WEBVTT - How to Take Care of your Brain with Dr. David Dodic 0:00:00.200 --> 0:00:04.800 Medical knowledge now is advancing doubles every seventy three days. 0:00:05.040 --> 0:00:08.000 It's impossible, wow for one doctor or even a team 0:00:08.039 --> 0:00:11.360 of doctors to keep up with everything. 0:00:14.280 --> 0:00:17.840 Prior to joining ATRIA, Doctor David Dotick trained at the 0:00:17.880 --> 0:00:20.720 Mayo Clinic and served on the faculty there for more 0:00:20.760 --> 0:00:23.840 than three decades. At the Mayo Clinic, he founded the 0:00:23.880 --> 0:00:29.360 Neurology Residency Program, the Headache Fellowship Program, the Sports Neurology 0:00:29.400 --> 0:00:33.559 and Concussion Program, the Migraine and Headache Program, and co 0:00:33.680 --> 0:00:38.279 founded the Vascular Neurology Stroke Program. He is a professor 0:00:38.320 --> 0:00:42.200 emeritus at the Mayo Clinic, a consultant for the Mayo 0:00:42.240 --> 0:00:46.560 Clinic International, and a guest professor at the Norwegian University 0:00:46.560 --> 0:00:50.640 of Science and Technology and an affiliate professor at the 0:00:50.760 --> 0:00:55.440 University of Copenhagen. That's a very impressive resume of some 0:00:55.560 --> 0:00:59.880 of your jobs. Doctor David Dodeck is a notable neurologist, 0:01:00.160 --> 0:01:04.080 a prolific researcher, and the founder of multiple programs to 0:01:04.160 --> 0:01:08.240 treat brain injury and disease. In other words, an expert 0:01:08.280 --> 0:01:10.559 on the brain. I wanted to talk to him today 0:01:10.600 --> 0:01:13.760 about brain health because, to paraphrase a quote he shared 0:01:14.280 --> 0:01:17.240 it doesn't help to live longer if the brain isn't 0:01:17.280 --> 0:01:21.000 in good shape. And I think all of us know 0:01:21.120 --> 0:01:24.560 that absolutely inherently, and I know that we all have 0:01:24.720 --> 0:01:28.880 questions about risk factors and warning signs for dementia, stroke 0:01:29.160 --> 0:01:32.240 and other brain diseases. So we will cover all of 0:01:32.240 --> 0:01:35.160 that today. Welcome to my podcast, Doctor Dodeck. 0:01:35.280 --> 0:01:36.479 Martha, it's a thrill to be here. 0:01:36.560 --> 0:01:40.399 Thank you so very very much. Now for clarity, I 0:01:40.640 --> 0:01:45.080 recently enrolled in the ATRIA program. This is and maybe 0:01:45.080 --> 0:01:47.960 doctor Dodeck can just describe it very simply for all 0:01:48.000 --> 0:01:50.280 of you. What is exactly a TRIA? 0:01:51.520 --> 0:01:55.640 Exactly? ATRIA is kind of a preventive healthcare ecosystem that 0:01:55.760 --> 0:01:59.480 seeks to translate science into medicine real time. What I 0:01:59.520 --> 0:02:02.640 mean by that as the Institute of Medicine has estimated 0:02:02.640 --> 0:02:07.040 that it takes about seventeen years for something that's validated 0:02:07.040 --> 0:02:09.120 in research to actually make it to the bedside in 0:02:09.120 --> 0:02:12.560 clinical practice. So we're looking to translate science and technology 0:02:12.680 --> 0:02:18.040 because it's advancing so rapidly real time to prevent, reverse, 0:02:18.480 --> 0:02:25.240 stop or delay the chronic diseases that reduce our longevity, 0:02:25.680 --> 0:02:28.920 you know, chronic diseases right now ninety five percent of 0:02:28.960 --> 0:02:31.440 people over the age of sixty have at least one 0:02:31.560 --> 0:02:35.800 chronic disease, and about eighty percent have at least two. 0:02:35.919 --> 0:02:39.360 And chronic diseases account for seventy five percent of not 0:02:39.400 --> 0:02:42.359 only a health care spend in this country, but seventy 0:02:42.400 --> 0:02:44.400 five percent of the deaths. So if we can stop 0:02:44.480 --> 0:02:48.320 those chronic diseases, we can extend healthy lifespan and importantly 0:02:48.320 --> 0:02:48.799 brain span. 0:02:48.960 --> 0:02:51.600 So what are the top six chronic diseases that you're 0:02:51.600 --> 0:02:52.280 talking about. 