Begin Again with Davina McCall - The Brain Health Doctor: Do This To Reduce Your Risk Of Dementia!

Episode Date: July 24, 2025

In this episode of Begin Again, Davina sits down with Dr. Sabina Brennan, a leading neuroscientist and brain health expert, to explore how simple lifestyle changes can prevent dementia and enhance brain health. Drawing from her personal experience as a caregiver for her mother, alongside her deep scientific knowledge, Dr. Brennan reveals actionable strategies for boosting cognitive function, preventing dementia, and improving care for those living with it. Discover how brain health goes beyond genetics and learn practical steps you can take right now to safeguard your mind. Whether you're caring for a loved one with dementia or concerned about your own cognitive future, this episode offers powerful insights, practical tips, and inspiring stories of hope and transformation. – Follow me here: www.instagram.com/beginagain https://www.tiktok.com/@beginagainpod Dr Sabina Brennan: Linktree to various purchase points of Still Me - https://linktr.ee/stillmesabinabrennan  Sabina's website - www.sabinabrennan.ie  – (00:00) INTRO (00:01:08) Intro to Sabina and 'Still Me'(00:02:33) Brain Fog vs. Dementia and Ageism(00:09:16) The Science Behind Dementia(00:13:35) How You Can Prevent Dementia(00:15:03) How Knowledge Impacts Dementia Outcomes(00:15:45) How to Manifest & What It Really Means(00:18:14) 3 Lifestyle Changes to Prevent Symptoms of Dementia(00:27:39) Napping & the Importance of Sleep(00:32:50) Hearing Loss & Dementia(00:40:02) 12 Modifiable Risk Factors for Dementia(00:44:21) Supporting a Loved One with Dementia(00:49:38) Live Well While Caring for Someone with Dementia(00:49:38) Self-Care and Dementia Care(00:54:05) UTIs, Delirium, and Misunderstood Symptoms(00:59:25) Davina’s Final Message from Her Father(01:03:55) Back to 'Still Me' and Poem - Sponsored by: Airbnb - https://www.airbnb.co.uk/host Ancient + Brave - https://ancientandbrave.earth/pages/planet Learn more about your ad choices. Visit megaphone.fm/adchoices

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You are not powerless. You can have the disease in their brain and not manifest the symptoms. It's about understanding how your brain works so you can optimize your potential. You lost your mother to the dementia and I lost my father to Alzheimer's. The things that make the difference are lifestyle factors. The biggest one is close your eyes and think for a minute about that feeling that you get when you're really, really stressed. Now think about that feeling that you get when you're really, really excited. What's the difference?

That's exactly the same. Poorly managed chronic stress is where we end up in big trouble. But also, too little stress is not good for you. Schedule some fun every day into life. Dementia may steal many things, but they do not steal what makes life worth living for all of us. The ability to smell of rose, to feel the sun on your face. In music. To hug something.

Yes. I hate when people say, oh, Dad has dementia. He's gone. No, he's not gone. He's in there. You just have to work a little bit. bit harder to find him. The biggest piece of advice if I was to give anybody caring for someone with dementia is...

Dr. Sabina Brennan didn't disappoint. I think what she has gifted us all is a much greater understanding that we have power. We are not powerless when it comes to lifestyle changes and the influence that they can have on our risk of dementia and Alzheimer's. I always thought, oh, well, if it's genetic, it's genetic, what can you do about that? You can do a lot. And I learned so much. I thought I knew a lot already, but I learned so much from this chat, so I really hope you enjoy it.

So nice to have you here. So nice to be here. So nice to be here. So doctor. Yes. Love that. But call me Sabina. Would absolutely melt that.

So you're so impressive to me because I read that you'd left school at 16, went to work in insurance, then you got into acting, you did super well in acting, then you decided to go to university in your 40s, which for me is something that so many people, including myself, would love to do at some point in their lives. but you did it. And I want to talk to you about manifesting a little bit later and how we can make these things happen. You just make it happen.

Yeah, yeah, yeah. But it's really good to talk to you because I think still me, which is your latest book, is the book that you've been trying to write for years. I've got goosebumps even saying the words, still me. Makes me feel emotional just saying that. Me too. You lost your mother.

Yes. To dementia. and I lost my father to Alzheimer's. Yes. And this is the book, we wish we'd had. It is. Yeah, yeah, yeah. I did quickly want to touch on the idea of brain fog versus dementia,

because I went to the doctor when I first had menopausal brain fog, and I said to her, I think I've got the beginnings of dementia. Please, can you help me? because I was 43. I had to, I had no idea. I didn't know about perimenopause. I didn't know about menopause. I didn't.

I didn't know about anything. Yeah. And she said, no, you haven't got dementia, but she said, I think your inbox is full. Like, you've just got so much going on in your life. And then later, she said, actually, I think you might be perimenopausal. And then we start the journey. But it's quite frightening for a way. woman of midlife.

Oh, yes. It is. Yeah. One of the first things that women say to me is, just don't feel myself. Yes. And that's the brain fog, right? It is. It is because we are our patterns of behavior.

That's our personality. That's who we are, how we predictably behave. And because of the hormonal changes that occur in menopause, I mean, you have estrogen receptors throughout your brain. And we tend to think of estrogen as just being associated with reproduction, but it's not. It's associated with so many other things and important things that happen in your brain like neuroplasticity, neuroprotection, neurotransmission. It impacts on so many things. But brain fog can affect your memory function.

It can affect your processing speed. It can affect your language. It can even affect your spatial awareness. You're more likely to bump into things. it affects so many different aspects of who you are. And what I try to explain to people is that if you're someone like you or someone who is a quick-witted individual always first in with a funny retort after something, and your processing speed is affected by brain fog, it's going to take you longer to take that information in,

formulator response, and show them the moment's gone. you can't come in quick enough with that reply. Now, to other people, that will look like, oh, she's a bit off with me today. Yes. Do you know? So other people notice a change. And because we're human, we tend to give ourselves

that we're the reason someone's behavior has changed. Do you know what I mean? You kind of go, what did I do to her? She's normally funny and laughing. So that can be like a complete change. It can also be if you're in the workplace, someone who comes up with ideas, not able to do that,

planning, organisation. I mean, I know when I've had brain fog, and I've had brain fog numerous times for various reasons, I would say we going to Brussels and maybe for one night and it could take me two hours to pack my clothes because I couldn't decide, well, what's the weather going to be like?

