Dr Bredesen chats about how modern gadgets are helping people track their mental health by monitoring critical information for people to know about themselves. He elaborates on how the current state of detecting Alzheimer’s disease is getting easier, but at the same time the age of the individuals affected is becoming younger and younger.
Daniel Amen, MD:
Welcome to the Brain Warrior’s Way podcast. I’m Dr. Daniel Amen.
Tana Amen, BSN RN:
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Welcome back. We are still here with our friend and colleague, Dr. Dale Bredesen.Talking about his amazing program, the End of Alzheimer’s. He’s got the book and the program. And I love we were talking about your clinical trial in the last episode, Dr. Bredesen, and you talked about something, which I think, we’ve been talking about for a long time. You’ve been talking about it for a long time, but not a lot of people have been talking about for a long time. And it’s really about treating the underlying causes that Alzheimer’s, isn’t one thing. So I just, I love this idea to get people well, we’ve got to treat the underlying causes rather than putting band-aids over bullet holes. If you will [crosstalk [00:01:24] try and use the shotgun effect?
Dr. Dale Bredesen:
How do you know, unless you [crosstalk [00:01:28] the major business principle is you can’t change what you don’t measure.
And we, it’s why we do imaging, because we’re measuring and the research backs up. We can tell years, maybe decades, before you have any symptoms if your brain is headed for darkness. I’m getting ready to publish a new study on happiness and if you have low frontal lobe function, you’re not happy. It’s pretty clear, brain health goes with happiness. That it also goes with memory.
What are some of the important numbers you think people should know on a routine basis? Important health numbers?
Daniel Amen, MD:
Well, I’d say first of all, certainly agreeing with the point that Tana made. That you really need to look at these things. You really need to go after what’s causing it. As you said, they’re critical numbers and years ago, you had the tremendous and critical insight that with psychiatry, you’re not looking at what’s actually changes. And the SPECT scans change that. So you can now actually see, you can see what COVID does, you can see what Alzheimer’s does, and you can see it coming. Which is really critical. And so we’re doing very much the same thing, biochemically. So we want people to know what their TGF beta 1 is, because that is a critical piece for their [inaudible [00:03:01] ability to deal with inflammation.
We want them to know things like, their hs-CRP. The good news is by the way, there are so many of these wearables now that we can find out a number of these things. We want them to know how their sleep is going, we really wanted the most important things for people to know, is their nocturnal oximetry. There’s a beautiful study published just a couple of years ago showing, if you simply take the mean oxygen saturation, the average through the night, that correlates beautifully with the size of specific nuclei within your brain, including your hippocampus. So as your oxygenation goes down at night, and unfortunately so many people don’t check, your brain is shrinking and that’s a major issue. .We’d like to know. [crosstalk [00:03:47] So people can do that a number of ways, you can either do it by with things like you do with an Apple watch. That’ll actually be aware that at night, it’ll tell you what your oxygen status is while you’re sleeping. You can do it with a simple oximeter, which you can buy inexpensively, or you can borrow from your physician.
You can do it with a sleep study. If there’s any question about your sleeping, good idea to have a sleep study. They will check that for you.
So there are numerous ways to do that, but one way or the other critical to know that. And another critical thing to know, is your oral microbiome. And we, of course, we talked so much now about the gut microbiome and how important it is, but of course also your sinus microbiome and your oral microbiome.
And one of the things that’s been found by the pathologist, repeatedly in the brains of patients with Alzheimer’s disease is P gingivalis, a specific bacterium from your mouth that actually gets into your brain.
This all by the way also goes systemically. It is part of your cardiovascular disease. It can contribute to cancers. It’s been remarkable. What’s going on in your mouth, the inflammation that’s going on, periodontitis, gingivitis, absolutely critical for your cognition. And so therefore, you can check this easily with an oral DNA test. You could look to see whether you have low levels of this in your microbiome or high levels. And there are a few other bad ones, T denticola, P intermedia. This is a [inaudible [00:05:22] species, F nucleatum. These are all the bad actors in your mouth that can unfortunately get into your brain. And then of course, toxic [inaudible [00:05:31]. And I know you’ve talked about that many times. So many of us have toxic [inaudible [00:05:37], whether it’s more on the metal, whether it’s air pollution.
And of course, here in California, with the fires, huge issue. With air pollution, there was, you probably saw there was a follow-up study on the people who’d been in the World Trade Center. And they’re now up to 14% of these people have cognitive decline. Because of the exposure to that air pollution, even though it was so brief, still enough to increase risk for cognitive decline. And then there was the organics, of course, the glyphosate and things like that. And then of course the mycotoxin.
