Can You Prevent Dementia? The Truth About Brain Health, Cognitive Resilience & Longevity.

“Dementia is not inevitable. Small, intentional changes in lifestyle can significantly reduce your risk.” - Jay Ingram

Have you ever wondered how much control we have over our brain health? Can lifestyle choices, education, and sleep patterns influence cognitive longevity and prevent conditions like dementia? In this episode, I sit down with Jay Ingram, a renowned science communicator, broadcaster, and author, to explore these critical questions.

Jay has dedicated his career to making complex scientific concepts accessible to the public. He has hosted Canada's premier science radio program, Quirks and Quarks, and Daily Planet on Discovery Channel Canada. With over 20 books published and translated into 15 languages, Jay has been a key voice in public science awareness. He is a member of the Order of Canada and has co-founded Beakerhead, an initiative that blends arts and engineering to engage people in science.

In this insightful discussion, we dive into Jay’s extensive research on dementia, including what it truly is, why it's often misunderstood, and what steps we can take to mitigate its risks. Whether you're looking for ways to keep your brain sharp or simply want to better understand how cognitive decline works, this episode is packed with valuable takeaways.

Key Takeaways:

1. Dementia Is Not Just Alzheimer’s – Dementia is an umbrella term for various cognitive decline conditions, including Alzheimer’s, vascular dementia, and frontotemporal dementia. While Alzheimer’s is the most common, understanding the different types can help in prevention and management strategies.
2. Genetics vs. Lifestyle – While genetics plays a role in dementia risk, lifestyle choices can significantly impact outcomes. Research suggests that nearly 40% of dementia cases could be preventable with the right habits.
3. The Role of Lifestyle in Prevention – Healthy habits such as eating a nutritious diet (favoring whole foods and minimizing processed sugars), regular physical activity, and maintaining social connections can significantly reduce dementia risk.
4. The Importance of Sleep – Deep sleep plays a crucial role in brain health, helping to flush out harmful proteins that contribute to Alzheimer’s. Establishing good sleep hygiene, such as maintaining a consistent bedtime and avoiding artificial light before sleep, is essential.

Bio

Jay Ingram has hosted both the premier radio science program in Canada, CBC’s Quirks and Quarks, and its TV counterpart, Discovery Channel Canada’s Daily Planet. 
 
Ingram has written 20 books, many of which have been best-sellers. His books have been translated into 15 languages. He wrote a science column for The Toronto Star for 12 years, and was a contributing editor to Owl magazine.  

From 2005-2015, he was Chair of the Science Communications Program at the Banff Centre. He is also co-founder and board member of the arts and engineering smashup called Beakerhead, which began in September 2013 in Calgary. 

In 2010, Ingram was appointed as a member to the Order of Canada for a lifetime of service in science communication. 

Contact

Instagram: https://www.instagram.com/jay.ingram.315/

X: https://x.com/jayingram

Chapters

• 0:16 Introduction to the Podcast
• 1:42 Practical Tips for Everyday Challenges

Transcript

[0:00] Music.

[0:06] Welcome to It's an Inside Job, the podcast where we equip you with actual skills to build resilience, enhance communication, foster well-being,

[0:14] and lead and coach with impact. I'm your host, Jason Liem, and every Monday we bring you expert insights and real-world stories to help you thrive and succeed. And with that said, let's slip into the stream.

[0:27] Music.

[0:35] Well welcome back this week's question we want to try to answer is have you ever wondered how much control we have over our brain health can lifestyle choices education and sleep patterns influence cognitive longevity and prevent conditions like dementia well in this week's episode, I sit down with Jay Ingram to explore these critical questions. Now, Jay has spent decades making complex scientific concepts accessible to the public. He's hosted Canada's premier science radio program, Quirks and Quarks, as well as Daily Planet on the Discovery Channel Canada. He's also an accomplished author who's written 20 books, many of them bestsellers, translated into 15 languages. His work in science communication extends beyond broadcasting and writing, including serving as the chair of the Science Communications Program at the Banff Centre, and co-founding Beakerhead, an initiative blending arts and engineering to engage people in science. Recognized for his contributions, he's a member of the Order of Canada and has received numerous awards for public science awareness. So in this conversation, we dive into Jay's extensive research on dementia. We explore what dementia truly is, why it's often misunderstood, and what steps we can take to mitigate its risks. So whether you're looking for ways to keep your brain sharp or simply want to better understand how cognitive decline works, this episode is going to be right down your alley.

[2:01] Dementia is a growing problem. It's always been around, but the numbers seem to be increasing. And maybe you, dear listeners, know someone who is suffering from dementia. So without further ado, let's slip into the stream with my compelling conversation with.

[2:16] Music.

[2:31] Welcome. Thank you, Jason. Glad to be here. Could we begin by maybe you briefly introducing who you are and what you currently do?

[2:42] Sure. So for my entire career, which is, you know, closing on on five decades now, I've been trying to communicate science to a general audience. So not necessarily people, well, definitely not people who have a scientific expertise, but people who are curious and interested in science, but don't necessarily have the background. And so this necessitates translation in a sense, not necessarily dumbing down my least favorite phrase.

[3:25] But trying to make people aware of where science is going, which branches of science are really undergoing rapid change, and trying to get... I mean, I've always been convinced that so much of science is really fascinating, and I try to communicate that fascination. So uh in terms of my career i've done everything from teach a biology course over the radio to uh hosting a canadian science radio show called quirks and quarks to hosting a canadian discovery channel nightly hour-long science show called daily planet and i've written a number of books and book writing and podcasting is pretty much what I do now.

