Instant Genius - How to slash your dementia risk in 12 weeks

Episode Date: March 2, 2026

Around the world, more than 50 million people are living with some form of dementia – a number expected to triple by 2050 as populations age. But the thing is, dementia is often talked about as a kind of genetic lottery. You either get lucky and escape it, or unlucky and develop it. But what if that framing is wrong? What if far more of our brain health is within our control than we’ve been led to believe? Our guest today is Dr Majid Fotuhi, a neuroscientist who has spent decades treating and studying people with cognitive impairment. His message is a bold one: dementia is largely preventable – not with a miracle pill or silver-bullet treatment, but through the way we live. The 12-week programme he and his team have developed has helped his patients improve their memory, regain independence, and even grow new brain connections. Today, he talks us through the essentials of the programme – and what it really takes to stay sharp for life. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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combine handcrafted tradition with cutting-edge innovation and high-end materials, delivering digital precision with analogue warmth. So you can experience exceptional sound at home. Music just as the artist intended. Visit name audio.com to learn more. Hello and welcome to Instant Genius, the bite-size master class in podcast form. Each week you'll hear from world-leading scientists and experts talking about the most fascinating ideas in science and technology today. Tom Howarth, Trends editor at BBC Science Focus. Around the world, more than 50 million people are living with some form of dementia,

a number that's expected to triple by 2050 as population's age. But the thing is, we often think about dementia as though it's some kind of genetic lottery. You either get lucky and escape it, or unlucky and develop it. But what if that framing is wrong? What if far more of our brain health is within our control than we've been led to it? to believe. Our guest today is Dr. Majid Fortui, a neuroscientist who has spent decades treating and studying people with cognitive impairment. His message is a bold one. Dementia is largely preventable, not with a miracle pill or silver bullet treatment, but through the way we live. The 12-week program,

he and his team have developed, has helped his patients improve their memory, regain independence, and even grow new brain connections. Today, he talks us through the the essentials of the program and what it really takes to stay sharp for life. So, Madrid, welcome to Instant Genius. Thank you very much for having many on your show. So when we talk about aging, we often know what that looks like physically on people. You know, they perhaps get wrinkly and they get a little bit shorter. When it comes to aging of the brain, that's a bit more hard to conceptualize for people.

So what's actually going on in people's brains as they get older? There are actually biological changes that happen to their brain just like it happens to their faces. There is a significant degree of inflammation and there are also problems with blood flow in the brain. And the combination of inflammation and blood flow, as well as some degree of difficulty with cleaning the brain, rinsing the brain that usually happens at night, these three things can really slow the brain with aging in general. And so there's obviously what we would expect as kind of healthy aging, which is what we're striving for and kind of what the message of your book is about aiming for. And then there's less healthy aging of the brain,

you know, whether that's sort of minor cognitive decline or more severe cognitive decline through things like dementia, Alzheimer's. What's the difference between those sort of different pathways that people can go on? The difference is in the biology of the brain. If you're someone who has had just a little bit of problems with blood flow and just a little bit of inflammation in your brain and just a little difficult difficulty with rinsing of the brain at night, you'll be fine. You'll be functioning just fine

as you go to your 40s, 50s, 60s, 70s, and 80s. There will be about maybe 5%, 2%, 3% decline in your cognitive capacity, but for the most part, you will be able to be sharp, independent, and enjoying life. However, if you're someone who has sleep apnea, which is a condition in which people snore at night and feel groggy during the day, that condition really affects the blood flow in the brain, increases inflammation, and affects the brain and the heart profoundly. So if you have had untreated sleep acne for a long time, your brain is going to literally

shrink by up to 18% if it remains untreated. it. Now let's add some stress to that. If you're stressed, levels of cortisol in your brain rise every time you get upset or anxious. And that cortisol is toxic to the brain and especially to the part of the brain for memory, which is called hippocampus. So if you have sleep apnea and you stress a lot, now let's add sudden to your lifestyle to that and let's add poor diet to that. And then all of a sudden your brain will be shriveling over the years at the rate much higher than it would be otherwise. So the difference in their healthy aging and someone who experiences significant cognitive decline is in the biology of the brain. And so I already mentioned it before, but I think

one of the first places that people's minds go when they think of cognitive decline is dementia and Alzheimer's. But I think one of the most illuminating parts of your book kind of really reframes Alzheimer's, tells readers that we've got a lot of things wrong about what we think about it. So what have we been getting wrong when it comes to Alzheimer's? We have gotten it absolutely wrong these days. The misconception is that Alzheimer's is a single disease that suddenly hits you out of nowhere and that you're either lucky and you don't get hit by Alzheimer's disease or you're unlucky and then you're going to get hit by Alzheimer's disease or you're unlucky and then you're going to get demented and you're going to die in a miserable way. The truth of the matter,

