585: How to prevent & reverse cognitive decline | Neurologist Dale Bredesen, M.D.
The mindbodygreen Podcast
播客名称：My Buddy Green 播客 主持人：Jason Wachub（My Buddy Green 创始人兼联合首席执行官） 嘉宾：Dale Bredesen 博士（神经退行性疾病专家，Apollo Health 首席科学官） 主题：探讨认知衰退的预防与逆转，重点介绍大脑健康的关键驱动因素及生活方式干预措施。
开场与产品推广（00:00 - 01:34）
核心讨论：认知衰退的逆转（01:34 - 50:23）
1. 认知衰退并非不可避免（01:34 - 04:55）
2. 认知衰退的三大驱动因素（04:55 - 07:56）
3. 血液检测：提前发现阿尔茨海默病（07:56 - 10:31）
4. 基因与认知衰退（10:31 - 13:35）
5. 生活方式干预（13:35 - 24:34）
6. 炎症管理（24:34 - 27:02）
7. 大脑训练与刺激（27:02 - 32:31）
8. 社会联系的重要性（37:44 - 39:22）
9. 未来展望（39:22 - 42:19）
10. 认知衰退的四个阶段（44:15 - 48:31）
11. 总结与号召（48:31 - 50:23）
广告插播（24:54 - 25:42）
总结
这期播客通过科学证据和实用建议，挑战了认知衰退不可避免的观念，强调了能量、炎症和毒性是大脑老化的三大驱动因素。Bredesen 博士提供了可操作的检测工具（如 P-tau 217 血液检测）和生活方式干预措施（如生酮饮食、大脑训练、社会联系），并展望了未来技术（如干细胞、肽类）的潜力。整体信息赋能且实用，适合关注大脑健康的听众。
Edit:2025.04.04
播客开场与赞助信息: 主持人 Jason Wachub 欢迎听众，并简要介绍了 My Body Green 的一款镁+酸樱桃饮料（Magnesium Plus），声称它有助于深度放松、睡眠和恢复，改善了他的深度睡眠和 REM 睡眠。随后是 Mint Mobile 的广告，由 Ryan Reynolds 配音，宣传其每月 15 美元的无线套餐计划。
嘉宾介绍与核心议题: 主持人介绍本期嘉宾 Dale Bredesen 医生，一位神经退行性疾病专家。他挑战了“认知衰退不可避免”的传统观念，认为认知衰退不仅可以预防，甚至可以逆转。本期节目将探讨大脑老化的三大驱动因素：能量代谢（Energetics）、炎症（Inflammation）和毒性（Toxicity），介绍评估认知健康的最新工具（包括能在症状出现前检测阿尔茨海默病的血液测试），以及保护大脑的生活方式干预措施（如精准营养、禁食策略、基于基因的抗炎方案），目标是让“大脑健康期”（Brain Span）与寿命（Lifespan）相匹配。
Dale Bredesen 医生的核心观点:
结语: Bredesen 医生强调这是一个充满希望的时代，通过科学的方法和积极的生活方式改变，绝大多数人都可以维持长期的大脑健康。他呼吁社会发起针对阿尔茨海默病的“登月计划”，通过系统性的预防和干预来减轻这一全球性负担。
Edit:2025.04.04
00:00
Welcome to the My Buddy Green podcast. I'm Jason Wachub, founder and co-CEO of My Buddy Green and your host.
00:07
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00:30
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01:01
Ryan Reynolds here from Mint Mobile. I don't know if you knew this, but anyone can get the same premium wireless for $15 a month plan that I've been enjoying. It's not just for celebrities, so do like I did and have one of your assistant's assistants switch you to Mint Mobile today.
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01:34
We've been told for years that cognitive decline is inevitable, that once memory loss begins, there's nothing we can do. But today's guest, Dr. Dale Bredesen, is back on the show to challenge that narrative and offer real hope. Dr. Bredesen is an internationally recognized expert in neurodegenerative diseases and the chief science officer at Apollo Health. He spent his career unraveling the mechanisms behind Alzheimer's and has made a groundbreaking discovery.
02:02
Cognitive decline isn't just preventable, it's reversible. In today's conversation, we'll break down the three key drivers of brain aging: energetics, inflammation, and toxicity, and discuss the latest tools to assess cognitive health, including simple blood tests that can detect Alzheimer's before symptoms even start. Dr. Bredesen will also reveal the lifestyle interventions that can help protect your brain for decades.
02:25
such as targeted nutrition, fasting strategies, and anti-inflammatory protocols tailored to your genetics. If you're looking to future-proof your brain, optimize cognitive function, or simply stay ahead of the latest in neurology, this episode is full of practical takeaways. So let's dive in and learn how to make your brain span match your lifespan.
02:49
So what are people missing in terms of cognitive decline and what can be done to reverse it and everything impacting their cognitive decline or cognition in general, hopefully not the decline?
