Evolving Past Alzheimer's: Recent Episodes
Evolving Past Alzheimer's
We are absolutely convinced that Alzheimer’s and other brain diseases are generally treatable and reversible. Early translational evidence supports this belief. The Evolving Past Alzheimer’s podcast brings you the highest caliber information about what you can do to identify, prevent, and treat Alzheimer’s disease. The show’s secondary goal is to use Alzheimer’s and cognition as a platform to explore consciousness and the human experience in it’s “second half of life.” Topics include emerging technologies, transhumanism, traditional medicinal approaches, spiritual conversations, and stories of people living with – and through – Alzheimer’s. This show brings you conversations with experts around the world that are leading the charge in treatment and prevention of Alzheimer’s and other brain disease.
What if what we thought to be the primary cause ofAlzheimer'swas not true? Dr. NateBergman delves into a research article published by Dr. Weaver to assess if the primary cause of Alzheimer's can be limited to only the amyloid area.
For years it has been believed that the main causes of Alzheimer’s disease are the abnormal build-up of proteins in and around the brain cells. The main toxic protein involved in this is called the amyloid beta which accumulates and builds up like plaque around the brain cells. However, in recent times, the hypothesis that originated in 2006 and was believed by many was brought into question leading to research being done on the alternative hypotheses and waiting on funding to expand the area of study accessible. The role of amyloid beta has been kept in focus when planning and prescribing Alzheimer's disease treatment to patients suffering from it. However, it is essential to understand that one person's Alzheimer's is not the same as another’s. Thus, one treatment cannot be the answer for everyone. Such observation requires that this matter is dissected further to evaluate what is the core cause of the disease, how it varies, and what Alzheimer’s treatment can prove to be effective against the disease.
For more information about your assessment options for cognitive issues or Alzheimer's, contact Kemper Cognitive Wellness in Cleveland, Ohio.
Email: info@kemperwellness.com
Website: https://kemperwellness.com/
Phone: (216) 337-1400.
In This Episode You Will Learn: Where are you in your career right now? Neuroscience research is fascinating. Dr. Ted is most interested in attention, perception, and memory. These three things work together harmoniously because you can’t remember something you ignore, and it’s difficult to notice something if you don’t perceive it in the beginning.
Dr. Ted studied how the brain encodes beats. He uses music perception to enable people to pay attention, listen, and remember information. He worked with Adam Gaza and researched aging's attention, memory, and perception. Their research indicated that some memory issues stem from attentional issues, inhibiting irrelevant information. How does this process change as we grow?
It’s not a problem with memory capacity; it’s more on the intentional filtering issue. When you add distraction (in a lab setting), adults will show deficient memory performance compared to young adults when you test them on the content they were told to remember. But if you test them on the content they were supposed to ignore, older adults remember the better.
The research now is more on assessing the different potential therapeutics to help people focus their attention and improve their memory performance. There are two ways: musical training to facilitate attention to memory performance and noninvasive neurostimulation using a magnetic field of electrical currents to retrain neuro oscillation that underlies attention to memory processes and rescues the brain’s cognitive abilities to mediate age-related problems.
What aspects of perception do you focus on? Dr. Theodore focuses on perceiving or experiencing things such as the sound of one’s voice or picture. Dr ted is focused chiefly on vision and audition. That’s humans’ ability to see and ability to hear. The brain has a region dedicated to visual processing and another region for auditory processing. These regions are highly connected.
The brain can ramp out or tune out noises. Like a radio equalizer, the brain controls the volume to either ramp up a particular sound to hear more or tune out from other background noise. You can focus on one person’s voice even in a noisy crowd.
Why is brain oscillation significant? Brain oscillation means the frequencies at which the brain and neurons are firing. They become active at different frequencies. When you sleep, you get these slow bursts of activities. We call these delta waves.
The neurons can burst in a range of thousand hertz. The brain oscillates at lower frequencies, but the other neurons pick up the slack. If you record a large group of neurons, you will get high frequencies.
Dr. Ted uses EEG or fMRI to look at large swabs of the cortex. It includes hundreds of thousands of neurons in one group. When you get that number of neurons synchronously firing together, you get temporal resolution and can detect oscillations. While you can’t get the resolution you need for an individual neuron, you can get a lot of exciting information from 70 Herts and below.
What would the program look like? The research is mainly on assessing how attention, memory, and perception. We are looking at the interaction of these things across the lifespan, how it degrades potentially as people get older, and how we might be able to remediate that. In studying the brain, they’ve identified specific mechanisms for specific interventions.
The frontal theta activity seems to be involved in the complex cognitive function of one’s multitasking ability. For example, one study looked at how people multitask. Research shows that people peak at multitasking in their twenties, which declines as they age. The process was a little car simulation where respondents had to drive a car and respond to street signs.
The goal was to assess how w brain can multitask by driving a car and responding to streetlights simultaneously. Younger adults were better at it, but a month into playing the simulation paradigm, older people were able to improve their multitasking abilities.
It shows that frontal data is related to one’s ability to focus your attention and remember objects.
Another study was done to shorten the brain’s improvement to multitask. They had young adults at their peak, stimulating their brains at six Herts. It’s what they call theta stimulation. Results showed that after an hour, this group improved this multitasking ability as opposed to those who could feel the stimulation but didn’t get the total dose.
This method was then replicated in older adults. The session ran over an hour initially. But for the older adults, the protocol was done in three days.
The Variables There are a lot of individual variabilities here since not everyone responds the same to the treatment. Even then, we can now estimate the conductivity and resistivity of the skin, the scalp, the cerebral spinal fluid, the gray matter, and the white matter in the brain.
But, to do that, we needed to have an actual picture of each brain. Dr. Ted and his team brought the respondents for an MRI to take a high-resolution picture of their heads, including the scalp, the brain, and the CSF. The results allowed them to assign resistance to all the tissue types. Eventually, they were able to get into each person’s brain.
It’s helpful to know that the efficacy of stimulation can be affected by one’s anatomy. As a person ages, the brain degenerates and shrinks a bit. The more it does, the less current is likely to go into the brain. When dealing with an aging population or people with neurodegenerative disorders, that's important. When dealing with an aging population or people with neurodegenerative disorders, that's important.
People with more atrophy will likely need a higher dose of stimulation for the current to reach the brain. This result helps us understand the individual differences of people. Other brains work faster, so they need fewer pulses per second for the current to reach the brain. It means people won’t function as efficiently when stimulated at the inaccurate Hertz level. This means that brains need to oscillate at a frequency that matches.
What does this mean for people with neurogenerative disorders such as Alzheimer's? Intensity is an important question here. They tried different intensities, showing that the higher the intensity, the more effective it is. However, they still saw some improvements in memory, even with lower intensities. Lowered beta-load is one of the biomarkers associated with Alzheimer’s. With the stimulation, we saw an increase in microglia. These neurons help clear the amyloid plaques.
TACS is a more practical solution than other types of neurostimulation requiring complicated electronics. If this demonstrates the efficacy, it can be used with other treatments for Alzheimer's. The study is still in the research phase, but still, this is a practical solution.
What’s great about this neurostimulation is that if you stimulate a node of network regions that are functionally connected, you can manipulate brain activities. Even if the stimulation doesn’t reach the hippocampus, if they’re able to hit a region of the cortex that communicates with the hippocampus, then it’s believed that it can impact the hippocampus and fire out activities in the rain.
TACS Stimulation It’s hard to hit a specific quadrant in the brain and stimulate it. It takes some time before the stimulation can start seeing real effects. Right now, it’s still in its early stages. So, it’s just about seeing what works, understanding the why, and looking for answers.
Everything comes at a cost. There are activities that people do that affect how the brain functions and be stimulated. The same is accurate with the hertz and other frequencies. The stimulation and work may impact the brain at a specific frequency. People could be doing other things to improve multiple functions, but at the moment, science is doing this, and hopefully, it bears good results.
About the Guest:
Dr. Theodore Zanto
Director of Neurology at Neuroscape and Assoc Prof at UCSF.
He specializes in brain imaging and non-invasive studies on the brain, especially on attention, perception, and memory studies.
For more information about your assessment options for cognitive issues or Alzheimer's, contact Kemper Cognitive Wellness in Cleveland, Ohio.
Email: info@kemperwellness.com
Website: https://kemperwellness.com/
Phone: (216) 337-1400.
6 Effective Ways of Heart Disease Prevention
Anyone who wishes to optimize health by protecting the heart and brain must listen to this!
Dr. Marwan Sabbagh and Joe Piscatella combine the six most effective principles for heart disease prevention. They unfold valuable heart and brain facts in their new book Strong Heart, Sharp Mind, which are equally beneficial for the prevention of Alzheimer's disease. In a way, they open hope for effective heart disease treatments, dealing with Alzheimer's, and other brain ailments with a multidisciplinary approach.
What is good for your heart is good for your brain and ultimately contributes to your overall healthy lifestyle. This episode guides listeners to optimal well-being using a 6-Step Brain-Body Balance Program. In this discussion, he adds that the mechanism that underpins heart disease symptoms considerably overlaps with the symptoms of Alzheimer's. Therefore, aggressively managing the cures for one has two or more benefits.
How Is Heart Disease The # 1 Cause Of Death Worldwide?
Researchers agreed that cardiovascular arrest, high blood pressure, and cholesterol are risk factors for many other diseases like Alzheimer's. High blood pressure is one of the mechanisms overlapping Alzheimer's and heart disease symptoms, making it the most deadly disease of all time.
Dr. Sabbagh believes aggressively managing cholesterol and high blood pressure might considerably help heart disease prevention through natural anti-inflammatory processes. He adds that saturated fats are bad for the brain, which triggers amyloid (an unhealthy protein in the brain), hindering ongoing heart disease treatment.
Is High Blood Pressure A Contributor to Heart Disease?
National Academy of Sciences, Engineering, and Medicines analyzed the whole shebang, including diet, cognitive stimulation, exercise, health conditions, etc. They came up with their thorough and expert analysis that blood pressure management, mental stimulation, and exercise were the only three things that showed sufficient evidence to recommend them in clinical practices.
Several other health organizations are researching, concluding that high blood pressure management is the ultimate risk reduction strategy for the heart and brain.
What Are Neurobics?
Neurobics are brain exercises that aid in healthy mental activities and prevent severe diseases such as Alzheimer's and heart disease. Dr. Sabbagh suggests Neurobics as a way of simultaneously doing physical activity and cognitive stimulation. In the book, the author outlines the perfect Neurobics that can improve heart function and blood vessel health.
Transforming The American Diet into A Healthful Way to Eat
According to Berkeley Wellness Letter, Nutrition Actions, and Tufts Newsletter, modest dietary changes can help fight heart disease symptoms. Similarly, one fish meal a week, two berries a week, and two vegetables a day can reduce Alzheimer's disease risk.
Managing Alzheimer's with A Good Sleep Regimen
Sleep apnea is a huge risk for heart attacks as well as a considerable risk for cognitive decline. Quality sleep is the procedure by which your brain removes the amyloids. That's why Dr. Sabbagh refers to sleep as an easy fix to our mild cognitive illness.
Exercise during the daytime, regular meal times, waking up, and going to bed are far more beneficial than sleeping pills. Also, there is a link between inadequate sleep quality, plaque building, and high blood pressure.
How Stress Management Is Vital To Defeat Heart Diseases
A person's mental health can positively or negatively impact their physical health, and the risk of heart failure may increase with high blood pressure. So, they refer to a phenomenon called 'hippie genetics,' which has secondary benefits in dealing with stress and reducing risks for heart disease. As said, you are more likely to be stress-free if you are physically active and socially connected, leading a healthy lifestyle.
Keep your heart pumping and passions alive by knowing what is good for you. If you have people that support you and share the same bond, you are more likely to be mentally healthy.
The people who practice cognitive stimulation are the people who exercise and eat right and ultimately lead a healthy lifestyle. However, it is more important to practice mental stimulation even if you have heart disease symptoms or Alzheimer's. The book gives you a great plan to follow that.
About the Guest:
Marwan Noel Sabbagh, M.D, formerly the Director of the Lou Ruvo Center for Brain Health at Cleveland Clinic, is internationally known for his expertise in the brain and vascular disorders like Alzheimer's and related dementias.
For more information about your assessment options for cognitive issues or Alzheimer's, contact Kemper Cognitive Wellness in Cleveland, Ohio.
Email: info@kemperwellness.com
Website: https://kemperwellness.com/
Phone: (216) 337-1400.
A familiar guest rejoins us for the show! Marwan Sabbagh MD is currently a professor of Neurology at Barrow Neurological Institute and a leader in Alzheimer's disease diagnosis and treatment. Dr. Sabbagh and his bestselling co-author and heart disease survivor, Joe Piscatella reveals new hope for treating and preventing these heart, blood vessel, and brain diseases like Alzheimer's with their new book, Strong Heart, Sharp Mind.
We discuss how, for the first time in his career, Dr Sabbagh is starting to see people with very early Alzheimer's hold the symptoms at bay. He attributes, in part, to the development of new medications for Alzheimer's (listen to podcast episode #64) as well as the adoption of principles of a healthy lifestyle and specific new blood tests such as homocysteine to assess the risk of heart and brain diseases.
The new book outlines 6 Key Principles to improve your brain, blood vessel, and heart health
1) Incorporating exercise into daily activities
- Check out the broomstick kayaking idea (very clever)
2) Transforming the American diet into a healthful way to eat
- Think about habits not diets or "fad diets."
- Trusted info from:
-
- Nutrition Action,
- the Berkeley Wellness Letter
- the Tufts Newsletter
- "even modest adoption of the MIND diet approach, such as eating two vegetable servings a day, two berry servings a week, and one fish meal a week, appeared to lower the risk of Alzheimer’s disease."
3) Building a healthy sleep regimen
4) Managing stress, anger, and anxiety
- great section on anger and your health
5) Creating opportunities for cognitive stimulation
6) Bolstering your social support system
To learn more about your assessment options for prevention or treatment of cognitive issues or Alzheimer’s contact Kemper Cognitive Wellness in Cleveland, Ohio.
Email: info@kemperwellness.com
Website: https://kemperwellness.com/
Phone: (216) 337-1400.
The conversation had on this episode is a little complex but is an excellent review in how science is done and "how the sausage is made" in terms of medical evidence in peer review for Alzheimer's treatments.
We discuss the results of the AMBAR trial - The Alzheimer Management by Albumin Replacement - where people with mild to moderate Alzheimer's showed significant improvements after having their blood plasma exchanged in addition to receiving either IV Albumin as well as IVIg (in some of the experimental groups).
The study doesn't offer an explanation of the mechanisms around why Albumin and IVIg might have been effective, but a robust conversation about the research and the durability of the positive results ensues.
Our guest is an international leader in Alzheimer's, Mercé Boada Rovira MD, PhD founder and director of the ACE Alzheimer's Center in Barcelona, Spain. Dr Boada has led and published results of over 100 Alzheimer's prevention and treatment trials over the many decades of her career.
This episode was co-produced and co-hosted by, Brett Graham, MD. Brett is a 2nd year neurology resident at Vanderbilt University Medical Center.
What is plasma exchange?
Also called plasmapheresis or PLEX. A procedure in which a machine is used to separate the liquid part of blood from the blood cells and then filtered similar to dialysis except that in plasma exchange big things like protein and antibodies are removed whereas in dialysis smaller molecules and electrolytes are the target. Because proteins are removed from blood in the process they are usually replaced with something like albumin afterwards. This treatment is mostly commonly used in treating certain autoimmune diseases like myasthenia gravis, Guillan Barre Syndrome, and thrombotic thrombocytopenic purpura (TTP) but it is also used in diseases where too much of a particular substance builds up in the blood such as in multiple myeloma or familial hypercholesterolemia.
What is albumin?
Albumin is the main protein component of blood that serves to balance concentration gradients between the blood and tissues as well as shuttle many other molecules through the bloodstream. This is removed during plasma exchange and so must be at least partially replaced after a session.
What is IVIG?
IVIG stands for intravenous immunoglobulin and is basically pooled antibodies from blood donors, which when administered to a patient have a variety of effects, many of which are still not fully understood, but you can basically think about these antibodies non-specifically binding to and neutralizing autoantibodies and other bad stuff in the blood. Again, this is most commonly used to treat autoimmune diseases.
For consultation or evaluation by Dr Nate Bergman call, 216-337-1400 or visit our website www.Kemperwellness.com
In July 2021, the journal Frontiers in Neurology reported on "groundbreaking research" out of Tulane pointing to the relationship between Lyme disease and Alzheimer’s dementia.
But since the 1980s our guest on this episode, Dr. Alan MacDonald, was stirring up the scientific debate by publishing and presenting data from his pathology laboratory that the bacteria - Borrelia Burgdorferi often synonymous with what's called Lyme disease, because of its association with its US origins in the town of Lyme, Connecticut.
Dr. MacDonald graduated with an MD from Columbia University. He has completed 35 years of research in Borrelia and Lyme disease and has published numerous peer-reviewed articles on the pathology of Lyme and its role in Alzheimer's, dementia, and other diseases.