Do I have to go out for dinner? What do I need to wear when... And that just was massive. It's ridiculous. But that's what I mean about, When you say people have problems planning or organizing or making decisions, they're thinking about things like, oh, deciding whether to have a mortgage or what. But you can open the fridge and look at it and go, yes.

I can't figure out what to have for dinner. And that's scary, that sense of losing yourself. But basically, when it comes to who you are, your brain actually just writes the story of you. It just you are, your sense of self is just a collection of information. that your brain has put together based on information, opinions of other people, information, that oftentimes, well, the reason the brain collects specific information is that it had some sort of salience at the time. It resonated emotionally with you or it meant something or you associated with feeling really good or really bad. And so your brain,

gets this message, this is important, we have to hold on to this, okay? What the brain doesn't do is assess the validity of that information. Yes. It doesn't assess whether it's true or not, but it goes into the story of you of who you are. And that is why that sends in menopause of feeling like you're losing yourself, it's awful. And I think it's probably one of those things that triggered my passion about ageism. And I am very passionate about ageism, and particularly how it's, you know, you know, visited on women.

You know, everywhere you go, if you go into a shop, it's like how not to look like me. Do you know what I mean? But it's kind of even more than that, and it speaks to things like dementia. You know, the care that is provided, the supports that are provided, they're not the same as those that are provided

to younger people who have cancer or various things. And I was talking to a journalist the other day who was interviewing me about, still me who is living the journey at the moment with her own mum and she was just saying to me, why is that? Why are there no supports?

I mean, we were just told mum had vascular dementia and that's it, go home. You know? I mean, if your husband had a tracheoctomy, you'd be shown how to change his dressing. I don't know if that was your experience with your dad, but you kind of are left.

She was just left, yeah. You just left with this really complex neurological condition that can be, it can be an enriching life experience, but it can be an incredibly stressful, challenging experience, and you can encounter some really challenging neuropsychiatric symptoms, and nobody tells you about it. Nobody gives you anything, which is why I am excited to have written that book. And that's actually really what transformed my life was while I was at university doing the research for, you know, you write your PhD thesis. And so I was reading all the academic papers about how the brain changes with age.

And, you know, I was, we were interested in, you know, whether we could find any predictors of, you know, what might show, say, when someone's 55, whether they might go on to dementia. You know, you're kind of trying to characterize how does it, how does it change? normally and then you know is there something that we can kind of um find out because there are genetic pointers aren't there that you can have yes so there's there is an allele um which is a genetic component and you can have one or two um allele's and you know the risk changes whether you have one or two but it's what's called in scientific terms neither necessary nor sufficient so that what What that means is the necessary part just means that you can have Alzheimer's disease without those. Without al-a-s, yeah.

And sufficient means just having that all-al doesn't mean you'll get to make this. So people have an alley. Interestingly, and this is what I think is exciting. The risk is so, so age is the biggest risk factor. Okay. It's a disease of later life. We can't change our chronological age. However, you kind of know you can kind of change your biological, your physiological age, your brain age in a way.

Right. So age is your biggest risk factor. There is no cure currently. There is a genetic risk, but it is small compared to the risk associated with modifiable risk factors. And I know you've had it. Right. Yes. This is huge.

This is so important for anybody listening or watching. Yes. Because I think there is a feeling of powerlessness around dementia and you are not powerless. You are not powerless. And this is, so basically when I was doing my PhD, which was in 2007, I'm coming across academic papers written in, now I didn't discover these academic papers. These academic papers are published in, you know, you know, really well-respected journals. But there's one of them.

And in 1986, there's a study by a guy called Katzmann. And he was interested at that time looking to see whether there was anything in the brain. that differed in someone with dementia and someone who had in dementia of the same age. So basically he was looking at slices of the brain, in people post-mortem, obviously, in a nursing home, I think they're kind of aged about 75, who had a diagnosis of Alzheimer's disease. Okay? And then his control group were also people of that age who had no diagnosis of Alzheimer's disease. And he's looking at slices of the brain to see what's the difference, what's going on. So this is 86, so it's early early, early,

on in kind of trying to understand. And he, in his control group, the people who don't have a diagnosis of dementia, he finds 10 cases of cognitively normal people, they're functioning perfectly normal, who have sufficient Alzheimer's disease pathology in their brain for a diagnosis of dementia. Oh, but they weren't showing signs. But they weren't showing signs of it. Fascinating. Wow. Huge discovery, okay? They were resilient somehow to the So that's the area of research that I was in doing my PhD. This is called cognitive reserve. What is it about them that they can have the disease in their brain and not manifest the symptoms?

So track forward, there's like 20, 30 years of research more, actually way more now, not just into Alzheimer's disease, but into things like multiple chlorosis and various other conditions. Because there is, even stroke, someone, two people can have an identical stroke and one has, severe symptoms and one has mild symptoms in the same place. People with multiple sclerosis, there is no relationship between the cognitive impairment experienced and the lesions. So they're the kind of marks in the brain of, so there's no relationship between the degree of pathology or injury in your brain and how that manifests in terms of functioning. This is at the core of brain health. So what we know is that the things that make the difference are lifestyle factors, things that

you and I have control. Things that you and I can do. So even if we don't know how to stop the pathology happening in our brain, okay, but that's okay, right? Well, it's not okay. Be fantastic if we could stop the pathology. But at the moment we can't. But we can change the trajectory of the disease and we can delay the onset of symptoms. And to me, I at the time, because I'd never been in university, I looked at this and I went, how come I don't know this? Everybody doesn't know this. So I knew I had to apply for funding for my research and really rather naively, but also very

optimistic and very ambitious and determined. I discovered that the European Commission, they release all these calls for research. Now, there was loads for research, but this one project jumped out of me. And what they wanted was someone essentially to do a project that highlighted the research that they were doing in the area of preventing dementia. So I wrote a really cheeky proposal. I did all my research and I said, you are mad if you think anyone is going to be interested in an advertorial about the great work you're doing investing in health research. However, You also want to add two extra healthy years to people's lives.

If you want to do that, the best way to do that is educate people about brain health and how they can reduce their risk of developing dementia. So you give me money to develop a website, an app, and little animated films, and I will overtly educate people about brain health and dementia risk reduction, and then covertly on that website, in that app, I will display and showcase the research you're doing. And they said yes, and they gave me a million euro. I love the way your brain works. And I think it's really inspiring for people watching and listening because it's like you have these ideas, but you can make it happen.