which is well established in the scientific community, is that with aging, your brain shrinks for many different reasons, most of which are treatable. So, for example, blood flow is one of the most important thing for brain health and people who have vascular risk factors, just like I mentioned before, sleep apnea, but also hypertension. obesity, sedentary lifestyle, you have less blood flow and that shrinks the brain. If you have a poor diet, if you eat a lot of junk food, there will be high levels of inflammation in your brain, and that too damages and shrinks the brain. If you have poor sleep, if you sleep only four or five hours a night, you don't give

your brain a chance to go through their normal rinsing process at night. So the metabolic byproducts, which are usually toxic, accumulate the brain and literally choke the neurons. So all of these things are reversible components of what we call dementia or Alzheimer's disease. Now, there are also these proteins that aggregate. It's called amyloid plaques and tau tangles. These protein aggregates are another component of this super-proliferation. which shrink their brain with aging and leads to cognitive decline. So the misconception is this, that only these plaques and tangles are the problem,

and if we find a cure to stop them, then we cure late-life cognitive decline. In reality, there's a super problems, mostly blood flow issues, inflammation issues, and brain-winsing issues, as well as these two protein and protein, aggregates, and we need to focus on treating the treatable components while we're figuring out how we can find new drugs that target these protein aggregates. Why do you think this myth about Alzheimer's that is caused by these proteins has been so persistent? Because it is, you know, a lot of people will just think that they are either going to be lucky or unlucky as they age and either get Alzheimer's or not get it.

Well, one of other things I find interesting about this whole concept of Alzheimer's is how it has changed over the centuries. See, in, you know, 5th century BC, people used to think that cognitive decline is the normal part of aging. But then during the pre-Renaissance era, people thought that you get demented because of the sins that you have committed. And this dementia was your punishment. And then the Neuronisans, people realized that strokes are the problem because when they looked

at their brains of people who had died with dementia, and compared to people who had died without dementia, they saw that patients with dementia had more strokes. So for a long time, they thought stroke was the problem. There was a period that people thought cephalis was a problem. And then after Alzheimer's discovered these plaques and tangles, but he was clever enough to say very explicitly that these are not the cause of dementia. They're just byproduct of things that happen to people's brains over time. And then in 1970s, people were able to actually discover the amyloid protein and its sequence,

and there was an excitement that only if we find a drug that would stop these things, we will cure Alzheimer's disease. And so that excitement has persisted in the literature, and many people are still pursuing the dream of finding a cure for Alzheimer's disease. About 20 to 30% of people who go to the Alzheimer's conference clearly understand that dementia is a multifactorial condition and that we need multiple approaches to treat it. But there are still many people who just want a cure. they genuinely want a cure and they generally are pursuing drugs that will stop this.

So the simple answer is in a Western continent, people want a cure. They want a cure for obesity, you want a cure for depression, they want a cure for economic problems. People want one thing that would just solve everything. And I think it's unfortunate because the reality is we have the opportunity to reduce the burden of dementia in the world by addressing lifestyle issues. A very prominent article in Lancet by a group of international experts, which is now one of the most cited papers in Lancet, clearly established that addressing 14 factors would reduce the burden of dementia in the world by

45%. And those treatable components are obesity, hypertension, sleep problems, hearing, loss, vision loss, sedentary lifestyle, air pollution, all these things that can shrivel the brain with aging can be prevented or addressed. So I've seen that 45% figure cited and it is kind of amazing to think about. What makes up that other 55% though in terms of the ones that we can't tackle with these interventions? Well, they have discovered that those elements that they studied reduce the burden of dementia by 45% by half. Imagine there will be half as many people with dementia in the world at very

little cost, mostly preventive lifestyle choices. But they have not also included other factors that can clearly shrink their brain and contribute to dementia because they're difficult to study. For example, they have not examined the role of insomnia or sleep apnea, which are clear contributors to dementia. So the factors that they have established are the things that were able to measure and quantify and establish a clear link. And they're still working. I honestly believe that 90% of dementia could be prevented in my clinic, in my experience of dealing with, thousands of patients with cognitive decline, 80 to 84% of patients improve cognitive function. Not only they slowed the rate of decline, they actually improve their memory, attention,

