Dementia Prevention: 14 Risk Factors That Can Protect Your Brain

00:00:00: Fourteen risk factors, and behind them a number that's almost too big to be true.

00:00:05: Almost forty-five percent of all dementia cases are fundamentally preventable.

00:00:10: That is not some wellness claim or marketing spin but the sober calculation Of The Major Lancet Commission from twenty-twenty four.

00:00:18: Blood pressure Hearing loss Vision loss Blood sugar Sleep All these areas have solid numbers behind them.

00:00:26: And thats exactly what we're going through today One by one with what you can directly implement in your daily life and what research considers possible.

00:01:02: What would you say your currently doing for dementia prevention, even if not consciously?

00:01:08: We're both still very young.

00:01:09: We're not even thirty yet So it's certainly not top of mind for us.

00:01:14: But we'll be talking a lot about Dementia Prevention today and what you can actually do already.

00:01:20: What Would You Say is part Of that For You?

00:01:24: Okay That'S Obviously A Broad Question.

00:01:28: I Could Basically Spoil The Whole Podcast Right Now But no, I'd love

00:01:32: to.

00:01:32: please don't do that.

00:01:33: No but i can just give a rough outline of course.

00:01:36: uh Of what i'm already doing.

00:01:38: so i of course measure Most things in my blood That are somehow related To it?

00:01:44: Look at my blood sugar look At my lipid metabolism these all topics that Are very closely linked to metabolism and therefore also two common cases of dementia.

00:01:53: So i look at that.

00:01:55: of course i've Also looked A bit at My personal risk especially of genetic nature.

00:02:01: First, of course you look at okay.

00:02:02: What's the family history like?

00:02:03: are there other many cases?

00:02:06: In my case At least that's not really the case That dementia occurs even at an advanced age and that's particularly a warning sign if it really occurs at a younger age Like in their sixties seventies or early eighties.

00:02:20: And I look at that.

00:02:21: Or i've looked at that Of course and what was also interesting we both did A genetic analysis once uh...and just checked.

00:02:28: Okay what's the deal with apo e four?

00:02:32: That would be this allele that has a negative effect on Alzheimer's dementia.

00:02:37: And I just don't have that, so i'm already a bit safer on that front.

00:02:42: but still of course you can get different types of dementia we'll dive into that in a moment and still dementia can happen to me too.

00:02:48: What will certainly be the biggest risk factor for me is probably my stress level which i feel like i'm bringing up in every podcast episode by now because it's somehow almost everything and That's certainly a factor that I probably need to work on more.

00:03:05: But I don't have under control so well.

00:03:08: yet

00:03:08: Mm-hmm, I mean dementia in and of itself isn't a classic sudden disease Of aging that just appears but it develops.

00:03:17: It basically works similarly to cardiovascular disease or diabetes So sugar disease?

00:03:23: It builds up over years decades beforehand And at some point it basically strikes right.

00:03:29: And everything we're talking about today is good for risk reduction.

00:03:33: But of course it's no guarantee that you won't end up getting dementia anyway, right?

00:03:38: We should probably point out not every thing is one hundred percent predictable and can also have a heart attack if you've always eaten super healthy or wonderful blood lipid levels so on and so forth.

00:03:51: So its just a risk reduction.

00:03:52: but thats still worth alot as will see later when we discuss certain when we discuss the extent of risk reduction for individual points, right?

00:04:01: It's quite impressive.

00:04:01: When you can reduce it by thirty-thirty five percent with something relatively simple like I don't know physical training or physical activity that's already pretty good and i also found a quiet fascinating according to current on just for individual point is quite impressive.

00:04:17: when you could use it by three.

00:04:19: thirty-five percent was something relatively simply like our physical training are physically activity.

00:04:23: thats all ready.

00:04:26: I also found it quite fascinating.

00:04:28: According to current understanding, let's say dementia or dementia and Alzheimer's disease.

00:04:32: they aren't actually the same thing but alzheimer is a subtype of dementia.

00:04:37: so dementia is practically the umbrella term.

00:04:39: And then there are many different forms of dementia.

00:04:41: There's Alzheimer's dementia, vascular dementia which affects blood vessels for example.

00:04:46: There's Lewy body dementia, frontotemporal dementia So supermany different forms.

00:04:52: But Alzheimer's is very common just like vascular Dementia.

00:04:56: And if you look at how something like that develops, meaning how the brain ages.

00:05:01: It's such that at some point these amyloid plaques start to remain in the brain and are no longer cleared away right?

00:05:09: So you have a net positive amylloid.

00:05:12: Amyloids is constantly being produced but of course it can also be cleared by the body which works via this glymphatic system.

00:05:18: we'll talk about later.

00:05:20: And this amyloid, these plaques they start to form over time.

00:05:23: that can start at twenty.

00:05:24: It could started forty and fifty kind of depends right?

00:05:26: it's also quite different individually in a second step These tau proteins then formed.

00:05:30: these are all so special type of protein but then aggregate meaning They Can no longer be cleared from the brain So easily.

00:05:37: Then At some point Brain metabolism gets worse due To these protein deposits.

00:05:42: then at Some point The brain starts to shrink because its No longer being supplied so well That means the.

00:05:47: the brain mass then decreases.

00:05:50: That sounds more drastic than it is, because its only a very small percentage that goes down the drain let's say.

00:05:55: But if you look at brain of healthy person versus a person who has advanced dementia You can see it as a glance!

00:06:03: You don't have to study medicine for this.

00:06:05: If we were looking at two images side by side We would immediately be like oh wow in person B The brain is significantly smaller.

00:06:12: These guiuri meaning these folds which are also much fewer The wrinkles exactly.

00:06:18: they are much less pronounced and the mass simply decreases.

00:06:22: that then in turn has an impact on memory.

00:06:24: And because you then notice oh I'm already forgetting things, and that becomes pronounced than at some point comes the diagnosis.

00:06:31: but all of what i've just listed first amyloid then tau Then brain metabolism then brain mass then memory All of that comes beforehand and happens over a period about twenty to twenty five years.

00:06:43: That means if so this amylloid can theoretically also be measured.

00:06:47: Why, you might ask?

00:06:49: Don't we do that as routine

00:06:50: diagnostics?".

00:06:51: Well because also super many people have measurable amyloid but they in turn never develop dementia.

00:06:58: so you actually have a biomarker there.

00:07:00: that is very typical for dementia But unfortunately it has very little significance Because super-many healthy people also have it who later never developed dementia.

00:07:09: That's why Tao Can Also In Turn be measured right.

00:07:13: that's why it is not quite as meaningful unfortunately.

00:07:17: nevertheless this has already been seen in people who develop dementia.

00:07:20: twenty-twenty five years later then.

00:07:23: This flushing out of the amyloid and the towel is all ready happening.

00:07:27: that is measurable.

00:07:28: but than also increases over time and thus impairs, yeah the brain metabolism.

00:07:35: so the brain can actually handle that super well.

00:07:38: we do have reserves and we could also clear this amyloid away again.

00:07:42: But if in turn this clearance doesn't work well, for example... If you sleep too little we'll get to that later.

00:07:49: Or if you have a lot of stress then it just accumulates much more easily even though the production rate of protein is actually the same?

00:07:57: Yes!

00:07:58: but if in turns this clearance does not work well For example..if you sleep so little We will be able to do that later.

00:08:06: or if there's lots of stress Then it just accumulates much more easily even though the production rate of protein is actually same.

00:08:13: Yes,

00:08:15: so that maybe as a starting point and makes all important no matter what age you are right now to look into dementia prevention or do many things early on.

00:08:27: but if your sixty seventy eighty now listening this podcast then its still worth take these things too hard.

00:08:35: Yes,

00:08:36: right.

00:08:36: In any case you can still slow down the progression or maybe even stop it completely.

00:08:40: That's always the case and that is actually a beauty of things which take so long to develop.

00:08:45: You could do something about this for relatively long time Even if you might notice first signs... ...you have a wonderful amount of reversibility in there.

00:08:52: It's also similar with diabetes.

00:08:54: We've talked before.

00:08:55: too Many who already developed diabetes would probably get out of it well again If they really took all different levers weight loss seriously.

00:09:02: But sure, there's also a point of no return at some point and then you're just seriously ill right?