0:02:52.400 --> 0:02:55.840 I'm talking about diabetes and other metabolic diseases that may 0:02:55.840 --> 0:02:59.560 be related to diabetes. I'm talking about neurodegenerative disease like 0:02:59.560 --> 0:03:05.240 Alzhema disease, Parkinson's disease, We're talking about cancer. We're talking 0:03:05.240 --> 0:03:08.960 about cardiovascular disease. Those are those are the four one 0:03:09.000 --> 0:03:12.160 biggest ones. And there are other chronic diseases like arthritis, 0:03:12.160 --> 0:03:15.240 which is very common of course. So those are really 0:03:15.360 --> 0:03:18.320 five major chronic diseases that we can do so much 0:03:18.360 --> 0:03:21.160 about today, and so many Americans right now are suffering 0:03:21.200 --> 0:03:25.680 from them. Medical knowledge now is advancing doubles every seventy 0:03:25.680 --> 0:03:29.040 three days. It's impossible, wow, for one doctor or even 0:03:29.080 --> 0:03:31.720 a team of doctors to keep up with everything. So 0:03:32.000 --> 0:03:34.079 it's called like an onion, a core group of internal 0:03:34.120 --> 0:03:37.600 medicine specialists surrounded by specialty pods, and then surround that 0:03:38.200 --> 0:03:41.200 with what we call the Atria Academy of Science and Medicine, 0:03:41.440 --> 0:03:44.280 which you have access to, which we have access to. 0:03:44.320 --> 0:03:47.480 And the people on this are really key opinion leaders 0:03:47.520 --> 0:03:51.560 across many medical and surgical disciplines. And the idea here, Martha, 0:03:51.640 --> 0:03:54.640 is that we can tap them, these experts around the 0:03:54.640 --> 0:03:58.560 world to get current best thinking on whatever issue, topic 0:03:58.680 --> 0:03:59.880 or question that might arise. 0:04:00.360 --> 0:04:03.720 But you have written so many fantastic articles, you have 0:04:03.880 --> 0:04:08.360 done so much research in a variety of very amazing 0:04:08.400 --> 0:04:13.120 medical fields. Do you ever stop to think what's happening to. 0:04:13.120 --> 0:04:16.480 All of us? I do. I stop to think every day. 0:04:16.640 --> 0:04:20.719 But I've never been more excited about the pace of 0:04:20.760 --> 0:04:23.320 medicine and the future of medicine than I am today. 0:04:23.680 --> 0:04:26.440 I'll really great, and I've learned more in the past 0:04:26.480 --> 0:04:28.599 two years than I think I've learned in the past twenty. 0:04:28.760 --> 0:04:31.480 Really, what is that from you? Things that I just think? 0:04:31.480 --> 0:04:34.640 It's the pace with which advances are happening, you know, 0:04:34.800 --> 0:04:37.720 like I said, if medical knowledge is doubling every seventy 0:04:37.760 --> 0:04:41.160 three days. Then you have an insatiable appetite for learning. 0:04:41.400 --> 0:04:44.040 You just can't get enough of it. So, and as 0:04:44.080 --> 0:04:46.359 the chief medical Officer and chief Science Officer, is my 0:04:46.480 --> 0:04:48.640 job to stay abreast of all of the things that 0:04:48.640 --> 0:04:50.039 are happening or as many as I possible. 0:04:50.120 --> 0:04:53.839 How many physicians are affiliated with ATRIAB forty five forty 0:04:53.839 --> 0:04:57.680 full time physicians. You say in us that we can 0:04:57.720 --> 0:05:02.720 transform medical care from sick care to health care and 0:05:02.839 --> 0:05:06.200 be a model that others will evaluate and scale so 0:05:06.279 --> 0:05:10.799 that healthy lifespan is extended for as many people as possible. Yes, 0:05:10.880 --> 0:05:13.400 So I'm a firm believer in that. Yeah, And I 0:05:13.440 --> 0:05:15.560 think that it is so important for us to think 0:05:15.560 --> 0:05:22.360 about living not anti aging, but aging gracefully and healthfully. 0:05:22.000 --> 0:05:25.159 Healthy lifespan, that's what we're talking about. Soever, however many 0:05:25.240 --> 0:05:29.039 years you have, make those years healthy years where you 0:05:29.120 --> 0:05:33.640 can cognitively you have your full cognitive capacity, physical capacity, 0:05:34.120 --> 0:05:38.680 mental health capacity, because it's about happiness, happy happiness span 0:05:38.720 --> 0:05:41.320 as I like to say, play span and brain span. 0:05:41.560 --> 0:05:44.520 So it's keeping pilled people as healthy as possible for 0:05:44.560 --> 0:05:45.400 as long as they live. 0:05:45.680 --> 0:05:48.000 What is the average lifespan today. 