, you mentioned Alzheimer's and this is exciting, interesting, and also scary in that there are so many tests one can do right now and you say it is one of the most misunderstood biomarkers in this new era. You know, what can you test for P Tau, amyloid, NFL in your View what is really important here and what are we missing with regards to these biomarkers?
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This is an excellent question, Jason. So the brain shrinkage that results in cognitive decline and eventually Alzheimer's disease has many components. One component of it is the amyloid plaques and tau tangles, which almost everybody has heard about these days. Another component is inflammation in the brain. Another component is reduced blood flow in the brain. And another component is the reduced rinsing of the brain that happens mostly at night. So these are the main components of a super problems which I describe in my book. There's a super problems that causes cognitive decline and brain shrinkage. Now, the new biomarkers focus on the amyloid plaques and tau tangles. And there is a panel of different blood tests that people can obtain. The most accurate and reliable component of that list of biomarkers is the ratio of amyloid beta 42 to 40. That's one number, and the other one is tau. So for example, you also have blood tests for NFL, norofibri light chain, and you have another blood test for gfap. These other blood tests are non specific and could be high, for example, in patients with multiple sclerosis or other conditions. So this dual blood test, the ratio of amyloid beta 42 to 40 as well as tau, are excellent reflections of one component of the super problems. They can detect the amyloid levels in the brain and they can detect tau levels in the brain. What they cannot detect is how much inflammation is in the brain, what's the health and vitality of blood vessels in the brain and how the rinsing process in the brain is happening.
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With that said, what can detect that?
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There are new brain MRIs that can detect the impairment in the rinsing process. See, when the rinsing process doesn't happen, the fluid back up and then there's a space around blood vessels called perivascular space and they swell. And so imagine like a straw and then around, like, imagine like you're looking at like a watermelon. You cut the watermelon and then you see these little, you know, blood vessels which work little straws. And around them is empty space on an mri. And these are the swollen perivascular space. And those brain MRIs are advancing well and I think they will become available for clinical use in next couple of years. We can also look at the health of the blood vessels through ultrasound. The ultrasounds can measure the velocity of the blood flow and that too can tell us how well the blood circulation is happening in the brain. We don't have a good biomarker for inflammation in the brain, But I can envision that in about two to five years, we'll have a panel of blood tests. See, if you go see a cardiologist these days and you have chest pain, they will probably do a stress test, which is to see if you run fast, whether it will be EKG changes, whether there are electrical changes in your heart. You may get an echocardiogram to look at the pulsation of your heart. And then you may get angiography, which would look at the blood flow inside the arteries of your heart. And you would get a panel of blood tests that would check your lipid levels and, you know, Check for hemoglobin A1C for diabetes and other things. And they talk to you to see what symptoms do you have. Your chest pain, maybe because you strained a muscle in your chest. So there will be 10 different things that they will look at and analyze to come up with determination of what exactly the problem is. Is the problem with the arteries in your heart or the muscles of your heart, or the pulsation of your heart. When it comes to the brain, we can think of cognitive decline as a chest pain. It's very non specific these days. Unfortunately, a lot of people jump on the conclusion that I'm forgetting names, I am misplacing things, I forgot a few appointments. I must be getting Alzheimer's disease. And that's absolutely wrong. If you have those symptoms, you may have treatable conditions such as sleep apnea or depression or vitamin deficiency or anemia. And that's why my program was so successful. 84% of our patients who were in their 60s, 70s, and early 80s had a remarkable improvement in their cognitive scores with my program. And this wasn't because I had some magic wand or I did something that nobody else has heard of. What I did was to go through a thorough list of all contributing factors to memory loss. And many of those factors are treatable. The bottom line is this cognitive decline with aging has many different components. There are many different components in the soup of problems that cause brain shrinkage with aging. Most of those components are treatable and reversible and manageable. The two components that are still being worked out are the amyloid plaques and tau tangles. And you want to hear the most exciting thing that is just fascinating?
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Sure.
