The Chris Voss Show - The Chris Voss Show Podcast – Reversing Alzheimer’s: The New Toolkit to Improve Cognition and Protect Brain Health by Heather Sandison

Episode Date: June 11, 2024

Reversing Alzheimer's: The New Toolkit to Improve Cognition and Protect Brain Health by Heather Sandison https://amzn.to/3KGoX0h A revolutionary and much-needed exploration of Alzheimer’s and how patients and their caregivers can take back control from this insidious disease. A significant portion of our population worries about the grip of dementia as we age. With over 6.5 million Americans living with Alzheimer's, the urgency for a solution has never been greater. Dr. Heather Sandison is at the forefront of dementia care and research. The founder of Solcere Health Clinic, San Diego’s premier brain optimization clinic, and Marama, the first residential memory care facility to have the goal of returning cognitively declined residents to independent living, Dr. Sandison knows better than most what Alzheimer’s does to people—to their brains, their bodies, their families, and their lives. If you're facing the challenge of Alzheimer's, either personally or as a caregiver, there is hope. A growing body of evidence shows that implementing a handful of strategies can improve cognition and quality of life in dementia patients. In Reversing Alzheimer's, Dr. Sandison lays out this customizable and doable approach so that you can start supporting you or your loved one's brain health right away. Within these pages, Dr. Sandison distills complex neurocognitive research into actionable steps, empowering you to: Fortify your brain health against cognitive decline Implement lifestyle changes that can reverse the effects of Alzheimer's Transform your environment to support cognitive wellness Understand options for brain health to fit any budget Dr. Sandison's expertise, derived from her clinical practice, residential care, and peer-reviewed research, charts the course for a future where Alzheimer's is not a terminal diagnosis, but a reversible condition. Reversing Alzheimer’s is an essential tool for anyone aspiring to rewrite their story and achieve a future free from the affliction of Alzheimer's. About the author Dr. Heather Sandison, a distinguished naturopathic doctor, has devoted her career to providing compassionate care and innovative solutions to those affected by dementia. Renowned for her pioneering work, Dr. Sandison has integrated groundbreaking, holistic, and multimodal interventions, seamlessly creating clinical, residential, research, and educational platforms. Her relentless dedication has not only transformed the lives of patients and caregivers she has also set new standards in the field of dementia care.

You wanted the best. You've got the best podcast. The hottest podcast in the world. The Chris Voss Show. The preeminent podcast with guests so smart you may experience serious brain bleed. The CEOs, authors, thought leaders, visionaries, and motivators. Get ready. Get ready. Strap yourself in. Keep your hands, arms, and legs inside the vehicle at all times, because you're about to go on a monster education roller coaster with your brain. Now, here's your host, Chris Voss. Hi, this is Voss here from thechrisvossshow.com. There you go, ladies and gentlemen. There are ladies and gentlemen. That makes it more official, whatever that means.

Welcome to the big show. We certainly appreciate you guys coming by. As always, we have the smartest people on the show, the brilliant minds, the surgeons, the scientists, the White House presidential advisors, the billionaires, the CEOs, you know the list, rock stars, all those people. They bring you the latest stuff,

hot off the presses of their work, and impart to you their knowledge so that they can make your life better. And, of course, I'm just some idiot with the mic who's been around for 16 years so they let me stay plus they don't let me leave either so that's why i'm still here i'm locked in anyway we have an amazing do on the show and we'll be talking about her amazing new book that's going to maybe help improve your life as long as you remember the name of her book. The name of her book is entitled, Reversing Alzheimer's, The New Toolkit to Improve Cognition and Protect Brain Health, which I probably need a lot of.

That's not the part of the title of the book, boys. I added that. It's by Dr. Heather Sandison, and she'll be joining us in the show to talk to you about her insights there. She is a renowned naturopathic doctor specializing in neurocognitive medicine and the founder of Health Clinic, San Diego's premier brain optimization clinic in Marama. The first residential memory care facility to have the goal of returning cognitively declined residents into independent living i clearly am cognitively declining these big words are getting me she has dedicated her career to supporting those suffering with dementia including me and is the primary author of the peer reviewed

researched observed improvement in cognition during personalized lifestyle intervention in people with cognitive decline or christmas she published that in the journal of alzheimer's Improvement in Cognition During Personalized Lifestyle Intervention in People with Cognitive Decline, or CRISPR. She published that in the Journal of Alzheimer's Disease. Welcome to the show. Heather, how are you? It's so good to be here. Thanks for having me, Chris.

There you go. You're my last step before I disappear into the Alzheimer dementia cloud, as it were, evidently from trying to read the big words in your pile. Give us your.com so people can find you on the interwebs. It's drheathersandison, S-A-N-D-I-S-O-N.com, drheathersandison.com. There you go. And give us a 30,000 overview. What's inside your new book?

So what I saw in my clinical practice was that the impossible was possible, that people who had been told there was nothing they could do for their Alzheimer's, their dementia, their loved one, they were able to come in to the office, take this protocol designed by my mentor, Dr. Dale Bredesen, and run with it and get reversal of disease and get improved cognition, which I've been told you couldn't do. And when I saw that happen for my first few patients, basically, I dedicated the rest of my career to telling as many people as will listen so they can avoid the suffering associated with dementia. There you go. And dementia and Alzheimer's seems to have been climbing or getting higher. More people seem to be getting it or is it maybe just

that perceived that way because people are living longer and getting older? And I think in particular, it's because baby boomers are aging. So there's this massive demographic shift where 4.1 million Americans turn 65 this year. And now a bigger and bigger percentage of our population is above 65. And the baby boomers are right now between about 55 and 75. And so the silver tsunami is upon us. And more and more people basically are experiencing this unmodifiable risk factor. There's nothing you can do about when you were born. You cannot change that part. And as you age, you have a higher risk for developing dementia. Now, the incidence, the number per 100 has actually dropped. But because of the demographic

shifts, there are more people affected by dementia these days. I've seen some people using their politicians on Twitter. No, I'm just kidding. They started to show signs of dementia, maybe. I'm not sure how much of it's clinical, but it seems that way to me. I don't know what that means. So you give throughout the book different ways that people can maybe fortify against potential cognitive decline? Absolutely.