03:05
That is such a huge question that we could spend a few hours just on that one question because there are multiple pieces to this. So, now the first thing that people are missing is that cognitive decline is inevitable. We have been told over the years repeatedly there is nothing that you can do to prevent, reverse, or delay cognitive decline. If it's coming for you, it's coming for you.
03:32
And our research and our studies over the years indicate just the opposite, that there is a tremendous amount you can do
03:40
There is what you can do to prevent it. You can do to reverse it. We've published reversal of cognitive decline. We were the first to do that way back in 2014. We're now in the midst of a six-site randomized controlled trial that shows unequivocally that you can reverse cognitive decline. Now, of course,
04:04
The later you wait, the more you have to do, the more difficult it is, and the less complete it is. Nevertheless, you can reverse it even in late stages to some degree. And in early stages, you can reverse it completely. We've published a paper showing you can sustain the reversals for over a decade. So that's the first thing that people need to know, that this is not something that is outside of our control. The second piece is,
04:33
that you want to combine protection and performance. So you want to improve your performance, but you also want to improve protection. You can improve performance, as you know, for a few hours with things like Adderall or cocaine or things like that, but they're not in your long-term best brain health interest.
04:55
But to get a better performance and better protection for a lifetime is the key. So what the new book is about is to be able to make your brain span equal to your lifespan. In other words, if you're going to die, whether it's 70, 80, 90, 100, 110, whatever it's going to be, you don't want to have years in a nursing home. Of course, you want to have a sharp brain for your life.
05:23
And you can do that for virtually all of us by looking at what actually drives the decline. And the three big factors that are driving this in the vast majority of people are energetics, inflammation, and toxicity. And of course, we're hearing all sorts about aging and reversing aging. And now that we have better and better markers,
05:48
we can look and say, we can look with epigenetics and say, aha, you've actually de-aged a few years. Well, now we have some wonderful brain markers as well. There are epigenetic markers that look at brain aging. And then there are also markers that look at where your brain stands with respect to cognitive decline. And what I mean by that is,
06:12
Years ago, we would know when people had diabetes, but people didn't know that you could measure prediabetes and then pre-prediabetes, in other words, insulin resistance. Now, of course, you can measure fasting insulin. You can measure HOMA-IR. You can measure hemoglobin A1C. So if you're paying attention, nobody needs to get to the point of having full-on type 2 diabetes with vision loss and renal failure and vascular disease.
06:41
Well, Alzheimer's has now gone the same route. We can now look ahead of time
06:47
We can look at your P-tau 217, which is now a simple blood test. We have a blood test called Brain Scan. We've worked with the group out of NeuroCo, Dr. Hans Frickman and his team. They have the most sensitive P-tau 217. We look at GFAP and we look at NFL, which is neurofilament light. So those three things tell us very complementary information. Number one, P-tau 217 tells
07:14
changes, goes up in your blood when you're headed for Alzheimer's disease. So you can see it coming and you can do something about it. You can correct the energetic insufficiency, correct the pro-inflammatory effect, correct the toxicity effect.
07:30
The second thing is GFAP, which is glial fibrillary acidic protein. This is a protein made by your astrocytes, which are supporting your neurons in your brain. When they get inflamed, they increase their size. They're trying to do more. They make more GFAP because it is part of the intermediate filaments of those astrocytes. And you can pick that up in the blood.
07:56
And then the third one is NFL, which is neurofilament light. And you can pick that up when you have damage to neurons from any cause, car accident, playing too much football, whatever it is. So that with those three together, we get very complementary information. As an example, when I see someone who has a high P tau, but a normal GFAP and a normal NFL,
08:24
They are on their way to Alzheimer's, but they don't have active Alzheimer's yet. On the other hand, if I see someone who's got a high P tau, a high GFAP, a high NFL, that is active, ongoing, damaging Alzheimer's disease. If you have
08:41
a normal P tau, but you have a high NFL and a borderline GFAP, that is typically someone who's going to have something like frontotemporal dementia. It's a non-Alzheimer condition, or they may have had head trauma, things like that. So with this, you can really look and say, what is going on inside the brain of each person so that we can prevent problems? So I think people need to be aware of this
09:10
Practitioners need to be aware of this. Most practitioners, you know, mainstream medicine is not reversing cognitive decline, has no idea what to do about that, and really is not aware that it even exists. So there's tremendous change. We really are in a time of great progress with respect to the brain. So much to unpack there. I feel like you've answered about a dozen of my questions, but I want to double click on the three tests you mentioned.