You can. You know, before Still Me, which is the, what we're talking about, you wrote the neurosaurus of manifesting. You are a natural manifester. But we are. This is what you do. Yeah, but we're all natural manifesters, right? And this is one of the reasons I wrote that book. Because, you know, my first book is 100 Days for a Younger Brain.

my second is beating brain fog, then there's the neuroscience of manifesting, and then still me. Why sort of jump to that? The others are wrong. Because it's the same thing. It's about understanding how your brains work, your brain works. So you can understand how you work, and then you can optimize your potential and make things happen. Manifesting just means to make happen. Now, when you look online and look at all the other books on manifesting, etc., you swear it's this magical thing that you have to learn how to do.

It's not. You are manifesting your reality every single day. Every day. You are manifesting your future now. How are you doing that? Through your beliefs, your thinking, the actions that you take. What manifesting is, I think should be called conscious manifesting. Most of our futures and our reality that we manifest, we do unconsciously, and that's influenced by our inherent biases, our culture, our limiting beliefs, those things that, you know, our brain has pulled together to make up the story of you. And so we are making it happen. You know, I'm here on this sofa today, you know, I didn't magically sit there and say,

oh, I'd love to be on Davina McCall's show and wait and hope that it would happen. You know, we went through a list when we were promoting the book. Well, who do we think we'd love to get and the PR people did it, etc. And I flew over from Ireland yesterday and, you know, got ready for, and we're here. So you do it through taking action, but you know what your goal is. And that's where manifesting really helps is having the clarity for the goal. What's interesting is that the word that just came into my mind was courage. Because I think a lot of us when we're stuck and we're not doing that, we're not consciously manifesting,

is because we're frightened of rejection, of looking stupid. The power of your imagination and what you can think, it can completely influence everything. And so, yeah, belief is hugely powerful. I really want to hone in on the lifestyle changes that we can make in order to really give ourselves the best chance of having the greatest brain health for as long as possible. Yes. What do we do? Okay. So we go brain health and then there's dementia risk factors.

Yes. Okay. Brain health. They're linked. They're very linked, very linked, because that's the science, you know. So basically brain health, I divided into three categories, activity, attitude, and lifestyle. Activity. And I mean, you are just a prime case, physical exercise. One of the best things you can do for your brain health. People are often surprised at that. But a healthy cardiovascular system leads to a healthy brain. But also, when you exercise, there is a chemical called brain-derived neurotrophic factor, which is relief. released. BDNF for short, I call it miracle growth for the brain. That's what happens. It makes it easier for you to grow new brain cells and new connections between them. And that's what you want in a healthy brain. Lots of brain cells and connections. I love that. Miracle grow for your brain. Yeah. I love that. Exercise equals miracle grow for your brain. Yes, absolutely. And the thing is, before I go on to the other ones, what I want to explain is that if you get Alzheimer's disease pathology in your brain, in the early stages, it is not about,

much pathology, how much disease you have in your brain. It's about how much healthy brain you have to cope with that disease that will allow you to continue functioning for as long as possible. How do you get a healthy brain? You grow new brain connections, new brain cells, physical exercise, brilliant. The next activity one is social engagement. Again, you're brilliant. Talking to people socially, it is, well, it is a really challenging activity, but it's a challenging activity for your brain. So your brain has to work hard and that's a very, and that's a and that's really, really good. And that is something that in later life,

something from a societal perspective and from a personal perspective that we need to do something about because we tend to hang out with people of the same age as us. And there's no nice way to say it. As you get older, your age cohort will die off.

And so people end up socially isolated through no fault of their own. We have to have more intergenerational friendships. And the research shows that everybody benefits in that case. that case, you know, younger people interacting with older people. Have to do something about that. If you know anybody who's socially isolated, it can be hard to draw them back in again.

But really, please do go and encourage them because it can really accelerate decline. I mean, not being socially active. If somebody young is thinking about volunteering in any way, just volunteer to go visit somebody. Yes. Like the difference that you can make to that person's life. It's interesting. Visit them as an equal. Do not visit them as someone.

someone who's doing a good deed. Yes. Yes. Talk to them as an intelligent individual. Sharon, I did a research study a few years ago where I wanted to kind of do this payback thing. It got shortlisted for an award, actually, with all the IBMs and all that.

Now, we didn't win, but I was just delighted to get it in there because what we were looking at, what I was looking at was a sort of payback scheme, whereas sort of a younger cohort of older people would visit an older cohort. of older people once a week and they would prepare a meal together and eat it together. That's it. That's all

it was. And then if you did that, you paid it forward so that when you're the one who's older, it's paid forward and someone does it for you. And basically it encouraged social engagement encourages volunteering, but it also encourages good nutrition because that's a biggie when we get

older. A lot of people don't eat properly. But that's in the lifestyle one. I'll go to that one. But social engagement is absolutely critical. I mean, I've just thought of this now, but like I'm imagining at my age, I'm 57, and going to visit an 80-year-old and having, cooking a meal together. I'd love that. Yeah. And preparing a meal together and eating together. But I'd also love to cook a meal for a 24-year-old and not patronise them either, go as like an equal to them. So I think for people, right, you have to start thinking outside the box about how to make this happen. In the book, it was very

really funny because you go and I'm not talking about just doing Sudoku and the crossword. No, because I love Sudoku and it was really funny because I've been thinking, oh God, that's down the train. Like, no. Do Sudoku if you enjoy it because doing things that you enjoy and have fun is really good. Yeah, so the third, right, I'll finish this list. I'm terrible. But my dad just always do this. You know, that's why I'm here. To keep me on, I'm corraling you. Thank you. Thank you. Made it. What's the third one? Yes. Third one. And go mental. I put. it, you know, and that is challenge your brain, learn something new because that's when you harness neuroplasticity. And it, I just wish there was another word for learning, because it's got

such connotations about education and school and for a lot of people, a lot of negative. My husband left school at 15, it's dyslexic and, you know, learning, oh, don't make me learn something. When you open a door for the first time, you're learning how to open that door. Your brain is learning how much pressure to put on that door, how much force you have to push it. So learning anything, it can be learning carpentry. It can be, you know, there's nothing wrong with Sudoko and crosswords. However, once you're good at it. You're comfortable. You've got to push yourself to the next level. Yeah, go Sadooka. Yeah, yeah, was that what it is? Go the next level. Go from simple crossword to complex

crossword. Put a timer on so you do it quicker. You know, you just got to keep challenging yourself, but it can be anything. If you play a musical instrument, learn another technique. What's so interesting about getting older is the reticence that we can get to learning something new. So Bitcoin. Oh God, no. I don't understand that. Yeah.

