Are You At Risk For Alzheimer’s Disease? Part 3 with Dr. Dale Bredesen

Dr Daniel Amen and Tana Amen BSN RN On The Brain Warrior's Way Podcast

In the third and final episode of a series with Dr. Dale Bredesen, author of the new best-selling book “The End of Alzheimer’s,” Dr. Daniel Amen and Bredesen talk about the risk factors for Alzheimer’s and Dementia. By attacking all of these major risk factors, you are putting yourself in the best possible place to avoid cognitive troubles down the road.


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Dr. Daniel Amen: Welcome to the Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.

Tana Amen: I'm Tana Amen. Here, we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions.

Dr. Daniel Amen: The Brain Warrior's Way Podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain SPECT imaging to better target treatment and natural ways to heal the brain. For more information, visit

Tana Amen: The Brain Warrior's Way Podcast is also brought to you by BrainMD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit Welcome to The Brain Warrior's Way Podcast.

Dr. Daniel Amen: Hi, everybody. I'm Dr. Daniel Amen. Unfortunately, Tana is not with me today. I have a very special guest, Dr. Dale Bredesen. We're going to talk about his new book, The End of Alzheimer's Disease.

In Memory Rescue ... I love the parallels with that and End of Alzheimer's, even though we came to what I think is a very similar conclusion but by different routes. I developed this mnemonic called Bright Minds, which highlight the 11 major risk factors that steal your brain. Actually, in the book, I list 36 of them, and there's a lot of over lap. Let's just, from a practical standpoint, talk about each one quickly.

B is for blood flow. Low blood flow is the number-one brain imaging predictor of Alzheimer's disease. There are actually studies that show you can predict it more than a decade before someone actually has symptoms. The things that steal blood flow, hypertension, heart disease, erectile dysfunction, although they tend to just go together, lack of exercise ... Caffeine constricts blood flow, as does nicotine.

Dale Bredesen: Yeah. These are all critical, no question about it. Healthy nitric oxide produced by your own body for your vessels, a good thing, as you know. No question, blood flow is a critical determinant. Of course, you can either go toward vascular dementia, so-called, or Alzheimer's disease. These are cousins. These are related entities.

Dr. Daniel Amen: They live in the same home. If you go to dinner, you're going to see both of them a lot in the same person, which is what we do. The number-one interventions for blood flow: exercise, obviously, treat heart disease and hypertension, beets, cayenne pepper, gingko, and vinpocetine. It's funny. The prettiest brains, the blood flow scans we do, I've ever seen are people that take gingko.

Dale Bredesen: Isn't that interesting? Wow, [crosstalk 00:03:23]-

Dr. Daniel Amen: Right. I mean, and this is the whole point of The End of Alzheimer's. By itself, gingko, vitamin E, fish oil, phosphatidylserine, whatever, is not going to work because it's not a single-cause illness. It's, as you say-

Dale Bredesen: Yeah, and as you pointed out, very interesting, the NIH spent $25 million on a single trial in which gingko was used by itself. You're not looking at the actual biology of the disease. I think gingko can be very helpful, just as you said, but as a monotherapy, we're asking too much of these different drugs. I actually have a piece in the book where we go through what a single drug would have to do if it were going to be a cure for Alzheimer's. There are over 100 different things that it has to do, so we're asking too much. Get yourself an entire program and include the gingko, and you'll be much better off.

Dr. Daniel Amen: Right. It's a multiple-mechanism illness, and you need to fight the war on multiple fronts.

Dale Bredesen: Yes.

Dr. Daniel Amen: The R in Bright Minds in retirement and aging. As you stop learning, your brain starts dying. Also, there is high levels of ferritin, which people don't really think about. It's one of the reasons to avoid red meat if your ferritin levels are high or to eat red meat if your ferritin levels are low, because low iron, you can't think. You become anemic. You're tired. High, it gives you heart disease, inflammation, and it'll kill you early.

Dale Bredesen: Yep. As Bruce Ames has pointed out, when you get anemic, you start damaging your mitochondria before you even have anemia. As your ferritin begins to drop, you have suboptimal function of your mitochondria.

Dr. Daniel Amen: A lot of people have too high levels. I'm like, well, how do you lower it? I was at the spice market in Istanbul, and they were selling leeches outside the spice market. I looked to my wife. I'm like, "Why are they selling leeches?" She goes, "Well, they bleed people. They think it's ... It's like a health fad, and it actually works." Now, I prefer donating blood than having pet leeches, but for people who have high ferritin levels, you need to be careful about the iron in your diet.