And Chris, it's really, it's common sense. It's just uncommon practice. So don't watch the Kardashians and The Bachelor and you'll be smarter? Yes, that could be a place to start. But it's really, it comes down to the things that you hear all the time. But it's about taking massive action around diet, exercise, sleep, stress management, the foundations of what really predict the outcomes of our health. So the trajectory of where we end up as we grow older really depends on those small decisions that we make every day about what we put in our mouths, what we eat,

what we consume, what we, yes, what we watch on TV, how we stimulate our brain with engaging, challenging activities, or just vegging out. It depends on what time we go to bed at night and how much we prioritize our sleep, how much movement we decide to get each day. Those decisions we make each minute, each hour of our day, how we spend our time, that determines the outcomes of our health and whether or not we end up with neurodegenerative disease as we age. Wow. And so you got to prepare and do the good stuff now if you want to have a good soft

landing in the end where you don't suffer some of these things. I mean, so many people think about investing in their 401k, right? But who thinks about investing in their health so that they can avoid, the financial strain of dementia is very real. But also those connections that we miss, those conversations we miss if we're not able to cognitively keep up with our family and our loved ones. Yeah. I mean, you see, I think a famous case of maybe Alzheimer's dementia, I'm not sure if it's exactly what he has, is the gentleman who did the movie Die Hard.

And evidently he's fading away. And it's really, it's heartbreaking because, you know, I've had friends that have had relatives that have Alzheimer's, you know, and they don't recognize them anymore. They can be hard to deal with because they're confused by their state of the world. They wake up and they're surrounded by strangers, and they can be very angry and battlesome. It's a tough thing to deal with and watch someone

because they're still alive, but it's almost like they've become a different person or forgotten everything and then they're dying before you really in some sort of ways. It's torturous. It's the long, slow goodbye of not losing someone physically, but losing them mentally over a drawn out period. And you're absolutely right. It can be horrific in terms of combative behaviors, aggressive behaviors,

paranoia, hallucinations. I think you were referring to Bruce Willis who has frontotemporal dementia is the type of dementia he was diagnosed with. And dementias are an umbrella term. And although Alzheimer's is the most common form of dementia, it affects women, about two-thirds of Alzheimer's patients are women, and about two-thirds of Alzheimer's caregivers, right, there's a ton of caregivers in this space because Alzheimer's doesn't just take the person, it requires a whole team of people who are engaged in caring for them as they lose capacity to care for themselves. So, in the case of Bruce Willis, this frontotemporal dementia, that actually affects more men than women and the onset is earlier. So, it typically affects men in their 50s or 60s and behavioral issues are the first thing to come up. So, it's often misdiagnosed as bipolar disorder or schizophrenia or just depression or anxiety and not recognized as a form of dementia. Wow. Now, the book is titled Reversing Alzheimer's. You found that

there's a way we can pull back from the brink. And how does that work? Yeah. So one of my very first patients, she came into my office with a MOCA score of two. Now, the MOCA is the Montreal Cognitive Assessment. It's a way we put a number on the severity of cognitive decline. And she had diagnosed Alzheimer's. So a perfect MOCA score is 30. You may have seen this.

We've had presidents who have referred to this test. It's a one-page worksheet where you identify zoo animals and draw a clock. And a perfect score is 30. And that means that you have normal cognition. Now, it's not like you got an A plus on an IQ test. This is normal cognition. 26 and above is normal. She came in with a mocha score of two. Wow. She should run for president. I know, right? She was answering questions with yes or no, but six weeks later, she had a MOCA score of seven and she was one of my earliest patients. And again, I had been told that this was impossible. I had been told by my instructors that to suggest we can help someone

with Alzheimer's was to give them false hope. And yet here was this person in front of me who had done the work. You know, I wish that I had just a pill or an IV, something simple I could give people. But this is a complex disease process and it requires a complex solution. So we need to systematically use complex system science to look at each individual, use precision-based medicine to understand why the person we are talking to as a clinician or the person in your family who has dementia, how they got there. Because someone with genetic risk and a history of traumatic brain injuries and elevated glucose is going to be really different from somebody who's had gum disease.

Plus, maybe they've had cancer treatment or maybe they've had estrogen deprivation or testosterone deprivation treatments and that was part of what led to their dementia. So you have different pathways for initiating the inflammation and then the neurodegenerative process. And we wouldn't treat someone with traumatic brain injuries the same way we would treat somebody

who had elevated blood glucose that led to their disease process. So we want to be precise about how we treat that. And in Linda's case, this first patient, she had a lot of things going on. She had toxicity. She had had cognitive decline associated with her menopausal transition. She was living in a moldy environment. She had stopped stimulating her brain. There were a lot of things going on for her, but her husband was totally dedicated, totally in on it. They dove into this fully. They didn't dip their toe in the water here. They were fully committed and they got the benefits. It really was this incredible turnaround for her. And I've seen that with many, many patients who have single digit MOCA's. Now, not all the

time. We have the highest confidence when people start early, when they're younger. So people before 65 who are starting to notice, oh, I put my keys in the refrigerator. I wouldn't have done that 10 years ago, or I can't remember that neighbor's name. I wouldn't have forgotten that 15 years ago, right? Those people who are starting to notice those small changes, that is the time to go see a provider who's been trained by Dr. Bredesen to get all the testing done, to understand what your pathway is towards dementia might be so that you can reverse it, so that you can go in the other direction. And you can start getting neural healing, neural regeneration, neural recovery, rather than going down the slippery slope of degeneration. There you go. Early in that, you mentioned, you know, people that have brain damage and stuff like that,

which I imagine, you know, one of the things we see is a lot of football players and people that are in sort of battle sports, as you were. It certainly explains Aaron Rodgers, even though he's kind of young, and everything he says out of his mouth on his twitter but there's that so i know that a lot of stuff that goes on the brain goes in our second brain our gut and so when you talk about diet and different things like that uh is that a real big effect, eating poorly, eating high fats? You mentioned sugar as well. Is that something that goes from the gut to the brain and mucks up stuff? Without a doubt. So I recommend an organic ketogenic diet and flipping that metabolic switch.