Or AI. AI, yes. I use AI. I use chatGBT. And in fact, that's what I talk about to people when we're talking about the brain. Let me do this and then I'll go back to the list. Yeah, great. Okay.

So in a world obsessed with artificial intelligence, I kind of say to people, just pause for a minute and move from that space in, you know, where, you know, we're over. overvaluing artificial intelligence. And just think for a minute that artificial intelligence is modeled on everything that we know about human brain. Okay. So AI is brilliant. It can process at phenomenal speed. But it cannot replicate what your brain can do.

You know, the human brain is the most... So you don't think panic about it because people are slightly... No, no, my point is your brain is capable of doing incredible. things, but because you're looking at all this technology and AI, you kind of think, oh, there's a risk, I think, that you can forget about this incredible resource that you have inside your head and an important source that you have to keep healthy. So the second one then I will talk about is lifestyle, and we've touched on that. So what's good for your heart is good for your brain, because I think it's so funny. It's really good. We know a lot about heart health,

but I kind of look at the heart as just a pump that surfaces your brain. Yes. And, you know, your brain needs a healthy cardiovascular system to get the oxygen and nutrients that it needs to work well. You know, and that's why stroke or blockages or mini strokes that you have, you know, damage your brain function. Ladies! Hey, come here. I have just found out a major, major secret, one that men have been keeping to themselves for far too long. and I'm here to blow the whistle on this entire operation. You know, creatine?

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There are B Corp and members of 1% for the planet with 2% of their sales going directly to environmental causes. So if you'd like 20% off your first three subscription orders, go to ancient and brave. dot earth slash planet. Sleep, sleep, sleep. You spoke a bit about it in your recovery. Sleep, sleep, sleep serves just such an important purpose. when you go to sleep, your brain has a job of work to do. It is not resting.

It is taking the information that you've taken in during the day. It's filtering it for what's important, what's not important. It's consolidating memories. It's linking those new memories with your existing knowledge, experience, etc. You miss any of those stages in a night and that part will suffer. It's where insight and ideas comes from, that linking of that information while you're asleep. But also, when you're asleep, sleep. The brain is a high energy organ, so it produces a lot of metabolic waste. You know about

this from exercising, right? But when you produce metabolic waste and the rest of your body, it's, you know, goes through your lymphatic system and is cleaned out. Your brain can't do that. The brain isn't on that lymphatic system. So your brain can't deal with the waste it produces while you are being you. It's using all its resources while you're awake for you to just stay upright, be who you are. Okay? So when you go to sleep, have you ever been in the United States where when they do their bin collection, their garbage collection, you know, the cars have to park on the other side of the streets so that the bin lorry can come along and take all there. So it's a bit like that. Basically, when you go to sleep, your brain can go around and it can

start clearing all that metabolic waste away. And that's really important because toxins interfere with your brain's ability to function well. It's very vulnerable to toxins, but it's also very vulnerable to beta amyloid, which is one of the hallmarks of Alzheimer's disease, and that is cleared at nighttime when you sleep. Sleep, prioritize it. So important. How important is napping? Okay, so napping is really, really interesting, okay? We definitely are what's called diurnal. You know, we have a dip mid-afternoon when we would like to nap. Okay? So that's what we did naturally. I think the thing is napping is good. You must do it strategically, however. Yes. Okay. So don't nap too late. Yes. So it affects your sleep. It affects your sleep at night. Right. Because it will, you know, decrease the,

the chemical signals that tell you to go asleep. However, napping strategically is very important. And, you know, if you feel like a nap every day, go for that nap every day. Um, basically the, an important thing is the timing of when you take your nap, but also the duration. How long? The duration. Yeah. So you know this. So basically no more than 15 minutes and if you're going more than 15 minutes, then you

need to go for 90 minutes, right? Oh my God. Fascinating. If you wake up in between those two times, you wake up sleep drunk and you feel really, really awful. So some people who say to, oh, I can't nap, I can't nap. I just feel awful. And I said, well, that's because you're doing it for the wrong amount of time. Yeah.

So 15 minutes can be enough. And that's why that, you know, the drink driving. 15 minutes would be my favorite amount. I do a 10 minutes. When I'm writing, when I'm writing a book mid-afternoon, I go, oh, God, oh, God. Set me long. I don't even. Do you set the left?

I actually don't even really have to kind of just after the kind of 10 minutes, you know, or else I switch an activity or else I'll go out and do some gardening. Because if you change an activity, that can give your brain a rest as well. So, yes. So that's it. 20 minutes is a full sleep cycle, so you can wake up refreshed or 15 minutes. And you can, you know, sleep debt, you have to repay it. So if you've lost sleep, you know, that's what I say to people, nap strategically.

You know, if you know you're going to be without sleep or you're going to have a late night, have a little nap before you go out and schedule a nap kind of the next day or vice versa. But yeah, sleep is critical. It's just really, really important. And I mean, that's the thing then in menopause. When you talk about menopause and brain health. Yeah. And brain fog.

I had perimenopause was just hardly ever slept through the night. Yeah. Yeah. And that's, so that's how mainly the impact, you know, what we see, the symptoms we see for menopause are to do with estrogen, you know, dropping. But progesterone plays a role in that it disrupts our sleep. But also progesterone ordinarily. supports gabber release.

It makes us calm and less anxious. And so we become more anxious. So, you know, the contributing factors to brain fog are, the lifestyle contributing factors to brain fog are disrupted sleep, poorly managed chronic stress, poor diet. What else am I missing? Can I just ask you something just before we move on to the disruptives? Are those the three main things that can help?

So exercise. Exercise. Exercise social engagement and learning. So they're your activity. And sleep. And then lifestyle factors are heart health, sleep, and looking after your hearing. Age-related hearing loss. Yes.

Increases your risk of developing dementia. Get your hearing tested every year. Say that again. Age-related hearing loss actually is the biggest. Is the biggest. This is mega. No, this is mega, folks. Age-related hearing loss accounts.