[4:23] Great, because I'd like to explore your podcast, and we'll bring that up in a sec. But today, I want to focus on sort of dementia. You know, you have extensive research, and you've discussed dementia quite extensively in your work. For our audience, could you provide our listeners with an overview of what dementia is and how it affects individuals and families?

[4:49] That's a very large question. um okay let me start by trying to differentiate among different dementias because it's not all alzheimer's disease alzheimer's disease well maybe i should even say what dementia is first.

[5:08] So generally and i think most people are aware of this dementia is something that is usually almost always associated with people who are over 60 years old, and it gets more and more prevalent as you move into your 80s. It's very generally a disease of old age. It is a disease, and this marks a contrast from the view, let's say, 100 years ago, when dementia was simply seen as one of the aspects of old age. And it was kind of inevitable. And people would dismiss it, at least here in North America, with phrases like, oh, aunt, aunt, aunt, aunt, Aunt Jane has gone dotty, meaning that she's losing her cognitive abilities. And it was not something that anyone saw, honestly, until almost the 1970s as a disease, something that doesn't necessarily accompany old age.

[6:22] So you know that's I mean that was still 50 you know almost 50 years ago but still was a dramatic change and interestingly at least in the U.S. It turned on the on the on one individual an actress named Rita Hayworth who was a big movie star in the 40s 50s and 60s But she was tossed out of her New York City co-op apartment because the residents thought she was drunk. She wasn't drunk. She had Alzheimer's disease. And this realization, which was quickly taken up by scientists as well, that this is a condition. It's not alcohol related. it is a disease, really turned around the research to direct it as something that maybe could be dealt with. So that's kind of a pocket history of dementia. Although, you know, even though today we think it's an epidemic, and you look at the numbers and you see, my God, the numbers are going up dramatically. There are going to be millions of people globally in another five years that have dementia. But there's no indication that dementia is in any way new.

[7:49] You know, there are compelling descriptions of people from the 1600s to 1500s who clearly had dementia. The issue now is, as I said a minute ago, it's a disease of old age. And so as more and more of the world's population moves into that old age band, you know, where more people are living in their 90s, even into their hundreds, it's inevitable that more people will come down with dementia. Okay, so that's that. Alzheimer's, which is what Rita Hayworth had, is the most common. I think the current figure is something like 75% of all dementias are Alzheimer's disease. But there are other kinds.

[8:35] Vascular dementia, which involves inadequate circulation of blood to the brain, is another one. And it often coexists with Alzheimer's. So, you know, you get a double blow. There's frontal temporal dementia. There's Lewy body dementia. There's even a dementia caused by prions, you know, relative. Those are the key components of mad cow disease. But there's a dementia called Kreutzfeldt-Jakob disease that also is a dementia. So there's a variety of them. and they're all scientifically different a little bit, which makes, obviously, coming up with effective treatments much more difficult.

[9:23] Is dementia, is it sort of found equally across the world, or is it more plagued in Western societies because of lifestyle? So that's a very good question. Lifestyle is key, and I hope we will come back to that, But it doesn't spare any cultures as far as we know.

[9:46] I'll sort of preview the lifestyle thing by saying that early education, ultimately, how far you go in school is... May surprise a lot of people to know that that is one of the biggest risks for dementia. So, you know, obviously school systems differ from country to country. But let's say if you leave school at the age of 10, for instance, your risk of dementia is significantly greater than somebody who finishes high school, goes to university, say.

[10:25] And there are some but not complete explanations for that. But just to get back to the cultural differences, a while ago, studies of senior-aged women in China showed they had a much higher rate of dementia. And it's because they didn't stay in school. I mean, I'm saying it's because that's pretty much what everybody accepts, that inadequate education raised their risk for dementia. And it does strike different groups differently. So, you know, blacks in the United States have a different rate for dementia, I think slightly elevated over whites. There may be differences in Asia. but across the board the risk is higher as you get older and there are many lifestyle risks that apply to every culture.

[11:33] So to sort of follow that lead. So if someone is in a continuous learning state, whether it's learning new languages, traveling, exploring new cultures, diving into subjects that they may find interesting for me right now, it's something I really dive into. I find geopolitics very vastly interesting. But back to my question, if people are constantly learning, do they create, I don't know if this is the correct term, a sense of cognitive density or brain density in the sense of the connections that their neurons are making?

[12:10] And within that density, is that some way of mitigating dementia? It may not be definitive, what I'm about to say. So I want to split that into two.

[12:21] It's quite clear that early education as i said is a key factor and it you know let me set this out so genetics plays a role there's no doubt about that specifically in alzheimer's disease there are uh some fairly common genes that if you get both copies of the mutated version one from your mother, one from your father, your risk is elevated dramatically. By dramatically, it depends on the study, but maybe as much as, you know, 10% to 15% higher risk. There actually are also some genes related to Alzheimer's that don't just raise your risk, but actually dictate that you will get Alzheimer's. Now these are rare. They represent probably 1% of all Alzheimer's cases, but given that Alzheimer's is 75% of all dementia, that's still a significant number of people. And these are genes...

[13:29] There's a very, that's a very, I want to just underline that. These are genes that dictate you're going to get it. Although just recently there's a case of one man who has this kind of gene who is now about 70 and hasn't shown signs of the disease yet. So he has obviously become, you know, a research animal. But generally these ones that dictate you're going to get it, unfortunately cause Alzheimer's in the early 50s or certainly by the time you're 60 years old. So early onset. So genes play a role and the best estimate is that 60% of dementias are due to genetics, but 40% aren't. And this is really critical. So to get back to your question, I'm sorry, I took a bit of a detour there, but it's kind of important to understand that it's not all genes.

