Mayim Bialik's Breakdown - Dr. Gary Small: Bolster Your Brain & Lengthen Longevity

Episode Date: July 15, 2021

Dr. Gary Small, Professor of Psychiatry, Biobehavioral Sciences & Aging and Director of the UCLA Longevity Center, breaks down the biological causes and symptoms of aging and its impact on mental wellness. He discusses the effects of neurodegenerative memory disorders on patients and caregivers, his personal experiences with Alzheimer’s, and the toll his work with the difficult aspects of cognitive transitions takes on him. Mayim and Dr. Small examine the negative effects of stress and isolation on the aging process and how technology has the potential to help or harm it before delving into the ways we can strengthen our brains through meditation, sleep, therapy, social connections, learning a language or instrument, and even certain foods. They unpack the roles of the elderly in our society and the ways various cultures treat aging populations. Mayim opens up about her father’s degenerative condition, details common reasons we distract ourselves, and explains the Look-Snap-Connect techniques we can use to maintain and improve active brain health and memory. Dr. Gary Small's Books: http://drgarysmall.com/books/ BialikBreakdown.com YouTube.com/mayimbialik Learn more about your ad choices. Visit megaphone.fm/adchoices

We did a study of 13-year-olds who went to nature camp, so they didn't have any screen time for five days. And we tested their emotional and social intelligence. It went up significantly just after five days. So as far as we know, it's not permanent brain damage. But, you know, how will that affect them in the future? If they play every day, it feels pretty permanent. Hi, I'm I am Bialik and welcome to my breakdown. This is the place where we break things down so you don't have to.

have to. Today, we're going to break down. Today, we're going to break down aging. I'd like to introduce the oldest soul I know, Jonathan Cohen. Hello, Ma'am. How you doing? I'm pretty good. You're feeling young today? I'm feeling a spry 750. Jonathan, where can people learn more about us? They can learn more about us at Bialikbreakdown.com. That's B-I-A-A-L-I-K Breakdown.com where you can ask my anything. You can also find resources that are listed in the episode

and articles written by science communicators who are trying to break down information and help people get smarter. I was distracted by the way you pronounced resources. How did I say it? Canadians apparently say resources. I have a list of funny things you say. We'll post those on the website.

But first, if you haven't subscribed to the podcast yet, please do so. And write us a five-star review. We read those reviews. I screenshot them and send them to Miam. So know that what you put there, she will see. Even the bad ones. Even the bad ones. Oh, there was a great one that said.

Are we doing this? We're going to do it. I'm going to skip the worst part. No, no, no. I think it's important. I think it's important. Because the worst part, it wasn't that bad. The worst part was essentially someone did not like the way I speak.

They said that my speech sounds frenetic and pressured. Those are mania terms. I get it. But they said that my pacing was making them anxious, which I have this experience of sometimes I listen to people speaking. And it's like, I can't. It makes my heart start vibrating. So I'm sorry that I was that person for you. What did they say about me?

In contrast. I want to look at you and I say. In contrast, her co-host has a common gentle manner. And I hope he will speak up more in future episodes. That's when I said to him, did your mother write this? It wasn't my mom or me. Let's break down aging, shall we? Let's do it.

Here's an astounding statistic. 80 million people, they're called baby boomers when they're of a certain age that we're talking about. 80 million baby boomers are basically now reaching the age when they're their memory is starting to fail. That's a lot of people. It's a lot of people forgetting where their car keys are. Pretty much. I mean, that's the reality. And people might be thinking like, well, isn't it always like that? No, because there was a boom after World War II of people having babies because like, we won the war. We should start a service. We'll deliver you another car key immediately when you lose it. I don't think that's the way to solve this problem, as it were. Most people will get some form of

something when they get to a certain age. I know that's a super vague statement, but think about it. If you live long enough, something's going to happen. And it, in many cases, will be Alzheimer's, another form of disorder that has dementia associated with it. By 85, 50% of people will have some form of cognitive impairment. Correct. Related to aging. Related to aging. And yes, there are genetic markers, there are genetic risk factors. When telomeres were discovered, and telomeres is something that, you know, the people researching telomeres knew about long before, I did, but I think somewhere in early, probably undergrad, you know, so 90s. Tell us what telomeres are. Word of the day. I mean, I'm going to, I'm going to do a very layperson's explanation. So, you know,

you know DNA? So DNA is inside cells, and cells have to reproduce. because cells die all the time. They have a life cycle. And so every time a cell reproduces, it has to replicate its DNA because it has to tell the other cell like, oh, you're replacing me. I know this might sound hard to visualize, but you've probably seen a double helix. At the end of those strands, again, this is a layperson's description, picture caps on either end. A little cap. Like they're each wearing a little hat.

A little cap. Like a Canadian tuk? Like a toque. With a little pump-pum? Like a yamilke or a beanie. No pom-pom. Okay. No pom-pom.

And these caps are designed so that every time that cell replicates, every time that DNA has to be told to make more, the cap gets a little smaller. Like it loses a little bit of its thread, if you want to think of it like that. It's tired. It, well, it is tired. It's tired of existing.

So with enough replications of that DNA, those telomeres get shorter, smaller. And when it was discovered that telomeres, exist. It was kind of, you know, one of the most concrete visualizations that we had as scientists and as a community to say like, oh, is this aging? What if we can stop the telomeres from getting shorter? When the fact is that it's a spurious question because is it the telomere shortening that's making you age? Are they aging because it's repla? Like, there's a million questions which have since been answered essentially. That notion, you know, introduces the fact that like aging's not this

amorphous thing. It's not sure you can look at it as, you know, the grim reaper come in and tell you it's time. You can look at it as God saying, I need you in heaven. You know, like whatever poetic way you want to think about it, that's what culture is for. That's what religion is for is to make you feel better about the fact that we're all going to die. So to try and up the positivity, there's a tremendous amount of really, really fascinating research and hopeful research that not only can help us understand the brain in its degeneration, but also can help us understand how to delay or make less impactful and significant the kind of degeneration that in many cases is simply normal. The general takeaway is that existing is exhausting.

As we break down aging, it's also, it's like I'm feeling very meta about this episode because there's breaking down aging and how that impacts mental health. But then I'm also thinking like, well, these kinds of aging processes impact our mental health because there's often depression associated with these things. My father had cognitive decline, which was, you know, pretty startling. And he was aware of it. And that was really, really sad. I mean, it was sad for me, but it was sad for him, meaning there's a mental health component

also to the aging process. And that's what geriatric psychiatry, you know, is seeking to address. But also, these are family. family diseases, especially if you come from a close-knit family or a family that is, you know, maybe too close-knit, but where you know a lot of what's going on, things like dementia impact the entire family. Caregivers are extremely burdened by having to take care of people who are losing faculty. My grandfather had started to go down the Alzheimer's path when I was about 11 and he would

and the level of agitation that he experienced and then, you know, he would wander off and not be able to find his way home and constantly leaving the house without telling anyone. And so you wouldn't, and this is before cell phone. So you couldn't find him. Wow. There's a statistic that 50% of people caring for someone with a neurodegenerative memory disorder will have experienced depression. It's a multifaceted thing to break down. But in particular, aging itself impacts mental health. it impacts mental wellness because how you've prepared your brain up until you start that aging process can have a tremendous impact on how well you're able to do things that we know are

good for the brain, right? Things like socializing. I mean, we're consolidating information from the time that we're born. And the brain gets normal exercise. You know, we don't really think about it, but everything you do is exercising your brain. Anytime you're bringing new ideas, ideas, learning new things, experiencing things, smelling things. Like, that's all stimulation for the brain. But our mental wellness is also a reflection of how we've been able to prepare, essentially, for the aging process. I was thinking, like, how do we feel about aging? Jonathan, how do you feel about aging? It's really this juxtaposition where I want all the knowledge I get from being older, but I don't want any of the limits of,

my physical body, my more increased pain. I don't know if my memory, I have a hard time with names. I'm very good with faces, but I definitely see it. What's my name? But I've seen increase of memory issues for myself. And I don't know if that's age, whether or not I'm doing a podcast and starting a business and running multiple teams and on tons of apps, increase of distraction, the fact that it's a pandemic.