0:05:48.160 --> 0:05:51.240 In the United States, it's about seventy seven years. But unfortunately, 0:05:51.720 --> 0:05:55.920 despite the fact that we outpace every OECD country in 0:05:56.000 --> 0:05:59.200 terms of technology, the science and technology in the United 0:05:59.240 --> 0:06:03.000 States is just staggering. What we have here and the physicians, 0:06:03.520 --> 0:06:07.760 the quality of the medicine is remarkable, and yet we're 0:06:07.760 --> 0:06:11.600 falling behind on every metric of health, whether it's infant 0:06:11.600 --> 0:06:14.279 mortality or whether it's lifespan. But right now it's about 0:06:14.279 --> 0:06:16.920 seventy seven years. It's a little bit different in women, 0:06:17.360 --> 0:06:19.800 so it's longer in women, so it's about eighty two years, 0:06:19.800 --> 0:06:22.080 and women about seventy seven, seventy eight in men. 0:06:22.240 --> 0:06:25.000 I like to give people at least some hope and 0:06:25.040 --> 0:06:28.760 some guidance and what they can do to extend that lifespan. 0:06:29.839 --> 0:06:32.719 What is the worst thing a person can do to 0:06:32.960 --> 0:06:35.080 bring on an early demise? 0:06:35.400 --> 0:06:40.400 Not move, not move, not move, So physical movement and 0:06:40.520 --> 0:06:44.080 cognitive exercise. So physical exercise and cognitive exercise, if you 0:06:44.120 --> 0:06:47.960 did nothing else, that is crucial, okay, or brain held 0:06:48.000 --> 0:06:49.520 for heart health and for longevity. 0:06:49.560 --> 0:06:51.359 And what you should not put in your body. 0:06:52.880 --> 0:06:57.080 So I don't put saturated fat in my body. I 0:06:57.120 --> 0:07:01.200 hardly put any alcohol in my body. And I don't 0:07:01.240 --> 0:07:04.240 put red meat in my body. Not that I'm saying 0:07:04.360 --> 0:07:06.279 I don't want anybody to think that red meat is 0:07:06.560 --> 0:07:09.479 necessarily bad, but I just happen not to put red 0:07:09.480 --> 0:07:12.200 meat in my body. So those are perhaps the three 0:07:12.240 --> 0:07:14.320 things I don't put in my body, and I would 0:07:14.360 --> 0:07:18.200 counsel my patients to think about alternatives in their diet. 0:07:19.080 --> 0:07:22.680 I was recently speaking to a doctor from Europe who 0:07:22.720 --> 0:07:26.720 has a list, and top of his list is alcohol. Yeah, 0:07:27.080 --> 0:07:29.920 top above heroin and cocaine. 0:07:30.720 --> 0:07:34.040 Well, alcohol, Martha, according to the World Health Organization, is 0:07:34.040 --> 0:07:38.120 a carcinogen, right, And no amount of alcohol, unfortunately, is good, 0:07:38.240 --> 0:07:40.440 good for you or good for your brain. So as 0:07:40.440 --> 0:07:44.240 a neurologist, if you cannot consume alcohol, that would be 0:07:44.280 --> 0:07:48.200 a good thing. However, risk factors are stackable. So if 0:07:48.240 --> 0:07:51.600 you keep yourself healthy, if you're exercising, and you're following 0:07:52.080 --> 0:07:54.320 a diet that's been shown to reduce the risk of 0:07:54.640 --> 0:07:58.520 cognitive decline in dementia, and you're managing your numbers as 0:07:58.560 --> 0:08:01.920 I like to call it, your blood sugar, your blood cholesterol, 0:08:02.080 --> 0:08:06.640 your blood pressure, you're screening for cancer. Right. If you're 0:08:06.640 --> 0:08:09.200 doing all of those things, if you're doing everything else, right. 0:08:09.680 --> 0:08:11.080 I don't want people to think they came to have 0:08:11.120 --> 0:08:13.360 a glass of wine or a glass of champagne. But 0:08:13.440 --> 0:08:16.840 alcohol to excess is definitely not good for your brain. 0:08:17.200 --> 0:08:21.120 So I've heard that forty five percent of dementia can 0:08:21.200 --> 0:08:21.800 be prevented. 