WEBVTT - Can Happiness Ward Off Dementia? 0:00:15.476 --> 0:00:15.916 Pushkin. 0:00:21.996 --> 0:00:24.876 This year, Finland has yet again been crowned the planet's 0:00:24.916 --> 0:00:28.516 happiest nation by the World Happiness Report. Country rankings like 0:00:28.556 --> 0:00:30.836 these are usually the only thing people hear about when 0:00:30.836 --> 0:00:33.076 it comes to this annual report, but here on the 0:00:33.116 --> 0:00:35.236 Happiness Lab we like to go a bit deeper into 0:00:35.236 --> 0:00:37.836 the well being science, and so in the next episodes 0:00:37.916 --> 0:00:40.316 we'll be diving into what the report says about other 0:00:40.396 --> 0:00:41.596 pressing wellbeing issues. 0:00:42.076 --> 0:00:43.116 Last time, we spoke to. 0:00:43.156 --> 0:00:45.876 John Helliwell, who's been working on the World Happiness Report 0:00:45.956 --> 0:00:49.436 since its inception. He explained that this year's report focused 0:00:49.516 --> 0:00:52.796 not just on overall differences and happiness across nations, but 0:00:52.876 --> 0:00:56.436 also on how happiness differs across age within a single country. 0:00:56.796 --> 0:01:01.316 So we split the population into those born before nineteen 0:01:01.436 --> 0:01:06.476 sixty five boomers and their predecessors, those born after nineteen 0:01:06.556 --> 0:01:10.596 eighty more than the millennials and Gen SAID, and then 0:01:10.636 --> 0:01:12.556 the intervening group of Gen X. 0:01:13.316 --> 0:01:15.796 In Eastern Europe, the young are markedly more happy than 0:01:15.836 --> 0:01:18.636 their parents and grandparents, but in the US it's Gen 0:01:18.756 --> 0:01:21.316 Z who's having a rough time. I wanted to look 0:01:21.356 --> 0:01:24.316 more deeply at these demographic quirks around the world, so 0:01:24.396 --> 0:01:27.036 I tagged in the lead author of a different groundbreaking 0:01:27.116 --> 0:01:29.236 chapter in this year's World Happiness Report. 0:01:29.636 --> 0:01:32.236 My name is Emily Wilroth. I am an assistant professor 0:01:32.276 --> 0:01:35.236 at Washington University in Saint Louis and the Department of 0:01:35.316 --> 0:01:37.116 Psychological and Brain Sciences. 0:01:37.516 --> 0:01:41.156 Emily studies well being across the lifespan, and specifically what 0:01:41.236 --> 0:01:44.476 it takes to maintain happiness as we age. Her chapter 0:01:44.556 --> 0:01:47.156 looks for the first time at the intersection of long 0:01:47.156 --> 0:01:51.476 life happiness and dementia. As life expectancy extends around the world, 0:01:51.836 --> 0:01:53.716 more and more of us will experience the sort of 0:01:53.756 --> 0:01:58.116 cognitive decline that often accompanies old age. Emily's research has 0:01:58.156 --> 0:02:01.036 found that happier practices can not only delay the effects 0:02:01.076 --> 0:02:03.876 of dementia, but can also let us live better lives 0:02:03.956 --> 0:02:07.676 as the disease develops. It's a fascinating and timely topic, 0:02:08.116 --> 0:02:11.196 and honestly that I hadn't really considered very much before 0:02:11.196 --> 0:02:14.276 I read Emily's chapter, So I started by asking her 0:02:14.516 --> 0:02:17.396 why do we so rarely talk about the happiness challenges 0:02:17.436 --> 0:02:17.956 of aging. 0:02:19.116 --> 0:02:21.156 I think, on the one hand, we all want to 0:02:21.236 --> 0:02:24.156 know how we can live our best lives for our 0:02:24.156 --> 0:02:26.956 whole life, So what we can do to age healthfully 0:02:27.196 --> 0:02:30.316 and happily. But oftentimes I think that we don't focus 0:02:30.356 --> 0:02:33.236 as much on older adulthood. And I think it's particularly 0:02:33.276 --> 0:02:36.116 important to understand how we can promote well being in 0:02:36.156 --> 0:02:40.636 older adults, and that means both leveraging their age related strengths, 0:02:40.836 --> 0:02:43.436 the things that we gain as we age, but then 0:02:43.476 --> 0:02:46.476 also what kinds of supports and resources we can provide 0:02:46.636 --> 0:02:50.676 to help people navigate age related challenges. And I think 0:02:50.716 --> 0:02:54.836 this is becoming increasingly important as our global population ages. 0:02:55.276 --> 0:02:58.236 So now in most countries around the world, the average 0:02:58.236 --> 0:03:01.316 person can expect to live into older adulthood, and the 0:03:01.316 --> 0:03:04.796 World Health Organization estimates that by the year twenty fifty, 0:03:05.116 --> 0:03:07.716 the number of older adults over the age of sixty 0:03:07.756 --> 0:03:10.876 five is expected to double worldwide. So it's going to 0:03:10.876 --> 0:03:13.876 become even more important for more people for us to 0:03:13.996 --> 0:03:16.756 understand what it means to age happily. 