This show is dedicated to my mother, Susan Bergman MD, the #1 fan and supporter of the show - who was the first and coolest pathologist I’ve ever known.
For more information on how you can prevent or push back against Alzheimer's and other dementias visit Kemperwellness.com or call (216) 337-1400. We have support programs, virtual classes, and many other options.
Consider supporting the Evolving Past Alzheimer's podcast at patreon.com/evolvingpast so we can continue to bring you the information most helpful to you.
3:00 - What is a pathologist?
9:35 - Why Alan believes some of Alzheimer's cases have microbial origins
15:07 - Why has it taken so long to recognize chronic Lyme disease?
24:34 - What percentage of Alzheimer's patients have microbes like Lyme in their body?
28:42 - How to get a diagnosis with Lyme
42:12 - The possibilities for the treatment of Lyme disease
This is a more theoretical episode that gives us some idea about what might be happening with the rhythms of an Alzheimer's or POST-COVID brain. Our guest, Dr Thom Cleland, is a professor of theoretical and systems neuroscience at Cornell University. His research is particularly focused on the mammalian olfactory system and on the emergent dynamical networks that govern communication and information transfer among brain areas. We talk about brain circuits, neuronetworks and how this relates to our sense of smell and Alzheimer's in general.
For more information on how you can prevent or push back against Alzheimer's and other dementias visit Kemperwellness.com or call (216) 337-1400. We have support programs, virtual classes, and many other options.
Consider supporting the Evolving Past Alzheimer's podcast at patreon.com/evolvingpast so we can continue to bring you the information most helpful to you.
1:42 - What we can learn from looking at brain waves
8:58 - The olfactory system and how it works
13:57 - What happens to people’s brain waves when they are experiencing dementia processes
24:43 - How the olfactory system connects to the memory and can help with dementia intervention
36:18 - Is losing the sense of smell a sign of neurodegeneration?
In this episode, we go deep into the potential benefits of specialized meditation for our immune systems, brain-related proteins, Alzheimer's, cellular energy, and much more. Our guest, Dr Hemal Patel - is a full professor and serves as the Vice-Chair for Research in the Department of Anesthesiology at the University of California, San Diego.
If you are skeptical about meditation I urge you to check out this episode so that you
Click here is a link to Dr. Patel's talk at a recent Joe Dispenza conference.
For more information on how you can prevent or push back against Alzheimer's and other dementias visit Kemperwellness.com or call (216) 337-1400. We have support programs, virtual classes, and many other options.
Consider supporting the Evolving Past Alzheimer's podcast at patreon.com/evolvingpast so we can continue to bring you the information most helpful to you.
12:47 - how cell membranes can cause or prevent Alzheimer's
15:52 - using meditation and other methods to strengthen cell membranes
28:31 - how you affect people around you by practicing meditation
37:23 - can meditation prevent you from contracting COVID-19?
44:16 - getting started with meditation
Earlier this year, podcast episode #65 - we spoke to Lisa and her daughters Stacy and Natalie. They told us about how they were Living Well with Alzheimer's and improving using lifestyle and personalized approach. Her cognitive decline had stabilized and seen small, but significant improvements in brain function. This episode we review some of the elements that have led to their success:
1) Hiring a personal assistant for Lisa as opposed to a caregiver to force her to do things
2) Inspecting & moving out of a water damaged "moldy" home and why they did this
3) How they continue to iterate and push back against her Alzheimer's process, some tools and tricks that are working for them every day.
For more information on how you can prevent or push back against Alzheimer's and other dementias visit Kemperwellness.com or call (216) 337-1400. We have support programs, virtual classes, and many other options.
Consider supporting the Evolving Past Alzheimer's podcast at patreon.com/evolvingpast so we can continue to bring you the information most helpful to you.
4:44 - What has happened since we last spoke to Natalie and Stacey
7:27 - How Natalie and Stacey revolutionized typical dementia care through choosing a personal assistant over a caregiver
12:45 - What they discovered from mold tests in their mother’s home
29:15 - Navigating the process of moving their mother to a safer home
34:50 - What kept Lisa motivated to keep doing the work
41:48 - How is Lisa doing right now overall?
47:10 - The ins and outs of the system that keeps the family on track with the treatment plan
“We’re actually able to change the brain, even in the face of things like Alzheimer’s disease.” This was the statement made by our guest for this show, Dr. Ben Hampstead. Dr. Hampstead is a professor at the Univ of Michigan and leads a lab that is doing several studies using transcranial direct current stimulation for mild cognitive impairment, Alzheimer's, and other forms of cognitive impairment. We talk about his work and compare it to some of our own results with our patients. Exciting and thought-provoking!
To learn more about the exciting work being done by Dr Hampstead
https://medicine.umich.edu/dept/psychiatry/benjamin-hampstead-phd-abppcn
To learn more about what we do in our clinical practice at Kemper Cognitive Wellness visit kemperwellness.com We are located in Cleveland, Ohio. Or call us at (216) 337-1400.
1:55 - How we are able to change the brain even in the face of Alzheimer's disease
9:00 - Technologies that can be used to treat cognitive decline
31:24 - Measuring the results of the non-pharmacological treatment methods
37:51 - Making medicine more personalized
47:22 - How these treatment plans can be used to prevent cognitive decline before it starts
Halloween is here and the other holidays are just around the corner, so we need to discuss sugar. I share about a conversation I had with Dr. Dale Bredesen about the importance of eating right when trying to prevent cognitive impairment. It has been a long time where food and wellness was not included in the treatment plan for patients with Alzheimer’s and Dementia, but it’s such a crucial part of preventing and slowing the progression of cognitive decline.
Nikki Gould, a registered dietician at Kemper Cognitive Wellness is also joining us today to talk about what sugar can do to your brain and your overall health and how we can navigate the holidays with this information in mind.
6:39 - Is there a healthy amount of sugar?
11:05 - How sugar is hidden in the American diet
15:38 - Taking the first steps towards sustainable change
20:30 - Keeping sugar intake at a reasonable level during the holidays
25:04 - Supporting family members during the holidays if they are struggling with their health
Untreated and unresolved trauma is now considered to be a risk factor and contributor to Alzheimer's dementia.
Trauma can be defined as any event that alters how we process, react to, and recall memories, by overwhelming the individual’s central nervous system. Additionally, trauma is defined as any event in which a person feels helpless and unsafe. It is not only an occurrence that happened in the past; instead, trauma is an event that leaves an imprint upon the body and the brain which persists to the present day.
Our guest for this episode, Dr. Ilene Naomi Rusk completed her PhD in Neuropsychology and Psychopharmacology in the UK , and Fellowships in Neuropsychology. She has dedicated her career to studying novel treatment strategies for Alzheimer’s Disease and sees trauma as a root cause of many illnesses. She is the author of several peer reviewed articles. Dr Rusk co-founded the Brain and Behavior Clinic over 25 years ago and currently directs the Healthy Brain Program in Colorado.
4:20 - Defining trauma through reflecting on a patient story
7:26 - How trauma influences more than just the brain
16:06 - A trauma informed approach to treating neuro degeneration
21:50 - Identifying cognitive decline symptoms in patients who struggle with other mental illnesses or trauma
33:24 - Classic signs of unresolved trauma in the older generations
42:44 - How to deal with unresolved trauma in someone before it becomes cognitive decline
56:12 - How long does it take to see improvement when working with trauma-informed techniques?
Strategies to improve the brain and nervous system:
- traditional talk therapy (eg with a psychologist)
- Simple deep breathing
- dance and movement
- waling
- Qi Gong, Tai Chi, Yoga
- other coregulatory exercises
DisasterShock.com is a resource for people struggling with the stressors and traumas. It includes:
- opportunities for social connection/coregulation (including on-line)
- craft projects
- walking
For more many more tools and strategies visit Ilenenaomirusk.com
To learn more about the BrainFit program at Kemper Cognitive Wellness visit kemperwellness.com
Dr. Nate Bergman quickly summarizes the story up the FDA's recent "accelerated approval" of Biogen's - Aducanumab (brand named, Aduhelm). He ends off with surprise about why he is excited about the approval...and it's probably not what you think! A quick, but useful listen.
In this episode we talk about…
- The terms of the approval of the drug
- What Aducanumab was able to accomplish in Alzheimer's patients
- The circumstances that led to Aducanumab being approved
- Some of the problems that arise with Aducanumab
- Why I am excited about Aducanumab
In this episode, we talk with Lisa, a woman in her early 70s living with Alzheimer's. Lisa is a patient of Dr. Bergman at Kemper Cognitive Wellness. Lisa is joined in this conversation by her daughters, Stacy and Natalie. We discuss the successes and challenges they have had as a family living with Alzheimer's disease. Lisa shares her thoughts about being diagnosed as well as the hope and results they have had since starting on a journey of living well with Alzheimer's.
This episode is an important listen for anyone with doubts, reservations, or skepticism around a precision, functional medicine approach to the treatment of Alzheimer's disease.
Note: names/identities were changed to preserve anonymity.
1:50 - what it was like to get diagnosed with Alzheimer’s and how the family responded
12:13 - living with Alzheimer’s during the events of 2020
14:33 - beginning treatment at Kempler Cognitive Wellness
19:05 - how patients can navigate the healthcare system to find the best treatment plan for their diagnosis
24:58 - implementing your treatment plan and navigating the necessary lifestyle changes
36:34 - results that this family has seen from this treatment plan
45:33 - maintaining motivation in a world where we don’t see a lot of people who are living their lives with Alzheimer’s
53:48 - processing the permanent lifestyle changes that are involved with Alzheimer’s treatment plans
55:44 - what “success” looks like with Alzheimer’s treatment
In this episode, we hear the argument in favor of the new Alzheimer's drug, Aducanumab (Aduhelm). Dr. Marwan Sabbagh is a clinical and research leader at the Cleveland Clinic's Lou Ruvo Center for Brain Health. He was a doctor that saw patients in one of the trials that led to the FDA's Accelerated (provisional) Approval.
Note: Dr. Sabbagh notes his disclosure as an advisor to Biogen, the maker of Aducanumab.
We discuss what Dr. Sabbagh noted in his own patients involved in the recent Phase 3 clinical trial of Aducanumab.
Controversy over the FDA's decision and why Dr. Sabbagh's 25+ years of diagnosing and treating Alzheimer's makes him optimistic about this drug.
Dr. Sabbagh talks through who he thinks might be a good candidate for Aducanumab, the drug's known practical side effects, and how people might get access to the medication in the near future.
Ultimately, Dr. Sabbagh sees people in the near future living with Alzheimer's like a chronic disease much like HIV or diabetes, or even cancer.
This episode presents a slightly different perspective than many of our listeners are used to. We hope you find it useful.
2:33 - what is this new drug and how does it actually treat Alzheimer's
5:28 - Why Dr. Sabbagh is optimistic about this new drug
11:43 - Reasons for some of the skepticism around the study
14:11 - Dr. Sabbagh’s observations of the people who have taken the drug
21:10 - What are the risks of taking the drug?
27:08 - Responding to the criticism of the drug
32:30 - Other promising drugs that may be available in the future for Alzheimer's patients
37:18 - How do people get access to this new drug?
This week we will do almost a Part 2 from the last episode with Drs Dale Bredesen and Kat Toups. In that episode, we featured recently released results data on MedArchive from a clinical trial in which 84% of 25 patients with early Alzheimer's Disease and Mild Cognitive Impairment improved with a Precision Medicine approach.
With that in mind, we want to get another perspective from the other 2 physicians who led this ground-breaking clinical trial. This week we are joined by Doctors Ann Hathaway and Deborah Gordon.
We dive deeper into the details of testing, treatment, and people involved in this trial.
The study results (not yet available in a peer-reviewed journal) were released here
https://www.medrxiv.org/content/10.1101/2021.05.10.21256982v1.full.pdf
Precision Medicine Approach to Alzheimer’s Disease: Successful Proof-of-Concept Trial
5:07 - how the care for the patients in the study is different from the normal protocol
8:40 - getting the study group to work with the technology required for the study
19:07 - some of the reasons patients were not able to be successful
25:23 - how they helped their patients create sustainable lifestyle improvement
34:48 - viral infections that contribute to Alzheimer's and how they approached treating that
44:52 - why is hormone replacement so important for cognitive recovery?
51:15 - bacterial infections that can lead to cognitive decline
1:11:15 - criticisms they will apply to future studies
Our guests today are Drs Kat Toups & Dale Bredesen.
Link to the study results just released online:
https://www.medrxiv.org/content/10.1101/2021.05.10.21256982v1.full.pdf
Important to note, this has not yet been peer-reviewed yet.
25 participants in this group, underwent a 9-month trial.
21 people improved, 1 person no real changes and 3 people got worse to some degree.
2:32 - what is MedArchive and have these study results been peer-reviewed yet?
5:05 - the results of the study and what they learned about cognitive impairment
10:23 - how they determined the cutoff for the participants in the study
17:15 - lessons Dale brought into the study from his previous trial
23:53 - how they proved that environmental factors were leading to cognitive decline
31:03 - key attributes to people who are successful in improving during the study
35:07 - main factors that lead to exposure to toxicity
44:34 - the decision to study genetic factors of Alzheimer's and cognitive decline
50:26 - responding to criticisms of the trial
58:58 - plans for a follow-up trial
Deborah Kan is a former executive producer with the Wall Street Journal. In 2017 she founded the website BeingPatient.com, a comprehensive website dedicated to Alzheimer's news, stories, and support.
This interview covers how Deborah sees the current world of Alzheimer's research and trends in brain health and wellness.
5:42 - Being Patient and how it serves people who are taking care of loved ones with Alzheimer’s
8:35 - Early signs of Alzheimer’s that are often overlooked
17:17 - How the dementia space is evolving with the rise in early diagnosis
20:25 - Why there are more women diagnosed with Alzheimer’s than men
26:09 - The importance of prevention over curing
31:04 - Functional medicine in Alzheimer’s treatment for the people who can’t wait for the science
37:10 - Education and prevention for Alzheimer’s that everyone needs
This is a really unique and important episode. We are witnessing a sea change in dementia. More people are being diagnosed, earlier and younger. And people are figuring out how to actually fight back against the disease and taking ownership of their condition. My guest this week on the Evolving Past Alzheimer's podcast, Chrissy Thelker, was diagnosed with Vascular dementia at age 57 and nearly 5 years later is still living on her own, driving, and living a life of incredible purpose... her story inspires, but she also gives useful information for anyone out there working through the early stages of the disease. This is one you're crazy not to listen to....an amazing episode!
- 2:00 - What it was like to receive a dementia diagnosis
- 6:22 - Why a dementia specialist refused to take Chrissy on as a patient
- 9:44 - How Chrissy followed the Bredesen protocol to slow her dementia symptoms and almost completely prevent herself from getting worse
- 14:56 - What it’s like to live with dementia
- 19:22 - How to balance fighting against the dementia with tending to your new needs living with the disease
- 21:22 - “You have to monitor yourself, and if we all learned from a younger age that it’s ok to rest, we would all be doing better in our health.”
- 23:37 - What does it mean to live with purpose after a dementia diagnosis?
- 29:45 - What it feels like to hear “you don’t look like you have dementia”
- 37:31 - How Chrissy thinks about the future
- 43:54 - Some major conversations happening in the DAI community and people living with dementia - the connection between sleep and brain health
- 48:33 - “Dementia is like a spider web. We need treatments to help manage the different aspects and symptoms rather than a cure.”
- 52:40 - Why organizations working towards treatments and cures need more people suffering from the disease at the table
- 1:00:00 - “Have those conversations early in receiving your diagnosis about your driving and other aspects of your independence.”
- 1:06:16 - How has COVID impacted her function as someone living with dementia
Resources Mentioned
Chrissy's Book - For This I'm Grateful
Chrissy's Blog
Dementia Alliance International
Some listeners have requested more personal stories of people improving and how they are doing it. In this episode, we want to introduce you to an amazing couple, Betsy and George Muller. George suffered a major brain injury as a result of his heart stopping about 4 years ago. Fortunately, he has successfully recovered from the brain injury and this is the story of how the Mullers did it!
If you're interested in more details of the Muller's journey, check out Betsy's book - The Comeback - An Energy Makeover Love Story (available on Amazon and Audible).
9:24 - What George and Betsy have learned about brain health and brain resilience from their experience
14:41 - How meditation can help anyone who is suffering from a cognitive issue or their caregiver
17:33 - Tapping into the power of routine to help someone recover cognitive function
18:44 - The connection between heart health and brain health
21:43 - How to deal with some of the challenges of navigating a loved one who needs a caregiver
26:59 - How to keep your brain as healthy as possible
Several Resources were mentioned that are relevant to folks with Alzheimer's and other dementias. Among them:
AlzU.org - comprehensive website for evidence-based, Alzheimer's education led by previous guest Richard Isaacson MD.