09:38
Are two out of those three blood tests or is the third test? Yeah, great point. This is one blood test that tests three things. So we just, yeah, just like testing your sodium and potassium and chloride in the same test, same idea. So you're getting one blood. So you could do this with any, you just get a script from your doc, you ask for these three tests and Quest, LabCorp, whoever you use, can you add this to your routine lab work? You mean you don't even need to get a script from your doc? So you can go online, get a script,
10:07
getabrainscan.com. Literally, they will come to your house. I actually had mine. I think everybody should know this. If you know your blood pressure, if you know your lipid panel, you should know what's going on inside your brain so that you can prevent problems in the future. And so I just had them. They came to my house, drew my blood. It takes a couple of days after that and you'll get a report. And so it's
10:31
It's very straightforward. But yes, you can also order it through your doc as well if you prefer. It's amazing. And I also noticed we didn't touch on genetics.
10:41
Your genes are not your destiny. I think that's an important point to make here. Yeah. This is a really important point because people, again, they misunderstand this on both sides. On the one hand, they think, oh my gosh, this is going to get me. No. In fact, very, very few people who have the typical genetics for Alzheimer's have to get Alzheimer's.
11:02
And on the other hand, people will say, well, if it's not my destiny, then I don't want to know it. Yes, you still want to know it because it's not your destiny. It's your propensity.
11:12
So what you want to know is, especially ApoE4 status, that's the most common and most important gene with respect to Alzheimer's disease. And there are others, but that's the most important one. Three quarters of the population has zero copies. Their risk is 9% for their lifetime. It's not zero, but it's not too high. 75 million Americans have a single copy of this gene and their risk is 30% during their lifetime.
11:41
Everybody should check. Anyone who's over 35, please check. Get on active prevention. It's not a problem. There's a wonderful website.
11:49
which is called APOE4.info, started by Julie G., who is an APOE4.4. She has two copies. That's 7 million Americans have two copies. Their risk is about 90%. In other words, most likely they will get Alzheimer's, but not if you get on the right approach. Again, we've shown this again and again and again. We have many people with APOE4.4 following our protocol, doing very, very well for years.
12:18
So it's a very good thing. As you say, genetics, not your destiny, but it's helpful to know because it is changing your metabolism. And so you want to take actually slightly different steps. If you're a 4-4, you actually want to go a little bit longer with your fasting because you are better at absorbing fat.
12:40
If you are a 4-4, you want to push a little harder on the anti-inflammatories, things like resolvins, because you have a pro-inflammatory state. We actually studied this in the laboratory for years and showed that when you have ApoE4,
12:57
This molecule, which has always been thought to be the fat carrier, it's like your butcher. It's carrying around the fat. Well, guess what? It's also your congressman because it enters the cell, goes into the nucleus, and interacts with 1,700 different gene promoters.
13:16
so that it actually changes your metabolic status of your cells and it puts you into a more pro-inflammatory state. Great if you're living in a third world country because you are fighting the various parasites and things like that. But if you're not in a third world country, of course,
13:35
Because of this long-term inflammation, you get more heart disease, more Alzheimer's, that sort of thing. So again, knowing that, we can address that early on. So assuming everyone's going to get their genetic testing, if they haven't already, they're going to order these lab tests. And how do we, from a lifestyle perspective, what can we do? And I think of nutrition, I think of exercise, I think of…
14:04
I think of, you know, exercising our brain, you know, should we be reading? Should we do in crosswords? We do in Sudoku, like you tell, like what should, what should we all be doing? Cause on,
14:15
On the genetics piece, I think it's important to call out just because you're high risk doesn't mean you're going to get it. Just because you have no risk, you are not immune. That is such a good point. And, you know, people believe that, you know, if you're looking at lifestyle, well, that's not that important. I mean, how can it be that important just because I ate a hamburger, just because I had a few fries? You know, why is that really important? And it turns out, you know, again, we came straight from lab work looking at all the different players
14:44
in the neurodegenerative process. And the surprise to me was this is really a network insufficiency. When we see these diseases, whether it's Parkinson's, Alzheimer's, Lewy body, frontotemporal dementia, they all are
14:58
These are all network insufficiencies for different subnetworks within your brain. And for Alzheimer's, it's really, as you know, about neuroplasticity. So when you are trying to improve energetics, reduce inflammation, and reduce toxicity, there are seven basics and two specifics.
15:18
That's it. So the seven basics are largely about lifestyle. It's just what you said. It's diet, exercise, sleep, stress, brain training, detox, and some targeted supplements. And the two specifics are diet.
15:32
Are there chronic infections, which are remarkably common? People don't know. You've been bitten by a tick, for example. You don't know it. You're carrying around Babesia or Bartonella or Borrelia for years.
15:47
Or the other thing is toxins, which are things like mercury or glyphosate or microplastics or air pollution or biotoxins like mold-related toxins. These are incredibly common and they are important contributors. You can address them. You can treat them.
16:09
And so no question, having a, just for example, diet as the part of the lifestyle, each of these things you can optimize. Having a plant-rich, mildly ketogenic diet with high fiber, high phytonutrients, optimizing your gut microbiome, high detoxicants, things like crucifers, detoxicants.