0:03:17.116 --> 0:03:18.636 And so when we think of some of the happiness 0:03:18.676 --> 0:03:20.996 challenges that older adults face, you know, what are some 0:03:21.036 --> 0:03:22.756 of the things that come to mind for a researcher 0:03:22.836 --> 0:03:24.156 like you that studies this population. 0:03:24.596 --> 0:03:27.236 So, on the one hand, aging comes with a lot 0:03:27.276 --> 0:03:30.436 of age related strengths. We know that a lot of 0:03:30.476 --> 0:03:33.676 wisdom comes with age. There's some research to suggest that 0:03:33.756 --> 0:03:37.436 older adults may even be better at regulating their emotions 0:03:37.476 --> 0:03:41.156 and might experience more positive emotions as a result. So, 0:03:41.236 --> 0:03:43.276 on the one hand, we know that there might be 0:03:43.356 --> 0:03:48.156 some wellbeing benefits of aging and in older adulthood, but 0:03:48.196 --> 0:03:50.756 there are also a lot of age related challenges that 0:03:50.836 --> 0:03:54.716 people need to navigate that can impact their well being. So, 0:03:54.916 --> 0:03:58.436 for example, many older adults will experience changes to their 0:03:58.436 --> 0:04:02.716 physical and cognitive health that impact their ability to participate 0:04:02.756 --> 0:04:06.396 in activities that are particularly meaningful to them. Many older 0:04:06.396 --> 0:04:10.396 adults will also experience more losses in terms of loss 0:04:10.396 --> 0:04:14.756 of loved ones, whether that's parents, spouse, friends, And then 0:04:14.796 --> 0:04:16.436 we also know that there can be a lot of 0:04:16.556 --> 0:04:21.276 social changes in older adulthood. Your role and your relationship 0:04:21.556 --> 0:04:26.356 with your children or grandchildren may change. Retirement can be 0:04:26.436 --> 0:04:29.276 really positive for many people, that it can also be 0:04:29.596 --> 0:04:33.436 a major life change that is challenging for others. So 0:04:33.716 --> 0:04:38.476 navigating this time where our health is changing, our social 0:04:38.556 --> 0:04:42.916 roles are changing, all of that can be challenging. But also, 0:04:43.156 --> 0:04:46.156 thankfully we have these age related strengths that are present 0:04:46.276 --> 0:04:49.476 there too that can be drawn upon to help people 0:04:49.636 --> 0:04:50.756 age happily. 0:04:50.756 --> 0:04:52.836 And so one of the things that can really challenge 0:04:52.876 --> 0:04:56.316 our ability to age happily is when older adulthood winds 0:04:56.396 --> 0:05:00.276 up becoming synonymous with dementia. And so talk a little 0:05:00.276 --> 0:05:02.596 bit about the prevalence of dementia and why this is 0:05:02.596 --> 0:05:05.116 something that well being researchers really need to focus on. 0:05:05.196 --> 0:05:08.796 Even more so, dementia's very common in older adulthood. Dementia's 0:05:08.796 --> 0:05:12.676 a clinic goal syndrome that's characterized by progressive memory and 0:05:12.756 --> 0:05:16.596 thinking impairments, and it impacts approximately one in ten older 0:05:16.636 --> 0:05:19.356 adults over the age of sixty five, and actually one 0:05:19.396 --> 0:05:22.436 in three older adults over the age of eighty five. 0:05:22.916 --> 0:05:26.516 And so what that means is as people live longer, 0:05:26.876 --> 0:05:30.436 because age is the largest risk factor for dementia, we 0:05:30.516 --> 0:05:33.876 can expect more dementia cases. For example, by the year 0:05:33.956 --> 0:05:37.156 twenty fifty, the World Health Organization estimates that there will 0:05:37.196 --> 0:05:40.156 be one hundred and thirty nine million people living with 0:05:40.236 --> 0:05:44.596 dementia worldwide. And dementia can really impact quality of life 0:05:44.716 --> 0:05:48.716 by reducing their sense of autonomy, by making it more 0:05:48.756 --> 0:05:52.276 difficult for them to engage socially with loved ones. And 0:05:52.436 --> 0:05:56.276 sometimes there's experiences of shame or embarrassment, particularly in the 0:05:56.316 --> 0:06:00.516 early stages when one starts noticing their new changes in 0:06:00.596 --> 0:06:03.836 memory and thinking, and dementia can also impact quality of 0:06:03.876 --> 0:06:07.236 life for care partners and loved ones of people living 0:06:07.316 --> 0:06:11.916 with dementia. It can be a distressing experience to see 0:06:11.916 --> 0:06:14.636 these memory and thinking changes in those that you love, 0:06:15.316 --> 0:06:19.036 and particularly in the later stages of dementia, it often 0:06:19.116 --> 0:06:23.556 requires a lot of caregiving, which poses sometimes a challenge 0:06:23.596 --> 0:06:26.996 for the care partners of people living with dementia. At 0:06:27.036 --> 0:06:29.076 the same time, I also want to make the point 0:06:29.156 --> 0:06:32.356 that it is possible to live well with dementia. I 0:06:32.356 --> 0:06:34.996 think that it's really common to take a sort of 0:06:35.476 --> 0:06:39.516 deficit focused medical model view of dementia where we only 0:06:39.556 --> 0:06:42.996 look at the challenges and negative experiences, and those are 0:06:43.116 --> 0:06:45.916 very real, so I don't want to discount those, but 0:06:45.956 --> 0:06:48.956 if we only look at that side sometimes I think 0:06:48.996 --> 0:06:52.356 it can prevent us from seeing people living with dementia 0:06:52.556 --> 0:06:53.676 as whole people. 0:06:53.876 --> 0:06:56.076 So many of our listeners will probably know someone with 0:06:56.156 --> 0:06:59.116 dementia or kind of have heard about it. But can 0:06:59.156 --> 0:07:02.356 you unpack for some of the happiness challenges that individuals 0:07:02.396 --> 0:07:04.276 with dementia face, like in their kind. 0:07:04.156 --> 0:07:05.916 Of day to day life because of this disease. 0:07:06.236 --> 0:07:08.516 So I think we can think of the sort of 0:07:08.556 --> 0:07:12.036 psychological needs of people living with dementia the same way 0:07:12.076 --> 0:07:15.236 that we think about everybody's psychological needs and what we 0:07:15.396 --> 0:07:20.156 all need to feel happy in life. Everyone wants to 0:07:20.196 --> 0:07:24.236 feel that their life has meaning and purpose, that they 0:07:24.276 --> 0:07:28.156 can set goals, that they can navigate their day to 0:07:28.236 --> 0:07:30.956 day life and engage in the activities that are meaningful 0:07:31.036 --> 0:07:34.036 to them, and that they can connect with others. And 0:07:34.276 --> 0:07:37.356 the memory and thinking impairments that come with dementia can 0:07:37.396 --> 0:07:40.636 pose challenges to all of those aspects of life. So 0:07:40.676 --> 0:07:42.716 on the one hand, we know that it's really important 0:07:42.756 --> 0:07:46.436 for people to experience a sense of autonomy, that we 0:07:46.636 --> 0:07:49.916 can care for ourselves, that we can direct our own lives, 0:07:50.476 --> 0:07:53.476 and the memory and thinking impairments that come with dementia 0:07:53.516 --> 0:07:57.356 can pose a challenge for autonomy if the individual is 0:07:57.396 --> 0:08:00.156 no longer able to engage in some of the sort 0:08:00.156 --> 0:08:02.756 of typical activities of daily living that they've done in 0:08:02.796 --> 0:08:05.956 the past and now require assistance or care to do 0:08:05.996 --> 0:08:10.916 those daily activities that can impact quality of life. Another 0:08:10.956 --> 0:08:14.356 important psychological need is our need to connect with others 0:08:14.396 --> 0:08:18.276 socially that can be impacted. In people living with dementia, 0:08:18.316 --> 0:08:21.796 it can be sometimes more difficult to follow a conversation, 0:08:22.196 --> 0:08:26.916 it can sometimes pose challenges and close relationships as those 0:08:26.956 --> 0:08:30.276 relationships and the nature of them begins to change, and 0:08:30.356 --> 0:08:34.436 so thinking about that, it's really important to create support 0:08:34.516 --> 0:08:38.316 systems and strategies that provide opportunities for people living with 0:08:38.356 --> 0:08:42.516 dementia to engage first of all with their loved ones 0:08:42.796 --> 