So I actually recommend a high-fat diet. Our brain is made of a lot of fat. The myelin sheaths in our brain are made of fat. It's made of a lot of fat. The myelin sheaths in our brain are made of fat. A lot of fat. There's quality fat. And then there's, you know, this is not a bacon and cheese diet that I'm recommending. This is a high veggie, high fiber, high quality fat with anti-inflammatory fats. So our avocados, our olive oils, our fish oils, our fatty fish, wild caught salmon, grass fed beefs, that kind of protein and fat, high fat helps to switch a metabolic,

basically we flip a metabolic switch from burning sugar for fuel. Ketones are the alternative and our brain actually prefers ketones. So it's a way that we burn fat for fuel as ketones, as opposed to burning glucose, sugar, carbohydrates for fuel. Carbohydrates, they burn, they basically put off a lot of oxidative stress, which is one of the hallmarks of aging. So if we can flip that metabolic switch and get into ketosis, we have less oxidative stress. It's an anti-inflammatory diet. People report sleeping better, better, more stable mood, less pain. And we have seen patients who don't remember their grandchildren's names and then they get into ketosis and a few days later, they're remembering

their grandchildren's names again. I mean, really profound shifts in energy levels and in cognition specifically. Now, maybe that's unfortunate for them because maybe they didn't want to remember. I've seen some grandchildren and everyone, I'm just kidding. That's not right. Well, they pretend, right? They can be selective at that point. That's usually what, I think that's what most men do that are married. They're selective.

What did you say, honey? And yeah, it's whatever. That's a marriage problem for men. So they can deal with that. Maybe you should write your next book on that. The Faked Alzheimer Dementia of Men. So you recommend an organic ketogenic diet. Do I have that right? I do. Yeah, that's exactly what we recommend. I was pulling up here. You know, one thing I really enjoy is, and I imagine this is part of a ketogenic diet, is intermittent fasting. And I know that when I

intermittent fast, my brain's sharper, everything is on point, partially because my body's going, where's the food? But technically, I just feel a lot better and smarter. Is there anything to intermittent fasting there with that? Absolutely. Yeah. So it depends on whether or not someone's goal is to lose weight or not. So often it depends on whether or not someone's goal is to lose weight or not. So, often it'll be easier to get into ketosis if you're using an intermittent fasting schedule. We are proponents always, regardless of weight, of having a fasting for about three hours. So, having your last bite of food around five or six and then giving yourself at least three hours before you go to bed and that will help you to sleep

better, right? Because your body's not involved with digesting and absorption. It's just focused on getting that high quality sleep, that deep sleep that can help, of course, to detoxify the brain, consolidate memories. There's so much happening in our brain at night when we're sleeping. It's absolutely crucial. And so the intermittent fasting, I think that there are ways to do it that you get maximum benefit for the brain. And that piece in particular of that fasting before going to sleep is really important. But then a lot of people will skip breakfast

because this is kind of the easiest. It's not as social, right? We usually are having dinner and it's more social, whether we're at home or going out. But many people will have at least a 12 hour fast, hopefully like seven to seven, six to six, something like that. But then if you want to extend it, having breakfast or your first meal, maybe even waiting till lunch, and you can have a little bit of coffee, even some fat in the morning that won't kick you out of ketosis. So

I'm a huge fan of intermittent fasting, as long as you're in the camp of people who maybe wants to lose a little bit of weight, that can be really helpful. Now, if you're struggling with too much weight loss and you want to keep on pounds, not lose weight, then I actually recommend avoiding intermittent fasting. But many people will agree with you that they feel sharper, they feel clearer headed, they feel more articulate when they spend more time fasting. Yeah. I mean, when you eat a bunch of stuff, like if you go on to buffet or, I don't know, you beat a big barbecue, set a ribs, you get that meat haze, you know, your brain just goes. But yeah, I like that. Note to self, stop eating

burritos in bed before bedtime. All right, there you go. So what are some other approaches you should take to your life? I know my mom who's 82, she's for a couple of years now, she's been into skill-based games. She plays either on her phone and board games and stuff, and she feels like those will keep her brain sharp to avoid cognitive decline. Yeah, I love it. So activities, but particularly cognitive activities coupled with physical activity. So this is what we call, we refer to this as dual task exercise. And this has been well studied in the stroke and traumatic brain injury space. But also now with cognitive decline, we are seeing research that promotes this as

having a greater effect, a greater beneficial effect than either of them alone. So you can, it's great, you know, if you're playing Sudoku or Mahjong or doing brain games, Luminosity, Brain HQ, there's a bunch of them online. But I'll have patients who say to me, oh, I hate, I hate getting online and doing that for 30 minutes a day. It's such a chore. Like, great, get off the screen and go play pickleball. Go play something or go to a class where you are being cued by an instructor, where you have to stay cognitively engaged at the same time that you're physically engaged. And this, you get more blood flow to your brain. There's a bunch of mechanisms that increase, you potentiate basically the benefit that you get out of the time spent in the exercise, cognitive and physical. There you go.

Do video games help at all? Asking for a friend who plays Modern Warfare 3 a lot. I love it. Do video games help at all? Asking for a friend who plays Modern Warfare 3 a lot. I love it. So Dance Dance Revolution, one of the guys who has published a lot of this dual task exercise research, he was a huge addict of Dance Dance Revolution. It's actually how he lost a bunch of weight when he was a child. And he has basically gamified these physical and cognitive combination exercises to use with Alzheimer's patients. And so I think there's a lot of these kind of physical video games that were out for a while. And I'm not in touch with the video game space enough to know what the current one is.

But anything that gets you physically engaged is a huge win. And I think a great way to put technology to work to support our cognitive function versus, you know, going the other direction. Yeah. You know, the VR headsets, and I think Apple's got something new too. But one of my friends, you know, he adopted the early VR headsets and he used to be, you know, pretty pudgy and overweight and he started playing the games on the VR headsets and, you know, so he's standing in his room, you know, dancing and, you know, doing the, all the game, whatever thing, but you're, you're doing a lot of movement. He's lost so much weight. I he's down to he looks like it probably

looks like when he was 20 weight wise and he's lost so much weight and it's all just from you know doing the vr stuff and playing the games or whatever you know dancing i guess too he's got they got all sorts of things you can do on there and i imagine that's made him smarter although we still think he's he's a friend of ours so we still think he's a friend of ours, so we still think he's suffering from dementia, but that's a personal thing. A little ways to go there. He's lost a lot of weight. Let's put it that way. That's about it. That's fantastic. So we know that

obesity is one of the modifiable risk factors associated with dementia, and so is a sedentary lifestyle. So, yes, put the video games to work, but just make sure you're moving. It's not a sedentary game where you're just sitting. The only thing you're exercising is your thumbs. Yeah.

