Optimizing brain health: Alzheimer's risk factors, APOE, & prevention strategies [AMA 46 sneak peek]

Watch the full episode and view show notes here: bit.ly/40brPHC
Become a member to receive exclusive content: peterattiamd.com/subscribe/
Sign up to receive Peter's email newsletter: peterattiamd.com/newsletter/
In this sneak peek, we discuss:
00:00 - Intro
00:08 - Diagnosing Alzheimer's disease
05:36 - Biomarkers for Alzheimer’s disease, the C2N test, and other tools for diagnosis
11:25 - Genetic component of Alzheimer’s disease: genes that confer risk
16:59 - Understanding your APOE status and why it’s important to know
21:16 - The prevalence of Alzheimer’s disease and other forms of dementia, and who is at higher risk
24:45 - Can the risk of Alzheimer’s disease be decreased with behavioral changes?
In the full episode, we also discuss:
-Overview of modifiable behaviors that potentially play a role in risk reduction of neurodegeneration;
-Things that clearly impact brain health: smoking, alcohol, sleep, head injuries, blood pressure, and more;
-How nutrition impacts brain health: common diets, metabolic health, energy balance, and more;
-Comparing common diets: data showing the association between the incidence of Alzheimer’s disease and specific diets;
-Supplements: EPA and DHA, vitamin D, and B vitamins;
-Supplements: theracurmin, cocoa flavonols, and magnesium L-threonate;
-Impact of exercise on brain health, minimum effective dose, and the most important types of exercise;
-Challenging the mind with brain games-does it impact neurodegeneration?;
-The data on sauna and brain health;
-Oral health and its association with brain health;
-How reducing lipids can improve brain health and prevent neurodegeneration;
-The potential impact of hearing loss on brain health and neurodegeneration; and
-More.
--------
About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 45 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
Learn more: peterattiamd.com
Connect with Peter on:
Facebook: bit.ly/PeterAttiaMDFB
Twitter: bit.ly/PeterAttiaMDTW
Instagram: bit.ly/PeterAttiaMDIG
Subscribe to The Drive:
Apple Podcast: bit.ly/TheDriveApplePodcasts
Overcast: bit.ly/TheDriveOvercast
Spotify: bit.ly/TheDriveSpotify
Google Podcasts: bit.ly/TheDriveGoogle
Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies.

[@SL-he2wt]

I read the show notes, before listening to this episode, a few weeks ago.......about half way through there is a 3 word blurb about 23 and me providing APOE results. I stopped mid read, opened up my results from 2 years ago and for the first time comprehended what it meant to see I have two APOE4 alleles. Thank you for that half a second blurb as I am one who wants to know and try all strategies I can to try and mitigate my risk for neurodegenerative disease. Perhaps, someday, results such as these could come from a doctor who can explain the need to take them seriously and still provide hope and options for prevention or slowing onset. I am 48. I have been focusing on exercise and metabolic health now for a few years. BUT also avoided managing cholesterol levels that would scare the pants of Dr Attia since I was in my 20's. Now I have an endocrinologist helping make a plan to get numbers down (LDL 191) but would never have done this without this one AMA episode because after all I just assumed I was "normal" not in the 1%-2%.

[@lindajones4849]

Hi- I know you posted this a year ago but I hope you see this . Dr.Dale Bredesen has shown that especially in the subjective cognitive impairment and early stages of mild cognitive impairment is reversible . They had much more limited improvement with advanced Alzheimer's ( such as someone who is so advanced they are nonverbal. He has also published books for the public on his protocol. Also Dr. Dean Ornish has published a trial on his results reversing EARLY cognitive decline with rigorous lifestyle changes. According to what I found on line the Ornish paper will be released in June 2024 in the journal of Alzheimers Research and Treatment .

[@angeliquepope5651]

Dr.Attia, you are inspirational and down to earth! You speak clearly and informatively. You give me the motivation to become healthy and help the next generation. I thank you and god bless

[@Moonmanwalker]

Love the videos !!!

[@RhythmicEye]

There are peer reviewed studies available that were completed by Oxford university on Alzheimers that draw some very interesting findings and which helps one understand why there are such vagaries around this topic. Kind of similar to what we've all experienced over the past three years. Vagaries seem to be the common thread here. Our family has recently had experience with both Alzheimers and dementia in seperate family members concurrently. The expereince left our family feeling totally perplexed especially when we were repeatedly asking for clarification on the difference between the outward presentation and the diagnosis. Zero clarity right up until their passing.

[@patrickfriel2353]

Great point. My wife has early onset dementia. I took care of her at home for 8 years, and then admitted her to memory care. It is a great place, and she is quite happy despite very advanced dementia. One thing the memory care nurses told me is that they don't see the neat academic forms of dementia, Alzheimer's, Lewy Body, FTD, vascular, etc. Every resident is a bit different, and many cases are mixed. The first neurologist I took my wife to wasn't very helpful, although he did order an MRI, which showed severe brain atrophy in her early 60s. But he didn't educate me about dementia, and dismissed my concerns about developing a long term game plan. Later I took her to an academic dementia center, which was better.