16:32
This is remarkably powerful because you are now changing the brain from not being able to get enough energy and literally downsizing because of its lack of energy into now being able to get enough energy. And as you know, your brain can only metabolize two things for energy. So two energetics, it's glucose or it's ketones.
16:56
Now, for many, many people and virtually everyone I see who's beginning cognitive decline, they've lost both of those. You lose the ability to optimally use glucose because of insulin resistance. And there are over 100 million Americans with insulin resistance. It's essentially pre-pre-diabetes. This is why type 2 diabetes is such an important risk factor for Alzheimer's.
17:21
But once you ramp up your insulin, that prevents you from making ketones. So now it's like, imagine you have a Prius,
17:30
which has got no charge and no gas. You're literally sputtering, and that's what your brain is doing. And you'll notice it. You'll get tired. You'll have some brain fog. These are telling you you're not getting the support that you need. You can return both of those by having a plant-rich, mildly ketogenic diet, doing some exercise, both aerobic and strength training. These have different mechanisms, which are synergistic mechanisms,
17:58
getting appropriate sleep. And I mean, it's really, these, the wearables are so helpful. CGMs, soon CKM, things like that. Looking at your watch and saying, you know, how did I sleep? Did I get enough REM? What's a CKM? That's just continuous ketone monitoring. It's coming. It's coming relatively soon. Spend a moment on that. It feels like for those listening who haven't
18:21
you know done the those lab works those labs excuse me yet insulin is a big giveaway huge yeah for something something's wrong and also this idea that your cardiovascular what's good for your heart is good for your brain so if those numbers are starting to creep up insulin resistance is on the horizon
18:41
Or you mentioned in the book, everyone should pick up the book. You go through in great detail all the lab work or your APOB, for example, is starting to creep up in a way that's not healthy. Those two alone are a sign, hey, you got to pause here and reassess what you're doing. Absolutely. So, you know, you bring up a really good point. And thank you for mentioning the book. It's called The Ageless Brain coming out March 25th.
19:06
And so the idea here is we've all been taught the medicine of the 20th century. You get symptoms, you go into your doctor, he gives you a prescription or he does surgery and you do better. That is unfortunately not the medicine of the 21st century.
19:22
Virtually all of us now are aging and dying from complex chronic conditions, Alzheimer's, cancers, heart disease, strokes, renal failure, these sorts of things. This is the 21st century. We've moved from the more acute illnesses, things like pneumococcal pneumonia, infectious things, TB, even HIV. You can have prescriptions that do that.
19:51
But for these things where these are about now networks, all the different pieces that work together to give you function that are now starting to fail.
20:02
You can pick this up early. So you don't want to wait for symptoms. By the time you get symptoms, for example, of Parkinson's, you have lost 80% of the dopaminergic input to your striatum. By the time you get symptoms of chronic renal failure, you have lost about 80% of your kidney function.
20:25
So the old strategy of wait to feel bad, then go into your doctor no longer works. And this is why wearables and getting appropriate labs and getting on long-term…
20:38
plans for working, for essentially optimizing your function is such a change. And I wish that more doctors understood that. I wish that more people understood that because there is so much. That's really what this book is about. We can all
20:54
have longer term and better brain function by looking at these things. As you mentioned, if your ApoB is going up, you may be getting some vascular disease. Okay, you can go very simply and get a calcium score for your heart.
21:09
If you are now having issues with brain fall or if you're even having, if you're not, if your P tau is a little high, you're on the way. And let's get that back down. The good news is as we treat people, their P taus come right back down. So just like you can go from having diabetes to not having diabetes, something that used to be also be denied.
21:33
We actually have a great case later today, a woman who went from full-on diabetes with a hemoglobin A1C of 7.5. She's now at hemoglobin A1C of 5.2, which is completely normal.
21:47
So these things are much more reversible than people realized. And as you see them coming, it's much easier to do something about them. Well, I think what you described in terms of diet is actually very accessible. My guess is most of our audience listening is probably adhering. You're essentially describing eating lots of vegetables, a lot of wild fish, beets occasionally, healthy fats, fiber. Essentially, you're avoiding ultra-processed foods and lots of sugar. And I think most people are probably on that program.
22:15
That's fantastic. And that's a great start. So again, you want to put these things together. If you're on that program, fantastic. And then you want to think about, you know, are you getting appropriate exercise? Are you doing both the strength training and are you doing the aerobic part? And some people, you know, a hit is a really good one.
22:35
of course, and some people like katsu bands. I particularly like IWAT myself, so exercise with oxygen therapy, because it gives you a double positive for your brain. So for anyone who's got- What is that? Anyone who's got any cognitive decline, okay? We're trying to improve your energetics. And so part of that, your energetics are based on your blood flow,
23:00
your oxygenation, of course, your mitochondrial function, and are you sensitive to glucose, in other words, insulin sensitive, and are you sensitive to ketones and are you capable of making them? So those are the big four. So when you do EWOT, what you're doing is you're exercising with oxygen. And when you do that, you're getting improved blood flow with improved oxygen. So you're getting more oxygen to further reaches of your brain.