Lumosity Brain Training
Donna Eden Energy Medicine - Betsy recommends do this with your partner of someone with dementia you are caregiving for. It takes only about 6-7 minutes.
We get many questions from listeners and people seeking Alzheimer’s prevention and early intervention about the risks and benefits of hormone therapies, such as estrogen and progesterone.
Our guest this episode, Felice Gersh MD and co-authors recently published an article entitled:
Postmenopausal hormone therapy for cardiovascular health: the evolving data
In this episode we talk about:
- Hormone Therapy in this episode is referring to Estrogen (ie estradiol) and Progesterone.
- 4:29 We talk about the ideal forms to take
- 10:28 We discuss doses and the best way to monitor for safety and effectiveness according to the recent journal article.
- 15:55 - Hormone Therapy’s potential benefits to heart and brain of Estrogen.
- 21:15 - How estrogen might help the natural process of inflammation that occurs in women’s bodies after menopause.
- 40:28 - Why it might make more sense to start estrogen therapy earlier rather than later.
- 48:50 - Considerations for starting estrogen after age 60 or more than 10 years after menopause and how long it may take to see results.
In this episode, you'll meet the co-founders of Kemper House and Kemper Cognitive Wellness. Betty and Kristin Kemper talk about the ideas that inspired them to start:
1) Kemper House - a dedicated assisted living environment pushing the boundaries of what people thought was possible for Alzheimer's and dementia care
2) Kemper Cognitive Wellness - one of the nation’s leading companies for Alzheimer's and dementia prevention, support, and services. We treat everything from brain fog and ADHD all the way through dementia
You'll also hear from Cheryl Freed, Vice President of Learning & Education at Kemper and family dementia coach at Kemper Cognitive Wellness on the principles that shape living well even with a diagnosis of Alzheimer's or dementia.
Finally, we'll tell you about our latest project that we are so proud of - a course for Caregivers of someone with Alzheimer's or other dementia - called, Live Well with Dementia.
Learn more at:
Livewellwithdementia.com
Learn more about the work at Kemper:
Kemperwellness.com
kemperhouse.com
7:48 - What they learned when Kristen’s father and Betty’s husband ended up in the care of their organization
10:49 - The mission of Kemper Cognitive Wellness to catch cognitive decline early
13:13 - What it is like to work in the innovative environment of Kemper vs a traditional assisted living model
15:25 - What can you do when you recieve a diagnosis?
20:03 - What does success look like when someone is moving through the later stages of Dementia?
23:50 - What does success look like when a loved one is at the end of their life?
We have discussed, photobiomodulation in several past podcasts. It’s essentially shining lights on the head in order to positively influence brain function. Growing research supports the use of photobiomodulation for Alzheimer’s and other dementias.
In this episode, we review the hot off the press positive results of a recent clinical trial done by Dr. Berman's group at the Quiet Mind Foundation and his colleagues at the Texas A&M Dept. of Neurosurgery using 1068nm transcranial and intraocular photobiomodulation to treat early to mid-stage dementia. This was a randomized, double-blind placebo-control trial.
Several of the folks using this "light helmet" for 6 minutes, twice a day for 8 weeks had significant improvement in memory and cognition.
Dr. Berman recounts his experiences and talks about where similar devices to the one used in this trial can be obtained.
In This Episode
2:24 - What is photo-bio-modulation?
6:11 - The clinical trial Marvin just completed on Alzheimer’s and Parkinson’s patients and what the results taught them about the laser treatments
16:43 - How does this intervention fit into the current dementia-care model? Does it slow the progression of the disease? Does it help increase the number of good days?
19:03 - The importance of functional medicine elements in the treatment of dementia and use of photo-bio-modulation
21:03 - Is this device commercially available? And how much does it cost?
Links
Quiet Mind Foundation
Joette Calabrese, an international homeopathic consultant, author, educator, and sought-after speaker who teaches around the world. As a physician, I admit that I have some skepticism towards homeopathy, but when it comes to Alzheimer’s and Dementia, I am open to anything that works as long as it’s safe.
In this interview, we talk about what homeopathy is, the safeness and effectiveness of homeopathic treatments, and how you can use homeopathic remedies if you are a caregiver of someone with dementia to benefit yourself and your loved one.
1:11 - “Homeopathy shines in areas where there are no solutions, and modern medicine leaves us great big gaping holes for us to fill.” - Joette Calabrese
3:34 - What is Homeopathy and when is it useful?
8:35 - Are homeopathic treatments a placebo effect?
15:06 - What are the side effects to homeopathic treatments?
17:36 - Homeopathic remedies Joette used to help her mother with dementia
22:11 - How could homeopathy slow the progression of Alzheimer’s
28:56 - “I’ve been doing this for over 34 years and I am still amazed.” - Joette Calabrese
29:19 - Can you get started with homeopathy yourself, or do you have to see an expert?
44:05 - How long does it take to see improvements with homeopathic treatments?
46:50 - How you can use homeopathy to support your own health if you are in the position of being someone else’s caregiver
Find Joette Online
James O’Keefe is the director of preventative cardiology at St Louis Mid-America Heart Institute in Kansas City and a professor of medicine at the University of Missouri. Dr O’Keefe taught me that checking your blood sugar right after you eat is really important. And even healthy people may see a huge spike in their blood sugar right after they eat. Many different chronic diseases are linked to problems with blood sugar. Dr. O’Keefe recently published a paper on the pesco-Mediterranean diet as the ideal way to eat for heart, brain, and overall health.
5:12 - Advantages of the Pesco-Mediterranean diet for preventing cardiovascular problems
12:33 - Dr. O’Keefe’s perspective on the ketogenic diet
16:38 - How dairy can cause inflammation
23:25 - “Erectile dysfunction is the canary in the coal mine. It is an early warning system of trouble with lifestyle.”
24:09 - How to test endothelial function and measure lifestyle changes that need to be made before real problems manifest
29:51 - Exercise for brain function and Alzheimer’s prevention
46:50 - Is fish oil good for your health?
Part 2 of the conversation with Francisco Gonzalez-Lima. We are talking about Methylene Blue as a potential therapy for Alzheimer’s. This is something that you can access yourself with the proper research needed to obtain a pharmaceutical grade. We talk about its potential as a therapy for early intervention and prevention of Alzheimer’s.
Part 1 of this interview was released two weeks ago, where we talk about brain bioenergetics and laser treatments as a therapy for Alzheimer’s.
0:30 - The “magical properties” of Methylene Blue
10:44 - What do people feel like on Methylene Blue?
25:40 - Benefits of Methylene Blue for early intervention and prevention of Alzheimer’s
35:47 - Why it is so difficult to find Methylene Blue. Is it poisonous?
This is a super technical episode. The guest is a world leader in brain energy and its impact on cognition and cognitive change that leads to Alzheimer’s. We had to break this episode into two parts.
The difference between early-onset Alzheimer’s (which is usually genetic) and late-onset Alzheimer’s that usually happens after age 65.
Dr. Gonzalez-Lima argues that there is a common pathway, a problem with the way the brain produces energy, which leads to late-onset Alzheimer’s. The causes of this can be multiple, and the major one is simply getting older.
So as individuals, we have to lead healthy lifestyles to push back on these changes.
The earliest changes in the brain are different than are commonly understood. They are changes in the way the brain metabolizes energy. These changes show up long before the common atrophies we see in Alzheimer’s patients.
Many of the factors that lead to the development of Alzheimer’s are vascular. Test that may help catch Alzheimer’s before cognitive symptoms…
Carotid Intima-Media Thickness Test (CIMT)
EEG or QEG - brain maps
Genetics, head injuries, and brain trauma are other factors that can lead to Alzheimer’s. There are also some infections and viruses that can be associated with the development of the disease. Environmental toxins are a new cause that is being accepted worldwide by even the most conservative organizations.
We finish by talking about mitochondria therapy, a low-level laser therapy, where photons are shot into the brain’s photon acceptors. It essentially makes more space, making the cells more likely to bind and use oxygen. The main risk with this laser is the need to protect the eyes.
Ultimately, the hope is that this treatment can be done with LED lights, and people can do it themselves.
The ketogenic diet can help repair even a damaged brain. We have seen a number of people improve through adopting this diet, even though it can be difficult to sustain, and I don’t recommend sustaining it for long. That conversation will lead us into part 2 which will be released in two weeks.
12:17 - Fundamental problems in the brain and nervous system that are leading to diseases like Alzheimer’s
21:05 - Why are some brains more vulnerable than others to Alzheimer’s?
38:48 - A practical way to assess cerebral brain flow
40:02 - Laser light treatment to help with brain flow
1:09:39 - The ketogenic diet and its potential to help with improving cognition
Dr. Dale Bredesen is a neuroscientist of the first order as well as a truly pioneering doctor in the fields of Alzheimer’s and Parkinson’s research. In 2014, Dr. Bredesen published a widely publicized case series of 10 people who improved from cognitive decline. He has gone on to teach thousands of practitioners his methodology. At the time of recording this episode, there is a clinical trial well underway testing his methodology. Dr. Bredesen is the author of numerous scientific papers as well as the author of New York Times bestseller, The End of Alzheimer’s. Most importantly, Dr. Bredesen’s work brings hope and potential solutions for those struggling with Alzheimer’s and other forms of cognitive decline.
In This Episode
- “The field has argued that some drug is going to be out there that will work, and they haven’t. So we wanted to start from ground zero.”
- The root cause of Alzheimer’s
- Subjective cognitive impairment vs mild cognitive impairment
- Factors that determine if you can reverse cognitive decline and how much you can improve
- “Chronic illnesses like Alzheimer’s are working against the physician because they are keeping people from coming to you for years.”
- How long the results hold after cognitive improvement and what you can do to retain the results
- The “pandemic within the pandemic”, how COVID-19 and Alzheimer’s are connected
- “The Five Personalities”, sub-types of Alzheimer’s
- “We should never follow Alzheimer’s with a period. Alzheimer’s due to what?”
- What is the ketoflex diet, and why ketone energy is so important in Alzheimer’s and cognition?
- What is detoxification, and how does it play into Alzheimer’s treatment?
- The role of psychotherapy in Alzheimer’s prevention and how to deal with apathy during treatment
Links
The End of Alzheimer’s
Read Dale’s Publications
Evolving Past Alzheimer's
The field of preventive neurology is coming. Detection of early brain damage is critical and our guest this episode, Darmiyan appears to have developed this technology.
This interview is with Darmiyan's co-founder, Kaveh Vejdani MD, currently serving as it's chief medical and technology officer.
A highly technical, but potentially game-changing episode. Darmiyan is a medical image processing company currently focused on applying ai technology for early detection of neurodegenerative brain conditions like Alzheimer’s. Changes in the brain early on lead to Alzheimer's before symptoms develop. If we can learn to detect these changes before symptoms manifest, then there is more opportunity for prevention.
In This Episode:
- 1:04 - What the technology is and what it can see
- 5:18 - Discoveries they have made about early Alzheimer’s prevention and how the test works
- 12:04 - “This is one of the tests that is going to change the course of action.”
- 14:04 - The accuracy you can expect from the test
- 17:10 - The criteria for diagnosis with the test
- 20:22 - What is on the horizon for Darmiyan?
- 21:50 - “If you wait for the person to be close to dementia that it’s visible on the MRI, that is too late for treatment actions.”
- 27:26 - Interventions that can improve results after early detection
- 29:24 - When this technology will be more widely available to people who want to detect degenerative diseases before they have symptoms
Links
Darmiyan’s Website
In Feb 2018 Michele Mootz started the CrossFit Wellness Program focused on bringing CrossFit to populations that were not being addressed including those with serious chronic diseases as well as aging adults over 65 including those with cognitive impairment. We discuss the tremendous benefits they have seen to date. We also discuss the impact COVID has had on this program and the overall health of this community of individuals.
Michele Mootz was a Physical Therapist for 13 years before starting work with CrossFit. She is currently the Program Director for CrossFit Wellness as well as a Flowmaster for CrossFit Training Department.
In This Episode:
- 1:23 - What is Crossfit?
- 2:29 - Michele’s journey from working as a physical therapist to CrossFit
- 9:45 - “The recipe to try to get our patients healthier doesn’t change, we are just paying closer attention to more high-risk factors they walk in with.” - Michele Mootz
- 11:12 - Results Michele has seen with the members of her gym
- 14:18 - “The foundation of CrossFit has always been that the movements are functional movements.” - Michele Mootz
- 17:03 - How CrossFit can improve areas of your life outside of just physical fitness
- 21:33 - “One of the mistakes that have been made by me and other CrossFit gyms is trying to integrate everyone into one class.” - Michele Mootz
- 22:54 - How likely is an injury in Crossfit?
- 27:23 - What the senior CrossFit classes look like
- 29:57 - How long it takes to see the results of CrossFit
To inquire about a local class or to join CrossFit's zoom offering:
michele.mootz@crossfittraining.com OR
classinfo@crossfit.com
The zoom class discussed in this episode occurs at 9am Pacific time.
In this episode we talk with neurologist Suzanne Gazda MD. Dr Gazda is an authority on neurodegenerative diseases and offers more insight to balancing the "mental" vs "physical" risks in the age of coronavirus and social distancing. We focus on inflammation, auto-immune disease, Alzheimer's, and isolation.
This is a review of the neurological symptoms that are associated with COVID-19. We discuss the implications of COVID-19 on Alzheimer's disease and other dementias. We discuss what you can do to protect yourself. This is not medical advice, please ask your healthcare provider before taking action to find out what is right for you. Protection: -N95 mask (or at least a cloth or surgical mask) -Low Inflammatory diet (low in processed foods that come out of a bag or box) -Increased exercise/movement - 20-30 minutes of moderate intensity 4-5 times per week. -Good sleep - 7-9 hours according to your chronotype (biological rhythm) -Managing stress- we outline box breathing technique Supplements that likely offer immune support -Zinc citrate or picolinate or acetate. about 30-60mg. -Quercetin - 1gram twice a day -N-Acetyl Cysteine (NAC) - 600-900mg by mouth twice a day -Resveratrol - 100-150 mg daily -Curcumin 500-1000mg twice a day -Vitamin D3 -3000-5000 IU per day -Vitamin C - 1000-3000mg daily (can be taken as 1000mg two or three times per day) If you would like information on where and how to obtain high quality supplements, dietary advice, stress management tools please email info@kemperwellness.com, that is our company. And we can direct you to those resources. If you have questions or comments that you would like us to address please find us on social media or email nate@evolvingpast.com
Dr Michael Fossel received his MD and his PhD from Stanford University. He has published numerous articles in both high impact medical journals and popular press. His book The Telomerase Revolution was hailed by the WSJ as one of the five best science books of 2015. In this episode we discuss the promise telomeres and telomerase therapies for Alzheimer's and dementia. Deep dive on epigenetics and the role of glial cells in the process.
This is the second part of a rich discussion between Anita Saltmarche and Dr Nate Bergman. It features transcranial photobiomodulation (PBM), or shining LED light energy into the brain. Anita has led numerous clinical trials and has over 17 years of experience with this technology. A good discussion about which devices, how much to use, and more information about the VieLight product.
This is the first part of a rich discussion between Anita Saltmarche and Dr Nate Bergman. It features, transcranial-photobiomodulation (PMB), or shining LED or low level laser light energy into the brain known. Anita has led numerous clinical trials and has over 17 years of experience with a variety of photobiomodulation applications. We talk about near-infrared and red light, the important wavelengths and intensities of over the counter and prescriber only devices. We specifically look at the research around the VieLight product.
The first of a 3-part series on light therapy (AKA: Photobiomodulation). This is an interesting discussion of light therapy helmet used with a 64 year old woman with significant Alzheimer's type cognitive impairment. With Dr Joe Diduro DC from ProNeurolight.
This is, Dr Nate Bergman on a solocast chatting about 3 cases of improvement with Alzheimer's and cognitive impairment. We are excited to be part of the changing conversation within the Alzheimer's and Dementia communities. Increasingly, the question isn't so much IF someone will improve, it's more of a question of how much.
In the first episode with Dr Richard Isaacson we discussed his journey towards the recent Oct 2019 publication which was the first forward looking designed paper showing improvements in people at-risk for developing or with early symptoms of Alzheimer's. In this second episode we discuss Richard's idea around how mitochondria might be a root-cause for Alzheimer's disease. We talk about different "personalities" of early Alzheimer's and how this might be related to lab levels and cognitive function tests. Other items we discuss towards a personalization of an approach in Alzheimer's are hormone replacement therapy in Alzheimer's disease and prevention. Cocoa flavanols, Intermittent Fasting, Ketogenic diet, metabolic goals and targets, body fat and quite a bit more. One more note, please understand that none of this should be construed as medical advice. Please consult your local qualified medical authority, even if only considering lifestyle modifications like fasting of any kind or nutritional ketosis.