0:08:22.160 --> 0:08:25.920 That's true, and you know the Lancet Commission, which published 0:08:25.920 --> 0:08:28.760 that report just several months ago. It's interesting that back 0:08:28.800 --> 0:08:32.520 in twenty seventeen they said thirty five percent. Four years later, 0:08:32.640 --> 0:08:35.560 it's forty percent. Four years later, like a few months ago, 0:08:35.720 --> 0:08:39.360 it's forty five percent. And they didn't even consider things 0:08:39.440 --> 0:08:43.360 like diet, things like gut health. So what are they saying. 0:08:43.640 --> 0:08:46.920 They have identified these fourteen modifiable risk factors, and it's 0:08:46.960 --> 0:08:49.400 gone from ten to twelve to fourteen. And every time 0:08:49.400 --> 0:08:51.880 they increase by two the number of risk factors you 0:08:51.880 --> 0:08:56.200 should target, it increases by five percent the decrease in dementia. 0:08:56.679 --> 0:08:59.840 So that's powerful when you sit back and think, Okay, 0:09:00.000 --> 0:09:02.240 the United States right now we have about seven million 0:09:02.240 --> 0:09:05.959 people with Alzheimer's disease, but we have close to fifty 0:09:06.040 --> 0:09:08.640 in the early stages at least with the pathology in 0:09:08.640 --> 0:09:08.920 the brain. 0:09:08.960 --> 0:09:09.520 Eighty million. 0:09:09.640 --> 0:09:10.920 Yeah, and they don't know it yet. 0:09:10.960 --> 0:09:14.680 Oh, because our total population here in the United States. 0:09:14.400 --> 0:09:18.840 Is three fifty or somewhere around there, So it's horrifying. 0:09:18.880 --> 0:09:22.319 And you know, we've got fifty million across the globe 0:09:22.440 --> 0:09:25.360 and it accounts for about eight point five trillion dollars. 0:09:25.360 --> 0:09:27.960 So if we can if you imagine if almost half 0:09:28.000 --> 0:09:31.520 of dementia is preventable if you attend to these modifiable 0:09:31.559 --> 0:09:34.320 risk factors, in addition to other risk factors that we 0:09:34.440 --> 0:09:38.680 know are important, like diet, like sleep, like perimenopause and 0:09:38.720 --> 0:09:42.439 how that's managed, like gut health. And I can go on, Wow, 0:09:42.720 --> 0:09:45.960 I guarantee you that in another four years it's not 0:09:45.960 --> 0:09:48.200 going to be forty five percent anymore. It's going to 0:09:48.240 --> 0:09:50.960 be something higher than that. So I'm very optimistic. 0:09:51.480 --> 0:09:54.560 But how can we educate the public to these facts. 0:09:54.600 --> 0:09:56.959 It's going to take just a public a massive public 0:09:57.000 --> 0:09:59.640 awareness campaign. And we've seen how successful they've been in 0:09:59.679 --> 0:10:03.200 the past, whether it's in autism or whether it's in tobacco, 0:10:03.360 --> 0:10:06.760 or whether it's an HIV. We've seen how successful these 0:10:06.800 --> 0:10:10.560 public awareness campaigns in terms of raising awareness. I think 0:10:10.640 --> 0:10:12.400 that's what we have to do here. The American Heart 0:10:12.400 --> 0:10:15.680 Association has done a phenomenal job in raising awareness of 0:10:15.720 --> 0:10:18.920 the risk factors around cardiovascular disease and heart health. We 0:10:19.000 --> 0:10:20.360 have to do the same thing with the brain. 0:10:31.280 --> 0:10:34.440 Given how rapidly research is coming out about how lifestyle 0:10:34.480 --> 0:10:38.720 impacts health. Is there an intervention or a strategy in 0:10:38.760 --> 0:10:41.000 the past two years that you're excited about that isn't 0:10:41.080 --> 0:10:43.040 yet widely distributed to the public. 0:10:43.640 --> 0:10:45.520 We'll just give you an example, Martha. We've been talking 0:10:45.520 --> 0:10:48.160 about diet. So there's this diet called the mind diet, 0:10:48.400 --> 0:10:51.000 which is a combination of the Mediterranean diet and the 0:10:51.120 --> 0:10:55.320 diet to stop hypertension. It's called the mind diet. And 0:10:55.600 --> 0:10:58.680 there are studies that looked at this mind diet showing 0:10:58.679 --> 0:11:01.280 that if you follow this rigor, you drop the risk 0:11:01.360 --> 0:11:03.600 of cognitive decline by about fifty three percent. 0:11:03.880 --> 0:11:08.000 Wow, it's just a diet, right, And what do you think? 0:11:07.679 --> 0:11:10.600 I think it's real. It's the diet that I follow. 