executive function. So in my world, much of dementia can be prevented, and even people who have started the early stages of Alzheimer's disease can slow down the rate of decline. So that brings us quite nicely onto the key bit of your book and your life's work, which is this brain fitness program which you put your patients through and you're now, what you're sharing with the world. Take me back to where the idea for this program came from. What kind of spurred you want to create it and how is it different to what others were doing at the time? My journey began when I was a resident at the Johns Hopkins Hospital doing a rotation in taking care of patients with. Alzheimer's disease. And my job was to evaluate patients who had dementia and monitor them over time. These people were coming to Johns Hopkins once a year for many years, some of them for 30

years. And as I reviewed their files, I found something very striking. Most of them were diagnosed with Alzheimer's disease, but they had conditions like sleep apnea, obesity, diabetes, depression, all the things I knew that contribute to brain shrinkage and Alzheimer's disease. And I asked myself, why do we call these people as having, quote, Alzheimer's disease? They have a mixed bag of so many factors, most of which are treatable. Yet we put a label of Alzheimer's on them and just put them on a nursing home. That's really a tragedy. And I looked around and nobody else was saying those things.

And then I went to a conference in Florence, Italy, just around. around when 2001 September 11 happened. It was just after that because I remember all the trouble I had with traveling. And in that conference, people said, well, chronic hypertension shrinks the brain. Chronic obesity shrinks the brain. You know, chronic sedentary lifestyle shrinks the brain. Insomnia are showing the brain. Sleep apnea shinks the brain.

And I just sank into my seat and I thought, somebody needs to go on the rooftops and say, this is wrong. Why are we doing this? We need to treat these treatable factors. And then I came back with just energy and excitement that I'm going to change the world. And so I wrote my first book, a neurology resident, I wrote my first book. I took two weeks. I wrote my first book, The Memory Cure.

And I remember my colleagues at Hopkins were not so happy with this young fellow who says, I found a cure for dementia, or he claims that he can prevent Alzheimer's disease. They were just to rule their eyes at me. And I felt even more energized. I published three articles in nature. I published an article about reversible causes of dementia, about all the factors that can shrink or grow the hippocampus, the part of brain from memory.

So as I evaluated the literature, I found that exercise grows the brain, good sleep grows the brain, good diet, Mediterranean diets associated with the larger brain size and better brain capacity. Meditation improves brain function, increase the size of this part of brain called the hippocampus. And so I wrote articles in, you know, nature and talked about how these parts of the brain have a high degree of malleability. This parts of the brain for memory, the hippocampus and the other part called the cortex,

have a high degree of malibility, and our daily routine can shrink or grow this parts of the brain. And then in 2010, I said, you know what, I'm going to establish a program where I will treat these treatable components and see what happens. And guess what happened? People improved in a matter of weeks. And I was pleasantly surprised because I thought it would take nine months or six months to see tangible results we can capture an objective cognitive tests. And yet we saw people improving in four months and then I realized three months. But then when I did it in six weeks, that wasn't enough. So I realized that three months were the sweetly.

spot. So when people came to see me, let me tell you about one of my patients. Her name was Carol. You know, she was 76 years old. She was sitting home doing nothing. She was confused. Her sister brought her to me so that I could confirm a diagnosis of Alzheimer's disease. So she could then sell Carol's house and then pay for her nursing home. And I said, wait a minute, Carol has all these treatable factors. Let's work on those things. Let's let her put on a program of walking, eating, right, sleeping well, let's see what happens. And then within weeks, she started to talk more, be more engaged. As she walked more, she felt more energized, as she felt more energized, she did more around the house. And by the time she finished the 12 weeks,

she was joining the church for community activities, she was looking for a job, and she was a totally new person. We had done MRIs at the baseline and after a 12-week program, and we saw that her campus had grown by 8%, which was the best we ever had. Usually it's about 3%, which is about a brain of someone that's about three years younger. So I provided a program for 129 other LLE in her situation with diagnosed with mild cognitive impairment, and 84% had objective improvements in their cognitive test. It wasn't they just told me they felt better. They did well in objective cognitive tests, which were computer-based. So then I was convinced that I have discovered something, and I went on to provide this program for more and more patients, even for people

who have attention deficit disorder, or people who had persistent concussion symptoms, or people who had just a complaint of a brain fog. And over and over again, something very clear happened. They improved. They improved so much they couldn't believe it. Their family's couldn't believe it. And then I had 25 staff in my office, and many of them were brain coaches, people who would monitor patients and encourage them to improve their lifestyle choices. And our office was packed. We were open seven days a week from 8 a.m. to 8 p.m. seven days a week. And I just could not keep up with all the patients who came from different states just to do this program. So then I decided, you know what?