[14:29] The early education piece is kind of addressed, like people do believe what you suggested, that somehow that intense period when your brain really is finished growing, let's say by the age of 10 or 11, and is busy pruning out, eliminating circuits that really aren't crucial, and that might last, well, you know, even into the early 20s, that's a crucial time, and something is going on, and nobody yet has really pinpointed what that is, but somehow it's more efficient communication among neurons. And it's generally called brain reserve. So if you have this brain reserve from early age, then it's quite likely that you will either not get dementia, or even if you live to a really advanced age, if you do get it, you'll get it later.

[15:40] So this obviously, whatever brain reserve is, it'd be nice, as you suggest, to continue to exercise your brain, to challenge it cognitively, so that you can maintain that brain reserve. The data on that is not nearly as solid as establishing brain reserve by staying in school. And I think it's probably because when you're in school, you're not only mentally challenging yourself in a more challenging way than you might when you're 40, let's say, because you have an option when you're 40, you can put the book down and go watch TV or something, whereas when you're in school, you don't. But also, it's a critical time for brain development. And there are some qualifications, but I'll just say it. So critical time in school, challenging situation, that's the best way to establish this kind of reinforcement of brain reserve. But, you know, as we continue to talk about dementia today, I will be saying that keeping your brain active and challenged is probably a good thing even later in life. It's just not yet clear that it's quite as dramatic a benefit as if you had stayed in school.

[17:09] Yeah, so what I'm hearing, Jay, is that in the early educations, when our brains are developing from whatever it is, from the time we're born till, I think it's mid-20s, when our prefrontal cortexes are fully established, this is the prime time to kind of shield ourselves to some extent against future dementia. If I was just to throw in another element in here of neuroplasticity. Now, neuroplasticity, for our listeners who don't know, is the brain's ability to adapt to new learning, such as learning a language or a consistent way of thinking, a mindset per se. Because of the science that we know that the brain is very plastic, that it can adapt to environments and to learnings, what aspect does this play into it? I know this is an extension of what you've just spoken about, but how does neuroplasticity play into this to the extent you know it? Well, just to go back to being in school, that's, you're learning because your brain is very plastic at that point. You know, plastic being adaptable, changeable, responsive to cognitive challenges.

[18:30] So the evidence in terms of later life is growing that not only, well, you know, I think everybody knows, take learning a language, for instance. It's way easier if you're eight years old and surrounded by the language, not just taking it at school, than it is when you're 48 years old. So that's more evidence that that's a critical time. But there is emerging evidence now that even in late life, let's say 60 plus, you can generate new brain cells. And, you know, it used to be thought that once the brain reached adult size, it was pretty much frozen in time, but it's not. And I think that that's still, these are all areas of ongoing research, but there is pretty good evidence that, if you really cognitively challenge yourself, you can establish not just new brain cells, but new connections among brain cells.

[19:39] I suspect that no matter how much we learn about that, that's still not going to be as good as doing it early, but it's still something that is absolutely worthwhile doing. Let me give you a really cool example of this effect. So there was a long-term study going on in the U.S. It's still going, but it had its main impact 20 years ago, called the Nunn Study. It involved a series of convents called the School Sisters of Notre Dame. And they agreed to, and they're a nice experimental group because they have the same living conditions, the same diet, the same activities, and everything else. So, and they agreed to do semi-annual, like every six months, psychological tests, and then have their brains examined after death. So, one of the amazing things that was found was that...

[20:47] To enter the convent, and this, girls would usually apply when they're 19 or 20. They had to write an essay, a short essay on why they wanted to join the convent. And these essays were just stuck in a desk drawer, and I'm talking like now the 1920s and 30s, and then re-examined in the late 90s and early 2000s. And it turned out that the richer the language that was used by novitiates when they wanted to enter the convent, so we're talking 19 and 20-year-old girls, the richer the language, the less likely they were to get Alzheimer's disease. And, you know, it's a remarkable example of how things that you were engaged in or doing when you were maybe still a teenager can extend over the arc of your life to when you're 80 or 85. And many of these girls also showed upon autopsy that their brains had the molecules that accumulate, the destructive molecules that accumulate in Alzheimer's. They had them, but it hadn't affected their cognition and behavior.

[22:14] So, you know, it not only offers more evidence for brain reserve, but it also leaves brain reserve as a bit of a mystery. Like, okay, if it's not forestalling the deposition of these molecules, what is it doing? So, yeah, great example, I thought. No, I really like that study with the nuns. The more articulate they were on their entrance papers, i just find that's fascinating i've never i've never come across that particular study or heard that study but so thanks for sharing that so if we can circle back to sort of lifestyle because people are thinking okay i don't have a time machine i can't bounce back you know 40 years to to create this um this brain reserve and people think okay.

[23:03] Perhaps there is some sort of lifestyle that Jay just talked about. Can you speak to, from your perspective, what are some of the key lifestyle changes people can do to reduce, perhaps, their risk of developing dementia?

[23:18] There are several. So maybe, let me just mention two or three to start. Please. because they, and I should say that I'm getting most of this information from a group called the Lancet Commission, the Lancet being an internationally respected medical journal out of the UK. And the Lancet Commission formed, I think, in 2017 to assess, because I already mentioned, you know, 60% might be genetic, but 40% is lifestyle. They wanted to pin down exactly what those lifestyle changes were. And of those lifestyle changes, which ones have the biggest impact? And then the Lancet Commission has continued. So they've issued three reports, I think 2017, 2020, and 2024. And the number of risk factors they've identified as being convincingly influential in the delay or prevention of dementia has risen from 8 to 14. So I think some of them that actually people can not only relate to easiest, but also see a way to change for the better.