0:11:11.520 --> 0:11:13.360 So if you and there's a lot more research to 0:11:13.400 --> 0:11:17.280 be done, but just take that alone. Physical exercise, no question, 0:11:17.400 --> 0:11:19.800 it's the best drug if you will, It's the best 0:11:20.000 --> 0:11:25.319 prescription that I could write. Cognitive exercise. People underestimate the 0:11:25.360 --> 0:11:28.679 power of cognitive exercise. I'll give you an example we 0:11:28.760 --> 0:11:33.520 recommend a program. No disclosure here, no affiliation to brain 0:11:33.559 --> 0:11:35.839 age Q. It's one of a number of platforms that 0:11:36.640 --> 0:11:40.640 challenge you cognitively. It's not like Sudoku or a puzzle 0:11:40.679 --> 0:11:44.359 like that, but it's more it's designed to enhance processing 0:11:44.440 --> 0:11:49.720 speed and memory, et cetera. People who have stuck with 0:11:49.800 --> 0:11:53.120 that reduce the risk of dementia by about twenty nine percent. 0:11:53.320 --> 0:11:54.960 So I could go on and on in terms of 0:11:55.080 --> 0:11:57.800 interventions that I'm excited about, but just some of the 0:11:57.840 --> 0:12:00.160 low hanging fruit are and sleep is another one. 0:12:00.760 --> 0:12:02.040 Now that's my big problem. 0:12:02.400 --> 0:12:04.720 Sleep is a risk factor for so many things, from 0:12:04.760 --> 0:12:09.160 heart disease to dementia, to hypertension, blood high blood pressure. 0:12:10.080 --> 0:12:13.320 It's a serious problem. And many Americans have a problem 0:12:13.360 --> 0:12:15.400 with sleep, and it gets worse as we age. 0:12:15.440 --> 0:12:17.480 I always have. It's horrible. 0:12:17.920 --> 0:12:20.120 And so there are many ways which we can treat 0:12:20.320 --> 0:12:25.000 insomnia and sleep disorders effectively. But sleep is really really important. 0:12:25.040 --> 0:12:27.120 If I if I told you one night of sleep 0:12:27.120 --> 0:12:32.360 deprivation really shuts down your memory organ in your brain, 0:12:32.440 --> 0:12:34.320 the place where you put files, in the place where 0:12:34.320 --> 0:12:36.800 you store files and store memory. Just one night of 0:12:36.840 --> 0:12:39.600 sleep deprivation. Now I'm not a great one to talk. 0:12:40.080 --> 0:12:43.040 But I wear this because I do monitor my sleep, 0:12:43.400 --> 0:12:44.320 and yeah, you're going to hell. 0:12:44.400 --> 0:12:46.960 I should be wearing mine. Say I'm not wearing mine. 0:12:46.760 --> 0:12:51.079 And just tracking how because it's a very powerful motivating factor. 0:12:51.080 --> 0:12:53.439 When I look at my sleep, open showed me. 0:12:53.520 --> 0:12:58.720 The aura ring right, Yes, it's the it's oh, you 0:12:58.960 --> 0:12:59.800 are a right. 0:12:59.840 --> 0:13:02.360 And there are many different types of trackers. 0:13:02.640 --> 0:13:04.400 So it tells you what exactly. It tells you how 0:13:04.440 --> 0:13:05.319 many hours you slept. 0:13:05.360 --> 0:13:07.400 Tell me how many hours you slept, how many how 0:13:07.440 --> 0:13:09.880 much you slept in rem sleep or rapid eyebooment or 0:13:09.960 --> 0:13:13.400 dream sleep if you will, deep sleep, which is really important. 0:13:13.679 --> 0:13:17.160 What's your heart rate and oxygen was during stay? 0:13:17.200 --> 0:13:20.240 You better get my r ring out? Now? What do 0:13:20.280 --> 0:13:21.559 you do for physical exercise? 0:13:22.200 --> 0:13:24.800 I tried to do both aerobic as well as resistance 0:13:24.840 --> 0:13:28.400 training sometimes what we call circuit training, which is both 0:13:28.400 --> 0:13:30.760 at the same time. I think it's really important. Both 0:13:30.760 --> 0:13:34.640 are really very important, and both have been shown unequivocally 0:13:35.120 --> 0:13:38.280 to promote healthy lifespan as well as to promote brain 0:13:38.280 --> 0:13:40.680 span if you will, or cognitive health. So I think 0:13:40.720 --> 0:13:43.040 resistance training is you can either use your body for that, 0:13:43.120 --> 0:13:46.240 like push ups or lunges or free weights or bands, 0:13:46.280 --> 0:13:49.680 but I think resistance training to keep muscle mass because, 0:13:49.720 --> 0:13:53.040 believe it or not, muscle secretes hormones and chemicals that 0:13:53.080 --> 0:13:56.160 are actually important for brain health, so really important, and 0:13:56.160 --> 0:14:00.440 it also prevents frailty over time. Right, So you know, 0:14:00.480 --> 0:14:03.520 resistance training an aerobic training. There was a study done Martha. 