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Lifestyle factors can change the level of amyloid and tau. So we always used to think that, okay, you have these treatable components that we can manage through lifestyle and addressing your medical conditions. And we have these Two stubborn Alzheimer's components, which are just, you know, Alzheimer's disease, they come out of nowhere. And what we have discovered in the past five years or so is that many lifestyle factors affect the levels of these amyloid plaques and tangles. Let me give you two examples. If you look at people and ask them what they eat and monitor them for 5, 10, 15 years, some people eat a Mediterranean diet and some people don't. It turns out that people who eat fruits and vegetables and they like olive oil and they don't eat junk food have a brain that is 18 years younger when it comes to levels of amyloid plaques and talent angles. 18 years younger. And the only difference between these two groups is a diet. Another example, they looked at people and asked them how much they walked and they measured how many steps per day they're walking. And they found that people who walk three to 5,000 steps a day have far less TAU in their brain than people who don't walk. So that's what's exciting, and that's what I talk about in my book, that these lifestyle factors are really getting to the core of, of what we call Alzheimer's disease. Not only these factors address these non Alzheimer's components, the inflammation, the blood flow and the rinsing of the brain, they also address the very evil plaques and tangles. And that's what's so exciting.
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It is exciting. And I want to zoom out and spend a minute on labs because anecdotally, I think a lot of people are going out there and getting lab work and that's really exciting. However, if you're just looking at one specific marker in a vacuum and your results aren't exactly favorable, you may be left freaking out. And so in my understanding, if you're concerned about cognitive decline, you should test for 1P tau levels, amyloid. So AB4240, NFL, HSCRP, MPO. And the last one I'm going to throw in is SARS, COV, Covid 2 spike. And I'm going to give you the why and I'll speak about this, My personal example, which our audience probably remembers. So I did all these labs. Amyloid normal. Well, first. First it came back, my TAU was high, both tau numbers high. I do not fit the profile at all for cognitive Decline. I've got one copy of the APOE4 gene, but like, metabolically, I'm super fit, healthy. I've got nothing. And so I was freaking out. I'm getting the lab results as they come in and I get that one first and I'm thinking this makes zero sense. Like, what is going on here? How is my tau? I know what Tau is. Why is it elevated? Zero sense. Then my SARS cov2 spike comes in sky high, and I thought I had Covid about a month before the test. Amyloid, then. So I'm feeling better. Okay. I've heard that this is a thing. People who have Covid, there's a temporary spike in Tau. AB4240, normal, NFL normal, HSC part HSCRP, normal MPO, all normal. So I'm feeling better. And so I've heard from a lot of doctors that they're seeing a lot of people come back with no symptoms at all ages with very high tau. And the working theory, we're learning about this on the fly, that Covid's just every. You know, Covid's a part of life now, but there's systemic neuroinflammation where it may not manifest itself in symptoms, but it shows up as elevated P Tau. And over the course of time, the P Tau probably clears itself. However, I'm curious your view. If we live in a world where we're just living with COVID it is what it is, and it's kind of, what if we're constantly reinfecting ourselves and constantly our P Tau is on this roller coaster. Get infected, goes up, healthy, immune response, comes back down, infected again a year later. That's not good for the brain either. So I'm just gonna. That's a lot to process. What. What's your take on my personal experience and. And observation here?
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Well, you're a good example of someone who's healthy and sharp but has high levels of tau. And this happens a lot. And fortunately, a lot of people are getting these tests even though they have no symptoms. And I really discourage that because the problem becomes the concern that I may be getting Alzheimer's disease, and I'm just in early stages. Many studies have shown that people who have high tau levels will eventually develop Alzheimer's disease 20, 30 years later. And so the catch is that tau levels can be modified. Just because you have high tau levels doesn't mean that it's the end of the world and that you're doomed to get dementia later in life. And tau level can also go high for other reasons, such as exposure to Covid. And in fact, there may be other viruses that can increase tau level as well, such as influenza or other infections. There are many people who believe that one of the many components of the super problems are infections. There's a whole group of neuroscientists who really focus on the infectious etiology for cognitive decline with aging. So my recommendation is if you have high tau levels and normal everything else, you may want to check it again in a year to see where it stands. And if it's lower, then it's great. But if it's higher, then you may want to consider to increase your fitness. You look very fit to me. You look like a very strong.