00:09:06: And nobody can change that anymore than your dependent on medication.

00:09:09: That is how it is.

00:09:10: but in itself this is actually very motivating thing.

00:09:12: as long as we still have control... You are probably all so still in control!

00:09:18: In many cases dementia is more of a systemic disease than an isolated one because We will talk later about fourteen different risk factors All of which you can actually influence yourself.

00:09:30: Genetics is just not one of them, but there was a super nice clear paper by Lancet with fourteen different risk factors all of which are modifiable and the basis of these fourteen risk factors are actually again only very few processes in the body And that is vascular health.

00:09:44: If your vessels are doing well then The brain can be sufficiently supplied With oxygen sufficiently supplied with energy and this clearance Of harmful substances including amyloid and tau also works.

00:09:57: That just works better.

00:09:58: What destroys vessels?

00:10:00: Sugar, so if the sugar regulation isn't right or the blood lipid metabolism is not right then we in turn have a negative effect on vessels.

00:10:09: and sleep is of course logically huge topic also simply because of recovery and rest.

00:10:21: as you said I think people underestimate that nowadays.

00:10:25: How often do you hear or how often?

00:10:27: Do you simply talk to people who then say like yeah, because I live totally healthy and i uh so I sleep okay.

00:10:34: I do work a lot but Then I also do sports and eat healthy But actually the body is in stress all day long And never has an opportunity To properly wind down and In The six hours that You might still Sleep That doesn't Work either Because That Is Simply Too Little.

00:10:48: That's Why Stress I think Is Also Simply in Our Latitudes Something totally underestimated or to which often far too little is attributed.

00:10:58: Totally, total

00:10:59: to that.

00:11:00: what I always found to be a very vivid analogy is there's this functional medicine doctor in the US called Mark Hyman you might have heard of him and he calls Alzheimer's in particular.

00:11:14: He calls it type three diabetes And uh...he basically says Alzheimer's also just a type metabolic disease A different type maybe but it's always associated with diabetes somehow, right?

00:11:27: Even if maybe one that hasn't quite turned into full-blown diabetes yet.

00:11:31: But its some how a kind of pre-diabetes in almost all cases.

00:11:37: and these classic metabolic factors you also see with metabolic syndrome That go hand on hand with diabetes... ...that go hand to hand with lipid metabolism.

00:11:48: They actually interlock and Alzheimer fits very well there too.

00:11:53: this genetic setup that we, I briefly talked about at the beginning is also just a probability.

00:11:59: That you'll trigger it right?

00:12:00: And accordingly yes It's a metabolic issue.

00:12:03: in The end its exactly the same thing.

00:12:06: We're going to say the exact Same things again Right and Alzheimer's In particular Is very Very strongly linked To that.

00:12:12: Still i think there are A few other exciting topics involved That You don't really have on your radar.

00:12:18: Let's Say Which in turn Are Also Metabolic Issues And with a poor metabolism, they just get worse faster.

00:12:26: But yeah I find that quite exciting.

00:12:29: also with this paper and these fourteen risk factors it's basically like... They said well if you theoretically addressed all of those fourteen factors or everyone worldwide addressed these fourteen factors then we would have almost half.

00:12:45: so about forty five percent fewer dementia cases And that is already an incredible amount because dementia is also rising very sharply in prevalence, Because we are getting older and older.

00:12:57: And dementia to a certain extent if you leave aside early onset Alzheimer's disease or the disease of old age... ...because all these factors.

00:13:05: I mean it makes difference for blood vessels whether you live seventy years or ninety years right?

00:13:10: The probability that the vessel will get substantially worse between seventy and ninety is super high!

00:13:17: Also, that your insulin resistance gets worse and so on.

00:13:21: That's why it all plays together a bit.

00:13:23: And if you imagine roughly in the phases of life... So which phase can we take care of these risk factors?

00:13:31: One is actually very early education.

00:13:36: Yeah!

00:13:37: A little unfair.

00:13:38: Totally unfair because this is something many people cannot do.

00:13:44: I mean, in industrialized countries it's a bit different.

00:13:46: But even there social mixing doesn't happen the way you'd want to do and they're sometimes simply a glass ceiling right?

00:13:54: That is not because your'e not eager to learn as child but those are just external circumstances.

00:14:00: which family did you grow up with?

00:14:02: what financial opportunities does that have?

00:14:04: so on and so forth.

00:14:06: Well i think...to put more nicely..i always find it silly when people say low education Because honestly, I mean there are plenty of people who maybe only went to secondary school or intermediate school Or whatever but then really made something Of themselves in the end and also very successful.

00:14:20: Whatever an acquired The education is some other way right which isn't measured In these cases.

00:14:27: But it does make a difference what kind of environment you hang out.

00:14:30: And that's probably the more relevant factor.

00:14:35: If You have low level of education Then you'll probably end up hanging with your whole life have different, I'd say routines than people who maybe come from a higher educational standard.

00:14:46: It's just more likely right?

00:14:48: And it's always ashamed to have such a generalization.

00:14:51: but unfortunately in most cases that's how is.

00:14:53: and then there are these exceptions who fight their way out somehow.

00:14:56: That actually according to newer data doesn't has so much do with what you study later on or what you do from age eighteen onwards But it's mainly about very early education.

00:15:07: It's about early cognitive ability in which I mean that naturally goes hand-in-hand with it, right?

00:15:13: but apparently the decisive factor is really Early Cognitive Ability In Childhood so up to about ten years of age where Education Is Very Strongly or Cognative Performance Not Only Dependent On School How you interact with your parents, right?

00:15:32: And how much time your parents can take.

00:15:36: What was measured there as an IQ measure or...

00:15:38: So partly they looked at IQ.

00:15:42: so if I were to ask now what is your IQ?

00:15:45: then You'd have to answer well whatever the IQ test measured because There are so many different intelligence tests and not all of them Are particularly representative let's say Of later performance It's about very basic cognitive functions like You know, how long can you hold your attention?

00:16:03: What about short and long-term

00:16:04: attention?".

00:16:05: We were just at years in Berlin recently.

00:16:07: And they did a cognitive test like that too!

00:16:09: Not all of them are particularly representative let's say... ...of later performance.

00:16:15: It is very basic cognitive functions Like How Long Can You Hold Your Attention?

00:16:21: What About Short & Long Term Attention?

00:16:23: We Were Just At Years In Berlin Recently And They Did A Cognitive Test Like That Too.

00:16:28: And these basic functions, they are apparently very representative then of having a certain protection in quotes against dementia later on.

00:16:36: So the better developed they are, the more cognitively flexible you are, The more likely you are to still engage with new things have a constant interest In learning other things too.

00:16:45: but yeah so that as I said just To clarify it a bit i mean It doesn't do You much good if you start downloading A brain training app at forty.

00:16:51: That's certainly Better than not.

00:16:53: At

00:16:53: least it Doesn't change this risk factor

00:16:54: Exactly.

00:16:55: there is another factor, I'd say just that the curiosity to really always engage with new topics.

00:17:03: To keep up this interest.

00:17:05: but yeah we'll get to that a bit more later.

00:17:06: That it's also not Just oh i'll buy crossword puzzle book or The daily paper comes and I do my crossword Puzzle every day?

00:17:14: That's actually not It because that's always

00:17:16: the same.

00:17:17: instead you Really have to engage With new topics like if You've never played an instrument starting to learn one at fifty if you only know two languages, German and English actually tackling a new language.

00:17:27: So it's really about this variety and not just yeah I read the paper anyway or do my daily Sudoku any way...I found that interesting too because i also kind of believe its enough to keep your brain active like that but actualy isnt so much about novelty value an activity should have for example learning.

00:17:51: Maybe it makes sense to pick up a tennis racket at some point because the brain then has to deal with completely new movement patterns.

00:17:58: And yeah, that's how you stay fit and young in the head even though the foundation for that is built very early.

00:18:04: so childhood youth more like ten years than fourteen years.

00:18:10: That was definitely interesting.

00:18:11: Interesting Yeah.

00:18:12: Then there of course big chunk midlife I'd say somewhere between forty and seventy or forty-five in sixty.

00:18:19: So you'd say like the last twenty, thirty years before retirement?

00:18:23: And that's where all these metabolic issues play a role again!