0:14:04.280 --> 0:14:07.640 It's called a finger study because there's five fingers and 0:14:07.679 --> 0:14:10.559 it was back about ten eleven years ago. It's a 0:14:10.679 --> 0:14:13.880 landmark study where they took sixty to seventy seven year 0:14:13.880 --> 0:14:17.040 old people who were at risk for dementia but who 0:14:17.040 --> 0:14:21.160 were cognitively normal, and they did five interventions. One was 0:14:21.240 --> 0:14:24.200 just social connectedness, right, just put them in groups or 0:14:25.680 --> 0:14:28.400 just to increase the amount of social interaction they had. 0:14:28.880 --> 0:14:33.320 Another one was managing their risk factors blood pressure, blood sugar, 0:14:33.960 --> 0:14:34.880 blood cholesterols. 0:14:35.000 --> 0:14:37.520 All of that include managing blood pressure. Do you have 0:14:37.600 --> 0:14:38.960 to take blood pressure medicine? 0:14:39.040 --> 0:14:41.720 No, you don't have to take blood pressure medicine. Many do. 0:14:42.160 --> 0:14:44.440 But if you weight is a big one. So if 0:14:44.480 --> 0:14:47.440 you lost weight and if you had a very low 0:14:47.480 --> 0:14:50.240 sodium diet, there are things that you can do like 0:14:50.280 --> 0:14:52.640 that that can keep controlling. 0:14:52.280 --> 0:14:56.000 Your Then environmental pressures. You can't really monitor that. 0:14:56.280 --> 0:14:58.240 No, you can't monitor that, but there are devices now 0:14:58.240 --> 0:15:00.280 where you can actually monitor your blood PRESSU sure, and 0:15:00.320 --> 0:15:02.400 so you can see you at a snapshot over the 0:15:02.400 --> 0:15:04.520 course of a week what your blood pressure has been. 0:15:04.640 --> 0:15:07.240 That is the single most important risk factor for stroke 0:15:07.400 --> 0:15:10.920 and heart attack. And so knowing your number and knowing 0:15:10.960 --> 0:15:13.040 what your numbers should be i e. Less than one 0:15:13.160 --> 0:15:17.320 twenty over eighty and accepting nothing above that is crucial 0:15:18.080 --> 0:15:21.920 for brain health and for heart health. And that's so 0:15:22.200 --> 0:15:26.640 these five fingers people who followed it had a fifty 0:15:26.680 --> 0:15:31.880 percent greater reduction in cognitive decline or the five fingers, 0:15:32.240 --> 0:15:36.960 so vascular risk factors, okay, right, Social connectivity, so physical 0:15:37.040 --> 0:15:40.760 cognitive exercise, nutrition, the diet, so the mind diet was 0:15:40.800 --> 0:15:43.160 it was actually a Norwegian diet. What looks almost identical 0:15:43.240 --> 0:15:47.280 to the mind diet, So diet, physical cognitive exercise, managing. 0:15:46.960 --> 0:15:49.120 Those already looks up mind diet. 0:15:49.880 --> 0:15:55.400 So those five things, just those alone made a dramatic 0:15:55.400 --> 0:15:57.920 difference over the course of just two years and reducing 0:15:58.000 --> 0:16:00.000 the risk of cognitive decline and dementsion. 0:16:00.080 --> 0:16:03.640 YEA, how much does the role of genetics play when 0:16:03.920 --> 0:16:06.800 it comes to dementia and other neurological conditions. 0:16:06.960 --> 0:16:09.840 It plays a role, but you know, the sort of 0:16:09.880 --> 0:16:13.560 rule of thumb, Martha, and there's no real science behind this, 0:16:13.680 --> 0:16:16.960 but by and large it's true. Eighty percent of brain 0:16:17.000 --> 0:16:21.080 health and eighty percent of longevity is lifestyle. It is 0:16:21.680 --> 0:16:26.840 maybe twenty percent is genes. But you know, there's this 0:16:26.880 --> 0:16:30.520 phenomenon known as the gene environment interaction. So if you 0:16:30.560 --> 0:16:33.480 don't sleep, if you don't manage those risk factors, if 0:16:33.520 --> 0:16:37.120 you don't move, if you're exposed to toxicans