So all of these things are critical to know, and then things like your heart rate variability, again, easy to check. And if you’re walking around here at 15 or 20 day in and day out, you’re under a lot of stress and you’re not going to do as well in the long run. So the good news is, as you said, we can now measure and follow these things. I just checked my oxygenation on my Apple watch [crosstalk [00:06:32] 97% [inaudible [00:06:33].
Tana Amen, BSN RN:
While we sleep? [inaudible [00:06:40]
Because I think we want to know specifically while we sleep, correct?
Daniel Amen, MD:
A sleep apnea, triples the risk of Alzheimer’s disease. [crosstalk [00:06:47] I can tell if you have sleep apnea because in early Alzheimer’s [inaudible [00:07:00] in parabola. One of the first areas that die in Alzheimer’s disease.
Dr. Dale Bredesen:
I think people are actually being diagnosed later, in the course of the illness because of their phones. It used to be when I first started in practice, I get a patient referred to me for Alzheimer’s disease because they lost their way home.
And in the city, they lived in for 30 years. Well now nobody loses their way home because you can just tell your phone, take me home. And maps will take them home. So I think that our gadgets are getting us later diagnoses. Than we had before, because people can sort of budge their memory.
This is such a good point. And on the one hand, they are absolutely being diagnosed later because there are so many workarounds now. But interestingly, they’re also being diagnosed younger. So, that’s a scary combination. When I was training back in the eighties at UC San Francisco, we never saw people in their 50s with Alzheimer’s disease. This was a disease of late 60s, 70s, 80s.
We see one of the most common things we see now, is a 52 year old person with Alzheimer’s disease. And so, in fact, that was reported with an epidemiological study about a year ago, that they’re seeing the same thing more and more young. But Daniel, you brought up something really interesting. If you don’t mind, I want to ask you a key question here. So you brought up the biparietal and of course on PET scans, you typically see it’s temporal and parietal. But what’s really interesting, so here’s my question for you. When we see people who have a largely, biparietal not so much temporal look, it’s a non amnestic presentation with things like a proxy as an agnosis and PCA and things like that. Executive dysfunction of the parietal type, rather than the frontal type, these people typically turn out to have toxic exposure as opposed to a more inflammatory or metabolic syndrome.
So do you see in your patients who have cognitive decline, do you see a group that is much more biparietal than temporoparietal?
Daniel Amen, MD:
Yes. And then I think of them as, I have to wonder about sleep apnea. And so that’s the first that I think about, but you also wonder if they’ve been dropped on their head. Because, traumatic brain injury is a major cause of dementia. That very few people talk about because they’re not looking at functional scans. We’ll look at stroke [inaudible [00:09:49].].
Tana Amen, BSN RN:
For our listeners. You guys need to translate this.
Daniel Amen, MD:
[inaudible [00:09:53] just means on both sides. So bilateral both sides of your parabola top back part of your brain, that’s involved with directions.
Dr. Dale Bredesen:
And it’s also involved in recognizing when you have a problem, especially not side of the brain [crosstalk [00:10:14] versus your temporal lobes underneath your temples and behind your eyes. And on the inside of your temporal lobes, that’s what [inaudible [00:10:21] in Alzheimer’s disease is very special. Part of the brain called the hippocampus. That is one of the very few parts of the brain that produce new baby cells every day. Hippocampus is great for sea horse. So you’re actually making 700 new baby [inaudible [00:10:43] every day. And if you’re starting them of oxygen, because you have slowed down, you’re murdering them. Or if you’re smoking weed, I’m like not a huge fan of being smoked. Cause it shrinks. [inaudible [00:11:00]
Daniel Amen, MD:
Great point. And the way we tend to see them is the ones who have the temporal parietal come in with memory problems. The ones that have the biparietal, as you said, kind of back here without the temporal, don’t have the memory problems. They have the problems with calculation and they have the problem with planning. And they have the problem with recognizing other people’s faces. And they often are the earlier ones in their early 50s. So those are the sorts of things that make me look. So that’s very interesting that it really makes you think about sleep apnea. That’s a great point. So very interesting. Thank you.
Dr. Dale Bredesen:
Well, and what the problem has been is, we can say, “what it is?”. So it’s Alzheimer’s, but we’re not saying why [crosstalk [00:11:52] got screwed up because everybody was saying it’s beta-amyloid plaque deposition. And your work and the work of a lot of people who publish in the journal of Alzheimer’s is, that’s complete nonsense because beta-amyloid may actually be a protective deposition for mold exposure or infections and [crosstalk [00:12:20] go after the lock, you’ll never fix the problem.
Daniel Amen, MD:
We have to go onto the next podcast, this is so interesting we could talk all day. In fact, we’ve got two more to do. We are here with Dr. Dale Bredesen author of the international best-selling book, The End of Alzheimer’s, The End of Alzheimer’s program. And the new book in August is the first survivors of all as love that title gives me goosebumps, [inaudible [00:12:54]
Tana Amen, BSN RN:
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