You're already demonstrating the answer to my question, because how quickly you ran away from the question. How do you feel about it? Oh, yeah. It's, ooh, very clever. I wasn't trying to be clever, but I don't feel good generally about aging. Like, it's scary to me.

Death sounds scary, dying, that process. I don't look forward to that. And, you know, our culture is really not supportive of age. We don't really see old people. You see them and they're sad or we put them in homes. Many of us do not grow up with old people around us. I mean, my mother did. You know, and people of that generation.

And obviously, certain cultural and ethnic communities do have different relationships with older people. And living together, you know, in homes with older people, allows children to experience more about aging. But now it's like this very sanitized kind of notion of aging. And like being a woman and thinking about aging is especially. terrifying because we do have a culture, which I get it, you know, really values female attractiveness, which, yes, you can be attractive and old, but, you know, those kind of Western heteronormative notions of beauty are almost exclusively associated with youth. When you hear that other cultures don't fear aging the way I think many in our culture do,

it's a... Who doesn't fear that? It's a real bummer. Okay, so indigenous cultures historically have elders who have wisdom. And in many cases, they're passing on the wisdom, storytelling wisdom, life experience wisdom, but also medicinal wisdom. The grandmother bench project, I believe it's in West Africa, but I would have to get specific. but the notion is that there was basically an untapped labor force in grandmothers who could provide mental health services to anyone in the community. And they created a project whereby they would use park benches and hold office hours where people could come and just talk to them. And the ability to have elderly people who have a different perspective and usually have a different intensity to their energy,

meaning that they're slowed down a little bit by life and potentially less to do. Hence hanging out on a bench. But that role in society to hold space to be someone to talk to, to be able to share with, to have, get perspective from is extremely important and valuable and has been lost in our society. There have been other projects in the West that have paired, retired and elderly people with students who need housing. You know, I have a couple, I have a couple resources. I'm going to add to our website also. there's a program that pairs teens from the inner cities with Holocaust survivors so that they can learn about a very specific life experience. There's also language pairings.

Maybe aging's not a problem. No one's afraid of it. There's all these organizations. Everything's great. And that organization pairs people who want to learn a language with someone who speaks that language so that they can have interaction. This concept of kind of how we view aging, like this is a concept we could do. do literally an entire episode just on. But I did want to talk more specifically

and introduce Dr. Small. What are the things that are bad for aging? We know this. Stress. Okay, so, and like, that's a scientific thing. That's not just like, don't be so stressed. It's going to make you look older. You'll get frown marks, which you will.

Tell us how you know. Oh, because cortisol's terrible in high doses for your brain. And it did an experiment that shows us this. I don't have that experiment right here. We don't have the experiment right here. This guy. When I read this, I was like, oh, not, people aren't just. Oh, it's not just made up.

And people are going to be like, my grandmother was so stressed and she lived to 130. That does happen. We're not speaking anecdotally. Don't start with me with anecdotal science. Generally speaking, and again, studies with adorable animals is very hard. Stress increases the aging process. We know that. What else is bad for aging, Jonathan?

Isolation. Isolation. Lack of interaction and communication with other people. We'll talk a little bit why that is later. What else is bad for aging? I'm going to say technology, but it's not technology in and of itself. It's passive use of technology that does not. And overuse and over stimulation by technology.

Primarily that removes novelty that makes our brain have to work hard and synthesize information. I mean, my parents used to say, if you keep staring at that television, you're just going to be a dumb person. Like, that's just like how they spoke to me. They've done fMRI scans where they show people watching TV and it puts your brain into a passive state that is not active in that passive state where we're not building connections is what's dangerous. Absolutely. What's good for aging, Jonathan? Meditation is always the answer, people. How many episodes of this show do we need to do where we tell you that you need to meditate? No one likes to be told what to do, but Dr. Smalls in his TED talk says that 10 minutes of meditation

can improve measures of telomeres. You with those telomeres. Meditation's good. You know what else is good for aging? the stupid stuff that your parents told you, sleep. You have to sleep. And things that disrupt your sleep, don't do them. That includes alcohol, caffeine, overstimulation before bedtime. But I go right to sleep. Sure you do. Your brain doesn't believe you. Sleep. What else is good for aging? And Dr. Small is going to talk about this. Talking about what bothers you. Therapy, folks. I know people don't like to be told what to do, but so far meditation and therapy are winning this podcast. Even talking to friends and having social interactions. Sometimes when I talk to friends it makes it worse. The right type of friends. What else is good for aging? There are certain foods,

and Dr. Small is going to talk to us about certain foods, certain spices. Novelty we mentioned, letting your brain get exercise, and good social connections and stimulation. Also, you're good for my brain. Identifying depression and anxiety, which can fall under stress, but they are different. True that. And they have long-term, impacts on our cognitive abilities. Correct. I'd like to introduce Dr. Small. I would like you to introduce Dr. Small. Dr. Small is a medical doctor. He's a professor of psychiatry and biobehavioral sciences.

And he was the Parlo-Solomon Professor on Aging at the Geffen School of Medicine at UCLA, my alma mater. He also was the director, I believe the founder and director of the UCLA Longevity Center on Aging, and also the director of the Geriatric Psychiatry Division at the Semmel Institute for Neuroscience and Human Behavior. He and I likely interacted. I probably spilled something on him. I'm a very klutzy person. I probably spilled something on him in one of the cafeterias that we might have frequented together. His team has developed brain imaging technologies that can detect the earliest signs of Alzheimer's disease even before people have symptoms, which has led to expanded Medicare coverage for this PET scan that he designed, and he tells us all about that. That's amazing. In addition to testing medicines that can delay the onset of Alzheimer's disease, he has studied and developed lifestyle and memory. training programs available throughout the United States in senior centers, community hospitals, and living facilities. He has authored over 500 scientific works. He has received numerous awards and honors by the Psychiatric Association, the Association for Geriatric Psychiatry.

Scientific American named him one of the world's top innovators in science and technology, which is, although Scientific American isn't like one of the main science journals, it is such a, it's a popular science magazine. That's really, really cool. He's been featured, you know, in the New York Times, Wall Street Journal, USA Today. He's appeared on the Today Show and all sorts of fun things. He also writes with his wife, which is just Adorbs, several popular books, including the Memory Bible, which he's going to talk about as having a reissue. That was a New York Times bestseller, Memory Prescription, Longevity Bible, eye brain. Very prolific him and his wife. What have we been doing? Well, clearly they must have the Fountain of Youth. Let's talk about that.