00:18:25: That is usually when cardiovascular diseases already develop because blood lipid levels are no longer right... ...that's why insulin resistance develops because sugar regulation no longer works well.. ..that's what most people get depressed actually also huge risk factor for dementia.

00:18:41: it already doubles the risks.

00:18:43: if you suffer from depression.

00:18:45: traumatic brain injury plays a role.

00:18:47: So just accidents, right?

00:18:49: In that sense it's also just stupid.

00:18:52: if you ride a bike without the helmet... If you ski with out a helmet is all so just uh-

00:18:56: Did you catch yourself

00:18:57: there?!

00:18:57: I just

00:18:57: caught myself!

00:18:58: I ride in this city without a helmet i have to admit now unfortunately of course when skiing..I always wear one....in that sense yeah.

00:19:06: and offcourse when road cycling too thats obvious anyway

00:19:10: Yeah, but there is also a matter of good form.

00:19:11: Of course

00:19:12: exactly that's almost an accessory.

00:19:14: I'd say

00:19:15: it was extra

00:19:16: expensive to Exactly because then it looks extra nice.

00:19:19: Then yeah classic classic lack of exercise.

00:19:22: right moving less Also starts in midlife and not just at seventy Right so that plays a role.

00:19:29: smoking?

00:19:30: Of course alcohol Yeah obesity That all stuff that develops In this middle phase of life.

00:19:37: And very interesting, if you look at the later phase of life again from about sixty-five seventy then a few issues become critical like vision loss.

00:19:48: We'll talk about cataracts and glaucoma later... ...and for example that a cataract operation is actually positive for dementia because you really see everything through a veil.. ..because thats real impairment off your vision.

00:20:06: And when you operate on the cataract, maybe there are some listening who have already done that.

00:20:11: The lens is then so a new lens is practically inserted and Then You Have A Step Up Again Afterwards.

00:20:17: I'd Say So You See Better Afterwards Than Before.

00:20:20: Now If You Have Glaucoma That's Increased Eye Pressure Which Over Time Destroys The Optic Nerve?

00:20:36: Right and no matter how many surgeries you do.

00:20:38: for example, You can shoot holes in the iris with a laser.

00:20:42: that doesn't bring back The previous vision.

00:20:44: That's why that is actually irrelevant For the development of later dementia.

00:20:50: I found that really interesting too.

00:20:52: And another thing Is hearing.

00:20:55: Hearing is also very relevant.

00:20:57: if you Can't hear you No longer have social participation.

00:21:01: Speaking Of Social Participation.

00:21:02: Another Reason Is Simply isolation and loneliness.

00:21:06: That's, I think currently especially with older people.

00:21:10: You kind of get the feeling that with social media and with AI And so on and so forth The whole thing is also shifting into a younger age group right?

00:21:19: So that more and more people

00:21:20: Significantly exactly

00:21:22: are lonely involuntarily i should add because there's A difference between i'm lonely and i'm fine With it and i still enjoy life and People who say okay i'm Lonely but actually I'd like to have more contact with other people.

00:21:38: So it's actually not just the loneliness alone that makes a difference but, The factor you're unhappy or suffering from exactly and if add up all these fourteen factors You can reduce your personal risk by forty five percent.

00:21:54: i think thats pretty good.

00:21:56: yeah lets say starting point now.

00:21:59: this applies especially to industrialized countries.

00:22:02: if you look more at developing countries they have many more problems with hearing loss too and vision loss because the country that like we can of course.

00:22:09: They also have much more high blood pressure untreated high-blood pressure i should add because it's treated then its fine for the time being, treat and prevent a lot of it due to our health care system.

00:22:31: And that's obviously not the case in developing countries, right?

00:22:36: Yeah interesting

00:22:38: but now we want to gradually dive into all these topics and see what is actionable for your own everyday life.

00:22:46: let's say... It makes total sense.

00:22:49: just start off with the whole topic of metabolism.

00:22:52: so blood pressure, blood lipids

00:22:57: Yeah, so in the end We've already touched on it.

00:23:01: but blood pressure.

00:23:02: So I mean everything that is somehow I'd say related to vascular health.

00:23:07: That means blood pressure cholesterol Insulin sugar actually all have a relatively relevant impact on on Vascular Health.

00:23:17: and The problem we have of course Is that?

00:23:20: In the brain the vessels are sometimes extremely small right It's a bit like with the heart.

00:23:25: they have an extremely important job But they're also extremely small and we also have tissue that once it dies, It can't be regenerated.

00:23:34: So if I have...I don't know something in the liver That dies then that can regenerate relatively well And the lungs actually relatively well too.

00:23:41: but when it comes to To the heart or even the brain If Something goes wrong Once Then its unfortunately broken right?

00:23:49: And thats why people talk about.

00:23:52: You often hear About there's a heart attack There is a brain infarction which Is a stroke.

00:23:56: That just means that yeah, the supply gets worse.

00:23:59: right and The problem is of course or not Of course.

00:24:02: The problem can be that in old age these small vessels that there are micro infarctions.

00:24:08: It's not necessarily that you have a stroke Or anything?

00:24:10: Right but it can Be that they slowly step-by-step keep dying off.

00:24:14: that means that this apply to the brain gets worse And worst over time.

00:24:17: that's called vascular dementia.

00:24:19: That's actually extremely common.

00:24:21: pretty much every old person has it right comes with age a bit and that is of course triggered by it.

00:24:29: And the worse off you are, the more its triggered!

00:24:31: The same as true for Alzheimer's for example... ...the supply gets worst & waste removal gets worse.

00:24:37: So all these things simply flow together right?

00:24:40: That´s why These very relevant levers can reduce our risk of dementia.

00:24:47: That means keeping blood pressure at good level Keeping ApoB-LDL keeping insulin and sugar healthy, not becoming pre-diabetic or diabetic.

00:24:58: These are all really big risk factors that you can actually stop super easily... ...and where you don't have to worry too much about it.

00:25:06: if you just measure once or simply regularly right?

00:25:09: Then um You can't go wrong because you measure!

00:25:13: You know where you stand And then the recommendation is always the same anyway.

00:25:16: That's why I find it very rewarding and that surely covers a large percentage, but you can certainly comment on this again.

00:25:25: Yes absolutely!

00:25:26: Blood pressure is sometimes a bit of shame when people only think about measuring their blood pressure too late.

00:25:32: instead they just buy a blood-pressure monitor at thirty which won't ruin anyone financially.

00:25:37: You probably don't even have to buy one.

00:25:38: Maybe there are still ones lying around in your parents' or grandparents place.

00:25:42: These these old devices, they're indestructible.

00:25:44: Right?

00:25:44: They sometimes last twenty thirty years.

00:25:46: if you remember to change the batteries and then You can measure it And maybe make a little log every year saying I'm going to go ahead for seven days now and Measure my blood pressure in the morning at noon and in the evening always At the same time right.

00:26:01: and Then in the end you have seven times three which is twenty one values.

00:26:05: and If out of these twenty-one values five or six are simply elevated at a certain Time Finding that you recorded yourself go to the doctor and have it checked out, right?

00:26:17: Then you might look at what is the daily profile actually like.

00:26:20: because with blood pressure.

00:26:22: It's similar to blood sugar.

00:26:24: It's not just bad to have constantly high blood pressure.

00:26:27: I mean we say one hundred twenty over eighty is a great blood pressure.

00:26:30: Lately it's more like one hundred ten over eighty or one hundred Ten over seventy five.

00:26:35: And you can if you have normal high blood Pressure.

00:26:37: now You actually have elevated blood pressure all day long For example, one hundred forty over one hundred or one hundred fourty over ninety.

00:26:45: Right?

00:26:46: You would definitely have high blood pressure and it's not only that That's bad but also if you have very high variability right.

00:26:53: so If your body has spikes like that several times a day So normally the baseline when you measure in the morning And then the evening might be totally normal.

00:27:03: But if you then have spikes five Or six times during The Day where Your Blood Pressure Rises Relatively Sharply then it's just as bad.

00:27:12: Just like with blood sugar, right?

00:27:13: They say that if your blood sugar is high all the time but also you constantly have these spikes where the pancreas is really squeezed to produce insulin in the

00:27:23: end The average is what actually matters Especially those blood pressure spikes.

00:27:28: they can of course be related to stress for example.

00:27:32: It's a very common reason.