Dale Bredesen: No question.

Dr. Daniel Amen: Then new learning is just absolutely essential.

The I is inflammation, which we already talked about. You have to find the cause, but Omega-3 fatty acids can be help, and then be on an anti-inflammatory diet, which is really a plant-based diet.

Dale Bredesen: Right. Then, of course, there are now resolvents. You can also resolve the inflammation initially with these specialized pro-resolving mediators, which are now available. Then, as I said before, find out what's causing your inflammation, and get rid of that.

Dr. Daniel Amen: The G is genetics. I love this part, is that having the genes that put you at increased risk for Alzheimer's disease is not a death sentence.

Dale Bredesen: Absolutely.

Dr. Daniel Amen: It should be a wake-up call.

Dale Bredesen: Exactly.

Dr. Daniel Amen: The most important intervention under that is you need to be serious rather than ... Some people will develop a laissez-faire attitude, "It's in my family. I can't do anything about it," which they do for obesity, diabetes, heart disease, and so on. I have fat people in my family. I took a genetic test once, and it said I had a 67% chance of being obese, but I'm not because I don't engage in the behaviors that make it likely so. But it's a war, right? I mean I will look at a cupcake and gain a pound. You just have to be purposeful and whatever. We're all at genetic risk for something. You just have to be more purposeful.

Dale Bredesen: The old-fashioned idea was don't find out your APOE status because there's nothing you can do about it. That is absolutely wrong, and so everybody should know their genetic status because there's a tremendous amount you can do about it.

Dr. Daniel Amen: I got into an academic food fight once because I was talking about how scans can help predict Alzheimer's up to 10 years earlier. This one guy from St. Louis University said, "Well, why would you want to know if there's nothing you could do about it?" GE actually published a study and showed 75% of the population would want to know even if they couldn't do anything about it, but what both you and I know is there is all sorts of things you can do about it.

The H in Bright Minds in head trauma. I think that should be your fourth type. We did the big NFL study at a time when the NFL was lying they had a problem. They don't have Alzheimer's disease, the NFL players with dementia. They have frontal temporal lobe dementia secondary to head trauma. Your brain is soft, about the consistency of soft butter, and your skull's hard, and it has sharp, bony ridges. Repetitive brain injuries are just a bad idea.

Dale Bredesen: Yeah. This is a very good point. Actually, I wrote about the three types in the book, but yes, there's also a fourth and fifth, as you know. The fourth one is vascular, and the fifth one is traumatic, so absolutely.

Dr. Daniel Amen: We have to do a better job of protecting our children because, of those 36 risk factors you talk about or the 11 categories I go through, many of them actually start in childhood, the bad diets, the lack of exercise, the addiction to gadgets so they're not learning new things or having to stress their brains.

Dale Bredesen: We sow the seeds of our longevity when we are young.

Dr. Daniel Amen: The T in Bright Minds is toxins. We've talked about that a little bit. When I first started doing imaging, I was the director of a dual diagnosis unit, which is a psychiatric hospital unit that takes care of drug addicts. Their scans were so bad. I brought the bad scans home to my children and, effectively, introduced anxiety disorders in all four of them about substance abuse. That's why I've always been suspicious of marijuana is good for your brain. We just published a study on 1,000 pot smokers showing every area of the brain was lower, especially the hippocampus.

Then I'm suspicious about the alcohol research just because, in our experience ... Our database now is at 130,000 scans. The people who drink every day have overall less activity than people who don't. Alcohol is related to seven different kinds of cancer, and chemotherapy is bad for your brain. So in my mind, less it better, but I'd be interested in your thoughts on it. I spoke at the Alzheimer's Association here in Orange County, and they had alcohol as one of the refreshments. I'm always polite when I go places, but internally I was like, "Seriously?" We don't love our brains as much as we should.

Dale Bredesen: It's a really good point. Then, for so many people, this is an important part of their lives. Of course, without it, there's a increase in cortisol. I think you have to kind of balance it. If you're going to have a lot of cortisol without it ... As you know, high cortisol, bad for your hippocampus as well. We recommend keep it down to a half a glass of wine or a glass of wine two or three times a week, and it's probably not going to hurt you, and it may relax you a little. Along those same lines, what do you recommend as far as CBD oil?

Dr. Daniel Amen: There's a new study out of NYU showing it helped decrease seizure activity in children. It's not been legal long enough for us to really have good studies with it, and there's so many other things to help relax you.