Who discovered the Fountain of Youth? Juan Ponce de Leon, Spanish Discover. I remember that from fifth grade. Your memory is clearly doing well. Work and overtime. Let's welcome my fellow Bruin, Dr. Small. Break it down. My Ambialx breakdown is supported by Superpower. We all know the feeling of leaving a doctor's office

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I'm well. How are you? I'm doing okay. Jonathan and I are very, very excited to talk to you about this topic, mostly because we spend a lot of our time thinking about death and dying. And so we thought it would really be appropriate to get to talk to someone who, you know, who has, you know, dedicated a significant portion of your life, you know, to studying the processes of aging. and mostly someone who can validate all of our concerns. Yes, exactly. I'm your man. The first question I have for you. Yes.

How did you choose to study this? You know, kind of what was your career trajectory? Were you like, let's go to medical school and study death and dying? I'm assuming that wasn't exactly how it came about. But tell us a little bit about kind of how you got here. How much time did you? We'll give you four minutes for this answer. Okay.

So let's just start. Let's start with this. So I always was a person who liked solving problems, puzzles, et cetera. And I was definitely thinking of a research career or a creative career. And my father was a physician. And he basically said, Gary, do anything you want. Just make sure you go to medical school first. So that kind of got me in that direction. And when I was in medical school, I was, I started out in internal medicine, with an intern. I was just struck by how behavior was so important to deal people. And that got me into psychiatry. So I ended up in Boston for three years, spending psychiatry. And I wanted to return to my native California and fall out. So I was looking for, I was still interested in the interface of physical health and mental health. And there weren't any jobs that seemed right for me, but there was a training program in geriatric psychiatry. So I thought, well, older people get physically ill, and that might

fit in with my interest. And from there, when I got into geriatrics, I realized memory, brain aging, Alzheimer's, that was just a huge problem. I started with Alzheimer's early on in my career once I got to UCLA. And it was interesting. You started the program talking about thinking about death the negative. I, you know, I always see the cup half full and I kind of turn it around and think about how we can live better longer. In fact, when I took on the longevity center at UCLA, that was our tagline. When did you first learn about Alzheimer's? What year was it? Just roughly. Well, I can tell you, it was probably my second year of medical school. And I was taking pathology, right? I was looking at slides and we had, you know, a session, what it looked like in the brain.

And I got to tell you, that was about it. We had very little education of dementia. And what year was this for those of us who are not following your CV along with the podcast? This was, I think this was before they discovered the germ theory. It was a few years ago. So I went to medical school. It was 1974. You've also, I mean, we'll get into several areas of aging.

You know, Alzheimer's is just one. but you've basically seen the complete trajectory of an identification, right, of one of these kind of classifications, which is typically diagnosed postmortem by slides and looking at brains and in particular plaques. But you've literally seen the full trajectory of identifying Alzheimer's, the research, you know, in the community surrounding it, and now sort of into a conversation about treatments for Alzheimer's. Like, that's an enormous trajectory for you to be part of in terms of your career working in this field.

What has that been like to literally be, you know, essentially living a discovery as we're discovering it? Well, it's been very exciting to tell you. I mean, it's a devastating illness. But I have been at the forefront of a lot of these discoveries. I've had tremendous opportunities with with some really bright, you know, creative people throughout the world. And you're right. I mean, when we started out in the area, we had no specific treatment. All we would do would be to try to find out is this a depression or medication side effect.

Then we had the discovery of colonistrate inhibitors, what we call symptomatic treatments for the disease, like cure it, but offer some temporary modest benefit, better diagnostic approaches, discoveries of genetic risks and genetic mutations and working on the imaging discoveries. Our team was involved in the discovery of the first pet brain scan that could actually visualize the physical evidence of the disease and moving people. It's been a very exciting run over the years. Absolutely. About that scan, you mentioned that it can visualize the disease.

And that's the first time because previously we were all. only able to see it post-mortem, as my mention. Well, there is usually a presumption of a diagnosis based on, you know, a variety of criteria, meaning most people, when people say like, oh, my grandfather, my father has Alzheimer's, my mother, whatever, it's usually because we have a collection of symptoms that, statistically speaking, we know post-mortem, their brain looks like this, and that's what gives you those symptoms. There are also a lot of other forms of dementia, normal cognitive impairment, memory loss, but Alzheimer's is specific for some of these physiological things, which can be imaged.

And yes. And so I'm curious, number one is, like, that breakthrough is enormous, the fact that you can now see it in people who are alive. So I'm curious how that innovation came about. And then the second part is, can you also see other forms of dementia or is it only Alzheimer's that it spots? Well, you've asked a lot of questions for somebody before. I'm telling you. So let me see if I can, you're testing my short-term memory.

So let me just tell you how it happened. I mean, we were, you know, the guy who invented the PET scan was actually at UCLA, so there was a lot of innovation in that area. And there had been a lot of research or some research at the time looking at a PET scan, conventional PET scan. So a PET scan is a big scanner is like a guide or counter, measures radio activity. And what you do, you inject a chemical with a radioactive label into the vein of the research volunteer patient, and it's taken up by the brain.

Most of the scans at the time and continue this way, you inject a form of glucose or sugar. We had done some research looking at how sugar is taken up by the brain. It shows you characteristic patterns in Alzheimer's business. Certain areas of the brain show dysfunction, less cellular things. function with the sugar test. And essentially, that's a metabolic measurement, correct? That's right. Yeah. So it shows you how well the cells are firing. And it could give you, and it's still a, you know, we actually in the early 2000s,

our group went to Baltimore and talked to policymakers and were able to change the policy for Medicare reimbursement for that type of scan. And actually differentiate Alzheimer's from another form of. dementia, you know, as you mentioned, Mayam, there's lots of causes, another one, frontal, temporal dementia. Policymakers thought that was important because the treatment's different. We were thinking, well, why not get to the bottom of it? Maybe there's a chemical that we can inject that would collect around the amyloid plaques

and tau tangles, which are the abnormal protein deposits that are associated with the disease and actually collect in areas that control thinking and memory. You can say the names of those areas. You're among friends here. You're really testing my memories. So the frontal loves, the thinking brain, the hippocampus, the very important memory consolidation area underneath the temples, the parietal area further to the back of the brain. So these areas tend to collect the plaques and tangles.

And those are also the areas where you see the cellular dysfunction on the root. So a group of us, a chemist, George Barrio, who had actually developed some of these chemicals for other applications, Parkinson's disease. Another basic scientists have worked with animal models, Greg Cole, and a couple of the other scientists, we're trying to figure this out. And George had actually synthesized a molecule that he had developed for a certain type of mites. And microscopy called confocal microscopy. It's very important. I know it well. So as a term, you probably know it better than I do, but it turns out that the chemical properties of this particular molecule, and the shorthand is FDNP, is such that it is attracted to lipophilic areas. That's fat loving.