[24:45] Would be diet. And I'll give you three, and none of them is a very big surprise. Diet.

[24:56] Exercise, social life. Now, diet is pretty, it's getting to be pretty well understood. There's a, there's the Mediterranean diet, there's an Alzheimer's diet, you know, there's the mind diet. And these break down to things that I think most people are at least aware of if they don't actually take action on them. Less fat, lots of protein and fiber, less sugar, all, you know, things that, less processed food, things that I think we have heard more often than not, that are good things. They do have the diet effects directly influence a lot of cardiovascular issues like diabetes, obesity, high blood pressure.

[25:57] LDL, cholesterol, the so-called bad cholesterol. These all are impacted by diet, so it's not surprising. And those things that I just mentioned, diabetes, obesity, LDL, cholesterol, and high blood pressure, are all considered risks. So here you have diet as being a kind of linchpin that if you adopt the right diet, this will have an impact, a positive impact on many risks. The best advice on our, I'm doing a podcast right now called Defy Dementia, where this is what we talk about, lifestyle risks.

[26:43] The best advice, the easiest advice to act on is, and I have to speak here for the organization of supermarkets, grocery stores in North America. I don't know, they might be better organized in Europe, probably. Is that as soon as you walk in the door, you go to the produce section and you select brightly colored vegetables and fruit. And if you do that first, and then of course eat them eventually, that's the best move you can make.

[27:23] Because you're getting more of your diet from fruit and vegetables, both of which are incredibly important, not just for the prevention of dementia, but everything else. And it's an easy step. This is one of the things, I'll talk about the other two lifestyles first, and then we can talk about maybe how easy is it to change. So, social life.

[27:49] Social isolation and loneliness sound like the same thing, but they're not. You can feel lonely at a cocktail party where you're surrounded by people you know, But you just don't feel that you're you're really good friends that you're not really connected to them You're lonely. So it's that's very different from social isolation Which by contrast can be you know I have a place in the woods in Eastern Canada where I am pretty socially isolated and I'm perfectly happy there, It's a different thing but the two of them I mean if I were to stay at my place in, all the time by myself, that wouldn't be good for me. And being lonely, and you know, the Surgeon General of the U.S., the outgoing Surgeon General said a couple of years ago that America is enduring an epidemic of loneliness, partly caused by COVID. So, how do you... It's very, very important to maintain social contacts.

[29:02] The question is how and i'll just get to i think the third thing i said was fitness exercise so you know again a quick a quick way of in increasing your fitness a tiny bit is that if you happen to drive somewhere to shop park as far away from the building you're going to shopping in as possible so instead of you know trying to shorten your walk make sure it's a little more substantial. That's a very tiny thing. But if you start adopting that mindset and walk more, I don't think you even need to establish a metric like 10,000 steps, you know, the legendary and somewhat artificial 10,000 steps. But again, fitness is really, the more fit you are, and you know, again, it comes back to the cardiovascular issues, obesity, diabetes, etc. You know you're going to address those if you're more fit. And one more thing about these three, and I can get to the others if you want, and that's that quite often you can combine them. So if you go walking with a group of friends, you've accomplished social connection, you've accomplished fitness.

[30:27] Very few people grocery shop. And bring a bag of apples for everyone. Yeah, exactly. And I say that because it's not easy to resolve to change your lifestyle habits, especially if you're older, you know, because you've been doing the same kinds of things probably for a long time. And it's, I liken it to New Year's resolutions, which I basically abandoned a long time ago because I never acted on them. You know, they were wishes that never got fulfilled.

[31:06] So I'm actually doing a bit better now. I'm doing much more fitness. You know, it's easy when you're young, right? Because you play sports like football. And in Canada, lots of people play hockey and basketball and then tennis and things like that. But that gets harder when you're in your 50s and 60s when people's bodies start to rebel against that. And then you're taking up lawn bowling and checkers and chess. Although they're good for cognitive stimulation. So it's a little bit more difficult to get yourself moving. But anyway, those three, fitness, diet, social life, those are super important. Yeah, for me, like diet is one of the major things I focus on. Like when I go into a grocery store, I pretty much stick to the outer walls. The only time I might go into the center is to buy cat food. Or paper towels. Which you're not eating, I hope. No, no.

[32:12] Yeah. Yeah. Maybe I have to make that clear. No, I do not eat cat food, but I stick to the, sort of the perimeter of the grocery store because basically that's all, all I need. Those are the whole foods I'm looking for. And then I'm out. When it comes to exercise, you know, I think going for a walk, it doesn't have to be 10,000 steps, but it's, it's just movement. And I've, I've been doing a lot of reading about sort of fitness and sometimes it's just getting up every hour and doing 250 to 300 steps especially if you're in a in an office just move right to have these micro movements through the day can actually be more beneficial than one long run per se over the the the the span of a day.

[32:54] Uh and social of course you know our brains thrive we we we get that social reward feeling valued and connected and secure in our community or our tribe or our family. And social pain, as we know, that lights up the insula. And social pain is piggybacked on to physical pain. And so if we took an aspirin, that would take away the physical pain for a while. But it would also reduce the social pain. But unless the underlying reasons for causing that pain, the social pain, and what is social pain? For my listeners, social pain are those relationships that we have with people. It's the quality of the relationships. So as you said, I might be at a cocktail party. I might know everyone there, but I don't feel I'm really, I belong. I feel disconnected, right? I could be in a sea of people in a big city, but still be, feel like I'm on an island.