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I am and so agree with everything you said. I think what I'm getting at, I think it's. It's amazing that everyone's doing testing. But my point is you can't look at Tao in a vacuum.
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Absolutely.
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You have to look at AB4240. You gotta look at NFL. You have to look at MPO, and you have to look at Covid and ask yourselves like, have I been? I'm like, there's a vicious flu going around right now. And there is. In my view, the cost of living in 2026 is you're probably going to be exposed to something pretty nasty at some point in your life. And just be aware that if the flu hits you very hard, or maybe you have Covid and doesn't really even do anything, tau levels can elevate. This is my psa. Just be aware for everyone. But there's also something. Do all the testing. But there's a lot you can do. Yes. And so getting back to what can we all do, let's talk about like, growing, like hippocampus, which you've also. You also talk about the book. What are some of the. And that can happen pretty fast. I think you. I think it was 3% in 12 weeks. So, like, in terms of growing the hippocampus, what are the sum. What can we do? Because that's significant growth in a relatively short period of time.
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Yes. So hippocampus is the size of your thumb. You have one on the right, one on the left. Hippocampus is the ground zero for learning and memory. If you don't have hippocampus, you can't learn anything new. The long term memory is stored on top of the brain in the area called cortex, which also has a lot of malleability. And it's important for all your cognitive functions such as reading, writing, typing, doing your taxes and so forth. So hippocampus and cortex have a high degree of malleability. But hippocampus particularly can change for better or worse in a short period of time. So people who have concussion, stress, diabetes, Obesity, sedentary lifestyle, over time, shrink their hippocampus. And in fact, hippocampus shrinks by about 1% per year on average after age 50. That means, on average means if you just don't do anything, if you just live old fashioned way, where you will just slow down with aging. Now, what I found exciting and what made me put my 12 week program together were all the studies that show 12 weeks of exercise can increase the size of hippocampus. In one study, they looked at people in their 30s and put them through an exercise program and a control group that just played football. So one group did cycling, bigger cycling, another group did football as a control group, and they saw that every individual in the arm for cycling increased the volume of hippocampus during that 12 weeks. So this is what excited me to start my program, because I realized that even exercise by itself can grow the hippocampus. So after I put all the literature together, I decided that there are five pillars of brain health that can grow the size of hippocampus. And those are exercise, sleep, nutrition, mindset and brain training. Each of these five pillars of brain health can grow the size of hippocampus substantially. The number one on that list is exercise. Number two is sleep. Remember I told you that during the night there's a rinsing of your brain that clears your brain off any waste byproducts. Well, if you don't get six hours of sleep on a regular basis, your hippocampus shrinks and shrinks. So if you had insomnia for five years, your hippocampus is just a little smaller. But if you have had insomnia for 20 years, your hippocampus is almost half its original size. So sleep is way up there in terms of importance. Third on the list is nutrition. Good food provides a lot of sources of anti inflammatory vitamins and also helps with blood flow in the brain. And bad food, such as processed food, literally shrink up a campus. People who have high levels of trans fats have small hippocampus. And then next on the list is your mindset, how much you stress and how much control you have over your life. People with high stress have high cortisol levels and they shrink their hippocampus by a lot. And people who meditate can grow the size of hippocampus. Even 12 weeks of meditation by itself can grow the hippocampus. And finally, brain training can grow the hippocampus. And the more you challenge your brain, the more your hippocampus grows So I argue that if I put all these five things together, I should be able to see substantial increase in the size of hippocampus even in older adults. And this is exactly what I saw people in their 60s, 70s and early 80s who did my program and we coached them for 12 weeks to improve components of brain health, improved the cognitive functions. They all did better in objective computer based cognitive test results cognitive testing and they increase the size of your canvas between 1 to 3%.
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I think nutrition self explanatory. You mentioned Mediterranean diet, sleep. I think everyone understands. Let's spend a moment on exercise. So is all exercise created equal? You talked about cycling, but I also heard you mention foosball. So like, how would you rank exercise?