It would be, yeah, it would be interesting to, to see, I imagine there's somebody studying VR and the use of Alzheimer's and dementia and brain patterns and stuff. Yeah, we've seen it. We've seen new kind of startup companies popping up all over the place using VR in this space. The thing is that older people who have cognitive decline, it's harder to get them to use technology because there's a lift there. But if there's a care partner or somebody else who's excited and engaged, then yeah, it can be very, very useful. You just lie to them, tell them their top score on whatever the VR game is. And they always have been.

They've been playing all their life and they'll just have to believe you. I don't know. I'm sure you would be convincing, Chris. It doesn't work that way, Chris. There you go. Yeah, I try. I like people. I'm trying to help.

What was the other question I had for you? You know, we've had a lot of neuroscientists, brain science people on the show. I know it's surprising given the quality of our show, quality of our hosts. But one thing they've always talked about is how these two-dimensional screens are so bad for us, these computers are bad for us, that we really activate our brain, our dopamine and our serotonin. And our brains really activate when we're in person-to-person formats, where we're socializing, talking to people face-to-face, reading body language is really important for our brains too. And a lot of this two-dimensional

computer phone stuff that we're always staring into now, it kind of breaks our brain. Our brain just can't, like, there's not a lot going on. And I know a lot of people as they get older, you know, they either become single through death of a partner or they're single and, or just no one loves them like me. But basically by being isolated and not around other humans and socializing, I mean, COVID was, I think, really bad for people's mental health because you couldn't socialize and go out and do stuff. How important is all that in preventing Alzheimer's and dementia? Profoundly. As you mentioned, COVID, I still have patients showing up in my office saying,

mom's decline started in March of 2020 when she was isolated from everyone. Just this week, I heard that from a family. And we also see that at Murama, Murama is the residential care facility where we have a cohort of people who are there. There's about 12 at any given time. And the goal is for them to move in with cognitive decline and go home and live independently. And we achieve that for some, not for everybody. It kind of depends on how far along in the process you are when you move in. But what we've seen is even people who have been doing this protocol at home, when they have, you know, they're socially engaged with caregivers and doctors

and physical therapy and occupational therapies coming over. And so they're engaging, but it's different from having a peer group. And the big thing that shifts at Marama when someone moves from living in their own home and having everybody kind of come to them, many people with dementia also, they lose their driver's license.

And appropriately, this can be dangerous, but many neurologists, it's their responsibility to tell the DMV to take lose their driver's license. And appropriately, this can be dangerous, but many neurologists, it's their responsibility to tell the DMV to take away their driver's license. And now they're even more isolated because they can't get around. They can't get to the gym. They can't get to church. They can't get to the places that they, the grocery store, the places where they usually would get that, that those facial cues and the non-verbal interaction, the non-screen interaction. And there's a few things at play here, but we see when people move into Marama, even when the only difference is the environment, you know, they're moving out of their home and they're coming to an environment where

they have a peer group. And I think that that piece is a social piece, undoubtedly. There's no question. We are social creatures and we need that interaction. There you go. I mean, I don't want to get dementia or Alzheimer's. I don't want you to either. That was, thank you. I'm glad there's one person on my side. Everyone else is rooting for me to knock over with Alzheimer's and be like, maybe he'll shut up then, finally.

I think I'd read somewhere that there's a peanut butter test for Alzheimer's or dementia. Is that true or is that some BS? A peanut butter test? I'm curious. You'll have to send me the link for that one. I have not heard of that one. I think I have it. Peanut butter test for dementia.

And it has you. This is coming up. And evidently, it's fairly, I read about it. It's the NCBI is up in here, Washington Post, a few people have talked about it. But basically you close your eyes, mouth, and one nostril, and you open a jar of peanut butter and move it closer to you, and you breathe normally. And if you can detect the odor of the peanut butter, blah, blah, blah, it was conducted by the University of Florida in 2023 and published in Neurological Sciences.

But they found that probable Alzheimer's disease had to move the peanut butter container an average of 10 centimeters closer to the left nostril than the right. Yeah, so this has to do with smell and smell being one of those early signs that, so with the olfactory nerve is part of the nervous system, right? It's going into the brain. And if there's damage to that, it can be an early sign that there's more damage in the brain. Now, what has come up over the last four years, we talked about COVID.

COVID also damages smell, sense of smell. And so I would not want someone to, and so can a stuffy nose, right? I would not want someone to kind of try to smell peanut butter and not be able to and have it more than 10 centimeters away and go, oh my God, I have Alzheimer's. That's not what's going on. I think that it's important that we don't send people into an anxious fit because they can't smell, particularly if it's temporary. But I think that there is, you know, I think what they're trying to get at is how can we get early detection? Because I'm 100% in agreement that if we can identify risk factors early, and if we can identify that someone's potentially going down the path of Alzheimer's, then we can intervene. Now, what's most important to me in

terms of that intervention is understanding why this person got dementia in the first place or why they're on this path. So we know that people who have cognitive decline, many times the path of physiological process or the cellular process in their brain has started about 20 years or decades before, 10, 20 years before they start losing their keys, forgetting the names of things. There's this long window of opportunity where we can be in prevention. And that's when we definitely have the highest confidence that we're going to reverse the disease process. So testing, like there's more and more testing from blood.

P-tau 217 is one. We have amyloid ratios that we can test now. P-tau 181. There's a handful of tests that you can get. They're not quite covered by insurance, but hopefully they will be soon. And they can generally tell us directionality. Are you going down this path? Can we test this early and understand if you are at high risk for developing Alzheimer's later, even though you don't have symptoms yet?