00:27:34: In certain phases we suddenly have high blood pressure Like a sharp increase.

00:27:38: that isn't really physiological, but just happens because you're stressed by something.

00:27:41: You can process very well and um That's of course a very difficult to capture Something like that?

00:27:47: You have to be honest about it.

00:27:48: It is bigger problem Because we need to measure during those phases To actually prove it.

00:27:53: And thats where I'd say the health care system often fails.

00:27:58: When your at doctors you might not in this situation At exact moment Then they cant see anything.

00:28:04: Thats why usually give you log sheet and write down And ideally you catch those phases, right?

00:28:09: That's the idea behind it.

00:28:11: Yeah I

00:28:11: mean You can also notice that some people with very high blood pressure Notice a ringing in their ears or they get headaches.

00:28:18: So if someone has that like constant ringing In their ears during the day and i don't mean tinnitus But its definitely on both sides then Or unexplained headaches quite regularly For example Very strong redness Like here at cheek area Which goes away again.

00:28:35: Those are all signs where you might want to consider whether you have blood pressure spikes during the day.

00:28:42: If you notice that, just take your blood pressure monitor with or wherever it is on-the-go and if I feel this ringing in my ears right now then quickly measure your blood Pressure.

00:28:52: You may get a handle of it but sure... It's obviously much harder to diagnose than classic high Blood Pressure Exactly, so those are basic things you should check.

00:29:03: You can measure your blood lipids and blood sugar levels.

00:29:07: We've already done separate episodes on each of them.

00:29:10: Listen or look back there to see which values are particularly interesting.

00:29:15: Another point is sleep.

00:29:17: we have touched on that.

00:29:19: Sleep is important because especially in the deep sleep phase which is why it's also interesting to have a wearable that tracks how long deep sleep actually is, what percentage is REM sleep?

00:29:30: How much is just light sleep for example.

00:29:32: During deep sleep the brain flushes out all these waste products and they are then transported away via the glymphatic system not lymphatic but with a G-glymphactic system.

00:29:44: if you get little or almost no deep sleep And there many different reasons This clearance can't take place.

00:29:51: And if you do that over years and decades, then You will have a significantly higher risk not only for dementia but also for many other diseases right?

00:30:00: Cognitive performance also declines.

00:30:03: at some point.

00:30:04: you can get into a range called mild cognitive impairment or MCI For short where you don't have dementia yet But you're still not as cognitively capable and That would already be measurable in that case.

00:30:18: I find that very interesting because they've looked at it in studies, also comparative studies.

00:30:26: They had two groups one with people with normal sleep and the other with under-sleep deprivation.

00:30:31: so those who slept significantly less than six hours for example In the people of normal sleep found more amyloid beta and tau in their blood.

00:30:42: Now you might think huh?

00:30:44: Wait!

00:30:44: That makes no sense.

00:30:48: But the fact that you can measure it in the blood means... ...that the brain has flushed out and actually be broken down by the body.

00:30:56: In sleep-deprived people, they found less amyloid and tau in their blood.

00:31:00: That means it tended to remain in the brain and accumulate accordingly.

00:31:06: You should keep an eye on this also because many say as I get older.. ..I don't need much sleep anyway!

00:31:14: There was also, I think very interesting data on that because between fifty and sixty...I know many people between fifty-and-sixty who say yeah well five hours a night.

00:31:22: That's actually enough for me.

00:31:23: i don't need more People between fifty & sixty who slept less than six hours versus people who slept normal seven hours Also had a thirty percent increased risk of dementia Mainly because this clearance right?

00:31:36: Because generally shorter sleep also means generally shorted deep sleep phases.

00:31:41: That's directly yeah, directly connected.

00:31:44: Yes

00:31:45: You know people who say they're happy with five hours of sleep

00:31:47: Happy with a five hours asleep and Five-and-a-half hours of Sleep or They already have a very shifted rhythm right because maybe they also do shift work.

00:31:57: in that sense That's already a risk factor in itself.

00:32:00: anyway.

00:32:00: I think that's just how it is Right?

00:32:02: That's obvious.

00:32:03: i think okay.

00:32:04: on top Of that this greatly

00:32:06: Okay.

00:32:07: But yes these sleep times there are relevant And as I said Considering that people generally assume a decreased need for sleep with age, That's not necessarily the case.

00:32:17: So you should definitely get your deep-sleep phases.

00:32:20: We also talked about sleep apnea in The episode on breath work and IHT.

00:32:27: so those are People who have breathing pauses during the night

00:32:32: Okay?

00:32:33: On top of that

00:32:34: they can occur twenty thirty times an hour And you wake up accordingly Which of course immediately disrupts your entire sleep cycle.

00:32:42: There's practically no deep-sleep left because you have these waking phases so often which You sometimes don't even remember in the morning

00:32:48: exactly.

00:32:48: it's not Not real waking up, but rather just a like a brief unconscious waking upright Because the body is exposed to stress.

00:32:55: that's definitely important dimension.

00:32:57: Yeah.

00:32:58: So in that sense if you're a person I mean If you snore if you feel like you're extremely tired during the day inexplicably Even though you get enough sleep Then maybe go to a sleep lab.

00:33:10: They'll look into it there in any case.

00:33:13: not good for dementia and anyway, Not Good at all for metabolism.

00:33:17: And four the whole circulatory system.

00:33:19: keep that in mind A bit.

00:33:20: then The next point is stress and Stress has a lot To do with the hippocampus Which functions much worse when cortisol Is constantly high like With you?

00:33:32: For example You would say exactly

00:33:34: I don't even know if It's Constantly High.

00:33:36: i can't really judge That right but i mean It's definitely a very, so what certainly an advantage is that I constantly have new things to deal with.

00:33:46: On the one hand and on the other hand...

00:33:48: You mean maybe

00:33:49: it levels out somehow?

00:33:50: And its fine anyway but of course has pros & cons everything right.

00:33:56: you always have challenges But my cortisol was not ideal.

00:34:02: i had also done various metabolomic profiles before.

00:34:06: I've also measured my cortisol before, although that's always a bit difficult because it has to be at the right time of day.

00:34:10: So there is already slight adrenal fatigue in case simply that can't produce so well anymore... ...so i might even BE someone for whom the cortisol was actually too low by now as the adrenal gland cannot keep up any more.

00:34:24: That means maybe don't have this risk factor yet but still relevant point!

00:34:33: Because the hippocampus somehow I'll say regulates memory.

00:34:37: It's of course super clear that this then also causes us problems when the cortisol attacks it, right?

00:34:41: That means hippocampus.

00:34:44: you definitely don't want to have a quick decline there.

00:34:47: You actually want to stay as stable as possible so that you can also remember things clearly and stringently tell stories Participate in conversations.

00:34:57: that just doesn't work.

00:34:58: if that doesn't function properly anymore.

00:35:02: And I'm not sure if there's anyone who really has high cortisol their entire life, because at some point that would suggest the kidney will also fail.

00:35:12: But they can certainly still be an elevated average of that.

00:35:17: and it is definitely another appeal you have to deal with stress management.

00:35:22: so even someone who has a very stressful daily life actually says stress is only self-made right?

00:35:31: It is nothing which you cannot influence But it is indeed like that, right?

00:35:38: And in the end.

00:35:39: It's actually just a way of looking at daily life Right

00:35:42: totally totally its one hundred percent out.

00:35:44: you have

00:35:44: the wildest daily life.

00:35:45: if You let say embrace it as they would say now write and say hey I think this is awesome i'm totally happy with it then de facto Its not stress anymore right and I think That something you Just Have to learn In The course Of Life As part of Your Personal Development At Some Point and Get Better and better at Then It'S Not Such A Big Deal Anymore.

00:36:04: But to assume that stress is just something thats part of it, I think its already a problem and should definitely not be lived in this way.

00:36:11: Thats also something you should change if your thinking like that right?

00:36:15: That's definitely unhealthy.

00:36:16: There

00:36:18: are so many people who get worked up over such small issues And thats the prime example because they react completely differently And that's why stress is to a certain extent also something you let get to, or just don't Let Get To You.

00:36:39: It's not to say That you shouldn't care about anything.

00:36:41: that's Not healthy either.

00:36:42: it does make sense to deal with problems and then Also solve them but like A Certain view of the world and um...That's also Something you Partly Inherit But partly also acquire over time also based on your environment.