23:28
and people notice, whoa, I'm sharper, things are better. Of course, other people will notice it with things like taking some exogenous ketones or some coconut oil or something like that or some MCT oil or they will notice it with
23:45
taking creatine, that's another common one, or Alcar. So the great news is there is a lot we can do to optimize your energetics, to reduce your inflammation. I happen to like Resolvents for that, for example. Some wonderful work out of Harvard on discovering Resolvents, Professor Charles Searhan, very, very exciting work. But there are, again, as you mentioned, anti-inflammatory diets.
24:13
And then, so the good news is all of these things are here. You know, we were told when I was trained in neurology many, many years ago, we were told there's nothing that you can do. When someone comes in with a cognitive decline, you can check to see if it's due to B12 deficiency or syphilis, and that's about what you've got.
24:34
The reality is the armamentarium is huge and it's growing. It's getting bigger and bigger. The armamentarium is huge. So we can address all these things. There are now stem cells and exosomes and all these things that at the appropriate time for the appropriate person can be very, very helpful. So what…
24:54
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26:04
Investing involves risk. Offer is subject to terms and conditions. There was resolvins. So resolvins are cousins of the omega-3s. They are chemically similar in structure. And what Professor Searhan showed is that when you have this
26:21
chronic inflammation as so many people do. If you've got metabolic syndrome, you've got some chronic inflammation. When you have that, if your HSCRP is up above about 0.8 or 0.9, you've got some chronic mild inflammation. And this is a driver of decline. It's a driver of aging. It's a driver of cancer. It's a driver of vascular disease. It's a common driver of age-related conditions.
26:50
And when you have this, you need to take this, instead of just an anti-inflammatory, you need to first resolve the ongoing inflammation.
27:02
And so his research over the years showed that there are specific compounds that you use to resolve that inflammation. Once you resolve it and reset, now you want to think about anti-inflammatories to not get inflamed in the first place. But there, as he showed, there is a different biochemistry to resolving what's already ongoing. Understood. So in terms of
27:28
exercising the brain. We lose what we don't use. And so if we're not, same thing, if you're doing resistance training and all of a sudden you stop doing it, you start losing muscle. Same goes for your brain.
27:41
How should we be thinking about what we're doing daily? Being engaged, reading, crossword, the list goes on. Like, what's your take for like, how do we make sure the brain is firing on all cylinders? So this comes under the general rubric of brain stimulation. It is not just the training, but also stimulating what's there. And you can, the stimulation is things like
28:05
light therapy, magnetic stimulation, microcurrent, all these things are forms of stimulation as is training. But here's the trick. You were talking about weightlifting. If you go out and say, I'm going to lift weights, but I'm malnourished, the weights aren't going to help you. And in fact, they may damage your muscle and you may not do as well with weightlifting if you are truly malnourished. So,
28:32
What you want to do is do this brain stimulation on a backbone of optimizing the support for your brain, making sure you have enough nutrients, that your hormones are in balance, that you've got enough neurotrophins. So you've, in other words, you want to have a, it's like if you're going to take out your car and you're going to run it at a hundred miles an hour, it better have oil. It better have a good transmission. Otherwise you're just going to tear up your car.
29:00
And so no question, using your brain, very helpful. And in fact, there's an important paper coming out very shortly from the father of brain training. Professor Mike Merzenich invented brain training and won the Kavli Prize for that and showed that you can improve brain.
29:20
your brain function. And recently what they've shown is that you can actually improve your measured cholinergic status, beautiful studies with brain training. And they're doing this for several weeks. So then there are specific things that they're doing. They published a number of years ago about a so-called double decision, which is one of the things that Brain HQ does.
29:46
And so there's no question that this improves brain function as long as you have the underlying support for your brain. And again, I would break it down into brain training and, as I always mention, the one that's got the most proof, and they don't pay me to say this,
30:07
It's just that we're always looking for the thing that gives you best outcomes. The one with the most proof is Brain HQ. There are other things that people like to do, illuminate and things like that. Great, elevate, stuff like that. That's great.
30:19
but that's the one that is the best proven. And then beyond that, there is some stimulation and V-Light is a good one. Neuronic has a good one. Origin has a good one for light stimulation. So-called photobiomodulation has been around for decades. And again, when you have the right support for your brain, it's very helpful. - So let me think about this a different way. So let's say, someone's engaged, they work,
30:48
They're reading, they're shooting off emails, they're strategic thinkers, they're having conversations with colleagues all the time. So when they're in the day-to-day, they're doing all the right things, so to speak. Let's say they're going on vacation for two weeks.