As our listeners know I get particularly excited about having certain guests on this show. This episode is one of those guests! I have been after Dr Richard Isaacson for over a year now and I had to make a special trip to NYC to go bang on his door to get his attention here...but the reason I am so excited is because the kind of work that Richard is doing is truly pioneering in the Alzheimer's community and his recently published paper. We'll talk about this in great detail, but by way of introduction. Dr Richard Isaacson finished both his undergraduate degree as well as medical school in just 6 years. Completed his neurology residency at Beth Israel Deaconess/Harvard Medical School and now serves as the Director of the Alzheimer’s Prevention Clinic at Weill Cornell in New York City. Finally, and perhaps most important, he and his wife just welcomed their first child into this world....congratulations and Welcome to the show, Dr Isaacson! This is a great episode where we discuss a first-of-its-kind (prospective design) paper showing that early interventions work to prevent Alzheimer's and treat early symptoms. An episode not to be missed. A deep discussion of the research and some of the controversies surrounding Alzheimer's research.
In this episode we explain non-invasive electrical stimulation, specifically transcranial direct current stimulation (tDCS). These techniques are used to alter brain function for the better. They harness and modulate the neuroplastic responses in the brain.
Our guest, Dr. Adam Woods, is cognitive neuroscientist and Assistant Director of the Center for Cognitive Aging and Memory (CAM) at the McKnight Brain Institute at Univ of Florida. He is a national leader in the field of transcranial electrical stimulation (tES), leading the largest tES trial in history, publishing the first comprehensive textbook in the field, and led multiple field standards papers. In particular, we focus on transcranial direct current stimulation (tDCS).
We talk about how these techniques enhance cognition in the aging brain and potentially Alzheimer's disease. These effects are being observed in pilot trials and now being tried on larger groups.
We discuss memory networks and functional MRI findings related to tES interventions.
This is highly technical episode, but well worth it for the information.
Click here information about Dr Woods and his work.
Deep Conversation on Brain Health Coaching and finding your edge, with brain health coach extraordinaire.
To contact Ryan Glatt or to find out more about the services he offers go to Somatiq.com or Ryanglatt.com. You can follow him on Instagram @glatt.somatiq
Dr McEwen explains her study of older adults with cognitive decline and begins by explaining what are the subjective assessment she used in her studies to label cognitive decline. The effects on cognitive functioning social experience and physical challenge of a group exercise class was the focus of the study. Discussion of what is similar and difference between psychosis and Alzheimer’s. The discussion to turns to how Dr McEwen ties together all the various indicators she is researching and the CogFit exercise program is laid out. Dr McEwen also works at Genius Gyms and helps translate some of her research into practical applications for a variety of people who could benefit from the cognitive training. She is also help to develop an app that help people do these exercises on their own as well. The discussion concludes talking about the other ways these exercises can help with emotional, attentional or executive function problems by addressing underlying cognitive problems.
Dr. Sarah McEwen is a Cognitive Psychologist, the Director of Research and Programming at Saint John’s - Pacific Brain Health Center in Santa Monica, CA.
We're back on track...here's a really helpful discussion covering why neuropsychological testing is important if you are dealing with memory loss, cognitive impairment, Alzheimer's, Traumatic Brain Injury, and even problems with mood (such as anxiety and depression).
Kristine Lokken PhD is a functional neuropsychologist with a passion for helping people restore brain health. Her extensive background in clinical research, medical neuropsychology, and holistic wellness merged together to create the Brain Health Institute (BHI). In addition to her work at BHI, she served as the Director of the Rehabilitation Neuropsychology Service at the Birmingham VA Medical Center and instructed as a Clinical Assistant Professor at University of Alabama at Birmingham. She has maintained a private practice for over 15 years, and has seen thousands of patients with varying neurological and psychological issues in her clinical work. Dr. Lokken has published several articles in peer reviewed journals and has lectured extensively on brain health. Since the time of the recording of this episode Dr Lokken has relocated to Seattle, WA to be part of the Brain Health and Research Institute.
Neuropsychologic testing is essential to make a diagnosis of Alzheimer’s or other dementia. This episode explores the role of a Neuropsychologist in a holistic approach to cognitive care. Our discussion begins by focusing basic definitions within the field of neuropsychology. We discuss what is coming down the line in terms of early recognition of Alzheimer’s from a neuropsychologist’s perspective. Later we take a deeper dive into the best tests or areas to test for early recognition. We touch on some of Dr Lokken’s recently presented evidence that homocysteine may be one of the more useful and affordable biomarkers to look at.
Dr Lokken talks about the value of online cognitive tests versus being evaluated by a Neuropsychologist. The discussion continues by looking at self-reported cognitive decline and what you can do if you feel you are worried about it. We finish talking about how the medical community has changed its perspective on prevention going back to the end of 2018 and what is possible in the future in terms of prevention.
Dr Nate Bergman welcomes you back for season 2 of the Evolving Past Alzheimer's Podcast. This season we're talking Neuropsychology, new approaches that incorporate both the brain and body for better results, begin talking about transcranial electric stimulation approaches to Alzheimer's and issues of cognition. We will also continue to discuss ways to optimally age in our bodies while our minds and spirits continue to soar!
Sara Gottfried M.D. is a mother, wife, Harvard-educated physician, keynote speaker, and author of three New York Times bestselling books, The Hormone Cure (2012), The Hormone Reset Diet (2015), and her latest book Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years (2017). For the past 25+ years, Dr. Sara has been dedicated to helping women feel at home in their bodies with functional medicine. After graduating from Harvard Medical School and MIT, she completed her residency at the University of California at San Francisco. She lives in Berkeley, California with her family. Dr Sara, shares what she learned from her own journey towards health highlighting how jumping straight to bioidentical hormone therapy isn't always the best option. Dr Sara lays out the issues of hormones in perimenopausal and the implications in Alzheimer's disease. The dramatic hormone shifts in perimenopause into the menopausal transition make women more vulnerable to Alzheimer's disease. We discuss the concepts of bioenergetics, glucose "hypometabolism" and mitochondrial changes in pre, peri, and postmenopausal changes. The premenopausal state is protective against brain changes leading to Alzheimer's. The HPA axis, or the control system for stress and hormone system, becomes dysregulated. Dr Sara describes how symptoms such as anxiety and depression may in fact may not be the diseases themselves, but harbingers of Alzheimer's and cognitive impairment. Dr Sara's Basics for Estrogen and Hormone Balance: * Food choices: basics of water, increased fiber, magnesium * Assessing nutrient gaps (organic acid panels, essential fatty acid, oxidative stress panel) * Assessment of microbiome (looking for infection, dysbiosis, beta-glucuronidase, etc) with Functional stool testing. * Looking at Estrogen metabolism (estrone, estradiol, estrone) * + this can be done with dried urine testing and other testing to determine how your body is breaking down estrogen and if it is getting rid of it efficiently + stool testing with beta-glucuronidase * An approach to identifying and actively managing stress and to develop stress resilience * + Using a the Perceived Stress Scale to assess + Measure blood cortisol, dried urine testing * Core supplementation: magnesium, DIM (di-indolylmethane). * Advanced maneuvers (of course, in the context of overall lifestyle changes) * + Phosphatidylserine 300-400mg - in divided doses or all at once or at bedtime + Lavela (pill form of Lavender) for anxiousness - can get on Amazon + Chasteberry - helps perimenopausal women who still get a menstrual cycle. Helps raise progesterone (a neurosteroid that helps to soothe the female brain). note: this can take 2-4 weeks to see a change + - Dr Sara often recommends: "Fertility Blend" brand name
When does Dr Sara move to using bioidentical hormone replacement? after basic lifestyle changes: * Step 1: Navigate stress (less coffee and alcohol). add flax seeds to a morning shake/smoothie (eg 2 tablespoons) * Step 2: Chasteberry, Siberian rhubarb, Maca (see Dr Sara's books esp The Hormone Cure for doses and timing and alot more strategy) * Step 3: Consider bioidentical hormones * + estradiol patch with micronized progesterone esp for perimenopausal women. she tries to use the lowest dose for the shortest time possible. she see's about 10% of her patients end up going on hormone replacement.
Towards the end of the interview (minute 50) we take a fairly deep dive into using bioidentical hormone therapy in women that are a bit older than perimenopausal ages and the controversy surrounding this issue. Dr Sara also lets the cat out of the bag with a new book on Brain that's coming out soon! listen towards the end of the interview for that. "The Brain, Body Diet" - a Functional Medicine approach. For more information Visit Dr Sara's website at: saragottfriedmd.com Also read her recent article on Women, Hormones, and Alzheimer's.
As Co-Directors of the Alzheimer’s Prevention Program at Loma Linda University Medical Center, Dr. Ayesha and Dr. Dean Sherzai, through research and their extensive collective medical backgrounds, work to demystify the steps to achieving long-term brain health and the prevention of devastating diseases such as Alzheimer’s and dementia. They are also the authors of the much acclaimed book, The Alzheimer's Solution: A Breakthrough Program to Prevent and Reverse the Symptoms of Cognitive Decline at Every Age They call their basic program NEURO which stands for, Nutrition Exercise Unwind (from stress) Restorative sleep Optimize cognitive and social activity. Currently TeamSherzai works at Loma University, the only recognized Blue Zone in the United States. They are currently studying how the Loma Linda community, which is largely a vegetarian-based, health-focused community has such a significantly lower number of cases of Alzheimer's. We discuss the role of "good" vs "bad" fats and an expanded scoring system to determine the best diet to avoid the risk of strokes and brain damage. The highlights from this episode we discuss: * omega 3 fatty acid supplements * tofu/soy * organic vs non-organic (simple key: try to know where your food comes from) * proton pump inhibitors (ant-acid medications) * statin (anti-cholesterol medications) * the relationship between vascular disease (blood vessel issues) PREceding Alzheimer's * Dose of exercise - 20-35 minutes per day. 4-5 days a week. to the point of mild breathlessness/pointing. Also, leg strength seems to correlate with brain strength. * "Living a Purpose Driven Life" - Team Sherzai has found that to enhance cognitive/neuronal "connectivity" is to sustain a combination of ongoing complexity, challenge and connection to a larger purpose. Keep these in mind as we make our decisions in the 2nd half of life! * Experimental labs/biomarkers for brain and neurodegenerative disease (exosomes, oxidation family, VEGF)
Find more about Drs Dean & Ayesha Sherzai's work in their new book - The Alzheimer's Solution
We are going to pick up where we left off last week talking to Dr Mary Ackerley about mold and the phenomenon called Inhalational Alzheimer's. Last week we spoke about the diagnosis side of mold related cognitive impairment. this week we speak about treatments. For the second part of the show we pick up where we left off talk about a program that is available online called,The Dynamic Neural Retraining System. -Step One Remediation- you have to get away from the mold/mycotoxin/biotoxin exposure. Make sure to use a qualified Indoor Environmental Professional (IEP). This can often be the most difficult -Step Two Basic Treatment * binders such as cholestyramine, clay, charcoal and other * assessing and treating MARCoNS - a colonization of a certain type of staph infections. can be treated by specific nasal sprays or ozone. * addressing hormones - such as estrogen, DHEA, testosterone. * VIP (vasoactive intestinal peptide) - a natural hormone. this perhaps encourage the growth of grey matter in the brain (FDA safety data has not yet been shown).
-Step Three Advanced Treatment * in cases beyond simpler mold/mycotoxin cases into coinfections. This includes looking deeper at hormones or infections or parasites. * addressing Mast cell activation/Histamine issues - gut issues, flushing, itching, tongue and throat swelling, POTS (postural orthostatic tachycardia syndrome), dysautonomia. * dealing with patient with Traumatic Brain Injury or serious psychiatric illness
Dr Ackerley is a co-founder of ISEAI, the International Society of Environmentally Acquired Illness. Society members are dedicated to researching and quantifying symptoms and treatment approaches from biotoxin mediated inflammatory illness.
Our guest today is Dr Mary Ackerley MD, Dr Ackerly is a Harvard and Johns Hopkins trained board certified psychiatrist. She holds active medical licenses in Arizona and Florida. Mary also is a co-founder of ISEAI, the International Society of Environmentally Acquired Illness. Society members are dedicated to researching and quantifying symptoms and treatment approaches from biotoxin mediated inflammatory illness. She is probably most well known for her internet article entitled “Brain on Fire” (related YouTube) which is a summary of the neuropsychiatric implications of biotoxin illness and her practice My Passion 4 Health is located in Arizona. She was also a co-author on an article with a previous guest, Dr Dale Bredesen called, Reversal of Cognitive Decline in Alzheimer's Disease. - this was sort of an expose of a novel concept called, Inhalational Alzheimer's. Disclaimer: please note, this show like all shows on the podcast is not meant to be medical advice. it is not intended to diagnose or treat any health condition. please see your personal health care provider for diagnosis and treatment. We discuss what is meant by Inhalational Alzheimer's. It focuses on the fact that toxins - like mycotoxins and others - come in through the nose to infiltrate the brain. Dr Ackerley describes the first cases she saw with cognitive impairment and the symptoms involved. When did you first notice cognitive symptoms specifically related to mold and biotoxin exposures To help make a diagnosis of mold related cognitive decline - Dr Ackerley uses * a persons story (patient history) and his/her symptoms * inflammatory labs such as TGFB-1, MMP9, Complement 4a, VEGF * Urine Mycotoxin testing * volumetric MRI (see previous episode 6 with Dr Cyrus Raji episode) * + Dr Ackerley uses the NeuroReader Triage brain report + she notes thalamus and amygdala enlargement + basal ganglia atrophy
We are going to take a little different turn this week and perhaps take a look into the future a little bit. We glad to have with us, Ira Pastor, Chief Executive Officer – Bioquark Inc. Ira has over 30 years of experience across multiple sectors of the pharmaceutical industry. Currently, he is also a Board Member of RegenerAge a clinical company focused on expedited translational therapeutic applications of regenerative and rejuvenative healthcare interventions, the Reanima Project (http://www.reanima.tech), and member of the World Economic Forum's Human Enhancement council. Ira's company is applying a technology called combinatory biologics to essentially regrow tissue! check this show out.... Learn more about Ira and his work at BioQuark here
According to Dr Gabrielle Lyon losing muscle is tantamount to losing brain tissue which is one of the core processes that occurs in Alzheimer's.
Dr. Gabrielle Lyon is a Functional medicine physician focusing on Muscle-Centric Medicine. She leverages evidence-based medicine with emerging cutting-edge science to restore metabolism, balance hormones and optimize body composition.
Prior to her foray into medicine, Dr. Lyon was a national semifinalist in Fitness America, and a professional fitness model. Dr Lyon currently works as a practicing physician in New York City. She recently co-authored a chapter in a textbook, the Chapter is entitled "Metabolic Interventions for Sarcopenic Obesity."
What is sarcopenia? Sarcopenia is age-associated loss of muscle mass and function. When sarcopenia AND obesity are both going on in someone they compound each other. Dr Lyon maintains that there are signs of muscle loss long before actual sarcopenia sets in. Interestingly, obesity is somewhat analogous to aging in that both are low grade inflammatory/catabolic/breakdown states where healing becomes more difficult. Dr Lyon's Ideal Body Weights -Women 15-20% body fat -Men 12-15% How does this get diagnosed or assessed? DEXA scan Gait Speed * time yourself to see how long it takes you walk 4, 5, or 10 meters * repeat this twice (walking at a comfortable pace for you) * an average speed of <0.8meters oer second
BIA (what are the magic numbers on BIA) Hormone Lab Patters Are Often as Follows * LOW: estrogen, total testosterone, SHBG, DHEA, Free thyroxine 3, growth hormone, Insulin-Like Growth Factor 1, * INCREASED: prolactin, cortisol, Free thyroxine 4, reverse thyroxine 3, leptin and insulin resistance. * Secondary hyperparathyroidism sometimes because of low vitamin D levels
When Leptin is higher than 10 Dr Lyon notices that people respond well to time restricted eating 2-3 times per week. If higher than 30 she likes them do 24-hour fast once a week (can drink water and coffee, under medical supervision of course). Women's muscle changes as they age. Muscle changes to Type 2 fibers, bulky and strong, and then begins to atrophy. Many aging women tend to lose muscle mass as they age. Dr Lyon notes that many women have under performing (low) thyroid. Thyroid, among other hormones, are important for muscle building, tendon tissue homeostasis (eg alot of musculoskeletal type injury). Dr Lyon goes into detail on where the RDA's recommendations for protein were derived from and how and why she disagrees and other noted experts with them. Dr Lyon suggests a protein intake of 1.5grams per kg of body weight for optimal muscle in aging. This is nearly DOUBLE than the RDA recommendation. The reason for this is to activate a muscle/protein building pathway (ie the "insulin mTOR-metabolic pathway") in the body that will not activate without this. The protein should be distributed over the course of a day (eg 3 times per day) with the right amount and enough of it. At least 30 grams with each of your 3 meals would be the minimum to engage the muscle building pathway. These should typically be spaced about 4 hours away from each other. 90 grams might be the lowest someone would go in order to engage the MTOR-based muscle building pathway. With age reduction of protein absorption, increased splanchnic extraction gives rise to needing to intake higher amounts of protein. 2.5grams of leucine equates to about 4-5 grams of something protein in something like chicken or beef or fortified amino acids powders. mimize carbohydrates to 30-45 grams with meals to reduce your insulin response as carbohydrates are made during your body's breaking down protein. Aging men with healthy kidneys may consider getting up to 40-50 grams up to three times per day. Leucine helps generate Glutamine and Arginine and other elements related to the immune system, blood pressure regulation, and other critical functions Rice/Pea protein are often fortified to have good numbers of branched chain amino acids (leucine importantly included among them). Dr Lyon Exercise Fundamentals Upper Body Resistance -Bench press -Push ups -Pull ups or rowing maching Lower Body Resistance -Squat -Deadlifts General Cardioaerobic -1-2 days per week of 12-20 minutes of interval sprints, rowing or skiing Note: Dr Lyon's approach represents one important approach to muscle synthesis in aging. There are other formidable opinions on the impact of amino acids, high protein diets and aging that were not covered in this episode.