So you know those, there's 12 modifiable risk factors that I'm going to talk about that add up to 40% of all cases of Alzheimer's disease are attributable to those 12 modifiable risk factor. The biggest one is age-related hearing loss. Okay. Get your hearing tested, protect your hearing. If you work near noise, wear ear defenders. If you listen to stuff on, on your earbuds, turn the volume down. If you don't. If you're on your own, don't use the earbuds, listen ordinarily, get your hearing checked regularly. It really is critical. And if you are prescribed, and let's get rid of the stigma associated with hearing aids.

This is the thing, you know? Because I think I know that if and when that happens to me, I, oh, it's just made me feel emotional. I will feel embarrassed about it. Oh, absolutely. And I have written about this. I've written about this in the newspapers in Ireland. It's really sad. And why do we feel like that?

It will really help us in the future. No, absolutely. I've tried to figure out. To stay connected. I was embarrassed when I was 15 and was I told I was needed glasses. So you got the pink national health glasses sort of thing. That's changed. Now people wear glasses who don't even need them.

They wear them for fashion. You tried on Mel Robbins glasses. You know, I just got cool for my birthday. I got Meta AI. Great. Oh, they're brilliant. Brilliant. but hearing aids are still in that somehow

if a person wears the hearing aid and and you know they're gone a bit stupid as well no they're not and the thing is the hearing aids now are oh my god you don't see them and they interact with the apps on your phone and you can turn volume up and down and you can play around with them the attitude ones are so we've got lifestyle physical social mental sorry that's activity lifestyle is heart, sleep, hearing, and then attitude is manage stress. There's nothing wrong

with stress. There is nothing wrong with stress. You need the stress response to reach the challenges, to learn new things, to do new things. But it has to be at your stress sweet spot. Poorly managed chronic stress is where we end up in big trouble because I heard you talking to the guy about the chimp brain because basically what happens is when stress is poorly managed and chronic. It enhances neuroplasticity in your amygdala, which is your fear center, and it suppresses it in your frontal lobes. So ordinarily, in a stress situation, the information about the stressor comes to your brain through two routes, a fast route and a slow route. It goes directly to your amygdala, loud noise, jump out of the way without thinking. Got to react quickly. Then the slow

route comes through your frontal lobes that have access to all of the information. Yeah. And can a message then to the amygdala to say false alarm, car back firing or, oh shit, there's a gunman over there. You need to prepare to fight, flee or freeze. Don't move, right? So your frontal lobes are meant to override your amygdala because they have access to all of the situation. When you become chronically, so at the end then, there's a feedback loop that says turn off cortisol, we've dealt with the stressor. That gets broken when stress is chronically released. So cortisol is constantly released.

And what happens is it makes the amygdala stronger. It gets bigger because neuroplasticity is enhanced. Your frontal lobes get weaker. And suddenly your amygdala is overriding everything that you do. So you're not thinking rationally. You're reacting reflectively. You are reacting through fear. You're not thinking through your actions.

You're not assessing the full situation. And you start to see threat where there is none. So managing stress is critical. It also, and when, When I say it suppresses neuroplasticity, that means your brain is shrinking that part. Similarly, it suppresses neuroplasticity in your hippocampus, which is a part of your brain involved in memory. So it will impact on your memory.

So stress impacts on how your brain functions, but also the structure, it changes the structure on it. Also, which isn't talked about enough, too little stress is not good for you. If you have too little stress in your life, your brain cannot afford to waste energy on brain cells that aren't being used. And so through a process called aptosis, it goes around and it clears them away and your brain will shrink also. You have got to have just a right amount of stress in your life. You've got to be... Do we know what the right amount is stress? Yes. That's quite interesting. Different for everybody because for me, you know,

for some people going on a roller coaster is just incredible, amazing. Oh, it's kind of, oh, not so sure about it. You know, for some people going up on stage on talking or doing something like this, I love it. I love it. I need it. Do you that? I can't, I can't sit down and do nothing. That makes me really stressed. Really stressed. Because I start thinking about things and I get, you know, that too much energy sort of thing. I think it really is about where, and what I say to people when I give talks is, okay, close your eyes and think for a minute about that feeling that you get in your gut when you're really, really stressed. Okay. Yeah. Now, forget about that.

Yeah. Now, close your eyes. Think about that feeling that you get when you're really, really excited about something. What's the difference? I was just going to say it's exactly the same. It's the same. Yeah. What's the difference?

How you've named it. You've named one stress and you've named the other excitement. And that is critical. That's the power of your brain. You have the power to change all those things. And it really is quite simple. It's not easy. There's a difference between simple and easy.

It's simple and straightforward. That's how I describe all these things, but it takes work and time and effort. But if you do, you can then learn. So managing stress and my favorite one, being present in the moment is also kind of good, but my favorite one on the attitude side of things is to have fun, to enjoy life, to smile, to laugh. Laughter is nature's natural stress buster. It actually lowers cortisol level.

It actually does. And also, smiling releases endorphins. It releases serotonin. It lowers your blood pressure. It boosts your immune function. I've got another brilliant thing about smiling. Yeah. Smiling, a new age, it doesn't matter how old you are, you will look beautiful. I agree with you. I agree with you. Smiling is absolutely brilliant and spread the health benefits because it's very hard not to smile back at somebody. This is amazing. So having fun, so often, And again, as we forget to have fun. You forget. You forget. Schedule.

Schedule some fun every day into life. Wear the outfit. Yes. You know, be naughty. Yes. Be spicy. Yes. Be saucy.

The other thing that I thought was interesting, you said about stress. And about, I was thinking like, your relationship, if you're stressed, will suffer because you, everything's troubled. You'll interpret things. Yeah. And also, like, love it. Irritable. You're more... Being intimate together is affected by stress.

You don't want to be intimate for somebody who's stressed out. I have a headache. And I mean, I mean, you know, I'm really... Yeah, yeah, yeah, really I have. So moving on then to the risk factors for dementia. As I said, 12 modifiable risk factors. If we could eradicate them completely, we could get rid of 40% of all cases of Alzheimer's disease.

There's 50 million people globally have Alzheimer's disease. That would be incredible. We are not going to eradicate all of those. But we can reduce the numbers and we can on an individual basis. Be aware of the things that impact your risk for developing dementia and made choices. So a lot of them are related to cardiovascular health. So you mentioned that. Smoking, low levels of physical exercise, type 2 diabetes, well, that's metabolic.