31:05
They don't want their brain to go to mush. The same way we say to our young kids, for a summer vacation, we're not going to let your brain go to mush. We got to do some work here. So if I don't want my brain to go to mush, but I'm going away for two weeks, do I read the newspaper every day? Do I do a crossword? Do I listen to podcasts? How do I keep the brain…
31:27
engaged. So it doesn't go to mush when I take time off. Yeah, this is a great point. First of all, it's not going to go to mush in two weeks, but you're right. You can lose a little bit. So what you want to do then is
31:42
The trick is you want to do something that's a little more than what you usually do. In other words, you want to be learning something new. You can be doing, you know, whether it's even beginning to do a new language, whether it's picking up a new instrument with something, just something beyond the usual without giving you stress. And that is a key point.
32:04
It's just like if you, you know, we hear about all this all the time. Someone says, gee, I'm going to go out and run a marathon and they haven't really prepared for it. And they have, you know, heart problem or they have, you know, joint problems or muscle problems. This can be damaging. And with your brain, then what you want to do is you want to go a little bit beyond. And by the way, that's what these online assessments do and brain training. They push you always a little faster, a little quicker, a little more,
32:31
a little more discriminatory, to be a little bit beyond where you are, but not so far that if you're feeling stressed, that actually hurts your brain. So you always want to be in. So whatever it is, push yourself. If you're good at certain Sudoku, do a little bit harder Sudoku. You know, if you've just begun to learn Spanish, you know, do a little bit more. But you don't need to do a lot. You know, these studies, they're often doing
32:59
30 minutes a day, you know, each day, or they're doing even 30 minutes four times a week, that sort of thing. And we, by the way, we used brain training in our first and this current trial, and we're getting very good results. Now, we're doing a whole protocol, but that is part of the protocol. So what came to mind for me, and I forget the exact details of the study, I'm sure you probably are familiar with this one. It's like the London cab drivers.
33:28
who, you know, pre-GPS, London's insane. The number of streets, you have to memorize where to go everywhere. Like the incidence of cognitive decline was fantastic. These people were doing, and it's this idea. Now we drive, we're looking at maps all the time. This is a simple thing. We're doing it all the time. Imagine if you just turned off your GPS and drove,
33:48
drove by memory, what that would do for us. Yeah. So it is true. Challenging your brain at which, you know, your brain then is bringing in that support that it needs to be challenged. And you are, as you know, the London cab drivers happen to have large hippocampi. So they have a large volume. Your hippocampus is part of what's directing you to go to the right place and know the right, remember the directions and other things.
34:15
So theirs are larger than average, which makes a lot of sense. They're using them all the time. So again, it shows the amount of plasticity in our brains is truly remarkable. Do you know one human brain, which has about 500 trillion synapses, can store more information than over 2,000 home computers?
34:40
So you really have a remarkable ability in your brain to store information. You know, I think about my children. I think about the future. You know, maps is just one example. Everyone's on GP. I find myself doing it. I know where I'm going and I'm trying to, you know, I need to like, I don't need to use it. I think of AI and the implications for AI.
35:01
Yeah, yeah. Well, I think you have to remember, though, as each of these new things comes along, you know, GPS and AI and things like that, we're learning to use those. So as long as we are exercising that plasticity and we're learning things…
35:19
then we're going to be in good shape. But you're right that the fear, the concern is for someone to just lie on the couch. You know, you can get your Uber Eats to bring stuff to you. You can flip on, you got your remote. You can literally get away with doing almost nothing. And that's what you want to avoid. That is something that is really going to be associated with a smaller and smaller neuroplasticity set in your brain.
35:45
So yes, we want to continue to challenge and to continue to upgrade as we go on. The great news is we can upgrade and we can support that continuous upgrade with the appropriate support energetically, the appropriate reduction of inflammation, getting rid of the pathogens that are giving us. Here's a simple example. Study in Taiwan a number of years ago simply took people who were getting lip herpes, so HSV-1.
36:14
And they simply said, okay, we're going to take the ones who are treating theirs and the ones who are not treating theirs. And let's look at the likelihood that they develop dementia. The ones that didn't treat it had a much higher risk for dementia. And literally the ones that were treating theirs dropped their dementia risk by over 50%, that one thing. So there's a
36:38
Again, there's a reason for chronic recurrent inflammation. Your brain responds to that. What we now understand is that the production of the amyloid that has been vilified in Alzheimer's disease is actually made to surround, sequester, and kill microbes. It is an antimicrobial peptide.
37:01
So people looked in the brain and said, oh my gosh, let's get rid of this stuff. No, what we want to do is we want to get rid of the things that are causing you to have to make that stuff. That is, it's literally like putting molasses around these things and stopping them in their tracks. You mentioned STDs and inflammation. Huge cause. Wasn't it Van Gogh who went crazy from syphilis, I want to say? Actually, many people went crazy. Syphilis, when you get what's so-called tertiary syphilis,
37:28
where you're now, it's affecting the nervous system. There's a whole set of things. And general parasis is one of the ones that was well-known. You know, 100 years ago, this was a relatively common thing. Very uncommon now. But yes, absolutely, it causes dementia. And by the way, the dementia, the way the brain looks,
37:44
when it gets syphilis, which is a spirochete, is quite similar to the way the brain looks when it gets Lyme disease, which is another spirochete. These are both spirochetes that both enter the brain and we want to get rid of them. So let's segue to social connection, which in my view is undervalued as it relates to not only our emotional well-being, but our mental well-being. So let's talk about social connection. Great point. Social connection is
38:13
is the personal analog of the cab driver's internal GPS.