0:08:47.796 and maintain those existing social relationships, but also group activities 0:08:47.836 --> 0:08:51.196 with other people living with dementia and experiencing memory and 0:08:51.236 --> 0:08:54.356 thinking impairments. So sort of group support systems can be 0:08:54.396 --> 0:08:57.876 really helpful. And then there's also some really interesting research 0:08:58.036 --> 0:09:02.876 on intergenerational relationships and some of the positive well being boosting, 0:09:02.916 --> 0:09:08.036 happiness boosting effects of connecting older adults living with dementia 0:09:08.076 --> 0:09:13.796 with youngers and having that intergenerational social support system as well. 0:09:14.036 --> 0:09:17.916 But unfortunately, there's currently no cure for dementia. We're just 0:09:17.996 --> 0:09:21.516 starting to see some biomedical treatments that might slow cognitive 0:09:21.516 --> 0:09:24.956 decline in individuals with dementia, but there is no treatment 0:09:24.996 --> 0:09:28.156 that is going to stop the progression of dementia or 0:09:28.276 --> 0:09:32.436 alleviate the existing symptoms of dementia and for that reason, 0:09:32.716 --> 0:09:36.956 we've really started also focusing on strategies to prevent dementia, 0:09:37.556 --> 0:09:41.356 and as a psychologist and a well being researcher, that's 0:09:41.436 --> 0:09:44.596 really where my side of the science comes in. We 0:09:44.676 --> 0:09:47.836 know that the way that people live their lives, lifestyle 0:09:47.916 --> 0:09:51.876 and psychological factors can have a major influence on who's 0:09:51.996 --> 0:09:55.276 likely to go on to develop dementia. So, for example, 0:09:55.436 --> 0:09:58.556 a growing body of research suggests that people with higher 0:09:58.636 --> 0:10:02.396 levels of wellbeing are actually less likely to develop dementia. 0:10:02.876 --> 0:10:06.396 These studies have assessed wellbeing earlier in the lifespan, so 0:10:06.556 --> 0:10:10.036 in midlife, our early older adulthood, and then followed people 0:10:10.076 --> 0:10:13.236 across time for years or in many cases decades to 0:10:13.276 --> 0:10:16.556 see who goes on to develop cognitive decline and dementia. 0:10:16.996 --> 0:10:18.956 And what these studies have found is that people with 0:10:19.076 --> 0:10:21.876 higher levels of wellbeing at the beginning of the study 0:10:21.916 --> 0:10:25.036 period are the ones who are least likely to develop 0:10:25.076 --> 0:10:28.076 dementia by the end of the study. And there's several 0:10:28.076 --> 0:10:32.196 different potential reasons or explanations for this relationship. On the 0:10:32.196 --> 0:10:34.756 one hand, we know that people with higher well being 0:10:35.076 --> 0:10:37.876 engage in a lot of health protective behaviors that are 0:10:37.876 --> 0:10:41.396 important for maintaining cognitive and brain health and older adulthood. 0:10:41.796 --> 0:10:44.236 For example, people with higher wellbeing are more likely to 0:10:44.276 --> 0:10:48.076 engage in physical exercise, they're less likely to smoke, and 0:10:48.116 --> 0:10:51.436 they're likely to have supportive social relationships that can be 0:10:51.756 --> 0:10:55.556 really protective across the lifespan. We also know that wellbeing 0:10:55.636 --> 0:10:59.236 can serve as sort of stress buffering effect or a 0:10:59.276 --> 0:11:02.396 shield that can protect our bodily systems from the harmful 0:11:02.396 --> 0:11:05.236 effects of stress. Stress is just a part of life. 0:11:05.316 --> 0:11:09.636 Everyone experiences stress, but when that stress is chronic or 0:11:09.836 --> 0:11:14.716 severe or particularly uncontrollable, it can harm a lot of 0:11:14.756 --> 0:11:19.356 our bodily systems, such as our immune functioning, our cardiovascular functioning, 0:11:19.516 --> 0:11:23.716 our neuroendocrine system and all of those different bodily systems 0:11:23.796 --> 0:11:27.036 are important for our risk for developing dementia, and what 0:11:27.076 --> 0:11:30.316 research suggests is that people with higher levels of wellbeing, 0:11:30.716 --> 0:11:34.436 they're less likely to be exposed to the same severe, 0:11:34.516 --> 0:11:37.876 chronic stressors, and when they are exposed to those stressors, 0:11:38.036 --> 0:11:43.036 they often show a more adaptive or protected physiological response, 0:11:43.476 --> 0:11:47.196 suggesting that wellbeing might be a buffer that can sort 0:11:47.196 --> 0:11:49.436 of stand in the way of those harmful effects that 0:11:49.476 --> 0:11:52.756 stress typically has on the body and in turn for dementia. 