We have spoken about the effects of stress and memory. This week we will talk about how stress effects memory. FAIR WARNING: This episode is super technical. This will be great for the geeks, nerds, and mechanism seekers among us. BUT HAVE NO FEAR, because practical information does emerge from this episode thanks to our guest's mastery of this subject.
Grant Shields is a Ph.D. candidate in psychology at Univ of California in Davis working with both Andrew P. Yonelinas in the Human Memory Lab and Brian C. Trainor in the Behavioral Neuroendocrinology Lab. He also works with a previous guest of ours, Dr George Slavich, at the UCLA Laboratory for Stress Assessment and Research.
Grant's research is aimed at understanding why our cognitive functions fail us when we seem to need them most. In particular, he studies the effects of stress on both memory and executive functions as well as the biological pathways through which those effects occur...and that is exactly what we want to know about.
What is stress?
In Grant's research he is speaking about "acute" stress which is a limited, subjective experience of a stressor (eg a car crash). This is distinguished from "chronic" stress which is the subjective experience of an ongoing stressor (eg getting a diagnosis of a terminal disease like Alzheimer's).
Classically, a stress response is evoked if an event is uncontrollable, unpredictable, ambigious or has a social threat component to it.
Acute stress is completely adaptive. in other words we typically are capable of experiencing this and moving on. Responses to acute stress can be useful. However, these responses can become maladaptive or inappropriate which can in turn be harmful. Chronic stress is not yet known to ever be beneficial.
Phases of Memory
- -Encoding - the phase of learning something new
- Stress at encoding can enhance or impair learning and memory. it enhanc
- Postencoding/consolidation period - last about about 60 minutes just after learning something new
- Memory for something you just learned can enhanced by stress
- Retrieval phase or postreactivation phases
What Stress Hormones/Glucocorticoids do to Memory
It isn't just cortisol that has an impact on memory. Grant explained that, within the hippocampus - an area known to be important for short term memory formation and conversion to long term memory- cortisol's relationship with norepinephrine in the basal-lateral amygdala to boost memory for information during the period of synergy between cortisol and norepinephrine. As cortisol secretion persists they exert genomic effects within the hippocampus and begin to inhibit the processing and storage (memory) of new information.
Executive Function
- inhibition - the ability ignore irrelevant information coming into your brain
- working memory updating - ability to add to what and update your current thinking
- cognitive flexibility/set shifting - flexibly shift between different kinds of thinking
The Physiologic Costs of Stress
Chronic stress, as stated, give rise to elevated glucocorticoids. Over time glucocorticoids less ability to shut off inflammatory signals. Over time, with chronic stress, develops a chronic state of inflammation, immune system function can become impaired, and autoimmune conditions can be triggered. When glucocorticoids bind in the memory centers of the brain, like the hippocampus, it degrades memory formation.
Practical Info
To improve your memory for newly learned things, consider a brief "healthy stressor" like exercise after you have some thing you want to commit to memory. Exercise promotes memory formation in the brain. Meditation, of course, is protective as well.
To Learn More about Grant's work find him here
Conscious Dance is something I think is extremely important in the transformation of a mind, particularly for those with Alzheimer's or at-risk of Alzheimer's. According to Mark Metz, a thought leader in the community, Conscious Dance is essentially "a non-competitive, body based way of raising consciousness."
Our guests today are the co-founders of Open Floor Dance.
Kathy Altman - is a co founder of Open Floor International, an organization that promotes conscious dance as a form of well being, community building, peace making and creativity. She has danced her whole life but moving without choreography imposed from the outside is the skill she relies on most. Kathy has taught dance to thousands of people on many continents for over 40 years.
Lori Saltzman - is a co-founder of Open Floor. Lori stumbled into her first movement workshop with Gabrielle Roth when she was 26 years old. She spent 30 years as Gabrielle’s friend, student and close collaborator. The same vital force that wed her to movement led her to meditation, writing and creativity. Five years ago she co-founded Open Floor International, an collaboration of seasoned movement teachers, artists, therapists, and educators who are translating their wisdom to the dance floor.
The 2 primary values of Open Floor Dance:
- help people move from fixed to fluid movements, extending this into consciousness.
- "move and include" - when we move, things come up. feelings come up and they can be included and processed in the dance to further our evolution as human beings.
In Open Floor we dance to learn rather than learning to dance. It is free-form dance and movement in a safe space. There aren't intentional, structured partners or choreographed dance steps. Often people use this as a practice and community through which they experience many of the common ups and downs. These groups are for young and "old" and are non-exclusionary. All levels of physical ability from professional dancers to dancers/movers in a wheelchair.
Our guests cite some research for dance lowering the risk for cognitive impairment and dementia.
They also talk about how they are able to push their movement limitations and how the body adapts to continuous activity as they age.
To learn more about Open Floor visit here To find a conscious dance group near you use the Conscious Dance Move Map
Traumatic brain injury raises the risk of Alzheimer's by up to ten times the normal risk.
Today we want to share the story of a real American hero. United States Special Forces Weapons Sergeant, Josh Lindstrom. Josh was awarded a Purple Heart for surviving an IED attack in 2012.
His story speaks for itself, but briefly, until 2012 Josh was one of the military's most fit, dedicated and resilient soldiers. After a traumatic brain injury he lost more than his cognitive abilities. He lost his identity, he lost his relationship with his family and struggled to figure out his "Why" for the rest of his life. Overall, Josh employed a Functional Medicine/root cause strategy and found the following interventions most impactful in his case. * a elimination then Ketogenic diet * testosterone replacement therapy * military adaptive sports training
if you would like to contribute to the healing of men and women like Josh please consider a donation to the Task Force Dagger Foundation. This is an extremely worthy cause.
Neuorfeedback therapy for Alzheimer's today has not yet been widely proven. Our guests today were the first ones to publish in a medical journal on this subject.
Robin Elisa Luijmes is a psychologist from the Netherlands. She started working with patients with aquired brain injury. Wanting a broader knowledge of the psychological impact in patients with various forms of medical conditions, she completed her training as a medical psychologist. While working in a hospital in the Netherlands, Robin met Dr. Sjaak Pouwels, MD PhD, an aspiring and highly motivated surgeon and research physician. Because of their common interest in neurobiology together they published the article: "The effectiveness of neurofeedback on cognitive functioning in patients with Alzheimer’s disease: Preliminary results." These results were ultimately published as an original article in the Journal of Clinical Neuropsychology in 2016. In this episode we discuss their journal publication and their results. You'll get an inside look at the challenges of academic research - recruitment, funding, and personnel. In brief, they studied a small group of 10 people with Alzheimer's type cognitive decline and performed Neurofeedback. Over the course of getting 2 treatments for 15 weeks these patients had no further decline and 3 patients had improvements in memory/cognitive scores.
Our cells, including brain cells, are influenced by movement mechanics. Our guest today is a leader in movement mechanics and aging. Katy is part biomechanist, part science communicator, and FULL-time mover. Katy Bowman has educated hundreds of thousands of people on the role movement plays in the body and in the world. She is a prolific author of many books and other media outlets. She directs the Nutritious Movement Center in the Pacific Northwest and travels around the world teaching Nutritious Movement™
Katy explains "Nutritious Movement" - the idea that our cells are influenced by mechano-transduction (AKA movement mechanics or the "mechanome"). Movement is not really the same thing as exercise as exercise is more of a sub-category of movement. Katy foresees the day that we will know how individual movements are good for specific aspects of health, similar to how we understand specific micro and macro-nutrients are important for health (eg fats, carbohydrates and various vitamins and minerals). We can open up way more opportunities for people to figure out how movement works if we move beyond thinking about physical activity as exercise alone.
For example, most people arrange their homes so things are easy to get to (reducing our movements) and so it’s easy to find a place to sit. And those seating options keep us in the same geometry whether it’s the dining chair, sofa or toilet. How can we create more movement opportunities in the home? Katy may suggest things like putting the tea bags on a higher or lower shelf than the mugs so we have to squat or reach for them. Clear an inviting space so one can sit on the floor and stretch. Add a Squatty Potty, etc.
Katy introduces us to some of the co-authors in her book, Dynamic Aging, who are all now in their 70s and 80s and have had success with Katy's movement methodologies over the last decade or so. She challenges cultural norms of how habit and sedentarism give rise to "inevitable" aches and pains of aging. It requires an inventory of all the aspects of our lives that impact how and where we move. Katy starts with how people get dressed, even what clothing we are wearing may restrict our ability to move. Note, footwear is a big deal! Shoes matter.
Our lives require changes in "shape" and "load." Katy explains what it means to change up things in these domains of movement. She elucidates how we can set up our natural state environments like homes and offices to adapt and thrive in our aging bodies and in our daily tasks.
We briefly discuss the roles of stress and trauma on our bodies and how this relates to mechanotransduction and movement mechanics.
Katy recalls her involvement in Move for Minds seminar last year (2017) and we focus the last part of our conversation on brain health.
Learn and Connect with Katy Bowman * www.nutritiousmovement.com * Her new book “Dynamic Aging”:
She has a great podcast, amazing books, classes and alot more!
Accumulation of stress over a lifetime is linked to cognitive impairment in general and Alzheimer's disease in specific.
To let the cat out of the bag, the practical piece here is to get your "life stressors test" in the form of a lifetime inventory of stress and adversity here (STRAIN score):
lifestresstest.com
Read the shownotes below and listen to the second half of the show to get the explanation on this tool.
Dr George Slavich's, research integrates tools and methods from psychology, neuroscience, immunology, genetics, and genomics to explain the effects of stress on aging, mood, and the brain. He is currently investigating how experiences of social stress and adversity reach deep inside the body to influence the activity of the human genome.
Dr. George Slavich holds several titles including a Professorship in Psychiatry and Biobehavioral Sciences at UCLA. He is the Associate Director of the Stress Measurement Network, and Director of the UCLA Laboratory for Stress Assessment and Research (http://www.uclastresslab.org).
Dr Slavich introduces the field of "Psychoneuroimmunology" Psychoneuroimmunology involves how psychological and cognitive processes influences the brain, body, and immune system. He explains what happens to the brain and nervous system over a lifetime of acute and chronic stressors.
"Stress" or a "stressor" may be defined has been defined as any situation, or set of external demands, that requires an organism to expend resources to adapt or cope with its circumstances (Monroe, 2008).
Human Social Genomics, a field pioneered in part by Dr. Slavich and his collaborator Dr Steve Cole at UCLA, demonstrates how basic human experiences - including both minor and major life stressors - influence the activity of the human genome. Using microarray-based genome-wide transcriptional profiles - which he explains is like a panoramic photograph of gene activity across all 25,000 human genes - Dr Slavich's team has observed patterns of negative changes in inflammation and virus susceptibility gene expression as a result of exposure to "stressors."
Dr. Slavich hypothesizes that these negative genetic inflammatory patterns may an innate human ability to preemptively read ques in his/her social environment that gives rise to mobilization of immune/gene products (from bone marrow and fat cells for example) into the blood. This may be why these inflammatory and immune patterns are detectable in his medical experiments. This may also be why even what a human thinks about can trigger these type of immune system abnormalities.
Regarding resilience, Dr Slavich cites some early data that indicate: yoga, meditation, Mindfulness Based Stress Reduction, and Cognitive Behavioral Therapy (CBT) practices likely have positive impacts on the immune systems and so-called resilience genes in the body.
Dr Slavich and his team have developed STRAIN tool - Stress and Adversity Inventory. This online tool allows you to take inventory of all the various types of stressors in your life and target a therapeutic strategy around this.
The STRAIN tool has allowed his team to predict elements around cognitive aging, memory impairment, and challenges in executive function. Notably, there is considerable peak risk-susceptibility in humans around age 55-70 where stress becomes another critical risk factor for cognitive function and overall degradation of health.
LEARN MORE ABOUT DR SLAVICH AND HIS WORK HERE: To perform the STRAIN test on yourself go here: * lifestresstest.com * UCLA Laboratory for Stress Assessment and Research (http://www.uclastresslab.org).
We shift gears on this show to begin to talk about thriving in the second half of life. I introduce you to an incredible friend of mine, Sharon Lowenstein Poisner JD, PhD. At the time of this show's recording, Sharon had just turned 80 years old. Sharon continues to give lectures on various topics on brain health and successful life and aging practices.
Parts of this episode are heavy. We talk about the ups and down of Sharon's life and the many challenges of growing through childhood trauma, midlife divorce, death of her spouse in later life. Sharon sheds light on how priorities, goals, and relationships change as someone progresses through their second half of life. Importantly, Sharon shares some of her deep insights on how meditation, forgiveness, and honoring past relationships have shaped her growth in the second half of life.
Robert Hedaya, MD, has been at the cutting edge of medical practice, psychiatry and psychopharmacology since 1979, and has been practicing Functional Medicine since 1996. He is also a Clinical Professor of Psychiatry at Georgetown University Medical Center. Author of three books (Understanding Biological Psychiatry, The Antidepressant Survival Guide, and Depression: Advancing the Treatment Paradigm), and the founder of the National Center for Whole Psychiatry in the Washington DC area. He has been on national media (20/20, 60 minutes, the New York Times, Washington Post etc.) on many occasions and is a frequent, nationally and internationally recognized speaker.
This is a great episode to get the low-down on just who's, what's, and how's of Alzheimer's and Cognitive Impairment programs. We discuss over-hyped and over sensationalized results you may be hearing about in the news and the internet and what you can really expect when you embark on a "reversal" program. Dr Hedaya has seen success applying a Bredesen-style approach to: Subjective Cognitive Impairment, Mild Cognitive Impairment, and early stages of Alzheimer's.
Dr Hedaya explains the difference in his approach to traditional psychological conditions, cognitive impairment, and Alzheimer's. Bob recounts a recent encounter he had at an academic conference where he challenged the current paradigm. We talk about how this approach is generally received by the medical community —because (like Semmelweis) it is often unfamiliar,uncomfortable, and inconvenient for the medical establishment in its current iteration.
We discuss our feelings about the realistic applications and limitations of applying "Alzheimer's reversal" programs. We cover who might be the best candidate to succeed on these programs.
Bob explains his understanding of the systems biology approach of Functional Medicine and how it applies to his work in cognitive impairment and mood disorders.
30-50% of people with depression with develop Cognitive impairment.
We discuss the personal commitments in terms of time and energy someone has to make to become succeed with this kind of program and Dr Hedaya outlines his the first case he handled where someone with cognitive impairment improved.
Dr Hedaya's basic panel to help with determine risk:
- Complete Blood Count
- Homocysteine
- Fasting Cholesterol Panel
- Fasting insulin (goal ~3-4)
- Avoid head trauma
- Check thyroid function (goal TSH ~1.4) as well as checking free T3 free T4
- Estrogen and progesterone (in some women)
- Zinc (RBC) and Copper (16:1)
- Inflammatory markers like high sensitivity CRP
Overall he recommends a Mediterranean style diet as the best diet in general.
- Learn more about Dr Robert Hedaya here https://wholepsychiatry.com/
If you have questions about the Keto diet...go no further. Our guest today is pretty much the Keto science guy. Dr Dominic D'Agostino is a professor in molecular pharmacology and physiology at the University of South Florida Morsani College of Medicine as well as a Visiting Research Scientist at the Florida Institute for Human and Machine Cognition.
Dr D'Agostino tells us how he found his way into the filed of ketosis. He combined interests in nutritional and neuro sciences. From there, Dom developed a deep expertise in underwater medicine and oxygen toxicity seizures where he made the connection with ketones and the brain.
What is Nutrtional Ketosis
Ketones - more specifically ketone bodies- are chemical produced by our livers. Ketone bodies are produced by avoiding most carbohydrates in the diet (eg sugars, breads, fruits, and certain vegetables). A much higher percentage of healthy fats are eaten during a ketogenic diet. When someone follows this diet the body begins to make and utilize ketones more so than on it's typical energy source - glucose. Nutritional ketosis is the sustained elevation of ketones in the blood. To be clear, as long as someone isn't completely lacking insulin (eg Type 1 diabetic), this low-level of ketosis is NOT the dangerous state of ketoacidosis which develops from having a lack of insulin.