Fat, right. You love fat, you love water. That's how it is in biology. So, and it turns out that the, the internal parts of these abnormal protein deposits, the plaques and tangles, are lipophil. So we said, well, let's try this out. So we look good in animals, in small animals. We couldn't get a good primate model to work. It wasn't really good. Let's try a really good primate model. Let's try it with humans. Right on. It's a little more, a little more pesky with humans, though, Dr. Small. They've got to sign all these forms. You've got to run it through. You've got to get it right. You have no idea. And it worked. So just to kind of like sum up this particular technique, so we have this tracer essentially that likes regions that like fat. And so if you put that into this kind of system,

you have these plaques and these tangle, tau tangles, though? It's not. Plax and tangles. And so the same tracer that can find anything that likes fat is able to essentially target these, and that's what you're seeing. Also, I'd like to note that this is not like a portable scanner that you can like take around to nursing homes. Like this is a very expensive diagnostic piece of machinery. So this is not something that, you know, we can at this point make readily available to everyone who we'd like to know if they have Alzheimer's. Apple's coming out with one in 2025. Yeah, I'm sure they are. built into my hat and it's going to tell me my brain function on any given day. That's where this is going next, right? No. You asked Dr. Small like three more questions. Well, I think it's important to, like, because this is a huge advancement that, you know, people who are listening to

the science and are trying to, you know, I'm not a, I don't have a scientific background, so I'm, I'm following along. But the main point here is that this is a massive change in how we can identify brain function and health in living individuals, which up until I don't know what year you can me was not possible, which is like, you know, a huge change in our ability to treat people. Well, you know, I think there are, there's definitely an advantage here, but, you know, there's, it's not so simple. You know, you already pointed out these are expensive devices. Now, despite that, there are PET scanners in many different places and there are radio

pharmaceutical companies that can deliver these tracers to these different scanners. so it can be scaled up. And if it were used quite a bit, I mean, you know, quickly mentioned Apple, the new scanner, these technologies can come down on the cost. But they are expensive.

And, you know, for someone who's done a lot of research in the area of these different scans, I'm relatively conservative of how I use them. You know, and in a way, we're at a step right now. There have been other tracers developed since then.

There have been traces that are specific for amyloid, those that are specific for tau. I prefer ours because I think it gives you a broader picture of what's going on in the brain. And we've also more recently done studies in military personnel that have had blast injuries and retired athletes, football players. And we see a different pattern in those head trauma victims. And the patterns are different in Louis-Body dementia. So it helps us differentiate these different kinds of disorders. And I think that's a good and important point that, you know, and with all due respect to my co-pilot, who is not, you know, a science type. People get very excited, especially in the field of aging.

All of our collective fears kind of come out when we think about this kind of research because I think in the back of all of our heads, we're kind of like, but what can this tell us about how to beat death? Like, really? because I think a tremendous amount of the value of the kind of work that Dr. Small and his colleagues all over the world have been doing is to give us more information so that we can also understand the healthy functioning brain and not just the aging brain. But I think that that kind of leads to a question that we wanted to ask. Well, I'm going to tee it up. Okay. Because once you get that scan, it's too late. This is the thing.

We're all going to die. And the longer you live, the more statistic chance you have of getting something you don't want. And it's going to be that your brain is showing that it's not made to live at a certain amount of functioning. Like, period. So this is, like, I can see, Jonathan's like, so we get the scanners, and then we can know how to all live forever. And I will always be young and beautiful. It's going to lead us into talking about the preventative things that we can do now that help us earlier on. And what I meant by too late is it's not that you can't intervene, but you want to try and start a healthy habit of brain health much earlier than, oh, wait a second, I'm experiencing something that.

I would argue a healthier perspective on death, dying, and aging would save us a tremendous amount of anxiety about things. like this, but I'll see what Dr. Small says. Well, you know, you guys are bringing up a lot of issues. And so one of them, first, let me clarify. I mean, this scan can actually detect Alzheimer's brain decades before you get obvious symptoms of dementia. So it isn't a really detector. So that's number one.

Number two, the problem we have, it's a bit like we have a cholesterol test, but we don't have a sudden drug. So, you know, why get, you get the scan. scan. You find out and go, I've seen this. People get these scans, you know, some of the competing scans, and they come to me, Dr. Small, Dr. Smith said, she gets the scan. I was just forgetting where I put my keys. And now I have Alzheimer's. Right. Very anxious. So my job is to calm them down. Right. Because my wife and I, we've written about a dozen books where we translate all this science

into language people can understand thanks to her. I did credit that she's the writer. And our first book, the memory Bible, if I could just do a little plug. Please. Please. And we're going to link all your books on my website. It's update. It's coming out this year.

Second edition, New York Times, a seller. But I remember when we first wrote it, the first chapter, the title, visibly the only note the editor had, first chapter was, you're one day closer to Alzheimer's series. Right, you're going to die anyway. Read our book. So she flipped it around. And it was you have more control than you realize it.

Well, that's a very positive spin. And there's truth to that. I mean, so for some people, they might get a scan and might motivate them. Sure. There's lots of data. on that. For others, it may make them anxious. It's quite complex. I mean, how, when we get these scans, how to fix it. Right. Okay. Okay. Okay. Let's take a step back. No, because I'm not ready to talk yet about, I have, I have a couple questions before we get into, go ahead, Jonathan. He really wants to just be,

how do I stay young and beautiful? That's, that's your stick. I've already given up. I'm no longer young and beautiful. What is it, okay, so here's, here's my question about someone who's getting the scan, You said it can detect decades in advance about the potential of getting Alzheimer's or the fact that you are going to get it. So, you know, the bottom line is if you do these scans, and it's particularly true about the scan we've developed, some of the other scans not so much, you can see a pattern of the buildup of these abnormalities in the living brain at different ages. And it correlates with normal mild forgetfulness, the more severe forms of forgetfulness. see you build up and it looks just like what you see in the pattern with autopsis. So another way of thinking about it is that we all have Alzheimer's disease developing in our brains through a subtle degree if you define the disease by the accumulation.

It's not unlike when you look at arteries. You can tell that, oh, if this pattern of artery clogged continues, you will likely have a heart attack. So you see patterns of abnormality and then You see accumulations. It's literally physical clumps. And if it clumps up, it's like the shower drain. You know, you can see that there's stuff already clogging the drain. And that's the earliest detection before you get symptoms of the drain not working. Very good analogy. I think everyone now understands clearly. And now you're projecting forward to say this clumping will continue or not at a certain rate potentially. Or you can start to engage. lifestyle changes that may change the progression or accumulation of those patterns. Yeah, but that's a good segue into what you can do to deal with this, to slow down or delay the onset symptoms. In fact, we've done studies where we look at these scans and we look at how much physical exercise the person engages, or even a surrogate of that, how much time you spend sitting. And actually, you know, if you filled out a questionnaire, you told us how much

time has been sitting during the day, that would correlate with how much Alzheimer's is in your brain. We should probably all get up. I got to get up. Sorry, got to go guys. So, yes. So this, you can actually have an impact on the trajectory of this disease if you live a healthy lifestyle. We talk about the things that are, quote, good, you know, for aging or good for your brain. But before we get into kind of some of the details, you know, we know that there are these regions on earth where people live healthy lives, statistically disproportionate portions. You know, people living towards 100 with a level of enjoyment of their life and participation in society. And, you know, there's a documentary Happy which examines people, these kind of

communities all over the world. There's many specials about certain regions. There's Greece. There's Italy. There's these isolated islands. Regions of Japan. You know, one of the things that that we know is happening in these kind of communities is a lot of interdependence in healthy ways socially. You know, Northern Europe also has a lot of establishment of integrated communities where people are really constantly in contact and have the ability to socialize. Why is that important? Well, socializing is very important. I mean, you know, when we're having a conversation, it's getting our neural circuits some exercise. I'm thinking, what are you saying?

What am I saying next? Do I listen? Do I interrupt? Do I check my email? I mean, all these kinds of bits of neural firing is going on in our brains. And so we think that that is a form of brain exercise. There's other things that are going on. When you connect with people, that gives you some emotional support.