0:11:52.796 --> 0:11:55.756 That means that it may protect the brain and cognition 0:11:56.196 --> 0:11:59.956 and reduce the likelihood that an individual experiencing stress will 0:11:59.996 --> 0:12:01.276 go on to develop dementia. 0:12:01.356 --> 0:12:02.516 It's such a win win, right. 0:12:02.556 --> 0:12:04.436 It's like, when we think about the kinds of things 0:12:04.516 --> 0:12:07.436 we need to do to prevent some of these diseases 0:12:07.476 --> 0:12:08.596 of later in life. 0:12:08.396 --> 0:12:11.076 Some of these things I feel honestly like a bummer. Right. 0:12:11.076 --> 0:12:12.916 You know, we have to change how we eat or 0:12:12.956 --> 0:12:15.276 eat much more healthy or whatever. But this is one 0:12:15.276 --> 0:12:16.916 where it's like, no, No, What you do is you 0:12:16.956 --> 0:12:19.636 focus on all the things that make you happier in 0:12:19.676 --> 0:12:21.476 mid life and early in life, and that's going to 0:12:21.516 --> 0:12:23.836 have this protective effect. It's like, it's something that we 0:12:23.916 --> 0:12:26.076 all want to be doing anyway, but it also is 0:12:26.076 --> 0:12:27.796 going to have this effect that we also don't think. 0:12:28.076 --> 0:12:30.156 Was this kind of shocking to researchers when they first 0:12:30.316 --> 0:12:33.836 started noticing this sort of connection between well being earlier 0:12:33.876 --> 0:12:35.316 in life and reduced dementia later. 0:12:35.556 --> 0:12:37.476 Yeah, And first of all, I just want to echo 0:12:37.556 --> 0:12:39.796 your point. I think one of the reasons that it's 0:12:39.836 --> 0:12:42.996 so exciting to think about well being as a potential 0:12:43.076 --> 0:12:46.196 protective factor is because many of the other things that 0:12:46.236 --> 0:12:50.836 we know impact dementia risk, such as diet and nutrition, 0:12:51.236 --> 0:12:56.596 physical activity, quitting, smoking control, and cardiovascular risk factors. Those 0:12:56.596 --> 0:13:00.436 things are really hard. We know that behavior change is hard. 0:13:00.916 --> 0:13:04.916 Some of those, like the cardiovascular risk factors, require medical interventions, 0:13:04.956 --> 0:13:09.836 which can be difficult to access, expensive, or have their 0:13:09.876 --> 0:13:14.236 own limitations. But improving well being is something that, hopefully 0:13:14.316 --> 0:13:20.156 for most people, is intrinsically valuable and intrinsically a positive experience. 0:13:20.676 --> 0:13:24.956 So I think that there's a long tradition in the 0:13:24.996 --> 0:13:29.116 science of wellbeing of thinking about the connection between well 0:13:29.116 --> 0:13:32.476 being and mental health broadly and physical health. So on 0:13:32.516 --> 0:13:36.396 the one hand, drawing from this longstanding science of well 0:13:36.436 --> 0:13:41.476 being and seeing that more positive psychological factors, greater happiness 0:13:41.596 --> 0:13:45.956 is associated with better physical health, it's not necessarily surprising 0:13:45.996 --> 0:13:47.916 that we would see the same thing when it comes 0:13:47.996 --> 0:13:51.036 to our cognitive health and dementia. But I do think 0:13:51.076 --> 0:13:54.436 there are some findings that we're surprising to me at 0:13:54.556 --> 0:13:58.156 least personally, and very exciting. So, for example, my lab 0:13:58.236 --> 0:14:02.156 did a study looking at the relationship between well being 0:14:02.796 --> 0:14:05.556 cognitive functions to sort of our memory and thinking skills 0:14:05.556 --> 0:14:08.676 that are typically affected by dementia and then the actual 0:14:08.716 --> 0:14:13.316 disease processes that cause dementia, so the neuropathology present in 0:14:13.356 --> 0:14:16.956 people's brains. And what we found is that well being 0:14:17.076 --> 0:14:21.876 was not necessarily related to the amount of disease pathology present, 0:14:22.436 --> 0:14:25.916 but what it was related to was people's ability to 0:14:26.036 --> 0:14:30.116 maintain those memory and thinking skills across time, even in 0:14:30.156 --> 0:14:34.276 the presence of that dementia causing pathology. So what that 0:14:34.396 --> 0:14:38.596 finding suggests is that well being might actually help us 0:14:38.636 --> 0:14:42.076 to maintain our memory and thinking even when the disease 0:14:42.276 --> 0:14:45.276 is already present in our brains. And to me, that 0:14:46.316 --> 0:14:50.116 was surprising but also really exciting because it suggests that 0:14:50.156 --> 0:14:56.116 there's these multiple pathways that scientists and medical professionals and 0:14:56.196 --> 0:15:01.636 individuals can pursue to reduce the likelihood of dementia, both 0:15:01.716 --> 0:15:05.676 strategies to prevent the accumulation of those disease processes, but 0:15:05.876 --> 0:15:09.716 also alongside that strategy is like improving well that might 0:15:09.756 --> 0:15:13.516 help us to be able to live well and tolerate 0:15:13.596 --> 0:15:15.996 a certain level of neuropathology. 0:15:17.156 --> 0:15:19.356 So there definitely are things we can do to help 0:15:19.396 --> 0:15:22.156 ward off the impact of dementia, and we'll hear about 0:15:22.156 --> 0:15:24.556 more strategies we can use to build up our cognitive 0:15:24.556 --> 0:15:27.516 resilience as we age when the happiness lab returns in 0:15:27.556 --> 0:15:36.156 a moment. When we think about how to avoid disease, 0:15:36.396 --> 0:15:39.116 we tend to think of factors that improve our physical health, 0:15:39.516 --> 0:15:42.796 things like access to medicine and clean water, maybe stuff 0:15:42.836 --> 0:15:46.276 like nutritious foods or sanitary practices. We tend not to 0:15:46.316 --> 0:15:48.316 think of the impact of stuff like hanging out with 0:15:48.356 --> 0:15:51.676 a friend, or taking an educational course or looking at 0:15:51.716 --> 0:15:55.116 a painting. But Emily Wilwroth and her colleagues have learned 0:15:55.116 --> 0:15:58.076 that one of the cruelest health challenges of our era, dementia, 0:15:58.196 --> 0:16:00.556 can be tackled in some unexpected ways. 0:16:00.996 --> 0:16:05.196 When we're thinking about strategies to prevent dementia, some of 0:16:05.236 --> 0:16:08.436 the things that we have the most control over. We 0:16:08.476 --> 0:16:12.116 can think about engaging in social activities and fostering our 0:16:12.156 --> 0:16:16.796 social relationships. That can be one of the strongest psychosocial 0:16:16.996 --> 0:16:20.676 preventative factors. And we also know that social relationships and 0:16:20.716 --> 0:16:23.516 social activity are really good for our well being. We 0:16:23.596 --> 0:16:27.196 also know that physical activity and sleep are really important. 0:16:27.396 --> 0:16:30.996 There's also various factors when we're looking into later life 0:16:31.196 --> 0:16:33.676 that people can do to lower their risk for dementia, 0:16:33.996 --> 0:16:38.796 and most of those are related to controlling cardiovascular risk factors, so, 0:16:38.956 --> 0:16:44.716 for example, maintaining healthy blood pressure levels, treating diabetes if 0:16:44.756 --> 0:16:49.596 it's present, quitting or not starting smoking, or excessive alcohol consumption, 0:16:50.076 --> 0:16:53.036 all of these sort of typical health behaviors we know 0:16:53.356 --> 0:16:57.276 play a really big role in reducing one's likelihood of 0:16:57.356 --> 0:17:01.156 developing dementia. And more broadly, when we look at strategies 0:17:01.196 --> 0:17:04.716 to promote well being and happiness, there's quite a few 0:17:04.756 --> 0:17:09.396 strategies that the scientific literature has begun to suggest might 0:17:09.436 --> 0:17:12.636 be effective. But I think it's really important for people 0:17:12.716 --> 0:17:15.636 to also pay attention to their own feelings and how 0:17:15.676 --> 0:17:18.636 they respond to these different strategies and sort of notice 0:17:18.676 --> 0:17:21.396 what works well for them. So, for example, there's some 0:17:21.476 --> 0:17:26.796 research to suggest that engaging in gratitude practices or mindfulness, 0:17:27.276 --> 0:17:32.676 social activity, getting out in nature, moving one's body, all 0:17:32.716 --> 0:17:35.276 of these things there's some evidence to suggest that they 0:17:35.356 --> 0:17:38.676 can promote happiness and well being, but that doesn't mean 0:17:38.676 --> 0:17:41.236 that they promote happiness and well being for everybody the 0:17:41.276 --> 0:17:44.516 same way. And one thing that is nice about trying 0:17:44.516 --> 0:17:47.676 to improve one's well being is that we are really 0:17:47.716 --> 0:17:50.956 the best judges of what's working well for us. Because 0:17:50.956 --> 0:17:54.636 we're the best judges of our own wellbeing and happiness. 