[33:54] In the first half of my conversation with Jay, he explained that dementia is not a singular condition, but a broad term covering various diseases, including Alzheimer's, vascular dementia, and frontotemporal dementia. While Alzheimer's is the most common, it is far from the only form. Jay highlighted how dementia was once considered an inevitable part of aging, but it's now understood as a disease, one that can, in many cases, be influenced by lifestyle choices. One of the key takeaways from this part of the discussion was the role of genetics versus lifestyle and dementia risk. Jay explained that while genetics can and does contribute to dementia.

[34:33] Lifestyle choices can significantly impact outcomes, with nearly 40% of cases being potentially preventable. He emphasized the importance of early education and brain development, stating that cognitive reserve built in youth can delay or even prevent dementia. He also shared insights from studies, including research on nuns, showing how early language ability correlated with a lower risk of Alzheimer. Now, Jay also stressed that practical lifestyle changes such as maintaining healthy diet, engaging in physical activity and exercise, and fostering strong social connections, while they can play a critical role in brain health. It just goes to show small adjustments in our lifestyle habits can be an incredible

[35:17] investment in efforts and brain health that can have lasting impact. So now let's slip back into the stream with my compelling conversation with Jay Ingram.

[35:26] Music.

[35:36] How important is sleep as part of a preventative measure? Very. And it's well-known. Well, it's one of the Lancet's 14 identified risks of disturbed sleep. There are, and of course it's well-known and sort of well-accepted, that as you get older, your sleep becomes more disturbed. You wake up. More in the night. There is probably a scientific slash medical reason, or there might be, that there's a contribution to at least Alzheimer's disease because it's widely believed that in deep sleep, like the dreamless sleep that you only spend maybe an hour and a half or at most two hours in every night, is an opportunity for the brain to flush out some of these chemicals that are contributors, maybe even probably causes of Alzheimer's disease.

[36:40] So, you know, addressing that is a little bit trickier, and I'm sure you've come across things like, you know, don't doom scroll on your cell phone just before turning out the light. Try to be consistent in terms of when you go to bed every night, you know, which is more These are not things to address the inadequacy of sleep directly, but they are more about setting up a context, a predictable context. So, you know, I mean, there's a good reason we sleep at night. It's dark. So what you've got to do is kind of control more than that because we all now live in a sort of synthetic environment, and make sure that you're not staring into artificial light until you actually turn off those lights, that you're going to bed at the same time. It's probably a good idea to have exercised to some degree. Again, you see there's a link there to another anti-dementia strategy.

[37:46] So, you know, I'm exploring this myself because I do find that, My sleep is a little less consistent than it used to be. I'm consoling myself because even if I wake up at five in the morning, I'm generally able to go back to sleep. And so I have that break, but it's not like I'm then sleepless from that point on. But I also think that an adequate amount of exercise helps me sleep better. Um you know there's all i mean of course if you if you go online then you're convinced that it's your mattress and your pillowcase that are the reason you're not sleeping very well um but you know it's worth and i think although i'm not sure anyone's actually investigated this that resorting to sleeping pills probably is not the ideal way of coping with what you think is irregular or inconsistent sleep. Many of the ones we've already talked about, you can do something about. And those are the ones that we like to emphasize because each of them is responsible for probably a single digit increase in risk, maybe only one or two or three or four percent. But you start adding those up and it becomes significant.

[39:08] Exactly. You know, you're going to build a brick cows one brick at a time and it is it is fortifying ourselves against that through lifestyle choices I mean how important when we come when we talk about mindset or outlook on life or managing stress what is the growing evidence that links mental health and well-being to brain health from your perspective it's growing you know I started.

[39:38] I started looking at dementia for two reasons. One, my mother had Alzheimer's disease, and it was pretty devastating to witness. But I was also really interested in the science, because at the time I got interested, let's say in the early 2000s, maybe a bit earlier actually, there was a lot of turmoil in the research, and I think there still is, because the dominant theory was, and to some extent still is, it's what the medications that have been approved in the U.S. So far are based on, is that there was an accumulation of two chemicals, what I've been calling the dangerous molecules, fibers called tau and plaques called amyloid. Alois Alzheimer himself identified these as unusual appearances in the brain of one of his patients. He was a combination neurologist and.

[40:49] Micro microscopist. So he was the first one that alerted the medical world in 1909, I think, to the idea that in Alzheimer's at least, well, that wasn't called then because that was him, that there is the accumulation of these. And there is generally, at least in Alzheimer's, not those other dementias I mentioned at the beginning, there is an accumulation of both tau and amyloid as you get older. The issue becomes, when does it start to affect your cognition? And there's really good evidence and an increasing awareness that by the time somebody shows, let's say, what's generally considered to be the first step, mild cognitive impairment, they already have a load of amyloid and tau in their brains. But they've probably had it for 15 years, or it's been growing at least for the 15 years previous.

[41:54] So this is actually one of the impetuses behind doing blood tests that could show you um you know whether you've got an accumulating set of those the plaque is this is this a built up of the detritus that our brains are not able to sort of clean out you know like when we sleep our our sort of the neural connections kind of shrink a little allowing cerebral spinal fluid to kind of wash it out almost like a dishwasher but is part of this what this plaque is is the detritus that comes from, you know, what we build up over a day per se, and it doesn't get cleaned out because we're not getting fitful, restful, restorative sleep. I think most people would say that it's not necessarily normal detritus. That, you know, this is where the genes that predispose you to Alzheimer's, and again, this is not the ones that dictate it, although they're involved with amyloid and tau as well, but the ones that raise your risk.