[@isa-manuelaalbrecht2951]

So it is, we shan't make us dependable of fears nor pre- or assumptions of... thanx for your clearifyings...🤩😏👏👏👏

[@billytheweasel]

Insta-liked. As always, thanks Dr Attia.

[@michaeldumaup5368]

"sneak peak" that's 35 minutes long. Gotta love it

[@jakulfirmus]

Please can you tell me who is the author of the music at the end of the podcast.

[@Thomas-kx5nj]

Merci docteur pour le professionnalisme avec lequel vous faites votre travail. Vous écoutez votre client et vous accordez toujours la priorité à ses besoins, pour vous assurer qu'il vit une autre journée sainement et dynamiquement. Bravo à vous mon docteur, je célèbre la façon dont vous faites votre travail. Si cela ne tenait qu'à moi, je vous décernerais le prix du meilleur médecin. Merci docteur pour tout ce que vous faites Docteur Akhande pour avoir guéri mon herpès 1:28.

[@markleblanc451]

What about statins and randomizing those that take them. Is it in relation to genes vs a cholesterol deficiency?

[@appl314]

What are the current thoughts on cause of regressive autism?

[@sportbilly6329]

Care to discuss with Professor Bart Kay on your Apo b “theories”

[@james263]

Shame the section you put behind the paywall is also the part that is most directly beneficial to people's health.

[@thinking-ape6483]

Yeah, guys like Attia and the like cater wo wealthy people with lots of options, the rest of us don't matter and I am an APOE4 carrer. It is the same for all other aspects of health and life, divided into the haves and have-nots.

[@charleedell92]

It runs in my family, Nana dad and aunt. I have chosen not to find out for now -i live as if I have an E4 while maintaining the hope that I don't 😁 I am also really interested in cholesterol as I have moderately raised LDL despite a healthy lifestyle. Doctors ignored my cholesterol for 20 years as I was a young healthy female and I can't help wondering if less aggressive treatment of cardiovascular risk factors in women accounts for some of the gender differences in dementia.

[@rp011051]

What about women and hormones for Alzheimer's See book THE XX factor.

[@optimalhealthmedicine1486]

As Dr. Dale Bredison has > 100 recovered Alzheimer’s patient documented and now a book, we have 21 successful AD recoveries . 17b-estradiol (Bioidentical) and it’s conversion to alfa secretase needed to cleave the CTFa on the amyloid precursor protein (APP) within the synapse of the brain is vital in the recovery processes of AD. Optimal levels, NOT “normal” levels of Bioidentical estradiol, Testosterone in both men and women and active component T3 of thyroid (not inactive useless Synthroid with most of us with 5’ Deiodinase enzyme deficiency) is vital to significant cognitive recovery. Controlling insulin (preferably 20 years ago). Hypoxia during sleep and the best, most powerful tool for AD, and overall health recovery is Human Growth Hormone, affectionately called Human Healing Hormone!! (Norditropin) Expensive but SO worth it!! Omega 3 (EPA and DHA) Pregnenolone 100mg DHEA with serum levels ~400, B Complex for neurotransmitters and to eliminate Homocysteine! Elevated TMAO from choline within the gut microbiome is also devastating to the cognition and so many other organs including mimicking Parkinson’s symptoms!! There IS hope and treatment for AD but obviously prevention ( avoiding visceral fat and it’s inflammatory cascade by keeping your Bioidentical hormones “optimal” not “normal” through the years of decline and avoiding statins and synthetic medications)

[@bigcat9977]

Research has shown that low levels of cholesterol can be associated with lower BDNF levels in the brain. BDNF is important for the growth and survival of neurons, and lower levels of BDNF have been linked to depression, anxiety, and cognitive decline. Cholesterol lowering drugs including statins and PCSK9 inhibitors can lead to cognitive decline.

[@robertusga]

What you did was storytelling. Mechanistic speculation. Now, back it up with actual outcome based data from quality studies in humans. Without those, all you have spun is a fairy tale. Hint: your brain does not depend on serum cholesterol for its cholesterol needs. It can synthesize all it needs.

[@jellybeanvinkler4878]

Going on drugs willy nilly will be the downfall of our civilization. Whether from illegal drug pushers, or legal drug pushers. But following the USA dietary guidelines will lead to the drugs in the first place. Mentally and physically. We are so screwed.

[@robertusga]

@Trevor Bohns Sounds cool! Completely tangential to what we were actually talking about, but definitely fun times! Now back to keeping ApoB as low as possible. Go!

[@flow2tech]

@@robertusga Excercise Excercise Excercise and in worse case scenarios - pharmacology...Very cool indeed ..Give it a go....My ApoB has spiralled down since embarking on ridiculous cycling endeavors.. its just most people want a quick fix with all types of data markers..Attia talks about this himself ..Excercise is the single most important longevity drug hands down zero debate..He has stated this exactly..

[@robertusga]

@@flow2tech sure, exercise is fantastic! That does not mean you shouldn't keep your ApoB below 40 to prevent CVD. If exercise gets that done, perfect. If not, you have many options.