in the environment, 0:16:37.160 --> 0:16:39.320 if you smoke, if you drink a lot of alcohol, 0:16:39.640 --> 0:16:43.600 you change the expression of genes, so you might turn on, 0:16:43.760 --> 0:16:47.000 for example, like bad sleep will turn on genes that 0:16:47.080 --> 0:16:52.480 increase the risk for cancer or cardiovas heart disease and 0:16:53.120 --> 0:16:55.880 decrease the expression of genes that are responsible for your 0:16:55.880 --> 0:17:00.560 immune system. So there's a powerful role between the environment 0:17:00.840 --> 0:17:05.080 in which genes are expressed. Is there some really exciting 0:17:05.119 --> 0:17:07.520 work being done now that there are some genetic risk 0:17:07.560 --> 0:17:13.560 factors for Alzheimer's disease, But some of these new targets 0:17:13.560 --> 0:17:16.760 that are being tested, these druggable targets as we talk about, 0:17:16.800 --> 0:17:19.080 that may find their way into clinical practice in the 0:17:19.119 --> 0:17:23.200 not too distant future completely neutralize, at least in animals, 0:17:24.040 --> 0:17:28.640 the effect of bad genes. So genes, yeah, important, responsible 0:17:28.680 --> 0:17:31.800 for about twenty percent of lifespan and brain span, if 0:17:31.800 --> 0:17:34.320 you will. But how you live your life has a 0:17:34.359 --> 0:17:37.960 powerful influence on whether those genes, those bad genes will 0:17:38.000 --> 0:17:41.360 actually be expressed versus the good genes that you want expressed. 0:17:41.920 --> 0:17:45.159 I've read that women are at higher risk for dementia 0:17:45.200 --> 0:17:46.439 than men. Is that's true? 0:17:46.480 --> 0:17:47.080 That is true? 0:17:47.200 --> 0:17:47.480 Why? 0:17:48.400 --> 0:17:50.440 Good question. We think it has a lot to do 0:17:50.920 --> 0:17:55.360 with hormones, particularly during that periman apostle phase where there 0:17:55.440 --> 0:17:59.440 is kind of a precipitous drop in estrogen. So hormones 0:17:59.440 --> 0:18:03.400 definitely play role. They're estrogen and progesterone receptors all over 0:18:03.440 --> 0:18:05.879 the brain, so I think you know there's a hormonal 0:18:05.880 --> 0:18:09.320 influence to this. There may be other risks as well. 0:18:09.520 --> 0:18:12.280 Hormone therapy is important to at least have a conversation 0:18:12.400 --> 0:18:14.879 with your doctor if you're in early in the early 0:18:14.920 --> 0:18:19.160 perimid apostle phase, because estrogen may be protective for the brain, 0:18:19.800 --> 0:18:21.680 so it's important. There as a lot of nuances there, 0:18:21.720 --> 0:18:23.800 but it's important to at least have that conversation with 0:18:23.880 --> 0:18:26.480 your doctor. Women are also at a higher risk of 0:18:26.520 --> 0:18:31.240 other diseases that may affect the brain, like diabetes, like 0:18:31.400 --> 0:18:34.720 heart disease. So all of these things. You can think, Martha, 0:18:34.760 --> 0:18:38.560 of the our health as a house. The brain sits somewhere, 0:18:39.320 --> 0:18:41.760 the heart sits in another house, but they're all connected, 0:18:42.119 --> 0:18:44.439 and so if one organ is sick, it makes the 0:18:44.440 --> 0:18:46.520 whole house sick. If one room is sick, it makes 0:18:46.520 --> 0:18:50.600 the whole house sick. So I think because women are 0:18:50.640 --> 0:18:52.639 at a higher risk for many of the diseases that 0:18:52.720 --> 0:18:55.719 affect the brain, and they go through these fluctures, you know, 0:18:55.760 --> 0:18:59.080 hormonal stages during their life, I think that's partly why 0:18:59.240 --> 0:19:00.360 they're at an increase risk. 0:19:01.160 --> 0:19:04.080 I had a very good doctor long time ago who 0:19:04.160 --> 0:19:07.399 put me on an estrogen and I've been on it 0:19:07.440 --> 0:19:11.280 for but sixty years or something, and I think it 0:19:11.520 --> 0:19:15.880 served me well. Yes, because good skin, good hair, good. 0:19:16.640 --> 0:19:21.479 My brain's pretty good. I think, if I'm interested in 0:19:21.480 --> 0:19:25.200 brain health and not an ATREAM member, what simple tests 0:19:25.200 --> 0:19:27.720 should I ask my doctor to check for during my 0:19:27.800 --> 0:19:28.760 annual checkup? 