What are the benefits of Nutritional Ketosis
Lower states of brain inflammation. Better insulin sensitization and use of ketones for energy in the brain.
What are good foods to stay on the Ketogenic
- See the list for ketogenic: ketonutrition.org
- Note: Dr D'Agostino is currently designing a vegan ketogenic diet (stay tuned...)
How Do I know if I am "in Ketosis"
There are a few things you can buy. Dr D'Agostino recommends:
- Abbot Labs Precision Xtra glucose and ketone meter. (sold on Amazon)
- A Ketomojo
What to expect when you are shifting into Ketosis You can feel somewhat tired, perhaps some "brain fog" or even flu like or low blood sugar sensations for a few days as your body shifts out of using glucose as its primary fuel. What does it feel like once you are in Ketosis and what are the Benefits of Ketosis * Many people feel more cognitively alert and more even brain energy. * Lower hemoglobin A1c
Dom explains the synergy between intermittent fasting (caloric restriction) and low carbohydrate/modified ketogenic diet. We discuss the evidence or more specifically the lack of evidence for the Ketogenic diet in Alzheimer's and cognitive decline and where the research is headed. What are some foods that help people stay in Ketosis People use coconut oil, MCT Oil (Medium Chain Triglyceride), Ketone Esters. Coconut Oil and MCT oil are available at many food stores. Ketone esters are available on line. We discuss some of the controversy of using a consistent ApoE4 and a high fat ketogenic diet and what labs you may want to follow if you are thinking about We talk about the possibility of enhancing brain energy metabolism with the ketogenic diet and hyperbaric oxygen. Learn much, much more about Ketonutrition on Dr D'Agostino's website: ketonutrition.org
We are honored to have, Dr Neal Barnard a noted physician, advocate for nutritional science, as well as president of the Physicians Committee for Responsible Medicine on the show.
Dr Barnard explains how and why he started the Physicians Committee for Responsible Medicine (PCRM). PCRM is an advocacy group for information about good medicine, nutrition, and animal rights.
Dr Barnard shares his own experience with Alzheimer’s with his father.
Dr Barnard and other experts wrote dietary guidelines to reduce the risk of Alzheimer’s. Here are the guidelines:
- Minimize your intake of saturated fats and trans fats. Saturated fat is found primarily in dairy products, meats, and certain oils (coconut and palm oils). Trans fats are found in many snack pastries and fried foods and are listed on labels as “partially hydrogenated oils.”
- Eat plant-based foods. Vegetables, legumes (beans, peas, and lentils), fruits, and whole grains should replace meats and dairy products as primary staples of the diet.
- Consume 15 milligrams of vitamin E, from foods, each day. Vitamin E should come from foods, rather than supplements. Healthful food sources of vitamin E include seeds, nuts, green leafy vegetables, and whole grains. Note: The RDA for vitamin E is 15 milligrams per day.
- Take a B12 supplement. A reliable source of B12, such as fortified foods or a supplement providing at least the recommended daily allowance (2.4 micrograms per day for adults), should be part of your daily diet. Note: Have your blood levels of vitamin B12 checked regularly as many factors, including age, impaired absorption.
- Avoid vitamins with iron and copper. If using multivitamins, choose those without iron and copper, and consume iron supplements only when directed by your physician.
- Choose aluminum-free products.While aluminum’s role in Alzheimer’s disease remains a matter of investigation, those who desire to minimize their exposure can avoid the use of cookware, antacids, baking powder, or other products that contain aluminum.
- Exercise for 120 minutes each week. Include aerobic exercise in your routine, equivalent to 40 minutes of brisk walking, three times per week.
We discuss what Dr Barnard has seen around memory loss and early intervention and prevention of Alzheimers’.
Dr Barnard discusses his views on the fallacies of the Paleo and Ketogenic diets and contrasts this to a low fat, plant based diet.
Dr Barnard explains gluten sensitivity and what a plant-based aficionado should do about bean and legume sensitivity. He notes
that 146 grams of protein are contained with 2000 calories of broccoli – so plants may be an additional and surprising
Extensive discussion around the potential health harms about cheese and dairy and I ask Dr Barnard to talk about his findings from his book, “The Cheese Trap: How Breaking a Surprising Addiction Will Help You Lose Weight, Gain Energy, and Get Healthy” Interesting connections with dairy and inflammation and behavior. I discuss my own stories of “dairy addiction” and behavior changes in one of our children.
Finally, Dr Barnard discusses some of his advocacy work and political activism around nutrition, food science, and transparency in the food industry and biggest fights going on in Washington. He articulates the conflict within the USDA itself with its dual mandate to represent the health of the American public as well as American industry.
Find Dr Barnard on his website: The Physicians Committee for Responsible Medicine see the Kickstart Program to start a vegan program to see if it’s right for you. Link to Dr Barnards guidelines on foods to eat to prevent Alzheimer’s: http://www.pcrm.org/health/reports/dietary-guidelines-for-alzheimers-prevention
Today we tackle one of the more controversial topics around brain health and Alzheimer's - hormone replacement therapy (HRT). Our guest is Dr Ann Hathaway (no...not the actress) a hormone expert.
We have an extended conversation about the history of hormone replacement, where the fear of using Premarin (estrogen) and Progestin (Progesterone) in the form of medroxyprogesterone has come from.
We discuss drops in estrogen and its role in Alzheimer's disease. These changes happen up to 30 years before actual memory problems occur.
We discuss the difference between standard hormone replacement and Bioidentical HRT.
Dr Hathaway answers the question "Why take estrogen and progesterone if nature is saying your levels should be low after menopause?"
Dr Hathaway shares some of her experience with patients on hormone replacements and some of the benefits they have seen and some of the scenarios that she has observed do not respond to HRT.
We discuss testing options and ideal hormone levels for estrogen and progesterone.
Discussion of some other things women can do to optimize their estrogen (eg vitamin D, b-vitamins, dietary strategies).
Dr Hathaway relays statistics on risks vs benefits from the medical literature around the use of estrogen and progesterone hormone therapy.
Learn more about Dr Hathaway here
This week we interview another leading scientist and author who views Alzheimer's as a more complicated process than one simple disease. Our guest, Dr Peter Whitehouse, is an MD, PhD trained at Johns Hopkins and currently is a professor of Neurology at Case Western University in Cleveland, Ohio. He authored the book, The Myth of Alzheimer's. Dr Whitehouse does not deny that Alzheimer's exists he just maintains that it is a condition with tremendous heterogeneity and is more like a syndrome, or a collection of multiple disorders. These may be characterized as a spectrum of disorders. Dr Whitehouse notes that is very difficult to distinguish senile dementia - brain changes that occur over the result of time - and dementia. He notes some of the key drivers of Alzheimer's of earlier onset being. 1) genes 2) concussions 3) environmental toxins (eg lead) 4) diet 5) exercise 6) infections (meningitis) 7) perhaps low oxygen states during surgery/anesthesia. Dr White discusses the controversy in the title of his book "the Myth of Alzheimer's" and how it was received. He disagrees to some extent with the conventional approach to finding a cure for Alzheimer's advocated by the NIH and Alzheimer's Association's view. The prevailing view is very much geared toward finding a single drug or set of drugs that will attack the problem. We discuss "Scientism," the faith in science based on 'pumping enough money into a proble' that Dr Whitehouse takes issue with. More and more he has adopted the idea that public health measures and intergenerational relationships are a key to successful aging and minimizing symptoms of cognitive impairment. A lot of this focuses on personal narratives, telling one's own stories, either through a journal or organizations like Storycorps or Timeslips. He tells stories about elders passing on stories of activism to younger generations. Reminiscence "therapy" is one modality he mentioned. He explains why he thinks the Babyboomer generation may have the collective power to work with other generations to evolve the conversation about aging and Alzheimer's. Read Dr Whitehouse's book "The Myth of Alzheimer's"
We finally have evidence for and Alzheimer's prevention diet and the best foods to eat to prevent alzheimer's. We apologize for the recording sound quality of this episode. Our guest this week, Dr Martha Clare Morris is the architect of the MIND Diet and a leader in the field of nutrition and the brain. Dr Morris' team showed that the MIND Diet, a hybrid diet of the Mediterranean Diet + the DASH Diet. To summarize the basic component of the MIND diet is: Foods to Eat: * Green leafy vegetables (eg mixed greens, spinach and salads): At least six servings a week * "Other" vegetables: At least one a day (eg squash, broccoli, etc) * Berries: Two or more servings a week * Nuts: At least five servings a week * Beans: At least three servings a week * Whole grains: Three or more servings a day * Fish: at least once a week * Poultry (e.g. chicken or turkey): at least twice a week * Olive oil: Use as your main cooking oil. * Alcohol or Wine: One shot/glass a day (note: a "glass" is not half a bottle)
Foods to Avoid: * Red meat: 3 times per week or less.
- Butter and margarine: Less than a tablespoon daily
- Cheese: Less than one serving a week
- Pastries and sweets: Less than five servings a week.
- Fried or fast food: Less than one serving a week.
The people with the best MIND Diet scores (in the top 3) developed half of the cognitive decline than the people with the lower scores. 53% reduction in the risk of developing Alzheimer's disease. We discuss a little bit about how difficult nutrition research is to conduct. Dr Morris discusses how some of the foods/nutrients work to prevent the changes that occur in Alzheimer's. Dr Morris discusses her current research trial that is being conducted at Harvard and Rush University at Harvard. We discuss the controversies of gluten sensitivities and other food sensitivities. We discuss which foods are good and bad for the mind. She notes that transfats and saturated fats increase the risk for Alzheimer's. High saturated fat may impair the blood brain barrier. Unsaturated fats seem to correlate more with good brain health and lower levels of Alzheimer's. She points out DHA (an omega 3 fatty acid) as an important fat in particular for neurotransmission. Fried foods are bad for the brain because they have high amounts of harmful fats as well as leach out the good fats. It's not clear whether or not coffee is good or bad long-term for the brain.
The next couple of episodes we are going to do a deeper dive into the role nutrition and best (and worst) foods for Alzheimer's prevention and treatment.
Our guest on this show is Dr Annie Fenn, M.D from BrainHealth Kitchen. She is a retired OB/GYN physician, writer and culinary instructor.
We discuss the format for Annie's - BrainHealth Kitchen (formerly known as Brainworks Kitchen) a multi-dimensional program designed to prevent and improve brain health and Alzheimer's. The main focus of this program is learning techniques of healthy eating and cooking in a group/community setting.
We discuss the virtuous cycle of becoming proactive about health. Whether you start with food or exercise or community, one good thing tends to lead to another.
We discuss the scientific evidence for Annie's approach. She has primarily adopted the approach of communities in Blue Zones.This is primarily a plant-based, Mediterranean diet. She points to one study of nearly 2000 people that had 40% reduced chance of developing Alzheimer's. She also mentioned the MIND Diet published by Martha Clare Morris which we will discuss in more detail in future episodes.
We touch on "anti-nutrients" and the controversy of legumes/beans from a Paleo diet perspective. Legumes and beans do seem to be an important part of the Mediterranean. Bottom line, Annie recommends a personalized approach because the long term data is not clear on the health of beans and legumes.
Annie (minute 24) discusses a couple of specific tips and tricks on oils and cooking. Olive oil use in general. Avocado oil for cooking at higher heats.
We discuss "Intermittent Fasting" - Annie has her student's:
- no eating 3 hours before they go to bed.
- no wine after 9pm to avoid sleep disruption
- attempting to eat nothing for 15 hours straight (with the exception of black coffee in the morning) - this is the ketosis idea.
We discuss the strategic use of caffeine and how that might be helpful for the brain.
We briefly discuss Annie's 23 years of experience as an OBGYN and the use of hormone therapy which we will discuss more in future episodes as well.
Find Annie Fenn on her website
https://www.brainhealthkitchen.com/
Twitter: https://twitter.com/anniefennmd
LinkedIn: https://www.linkedin.com/in/annie-fenn-md-27159a32/
To sign up for a monthly newsletter about what's new in keeping our brains healthy (with recipes), register at BrainHealthKitchen.
Dr Marvin Berman recieved his PhD in Psychoeducational Processes. He is trained in Bioenergetic Analysis and is trained in numerous other therapeutic interventions including EEG biofeedback and the Feldenkrais methodologies. He consults with senior executives and management teams on the application of cognitive neuroscience in leadership development and performance. Recently, he is exploring the application of EEG biofeedback and related technologies into the treatment of neuropsychological and neurodegenerative disorders including Alzheimer's disease and Parkinson's.
In Alzheimer's disease the brain shrinks over time. Certain forms of light energy may help defeat this problem. Near infrared wavelengths are particularly good because not only do they travel deeper into tissues; they are not lost by being absorbed by blood and water before they reach the brain.
On this show we talk about two different and distinct technologies on this episode. One is Photobiomodulation the other is Neurofeedback. Neurofeedback we have talked about with Drs Majid Fotuhi (episode 3) and Dr David Merrill (episode 9).
Photobiomodulation (PBM) introduces certain frequencies of light. The light has an impact on the brain's mitochondria. Institutions like Harvard, Standford and MIT all have and continue to explore Photobiomodulation. There are LED lights that are placed on head or shined into the nose and they seem to do a several beneficial things. To be clear, the signaling within the (brain) tissue takes place as a result of exposure to light (photonic) energy.
The Key players in the PBM story are 1) Cytochrome C oxidase (substance that absorbs light) 2) ATP (energy and healing) 3) Reactive Oxygen Species - mild oxidant that signals cellular repair 4) Nitric Oxide (increases blood flow)
Mitochondria have a substance called the cytochrome oxidase that can absorb red and near infrared light and convert the enregy into a form of bilogical energy called ATP. Part of what ATP does is lead to healing and tissue repair. The process - among other things- generates a mild level oxidant (ROS) which acts as a signaling molecule to activate transcription factors that lead to tissue repair. Some people see this as a "redox" signaling molecule. Herein is where the physical healing can be accelerated when photonic therapies (red and near infrared light) is introduces.
Another important player is Nitric oxide (NO) - if it sits in the cell it "clogs" the respiratory chain that leads to ATP production. PBM frees the NO back into the body and restors the function fo the respiratory chain. Then it takes on an impotant wide ranging role of improving nerve function and improving circulation by relaxing the blood vessel walls.
Dr Berman explains how he connected Neurofeedback and PBM in the development of a comprehensive treatment model.
He explains the use of light frequency of 1060-1080nm.
For those not involved in research is there any risk or benefit in doing Neurofeedback with a particular doctor and trying out a Vielight (one PBM device) on their own. contact Dr Berman directly.
Learn more about Dr Berman's work with the QuietMIND Foundation http://www.quietmindfdn.org/
Scott Sherr MD lives in the San Francisco Bay area where he works both as a hospital medicine physician as well as operates his own independent hyperbaric oxygen consultation practice. He is also Director of integrative Hyperbaric Medicine and Health Optimization with Hyperbaric Medical Solutions.
What is hyperbaric oxygen (HBOT)
Bottom line....it's high pressure oxygen. Originally used to treat underwater injuries ("the bends" or "decompression illness"). Nowadays, Hyperbaric oxygen also refers to a treatment in which the entire body is exposed to 100% oxygen under increased pressure. Using pressure allows for more dramatic delivery of oxygen to the entire body. Bottom line "it heals wounds."
How HBOT Works:
The basic mechanisms of how HBOT works:
- reverse hypoxia (low oxygen state)
- reduce inflammation
- fight infection
- stimulate stem cell release
- increase mitochondrial (energy) function.
There are only about 14 FDA Approved uses for HBOT. Most of what insurance pays for are wounds, diabetic ulcers, infections, and radiation therapy treatments.
Investigational uses (non-FDA approved) for HBOT are Alzheimer's, Traumatic Brain Injury, post-stroke neurologic injury, Parkinsons, Multiple Sclerosis, some chronic pain syndromes, and several others.
We discuss synergies between HBOT and ketogenic diet (like a modified Atkins diet) or exogenous diet (min 18:30) and some of Dr Sherr's experiences with patients. These appear to cause changes at the level of genetic expression.
We talk about "leaky brain or a broken blood brain barrier" and how HBOT may be used to address issues with a "broken" blood brain barrier.
Typical use of HBOT is with a "hard chamber." Hard chambers are regulated and physicians running these places need to be certified in its use. "Soft chambers" or Mild HBOT may actually be more appropriate for cognitive impairment, but are not as regulated. Soft chambers are more widely available than larger hard chambers.
What are the side effects of HBOT?
- ear barotrauma (completely preventable)
- myopia (vision changes)
- cataracts get worse
- increased insulin sensitivity (so diabetics run risk of low blood sugar)
- claustrophobia
- seizure
How much does HBOT cost?
Cost $120-$420/treatment depending on what type of chamber and where you are. People would likely need successive treatments - eg several "dives" per week for 4 weeks in some cases. So that can add up, but benefits may be worth it for some. Need to consult an expert.
Towards the last 15 minutes of the interview we talk about considerations when making a decision if this is right for you and what complications may be involved.