00:36:55: I think that's something Where you can definitely start right?

00:36:57: Because that does something to you and it makes daily life so much more pleasant, when you just don't expose yourself to this stress.

00:37:05: And say well... It is what it is right?

00:37:07: I can change now then its fine too!

00:37:09: Then also sleep better.

00:37:11: The second point is relaxation.

00:37:14: So even if your are still exposed to stress You cant completely avoid that anyway.

00:37:19: Relaxation is also trainable.

00:37:21: The best example of that is breathwork or breathing techniques, which actually cost nothing at all.

00:37:27: Which everyone can incorporate a little bit into their daily life.

00:37:29: we even had that in the last well in the breath work episode.

00:37:32: I don't remember exactly when it came out but It also has positive effect on blood pressure Blood pressure right?

00:37:38: That's super exciting too where you see again.

00:37:40: okay its somehow connected Right

00:37:44: Exactly!

00:37:46: Next point besides the topic of stress is logically exercise.

00:37:52: Classic training is good for dementia.

00:37:55: A high VO two max, it's good for Dementia.

00:37:59: There's even a tendency for strength training to be a bit better for dementia than endurance Training if you compare them directly.

00:38:06: But I would always advise everyone please find a good happy medium right.

00:38:10: so It's also not.

00:38:12: i mean people are certainly healthier Also over longer period of time who incorporate both maybe also with age focus more on Strength training because you lose muscle mass much faster there.

00:38:23: but otherwise just a good mix.

00:38:26: that yeah it's just massive risk reduction.

00:38:29: to back this up with numbers.

00:38:31: There were various large studies I don't want go into too much detail now, you have between thirty and fifty percent in dementia if your simply fit?

00:38:41: And i dont mean anyone who nobody has completed triathlon or even do half-triathlon.

00:38:49: This regular strength training, this building of muscle because in a figurative sense we say so often.

00:38:57: Muscle is metabolically active right?

00:39:00: Because it's like a sponge that metabolizes sugar, that metabolises fatty acids.

00:39:05: That means its just good for the metabolism in general both for blood lipid levels and for blood sugar.

00:39:12: In that respect It also has carry over effect on vascular health.

00:39:16: Thats why it makes total sense.

00:39:19: Maybe another exciting biomarker that you can theoretically also measure in the blood.

00:39:23: That's brain-derived neurotrophic factor, so BDNF for short.

00:39:27: as I said You can also measure it in the Blood.

00:39:30: It's actually not that meaningful because there is a normal range and Theoretically you want to have as high a brain derived Neurotrophic Factor As possible.

00:39:39: So Actually maybe even A bit above the Normal Range.

00:39:41: But you Have To be able to Tell Things Apart Because Stress Also Increases bdnf right?

00:39:48: but if I'm actually totally stressed out all the time, i think to myself ah great yeah my brain is totally adaptable because this value or this biomarker it reflects to a certain extent how plastic...or how neuroplastic your brain is right?

00:40:03: so the more plastic the brain..the better it can adapt to new situations.

00:40:07: The better you find your way in new environments!

00:40:10: So you're just much more-I'll say cognitively or mentally flexible.

00:40:13: that's why you want to have as much of this BDNF possible.

00:40:17: But as I said, too much of it can also simply be triggered by stress because that two is something that demands constant adaptability from the body but just to an overwhelming degree.

00:40:28: Have you ever measured?

00:40:28: I

00:40:29: measured once and it was actually too high.

00:40:32: so... Of course i looked into it!

00:40:34: And then it said that could also be stress-related Hyperintelligence

00:40:37: or Stress

00:40:38: Or hyperadaptibility..but It has very little to do with intelligence.

00:40:43: As I said ,it can also be stressed mediated.

00:40:46: I mean, my whoop traditionally doesn't show me that much stress.

00:40:50: But yeah, i definitely found it interesting and only measured at once And now not really

00:40:54: well.

00:40:55: then It also has little impact right?

00:40:56: What do you do with it?

00:40:57: Right

00:40:58: exactly so That's why its Also just a biomarker.

00:41:00: thats So-so.

00:41:01: Its Not Really A Real Biomarker Its Just The Value You Can Measure With Limited Added Value I'd Say!

00:41:07: SO YOU SHOULD DEFINITELY NOT FORGET TRAINING As I Said A Good Happy Medium.

00:41:12: There Isn'T That One Dementia Training Plan where you can say that's if you train like this, then you have the lowest risk of dementia.

00:41:20: It's just about a basic fitness that you should have Just pushing the body to its limits every now and then building muscle mass And simply making sure That the tissue in The Body Can Then Better Handle What You Take In Through Your Diet?

00:41:47: Here we're obviously going to preach the whole standard stuff again, but there is of course an impact.

00:41:53: There right so We have the classic Mediterranean diet which we've talked about a lot.

00:41:58: by that?

00:41:58: We don't mean eating spaghetti and eating pizza.

00:42:01: No

00:42:02: even though it tastes very delicious Of course

00:42:04: It's the classic things.

00:42:05: its generally quite rich in vegetables And everything quiet fresh and maybe some fish too right

00:42:13: healthy fats olive oil

00:42:15: Exactly, olive oil is a very good example of course.

00:42:17: Very classic yes.

00:42:18: so That has a very strong impact.

00:42:23: They also measured this once that in an observational study.

00:42:26: This apparently led to a brain that was on average seven and a half years younger right?

00:42:31: when you compared people who On the one hand ate a Mediterranean diet And those who didn't eat a Mediterranean Diet?

00:42:37: That means, of course it makes sense just like exercise that this pays off.

00:42:49: And that in turn also pays for the biomarkers we mentioned a bit at the beginning right?

00:42:53: If you follow this diet then most likely won't get diabetes or any major cholesterol problems either and so on.

00:43:01: It's all connected as always.

00:43:02: What else is quite interesting is omega-three but The reality is that effects weren't exactly earth shattering But we do know that it tends to have positive effects on vascular health.

00:43:16: The effects are in any case smaller, right?

00:43:21: That means you can use it to your advantage but its not the same as really consistently eating well overall.

00:43:27: Getting enough omega-three fatty acids is just a very small part of diet and not foundation.

00:43:33: You cant drink white food all day.

00:43:36: now.

00:43:36: I've named brand some drinks like this Omega-three fatty acids and then the matter is settled, right?

00:43:45: So unfortunately it doesn't work that way.

00:43:47: But you of course also have to make sure overall That the diet is somehow fresh and fits together And that you don't consume everything processed Otherwise.

00:43:57: we also listed creatine which is another quite interesting factor because recently Quite a lot of data has also come out regarding memory performance.

00:44:08: So that could definitely still be a very, very interesting topic.

00:44:10: whether That's really enough to send their trap and then nothing was to be seen.

00:44:14: There is mine hood.

00:44:14: after recently quite A lot of data has also come out regarding memory performance.

00:44:20: so that Could Definitely Still Be a Very Very Interesting Topic.

00:44:23: Where how the they're Mathemery Ants To Hand?

00:44:25: They're All Against That Inlas Would Be Sowing With Meat.

00:44:27: Esk Nisabh Netta Was The Protosin Protosing.

00:44:29: He Stated to be Tratization in your Aids or Unhidden and Immettishly Aided to Your Gramps.

00:44:34: Trust Madame for Dood Down on Inday.

00:44:36: And it's very wrong to say I'm having no idea.

00:44:38: To say you're distressing plans and engine is not being like a finest,

00:44:42: You can't really see in young this.

00:44:44: now Melphibs that come into studying some processing studies on the very, it's actually very recent there.

00:44:48: in taxclips they were all TvT are doing running RCT or nicely derive something right?

00:44:53: That's why we might have to remain cautious.

00:44:55: I found another really exciting nugget was homocysteine at a single episode of The Episodic.

00:45:01: so what does homocystine basically like so super important for methylation cycles in the body.

00:45:07: And when homocysteine is high, then it's also a measure of vascular inflammation.

00:45:15: that means high homocystines or in the end poor vascular health.

00:45:18: to put it simply.

00:45:19: you can summarize it right?

00:45:21: Especially if over long period time ensures vessels deteriorate disproportionately fast And that, of course also fits very well with dementia especially through this vascular arm because it's very high.