38:21
So in other words, you can be a London cabbie, as you just talked about earlier, and learned all these places and how to go and how to get there. Or you can have lots of colleagues and friends and interactors and be talking with them. And it's the same thing. In one case, you're setting up locations. In the other case, you're setting up feelings and discussions and ideas and all those things.
38:45
And in both cases, you are storing and interacting with information. And so no question, and this is as you implied,
38:55
repeatedly research shows that social connectivity is helpful and supportive. And of course, it's also an antidepressant in many ways. And depression is another big risk factor for cognitive decline, in part because they have some of the same causes. Depression, pro-inflammatory, that increases your risk for depression. Leaky gut, things like that can increase your risk for depression.
39:22
So there are some things that are very, very similar. But again, having these social connections, having the ongoing interactions, and quote, something to live for, no question, has an anti- and a dementia-preventive effect. And so you touched on this briefly, but where is the science going? You talked about stem cells. In the book, you mentioned peptides, hyperbaric. What is…
39:49
the future look like? The future is very bright. To me, the future is this.
39:56
Just as we eradicated, there was a time when you lived and the scourge was leprosy. Boy, you just don't want to get leprosy. Whatever you do, don't get leprosy. And then there was a time when the scourge was polio. There was a time when the scourge was syphilis. And the time when, in my generation, the scourge has been Alzheimer's. Oh my gosh, our friend got Alzheimer's. It's over.
40:21
that's going to be gone. It will no longer be a scourge, just as leprosy is no longer a scourge, just as syphilis is no longer a scourge, because we can see it coming years ahead of time now, and we can do something about it so that you don't have to get this problem. And if you begin to get it, we can actually reverse the cognitive decline. That's where things are headed. Now, you mentioned the
40:48
new approaches. And you can imagine, because of these various new approaches, which all have relatively modest amounts of proof at this point, we need more studies.
40:59
So I hope that the NIH isn't dismantled because we do need more studies to understand when do you use these things optimally, on whom are they used optimally, and what is the optimal method to utilize these. I see this all the time. Someone says, well, I'm not doing any of the right things that really have been shown to help, but I'm thinking of going and getting stem cells in Panama or something like that. Well,
41:27
Okay, but let's not forget it's the foundational things. You've got to make that network function once again. Then when do you get exosomes? The great news is that there are all these new things, but the important thing is when are they best used and on whom and in what way? Because as you can imagine, there are a lot of claims trying to make a lot of money with no efficacy.
41:54
So, where we're headed is better and better scientific understanding and more and more accuracy. So, this is a precision medicine approach. We can now improve each of these parameters in your brain and then measure as you're getting better. With your P-Tau, you can do a simple blood test. And I recommend everyone get it every five years. When you turn 60, get it every two years.
42:19
As I mentioned, I just had mine done recently. I'm happy to see that all's in good shape. I'll repeat it in a couple of years. So that's where we're headed. That's interesting because it's not like your APOB, which will fluctuate throughout the year. It's a test you do every couple of years, similar to like a calcium score. Or if you do a Clearly exam or a Prenuvo or one of the scans, you do it once every five years or so. That's good to know. And, you know…
42:43
You know, you're talking about stem cells and peptides and very exciting, but completely agree. I compare it to kind of liken it to the frosting, so to speak. You got the cake is a lifestyle. You got it before you put on the frosting. You got to bake the cake. So you have to dial in the lifestyle in terms of nutrition, sleep.
43:02
exercise, connectivity, socially, you know, you're engaged mentally before you start down the path of all these other things. And you really want to have proof because, you know, so many people are kind of, you know, they're fooling themselves. You know, the great physicist Richard Feynman said, you know, the first thing is not to fool yourself and you are the easiest person to fool. Of course, because you want it to work.
43:27
So what you want to make sure is that your proof, are your scores improving? This is why these trials are so important. We can show improvement in cognitive scores and they're striking. We can show improvement in their MRI volumetrics. We can show improvement in your P tau. So all of these things are saying, yes, this is now a better brain than it was before.
43:51
six months ago, nine months ago, that sort of thing. And for the cognitive score, I believe it's the mocha. You referenced this in the book. Great point. And I'm glad you brought that one up because the mocha is a simple one, which is why it's nice. You can do it in 10 minutes, but it's not the best one to follow as we've found because there is what's called a learning effect. So if you take it multiple times, you get better at it.