Both you and I are huge fans of meditation. I'm a huge fan of hypnosis and self-hypnosis. It's one of the reasons I wanted to be a psychiatrist, because I thought it was so interesting. My first four published papers were on hypnosis for a variety of conditions. Being purposeful ... I just interviewed someone who is a friend of Viktor Frankl. Stress tends to go down ... he survived the concentration camps ... when you are an incredibly purposeful person. I also like saffron, one of my favorite spices to improve your mood and decrease stress. Relora is another one that blocks cortisol.

Our listeners know we founded BrainMD, our supplement company. I got interested in it because a lot of the medications I'd use to lower your stress and anxiety were just flat-out toxic for brain function, whether it's Xanax, or Ativan, or Valium, or Klonopin. It's very rare I prescribe them anymore because they cause overall decreased blood flow to your brain. I always say, as a psychiatrist, that Freud was wrong. Penis envy's not the cause of anybody's problem. It's brain envy. You need to care more about how that thing looks or how big that thing is.

Dale Bredesen: Yeah. Look at the remarkable things you have with the herbs. I mean look at what we have from bacopa, to rhodiola, to Hericium erinaceus, to ashwagandha. These things can be very helpful. Why are you out there prescribing a drug?

Dr. Daniel Amen: Right. I mean, here at Amen Clinics, we're not opposed to drugs. We're just opposed to that's the first and only thing you do when there's so many other things. In our focus and energy formula, we have rhodiola, ginseng, ashwagandha, and green tea extract. It works so well. It doesn't amp you like Adderall. It gives you focus while, at the same time, decreasing stress. I'm just a huge fan of other ways to think about helping people.

The M in Bright Minds is mental health issues. I mean, we know depression, bipolar disorder, post traumatic stress disorder increase your risk for Alzheimer's disease, likely from the chronic stress associated with them.

Dale Bredesen: Absolutely. Certainly, a lot of people from-

Dr. Daniel Amen: Then I-

Dale Bredesen: Go ahead.

Dr. Daniel Amen: I is immunity and infections. I know that it's part of what you've seen as well. In the Journal of Alzheimer's Disease, there was an editorial, and I think it was signed by 33 scientists, that said, "We're missing the boat. We need to be screening for infectious disease because it's a major cause of Alzheimer's disease."

Dale Bredesen: Here's the bottom line biochemically. Amyloid beta is part of the innate immune system response, so when you have Alzheimer's disease, you are saying, "I have a chronic innate immune system response to something or some combination of things," so absolutely infection. It is the neurosyphilis of the 21st century. It's just that there are many organisms that could lead to this instead of one.

Dr. Daniel Amen: It's hard to screen for them in a cost-effective way because there is a lot of them that ... Lyme, which is often hard to detect, Herpes virus. In fact, I was reading if you have cold sores, of all things, it increased your risk of Alzheimer's disease 20%. It's another reason ... If I had to pick one immune-enhancing tip, it would be optimize your vitamin D level. What's interesting, there was a study published on people whose vitamin D level was above 40 compared to those that were below 20. The people below 20 had more than double the risk of cancer.

Dale Bredesen: Wow, yeah. No question. Some people like to use tinospora cordifolia. Some people like to use cat's claw. Some people like to use transfer factors, fulvic acid, whatever it is that you like to use to enhance your immunological status. Again, the best thing you can do is getting some sleep, living a good life, and having the right foods and nutrition. Whatever it is, this is a critical piece to prevent this problem we call Alzheimer's disease with the innate immune system in activation chronically.

Dr. Daniel Amen: The N is neurohormone deficiencies. I think you talked about that [entrophic 00:17:34], one of the trophic causes. One of the most interesting things I've learned ... I think you know Mark Gordon ... is in my NFL study, all these guys had terribly low testosterone levels, and I'm like, "How's that?" I mean these are monsters who you think of as being the most manly men on the planet, but when you rattle your brain repeatedly, it can damage your pituitary gland and alter your hormone levels in your body.

Dale Bredesen: No question. You are damaging that axis.

Dr. Daniel Amen: The D is diabesity. First time I heard it was from Mark Hyman. Mark and I wrote The Daniel plan together with Pastor Rick Warren, and so I've been following Mark's work for a long time. It's that combination of diabetes and obesity. What I learned in Joe Pizzorno's book, The Toxin Solution, was it's not just food that caused diabesity. It's the toxic load we have that damages the pancreas and makes us more likely to be overweight and diabetic.