And I think that's a really valuable thing to do. Now, the MOCA score, the Montreal Cognitive Assessment, that's a pretty easy test to get through a provider. That's not what the president said. Now, the test itself is not that easy, but it's easy for a provider to administer it. And it's inexpensive. So if you ask a neurologist or you ask a primary care provider, they can usually administer a test like that. And I think that's a much better test these days than the smell test, like the peanut butter test.

So I should quit snorting peanut butter every day? Because you enjoy it, you know, if it's fun for you. It's kind of addictive now in this space. Not sure. I'm just trying to, I'm just trying to vent on something. But what if, what if you're that person that I think we all, I don't know if we all get there, but that person who walks to a room to get something and then you forget what you're looking for in that room. Does that happen to everybody? Is that a sign? This can be a sign of distractibility, right? Are you constantly distracted? Do you have too much on your plate? Are you overstimulated?

I have ADHD. I'm anything. I was a squirrel. A squirrel, squirrel. Yeah. You know, this can be, you might want to talk to somebody about that. I have. They have seen me and I have seen them.

And again, you don't necessarily need to jump to, I have. They have seen me and I have seen them. And again, you don't necessarily need to jump to I have Alzheimer's. Now, taking a vacation, getting a good night of sleep, making sure that you're full of protein and fat and veggies. If there's a difference, if you notice a difference, then it might just be maintaining better habits, like a daily routine that includes meditation or some kind of prayer practice or some sort of grounding mindfulness practice that can help. There's great literature around kirtan kriya, a type of meditation, the satanama that yes, that helps both caregivers and people with dementia to basically improve all types of age-related diseases and chronic conditions, but in particular, cognitive function. Can I sacrifice a goat to Satan?

Will that just fix it all maybe? You should try it. Let me know. We'll write a case study if it works. We'll publish it. If I remember, I will. Now, let me ask you this. My understanding, and I'm not a a I'm a layman of anything I'm

probably below a layman when it comes to I I'm a one on the mocha or using that as a reference as a callback joke on the show I'm a two on a mocha people are what the hell is he talking about you gotta watch the previous show so don't women have a higher memory center in their brains than men? Don't they have a higher, isn't that part of their brain larger? Or is it just their ability? The hippocampus, probably the hippocampus. I mean, the hippocampus is affected by dementia, absolutely. And everyone's hippocampus declines or atrophies.

Basically, the volume of the hippocampus, the size of it decreases with age. And what we see when we apply this process is that the hippocampus does not decline. It doesn't shrink at the same rate. It actually stays larger, longer. So, we have control over the size of our brain and exercise, diet, sleep, these things, stress management, these are crucial. So stress and memory are very, very well connected, right? We've all been stage fright, right? High, high stress, we can't remember anything. This is why torture doesn't work. When we're under extreme stress, we cannot remember things well. And we also, jet lag, right? Sleep deprivation.

Our brains don't work. I think many of us can relate to these things. And it's when you start stacking them on top of each other, sleep deprivation plus stress plus a bad diet, that's when we start to have brain atrophy. Sounds like my first 10 marriages. So if women, you said women have two thirds of the amount of dementia or Alzheimer's than men, but if they have larger, I mean, women have incredible memories and they're designed that way on purpose, I think for biology and stuff. How come they're getting it two thirds of the time? Like why are they getting picked on? Yeah, great question. I think that there are probably multiple pathways at work here.

And many of the ones that have been proposed are the steep drop in estrogen and progesterone when a woman goes through menopause. Also, women experience stress differently in a potentially more toxic way than men do. And it seems to be more toxic to the brain itself. So that difference in our metabolism of stress hormones and then also sex hormones, I think plays a big role. Women are two-thirds of caregivers for people suffering with dementia. And this is often the adult daughter of a mother or a father that has dementia or the female spouse of a partner with dementia. And just being a caregiver for someone with dementia makes you anywhere from two and a half

to six times more likely to develop dementia later in your life than if you were never a care partner for someone. You're just horrifying me now. Well, my mom has been a caretaker for my sister who's got MS at 19. And she's been pretty much caretaker, I don't know, the last 30 years, 20 years. But, you know, I've had to, we've had authors on the show that have talked about how people that are caretakers need to, you know, take care of themselves as well. Yeah. But, so the stress from it is really challenging, huh? Wow. Extremely challenging. Many caregivers, right, their sleep is affected. They're not eating as well. They're not prioritizing exercise. It's a full-time job, particularly to care for an adult

who's suffering, right? When you have a child, I have a five-year-old, she's going to get older, she's going to get bigger, she's going to need less and less care. By the time she's 10, she's like relatively independent. But for someone who's, she's also never been independent. She's going to get older. She's going to get bigger. She's going to need less and less care. By the time she's 10, she's like relatively independent. But for someone who's, she's also never been independent. She's never had a driver's license. So she's not fighting me about wanting to go to the store, go see her friend. The expectation is that she's going to be more and more independent and require less and less care. With dementia, it's the opposite. You have this independent person who is becoming more and more dependent. There's a lot of unpredictability. You don't know if they're going to be combative and aggressive tomorrow. You don't know if they're going to lose their circadian rhythm

and not be able to sleep at night, and then you can't sleep at night. And there's also a lot of guilt and shame around getting help. I think many people feel, and I don't know if your mom went through this with your sister, but they feel responsible. And okay, I can do this. I can do it all. And I wouldn't want, nobody else can take care of my daughter or my son or my mom or my dad as well as I can. So I'm going to do everything.

And then you get to this breaking point where like, you just can't anymore. And the person that you're caring for is actually suffering. They're not getting the best care because it's not a one-person job. You need help. And I've seen so many families backed into a corner where all of a sudden the care partner breaks their leg and now they can't do it or they're in the hospital for some unrelated reason.

And now the person who needs care is on their own or they're stuck with a care partner who doesn't know them, who doesn't know their preferences, who doesn't really know how to take care of them. And so I always encourage families, get help before you need it. Get help before you think you need it because you want to find that right fit and that's not always going to happen immediately with the first person you interview. Yeah. Our challenge is she did that alone. She did that a long time here at the house, but then once it became, she couldn't lift and you know there's a point where you need two or three

people to help bathe you and change you and stuff like that and then but the care centers are so awful now i mean they're just really so awful the i mean she's up there almost every other day taking care of my sister and she's in that same mode you mentioned earlier of no one can take care of as much as I can. She's a mom. You know, this is, that's the great thing about moms is, is they'll look off their hand to feed you and take care of you.