[@TheTibo13]

Is there any way to delay the onset of the early form( PSEN1/2, APP)? For example with exercise, diet or anything else or is there no relevant data on this?

[@Cathy-xi8cb]

Early onset types are considered to be genetic in origin. They are among the most devastating, and the current (weak) medications don't seem to work much at all. The good news is that there may be gene therapy in the future. Way in the future. If I developed Early Onset Dementia, I would be booking a flight to Switzerland. Robin Williams is a good example of the suffering to expect. All the money and fame in the world, and it didn't prevent his tortured existence w/LBD.

[@optimalhealthmedicine1486]

As Dr. Dale Bredison has > 100 recovered Alzheimer’s patient documented and now a book, we have 21 successful AD recoveries . 17b-estradiol (Bioidentical) and it’s conversion to alfa secretase needed to cleave the CTFa on the amyloid precursor protein (APP) within the synapse of the brain is vital in the recovery processes of AD. Optimal levels, NOT “normal” levels of Bioidentical estradiol, Testosterone in both men and women and active component T3 of thyroid (not inactive useless Synthroid with most of us with 5’ Deiodinase enzyme deficiency) is vital to significant cognitive recovery. Controlling insulin (preferably 20 years ago). Hypoxia during sleep and the best, most powerful tool for AD, and overall health recovery is Human Growth Hormone, affectionately called Human Healing Hormone!! (Norditropin) Expensive but SO worth it!! Omega 3 (EPA and DHA) Pregnenolone 100mg DHEA with serum levels ~400, B Complex for neurotransmitters and to eliminate Homocysteine! Elevated TMAO from choline within the gut microbiome is also devastating to the cognition and so many other organs including mimicking Parkinson’s symptoms!! There IS hope and treatment for AD but obviously prevention ( avoiding visceral fat and it’s inflammatory cascade by keeping your Bioidentical hormones “optimal” not “normal” through the years of decline and avoiding statins and synthetic medications)

[@GwaiZai]

@@Cathy-xi8cb There was a study published this week that said alcohol abuse and loneliness can also be contributing factors.

[@isa-manuelaalbrecht2951]

Noni stands for * non- secretors* in Genotypings by Peter D'Adamo ,that always is overlooked...😉🙄

[@formxshape]

What if inflammation in the lungs from pollution leading to excess mucus lead to less ability to absorb oxygen and then Alzheimer’s?

[@robertusga]

Nice hypothesis. Have any outcome based data from quality studies in humans that have outcomes matching your predictions?

[@ID30394]

Because of increasing toxins in our environment, it's more important than ever to go through periodic fasting to cleanse the levels of heavy metals and other substances detrimental to a healthy functioning body.

[@robertusga]

@Gregory Vadnais yeah no, none of that shows up in actual outcome data. Also, fasting, unless just a very short one, leads to massive lean mass loss. Even Dr. Peter Attia changed his mind on this.

[@thinking-ape6483]

I have a copy of APOE4 and I cannot help but feel doomed. I am not rich so cannot afford the things that Chris Hemsworth and others can. Still, I live in Europe and I can have myself euthanised if it comes to it, which is a better way of going out than being a mindless meatsack. It is a shame so much of the material out there is for wealthy people and elites with unlimited resources. Oh well. Maybe I can still learn something, though it never seems positive.

[@rl9702]

Bro, Chris's anti-Alzheimer's strategy isn't injecting liquefied cash into his veins. #1 Exercise, then nutrition, sleep & maybe some sauna. All of Peter's and Rhonda Patrick's videos are free online. Just listen to them while doing your zone 2 run. You got this 💪

[@zhilahaghbin4766]

I too have one copy but I am not dwelling on it, please know these are not causal relations, just some observations, that are subject human and statistic errors, the most important factor n development of Alzheimer is metabolic disorder esp. with high glucose and fructose diet , [please listen to Dr. Robert Johnson's book, [Nature wants us to be fat or just type his name in you tube , what he talks about fruits and fructose], the things you can do are [avoid alcohol, cig, processed foods, anything out of can, out of a bag, keep BP low normal, blood glucose low normal, make sure your vitamin b12 and folate are normal, eat food/with high antioxidants [you can read Dr. William Li's boo, on nutrition; and one thing I believe is important for example at any age you can learn a new language , once your learn even to remember a few words of it, your brain is different and better than when you didn't know that language, thus keep reading, expanding your vocabularies esp on your own language [main reason we forget certain words is that we have not used them for a long time], for example you can learn names of birds, animals that you don't see normally, so brain exercises, on top of all cardio conditioning is best way to send blood to your brain. Even in his book Dr Attia talks about centenarians with E4/E4 without evidence of "dementia". having this gene or that and trying to find out which one of the ones he mentioned you got and get worried more won't help you, hope this helps, I am a geriatric psychiatrist and MD

[@2K9s]

Peter, by saying “right” you are implying to the listener that what you’re saying is not only obviously correct but that the listener already understands and is already in agreement with them.

[@whitGGG]

Wow! Seriously?

[@2K9s]

@@whitGGG ☠️