And we know, for example, depression. isolation, these factors are associated with the shorter life expectancy with more disease outcomes. And that affects our amygdala, the emotional control center of our brain. If we don't have that social connection, that empathic interaction with people. And another, it's probably a third, another way, many other ways, but a third big way that socializing helps in a practical sense. You know, you spray your ankle and you call up your friend, you know, who's a good doctor for ankle spruits? Or can you give me a ride? I can't even get to my car. So I think those practical connections are very important with social. Another thing that we talk about that's kind of

good for the aging brain or just good for our brains in general, you know, there's a lot of discussion about also the food of different cultures. And, you know, it's like we're all kind of searching for like, what's the perfect diet so that I'll stay young and beautiful and live forever. And one of the kind of dangers, I'm sure, of your entire field is, you know, the risk of association versus correlation discussions. Because you could say, oh, all these people live to 100 in, let's just pick a place, you know, and this island in Greece, it must be the weather, right? Or it must be the olive oil, or it must be the chess. Like, you know, you have to, we have to be scientific about the ways that we approach, understanding what these correlations are and not simply just associations. So, you know,

there's a lot of talk about like coffee and like alcohol in moderation and like, oh, certain communities or certain cultures that eat a lot of this certain spice or this collection of spices seem to have longevity. How do you kind of like, how do you weave through all that? So when people say to you, like, well, what should I be eating? What should I be drinking? Like, what's going to make my brain, you know, my mother every week is like, did you know? Did you know? that I need to eat more blueberries, Ma'am? Yes, Ma, eat more blueberries. Like, eat anything that's rich in color and don't eat processed food. And then we all just sort of like, hope you're praying to the right God about how long you get to live.

You know, it's complicated. I think it's very different. It's hard for scientists to understand all the data and there's conflicting data from different studies. And it's especially hard for the public because every day there's a, you know, if you look at the area of all times, and one day we say, take vitamin and the next day we say don't take vitamin. It depends on how you interpret with these studies. And so these kinds of association or epidemiological studies help inform us. They give us a clue, but you're right. It could be spurious connections. You know, I think, for example, I got into studying curcumin, which is part of the spice tumorin because of these epidemiological studies. You find in India where you eat a lot of curry,

curcuminic makes curry yellow. There's a lower rate of Alzheimer's disease and people are 70s and people who consume spicy foods more often, they actually score better on memory tests. I didn't have to eat while you're taking the test. But we don't, you know, could it be something else? Well, turmeric is anti-inflammatory also, right? Well, yeah. So then, you know, so then we looked at that and we look at the biology and it ticks all the boxes. It's anti-inflammatory, anti-oximate, anti-tow and anti-emone.

But it doesn't prove it. And the whole grid for me in science is the double-blind placebo-controlled study. Yep. So that way you kind of randomize half the people usually to the active ingredient or intervention, have to see a fake ingredient. And neither the doctors or the scientists or the volunteers know who's getting what during the course of the trial. And then you have standardized measures. In this case, you look at memory or cognition before and after.

And that tells you the result. It seems especially hard, given the length of time that this is affecting someone's life. So like, you know, the long-term studies. And it also seems extremely complicated because the number of factors that could potentially be influencing someone, where we talk about overall stress level, social interaction, novelty and being exposed to new things, your brain having to adapt and having that be exercised for us, it seems just impossible to isolate. one factor and say this is going to help and this won't well you know the three most important aspects of real estate right location location location in this area it's timing timing timing and

scientists have made the mistake many times so they do for let's take it and go back to inflammation in the 1990s Baltimore longitudinal study reported that there was an association between taking anti-inflammatory drugs like ibuprofen for two or more years and a 60% lower risk for developing also. So the scientists, you know, they all, great, let's do a randomized control. That was easy. We already produced that like Coca-Cola. So they took ibuprofen and they gave it to people who already had dementia. And guess what? Didn't work. It actually made them worse. and the timing was wrong.

So when we studied the anti-inflammatory effects of curcumin, we didn't look at people who had dementia. We looked at people who were much milder who were at risk before there was extensive damage in the brain. So, you know, I always think it's early, easier to protect a healthy brain rather than try to repair damage once in it. Good to remember.

Well, I mean, I think... Don't damage your brain. It's not going to be easy to fix. You know, one of the questions that Jonathan and I were talking about is like, let's ask Dr. Small, if we can beat death, you know? And I think like, you know, I mean, I say that kind of, you know, with a dose of humor, but the fact is like this kind of contemplation, you know, this is unique to our primate system.

I know people who are fixated to a clinically obsessive level as to what they should be eating or not, specifically because they're hoping to prevent this. You know, and that is a different perspective on how to approach your life, meaning all of this kind of research does inform how we should live when we're 20, you know, when we're 30, meaning the time to start ingesting blueberries is not when you're 70, you know, the notion is, oh, look, this kind of research can show us how critically important certain aspects of brain health are, But those things, we all get to do our best before we get to 70 is kind of, I mean, at least the way I'm sort of trying to look at it. But you know, you're absolutely right, but it's hard to motivate people unless they see a problem.

Our brains are really wired for immediate gratification. We're thinking about one might have for dinner. You're not thinking about long-term care insurance. So, and we actually looked at this. We collaborated with Gallup to, you know, they called people up every day and represented a sample of 18,000 people across the U.S. ages 18 to 99. And we found that the older person was the healthier of their lifestyle. So, you know, you could argue, well, if you're young and you live a lousy lifestyle,

you're never going to live to 70 and have some Gellup holster called. you up. But also what happens, you know, when you get in your 50s or 60s, your doctor says, you got to watch your weight, you got to stop smoking, you take this blood pressure medicine. Take away all my fun when I'm in my 50s. Well, there are medicines that are still fun. Well, this is an important point because in your TED talk, you mentioned that by age 45, that's me. scientists can identify memory loss in the average person.

So if you took an objective memory test, on average, it would be worse than when this in their 20s. So people start noticing these issues. And to me, that's been the low-hanging fruit, complaints about memory. That's why we've written books about it. Well, I mean, both of you could take advantage of the 45-year-old in the room. what I have noticed

specifically I've noticed that it's literally like I used to be able to hold more I used to be able to hold more information at once I used to be able to hold a larger collection of information certain things like lyrics those are in there every Elvis Costello song is not going away

it's different things but you put those in a long time ago and then put them into long-term storage it's like I filled up the jar with so many Elvis Costello lyrics and now there's no room for other things. No, but I mean, I make my living learning words, and I do have a partial photographic memory,

but I've noticed those kinds of things. And, you know, sometimes you have like a word, but I'm always like, is this it? Is this starting now? I'm going to be that lady. I'm curious if 20-year-olds today, 25-year-olds today, have a worse memory than 20 years ago. The neuroscientist says yes,

Dr. Small, over to you. Well, I would agree. I mean, I think part of the big issue is our technology. And so we've kind of changed how our brain processes information, how we use memory. And so we're not paying as much attention to what's going on because we're checking our social media themes all the time. And that kind of repetitive mental activity doesn't really stimulate the mind as well as this kind of conversation. So, and, you know, I can tell you from my own experience, and this is, look, our brains process things different as we age. And having studied this throughout my career, I'm aware of it.