I need to provide this program and the details of it in a book. I make it available for people everywhere in the world. And that's where we are now. Wishing you could be there live for the big game, soaking up the atmosphere of the crowd. But too often, life gets busy, or the price holds you back. Price Line is here to help you make it happen. With millions of deals on flights, hotels, and rental cars,

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and unforgettable listening experiences at home. Try it for yourself at a focal powered by name boutique. Visit focal powered by name.com for more information. Obviously, you go through in a lot of detail in the book what the program actually is, but give me an overview here. If I'm somebody who's walked into your clinic or is beginning this journey through your book,

I fear that my memory isn't as good as it used to be and I've lost a bit of myself. What does this program look like? Yeah, there's a four step process. Step number one is to do an evaluation and find out what are the things that are affecting your memory or other cognitive functions. Are you sleep deprived? Are you stressed too much?

Is your diet poor? Are you not getting around as much? Are you not challenging your brain? And which medical problems you have. In my book, I have a list of 40 questions to tap into all the little things that can contribute to cognitive decline, including here, laws, you know, medical conditions and so forth. And then I do what I call a brain portfolio, a series of tests to establish where you are now. For example, I check your fitness level.

And I ask you questions about who is your role model? What do you want to achieve in your life? And then I do specific questionnaires to establish what it is that you want to achieve. You want to have better memory? Do you want to be able to think faster? Do you want to be able to be better at your work? We need to establish what your goals are. So once I have a very thorough baseline assessment of where you are now, I can identify the three or four things that you need to work on. I often talk about five pillars of brain health, fitness, sleep, nutrition, mindset,

and brain training. But not everybody needs to work on all five pillars of brain health. health. Most people need to work two or three of these pillars. So then I establish, step number one, we establish your baseline, then we establish your goals, and then I tailor the program to your specific situations. What are the things that you need to work on? And I give you specific instructions of what to do. Like, you know, if you haven't exercised in the past two months, I ask you to walk five to ten minutes a day. But if you're already exercising, I ask you to push your stamina.

You know, if you have been sleeping only three or four hours a night, I would try to figure out the reversible, treatable causes of insomnia. And I work on those with you. So the goal is this. We are going to treat the treatable component of the factors that are shrinking your brain. And I know that it doesn't take years to see results. it takes weeks. Definitely within months, people turn around and improve so much that other people in their

family notice. And then the next step is monitoring. So we have your baseline factors, your baseline numbers, your fitness, your heart rate, your, you know, something called heart rate variability. And then when I monitor it at six weeks, I can see which things improved, which things didn't improve. And then you do six more weeks of the program and we do the final assessment. So the last step is step forward, which is the assessment to see how you improved.

Now some people improve by 30%, 40%, and they love what they do, and they will continue to take on and continue with the habits that they have formed within that three months. The key factor is this. This is going to work. It's not like it may work, it will definitely work. It will definitely work because our brain has a high degree of malleability. I feel frustrated at times that people walk around with treatable conditions that can easily boost their memory and brain vitality, yet they just walk around complaining that their brain

is fading and they're not doing anything about it. Let's dig into some of those pillars then, which is fitness, sleep, nutrition, mindset, and brain training, right? Of those you kind of highlight fitness as being perhaps the most important thing that people can do to protect their brain, to produce that invincible brain that we're aiming for. Why is fitness so important for this? What's it doing to our brains? The science of the benefits of exercise is so compelling. Nobody can argue with it. When you exercise, you increase the number of mitochondria, these energy-producing

organelles inside your cells. And the more you exercise, the more mitochondria you have your cells and the more your energy is available for cells to function. This is for cells in your heart, your skin, and your brain. And people who have a higher number of mitochondria, they also have larger size of hippocampus, the part of the brain for memory, literally larger. So the first thing that exercise does is increased number of mitochondria, which has been shown to contribute to a larger size of hippocampus. Exercise also generates new neurons in hippocampus.

See, everybody thinks that as you get older, you lose brain cells and everything is downhill. But we know for a fact that exercise increases the number of neurons in human brains, not only in animal studies, but in human studies. So we know that exercise can generate new neurons. The other thing that exercise does is to increase levels of neuroprudence. protective peptides and proteins such as BDNF. BDNF is also sometimes called the miracle growth for the brain. And so when you exercise, you increase BDNF levels which help with maturation and healing of brain cells. Finally, exercise is associated with reduced levels of inflammation in the brain.