44:15
And so what we're finding is things like CNS vital signs, which is the one we're using in our trial right now, which is an online assessment, takes about 30 minutes. So it's pretty easy, but it's much more sensitive and it can show changes much better. The MOCA does show changes. And we see people go from MOCA's of, you know, goes to zero to 30 is the scale. We've seen them go from 18, which is early dementia to,
44:45
all the way up to perfect 30. So you can certainly change that. But what you'll find is if you repeat this test in people who weren't treated, they'll get a little bit better as well. Not quite as much, but they'll get a little bit better. So it's not a great test for longitudinally. Interesting. If someone were to take the mocha just one time, ideally, where would you want them to be? Oh, yeah. So if you take the mocha one time, you want to be 28, 29, or 30.
45:14
If you're even down at 27, 26, 25, you better get checked out further because you're likely to have some early MCI. And that's another thing we should mention. When you develop cognitive decline, the good news is it takes over 20 years to do this. So the window of opportunity to do something about it is huge, right?
45:36
You go through four phases. So you have a pre-symptomatic phase where you don't even know you've got problems, but you're already beginning to have biochemical changes. This is why it's good to have a PTAL 217 and GFAP so-called brain scan. It's really a good idea to have that because of this.
45:55
The second thing then you go, the second phase is called SCI. And that's what people are so aware of. So subjective cognitive impairment. And this is so common. People in their 40s and 50s, even in their 30s,
46:12
will notice, wait a minute, I don't remember phone numbers the way I used to, or I don't remember some of the names of my friends the way I used to, or names of new colleagues the way I used to. And so the doctors keep telling us, oh, that's just normal aging. No, that's telling you that things are suboptimal. By the way, a very, very common reason now, of course, is COVID. And
46:35
And people will say, gee, since my COVID, I'm really not remembering things quite as well. Okay, time to get in, find out whether you've got some continued inflammation and what to do about that. So SCI lasts on average 10 years before giving way to MCI. Oh my gosh, please don't wait beyond that. We get virtually 100% of people with SCI to reverse their decline. That's an easy time.
47:04
The third of the four phases is called MCI, mild cognitive impairment. And that's when the drug trials are done. Our trial was done on people with MCI and early dementia. Dementia is the fourth phase.
47:19
And so these people typically, MCI, you typically have your MOCA scores are coming in anywhere from 20 or 21 up to 27 or so. And that's telling you something is not right. By definition, what MCI means is you are no longer able to score normally on cognitive tests.
47:40
But you're still able to do your activities of daily living. Whereas SCI, you're saying something's wrong, you know that things are not right, but you're still able to score normally on cognitive tests. Then the fourth and final phase is called dementia. That's dementia of Alzheimer's. Alzheimer's is the most common, but there are others like Lewy body dementia and vascular dementia, things like that.
48:03
And by definition, that means that you're now losing your activities of daily living. And so you don't want to wait that long. So if we get everybody in these early phases, very few people would ever have to go on to get dementia. It really, it's one of these things that doesn't have to happen, and yet it's happening so commonly. 45 million of the currently living Americans are slated to die of Alzheimer's-related dementia.
48:31
If we don't do something about it and there's so much we can now do about it So we just don't want to wait in the UK It is the number two cause of death and number one cause of death in women in the UK is Alzheimer's disease Well, well again, I want to emphasize this is a message of empowerment There is so much you can do and just because you have the gene, you know, your genes are not your destiny Whether you have the gene or not
48:59
There is so much opportunity and the time horizon is, we're talking decades.
49:06
And no matter where you are, unless you're end-stage Alzheimer's, there are numerous case studies that you've conducted personally through your work and researchers around the world. You can reverse this. Absolutely. And others are showing the same thing now. It's a very exciting time because there is this beautiful growth. And again, you don't have to wait. We used to think of this as overwork.
49:29
old-timers disease. That's what we would call it because we saw people in their 60s, 70s, 80s, and 90s getting this. It's turned out because of the biochemistry you can look in, and it's really a disease of your 30s, 40s, and 50s that is diagnosed 20 years later. Yes.
49:47
Well said. We covered so much today. Everyone go pick up the book. In closing, is there anything we didn't touch on that you want to touch on before we close? I would just say that, you know, under President Obama, there was a moonshot for cancer.
50:03
It's time for a moonshot for Alzheimer's. We can make a big difference and reduce the global burden of decline, cognitive decline. And to do that, there will have to be essentially a multi-tiered system where everybody does some basics and then a few of the people will begin to get symptoms despite that. Most won't.
50:23
Those few people then have to have more evaluation, et cetera. So you have a hierarchical system so that you can be quite efficient and you can reduce. This is a over $350 billion a year issue. So look, if you want to have government efficiency, reduce the global burden of cognitive decline. Dale, thank you so much. Great talking to you, Jason. Thank you so much. Always great to talk to you.
Edit:2025.04.04