[43:02] So you have genes that have mutated, And they increase either the amount, the production of amyloid and tau, or the clearance of it, one or the other, or perhaps both. And I should really qualify this to say not everyone buys the argument that amyloid and tau should be the two molecules that are targeted by anti-Alzheimer's drugs. They are the ones that are being targeted now, but because there are many, many people, including many of the nuns in the nun study, who on autopsy were found to have loads of amyloid and tau and yet showed no cognitive decline, even at the age of 100, it's got to be something more than that. And there are some scientists in the U.S. who have argued for a long time that it's really based more on blood sugar and insulin and the Alzheimer's should be called type 3 diabetes. There's a lot of, not ambiguity, but there's a lot of discussion. And there are still many people who don't buy the amyloid and tau argument.

[44:23] But that's where the, you know, here's the thing. So it's only in the last two years that any drugs have been licensed to reduce the cognitive decline associated with Alzheimer's. But they're all targeted at amyloid and tau and they all work to some degree. They're not perfect. They, for some patients, they only, temporarily slow down cognitive decline, but it's early days yet. We don't, I mean, most people have only been taking these drugs for a year. So the story is unclear, but the fact that they have some discernible effect, suggests that, yeah, amyloid and tau is important. Both are important, but, you know, is one more important than the other? Does one depend on the other? It looks like tau only really starts to ramp up once you've got a significant amount of amyloid.

[45:26] So in terms of the research toward medication, we're still early days, but I think the pace is such that we're going to get somewhere. I mean, if you asked me five years ago, when are we going to see anti-Alzheimer's drugs, I would have said 10 years. Well, it's been much quicker than that, which is why I'm willing to go out on a bit of a limb and say within 10 years from now.

[45:57] Maybe there'll be some pretty efficient, affordable, because they aren't yet, drugs.

[46:04] But, you know, in the meantime, it would be a really bad mistake to listen to me and say, oh well i'm good i'm 40 if i start you know by the time i'm 50 there's a great drug so i i won't go for a run today maybe i'll have a hamburger you know that would be a mistake i was just wondering since we're talking about sort of different perspectives on this how important is the gut, microbiome when it comes to this because we were talking about seeing dementia as maybe a type 3 diabetes and that that's about the sugar it's about the ability of the body to be able to shift from using glucose as a fuel source to ketones especially when we sleep you know the we burn through our glucose and glycogen reserves quite fast and those who don't have that metabolic flexibility to switch from glucose to ketones as a fuel source this what i've read may be part of what may be fueling this type 3 diabetes but a lot of that comes down to our gut microbiome the ability for i was wondering if you could speak to as much as you know about that where you'd like to begin yeah it'll be brief um partly because i haven't looked into it in any great depth and partly because there isn't any great depth to look into so there definitely are uh.

[47:33] Published reports that suggest there is a microbiome. Well, everybody knows there's a microbe, not everybody, most people know there's a microbiome connection to brain health. And now it's been more specifically narrowed down to, looks like there's a microbiome connection to onset of dementia. And again, remember, like these other dementias besides Alzheimer's aren't nearly as common as Alzheimer's, but it's also true that while the remedies, if you want to call them that, lifestyle changes seem to apply to all of them, there are going to be for sure drugs that apply to Alzheimer's and none of the others. On the other hand, that's a good thing, right? Because it's 75% of all of it. But so one can't make general statements about the microbiome. Well, And, you know, maybe 10, 5 years now, we're going to be able to make general statements. But we're so early on in the microbiome, our knowledge of the microbiome. I mean, there was just a paper published in the last couple of months.

[48:47] Showing that working in the garden alters your microbiome fairly significantly and as far as anyone can tell for the better. And, you know, that sort of, for me, that links back to the whole be out in nature idea, which usually is, you know, suggested as a good route to mental health, relaxation, lowering your blood pressure, just lowering stress. We haven't even really talked about stress yet, and those do connect. But the idea of sort of digging in the garden and weeding your garden and doing things like that, that it might be good for your microbiome, I think struck a lot of people as being novel and fascinating.

[49:36] I just, honestly, I'm beginning to think, just go outside, right? Like, no matter what. But I'll give you another sort of off-the-cuff example, and that is air pollution, because it may not be a good reason to go outside sometimes. But air pollution has been identified by the Lancet Commission as a significant risk. It ties to smoking cigarettes, because that's just a more efficient way of polluting your lungs. But also now, especially to wildfire smoke, And I know that there are issues of wildfires in Europe, but North America, Canada particularly.

[50:20] You know, we now see summer, at least in Western Canada, as wildfire season. I mean, that's just a fact of life, allied to climate change. There's a particulates in the air, you're breathing in. Yeah, but I just think, you know, if it isn't wildfire season, if the air quality outside is pretty good, just being outside uh especially if you can be outside in a high vegetation zone like a forest or even a garden outdoor garden anything is better for you yeah let's i'd like to segue more to stress because you know a lot of us feel psychosocial emotional stress what is the connection between duress the negative stress on what you know of how it can affect dementia and how we can regulate that duress to as a preventative measure i think the awareness is probably the important first step you know wow i'm finding this incredibly stressful do i have to do this i mean i i think of sport you know where you're even if it's just like pick up football at the neighborhood park with a bunch of people that you know and have played for years. And none of you are very good, but you want to win.

[51:45] And so there's a certain amount of stress associated with being a competitive person. But I wouldn't say generally. It's a bad thing. I think it energizes you. It forces concentration and attention.

[52:02] You know, there's nothing wrong with, in my mind anyway, wanting to win. It's just that, you know, when the game's over, you go have a beer or something, and you don't carry over your antagonism to the pub.