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I think the most important component of exercise should be fun. You should do exercises that you enjoy doing because that will make you keep doing it. For example, I love cycling, I love tennis, I love skiing. And I don't do those things because I know they're good for me. I do them because I love them. So I think people should do what they enjoy doing, whether it's rowing, taking classes in gyms or swimming or whatever else they enjoy. As long as you get to a point of huffing and puffing, I think gentle walking is good. Anything is better than nothing. So people who don't exercise at all and start walking 10 minutes a day can see improvements in their brain functions. Even 10 minutes of walking. Of course, if you walk 45 minutes and it's a brisk walk, it's even better. If you walk one hour, great. If you go for a hiking trip with your friends for two hours, even better. So the bottom line is this. Do it. Don't think about it. Don't worry about this and that. Just do it. And if you want to gain extra benefit, try to push yourself so that you get to a point of huffing and puffing for for a period of it. So if you go for an hour walking, just periodically walk faster so it can get to a point of huffing and puffing.
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Sure. Makes sense. And in terms of mindset, you mentioned meditation. Is there a minimum effective dose? And you know how do you think about frequency, recency? What. What moves the needle?
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I think it depends on the state of mind. You are at baseline. So if you are a relaxed person already, if you don't have too many stressful things in your life already, then you know, meditation is good for you. But it's not going to be as critical as other components of five pillars of brain health. And that's one of the things we did for our patients. We personalize a program to the specific characteristic things they had. But in General, I think 10 minutes of meditation is sufficient to calm the brain and increase blood flow to the brain. What most people don't appreciate is that meditation does reduce cortisol levels. It does reduce sort of the stress response. But several studies have shown that meditation increases blood flow to the brain. So if you look at the blood flow to specific testing, you can see that during the meditation, there is increased blood flow in the brain. Now, recent studies have shown that if you just sit and do slow breathing, something we call HRV biofeedback, heart rate variability biofeedback, you can see incredible results, including you ready for this? A change in amyloid level. Remember I told you how amyloid ABA 42 to 40 is really more specific than just, you know, the levels of either one. One recent study showed that if you do HRV biofeedback, which is basically breathing slowly, like, you know, five times per minute, that alone makes you feel better, reduces stress, and it reduces amyloid levels in the brain. This is what I'm talking about, reversing Alzheimer's disease. So if you have tau and ant amyloid levels and you're worried about Alzheimer's disease, sitting down and doing slow breathing for 30 minutes three or four times a week can reduce the amyloid levels in your brain.
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In your view, it sounds like Alzheimer's is not. Is a diagnosis that is reversible for most people. You get that diagnosis. There's a hell of a lot you can do in terms of lifestyle to stop it in its tracks.
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Absolutely. No. This is what excited me to write the book. In the past two or three years, we have come to appreciate that we can view Alzheimer's disease the same way we view diabetes. A condition that could be prevented, managed, and reversed. And this is what most people don't appreciate. They feel like, oh, I have high blood levels of these biomarkers. I'm doomed. And they don't realize that lifestyle interventions can reduce the levels of these biomarkers.
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And lastly, you talked about brain training. What you know, there's there's the classic story of someone retires and. Or they stop working and they're less engaged, and the brain kind of goes to mush over time. So in your. In your view, what are the things, no matter what stage of life you're at, maybe you're not working, maybe you're retired, maybe you're not challenged. Like, what, what. What must you do on a daily basis to engage and train your brain?
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I think you need to look at your brain like a muscle. The more you use it, the stronger it gets. And brain training is very similar to physical training. Remember, I told you that the exercise should be something you enjoy doing. So brain training should not be a chore. You shouldn't do brain training because you just want to prevent Alzheimer's disease. Brain training means that you challenge your brain in a way that it's hard for you. So, for example, you could do Sudoku, you could do crossbow puzzles, you can do brain games. But you can also learn a new hobby. For example, you can learn how to play golf. One study show that if you take a group of people and show them how to play golf, you give them 72 hours of golf lessons, and you have a control group who does not get this brain training or golf training. And then they look at their brain. After three or six months, you can see that the parts of the cortex and hippocampus in the group that learned how to play golf increased. The areas which were important for hand, eye coordination, and control of arm movements increase in volume in three to six months. So I always tell people, find something you enjoy. And there's like a list of 20 things I suggest at the end of the chapter on the mindset in my book. And so, you know, do those things or take a dance lesson or, you know, learn a new language or do something you enjoy.