0:17:54.956 --> 0:17:57.396 You know, so many of these happiness interventions are things 0:17:57.436 --> 0:17:59.716 that we can do at any age. But I'm thinking 0:17:59.756 --> 0:18:02.076 of my listeners who might be in their twenties and 0:18:02.116 --> 0:18:04.716 their thirties and forties. You know, if you had to pick, 0:18:04.836 --> 0:18:07.116 you know, one type of intervention that might be good 0:18:07.156 --> 0:18:10.316 at different age ranges, what would you suggest to listeners. 0:18:10.836 --> 0:18:14.436 So in early life, thinking of teens and twenties, I 0:18:14.476 --> 0:18:20.316 think staying engaged in education can be really protective. When 0:18:20.356 --> 0:18:23.916 thinking more about midlife and thirties and forties, I'm not 0:18:23.956 --> 0:18:25.756 gonna pick one, I'm gonna pick two. I'm going to 0:18:25.796 --> 0:18:30.196 say one. We know that social activity is so important, 0:18:30.596 --> 0:18:33.676 and one thing that I think is really helpful to 0:18:33.676 --> 0:18:35.956 know about that is a lot of research suggests that 0:18:36.036 --> 0:18:39.396 it is the quality of social interactions and social relationships, 0:18:39.676 --> 0:18:41.836 not the quantity that matters. So it doesn't mean that 0:18:41.876 --> 0:18:44.716 everyone needs to be extroverted and go out to parties 0:18:44.756 --> 0:18:49.036 and have a million friends, but instead really just nurturing 0:18:49.116 --> 0:18:53.196 those social relationships that you do have and spending time 0:18:53.276 --> 0:18:56.356 with close loved ones. The other that I would say 0:18:56.436 --> 0:18:59.396 for midlife is engaging in physical activity. This is so 0:18:59.476 --> 0:19:02.396 important for our mental health as well as our physical 0:19:02.476 --> 0:19:06.236 and cognitive health, and midlife is a really important time 0:19:06.396 --> 0:19:11.116 to sort of be prevention focused when thinking about cardiovascular 0:19:11.156 --> 0:19:15.116 health and ultimately cognitive health. So either maintaining or starting 0:19:15.396 --> 0:19:19.716 a physical activity routine that is one that you feel 0:19:19.876 --> 0:19:22.396 like you can maintain across the lifespan. So for some 0:19:22.476 --> 0:19:25.756 people that might look like typical exercise going to the gym, 0:19:25.956 --> 0:19:28.156 but for other people that might look like a daily 0:19:28.196 --> 0:19:32.356 walk or getting out in nature or playing pickleball with friends. 0:19:32.356 --> 0:19:35.676 So finding something that brings you joy, that gets your 0:19:35.676 --> 0:19:38.276 body moving in mid life I think is really important. 0:19:38.556 --> 0:19:40.516 You mentioned in your twenties you really want to focus 0:19:40.596 --> 0:19:43.716 on education. Why is education so important? This is often 0:19:43.836 --> 0:19:46.836 not necessarily something I would think would matter for happiness 0:19:46.916 --> 0:19:49.596 or sort of dementia prevention, But what does education help 0:19:49.676 --> 0:19:50.916 us do psychologically? 0:19:51.116 --> 0:19:54.956 Yeah, So we see a really strong protective effect on 0:19:55.636 --> 0:20:00.956 high quality education in lowering the likelihood of cognitive decline 0:20:00.996 --> 0:20:04.756 in dementia in late life. And there's several reasons why 0:20:04.796 --> 0:20:08.556 that might be. We know, for example, that cognitive activity 0:20:08.716 --> 0:20:13.316 is really important for cognitive and brain health, and so 0:20:13.756 --> 0:20:18.476 early life education might set the foundation for that, and 0:20:18.556 --> 0:20:22.516 it also may simply be so many people have dementia 0:20:22.556 --> 0:20:28.116 related neuropathology the disease processes that cause dementia, without necessarily 0:20:28.436 --> 0:20:33.556 experiencing the clinical syndrome of dementia. And one reason for 0:20:33.716 --> 0:20:38.876 that might be that if we are consistently engaged in 0:20:38.916 --> 0:20:43.596 cognitive activities, we are sort of able to maintain those 0:20:43.636 --> 0:20:47.956 memory and thinking impairments even in the presence of that pathology. 