I mean, they'll, they'll throw their life in front of a, in front of a speed trainer bus to save her. But except for me, my mom wouldn't do that for me. She'd be like, not that.

Yeah. Sounds like she's busy with your sister. I'm going to Darwinism just fix that one. But we'll save my sister. My sister's probably better looking too, so that's probably it. I don't know. What have we touched on that you want to tease out to people about? Well, you just mentioned care facilities.

And our goal at Marama is to turn memory care into memory recovery. Ah. I lost you on the audio. Testing one, two, three. I think we lost you on the audio. You muted yourself. The goal when someone moves into Marama is that it's not about memory care. It's now about memory recovery. The goal is for them to move back into independent living. And I think that anyone who is looking for a care facility for a loved one, you know, when you get on the phone and you ask about what the programs are and what's going on at that facility,

is there a brain healthy diet? Is there engaging cognitive exercises that are available? And are they prioritized? Or is it just kind of like, oh, yeah, we do that occasionally? And what about exercise? Is it easy? Our environment really impacts our behavior. So if it's easy to exercise, if it's easy to eat, if that's what's put in front of us, we're much more likely to do it. But if it's easy to eat a Snickers bar for lunch, then that's the choice we're going to make. So our environment, if it's easy to just turn on the TV, if it's easy to isolate, as we talked about,

then we're going to do the easy thing. And so ask about these environments that you're considering for a loved one. Is it easy to engage socially? Is it easy to exercise? Is it easy to eat? Prepare to put them in a place where that is emphasized. And I hope really one of my overarching goals of my career is to shift that senior living industry towards what we're doing

at Marama. And the standard is so low in so many places that even just getting better food, even just getting better facilities for exercise, even just getting more social and cognitive engagement, we can move the needle, I think, in the outcomes that we get. There you go. This is good to know because if anything were to happen to my mom, please, I want her to live forever. And thankfully, she has genes where, I mean, at one point I had my great-grandmother and my great-great-grandmother alive.

They all lived to 100. So I'm hoping we all have those same genes. But I have to take over care for my sister, if anything were to happen to my mom. But this is really important. Caretakers need to take care of themselves. And when I was referencing that care centers have really gone to crap, I'm referencing these, not yours, but there's a lot of these care centers that used to be privately owned. And they've been taken over by these corporate behemoths. And they understaff them.

We constantly go up there, and they're understaffed. There's temporary workers coming in. They basically buy them out, and then they just lean the crap out of them for max profit. And you find all sorts of horror stories. So I'm glad that you're trying to change that industry. It really does need to be changed. And I don't think their type of industry is one that's trying to get people back out there in the world.

But, you know, it's good for the better. I'm glad you guys are doing what you're doing. I mean, it's such a wild, right? The whole system is so crazy, right? These behemoths, as you mentioned, come in and buy them up and they're publicly traded. And so it's someone's pension fund, right? The pension fund is doing better. So somebody in the workforce is going to make more money if that bottom line is bigger.

But their parent who's in the care facility is going to suffer. And they're going to suffer when they do retire and they need that pension fund. They're going to have to pay for this overpriced facility that doesn't offer great care. I mean, it's just so crazy, the whole system. And I think that more and more people are going to be looking for alternatives and I hope to be offering one. There you go. I've heard that more people are trying to do home health care than ever before, partially because it's so expensive to put people in these places. Is that true? It's so isolating to stay home. But

the other thing with home health care is it's extremely expensive. So you don't get the economy of scale of having, you know, one care provider who can provide care for three, four or five people. You have one on one care and 24 hours a day. That's extremely cost prohibitive. Pretty quickly. I think they're trying to do it as a family. Provide for multiple people. Just for just for one. I've heard that if people

have a mother or grandmother or somebody, they're just taking them home and trying to do the home care first. Yeah. So that intergenerational kind of living situation, that can work well. We have so many people call us and say, hey, I love this idea of what you're doing for people with dementia. And I've got a full-time job and I've got kids to raise and I've got a family. I've got my husband. I don't want to end up in a divorce and my yard needs to be taken care of. I've got life to manage. And the thought of having my loved one move in and then having that take over my life, I just can't sacrifice that much. And so I think every family, there's cost

constraints. There are bandwidth constraints. There are stressors. And at Marama, we have the luxury of, we don't have decades of history with this person. So when they say the wrong thing, we don't take it personally. And that can be helpful too. There are dynamics between family members, between adult children and their parents that are really hard as someone struggles with dementia. So there's no one right answer. And I think having good support as you navigate those constraints, whether they're financial or emotional or physical, as you mentioned, your sister sometimes will need two and three people to help her transfer from a wheelchair into a shower chair or to help her with toileting. And with all of these things, it can become very physically demanding.

So navigating that is not simple. Yeah. And dealing with the, there's a loss, there seems to be a loss of the wall. I've had a few friends that ran care centers and so they tend to lose you know we don't talk about usually in life you know and so they become more sexual in their conversations and graphic more flirtatious sometimes the other thing is the violence like i've had some friends that ran care centers where where you know the guys throw them down have they just push them all over, become violent.

They get angry because they're confused. It's a real tough situation because they're confused. They don't understand what's going on and who all these weird people are that are bothering them and mucking about them. They have a brain disease. So the inhibition, the violence, the paranoia, combative behaviors, they're very real and very very very challenging

we see that people go through phases though sometimes they'll get up and over a violent hump and they're no longer they're more passive that can indicate a progression of the disease and sometimes we see it as people get better as well it's it's very very very challenging to navigate there you go. Anytime I'm ever married, I'm pretending that I have Alzheimer's. What, honey? I didn't forget that.

It's the Alzheimer's kicking in. There you go. I do want to say that if you are serious about preventing Alzheimer's, hearing loss is a modifiable risk factor when it comes to dementia. So if anyone listening is struggling with their hearing, I implore you, I beg you, please go get hearing aids.

