In this “Ask Me Anything” (AMA) episode, Peter goes into depth on the topic of brain health, starting with how Alzheimer’s disease is diagnosed, the significance of blood-based biomarkers in diagnosis, and what the various APOE gene variants mean in terms of a person’s risk of developing Alzheimer’s disease. Next, Peter discusses the various strategies for preventing Alzheimer’s disease and neurodegeneration. He touches briefly on exercise as a potent tool, but focuses more on lesser-known factors that could impact brain health, such as nutrition supplementation, lipid management, brain games, sauna, oral health, hearing loss, and more.

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We discuss:

  • Diagnosing Alzheimer’s disease [2:45];
  • Biomarkers for Alzheimer’s disease, the C2N test, and other tools for diagnosis [7:30];
  • Genetic component of Alzheimer’s disease: genes that confer risk [12:45];
  • Understanding your APOE status and why it’s important to know [17:15];
  • The prevalence of Alzheimer’s disease and other forms of dementia, and who is at higher risk [21:15];
  • Can the risk of Alzheimer’s disease be decreased with behavioral changes? [24:15];
  • Overview of modifiable behaviors that potentially play a role in risk reduction of neurodegeneration [30:15];
  • Things that clearly impact brain health: smoking, alcohol, sleep, head injuries, blood pressure, and more [34:15];
  • How nutrition impacts brain health: common diets, metabolic health, energy balance, and more [46:15];
  • Comparing common diets: data showing the association between the incidence of Alzheimer’s disease and specific diets [59:45];
  • Supplements: EPA and DHA, vitamin D, and B vitamins [1:13:00];
  • Supplements: theracurmin, cocoa flavonols, and magnesium L-threonate [1:25:15];
  • Impact of exercise on brain health, minimum effective dose, and the most important types of exercise [1:33:00];
  • Challenging the mind with brain games—does it impact neurodegeneration? [1:43:00];
  • The data on sauna and brain health [1:49:45];
  • Oral health and its association with brain health [1:52:45];
  • How reducing lipids can improve brain health and prevent neurodegeneration [1:55:30];
  • The potential impact of hearing loss on brain health and neurodegeneration [2:04:30]; and
  • More.

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Diagnosing Alzheimer’s disease [2:45]

*Previous podcasts on this topic:

“Anyone who has a brain is at risk for this.” —Richard Isaacson [episode #18]

Diagnosing Alzheimer’s disease [4:45]

  • A lot of what we’re going to talk about today is around Alzheimer’s disease because Alzheimer’s disease is both the most common neurodegenerative disease and the most common cause of dementia
  • Some other causes of dementia:
    • vascular dementia, which would be quite prevalent
    • Lewy body dementia
    • Parkinson’s disease
  • As it pertains to the diagnosis of AD, unfortunately, it’s not a neat and tidy diagnosis the way we would have for breast cancer, for instance
  • For AD, it really starts with a clinical diagnosis made by a neurologist
  • They will assess various symptoms such as:
    • Difficulty remembering events
    • difficulty concentrating
    • planning or problem solving
    • confusion with location
    • temporal confusion (confused about different events over time) 
    • language problems
    • reduction in vocabulary, speech, writing, etc.
  • There may be some sort of mental status exam or neuropsychological tests
  • There will also be some lab tests done to rule out other causes
    • For instance, a patient looks like they have all of the signs and symptoms of Alzheimer’s disease, but you come to find out that they’re profoundly hypothyroid, or they have B12 and B6 deficiencies or things like that
  • The bottom line is this diagnosis really isn’t definitively made until an autopsy
    • That said, there are other biomarkers that are increasing in the sensitivity for this
    • we now have the ability to look at serum, amyloid, and tau, and those can be coupled with the things described above, in addition to things like amyloid PET
  • A really good diagnostician can probably be almost assured that a patient indeed has Alzheimer’s disease based on the presentation

 

Biomarkers for Alzheimer’s disease, the C2N test, and other tools for diagnosis [7:30]

When you talk about cardiovascular disease, you have ApoE as kind of a biomarker that’s kind of a predictor of risk. Is there anything equivalent to that for Alzheimer’s or neurodegeneration?

  • No, Alzheimer’s is much more complicated in this regard
  • We do have biomarkers like amyloid and tau

{end of show notes preview} 

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