So you have more mitochondria, you have more neurons, you have more BDNF, you have less inflammation, all of these things literally rejuvenate your brain. I always say exercise is really the fountain of youth for the brain. Yeah, I think in the book you say, you know, if there was a drug that could do what exercise does for us, it would be worth a lot of money, basically, and it's free. Anyone can do it. Exactly. And it's simple.

And it doesn't have to be running a marathon to see results. One of the things I find surprising, actually, is how little it takes to generate new neurons. You know, so if you walk 3,000 to 5,000 steps a day, like if you walk an hour a day, you can reduce your risk of Alzheimer's disease by anywhere between 30 to 50%. That's a huge number and you're not doing anything crazy. You're just walking. But you're not just walking. I mean, walking is a very powerful tool for improving the health and vitality of cells

everywhere in your body, your liver cells, your kidney cells, your heart cells, and your brain cells. What would be some advice then for our listeners who are perhaps at the beginning of this journey and maybe feel a little bit overwhelmed at tackling all of these different pillars and starting new habits in order to build that resists. brain as they age? My recommendation is forget Alzheimer's. I think a lot of people lose hope by thinking that there are the earliest days of Alzheimer's disease and that there's nothing you can do about it.

That's unfortunate. So forget about Alzheimer's disease. You know, only in my practice, in my world, I've seen the patients that I've seen, Only 5 to 10% of people have late-life Alzheimer's disease that cannot be prevented or delayed or slowed. Most of the time, people have a soup of problems in their brains, and most of the ingredients of soup are treatable problems. So step number one is forget about Alzheimer's disease, have a positive attitude toward aging, realize that you can improve your brain functions. To me, that's a most important factor. Have belief that I am going to have a sharper brain in three months, six months, or a year.

And then, you know, do simple daily changes in your lifestyle choices. Walk more. You know, if you see junk food, don't eat junk food. I mean, if you see a highly processed thing like a donut or muffin or cookie or pizza, things that you know are not good for you, well, don't eat them or eat half of it. much. You know, so if something stresses you out, realize that stress is really bad for your brain, and you have to realize if this traffic, if this person's comments, if this happened to, you know, it's car accident, whatever happened, is worth your brain cells. Let me give you a little story

about my daughter. I have two daughters, we're in college now, but when they were younger, they used to come to my talks. And my younger daughter, Maya, was actually a little in, you know, hippocampus and Alzheimer's disease. And when she was in second grade, she was not preparing her homework and just read a book and she hadn't even started reading it. So I said, honey, you haven't even started reading this book that you're supposed to write a review on in two days. I said, Dad, you're stressing me out and that's not good for my hippocampus.

So I think of that in daily life. I really appreciate whether whatever is happening is worth my hippocampus. most of the time the answer is no. And then, you know, if there are opportunities to use a calculator or use a GPS, well, try to challenge your brain, do a Suduco, you know, join a book club, do things that require you to think, learn a language, learn how to dance, take a hobby you always wanted to do. The things that help improve brain functions are not expensive and they're not dramatic. They're simple daily habits that we have. So focus on five pillars of brain health.

Exercise, sleep, diet, stress reduction, and brain training. And every day, when you have choices, pick your choices that are aligned with those five pillars of brain health. And once you're in the habit of doing those things, you really will work toward keeping your brain that's vibrant and strong. I sometimes talk about how you can think of your brain as a garden. You can let the garden be and thinks, you know, the weed will grow and some of the plants will fade and die if you don't water them.

So think of it the same way. Your brain needs water, needs the blood flow, and your brain needs nutrients. You need to, you know, take care of feeding your brain just right. And, you know, think of weeds as stress that are unnecessary. Don't let weeds grow. So think of your brain as a garden and how easy it is. is for you to have a garden that blossoms and is full of life or a garden that's scattered and dry and falling apart.

So that was Majid Fetui, a doctor, neuroscientist, author and creator of the Brain Fitness Program. His new book, The Invincible Brain, goes on sale on the 3rd of March, 2026, and is available from all good bookstores. Thanks again for listening to this. this episode of Instant Genius, brought to you by the team behind BBC Science Focus. If you liked what you just heard, and please consider subscribing to Instant Genius on your preferred podcast platform. If you'd like to watch our presenters and guests speaking in person,

then you can also check out our YouTube channel at Science Focus. The current issue of BBC Science Focus magazine is out now. Pick up a copy wherever you buy your favourite magazines, or download us on your app store of choice. You can also find us on Apple News, or online at sciencefocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal. Name Audio believes you can have digital precision

with analog warmth. Alongside French acoustic specialist focal, name creates high-end audio systems combining innovation with craftsmanship, so you can listen to music, just as the artist intended. Discover more. at name audio.com.

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