Dale Bredesen: Exactly. It's that horrible combination, and as you indicate, and diabesity is one of the most important risk factors for dementia.

Dr. Daniel Amen: Wow, and it's one of your subtypes. I mean it's just so critical. That's why when you just look around ... Go to the mall and you see the number of people who are overweight or obese. It's horrifying. Then, if you walk around the restaurants or the food courts, and you watch what people are eating, it just is horrifying.

Dale Bredesen: We've grown up not thinking about this. It's just standard to see people eating all these processed foods. Unfortunately, it's just like the old days, many, many, years ago when people thought, "Yeah, smoking. How much could it hurt you?" Well, it turns out to be bad, and so does most of the food we're eating.

Dr. Daniel Amen: That's a great analogy.

Then S is sleep. How I got interested in sleep, well, you read the studies. The people who get less than seven hours of sleep at night have lower overall blood flow to your frontal lobes, so that's a bad thing. That's the part of your brain that stops you from saying or doing stupid things, right? We all know people who have decreased inhibition.

Dale Bredesen: Yeah. [crosstalk 00:20:34].

Dr. Daniel Amen: I was at a conference once with a friend of mine who'd been in a bad accident, but she was all better. It's what everybody said, but she had no filter. Two overweight women in front of us were talking about why they were overweight. One looked to the other and said, "I don't know why I'm overweight. I just eat like a bird." My friend, so everybody around us could hear, said, "Yeah, like a condor." I looked at her, and I turned red. I was so embarrassed. She put her hand over her mouth, and she said, "Oh, no. Did that get out?"

Dale Bredesen: No, that's a very good point that frontal lobes are critical for that filter.

Dr. Daniel Amen: Right. If you don't sleep, your frontal lobes are low, which means you're going to eat more. Your decision making will not be as good. Then I began to see, so on SPECT ... and this was published in the late '80s ... decreased parietal temporal lobe hypoperfusion, so decreased blood flow to the parietal lobes, top back part of your brain, and decreased blood flow to the hippocampus on the medial temporal lobes. That's not a new finding. It's been published. It's been replicated. It's even been shown in subjects who later died that had autopsies. I started seeing saddling or decreased perfusion in the parietal lobes, and I'm like, "Why is that?" Then there was a paper that came out on sleep apnea causing that saddling. Then it turns out sleep apnea is actually as risk factor for Alzheimer's disease because your brain's the most metabolically active organ. If it has an oxygen debt, it's going to kill it.

Dale Bredesen: Yeah. That's a good point.

Dr. Daniel Amen: Sleep is just absolutely essential.

Dale Bredesen: Let me ask you a question, Daniel. We see people who have more of a Type Three or toxin presentation as having a cortical, typically biparietal syndrome, nonamnestic, whereas the people that have more of the Type One and the Type Two, the inflammatory, and especially the atrophic, as having a predominantly hippocampal and amnestic presentation. Very different looking people. Do you see differences like that on your SPECT scans?

Dr. Daniel Amen: We do. In fact, I mean we've done 25 or 30 of them together. The interesting ... clearly, to do more when you have classic cases to go, "What does the scan pattern look like?" In the toxic pattern, what we see is a scalloping appearance overall. It's not hard to see in the 3D renderings we do. It's like, "There is a toxic pattern." It's this overall bumpy decreased blood flow, but less likely to be focal to an area like the hippocampus. I think we would see a difference.

You'll like this. We just remodeled our house. In the shower, my wife put two seahorses because in Memory Rescue I talk about you have to love your seahorses because you're making baby seahorses all the time.

Well, I couldn't be more grateful for your work, your friendship, your time. I'm thrilled for you that The End of Alzheimer's Disease is becoming a huge success. I'm right there with you wanting to tell our listeners about it, our community about it. It's Nobel-Prize-winning work, and I'm just proud to know you.

Dale Bredesen: Thank you very much, Daniel. I love the work you're doing, and I look forward to more. I look forward to your upcoming book. This is some very exciting stuff. As you pointed out, you have the largest group of SPECT scans in the world, so you're going to be learning a tremendous amount from these, and we're going to learn on head trauma, on Alzheimer's, on other neurodegenerative conditions. We are truly at the dawn of the era of treatable neurodegenerative disease. Thank you very much, Daniel.

Dr. Daniel Amen: Great. Thanks, everybody. You're listening The Brain Warrior's Way. Dale Bredesen. I'm Dr. Daniel Amen.

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