Midlife, high blood pressure. Get your blood pressure tested regularly. High blood pressure has no symptoms. You know, I think you've got high blood pressure. Yeah, yeah. High blood pressure has no symptoms. And then you can mitigate that risk then if you, you know, follow the lifestyle advice or the medication that you're given. It's the same with the hearing loss.

You're mitigating it by wearing hearing aid depression, social isolation. The things you're talking about in terms of, like, isolation can make you a bit depressed. Yes. not having fun, losing that kind of will. Social engagement. Social engagement. But hearing loss, right? We're not sure exactly why that happens.

Some of it can be that you have a degraded signal coming in. That's one theory. Another theory is that the amount of cognitive resources that you have to put into hearing and understanding is taking it away from memory or somewhere else. But another aspect, and I suspect it's all three, is that when people have hearing loss, They don't want to be embarrassed going out and they don't want to keep saying, pardon. Pardon? What did you say?

And so they start to retreat and isolate and shut down. Then they get a bit depressed because they're isolated. And then they turn to things like drinking more alcohol. So alcohol is another one, excess alcohol consumption. But we also know that actually from research, we used to say that moderate alcohol was okay. but actually research shows that people who drink alcohol, people who don't drink alcohol have better cognitive function than people who even drink moderately. Now, that's not talking about Alzheimer's disease, it's just when you test people on

cognitive tests, mental tests, those who don't drink alcohol score better than those who even drink a small amount of alcohol. And midlife obesity. That's also a biggie. And I'm very hopeful that drugs like Ozempic and those kind of ones, when they can help people with type 2 diabetes and with obesity, that that will help really reduce the risks, you know, the amount of people who go on to develop dementia. That's really, really important. Interestingly, about midlife obesity, that flips. Okay, in later life, if you are underweight and frail, that becomes. A risk. A risk.

So we've got to keep healthy. You've got to keep exercising like you do. Muscle strength is absolutely critical. And so too is balance. Balance exercises. I'm always amazed by this. So this, so funny, I was asked on a shoot the other day to stand on a little box on one leg, kick the front leg up and lean backwards. Oh, gosh.

That's hard. And close my eyes and laugh. Did you follow them? I just, I was wobbly. I was really wobbly. And I was like, well, God, why am I finding this so hard? And it made me think of all the times that I've read, balance on one foot for 45 seconds.

Can you do it with your eyes? When I'm giving talks, when I talk about that bit, I do it on one foot. And the reason that's important is when you fall once, when you get older, you're more likely to fall again. And falling predicts decline. Again, for complex reasons too. It could be that there's something going on in your cardiovascular system. that makes you a bit dizzy and you're falling.

But also when you fall, then people become afraid that they might fall again and they don't go out and they isolate and they overeat or, excuse me, whatever, to compensate. So they're those risk factors. I do want to talk about caring for people with dementia. Can we just quickly talk about that as well? Because what I love is the three sections in this book. Yes. Which is absolutely amazing. So the self-care section is really good about how we can look after our.

That whole first part of the book is for the person who is caring for the person with dementia. Which is really important. If you don't look after yourself, you can't look after someone else. And, you know, don't be acting on guilt. You know, you are entitled to have a life. You are entitled, you know, to be you. And that's where there's still me in that book comes from too. Because in some way, I think carers end up feeling selfish if they want to do something.

Yeah, no, self-care is. Yeah, no, no. What I say is it's not selfish. It's really good judgment. It's so important. It's really important. And then the second part of the book. Always makes me a bit.

I guess because. Yeah. I was trying to tell my boyfriend after I'd had the operation was I'm still here. But I didn't know how to tell him without him thinking, you're just telling me that. Oh my God. But I'm coming back. Oh, my God. And every day or every week I'd go, I'm back.

And I'd think, I know I said this last week. But I'm better than I was last week. But I used to think, now he just thinks I'm just saying it willy-nilly because it's what he wants to hear. It was really interesting, like trying to say I am still in here. Yeah, and I think that's really challenging for people who have. It didn't feel to him like I was. That you were there?

No, he was struggling with that. Like, I was different. Right, yes, yes. So this to me is immensely powerful. So you weren't just dealing with the aftermath of the actual physical surgery. You were dealing with that trauma of going in thinking you might endeavor come out more, that you might come out different. Yeah, well, I didn't, I knew I'd come out different.

I knew that there'd be an effect on my short-time memory. I just wasn't aware of, like, quite how massive it could be on my relationship. I was thinking, like, I'd like to go back and give talks to anybody that has the same operation and go, it could be like this. Yes. Yes. Do it. You're brilliant.

Yes. Yes. No, no, no. I'd like to do that. But I also felt that was a, you know, it was a, trauma, but it was such a gift, and I know you're this person, that letting go, which is the hardest thing I think in the world to do, and I'm not really good at it. Before I went on into the operating theatre was the greatest gift I've ever been given because I have let go of dying.

Really? I am not afraid of dying. Really? No. Really? No. Wow. Okay. Oh gosh, that's kind of big. Isn't that that thing? It's kind of big. Such a liberating feeling. I suppose, like in a way, it's funny, it's in this book actually, I think,

that I talk about, you know, people talking about an afterlife. I don't mind. Yes, yes, yes. Yeah, believe whatever you want, but I kind of feel, well, if it's the absence,

your brain is not there. So there's no suffering. There's no feeling, if you know what I mean, it would be gone. follow any hospice nurses online? No. So they are amazing. So they talk about, and they film sometimes, at the end of life, people often go like that. Wow. Yeah. And it's like they see someone or something. It is, it is, it is like, you say that, you say that about your mum

yeah, yeah, yeah. Yeah. About like going to see like people, like that it's, that it's okay, you're going on a journey. I think it's, yeah. I told my dad he was going to the best party ever. Did it? The hearings, the last thing to go. Yes, absolutely. And it's like, you are going to the best part of ever.

Like, your mum's there, your dad's like. Yeah, I think people don't realize the very later stages are very different, very challenging. I think people with dementia should be out in the community more. You know, there's nothing to be afraid. But this is what I love about this chapter, just bringing it back to the book for a moment. If anybody is out there and they know anybody, or they are taking care of anybody, please get this book because this chapter, still me, is what everybody needs to read.