It doesn't bother me. And people will come into my office and they'll complain about things and I'll think, well, I've got that. And I know it's not really that big a deal. But it's worrisome to many people, particularly if you have a family history of all times. Because every time you misplace your keys, you think, oh, my God, I'm on the really big a deal. to them. So anxiety will affect this. And I think it's going to be different with the younger generation, digital natives, how that's going to affect their mental processing. We've actually looked at this. We've done studies using functional MRI to see what the brain looks like

when people search online, whether they've had experience doing it or not. And even searching online can be a form of mental exercise. But if you do things repetitively, it's not going to necessarily stimulate those neural circuits. You don't want, some things you want to be wrote. For example, when we teach people memory techniques, you want to make that, that should be secondhand, like learning a language that doesn't necessarily have to exercise your brain because it has a practical application. But we want to stimulate our minds. I can tell you, you know, I was at UCLA for most of my career, just moved to New Jersey and taking on a new job that requires all kinds of new mental skills, going to a new place. You know, my wife and I moved out here. And you think it would

be, it is kind of daunting, but I got to tell you, it's also energizing. I feel like my mental capacity is actually improved. So this whole idea about lifelong learning, challenging yourself can really make a difference. the part of the TED Talk that I was fascinated about, the idea that it's about the novelty and that searching the internet or interacting with digital technology is not necessarily bad. What's negative is when it becomes rote and we're sort of mindlessly doing it and we're not being challenged. You know, when we say that 20-year-olds have a different type of memory. Impairment. Impairment or reduced amount of memory capability. Do we think that that will

then, you know, fast forward 40 years, 50 years, is that going to change their propensity or probability of having dementia or Alzheimer's or even further reduced memory as they get older. Is this another way that we can scare our children out of getting off of their phones is what you're really asking? And I'll add here, what you mentioned, that novelty, being on the internet can be good if it's challenging. It's a brain exercise to decipher and distill and process at a large amount of information or take in new images. But when we're just by road on our social media feeds, which is so many of us do, where we're just endlessly scrolling and not actually taking an information, we're just.

not challenging the brain at all and we're not doing it at any services. We don't know the answer to that question. There are some issues. It reminds me, you know, this question, my kids were teenagers. I was concerned about it. My son was playing video games. My daughter was going to bed with her Blackberry under her pillow. You know, I remember once shouting to my son, you're even playing this video game.

Harry, get off that game and come downstairs and watch television with me. completely ridiculous. And he told me, you know, he reprimanded me. Dad, you know, I was playing with my friends. We were having a social experience. So it's complicated. Some of the concerns is a young person, a lot of neural development goes on from birth to the teens.

And there's actually a process called pruning where supposedly 60% of the synapses, the neural connections are pruned away. And also your frontal, We mentioned the frontal lobe, the thinking brain, complex reasoning, that continues to develop even when people are in their 20. So how will it affect that? The other problem is emotional and social intelligence. We did a study of 13-year-olds who went to nature camp, so they didn't have any screen time for five days.

And we tested their emotional and social intelligence. It went up significantly just after five days. So as far as we know, it's not permanent brain. damage, but, you know, how will that affect that in the future? If they play every day, it feels pretty permanent. Well, their punishment will be five days of nature fans. Or the threat of Alzheimer's. This is terrible.

I actually did have a question. It's kind of a creative question about music. And, you know, Alive Inside is the really beautiful documentary about introducing music into nursing home and nursing care facilities. to kind of use music to reawaken certain aspects of memory, even in patients who are significantly impaired, you know, and are in really the depth of dementia, in particular in Alzheimer's. Just wondering if you have any personal, you know, take on this.

We're both, you know, musically inclined and, you know, such a huge emotional and memory component, you know, to music. And so I, you know, highly recommend this documentary to anyone who's listening who hasn't seen it. essentially what this one amazing guy did was he would find out how old the patient was and find the songs that were popular when they were in the prime of their teens. And he would play this music to them. And they would literally like, I mean, it awakened even an ability to be cognitive, an ability to be emotional, an ability to move their bodies in ways they hadn't.

Well, my brother, who has a traumatic brain injury and who had, you know, He struggles now even to articulate himself and to find his word retrieval is his struggles. He has a hard time forming long-term memory from short-term memory. But if you play a Led Zeppelin song or a tragically hip song from when he was before his accident, he knows every single word. And he's even surprised at himself that these words are coming out of his mouth. So it's fascinating. It is fascinating.

And, you know, I actually studied classical piano when I was a kid. You know, I can sit down. I have a medical school atrophied the skills. If I could sit down, I could start playing a late Beethoven Sonata or Chopin H. If I don't think about it. But if I start thinking about it, it's gone. It's almost like a motor emotional memory. And those feelings and those keyboard strokes come back without conscious thought.

And I think that's very clever going into nursing homes or places where patients with more advanced dementia can reactivate those experiences. And I think that's only going to be good for them. You know, we talked about socializing. One of the problems with our COVID pandemic is many of these patients are isolated even more. And it's a huge problem for the family members with patients. So I like that. music. Is it just novelty that learning a new language has shown to be helpful, playing music,

socializing? Is it just that the brain is being forced to do something that it's not used to? Or is there something specific about language and or learning an instrument that is activating the brain and helps us, you know, strengthen it? Again, we don't, you know, I can't give you a definite answer to that. But what we hypothesize is that if bilingual, you're using, um, you're using, more neurosurcuits with fine words. What's the word in Spanish or what's it in French? And so you're keeping your mind active. And there is that novelty.

Same thing with music or any other activity in your experience. So I think it would be interesting to give you precise answers, but I think at this point I think we should pretend like there's a neuroscientist in the room. You could also, it's like he's acting like he's never asked. You could ask me these things, too. What I would also argue. I'm asking both of you. What I would also add to that, as a person also who grew up speaking more than one language,

I would also add that, you know, anytime we learn something like a language, an instrument, a new skill, you're simultaneously expanding your consciousness of where you fit in the world and where other people fit. So that's one of the things that, especially children who are raised in bilingual families where one parent only speaks one language to them and the other parent, that child is now learning certain people understand me when I'm like this and other people understand me when I'm like that. And that's actually a beautiful lesson about just how we have to exist as humans. So the notion is when you speak, you know, when you speak math, right? Math is a language as well. You're learning about a consciousness outside of yours, which is part of, forgive me,

a human constructed reality, right? We put words to concepts and we call that language and we call that than math, right? But it does. It expands your brain in terms of placing you in a larger context of your existence. And I would argue that is really good for your brain. But what do I know? Talk to Dr. Small. I'm not needing. Well, listen, you've been asking me a bunch of questions. Let me ask you mine. Tell me, what did you focus on in neuroscience? I'm really curious. I studied psychoneuro endocrinology. I mean, that's my field. And I looked at obsessive-compulsive disorder in Prater-Willi syndrome. specifically assaying oxytocin, vasopressin, and cortisol.

So we did blood draws. And then we correlated it with, you know, the Y-box and sort of some of the standard obsessive compulsive scales. And Prater Willi syndrome is a syndrome of hypothalamic dysfunction. And, you know, there's a tremendous amount of comorbidity with other psychiatric conditions. It can be a very combative population. But anecdotally, it's a population that absolutely. loves babies and animals, which is the beginning of the conversation about what is this

hypothalamic dysregulation. It's obviously affecting their eating, but it seems to also be affecting affiliative behaviors. And there's so many feedback loops, you know, in the hypothalamus that it's very, very difficult, you know, to pin down. But this was a pilot study, as doctoral studies often are. So I worked under James McCracken and Elizabeth Dikens. And Michael Levine was on my committee, and Nancy Wayne was my endocrinologist. So I know a lot of those usual suspects. Yep. Wonderful team, yeah.