0:19:29.680 --> 0:19:32.800 He or she should do a cognitive health examination. So 0:19:33.119 --> 0:19:36.159 where are you? What is your baseline? It's not done today. 0:19:36.560 --> 0:19:37.120 Oh it isn't. 0:19:37.359 --> 0:19:39.640 When you go in for your annual physical they don't 0:19:39.640 --> 0:19:41.440 really test your brain health. 0:19:41.560 --> 0:19:42.199 No, they do not. 0:19:42.400 --> 0:19:43.919 They take a chest X ray. They might do it. 0:19:44.000 --> 0:19:46.560 But who would you go to for that? To a neurologist. 0:19:47.000 --> 0:19:49.560 You would go to a neurologist. But also you should 0:19:49.560 --> 0:19:52.000 be able to go to a primary care physician as well. 0:19:52.119 --> 0:19:55.359 So just like you know route there's routine screening for 0:19:55.480 --> 0:19:58.920 heart health, and you know blood pressure and blood glucose, 0:19:58.920 --> 0:20:01.440 the should be routine root teen screening for brain health. 0:20:01.960 --> 0:20:05.760 So that includes maybe some certainly a cognitive test of 0:20:05.800 --> 0:20:08.840 the brain. Right now, we might as well talk about it. 0:20:09.720 --> 0:20:12.960 There are a couple of blood tests right now that 0:20:13.680 --> 0:20:16.920 will actually tell us what the health of the brain 0:20:16.960 --> 0:20:19.680 actually is. Oh wow, So in the future Martha was 0:20:19.720 --> 0:20:22.800 working on that. Oh, there are lots of pharmaceutical companies 0:20:22.840 --> 0:20:24.800 working on that. They are a scientists working on that, 0:20:24.840 --> 0:20:27.880 and a couple are commercially available right now. So, as 0:20:27.920 --> 0:20:32.400 we alluded to earlier, Alzheimer's disease and other nerod degenerator 0:20:32.440 --> 0:20:35.480 diseases begin years to decades before they actually show up 0:20:35.480 --> 0:20:38.840 as symptoms. And imagine a future where when you go 0:20:38.880 --> 0:20:40.320 in and get your blood drawn and you get a 0:20:40.840 --> 0:20:43.199 you know, a blood count done, and you know, you 0:20:43.280 --> 0:20:46.080 get a cholesterol test. Imagine if you've got a test 0:20:46.119 --> 0:20:48.800 for the brain. Yeah, I would love that that determined 0:20:48.800 --> 0:20:51.600 your brain health and that provided you with the opportunity 0:20:51.640 --> 0:20:56.240 to intervene early and maybe never develop the actual disease. 0:20:56.640 --> 0:20:58.160 I think that's the future and that's what. 0:20:58.080 --> 0:21:01.720 We're I went to that laboratory is famous laboratory in Iceland. 0:21:02.200 --> 0:21:06.120 Do you know about that laboratory that reads your genome? Oh? Yes, yes, 0:21:06.520 --> 0:21:09.920 So I did that, oh twenty years of seacode. Yes, yes, seacode, 0:21:10.520 --> 0:21:13.320 and I went through the whole test. They test you 0:21:13.480 --> 0:21:19.960 against the Icelandic population, which is a very protected and 0:21:20.119 --> 0:21:25.240 very small population that I had really no propensity for 0:21:25.280 --> 0:21:30.880 any life threatening diseases in my genome except for maybe obesity. 0:21:31.840 --> 0:21:34.120 So I felt really good about it, But I wish 0:21:34.160 --> 0:21:36.600 I could have that again. Where are there places in 0:21:36.640 --> 0:21:38.760 America now that are reading your genome like that? 0:21:38.960 --> 0:21:41.720 Absolutely, we do it, and we do on every member 0:21:41.720 --> 0:21:45.280 at ATRIA. We do full genome sequencing good as well 0:21:45.320 --> 0:21:48.280 as what we call polygenic risk scoring, because not all 0:21:48.320 --> 0:21:50.720 diseases are due to a single gene or a mutation 0:21:50.840 --> 0:21:54.240 a single gene. They're due to variations in multiple genes, 0:21:54.640 --> 0:21:57.080 So we test people for that to see what diseases 0:21:57.119 --> 0:22:00.800 they're at risk for. We do something called pharmaco genomics, 0:22:01.040 --> 0:22:04.720 which means that we test the genes that are responsible 0:22:04.880 --> 0:22:08.639