00:45:35: so an elevated homocysteine is linked to dementia and brain shrinkage.

00:45:41: Brain shrinkages in a way are always part of dementia right?

00:45:44: Because if the supply is no longer right then the brain atrophies which means they get smaller and the brain mass itself decreases.

00:45:51: The threshold value there was thirteen micromoles per liter, we also talked about it in the episode.

00:45:56: Ideally you have a value of under eight and the threshold here is thirteen if with your value under thirteen micromoles on entities per litre.

00:46:08: so for homocysteine you had around fifty three percent slower shrinkage.

00:46:12: So already relatively impressive right?

00:46:15: Although would say twelve actually still too high.

00:46:19: Ideally, you are just under eight.

00:46:21: But equally there are people who are over twenty right?

00:46:25: There I would already ring a very loud alarm bell but otherwise yes that fits together quite well and should also be taken into account.

00:46:31: if the homocysteine is too high then there are few different options You have.

00:46:34: on one hand it's B vitamins which Is why you can Have your b status co-determined.

00:46:39: If The B vitamins Are fine anyway That's probably not the big Lever in relation to Homocystein Then They're still TMG right?

00:46:47: So trimethylglycine, because that is also a methyl group donor.

00:46:50: And in that respect then good again for the homocysteine metabolism to lower it.

00:46:55: Yes basically of course an elevated homocystine can also doesn't always have to be a deficiency Right?

00:47:00: It kind Of Course.

00:47:01: Also Just Be Dietary Be The Diet That Doesn'T Quite Fit Together Like A Lot Of Beer Or Whatever Which?

00:47:07: so Many Things That Just Contribute To Vascular Inflammation Increasing And that is sometimes super difficult to grasp what it's really down too in the end, or whether it's down to the overall situation.

00:47:17: Right?

00:47:17: But often you can keep it relatively well and check with betaine or TMG and the vitamin B supplements right but its not necessarily a basic mechanism.

00:47:29: thats why its high.

00:47:31: The

00:47:33: next factor also plays an important role And in Japan is actually the number one factor, or the num-the number one modifiable factor for dementia.

00:47:45: Is actually hearing loss?

00:47:47: You wouldn't think so but japan also has a very heavily aging population Even moreso than we have here in european countries and Hearing loss is of course Also simply a problem of age?

00:48:00: That will I Think become a much stronger problem In the future since headphones exist.

00:48:06: right You wouldn't think so, but Japan also has a very heavily aging population even moreso than we have here in European countries.

00:48:15: And hearing loss is of course also simply a problem of age and that will I think become a much stronger problem in the future since headphones exist right?

00:48:24: Because people listen to music incredibly loud and otherwise just discos and so on and so forth.

00:48:28: So if you go into disco again now your always totally shocked how incredibly or in club how incredibly loud it is Right!

00:48:34: And you notice it yourself when your exposed to noise like that for a long time, then you walk out of the room or building whatever.

00:48:42: Disco?

00:48:43: Yes!

00:48:44: You really noticed that you're a bit deeper right That's only temporary... When you sleep next day after twelve-to twenty four hours It gets better again than hearing adapts to it.

00:48:53: but if you have that permanently Of course and thats not good for hair cells in ear Then the hearing also get worse.

00:49:00: So hearing loss is just super important Because from the moment you can no longer hear well, You cannot participate in conversations.

00:49:08: You not only have less social participation but also less sensory input for brain.

00:49:12: and less sensory inputs is always super bad.

00:49:15: that's why vision loss is so bad because vision loss seeing worse ensures it gets less sensory stimulation In this case its visual cortex.

00:49:25: In the other, so with hearing it's... The auditory area in the brain where simply less input arrives then its not used as much and also starts to atrophy.

00:49:35: And starting from these areas those are sensory stimuli So input stimuli into the brain.

00:49:40: Then in turn less processing takes place.

00:49:44: If I don't hear an opinion than the brain can't deal with either.

00:49:48: What i might make of my opinion myself now.

00:49:51: That's why you should definitely think about a hearing aid as early as possible.

00:49:54: And above all, don't buy a hearing aids straight away but do a hearing test at thirty forty fifty.

00:50:01: Definitely Think About that.

00:50:02: maybe every five years.

00:50:03: with most Hearing Aider Custitions out there thats even free

00:50:07: Exactly!

00:50:07: Thats the upsell The Hearing Aid is At the end of it.

00:50:10: But no whats also really cool Is that You can now I think With the latest generation Of AirPods Pro From Apple.

00:50:16: So i've just made Unpaid Advertising Here Again Crap.

00:50:20: Anyway, I thought it was really cool because i got them last year At some point.

00:50:25: maybe newer ones are out now in any case.

00:50:27: I bought them last if I remember correctly and You can also do a hearing test with the minute actually works very Very well And you also get a really good evaluation afterwards?

00:50:36: That wasn't really far from what we did at years so It's actually quite close.

00:50:40: I compared recently and but it was somehow Also quite cool Because I have that thing at home don't need to go anywhere.

00:50:46: then I could myself every few years.

00:50:48: All you have to remember is do it.

00:50:50: But de facto, there are enough tools also like that which some might already have in everyday life... ...to try out.

00:50:56: and I think you can't plead enough for definitely getting older people to wear a hearing aid.

00:51:04: And i know from the experience of my grandparents what a struggle sometimes is because first adjustment phase is terrible.

00:51:14: So I can totally understand that when you suddenly have this thing in your ear all the time, it's really uncomfortable.

00:51:18: Then you have it in all day right?

00:51:20: That is also hygiene wise something to get used too purely for cleanliness of the ear canal but its extremely important and makes a huge difference how long these people can participate in everyday life And be part of conversations really very, very important and definitely stick with it even if they resist because many do or I'd say at least half-resist.

00:51:49: Yes totally so.

00:51:50: i know that from my grandmother who was also took a lot of convincing until we just drove there with her bought a hearing aid.

00:51:59: then she sat at home afterwards and said... Then she sat like this.. And yes what is it?

00:52:06: She said yes its unbelievable!

00:52:07: She can hear herself breathing again.

00:52:10: So when you sit here like this, and you breathe in an out.

00:52:13: Then you perceive that yourself right?

00:52:16: And that was obviously already so bad that it's no longer possible In that respect.

00:52:21: hearing aid of course high time.

00:52:24: That is then also nice to see She likes to wear accordingly Because that was also crazy Step.

00:52:32: You can't estimate that in advance because hearing doesn't get worse suddenly but very slowly.

00:52:37: It means just getting used too much.

00:52:41: Yes, when you still heard everything.

00:52:42: That's the comparison factor that's missing exactly.

00:52:46: What else is a classic topic for aging?

00:52:48: Social isolation right.

00:52:50: I already mentioned that at the beginning and there i find it exciting that Isolation does not equal loneliness.

00:52:56: Right because just Because A person is Alone or Lives alone Or is Alone in Old Age And Maybe no longer has A partner or Never had One.

00:53:03: that Doesn't necessarily Mean That The Person Feels Loneliness.

00:53:09: Some can also occupy themselves totally well.

00:53:12: Also like to do that, maybe you'll need a bit more me time in quotation marks.

00:53:16: then it's all so fine and is not risk factor for dementia but only the other way around.

00:53:22: if your are really alone But you will simply wish this social contact right?

00:53:27: Then becomes yes problem The nice thing about finding out of loneliness again.

00:53:35: Yes The risk decreases again, so that is actually a reversible risk factor.

00:53:42: That's why definitely also I'll say now an appeal if that Is important to someone?

00:53:47: To also take care of in A way as social network and always make sure you have people with whom You can exchange ideas no matter whether it's family or friends Or whether then go to some In cities easier to public events or senior events.

00:54:01: but As i said thats age independent problem.

00:54:05: even If your are lonely at twenty its not good Because then it is above all over a much, much longer period of time.

00:54:11: Just think about that bit and build up a few nice social routines.

00:54:14: That's definitely worth it.

00:54:15: Okay

00:54:16: Yes You definitely tend to neglect It right?

00:54:18: Definitely yes especially nowadays Right through Social media And so on & So forth.

00:54:23: you still have the feeling Of catching everything.

00:54:24: that wasn't The case in the past.

00:54:26: if you weren't somewhere Then you didn't catch it.