Connect with Dr Sherr and learn more at
www.integrativeHBOT.com
Michael Lewis MD is an expert on brain health, prevention, treatment, and management of brain injuries. He is a retired Colonel in US Army and has impacted the military's approach to traumatic brain injury. Since retiring from the Army he founded the Brain Health Education and Research Institute outside of Washington DC. He is the author of the recently published, "When Brains Collide."
Shownotes:
We discuss the mechanism of concussion and how it creates brain deterioration both in the short and long terms. "Primary injury" is the near term injury. "Secondary injury" can lead to persistent oxidative stress, reactive oxygen species, oxygen deprivation and ultimately brain damage that relates to Alzheimer's disease.
We have more discussion on concussions and head trauma and how that may lead to blood brain barrier permeability AKA "leaky brain." This seems to relate to inadequate drainage of the newly discovered "glymphatics system" of the brain and inefficiency with the healing process therein.
The ApoE4 gene - linked to significantly higher risk of Alzhiemer's - is also an indicator of higher risk of having difficulty recovering from head injuries or having more severe symptoms if and when a head injury occurred in the past. Some researchers, for example Dr Caleb Finch at USC maintains that from an evolutionary biology perspective the ApoE4 gene status -which confers a 50-90% increased lifetime risk of developing Alzheimer's - seems to be more associated with a proinflammatory state thereby making recovery from persistent oxidative stress and inflammation more challenging.
30% of the brain is fat. Omega fatty acids are analogous to bricks in the wall of your brain. The balance between Omega 3 and Omega 6 fatty acids is important. Omega 6 fatty acids are more inflammatory and an overabundance of them in your body can prevent healing.
The critical omega 3 fatty acids seem to be DHA and EPA. DHA, a precursors of Resolvins and neuroprotectins, and EPA influence healthy blood flow, cell to cell communication, and mediate anti-inflammatory and antioxidant effects.
You can ask your doctor to measure your Omega 3 (i.e. EPA + DHA) levels with a lab called an
"omegacheck"
"omegaquant"
"omega3index"
These terms are commercialized lab terms that can be drawn at many of the larger standard lab companies.
Ideally Omega 3 (EPA +DHA) levels should be greater than 8% on one of these tests (there may be exceptions depending of your family history and what medications you are on so - as always- check with your doctor when looking into this, this is not medical advice as there is some risk to high omega 3 levels for a small subset of people). We think the ideal ratio of Omega 6:3 is about 4:1. Most Westerners have proinflammatory diets making this ratio much higher.
Through this interview there is discussion about processing practices for fish oil companies and how to understand if your fish oil is of high quality. Quality fish oil should be molecularly distilled for safest processing and lowest toxicants and in triglyceride form for best tolerance on your stomach and most easily digested. Dr Lewis recommends a concentrated form so you can get enough with a minimal number of pills.
There is also a brief discussion about bleeding with high dose omega 3 fatty acids.
It takes 12 weeks to saturate the brain, but Dr Lewis with his Omega 3 protocol uses 3-6 times the regular dose for the first month or so.
If you can't consume clean fish multiple times per week or are a vegan consider using algae-based omega 3 fatty acids. This is, in fact, where fish get their omega 3 fatty acids from.
A newer supplement, Specialized Pro-resolvin Mediators (aka: SPMs) which seem very promising, primarily based on the work of Dr Charles Serhan and his group at Harvard, are a downstream product of omega 3 fatty acids and are important in the resolution of inflammation. Some of the "SPM" products on the market today may in fact not be actual SPMs but simply closer down the metabolic chain of events to SPM than traditional Omega 3 fatty acid oils.
Transparency note: at the time of the recording, Dr Lewis was a paid consultant to Nordic Naturals a purveyor of Omega 3 supplements.
Resources:
Learn more about Dr Michael Lewis and his work with the Brain Health Education and Research Institute
http://www.brainhealtheducation.org
or his Book "When Brains Collide" on Amazon or other common outlets.
Interventional neuroendocrinology is a relatively new concept. It is championed by, Dr Mark Gordon. He promotes proactive monitoring and replacement of multiple hormones as needed to optimal levels. Dr Gordon elucidates his approach and clarifies his issues with the current standard of care and the use of standard reference ranges.
Dr Gordon introduces the concept of "neurosteroids" which are hormones that are made by glial cells - support cells - in the brain. Hormones like Growth Hormone in Insulin Like Growth factor protect the brain and can be given or stimulated to create supportive neurochemistry and aid against brain damage.
The Blood-Brain-Barrier - which protects the brain from things that are running around in the rest of the body - can get leaky after a head injury. This allows things that aren't normally given access to the brain to get access. White blood cells among other things from the rest of the body get into the brain and initiate an autoimmune response (e.g antibody against pituitary and hypothalamus) and set off a cascade of harmful reactions.
We discuss what Dr Gordon means by "the neuropermissive environment" which is a fascinating idea of giving the body all thing things it needs to heal the brain.
Dr Gordon notes the importance of zinc in down regulating the production of harmful products in Alzheimer's and explains this process. He also discusses why aluminum is thought to a contributor to developing Alzheimer's.
Long discussion about inflammation and oxidative stress in the brain and the use of N-acetyl cysteine and mixed tocopherols (E vitamins) that slow down inflammation.
Extensive discussion about thyroid hormone and the brain and nutrients and thyroid hormone's role in the "neuropermissive" environment.
Conversation about whether or not there is a role for progesterone in men with brain damage.
Dr Gordon's tells us about his work with brain injury and those who have served in the military.
Resources:
To find out about Dr Mark Gordon's work: TBIMedLegal.com
A documentary in which he is featured will be release soon as well:
Dr Mark Hyman - Mark is the world renowned leader of the Functional Medicine movement. He is the Director of the Cleveland Clinic Center for Functional Medicine.
Functional Medicine is an approach that tries to discover the root cause of chronic disease and personalize and approach to getting better. Dr Hyman has been using this approach for years and shares a couple of stories of patients with cognitive impairment that improved with this approach.
We explore the idea of Alzheimer's as a syndrome with drivers including metals, environmental toxins, and infections.
(Min 11:23). We have a deep discussion about cholesterols and fats and the relative benefits versus harms of fats and MCT (coconut oils). We discuss practical lab testing of cholesterol, statins and other medications.
7 Steps for Do It Yourself Prevention of Alzheimer's
(Dr Hyman points out that what is good for your brain is good for the rest of your body as well):
- Adopt a Low glycemic diet - low sugar and sugar like processed foods that contain shelf stabilizers and preservatives
- Increase your fat intake - eg avocado, olive oil, nuts, seeds
- Eat 6-9 servings of vegetables (serving = 1/2 cup) every day. A little bit of colorful fruit fairly often may be good to.
- Exercise (increasing antioxidant enzymes, increasing brain chemicals, increasing brain connections, increasing blood flow)
- Reduce stress - easiest way is to do adopt a daily meditation practice 20 minutes, once or twice per day.
- Nutritional Supplementation - MCT Oil, B-vitamins for methylation support, basic multivitamin, omega 3 fatty acids (e.g high quality fish oil), detoxification support.
- Minimize Toxic Exposures - use the EWG.org - Environmental Working Group website to learn about how to minimize toxicants in food and personal care products.
If the Do-It-Yourself approach isn't working consider visiting with a Functional Medicine doctor.
Find one on: https://www.ifm.org/find-a-practitioner/
Dr Hyman is leading the way on getting the word on Alzheimer's and cognitive impairment. Check out his upcoming documentary "Broken Brain" - anticipated to be out in Late 2017.
Learn more about Dr Hyman by reading one of his many NYTimes bestselling books or on his website http://drhyman.com/
This week's guest is Dr David Merrill MD, PhD Assistant Clinical Professor, Psychiatry and Biobehavioral Sciences at UCLA. Dr Merrill is an active proponent of prevention of Alzheimer's and an expert in many areas relating to this.
Quantitative Electroecephalography - AKA: qEEG - and structural MRI are two technologies that are widely available. Dr Merrill explains how they can be used to assess if you have brain wave or structure changes that look like impending dementia.
qEEG essentially creates a map of the function and electrical activity of many of the parts of your brain. These maps can also give you an indication of how "efficiently" your brain is connected. Dr Merrill talks about the signatures that distinguish depression and cognitive impairment or dementia including Peak alpha frequency interpretation (<8 hz) and Evoked Response Potential and the p300 wave. Also there is a brief mention of how to keep your white matter (the connecting brain cell components) in tact.
A good "brain dose" of exercise is about 30 minutes a day, 5 times per week, intensity of the exercise should be enough so that you feel breathless/winded/sweaty. But recent evidence suggests that walking one mile per day about 6 days per week that this preserves gray matter (or the area in the in the brain that does the work so to speak, ie neurons).
Neuronetrix - Cognision is the office-based cognitive testing product that Dr Merrill uses: www.neuronetrix.com.
We have a discussion around 23andMe and ApoE4 and Alzheimer's genetics and how these relate to brainwave activity and the p300 wave.
Deep discussion about trauma, stress and concussion and their roles in developing Alzheimer's and dementia. Discussion about the Adverse Childhood Experiences score.
Connect with Dr Merrill at www.cogclinic.net
This week's guest is Dr Ross Grant, a clinical professor of medicine at Sydney Adventist in Sydney, Australia. He is considered one of the world's foremost authorities on NAD+ science and therapeutics.
Fair warnings: this episode is deeply technical and scientific, but during the last 15 minutes of the interview Dr Grant speculates on how NAD+ might be beneficial directly to Alzhiemer's (and Parkinson's patients). ALSO, we apologize for the sound quality of this episode. we are working to bring you better quality sound with each episode.
NAD+ or Nicotinamide Adenine Dinucleotide is a molecule necessary for a huge number of biological processes supporting human life. NAD+ levels decrease as we age. The body produces NAD+, but in addition to the natural decline in production, as we age there is also likely an increased need for NAD+ that is beyond our bodies ability to produce.
Key Biologic Processes where NAD+ is involved
- Repair of the DNA (single base pairs) via PARP (Poly-ADP ribose polymerase)
- Energy Production Enzymes
- Redox-Repair Enzymatic activity
- Epigenetical Switch - controlling gene expression especially of SIRT1 activity.
- Immune system regulation/repair - especially relevant in Alzheimers where the immune systems and inflammation appear to be overactive making self repair more difficult.
- Activate Tankyrase in order to extend telomeres.
- It may act as a direct neurotransmitter in the brain and nervous system.
In an aging brain, inflammation and susceptibility to oxidative stress increase. As this happens, NAD+ levels drop and the brain loses NAD+'s sponsorship of longevity genes and mitochondrial support via sirtuin activity all contributing to eventual cell death.
Taking or using an outside source of NAD+ seems less likely to help someone if they have a lot of free radical damage (super oxide activity where oxygen free radicals are doing damage) occurring.
Caloric Restriction is one of the only scientifically proven methods to reduce damage from oxidative stress. When there is excess caloric intake (i.e. eating too much) or eat poor quality food our usable NAD+ is "tied up" in a less usable form called NADH.
Intake of excess and/or poor quality calories (i.e. bad food) gives rise to excess free radicals in the body. This occurs as cell turnover and reproduce themselves over time. Each "generation" of cells in our bodies (sometimes just hours or days later) will be made with increasing damage from these free radicals being made from a poor diet, so when this generation of cells is produced they are produced as damaged goods and effectively tie up NAD+. This increasing injury over time is known as "aging" and it depletes the body of its usable NAD+.
SIRT1 - Sirtuin (Silent Information Regulators) are able to switch on and off genes, including those that produce anti-oxidant capabilities in the body. When the body gets too many calories or the wrong kind of calories these genes - through an epigenetic mechanism known as acetylation - get down shifted and aren't able to protect us like they are designed to because the NAD+ and materials that turn them on are "busy" (ie they take the form of NADH). Being busy renders them unable to "hit the activation switch" as it were.
In general, mitochondria (energy producing parts of cells) seem to function less efficiently over time (ie aging). Some of the earliest changes in Alzheimer's occur in the mitochondria. The brain has an inordinate number of mitochondria relative to the rest of the body. NAD picks up electrons through a mitochondrion in a fairly efficient way to create energy currency in the body. Over time, this process can breakdown and become "leaky." Nutrient rich, energy limited diets (healthy, modest portions) seems to be one way to minimize these inefficiencies over time (i.e caloric restriction).
Mitochondrial Biogenesis -is the process of adding mass and function to the mitochondria (energy producing parts of our cells). Mitochondria are known to "crash" and are susceptible to damage early on in Alzheimer's. You can increase available NAD by increasing the bodies production of NAD 1) from Tryptophan 2) from over the counter forms of NAD.
Practically- these 3 forms can be bought over the counter:
1) Nicotinamide Riboside
2) Nicotinamide mononucleotide
3) Niacin
Dr Grant mentioned about 350mg may be a responsible dose, but also cautioned that some oral forms of Nicotinamide may end up stacking up and having the opposite effects that are intended (eg blocking sirtuin and PARP pathways), so you will - as always - definitely want to consult with your healthcare practitioner before trying this.
Each one of these three forms can increase the NAD inside our cells. But just supplementing with NAD without addressing other lifestyle factors of a good diet, proper sleep, enough exercise and stress reduction can lead to a build up of a recycling chemical in the body called, homocysteine which is associated with Alzheimer's, heart disease and other health issues.
Currently, there are only a few research institutions in the world that can truly measure NAD. It is unfortunately not widely available outside a research setting. According to Dr Grant, Dr Charles Brenner lab at the University of Iowa is the most reliable in the United States
IV (intravenous) NAD+ is being administered through a variety of clinical outlets in the US under medical supervision. This might be the most useful way to use it in neurodegenerative diseases like Alzheimer's and Parkinson's.
To learn more about NAD+
https://medicalsciences.med.unsw.edu.au/people/dr-ross-grant
http://www.springfieldwellnesscenter.com/
http://www.nadtreatmentcenter.com/nad-research/
On the cusp of her 50th birthday Julie Gregory started to experience symptoms of cognitive decline. Feeling alone and terrified, and given her family history of Alzheimer's, Julie sought to do something. Julie learned that she was an ApoE-4 homozygote - in other words she has both genetic copies of the ApoE4 gene which increased her chance of developing Alzheimer's by 50% - 90%. This episode discusses Julie's health journey and what she done to improve her cognitive and general health.
Along with a few other people, Julie founded ApoE4.Info Inc. - a crowdsourced website that brings people info in science and self-experimentation for those with one or two copies of the high risk gene for developing Alzheimer's (ie the ApoE4 gene).
Important NOTE: not everyone that is diagnosed with Alzheimer's has copies of the ApoE4 gene.
Julie's Most Effective Strategies for Brain Health
- Exercise 60 minutes per day - low and moderate intensities.
- "Super clean diet" - no grains, high numbers of natural colors, high vegetables, healthy fats (she focuses on plant fats and less so on the saturated animal fats).
- Reduced cerebral glucose utilization - ketones can create alternate fuel (mild ketosis) you can do this by reducing sugar intake and ingesting MCT oil
- Optimizing sleep - blue blocker glasses 3 hours before bed (to ramp up melatonin production)
- Meditation - any kind for any amount of time
- Impeccable tooth care- coconut oil pulling (10 minutes per day). Julie uses non-fluoride toothpaste
- "Skin Deep Database" by the Environmental Working Group- to find safe skin care products
Minute 22:30 - Discussion about Babesia Duncani, Lyme related infections, chronic microbial infections (ie potential infectious micro-organisms) and how the research seems to suggest that these may lead to some of the proteins (beta amyloid in specific) that we know our causally related to Alzheimer's. Also, Julie tells her story about getting tested and treated for some of these infections.
Minute 32:01 On why talking about Alzheimer's or Pre-Alzheimer's is such a touchy subject and the goal of APOE4.INFO - the crowd-sourced website that Julie and others founded to help those looking for accurate information. They have an active forum and facebook page that you can interact with. We also discuss the ethical controversy of genetic testing to understand your Alzheimer's risk (spoiler alert: Julie and I are both fans of checking) and the controversy around talking about the view that Alzheimer's is potentially reversible and preventable.
Find out more about Julie's organization to help you understand your risk: apoE4.info
In this episode we explore emerging radiology technologies and the new field of Preventative Radiology The info in this show will help you understand your risk for Alzheimer's and cognitive impairment and possibly even concussion related brain changes - and what to ask your doctor to get it ordered correctly.
Our guest, Cyrus Raji MD PhD, is a clinical fellow at the University of California - San Francisco. He completed his combined MD and PhD at the NIH-funded Medical Scientist Training Program at the University of Pittsburgh School of Medicine in 2010. He has worked with leaders in the field including Dr Bennet Omalu (the pathologist played by Will Smith from the movie, Concussion). His current research involves Diffusion Magnetic Resonance Imaging based Edge Density Connectome Mapping for Prediction of Alzheimer's Disease. He is an advisor to the NeuroReader.