It is a great and deep understanding of what the person who has dementia is going through and what they are experiencing. And I wish that I'd had this book so much. And the last chapter, which was my absolute favorite. Oh, the last section then is all. All the things that you do to live well. So look, people think I hate when people say, you know, oh, you know, I'd say, how's your parents or whatever? Oh, dad has dementia.

He's gone. No, he's not gone. He's in there. You just have to work a little bit harder to find him. He still feels love. He still feels depressed. He still has all of those feelings. You've got to work at it.

And it doesn't matter whether they don't know your name or what you did yesterday. They know that there's, if you go in and have a good time with them, they will be happy to see you. If you go in and keep criticizing them and reminding what they're missing and all that, they won't want to see you particularly because they'll know they'll feel bad about themselves. So they are absolutely still there and it's important to treat them with dignity, with respect. Your father is always your father. They're not a child. It's absolutely critical.

Oh, yes, yes, yes. What I wanted to say there is as you were talking about the last chapter. The last chapter is I talk about maximizing the good stuff, you know, do it. as much of the good stuff as you can. Minimizing the tough stuff, there is tough stuff. And there's stuff in there. I don't need anybody to read about it unless they encounter it because you don't want to depress yourself reading it. You may never encounter it. Yes. And then it is really just, you know, it's just maximizing, making the most of what you got maximizing. The thing is, dementia may steal many things, but they're only stealing aspects of your cognitive function.

It might be memory or language or whatever. They do not steal what may. makes life worth living for all of us. They do not steal the ability to smell a rose, to feel the sun on your face. In music. To hug someone. Physical touch. That's a big one, isn't it?

It doesn't. So you can do all those things with your loved one when you have dementia. And you can do it if you're caring for someone with dementia. And in fact, the thing about dementia is, the biggest piece of advice if I was to give anybody caring for someone with dementia is to be present in the moment with the person. Forget about the future, forget what was or what might have been, just be in the moment and have fun.

And I think that's brilliant advice for life, isn't it? Just be in the moment. It's so interesting because my dad ended up being very much the person that he was when he was the things that he loved were the same. And yes, the thing that my mom loved the same, she loved music. My mom changed and this is an interesting thing and I'm not the only person who has experienced this. My mum and I did not have a great relationship, really,

throughout my childhood, my teens. We had a very appropriate relationship. I visited as we should and all that. We were never best friends. No. I always envied people who had a mom. It too. It was best friends.

Never had that. My mom was very controlling, and my mom could also completely withhold her love. So as a child, if I did something that she didn't like, she could not talk to me for six weeks. Oh. Like she really just punished. Could really withhold.

But when, and she also, which is why my family completely fell apart. I think if you're a strong family together, when someone has dementia, it can become stronger and closer. I think if you're fractured and dysfunctional as my family where it's very hard to get through that dementia journey. And that's why I share that in the book. This is not a book me saying, hey, look what I did. caring for dementia. This is a book that I wish I'd had. And here's the mistakes I made. And here's the things I did that actually kind of worked. But I didn't do all perfect stuff. And I didn't, I cared for mum, but I didn't. I wasn't able to give up my job to care for my mom. I wasn't

able, you know, I was putting my kids through university. We had a mortgage all the way. Yes. But whatever amount of caring you're doing is still caring for that person. And it makes a difference. But yeah, our family sort of fell apart. But what was really interesting, with mum with dementia was that the dementia took away all those, it took away expectations. There was, it was just we were there in the moment and we were just having fun in the moment, whether it was singing nursery rhymes. It healed you in a weird way.

It kind of did. We had a, yeah, we had a much, because there was things like I remember disclosing something to my mom that had happened that an uncle had done. And oh, God's sake, not you as well. Your sister said that. God's sake. And that was it like, do you know? So there was a lot of things.

But I do think that when you're in something like that, it can make you realize that actually they don't matter. This is what matters now. And we had fun. And it helped immensely that I had a really supportive husband. and also helped immensely that my mother, she had sort of frontal to mention, so she became quite disinhibited. So she just fancied him unashamedly and he would play along and it just made her so happy. My granny fell in love with my husband.

Did she? Yeah. It's rich by tweets actually. It was really funny and she was really apologising for having an affair with him. Oh, I love. She was like, you're not angry with me and I was like, no, I totally understand. And she was like, thank you. Thank you.

It was really fun. Oh, that's so lovely. Yeah, it was sweet. And I think that's a really strong message is you have got to be there in the moment with them, with their reality. Don't say, oh no, you know, Nana or Gran, you didn't have an affair. It's okay. You know, and I think it's just acknowledged. So my mum would have moments of insight as well.

So when mum had delirium in the first instance, that's kind of what accelerated and brought the dementia to core from a urine retract infection. It's really important. If you're older, can I say this? Yeah. This is a message, I think. This is really big. Public health services, this would be, oh, this would just make a huge difference to the number of people who accelerate their journey on dementia.

When we get older, we do not, our capacity to mount a temperature is not as good as it was before. A lot of older people think you're not sick unless you have a temperature. You can have a really severe. urine re-track infection and not have a temperature. So that's what happened my mum and thousands like her. Drink, drink, drink, drink water. And often people with dementia have to be reminded to drink and to eat. And my mum loved going into town every day.

That was kind of her social thing and mass in the morning time. And she just was peeing all the time. So she said, fact that, I can't even get into town. So she stopped drinking. tea, water, coffee. Right. So when then your brain becomes dehydrated, your brain is a really thirsty organ.

Forget about even if you're older, drink, drink water, water. Your brain needs water. Because cytokines gather in your brain and they cause delirium. So my mom got acute delirium into hospital. And basically, delirium can resolve if you got a severe infection

and you got delirium and you're fit and you're strong and you're healthy, it may last, a couple of days, could last longer. but it will resolve that come out. If you have any underlying mild cognitive impairment or are already slightly starting on that journey,

delirium will just completely accelerate that. It's quite frightening. It's very frightening. My granny was in her 90s. She was trying to escape trying to climb out of a window. It was... That would happen to me. My mum, I'd been on the phone to her

and she asked me, would I meet you for coffee? And I said, I can't have meetings all day, but I said tomorrow's Saturday, I'll meet you for coffee. Next thing, I got a phone call from my brother. I have a brother who kind of needed to stay living with my parents. And he rang and he said, Can you come come quickly? Mom's acting crazy.