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So in terms of learning, would it apply to, say, listening to a podcast or watching a documentary where your brain, you know, maybe you're driving and you're listening to an engaging podcast where it's passive, but the brain is engaged, you're actively listening and soaking information. Would that qualify as brain training?
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Yes, I think that will be similar to a light walk, because when you're listening while you're driving, as you mentioned, is a passive learning. However, if you're listening to French lessons, which sometimes I do when I drive now, I am really using my brain because I'm memorizing words. I am actively involved with the process of, you know, learning or improving my French. So I think listening to podcasts or listening to ebooks are great. They're engaging your brain. You're paying attention, you're sustaining your attention. And that's a good thing. It's similar to a light walk as opposed to going for a run or doing half marathon.
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So I'm assuming reading a book would be better than listening to a book?
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Yes, because the reading a book, you're more engaged, you're actually looking, reading, and you're all focused on it. Again, I think the focus should be on enjoying the activity. So anything is better than nothing. And if listening to podcasts is something you do, and that's all the time you have your brain training, great. It's better than nothing.
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So you mentioned HRV earlier. It feels like possibly a metric we should be paying attention to in terms of our brain health.
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C
Yes, in terms of the things that are bad for the brain. You know, poor sleep is really bad for the brain. Sedentary lifestyle is really bad for the brain. But high stress levels chronically are horrible for the brain. People who are constantly stressed on a daily basis, they're stressed on drive to work, they're stressed with dealing with co workers, they're stressed in dealing with children, they're stressed with economy, the politics, they're constantly stressed, they're really shrinking their brain every day and that is really bad. People who feel they are in that category need to really hit the pause button and realize that their brain is very important and they should not waste it. Let me give you a little story about my daughter. Two daughters and my younger daughter, both in college now. But my younger daughter Maya was in elementary school and she had come to some of my talks and knew about hippocampus. So I told her one day, I said, honey, your book review is due in two days and you have not even started reading it. And she said, dad, you're stressing me out and that's not good for my hippocampus. And so I think that's a good lesson for a lot of us. And in a daily basis, when something stresses out, we have to ask ourselves, is it worth my hippocampus?
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And so for one who wants to track how they're doing here, HRV inching higher would indicate I'm doing a better job of managing my day to day stress and vice versa. HRV dipping lower, maybe have some more room for improvement.
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Yes, HRV is a little tricky in that there is day to day variability and hour to hour variability. So if you measure HRV in the morning when you wake up, it will be different. Than it is in the afternoon. So what you need to do is to measure your HRV at the same time every day for a week.
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So if someone's wearing a wearable, like a whoop on aura, just does it overnight and you wake up and you see your hrv. Yeah.
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Yes. Many smartwatches oura ring these days. Just calculate the hrv and you can see it on your watch. And so you want to measure it exact same time every day for a week to get a feel for where it is. 34, 32. Or is it 42, 45, 46. And. And then there's no, like, optimal level because every person is different. You want to know your baseline and then monitor it over time. More like a weekly basis, not like from day one to day two. So you should look at a broader view, not on an hourly basis or daily basis, more like a weekly basis. How I'm doing with HRV.
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A
Sure. Intelligence. You outline over 30 forms of intelligence. Why do you think so many successful, bright, smart adults don't think they're smart?