Neuroradiology is the branch of radiology focusing on the brain and spinal cord. Ironically, very few radiologists actually have deep expertise in neurodegenerative conditions like Alzheimer's.
An MRI of the Brain- looks at brain structures and is readily available to most anyone through a local doctor. Typically they are simply interpreted by an individual radiologist which may or may not be useful in assessing your risk of Alzheimer's.
A better assessment may be the individual radiologist joining forces with computer programs that perform volumetric analyses of specific brain regions (explained in min 26:38). These volumetric analyses programs assist the radiologist by comparing domains of your brain to a database of normal brains and may give you a more detailed analysis and detect areas of early concern before it is obvious to the naked eye (even a trained one sometimes!). It can also identify other patterns of brain shrinkage - like vascular disease (e.g. strokes, mini-strokes, and suboptimal blood pressure issues), alcoholism, and psychiatric disorders.
The Different Types of Imaging Used for Alzheimer's
1) MRI (Magnetic Resonance Imaging). Looks at the structure of the brain alone. Does not look at function. A brain MRI contains no radiation if it is done without IV contrast.
2) fMRI (functional MRI) measures oxygen reflecting blood flow in the brain. Can identify problematic areas before structural changes are evident. It is overall a more sensitive tool than regular MRI, but for the most part is only available in research setting.
3) "Nuclear imaging" - looks at metabolism in the brain using radioactive tracers that have patterns consistent with Alzheimer's and other dementias. 2 examples of nuclear imaging a) PET-fdg assesses glucose utilization, high cost if not covered by insurance and not as available as MRI b) SPECT scans - not widely available and cost is somewhat prohibitive at this time.
What insights imaging can give you about Alzheimer's Brains
Classic brain atrophy (shrinkage) in Alzheimer's happens in the hippocampal regions in the medial temporal lobes near the middle of the brain. The hippocampi are important in the making (encoding) of new memories. The hippocampi start to shrink up to 3 years before actual symptoms of Alzheimer's begins. And in that area one can get a loss of volume in the temporal lobe.
Posterior cingulate gyrus and precuneus in the brain's parietal lobes can develop problematic changes as well. These areas are important in tracking information and cognitive integration.
What do my MRI volumetric numbers mean?
To be considered abnormal and potentially consistent with Alzheimer's diagnosis - the "magic number" for hippocampal volumes on MRI of the brain (using the Neuroreader or Neuroquant tool) is a number below the 25 percentile (this information is included in the report provided by Neuroreader or Neuroquant). Ventricular volumes, if higher than 75th percentile, may be too big and suggestive of Alzheimer's or another disorder as well.
An Introduction to the field of "Preventative Neuroradiology" (discussed at minute 23:30).
Knowing your risk for Alzheimer's with imaging. It's not the whole story but its good data.
If your MRI is read as "normal" but is noted to have some "periventricular white matter" or white matter changes suggesting "chronic ischemia" and low blood flow - this may not be exactly normal. Remember T2 FLAIR (one way the radiologist views the MRI images where fluids lights up brighter) is the easiest place to see these changes on your MRI. These changes may represent issues like hypertension, diabetes, or artery disease. When there is white matter problems then gray matter disease (or problems with brain cells like neurons) is probably not far behind.
Lifestyle changes seem to be able to impact the hippocampus in a positive direction.
Brain changes classic for CTE (Chronic Traumatic Encephalopathy) that happen as a consequence of concussion/traumatic brain injury may be found within the brain stem. Ventral diencephalon and frontal lobe may be affected as well.
How to Get a Volumetric MRI of your Brain
To get a Volumetric Brain MRI study done so that it can be computer-read by Neuroreader (by the Brainreader company) or NeuroQuant (by Cortechs labs). Make sure to have it done in a "volumetric acquisition" (ie really "thin slices"). Ask the imaging center's MRI technologist:
if the MRI Volumetric scan is done in the "sagittal" orientation with General Electric machine- "acquisition in SBGR" or if the machine is a Siemens machine-acquisition ask for it to be done in "MP-RAGE" or whatever settings the institution uses for volumetric acquisitions.
Lisa Feiner is a co-founder of the grassroots, not-for-profit organization - Sharp Again Naturally - focused on preserving memory and restoring minds.
SharpAgain's "roadmap" to reversible causes of memory loss is really quite impressive. They advocate working on your own and in partnership with your healthcare practitioner to look for reversible causes of Alzheimer's, dementia, and memory loss. Here is the list and you can find this on www.sharpagain.org - check out the "roadmap."
10 REVERSIBLE CAUSES OF MEMORY LOSS (PER SHARP AGAIN NATURALLY)
- Nutritional imbalances and deficiencies
- Toxins in food, water, air, work/home environments
- Effects of prescription medications
- Mercury and other heavy metal toxicity
- Hormonal imbalances (thyroid, estrogen, testosterone and others)
- Inflammation from low-level infections, mold, food allergies, and Lyme Disease
- Inadequate physical activity, mental stimulation, and social interaction
- Stress, especially from life changes and how we process information
- Sleep and breathing problems related to oxygen deficiency
- Traumatic Brain Injury
We also touch on the roles of meaning and spirituality and prevention (min 22:43).
We discuss the importance of oxygen and the airway on brain health (Min 30:24). Interestingly, there is a role for proper nutrition (including MCT oil) in terms of airway development.
Listen to stories of people that have improved using the the concepts advocated by Lisa's organization (Min 33). Treatment may take several months or longer to really see the powerful impacts.
Show Resources:
Lisa's organization's website: Sharp Again Naturally
LA TIMES Article linking pollution and Alzheimer's
"The Polluted Brain - Evidence builds that dirty air causes Alzheimer's dementia"
"GASP - The Hidden Path to Wellness" by Michael Gelb DDS and Howard Hindin DDS. This is a book that explains many of the complexities around sleep disorders, airway problems and how to assess and treat them. It connects the concept of airway and sleep to problems with cognition.
BrainHQ by Posit Neuroscience.
Get ready because this episode takes us 5-10 years into the future - where Big Data meets Alzheimer's. But the future is already here!
Dr Nathan Price PhD is the associate director of the highly esteemed Institute for Systems Biology (ISB) and co-founder of it's spin-off company Arivale - a leading company in the Scientific Wellness space. ISB and Providence St. Joseph Health, a 50 hospital system to which ISB is affiliated, have particularly focused on solving Alzheimer’s and have invested millions of dollars into research in finding both cures and prevention programs.
Dr Price gives us an intro to the concept of "Scientific Wellness" and it's role in creating health and predicting and preventing disease. Scientific Wellness - refers to technologies that quantify and assist to enhance health in the human body. Using methods of measurement called "Computational Biology" this approach builds models to make sense of disease and resilience states and gain insights from vast amounts of information generated using computer technology. This information can be from a person's genes or gene expression products or even the bugs in their stool and saliva. In some cases these methods may even try to make sense of data streams collected by a variety of sensor-based information (for example, from a FITBIT).
All of this information can be overwhelming to handle and requires "supercomputing" capacity which companies like Arivale and ISB possess. Dr Price and I discuss how all of this information comes together in the case of Alzheimer's disease in the form of "dense dynamic personal data clouds" and how this will likely be important in solving the Alzheimer's puzzle. Dense dynamic personal data clouds - refer to huge data sets that are followed on individuals over time to help predict and prevent disease. The first such project was called the "Pioneer 100." While some of these data collections are investigational at this time, the near term goal is to leverage these data to practical help people get better or possible prevent Alzheimer's.
In order to make sense of an individual's information, his/her genome need to be compared against what is know about Alzheimer's in the highly touted Genome Wide Association Studies (GWAS). GWAS data are important because they tell you about gene variations that are associated with a variety of aspects of Alzheimer's disease. Fortunately, there is good GWAS data for Alzheimer's and based on this, Dr Price and his team at Arivale believe that this will help track the manifestation of Alzheimer's disease based on tracking way the way genes express in a variety of other measurable data from a human being. This information is collected from multiple levels of a person including stool, saliva, urine, blood and potentially more. The variety of levels of "Omic" information is aggregated then with the assistance of computer technology is made sense of in the form of a "dense dynamic personalized data cloud."
Other Interesting Topics discussed in this episode
- Connections between diabetes type 2 and Alzheimer's a
- Where stem cells might have a role in treatment.
- CRISPR technology - the benefits and ethical questions of gene-editing technology.
I want to highlight CRISPR in this summary because of how significant it appears it will be in the future of achieving real health on multiple levels. CRISPR is a gene-editing tool - that Dr Price calls one of the most exciting developments in biology in his generation. CRISPR is a simple technique for gene editing that allows someone to effectively "pull out" risky genes at the stem cell level, fix them, and put them back. But, Dr Price also considers the ethics and potential unintended consequences.
Changing the paradigm of how clinical research is done in the Information Age. In the age of Personalized Medicine the paradigm of the single pill for a single ill is being challenged and a new approach for clinical trials is emerging with ISB amongst the leaders of this emerging paradigm.
Find out more about Dr Price's work here:
The Institute for Systems Biology
Arivale
Today's Guest is, Dr Majid Fotuhi of the Neurogrow program and Johns Hopkins University. He is the author of 3 books and multiple academic as well as popular scientific articles. Dr Fotuhi's work has been featured in Time Magazine and Reuters and he has been seen on PBS, CNN, NBC, ABC and FoxNews.
Show Summary:
The hippocampus is an area in our brain that - when smaller than average compared to those our age - seems to be highly related to Alzheimer's. The hippocampus is partially responsible for storing and processing memories. it is highly susceptible and sensitivity to toxicants and the ongoing effects of stress. Over time this area can get penetrated resulting in leaks through the blood brain barrier (a protective lining of cells that protects the brain from harmful elements in the blood). This "leaky brain" has an effect on over all brain function and is associated with Alzheimer's disease and poor brain functioning.
Hippocampal "size matters" - hippocampal volumes of the brain correlate with better brain function and seem to protect against memory loss and Alzheimer's. and you can impact the size of your hippocampus.
Poor diet, obesity, lack of activity/exercise, poor sleep/uncorrected sleep apnea, high stress all seem to impact the hippocampal size either positively or negatively.
Ask your institution about getting an MRI of your brain with "quantitative volumetrics" with software like Neuroquant or Neuroreader (listen to episode with Dr Cyrus Raji for more information) that can tell you how large or small your hippocampus is compared to those your age.
Dr Fotuhi published an article that showed 84% of participants improved their in memory and positively increased the sizes of their hippocampi after participating in a 12 week brain health program.
The Key Practical elements of Dr Fotuhi's program are:
- adherence to a Mediterranean diet with the additional of omega 3 fatty acids
- stress reduction and meditation
- regular exercise
- identifying and treating sleep apnea
- memory and brain training
- brain mapping with qEEG and neurofeedback
Significantly positive EEG (brainwave formation) changes were shown on the "brainmapping" portion of his program within just 6 weeks. This was due to the use of neurofeedback, a way of training the brainwaves using EEG-related biofeedback technology. The result...better brain function!
Walking 10,000 steps per day seems to be more effective than at least one FDA approved medication for Alzheimer's.
Practice Makes Cortex Article
Dr Fotuhi's Brainfitness Calculator - take this test and score your own brain fitness
Dr Majid Fotuhi's website: www.neurogrow.com for information or to enroll as a patient
Books by Dr Fotuhi:
Boost Your Brain: The New Art and Science Behind Enhanced Brain Performance
The Memory Cure : How to Protect Your Brain Against Memory Loss and Alzheimer's Disease
The New York Times Crosswords to Keep Your Brain Young: The 6-Step Age-Defying Program
Dr Dale Bredesen is an internationally recognized researcher in Alzheimer's. His incredible resume includes being the Director of the Easton Center for Alzheimer's Research at UCLA as well as founding president and CEO of the Buck Institute on Aging in Novato, California. He has worked in the lab of 2 nobel prize winners and has run his own labs for 28 years looking at neurodegenerative diseases - focusing on Alzheimer's. Dr Bredesen's fundamental theory is that Alzheimer's is actually a protective brain response to different classes of insults. Classes of Insults Leading to Alzheimer’s
- Inflammation and the brain’s response to pathogens/infections – these trigger the creation of amyloid beta, a key chemical in the brain that destroys brain cell connections and is believed to be a key factor in the development of Alzheimer’s. Amyloid Beta is a part of the Innate Immune system which seems to be over stimulated or dysregulated in most cases of Alzheimer’s. Dr. Bredesen explains the connection of immune activation in Alzheimer’s.
- Inadequate amounts OR withdrawal of support of brain-“growing” chemicals like B12, vitamin D, and other hormones. This results in a downsizing of the networks of brain cell connections.
- Sugar toxicity – damages via:
- advanced glycation end products (AGEs) acting to damage through inflammation as well as,
- loss of cell supports because of shoddy insulin signaling necessary for healthy brain activity.
- A protective response by amyloid that bind to things that the brain perceives as a toxin – things like: copper, iron, mercury, biotoxins, infections.
- People in their 50s and early 60s tend to have the more “toxic” form.
- Problems with blood vessels and leakiness in the protective blood-brain-barrier which result in lower support chemicals and toxicity.
- Trauma, e.g., from things like concussions – which also lower chemical and hormone support as well as make the brain susceptible to all the insults mentioned above.
The story of “Patient Zero” (Minute 28:53)
Dr. Bredesen describes the first success he had with his program.
Things that induce Alzheimer’s a.k.a. “Dementogens”
- Biotoxins
- Exposures to water building and the harmful effects of mold
- Tick exposures
- Heavy Metals Exposure
- Aluminum, copper, mercury
- Water damaged building, mycotoxins
- Certain types of infections
- Concussions
- The effects of diabetes and poor diet
- Certain types of pollution
- Not enough time asleep or insufficient oxygen when you sleep.\
- Not enough exercise
Elements of a “Cognoscopy”Because the brain changes in Alzheimer’s can creep in 20 years or more before symptoms start prevention makes a whole lot of sense.Though a cognoscopy doesn’t really exist yet in a conventional medical setting, Dr. Bredesen’s thinks that one should probably be done around age 45 to assess the risk of developing Alzheimer’s and might include the following:
- Genetic markers and blood work that elucidates Dr. Bredesen’s three metabolic subtypes (see an MPICognitions.com to find a doctor trained in the protocol).
- Functional cognitive testing using BrainHQ, Lumosity, Cog-state, CNS vital signs to see where your brain function is in a “testing environment”.
- Brain MRI with volumetrics (listen to Evolving Past Alzheimer’s podcast with Dr. Cyrus Raji episode #6 for full explanation) if someone has symptoms.
The Role of Sleep in Alzheimer’s
- Time of repair (don’t eat 3 hours before bed)
- Time for autophagy (brain cell “pruning”)
- There is a slight change in the microanatomy of the brain where some of the accumulated toxicants get “washed away”
- Sleep hygiene is important
Who typically improves with the Bredesen Program?Dr. Bredesen mentions the “MoCA” which refers to the Montreal Cognitive Assessment. This is a screening test that won’t tell you if someone has Alzheimer’s but can give you a general indication of different levels of cognitive impairment. Dr. Bredesen mentioned that people that score 22 or greater (out of 30) are seeing improvements with his methodology. These are people that are typically early on in their disease.
Who typically does not improve with the Bredesen Program?
- People that are more “frail” (less able to exercise, etc.)
- People that are further along with the disease and have had symptoms for longer periods of time.
How much improvement do people see with the Bredesen Program?Some people seem to get just a bit better in terms of mood, outlook, and brain function. Others get much better and almost completely back to their best brain function. Too early to say how many, but more than half of the people using the methodology report some sort of improvement.
A discussion of an upcoming Documentary of the impact on people’s lives using Dr. Bredesen’s program.
Resources * Dr. Brdesen’s Book: The End of Alzheimer’s * To find a Bredesen trained physician, visit Dr. Bredesen’s website – MPI Cognition * Website: Institute for Functional Medicine
Our show and website is here to help you or someone you know with a problem that is destroying minds and families all over the world. This problem is Alzheimer's disease. Our fundamental belief is that Alzheimer's is generally preventable and reversible (especially if discovered in the early stages).
My name is, Nate Bergman, your host on the "Evolving Past Alzheimer's" Podcast. I am a physician in Cleveland Ohio. Listen to this episode to hear my own story of memory loss and how I coped with feeling like I was losing my mind...and how I have gotten better. The Evolving Past Alzheimer's podcast covers Alzheimer's issue from many angles. This show is focused on preventing Alzheimer's, or at least identifying the disease as early as possible (if not before it starts...yes that may be possible). But our greatest desire is to help our listeners avoid the disease and "get better" from Alzheimer's. This show will explore the latest research and technologies with an emphasis on what you can do yourself or bring to your healthcare provider. Everything from diet, exercise, stress, medications, genetics, genomics, brain games, "Big Data', Artificial intelligence (AI), and gene therapies. At times we will sidebar into the spiritual and futuristic sides of Alzheimer's and aging. These are exciting times...come learn with us, interact, transform, and get better!!