[52:19] But I'm definitely not an expert on how to manage stress. I mean, for me, if I find things really stressful, I do try to avoid them. You know, the workplace you mentioned is a really good thing because I know some young people now who are in various jobs that are incredibly stressful. Like a first-time lawyer who has a kind of unpleasant boss. Well, that's stressful on a daily, maybe hourly basis where you're working for someone who never gives you any positive comments.

[53:04] That's like unbearable. But, you know, then you can take the long view and say, well, after this year, when I'm more independent, I won't have to deal with that. And so I can endure it. And I think even, and I'm really talking off the top of my head here, but I think that if you're in a position where you can see that it's not long term, that it's short term, and you will be beyond it, Well, it really probably reduces the chemical effects that stress obviously has on the brain. I know somebody else. Again, these are people in there, you know, around the age of 30, working for a startup. Well, everybody knows working for a startup is stressful. I mean, it's risky. You may not have a job in six months, but you may. And so, again, you can sort of take the long view. But I think that if you're employed in a way that every single day is stressful and there seems to be no way out, makes life very difficult, and stress is definitely a component of a risk for dementia. I'm not sure it's been identified yet as an individual identifiable risk with a certain percentage attached to it. but you know.

[54:30] It's like starting the day on a positive note. There's a great amount of overlap between how to deal with aging in an effective way and how to avoid dementia in an effective way. A lot of it is mindset, and you mentioned that. And avoidance of stress is part of a positive mindset. So it's just, you know, again, it comes down to my New Year's resolution fear. That it's in the end, it's up to you.

[55:06] And what is going to, what is going to trigger you to actually change, you know, the desire to avoid dementia, but that's still a, for many people, a remote fear. I mean, I have kids in their thirties. I don't really talk to them much about avoiding dementia because I don't think they'll listen. So I instead try and, you know, slip in some of these other things like avoiding traumatic hit brain injury and eating properly and getting better sleep. Considering my daughter has a one-year-old, she's not going to look on her sleep for a while. I've been there with three small kids myself earlier in the game.

[55:53] I'd just like to take a sidestep. I'm very, very respectful of your time jay you have a forthcoming book that delves into the science of pets and i i just kind of made the connections i was wondering if can you share some insights on how maybe having pets might influence mental health and potentially play a role in building, a resilience or conditions against dementia is there any research there.

[56:22] So there's a lot of research, but my overall, and I've tried to read as much of it as I can, it's scattered. There's just a little bit too much ambiguity. So for instance, papers have been published going back to the 90s showing that pet owners have lower blood pressure than non-pet owners.

[56:53] But then there are studies that have shown, at least during COVID, having a pet didn't seem to help much in terms of loneliness.

[57:04] And, you know, without offending people who have found positive results, my sense is that, and preventing depression is another one, Really extensive survey of all those studies by a guy, a sort of animal expert named Hal Herzog, showed that you could conclude almost nothing about the effects on dementia. Then, of course, of course, people try to differentiate between cats and dogs. And um you know there's sporadic things that suggest like for instance the the assumption would be having a dog is better because you have to walk it and so and like i know this when we're finished i'm going to walk my dog and i might do you know six seven thousand steps or something. So surely that's better for me. And yet it's very, very hard to demonstrate unequivocally that having a dog is better than having a cat. And then you get into the whole other issue, which is, are there personalities that are more likely to be dog owners than cat owners.

[58:24] And again, pretty ambiguous, but let's say there were, then you'd have to take the second step analysis and say, well, are those personalities more likely to be eating properly, exercising, and so on and so on. My personal view is I don't see, well, my dog is kind of frustrating from time to time.

[58:50] But overall, I love them. So I don't think that can be a bad thing. You know, everything from tiny fish to giant dogs, horses, everything. It's very, very hard to draw conclusions. So, you know, in the absence of the enormous amount of time it's going to take to prove which pets are best for your prevention of dementia. I would act on the things that we know well, like...

[59:20] Diet exercise social life etc yeah i i guess i mean if you love your pets it adds something to your life it it calms you down it's it's something that enriches you i can't see it being a negative thing we can't prove it scientifically now or papers on it but i guess you know if you love your dog you love your cat your pet elephant whatever i i just only see that's a good thing because that creates that social bonding, maybe at a different level. I think even if you don't bond, so I've had pets that, like I had a pair of lizards once, it would be a stretch to say that I bonded with them. I was interested in watching them behave, but I didn't talk to them like I talked to my dog. So even if it's just limited to your own sense of well-being.

[1:00:15] Then that would be something worth thinking about. I want to just add, something just came through my mind that I wanted to add to the whole idea of keeping yourself cognitively engaged. Because we talked a lot about the early education effect and maybe not as much as we should have on the continuing to engage yourself cognitively. So people say things like, play Sudoku, do a crossword puzzle, play the New York Times Wordle, and so on and so on. One piece of advice for people who depend or are using those with an idea to preserve their cognition is that once you get really skilled at the puzzle and you've learned the routines.

[1:01:04] You know what the crossword puzzle designer likes to put in the puzzle, it's time to move on to a different puzzle. And that's not a point that's often made, but it appears to be really important, that cognitive engagement must include a sense of something about novelty. The other thing about cognitive engagement, so I played the violin when I was a kid and then kind of got, well, definitely got away from it. I'm starting to pick it up again, though, because any sort of expression, you know, like painting a musical instrument, joining a choir, You wouldn't believe the number of, where I live in Canada, the number of choirs that have been formed from people... Just older people who want to keep engaged, people who already have dementia, and caregivers.