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C
Yes, that's the first chapter of my book. I talk to you about cortex and hippocampus. Cortex is important for our higher cognitive functions. Anything we do that requires thinking, problem solving, reading, writing, typing, doing our taxes, preparing for a podcast, writing a book. Everything we do requires primarily the cognitive functions, require cortex, hippocampus. Unfortunately, over the past century or so, people have decided that intelligence is being good at logic, problem solving, and processing speed. And somehow this is the IQ test that determines how intelligent you are. And that's an absolute mistake. That is totally wrong. Because who's there to decide as to why being good with logic and problem solving is better than being able to play the piano, for example? Because if you could, if you could be a master pianist, but you would do poorly on IQ test, Are you not intelligent? You could be a great cook and have poor scores on IQ tests. Are you not intelligent? You could be a billionaire and do poorly on IQ tests. Are you not intelligent? So I think we need to appreciate that intelligence comes in many different forms. One of the favorite forms of intelligence for me is emotional intelligence. For a person to detect that the other person is happy or unhappy and then connect to them. This is a form of intelligence, can make you very successful in life. And this is not something that can be measured on an IQ test. So in my book, I list 30 different types of intelligence, but these are not all types of intelligence. Bottom line is this. Your cortex and hippocampus can do pretty much anything like you can become a pianist, you can become a cook, you can become a businessman. And all of those functions are things that are done by cortex, hippocampus, and the parts of the cortex and the campus can be trained to be better at it. Remember I mentioned earlier to you that playing golf will grow the size of the brain for hand eye coordination and other functions in order to be better at golf. If you learn language, the corresponding parts of the brain for language improve, especially the cortisol hippocampus.
- [38:53]
A
Can you spend a moment? Why is hand eye? You know, I think of all the great hand eye activities one can participate in as they get older. You know, ping pong, the, you know, pickle, what the list goes on. Why is hand eye just so great for the brain?
- [39:09]
C
Yeah. Because it requires a lot of attention. You have to focus your hands and your eyes, which means that you really need to focus on what you're doing. So if you're going for a walk, you could be thinking about things, you really are not focusing. But when you play ping pong, you can't be playing ping pong and then do arithmetic at the same time. Because the ping pong, the hand eye coordination really requires your brain to maintain its full attention on the ball. You cannot pay attention. That's one of the things I like about ping pong, because when I play ping pong, my mind is off everything else and I'm just so immersed in the game. But going back to the intelligence, I think people need to realize there are two types of intelligence. Innate intelligence, which means you're born with some forms of intelligence. You just find it easy to learn language, you just find it easy to play with numbers. You just find it easy to play the piano. And then there's the acquired intelligence. You were never good with playing the piano to begin with, but you took a thousand hours of lessons and now you're as intelligent when it comes to playing the piano as somebody who had an innate talent. People make the mistake of looking at other people who have an innate talent for something and they think that they are smart people. And then they don't appreciate all the things they're good at. They don't appreciate how other people look at them. And they wish they could be able to cook as well as they do, or they could be as good a handyman as they are, or they could write as well as they do, or they could tell jokes as much as as well as they do. So I think it's important for people to appreciate that they have some innate talents but more importantly, they can acquire any talents they want. And this becomes important when it comes to memory. A lot of people think that their memory is not good. You know, I give lectures around the world. I've been to, like, 40 countries, and I often ask the audiences to just raise your hand if you have difficulty with remembering names. And 90% of people raise their hands. I ask people if you have difficulty, if you think your memory is poor. 90% of people raise their hands is really. Except, you know, there are a few exceptions that when somebody raised their hand and say, yes, I have good memory. And I realized that, is it possible that 90% of people in the world have some kind of memory disease? No. The mistake they make is to think that they just should remember everything because they were told once or twice. They don't realize that memory is a form of intelligence that they can develop. They can work on memory training, and they can have much better memory if
- [42:00]
A
they practice what I've found as I've gotten older, maybe it's a protective mechanism, but my memory has become a lot more selective, especially as it relates to running a business. There are certain things, certain numbers I do not forget. I know exactly what they are. And other things. Yeah, what was that? I move on.
- [42:23]
C
Yes, And I think that's a good system to have. In general, we remember things that are important to us. Our brain is wired in such a way so that we remember things that are important to our survival. Like if you're a deer, you know, roaming in the woods, and there's a lake, and you see a lion once near the that corner of the lake, you remember not to go there again, because it's important for your survival. And us humans is same way. We remember things that are important to us, mostly emotional things. You remember the first kiss you had, the first time, you know, when you graduated from high school, when your first child was born, you remember things that were highly emotional, and you remember those effortlessly, but everything else, you have to put in effort. And I think it's a good system to have that you will remember the things that are important to you, and you don't worry about forgetting things that are not important to you.