The field of longevity has gotten very popular lately. There's David Sinclair and Aubrey de Grey are two names that sort of jump to the surface and the notion that we don't have to think of our lifespan as to 70 to 80 to 90. They're trying to push the boundaries of that through both technological ways as well as lifestyle ways. And so, you know, we started in memory, but I'm curious about your perspective on longevity as a field

that is pushing our understanding of what is an expected lifespan. So, you know, a lot of people are in this area, and I think they're overly optimistic that you can really extend life expectancy. Thank you, Dr. Small. That's what I always tell him. But that's in the short one. We don't know what it's going to be like if we survive all this craziness in a thousand years. The big innovation when I was starting out was an IBM Selectric 2 type letter, which you can actually erase a letter.

But now we're all walking around with computers in our pockets, personal devices. I mean, there are, when I was heading the longevity center, we have a technology and aging conference. And I got to know some of the computer scientists there. And we were dealing with technologies where you could wear a sensor on your head. And just by thinking about it, turn on and off a light bulb. And studies have been done where you can actually type on a computer just through your thoughts. So where things are going, you don't know. I think it might be possible to live infinite.

I don't think it's not in our life. It's all about the telemirs. That's what the big research was when I was in grad school. Like, oh my gosh, telemirs. And what about sort of AI-assisted technology to help either identify conditions? So, for example, like voice recognition patterns, there has been some evidence to say that analyzing voice and speech patterns over time, you can tell when there's a change and start to do early intervention that way. or there have been chatbots for elderly people to try to get them more engaged in sort of continuing to use speech and language to communicate where they may otherwise sort of retreat during dementia and Alzheimer's. Any thoughts there?

Well, you know, I think the new technology is a very exciting pathway to facilitate health throughout life. And all these things we're talking about, you know, whether it's a health. scan or genetic markers. You know, that, it comes out of the science. And if you bring in the computers, it gets to be very powerful. So it's, you know, I'm very optimistic about where we can go in the future if we use our funding properly and we invest in the science. This is more about kind of you as a person.

Is what you do is, is it depressing? Is it inspiring? Like, do you get sad? You know, I don't know if I could do what you do. You know, my father had a degenerative condition. He had multi-system atrophy. And, you know, it looks a lot like Parkinson's. It looks a lot like ALS, you know. And obviously it's different when you're going through it on a personal level. But also as a scientist, you know, I had this, this tremendous, you know, perspective on this process, you know. And it's a vessel. We're in a vessel. You know, I'm, I happen to be a person of faith. So I know that there's a soul that I believe in, you know,

that exists outside of that vessel. But you work in a business, you know, of watching some of the most difficult aspects of our transition as physical beings. And I wonder what that's like for you. Like, you know, what is the toll it takes on you? Do you have a different perspective as a father, you know, as a, as a partner, as a, just as a person? What does that do to work in that? Sometimes it is sad, particularly when you see people who were vibrant or really accomplished individuals who gradually fade away. You know, I think if I just did clinical care all the time, it would be harder, to be emotionally more taxing. You know, in the last decade or so, I've seen Alzheimer's in my family, my mother and my mother-in-law got it. And I got to tell you, I must have learned more about it during that time than I did with all the scholarly work.

So, you know, I think when it's personal, it's a bigger impact. And despite all my, I think it helped all my knowledge and experience, but it's still tough. And you see very intelligent people who are very close to these family members. And it just doesn't, you know, they take the illness personally, you know, the issue. accuse me of this and how could she do that? I just told her this. You've got to sort of stand back and realize it's not the person talking. This is a disease problem. I think it is tough. On the other side, on the other hand, you know, it's been a very exciting time to be in the forefront of discovery. I mean, I'm a crossword puzzle, Sudoku fan. I love to do puzzles. And here I'm solving puzzles

sit and help people and make an impact on our lives. And that's tremendously rewarded. Tell us where we can find your books. Give us a couple names of name drops. You mentioned your the reissue, but also there's, I think of... Updating of the memory Bible. But, you know, we've talked about a lot of different topics here. We're talking about technology. Gigi and I wrote a book called iBrain and how technology affects your brain. You can go to DR.Garysmal.com, my book website or just go on Amazon or Google me and you can find a lot of these books. This is one of my favorite ones that you wrote called The Other Side of the Couch

is about my most unusual cases as a psychiatrist. Oh, it's a little Oliver Sacks moment you're having. I see. It follows it. It follows me from being a bumbling first-year resident I'm asked general to someone who will experience. And each chapter is sort of a medical mystery. Oh, I love that.

So maybe I can come back and we can talk about these broader issues. That's really awesome. I'd love to just have you on with my mother and have you explain to her that she should keep eating her blueberries. I would like to do a whole episode on the technology and the brain, the eye brain. I'm curious. There's a whole other area. It's fascinating. When did you write that?

That was, boy, I didn't know how to be tested here. I think it was in late 2008 or something like that. So it's changed a lot now. You know, in 2008, the number of smartphones, the type of use that was happening is different than it is now. It's changed, but the same issues are there. I was going to say, the brain hasn't changed in the last 10 years. No, I'm saying our exposure to the amount of technology that we're consuming has changed, I would say the amount of distraction has increased. You know, we're going to cover this in the conclusion.

but you have the look, snap, and connect model for increasing memory or helping form memory. And I was wondering in the look section where it says, you know, you have to pay attention if our collective distraction from technology is sort of eroding our ability to have that first step. I think it is. You know, it's sort of training our brain and going back to music to kind of a sticado way of thinking. You jump from idea by idea or website to website rather than stepping back thinking about problems in depth and really coming up with solutions and being more creative. So it's not a good situation, but it's not hopeless. I think in fact, we're even discussing it.

I would say that it's a huge, huge concern that we're collectively underestimating. You know, the level of exposure that we've had really has. exploded in the last 10, 15 years, and we actually don't know the long tail of this or what it's doing. When most people sit down at a computer to do a job if they're working on a computer, like I have Slack, Messenger, multiple platforms, hang out. You have too many windows open all the time. Way too many windows. I have to consciously either disconnect from the internet to try to do deep work. And the fact that as a world, we're putting all these barriers up to any sort of deep reflection, spending an hour plus on one topic to actually think it through and dissect,

I think is a serious problem for our attention, brain health, overall well-being that is not being considered. Also, drugs and alcohol. I mean, I'm just going to say it. Like, drugs and alcohol and untreated mental illness. There you go. Like, that's a, no, it's a trifecta of a crisis. that, you know, sure, it's very important to eat blueberries, but also, like, what would fundamentally be super significant is for people to have access to mental health care when they're younger

so that, you know, they're also not filling that with drugs and alcohol that also are not good for the brain. And often that distraction, again, avoids us or that sort of subtle distraction all the time because anxiety can be a subtle distraction. It helps, prevents us from being able to pay attention. I'm curious if what you think of neural net or the or neural link, I forget the name now, the Elon Musk venture to put electrodes in our brains and connect us to the internet. Obviously, it's being used right now for paralysis and helping people with cognitive impairments. It could obviously expand, but I'm curious if you have been following that closely and if you're

interested in it as it relates to memory and Alzheimer's. I haven't followed it. I haven't followed it. closely, but I think it's the future. Things like this are going to happen. I mentioned the sensors on your skull that are allowing you to interface with the computer. I think most people would rather put it a sensor than have an implant. But who knows what the future holds? It reminds me of Google glasses where you can see if you can walk. Big problem with you mentioned looks snap connect.

the most common age-related memory complaint is people's names. So you're walking down the hallway. You see someone, you know their name, but you don't remember it until you pass them. You feel like an idiotic, hi, how are you? Instead of hi, Jonathan, high mind. Right. So, you know, Google glasses, it pops up, identifies it and be socially appropriate with that. I'm sure nothing bad could happen from Electra's being implanted in our brains.