Get your hearing checked. Keep the batteries charged. Put them in. My uncle, I saw him last summer and his wife was like, he has the hearing aids. He just won't put them in because they're not comfortable. But he's putting himself at risk for dementia. So we were like, get him in. The other big one is sleep apnea.

So if you snore or if your partner tells you you snore or if you're at any risk at all of sleep apnea, go get tested and treat. We have seen people with, again, single digit MOCA scores, MOCA scores of eight that double their MOCA scores when they start wearing their CPAP. If you're not getting enough oxygen to your brain at night, this puts you at high risk. You are starving your brain of oxygen. And that means that you're going to do damage every time you have an apnea event. And many people are having these hundreds of times, sometimes per night. And since COVID, some of the technology is better. So you can wear a watch and a ring combination at home. You don't have to go into an overnight sleep center. Now that is the gold standard still, and you can't rule out sleep apnea, but you can rule in sleep apnea and get treatment faster. If you do one of

these at home sleep studies for mild sleep apnea, mouth tape will work. So you can just tape your mouth shut at night. That'll force you to breathe through your nose. For some people, that'll help train them to breathe through their nose. We've seen a reduction in anxiety and allergies and in sleep apnea with just a simple mouth tape at night. But anyone, hearing loss and sleep apnea, treat those aggressively. You have to advocate for yourself often

in the healthcare system. You've got to call repeatedly, check in, schedule all the appointments. It's a total chore. Sometimes it can be expensive, but the cost of losing your mind is so much higher than doing the chores of scheduling these appointments and getting those conditions treated. I don't know. I've seen how the world's going. It might be a good thing. No, I'm just kidding, folks. Don't you? You don't want to go out that way. Nobody wants to go out. I don't want to go out on the side of my mouth. I do that enough already.

No. I did start the tape thing recently because i don't i don't want to have a darth vader mask when i'm trying to sleep uh my mom does that but i did start the tape thing recently and i really enjoyed it i don't know if i'm having less whatever but there's some people that want me to use the tape during the day too man even on the podcast just so i'll shut up i'm gonna start i'm gonna download this mocha test and just start taking every day let's see lion rhino and camel oh man the first time i took that test i called it a hippo i got it wrong i missed that right there in the middle so i know there you go and then you touch your face is that what it is or something memory i don't know what i'll have to read the rest of this all i know is what that one guy talks about

it and brings it up so what's he always say tv radio i don't know what see i'm losing my cognitive resources but yeah we'll wait you to help chris you just say the word we'll give you all the testing i'll definitely read your book and probably submit myself early to your care center. Save you a room. Yeah. I did drink a lot of alcohol when I was younger, but I did that for about 20 years, but then I quit in 2020. I wonder if that's going to come back to haunt me, all that booze I drank. Well done.

We see that you can recover. So B vitamins are really important. You can get thiamine deficiency without accessible alcohol consumption. But with alcohol, cigarettes, these are modifiable risk factors when it comes to dementia. And if you can, well done, kudos to you, you stopped. And you know, for anyone struggling with cognitive decline, I recommend zero alcohol, because it's a toxin. It's one more thing that your body and your brain have to deal with. And it directly impacts the quality of your sleep at night. You can measure.

I don't know if you guys, anybody's measuring their sleep. I'm wearing an aura ring. I measure my sleep. And one margarita, one glass of wine, it will decrease the quality of sleep no matter how old you are. And even one night of sleep deprivation, we can measure an increase in amyloid plaque in the brain. If you're in your 20s, 30s, 40s, doesn't matter how old you are. You get an accumulation of amyloid after one night of sleep deprivation. So just imagine if night after night, decade after decade, you are depriving yourself of sleep.

You are not rinsing the brain of those misfolded proteins that accumulate and contribute to the diagnosis of Alzheimer's. There you go. I mean, I just went through, I started intermittent fasting two or three days ago. And so usually when I don't fast, I'm kind of jacked up a little bit with energy and focus. And there's a scientific reason for that because, you know, if you were a caveman back in the day and you were starving you're hungry your brain's like we're going to help you find food by helping your focus you know

and give you some energy to you know hunt down the lion or whatever and so i i think i lost i only slept four hours the first night and i was kind of fine but the second night i did it again and i'm like okay i'm breaking down this isn't working i can't function anymore. And so, yeah, sleep is really important. I use the eight sleep bed. I don't know if you've ever heard of it. But it's a bed that warms and cools. And it has an AI inside of it that actually tracks and keeps history of your REM sleep, your deep sleep, and all the variations of when you're asleep. And it will adjust the temperature to target you for your best sleep.

And you know, I'll wake up in the middle of the night and it's, it's been, it's changed its temperatures around to give me my best sleep and where I am my deepest and monitoring that's really helpful. So I like what you say, you know, the R ring or different other, there's lots of different ways to measure sleep now. And usually my jailer, my prison does that for me and lets me know when it's time to wake up and get out of my cell. Those are my prison days.

But yeah, there you go. Anyway, all the jokes aside. No, that's great. That was my first 10 marriages. How was your sleep in prison? It was my first 10 marriages. So we're just going to keep calling that joke back for us, the show. So there you go. But is there any help that we can give to,

to, oh damn, I lost his name and look at the screen. Aaron Rogers, is there any hope if you were to take him to your care center? Is there anything we can do for him? He still believes in conspiracies of everything, Evan Ellie. I know I read it. I read an article the other day. I think it was titled conspiracy theories. Might be Aaron Rogers, Achilles heel. Yeah. I know. I read it. I read an article the other day. I think it was titled Conspiracy Theories Might Be Aaron Rodgers' Achilles Heel. I heard the same one. Yeah. Aaron Rodgers. I wish he would heal up. Yeah. I mean, but a lot of these football players, you know, these older guys, man, they got a lot of damage to their brains. And I can't remember what it's called, but there's that movie and that study about it. And, you know, wrestlers and people that war and stuff they just found out that a bunch of the infantry men who are shooting those big guns and the big infantry guns mortars