[1:02:08] It's astounding. And, you know, it's just an amazing experience. And there was a famous, I can't remember the title of it, there was a famous YouTube video that was circulating maybe 10 years ago, where a guy took iPods into long-term care homes in the U.S. And played music for, you know, people living with dementia, sometimes deeply in dementia, played the kind of music they loved when they were younger. And the impact on those people, even just for a few minutes, was amazing. From inaction to joy. And the power of music, I think, is important and maybe has yet to be explored in quite as much detail as it should be. And, sorry, maybe I'm going on too long here, but there's another aspect when I mentioned people in a choir being, you know, people that are cognitively intact, people living with dementia and caregivers.

[1:03:17] Caregiving raises the risk of dementia for the caregiver significantly. Significantly and I think from what we've talked about it should be pretty obvious why that is do you really eat normally if you're a 24 even if you're not 24 hours if you're caregiving for somebody do you sleep well no are you stressed yes are you getting are getting adequate fitness probably not, And, you know, I've seen figures that your risk for dementia rises seven, is seven times greater if you're caregiving for someone with dementia. Now, you know, your risk might have only been 1%, 2%, you know, whatever it is as you get older. And so it's, you know, it's 15% or something. That's kind of equivalent to the genetic risk. But it's really, really, really important for caregivers to take time for themselves. We've heard that on the podcast over and over and over again. Do not neglect yourself. It's a generous thing to do, but in the long term, it's a bad thing to do. So, yeah, you know, this is a multi-complex issue.

[1:04:38] No, there is complexity in understanding dementia, the different types of dementia, 60% being genetic, 40% being lifestyle, in those kind of numbers. And if people are thinking, okay, this is so overwhelming, but I think it comes back down to the fundamentals that you were talking about, Jay. It's getting adequate rest. It is eating well, whole foods. It's getting exercise. It's not running a marathon every day. Maybe just a few thousand steps, getting outside, making those social connections, you know, managing stress. You know, yes, you rest, positive stress is great for you, but it's, you know, minimize negative stress to the extent one can. And that has to do with controlling the autonomic nervous system, right? Understanding your heart rate variability. All of these different things, I think, can really contribute to, you know, as you said, it might only be one or two points. But all together, the summation of this, when we amalgamate all of these effects, they can have a significant impact in mitigating or reducing the risk of gaining dementia.

[1:05:49] Well, you know, if you're told that 40% you can deal with as much as it may, it's probably even a bit more than 40%, 45%, somewhere in that range. If you're told you can reduce a significant part of 40%, why wouldn't you do it?

[1:06:10] Well said. Well said. We are coming close to wrapping up this episode. Jay, I was wondering, is there any last words you would like to share with our audience today?

[1:06:24] Well, I mean, I would recommend people listen to our podcast called Defy Dementia. You can find it on any podcast outlet. But, you know, setting aside the marketing that I just did, I think the first and most important realization is abandon the idea that because your aunt had dementia, you're going to get it. Even abandon the idea, if one of your parents had it, abandon it. Because there's not a lot you can do if you have bad genes, but there is a lot you can do if you have bad genes. And so it's up to you. And, you know, I would admit over and over that something being up to you still represents That's a giant step to take.

[1:07:25] But like you just said, take a little bit at a time. You don't have to ramp up to 100% involvement in everything that we've talked about. A ship is hard to change course. It takes a while. A life is the same. But you can do it, and you would be amazed. If you just did some of these things like the way you treat the grocery store Just do that instead of having heading right for the pros the cans of processed meat You know go around the perimeter and then shape your menu, according to that even if you just do that and, It's the effect of doing that that's one thing, but the most important effect is that you've caused a change. And once you can create change a little bit, it's a lot easier to create change a little bit more and so on. Jay, I just want to thank you for your time today. It's been a fascinating conversation. Well you know that's sort of the tragic but wonderful thing about dementia is that scientifically it's fascinating personally it's very difficult but, together i think we all can do something about it.

[1:08:51] Music.

[1:08:57] As we bring this episode to a close jay emphasized the critical role of sleep in preventing alzheimer's disease he explained how deep sleep helps flush out harmful proteins from the brain and share practical ways to improve sleep such as maintaining consistent bedtime routine and reducing exposure to artificial light before bed we also explored the strong link between exercise and sleep quality, reinforcing the idea that movement plays a key role in cognitive health.

[1:09:27] Stress management was also another crucial topic. Jay pointed out that stress itself isn't necessarily harmful. It's how we respond to it that matters. He suggested viewing stress with long-term perspective and incorporating outdoor activities, particularly in high vegetation areas such as parks and forests, to help reduce its effects. He also highlighted how maintaining a positive mindset and engaging in challenging cognitive activities, such as learning new skills or playing a musical instrument, well, how it can contribute to cognitive resilience. We also discussed the importance of personal agency and brain health. You know, Jay encourages us all to move away from the idea that dementia is inevitable, even for those with a family history.

[1:10:12] Small, intentional lifestyle changes, whether it's diet, exercise, sleep, or stress management, well, they all can significantly reduce cognitive decline and promote long-term well-being. Well, I hope this conversation has provided you with some valuable insights, knowledge, and some actual strategies to incorporate in your daily life. Now, if you found this episode helpful, consider sharing it with someone who might benefit from it. Jay a personal thank you from me for spending some time with me today it was a brilliant conversation and I found it very very insightful and I also see that I can make some tweaks in my lifestyle in order to well consider brain health impact for the future so thanks a lot and folks thank you for spending some time with me today and allowing me to be part of your week I will see you Friday for Bite Size Friday and until then keep well keep strong and we'll speak soon.

[1:11:06] Music.