00:54:29: Nowadays you Still catch Everything but you just don't really Have this social participation anymore because It's not the same to write on Instagram as it is, sit with someone in that room and talk about a few topics where there are facial expressions or gestures.

00:54:45: To be able read these social cues.

00:54:50: then cognitive reserve.

00:54:52: we already fully anticipated when said education such an important factor especially early education.

00:55:02: And when it comes to the topic of cognitive reserve, It's very important to engage with new topics.

00:55:07: So really doing something completely different learning an instrument Learning a language learning and use sport getting into I don't know plants Getting hunting license fishing license all possibilities that you can use.

00:55:23: Of course hobbies are always expensive but not all hobbies Are equally expensive.

00:55:28: That is why You should just maintain this routine Always engaging with new topics no matter how old you are and not saying oh, we've always done it this way And that's how it's always been.

00:55:40: That's Not only tedious for the younger generation but It's also bad For your own future from a health perspective in that You're more likely to get dementia More likely to Get cognitive impairment.

00:55:54: This is The point where the longevity guitar and the longevity piano come onto the market because because it's finally time that you can also market that as a health product.

00:56:04: Yeah, but then it costs three times as much.

00:56:06: is normal guitar?

00:56:08: Because It's a longevity guitar.

00:56:09: know

00:56:09: that would have to measure your cognitive currents in the meantime or

00:56:13: definitely also your pulse right.

00:56:15: every key Then Also has a measuring device at The same Time.

00:56:19: That

00:56:19: Is Definitely so.

00:56:21: whoever wants To do that I Would love to be the investor.

00:56:26: That will definitely be huge.

00:56:27: Yeah,

00:56:28: we definitely have to do a separate podcast on that then?

00:56:30: Yes

00:56:30: very important

00:56:31: exactly.

00:56:32: just a tiny nugget regarding multilingualism.

00:56:35: people who are multi lingual get dementia On average four two five years later than People Who Are Not Multilingual.

00:56:44: Multi-lingualism

00:56:45: Starts at Two Languages There.

00:56:46: yes Exactly so.

00:56:49: We Definitely Already Have A Protective Factor there.

00:56:51: I also Speak German and English a bit of Italian And a Tiny Bit Of Norwegian.

00:56:55: Can we still count Italian for you?

00:56:57: Yeah.

00:56:57: Of course it's not used that much anymore, right because even South Tyrolian speak German better than Italian.

00:57:02: I come from there... From near the border but still on the Austrian side and yeah That's why It is of course more a school topic where you mainly learn it But in everyday life its' not really use that much!

00:57:14: But i would be able to have normal conversation.. I'm actually relatively sure about that.

00:57:17: So no thats good.

00:57:19: so i learned French Spanish at school Could have a proper conversation.

00:57:25: Well,

00:57:26: yeah but one or two weeks is still good right?

00:57:28: So it's significantly less than if you have to learn the language completely from scratch.

00:57:33: in any case The call to engage with such topics.

00:57:35: I think there's nothing nicer then when people speak different languages Or maybe play an instrument.

00:57:40: i am unfortunately Yeah not particularly musical But I did play the recorder once.

00:57:46: all awesome

00:57:47: that contributes to it.

00:57:49: One last topic.

00:57:50: It's I mean its totally logical alcohol.

00:57:53: There is no brain healthy amount of alcohol.

00:57:56: That's why this is probably already the thirty-fourth episode where I'm saying, but please stop drinking alcohol.

00:58:01: every drop is bad for the brain and also bad for dementia.

00:58:05: It's the same with smoking.

00:58:06: there are also not a lot of healthy cigarettes that it best to just leave out too.

00:58:11: What you should avoid is head injuries Because that is also a choir.

00:58:16: not responsible for all head injuries yourself because if I have.

00:58:21: A car accident now, That isn't my fault and i still get a traumatic brain injury then you can help it.

00:58:27: but when It comes to the topic of head protection in sports especially You Can do something about it right?

00:58:33: I

00:58:34: Have one more critical question namely If we talk About alcohol again i mean that's obviously bad.

00:58:40: so i agree with you there Of course And that its always a toxin.

00:58:44: The question is of course if I'm someone who finds it hard to interact socially, i just sit at home way too much and alcohol helps me get out my shell start talking with people.

00:58:57: Can't be okay then?

00:59:00: To go out every two weeks have a drink?

00:59:03: the question what's worse than complete social isolation or the alcohol consumption?

00:59:11: So you're practically assuming that alcohol is the prerequisite for having friends or?

00:59:16: No, it's.

00:59:17: I'm not speaking from myself.

00:59:18: I am luckily so i don't have a problem but could imagine its difficult to find some people like this.

00:59:25: That certainly exists right.

00:59:29: and now if helps these people get out of their shell even with just one or two beers in everyday life Yeah, just generally get into conversations with different people because of it.

00:59:43: It is like that right?

00:59:44: So even if the two of us drink alcohol we will definitely get in to conversation with more people than If We Hadn't Drunk Any Right!

00:59:50: so this effect you get disinhibited and venture out And The Question Is Of Course What Is Worse

00:59:55: Right?!

00:59:57: yeah its really hard To Say.

00:59:58: I mean if You Wanted To Be Ignorant You Could Say Well Then You Just Have To Work On Yourself Because Also Social Competence Is also Something That Many People Already have.

01:00:08: But it's also something you can learn that you can train, right?

01:00:12: You can also expose yourself to the situation.

01:00:16: For example in psychology studies we once went through this... That is incognitive behavioral therapy.

01:00:24: It's very in-to face these fears.

01:00:27: The same if I'm afraid of a spider Then i have to approach first with a plastic spider and put on my arm And see how i handle it.

01:00:36: And that if you have this social anxiety, You then for example go to the supermarket.

01:00:45: Go shopping and at checkout say forgot your wallet home.

01:00:50: That's a very embarrassing situation.

01:00:52: so I forget my wallet but leave all of it here.

01:00:59: Totally silly examples i'd say to tackle this topic of social anxiety.

01:01:06: Nobody gets hurt there, right?

01:01:08: Because I mean you leave the stuff.

01:01:10: that person behind might be a bit sad because they have to wait two minutes longer but yeah... That is also something you can train.

01:01:17: You should do it in case too whether at end The net benefit is greater To say.. I'll just drink alcohol every few weeks so i could get into conversations with people Instead of remaining socially isolated.

01:01:31: put it

01:01:31: this way.

01:01:31: Maybe It's the GLP one of social interaction.

01:01:35: so that means You take glp-one to lose weight faster To maybe get over the hump The alcohol and that's probably not necessarily always healthy either, right?

01:01:45: We just don't know for sure.

01:01:46: yet With alcohol we know that it's definitely unhealthy.

01:01:49: but in any case Yeah, it is an icebreaker.

01:01:54: But yeah, you're of course right.

01:01:55: So at the end of the day if your in this situation You should have cause ask yourself whether you shouldn't look for the fault on yourself anyway.

01:02:01: and And that's not meant negatively but rather than to work more on Yourself Yeah?

01:02:06: so Of Course Right.

01:02:06: It is Of Course That We Always Want To Solve The Fundamental Problems.

01:02:09: So You Are Of Course Absolutely Right.

01:02:12: I mean it depends If You Then If You're Out Three Times and You Drink Alcohol Three times then You Have Your Social Circle Than Its Probably Okay Right Then You Need

01:02:22: To Drink Alcohol.

01:02:23: That's of course another example, but if you then also meet up with the people regularly afterwards.

01:02:29: It's probably also just fine because I think the body can handle that.

01:02:32: But if you do that every weekend for sixty years it's probably not so smart right?

01:02:37: It's definitely not healthy.

01:02:38: Yeah

01:02:38: yeah Then it's the wrong social circle Mm-hmm.

01:02:42: Yeah good

01:02:43: That is a topic, and now we have to briefly talk about ApoE-IV because I also did the genetic test once.

01:02:48: I'm the same as you!

01:02:49: I also have Apo E-III twice so luckily no Alzheimer's risk gene.

01:02:54: What has to be said about this?

01:02:56: You always have two copies of each gene one from The Mother And One From The Father.

01:03:02: that means...that's why we say We Have Apo e-III Twice Because We Got The Apoe-III Once From The Mother & Once FromThe Father.