0:20:48.396 --> 0:20:53.236 We call that cognitive resilience, and research suggests that education, 0:20:53.356 --> 0:20:56.516 and in particular high quality education is one of the 0:20:56.676 --> 0:21:01.716 biggest factors associated with cognitive resilience. So for many people 0:21:02.076 --> 0:21:05.676 it's going to be inevitable at least now, with where 0:21:05.676 --> 0:21:09.956 our biomedical treatments are, that demention related neuropathology you will accumulate. 0:21:10.356 --> 0:21:12.756 But education is one of the things that we can 0:21:12.916 --> 0:21:15.876 sort of arm ourselves with or protect ourselves with that 0:21:15.916 --> 0:21:19.716 will allow our memory and thinking abilities to continue and 0:21:19.756 --> 0:21:23.476 to maintain those cognitive functions in the presence of this 0:21:23.876 --> 0:21:24.796 disease process. 0:21:25.196 --> 0:21:27.396 And so as we think about these tools and strategies 0:21:27.436 --> 0:21:30.516 we should begin engaging in, there's also this question of 0:21:30.556 --> 0:21:32.596 when we need to start them. What do we know 0:21:32.636 --> 0:21:34.756 about the kind of early history of some of these 0:21:34.796 --> 0:21:38.036 preventative measures sort of dealing with dementia down the line. 0:21:38.156 --> 0:21:40.596 That's a great question. On the one hand, you can 0:21:40.636 --> 0:21:44.356 imagine that maintaining and increasing well being as early as 0:21:44.396 --> 0:21:46.916 possible and then maintaining it across the lifespan might be 0:21:46.996 --> 0:21:50.436 the most protective. Right, there's probably no better time to 0:21:50.556 --> 0:21:53.796 start increasing well being than the present and then maintaining 0:21:53.836 --> 0:21:57.916 that across time. And given the mechanisms that we think 0:21:57.956 --> 0:22:00.756 are at play with the link between well being and dementia, 0:22:01.196 --> 0:22:04.116 I think that approach makes a lot of conceptual sense. 0:22:04.556 --> 0:22:08.476 Health behaviors and their impact on health is cumulative, the 0:22:08.516 --> 0:22:11.876 harmful of stress on our bodies that wellbeing might buffer 0:22:11.956 --> 0:22:15.996 our cumulative So from that perspective, starting early and maintaining 0:22:15.996 --> 0:22:19.236 well being across the lifespan might be the most beneficial. 0:22:19.636 --> 0:22:21.596 But then on the other hand, when thinking of going 0:22:21.596 --> 0:22:26.756 to implement these wellbeing interventions to improve cognitive outcomes and 0:22:26.796 --> 0:22:29.956 reduce dementia risk for the greatest number of people, I 0:22:29.956 --> 0:22:32.916 think that's still an open scientific question whether we should 0:22:32.956 --> 0:22:36.236 be intervening in midlife or more proximal to when we 0:22:36.316 --> 0:22:41.636 start to see cognitive change and the mint related neuropathology accumulate, 0:22:41.876 --> 0:22:44.116 such as an early older adulthood. So I think that's 0:22:44.116 --> 0:22:48.036 still an open scientific question that we as researchers need 0:22:48.036 --> 0:22:52.076 to dig into more. But in terms of the general public, 0:22:52.356 --> 0:22:56.236 I think that a strategy of increasing your wellbeing and 0:22:56.276 --> 0:22:58.916 putting your mental health first, no matter where you are 0:22:58.956 --> 0:23:01.596 and the lifespan, is likely to be effective. 0:23:01.916 --> 0:23:04.156 And so so far we've been talking about ways that 0:23:04.196 --> 0:23:07.556 we can engage our well being to prevent dementia. Later on, 0:23:07.916 --> 0:23:09.436 you know, what do we know about what we can 0:23:09.476 --> 0:23:12.916 do to use well being practices to improve dementia, kind 0:23:12.956 --> 0:23:15.156 of once the disease has already started, Because I think 0:23:15.236 --> 0:23:18.316 sometimes when people get these diagnoses, or you know, family 0:23:18.316 --> 0:23:20.556