- [43:27]
A
So in closing, where do you think the future is headed in three to five years in terms of Alzheimer's, dementia, cognitive decline? I think of all the lifestyle modifications, your program, what they can do. We haven't even talked about pharmaceutical interventions and some of the exciting experiments, not just here, but studies happening in Europe with regards to new GLP1s that could potentially Help lower P tau. What's Your view? In 5 years, 10 years? Are we going to be even talking about cognitive decline? Are we on the cusp of major breakthrough? What do you think the future holds?
- [44:08]
C
I think we are at the cusp of a paradigm shift in the way we look at cognitive decline. In the past, it was accepted that as you get older, your brain decays, your memory fades and you eventually get Alzheimer's disease. Now we know that that is not the case. It does not have to be the case. You are in control of your brain health just the same way you are in control of your heart health or your physical strength, your fitness levels. You are in control of whether you're fit or whether you're not fit. You are in charge. It's not just luck. And so I think in the next two to five years, more and more people will appreciate that they can have a better memory next year, just like they can have a better body next year. And that is exciting because they can look forward to getting to their 60s, 70s and 80s and staying sharp. I plan to start a new movement, what I call brain superager community, where people will just sign up and say, I pledge to become a brain superager, which means I will reach the age of 90 and stay sharp and independent. And let me tell you one more thing. In terms of the clinical trials in this field, I reviewed personally the results of clinical trials for the new Alzheimer's drugs, as well as the objective clinical trials for multimodal lifestyle interventions similar to mine, lifestyle interventions such as exercise, diet, brain training and stress reduction. When you combine them, you can call it a multimodal lifestyle intervention program. So there are several clinical trials for new Alzheimer's drugs, and there are several clinical trials for multimodal lifestyle interventions which used the same cognitive measures as the ones that were used for the clinical trials for drugs. So it was comparing apple to apple, and what I discovered was that the Alzheimer's drugs were changing. They were slowing the rate of cognitive decline. They were just making people decline a little less than they would otherwise, whereas the lifestyle interventions actually improved their cognitive functions. Now, drug companies often talk about how the drugs reduce the Alzheimer's disease by 27% or 35% in terms of the change in cognitive function. How much less worse did they get? Is about 27 to 35%. When you look at the same calculation for clinical trials of multimodal lifestyle interventions, the improvements are 200% or 400% better. So the lifestyle interventions are far more effective than these new drugs. What I believe will happen in the next three to five years is super exciting. I think that the next generation of drugs will be more effective. The current generation are like first generation. They're just starting to get a hold of it. And the lifestyle interventions already we know that are powerful not only to reduce inflammation, increase blood flow and increasing the rinsing in your brain, but also reduce amyloid and tau. All those things combined versus these drugs that focus on the plaques and tangles in the brain. So if you combine them, you'll be super successful. So I think in the next three to five years we're going to look at Alzheimer's disease like diabetes, a condition that can be prevented in the first place and if somebody has a diabetes already can definitely be treated and reversed over time. I'm really excited about the future. I'm 63 years old now and I'm set to become a brain superager. I'm going to get the age of 90 and be sharp and independent and no, from little I know about you, I think you'll be there with me.
- [48:10]
A
I'm in. Sign me up and look. I couldn't agree more. I think where we're headed with pharmaceutical breakthroughs combined with lifestyle modification like we've never seen before, the future is just incredible. And I think what's particularly exciting is pharmaceutical is understanding that lifestyle is critical. It's not just one or the other. And I don't know if that was the case before and the same time. I think for some people lifestyle can be game changing but may only get you so far depending on genetics, various factors and that it's that combination which is just incredible. The book is Invincible Brain a must read for anyone interested in brain health. Majeed, thank you so much.
- [49:04]
C
It's my pleasure. Thank you very much for having me on your podcast.
- [49:09]
A
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