01:03:09: But There Is Also Apo-E-II and APOE-IV.

01:03:13: That means there are basically three different variants, APOe-II would be protective for dementia, APoE-III is neutral it's also the most common variant And APO EIV then again a risk allele.

01:03:28: If someone has APO eIV twice now Then The probability that you develop Alzheimer's dementia Is very high.

01:03:40: There is relatively new data from twenty-twenty four where this pathology, so these amyloid plaques.

01:03:47: These tau plaques and this progressive development can already be detected from the age of fifty five if you only have one apo E for allele then You would statistically speaking definitely also Have a higher risk.

01:04:01: but you can still tick off This list with these fourteen points.

01:04:05: I'd say That's my risk reduction, right?

01:04:10: If you only have one APOE-IV allele then you would statistically speaking definitely also have a higher risk.

01:04:18: but You can still tick off this list with these fourteen points.

01:04:21: I'd say and say okay.

01:04:22: that is My Risk Reduction.

01:04:24: Right because the fact that you have an APOe IV allele doesn't mean that you'll develop dementia sometime later.

01:04:30: It just increases the risk.

01:04:31: But the risk is dependent on very many other topics too.

01:04:35: If you then also drink alcohol and smoke, are socially isolated.

01:04:39: And don't engage with anything new than the probability You haven't lowered it but even increased it again right?

01:04:46: But yeah maybe APOE in general.

01:04:49: I think we both be of The opinion when We say It doesn't make sense for every person to measure or To measure their APOe status Right simply because For many people i Think its Also just a stressor.

01:05:00: Or how do you see that?

01:05:02: so to Say I'm doing a genetic test now.

01:05:04: Now, i want to know what my ApoE for status is.

01:05:08: then it can end up like with us that you have no risk allele Then your happy everything's fine but It Can just as well turn out okay?

01:05:15: I Have an Apo E four now Like That

01:05:19: yeah so i understand What do You mean.

01:05:21: So i think i wouldn't recommend it To everyone and its definitely also not a beginner biomarker that i would Just flat-out measure in Everyone Immediately.

01:05:31: Because Because you have because yeah, that's just it like fate already right?

01:05:34: So we can't change that anymore and That is of course a significant increase in risk.

01:05:39: And In that respect probably so I would prioritize.

01:05:42: okay always measure cholesterol levels anyway Always measure sugar level any way Those are all these real underlying mechanisms.

01:05:48: I can definitely do something about those.

01:05:50: anyway, and if i have let's say found my piece of mind with that already know okay?

01:05:54: My ideal is not a deal but i've adjusted it better now And so on.

01:05:56: So i've already dealt With the topic and have already had The first lets Say shockers or Not had them But in any case i've dealt with It very intensively.

01:06:02: Then you Can i think still add apoe for and say Okay Now i'll take A Very close look.

01:06:07: Do i maybe Have to adjust Myself even more aggressively pay Even Even closer attention to my health, let's say in comparison than then if I didn't have that right?

01:06:17: In the end It's actually just like a the icing on the cake.

01:06:19: That comes on top because in the end The basic fourteen risk factors they always remain the same Right and In that respect i don't know.

01:06:28: so as said If you're someone who generally Always has a bit of difficulty with that get stressed Because of different biomarkers Then I wouldn't necessarily add ApoE for because then You already Have enough levers To deal With anyway.

01:06:40: If you're someone now who has absolutely no problem with that, always rather sees the positive and says okay.

01:06:46: The more I know, the more can improve then definitely do it right away.

01:06:50: so i did it right way never stressed me wouldn't have stressed significantly neither.

01:06:54: if had head on top would've just known ok um...I have to pay even more attention to my ApoE cholesterol into a blood sugar than others.

01:07:02: but in end admittedly its like deal.

01:07:06: things you can change.

01:07:07: we already said this few times And that's just one of the things you actually can't change, right?

01:07:11: That's why they just changed your view.

01:07:13: Of these fourteen risk factors a bit and sharpen it again but nothing more.

01:07:19: Strictly speaking You actually have to say that whenever you get your own ApoE for tested.

01:07:26: Uh...you're Actually dragging two other people into It as well because if I had Apo E four then i know it comes either from my mom or From My dad.

01:07:35: Right, so one of the two must have it as well.

01:07:39: They don't have to be homozygous meaning having both alleles.

01:07:42: they could just have one.

01:07:44: But that's the implication.

01:07:45: So if you get this tested for yourself You always get information If you actually have it That one of your parents must have at too who in turn then also have an increased risk right?

01:07:55: Keep that in the back of your mind.

01:07:57: Yeah now we've actually gone through all the points really Well.

01:08:03: What we wanted to say with Today's episode was, I think that there are so many modifiable risk factors.

01:08:12: Yeah

01:08:12: everything we talked about today is modifiable and controllable right?

01:08:16: If i have poor vision...I go to the eye doctor get glasses.

01:08:19: if i have cataracts..i Get the cataract fixed!

01:08:21: If i Have poor hearing then i get a hearing aid

01:08:23: Right?!

01:08:24: If ive high blood lipids Then i lower the blood lipid.

01:08:26: Whether thats through diet or medication Is not beside point....If i have Poor Blood Sugar Levels then I make sure to get those blood sugar levels back into the normal range, and so on.

01:08:35: And that's all stuff where you can check off a box for yourself.

01:08:39: some things are easier to implement somewhere bit harder or even just getting your blood pressure checked right?

01:08:45: So go for regular checkups.

01:08:48: Just think about these topics.

01:08:51: It is worth it!

01:08:52: Not statistically worth but also in practice.

01:08:56: Because if you're being completely honest, a really long life which is what many people would actually like.

01:09:01: Is only worth it If your still fit enough in the head at end to enjoy that You can spend time with family and friends And so on.

01:09:10: That's why its definitely nice investment not just for health but also later quality of life especially For yourself But those around you.

01:09:19: A person who has dementia is usually not easy to manage In care situation either And that's why, yeah just keep it in mind and implement as much of is possible.

01:09:31: It's worth it!

01:09:31: Do you have a nice closing sentence?

01:09:34: Yeah no I don't really need to say anything else...I also thought was very nice now saying something anyway but then brought those around into because i think thats always the factor where many people dont take care themselves becuase they want please everyone somehow.

01:09:50: Then I think to myself if you don't take care of yourself, then that's actually even disrespectful To those around you because then you also become a burden right?

01:09:57: I mean That's actually the nobody really wants to be a burden.

01:10:00: Right.

01:10:01: and and i think Nobody ever wants to get into that situation.

01:10:05: And Then I Think to Myself If You Don't Take Care Of Yourself Than That'S Actually Even Disrespectful To Those Around You Because Then You Also Become A burden right.

01:10:13: I Mean That's Actually The Nobody Really Wants To Be a Burden Right.

01:10:17: and I think Nobody ever wants to get into that situation.

01:10:21: And I think, also always a really nice perspective even if it hurts at first.

01:10:24: But hey, you actually owe it to those.

01:10:26: If you don't do that just your responsible right?

01:10:28: And sounds harsh.

01:10:29: but that's how is because nobody around us taking care of when can think straight anymore even if many might still do it gladly be cause its mom or dad and so on.

01:10:38: I mean we dont mean at all.

01:10:40: You do anyway as i said always have a responsibility for yourself also others not only raising the child but ageing yourself.

01:10:47: At least take care of these modifiable risk factors in our own hands.

01:10:51: great start comes along, you just have no influence over that.

01:10:55: Right?

01:10:55: But you've made your own contribution and that's actually what this whole longevity movement is about let say right personal responsibility.

01:11:01: That's why uh yeah that of course starts relatively early in life.

01:11:04: Yeah sure exactly if you say so wonderful.

01:11:07: I hope you enjoyed the episode.

01:11:08: If there are any questions about it feel free to write an email To podcastatbrainlife.de or leave a comment on Spotify And YouTube.

01:11:15: if you think someone else could benefit from The Episode two please share It.

01:11:19: Leave us A review.

01:11:19: we're always especially happy About.

01:11:21: Otherwise, yeah.

01:11:22: Thanks Max!

01:11:23: Thank you guys for listening or watching and we're already looking forward to next time.

01:11:26: until then and bye.

01:11:27: thanks Mario Bye.