and stuff like that the shock wave is doing damage to their brain especially if they're doing it on on a long-term basis you know there's a great movie called Quiet Explosions about exactly this. People who have either played football or been in combat and had traumatic brain injuries, there's a pattern to it. And CTE is the type of brain damage that football players most commonly get. And this comes with behavioral changes as well as cognitive decline later on, dementia, and really classic. There are things that we can do for traumatic brain injuries. We can give nutrients. Many people will say, oh, I had a concussion and I went to the hospital. They just told me to stay awake or to sleep or whatever. There are these kind of general recommendations, but not a lot of treatment. And post-concussive syndrome, there's a ton that we can do nutrient wise and exercise

wise. Yeah. There, there's a lot of treatment that we can do to help to repair the injury and to reduce inflammation in the brain. Ideally we get treatment to people within about 12 months of the concussive event, but if we can't, there is still help. Actually, functional neurologists, chiropractor, chiropractic neurologists, they can offer a ton of help. I typically refer to them for the exercises where they kind of can track where in the brain there was damage done, what's not functional. And then they can give people specific exercises to either rewire that or to kind of bring that function back. Whether it's movement or speech, whatever it is that's been affected. Because if you hit your brain, hit your head in different places, you get a different manifestation because different regions of the brain

have different functions. There you go. Does reading and stuff like that work? I'm hoping that by doing the podcast a lot, it'll help my brain. Because you guys come on here and I learn all this stuff from you, and, I'm hoping that by doing the podcast a lot, it'll help my brain because you guys come on here and I learn all this stuff from you and then I'm smarter. I think it's a great way to do it.

Yeah, just constantly staying engaged. You know, one really important thing about the activities that we choose to stay engaged in needs to be fun. If it's not fun, one, we don't do it, but we also learn more.

I was talking about how when we're stressed, we can't remember. We don't learn as well when we're under stress, when there's a lot of pressure. I think we think we do because we're socialized. We're like, if there's a test, you study for it and you cram and you're like, you know, whacking you with a stick if you were in Catholic school, if you weren't learning right or if you weren't doing things right in school. And we associate school with stress often.

And yet kids learn and adults, it's the same. We learn best if it's fun and also if it's physical. So if we can learn at the same time that we're engaging physically, and if we can learn at the same time that we're laughing, if we're enjoying it, we remember the things that are more emotional. And if they're a good emotion, joy, happy, funny, exciting, surprising in a good way, then we're more likely to cement those memories and be able to recall them. There you go. I mean, that's the one thing I've enjoyed as I've gotten older is my memories. And I'm glad I, you know, I have these great memories when my body could do, I don't know,

somersaults, you know, whatever, you know, stuff that I can't do now. And so you have these great memories you can reminisce on. You'd be like, yeah, that was a cool, I was able to do that. And if I do that now, I'll pull my back out and you know the memories of my you know i don't have kids so my dog kids you know and and just you know i think there's a certain point in life where you you maybe can't do all the somersaults basically 10 marriages and no kids no no no kids i'm not sure what that's about but i don't know i don't have a joke for babies i know you set me up and i'll have the joke for it i'm just just for babies i don't know i just think they didn't want to breathe with me there was a lot of sex it was marriage no i'm just kidding there we go

there's the joke the but no i the you know i i i joke with my friends about how you know hopefully remember this when we're sitting on the porch at 80 years old and spraying the hose on kids, telling them to get off our lawn, you know, with that old Clint Eastwood character, which he's been playing for 50 years. And, you know, you want to remember these things. I mean, I imagine, my imagine is, you know, I'll tell people, you know, what do you want to think about on your deathbed?

What are you going to be? What are you going to think about? What are you going to remember? And I would never want to lose all the memories I've acquired over my life. I like to keep those, please. No, they make us us, right? We ask people all the time, right?

I see mostly elderly patients and I always ask them, what are your happiest memories? What do you think that we should be learning from you, our elders? And it's always relationships, right? It's the relationships with their children, the relationships with their spouse, with their siblings, with their parents, with their friends. And one of the best stories, we have people reach out from all walks of life and all kinds of situations, some of them quite heartbreaking. But recently we had a woman reach out and she's, I want to do your program because my friend,

my best friend who I've known since I was four is at risk for dementia. I think she's going down that path and I'm going to do this so that I can tell her I'm doing it with her. And I just, because she was describing exactly what you did. I want to sit on the porch with her and be around our grandkids and I want to be able to remember it and I want her to remember it and I want to have a real conversation with her where she's present. And I don't want her to go down the path that I saw that we saw her mom go down. And it was just so inspiring, like seeing the families, the spouses, how much they're willing to do, how much they love the people that they're showing up with. It is so inspiring. It makes me want to be worthy of that.

It's tough to deal with. I mean, I remember years ago when my sister started calling me every week to wish me happy birthday. And at first I would push back on it and be like, Delaina, it's not my birthday. But then it became, oh, thank you. And you just had to roll with it. And she was happy about it. She was happy. She remembered it. And you just had to roll with it. And she was happy about it. She was happy she remembered it. And, you know, you just had to realize it was going to happen every week or every week. Now she can't remember my phone number, so that kind of fixed that. But, yeah, COVID was so hard on people, all this sort of stuff. I'm glad that you've given people some concepts that they can take and utilize. And inside your book, you've got some ways that people can do that.

Give people, as we go out, your final thoughts. Pitch to pick up the book wherever it's found. Yeah, please find the book. The whole point is for people to know that there is almost an overwhelming amount that you can do for dementia, that no one should be told that there's nothing you can do for dementia and Alzheimer's. That's outdated information. It's not supported by the science. And our goal is to make this overwhelming amount of things that you could potentially do for your brain digestible and easy to implement. That's the whole goal of the book, Reversing Alzheimer's, which is available wherever you buy books on June 11th.

There you go. It's been wonderful to have you on the show. We really appreciate it. Thank you for coming on and give us your.com one more time so people can find it there. DrHeatherSanderson.com. There you go. Pick up the book, folks, wherever you can find it. You can still remember, damn it, Reversing Alzheimer's, the new toolkit to improve cognition and protect brain health. Thanks for tuning in.

Go to Goodreads.com, Fortress Crispus, LinkedIn.com, Fortress Crispus, YouTube.com, Fortress Crispus, and wherever.com, Fortuna's Christmas, YouTube.com, Fortuna's Christmas, and wherever the hell else you can remember we are on the internet. Thanks for tuning in. Be good to each other. Stay safe,

and we'll see you guys next time.