Nothing bad. The only thing that could happen is something good. That's right. Dr. Small, thank you so, so much. You really appreciate you talking to us and bearing with us through all of our questions. I really enjoyed the conversation. Thank you. We're both booking our brain scans with you next week.

Very kind. And it's great to chat with the fellow Bruin alumnus. Absolutely. Take care, Dr. Small. Okay, be welcome. Mine Bealeck's breakdown is supported by Scoremaster. This shocked me. The average American has 97%.

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That was Dr. Small. Interesting man. I mean, I can't imagine studying what he studies. I think I should start doing the protocol, getting that memory back. So you mentioned the look snap connect. So let's just talk about it. You might need help if you have trouble doing these things. So look snap connect is this kind of method of thinking about memory and, you know, keeping your brain

healthy looking is the ability to pay attention. We often have trouble remembering things and kind of getting our brains working if we're distracted. And, you know, this is like a little bit of like a, we sound like your mom and dad, you know, saying like, quit being so distracted. Get your face out of that book. Like even that, you know. No, put your face in a book is better than. Well, no, but when you're trying to interact with someone, look, distraction can be protective, especially for children who don't want to talk to their parents. No, but distraction as adults is important. It is protective because it usually means we can't handle what's actually going on.

So we need some sort of break. But as our technology has increased, our ability to be distracted and our distraction level in general is just at such a high level that it can be. I mean, I can't tell you how many times. I mean, this happens to me daily, daily at least half a day. dozen times where I think I've been listening to someone, but I haven't. I'm a part of most of this. That's just because I don't want to listen to you. That's different. No, but where I think I'm reading something and I'm paying attention and I'm totally not. And it's like I'm having an entirely different set of thoughts or even if I try and meditate or if I'm in yoga. Like I'm still

it's normal to be distracted and that's part of the meditative process is to not judge that distraction and, you know, to kind of keep re-centering yourself. But when it comes to sort of our normal daily functioning outside of a meditative state, just the ability to look. So that's the look. We're losing our collective ability to pay attention. I believe that. The second part of look snap connect is snap.

Force yourself to take a mental snapshot of what you want to remember. Many brains are hardwired to remember things visually. Mine is in particular. I met one person who said that they could not visualize. Like, she just didn't want to date you. Very fair. I can't picture a life with you. Oh, you have visualization.

Yeah, that's it. She said that... She's just not that indeed. The third component of look, snap, connect is to connect. I love this. If it's meaningful, it's memorable. That's true. That's what we're doing here.

Connecting. Well, that's true emotionally and it is true scientifically. Things that are meaningful are literally activating multiple systems as opposed to just the system of what you're trying to remember. This is why salient events, both good and bad, are often very difficult to forget. And I know someone's like, but I can't remember traumatic things. That's your brain's other response to when something is too much information. Tell us what happens. You dissociate. You can create essentially pockets of blankness that are,

protective and that's usually from severe trauma. Anyway, look, snap, connect. Be able to attend and look at what you need to be doing, what you need to be focusing on in the absence of distraction as much as possible. Snap, take a snapshot of what you need to compute or remember and connect with that memory, make it have other dimensions and lean into those other dimensions. Those are just general ways to maintain active brain health and memory. But as Dr. Small indicated, this is a multi-dimensional field which is best designed for helping us understand the functioning brain and not the dysfunctioning brain. You know, it's helpful to know, oh, you know, it's a lipophilic, you know, center to these amyloid plaques and the tau tangles and we can trace them and this, that, the other. But we're really

most interested in how it can inform us about how the brain functions. And don't wait until you get to dysfunction. Take active steps now because... You only get one chance. Brain inflammation is normal as we get older is what we heard. Well, I mean, as we discussed, you know, he who is not busy being born is busy dying. Meaning we're all in a process of decay and degeneration and, you know, chaos. That's the title of the episode.

Decay, degeneration. and chaos. Thanks for listening. No, but what I mean is like, you know, what Dr. Small does is he lives in the now. He deals with people and has to deal with situations of people that are in a transition of life from a functioning brain to a brain that is not functioning well. We will all reach that. It sounds like we're all on a general spectrum of it continually not functioning well. Well, I mean, look, in some ways, you know, you get, I mean, I feel a lot smarter now than I did when I was 25. And, you know, that was the point in my life where I was making enormous decisions. Like, let's get married and make children.

But, yeah, in so many ways our brains continue to get better, more interesting, you know, I think for women especially, you know, many of us feel we come into our own in our own. 30s and 40s after we've already wreaked havoc, you know, on the people we've interacted with before. But yeah, this is a constantly evolving process, this brain thing. And the notion of aging has so many other components to it. I think it's important to recognize that we do get things that like we get wisdom as we get older. We have life experience and we have perspective often that we don't have then. And what Dr. Small said was that people come into his office being like, oh, I'm worried about this X, Y, and Z that may be a little minor change that they're noticing. And he's like, oh, I have that also.

So I think we don't, we shouldn't be absolute about it. It's not that we're going to prevent any sort of brain change, but how do we age and have our brains change well? I think so much of it is also not necessarily about how we age well and how our brains age well, but how. So not what I said. Go on. No, I think it's more about how we encapsulate it and how, how,

that gives meaning. The notion is also kind of a, you know, it's our perspective shift. And, you know, I work in an industry where age is, it is loathed. It's feared. For women in particular, there's so many interventions we are now starting, I mean, this has changed in the last decade. You know, the interventions are supposed to start in your 20s. And that's what they keep, that's what they're telling you. Well, you'll never look old if you do this. And while that has nothing to do with looking and snapping and connecting, it's how our entire lens is wrapped around aging. And in our culture, when we close older people away,

we close them away from public media in many cases. And of course, we're like, Helen Mirren, yes, Helen Mirren is stunning. She is. I love her. I want more women like Helen Mirren to be on the red carpet, you know, in their beautiful dresses with their hair. Helen, if you're listening, come on the podcast. No, but gray hair, it's not a thing that exists.

And I'm not saying my industry is the world, but that is how, at least in our media, we are presenting what's desirable, older men with younger women. That's a very common pairing. And you know what? It's like, I understand people who complain. But that's also what's reflected in our culture. Youth is desirable. And making babies with young people is smart.

You're speaking to a larger issue of what is the role of older people in our society and what value are they providing. I'm not saying they don't have value, but in other. No, but we hide them away in our culture. We hide them away. I think you're valuable, Jonathan. He'll be valuable no matter how old you get, ma'am. Until you stop remembering who you are and then we put you in a little home. Go to Biolikbreakdown.com.

Learn more. Ask me anything. Yeah. Check out all of Dr. Smalls. stuff, his books and his research is really fascinating. From my breakdown to the one I hope you never have. We'll see you next time. It's my and Bialyx breakdown. She's going to break it down for you. She's got a neuroscience PhD or two. One fiction. And now she's going to break down. It's a breakdown. She's going to break it down.