I said, what are you doing? She's trying to leave the house and she's not dressed. And then she threw a lamp at him, I think. And, you know, she was really quite challenging to manage. When I got there, she was really, no, I'm going, I'm going, you know, and quite strong. So I told her, yeah, no, no, no. And I had to. I knew I, because I was working with a geriatric psychiatrist.

And I went and I said, can come to the meeting, told him what happened. And he says, that's delirium, that's UT. I try and get a urine sample offer if you can and get her to a hospital. She's in a bad way if it's just kind of happened like that. And yeah, I had to tell. I had to tell a little porky. I said, you know what, Mom, there's a lovely hotel. Why don't you come over with me and we'll go stay there.

And we went over to a private hospital. And they took her in and she was three days in there. And she was going, she sang nursery rhymes 24 hours a day and did Irish dancing for three weeks. Wow. But then there was loads of other things. But I also, as well, here's an interesting thing just to listen to. Just as an aside, one of the times I went in to visit her, she said, they brought me to the top of the house.

I think they want me to run the place. They put me in a spaceship and sent me off, right? And I said, okay, there's something in this. There's something in this. So I asked the nurse, I said, was Mom anywhere today? Oh, yeah, she was brought for an MRI scan? I said, where is that? Oh, it's on this.

Amazing. So do, these are kind of things I talk about in the book that as well, if you are living with someone and they're having, you know, and they're talking, try and figure out sometimes actually what they're talking about is very, yeah, absolutely, truth. She was just figuring it out. I want to do something. I want to show you something because my dad had delirium and couldn't really speak for the last six months. Oh, that's tough. And, but the day before he died, I went to see him and he'd been awful the week. before. Yeah. It's hard at the end. I went to see him and he had colour in his face and he

looked amazing and my my mom. Very handsome ma'am. Yeah. Oh, very much. My mom and my sister were in Australia and I woke them up in the middle of the night and I said, we've got to FaceTime. Dad looks unbelievable. He's so good. He's singing and he he kind of mumbled at them for a bit but they were like, oh wow, thank you. He looks so good. Yeah. And the next day I got a call in the morning and they said he's dying. He's going to die today. Yeah, yeah, they know. So it's amazing, isn't it?

And me and Michael went and we were there with my auntie Becker when he went and it was beautiful. It was amazing. Oh, good. But this, I got it on film because I was like, oh wow, he's really so good. And I thought, I'm going to film this. And I put on some music and he was mumbling along and then this happened. Okay.

Daddy. I love you. No, what, but... I love you. I love you, too. Oh, my God. That was the first thing he'd said in weeks. He smiled. And he looked straight at me.

He hadn't looked at me. Oh, that's lovely. That's so lovely. Yeah, and my mom as well. Because when you get to the end, I don't think people realize, but it's hard to swallow, start to eat. Yes. You know, they start to drown, you know. It was, you know, and my mother was just bones in the bed.

So there is a release, you know, and they keep getting pneumonia and they keep making them better. And I kind of go sometimes, you know what. Yes. Maybe pneumonia is just a kindness of nature to say, you know, to say the end. But my mom, I write about this in the book, because again it was a big mistake that I made. and this was well on

at this stage and just out of the blue one day she just said to me sitting in the kitchen and she said Sabina why why does your dad

not come visit me so then I went oh mum dad's dead oh my God oh my God oh de Vina it was awful

and my two sons were sitting there and there was so many things going on in my head that she was lucid enough. All I kept thinking was,

she's all this time in this nursing home wondering why her husband hasn't come to visit her. Number one. Number two, she literally, it was grief. Like you just said there,

and she cried and cried. My kids were in floods of tears. The thing that that I think makes me really, really adamant that you've got to understand that there's a living, breathing, feeling, loving individual inside that person is that I did everything I could that afternoon to, I mean, I let her cry and we all cried and we hugged

and she made me tell her exactly what had happened. So we all had to kind of live through that again. And then I tried to distract her and I distracted her and we did other things and we spoke. And so that was a Saturday and so we would take mom out during the day. So about 9 o'clock, My husband was out playing football actually and so when he came back, I know, oh God, Dave, you're not going to believe what happened. It was awful. Our mood was all really low. He brought her back up to the hospital and when she arrived into the nursing home, you know, they would open the door to the room and the nurse that she knew because she'd been living there. Yes.

I don't know. Maybe two years at that stage it opened the door and she said, oh my God, I can't remember the girl's name. Let's say it was Helen. Oh my God, Helen. My Pat is dead. So she had spent hours in my house She'd forgotten about it Yes

Playing along I think That with whatever I was saying She remembered But what I'm saying is I don't know that I think she was just Maybe she was playing along And I don't know But it was there I hadn't distracted her from it

It was there to the forefront a few hours later Anyway Yes love them, love them like you've always loved them and, yeah, treat them. And this is a blueprint. And what I love, I'm going to finish here. Yeah. But what I love about this book is the simplicity of it. I think there are some very wordy, weighty tomes with language that is hard to decipher. And when you're in this situation of caring for somebody or somebody you love is going into this, you just need tools and this is full of them. So thank you.

Oh, thank you so much. Another thing I wanted to say and ask you to do just to finish off this amazing interview. Thank you. Oh, thank you for us so much. It's been lovely. Is to read Still Me to us, please. You read it? No, you read it. Oh, I don't know. Will you read it? Really? Yes. It's so beautiful from you. Okay. Well, whatever you want, but I yeah. You wrote this. Yes, I did. For those who care, still me, I have dementia. I am still me. When I'm confused and frightened, hold me close, calm my heart and still me. I care for you and I am still me. When my patience wears thin and I ache to be free, when I wish for you to be you and me to be me, I'll pause. Deep breath and let our love

still me. Together, we walk through fog and stormy sea, bound by our love and the truth that you are still you and I am still me. Thank you so much. Oh! Do you know, that's your book, isn't it, in a nutshell, you know, chapter one, chapter two. It kind of is really. And chapter three.

Yeah. But honestly, let's shout about this a lot. Like, this is so great. Thank you so much for coming. And actually, also loving this. Like, what got you here was this. No way. Like, no, but what you here was manifest.

Like, do you know what I mean? And I like your slightly different take on that. Anyway, all your books are amazing. Thank you. Like everything you've done, I know we were here to talk about still me. Yes. But they all are all interrelated. If you like what we've talked to,

today on this podcast, go forensic on Dr. Sabina Brennan's books and enjoy. I love you. Oh, God. Thank you so much.