Neuroscientist: Most Women Are Raising Their Dementia Risk (Without Knowing It)

Let's talk about women's brain health. Let's talk about women's brain health. >> It's getting a lot more attention these >> It's getting a lot more attention these >> It's getting a lot more attention these days. Very rightly so. days. Very rightly so. days. Very rightly so. >> Absolutely. >> Absolutely. >> Absolutely. >> Um I know you've got some >> Um I know you've got some >> Um I know you've got some some really quite thoughtprovoking ideas some really quite thoughtprovoking ideas some really quite thoughtprovoking ideas relating to women's brain health through relating to women's brain health through relating to women's brain health through the lens of your 3S model in terms of the lens of your 3S model in terms of the lens of your 3S model in terms of stimulation. So can you speak to that as stimulation. So can you speak to that as stimulation. So can you speak to that as a topic? a topic? a topic? >> Yeah, absolutely. So, >> Yeah, absolutely. So, >> Yeah, absolutely. So, one of the another reason why I think we one of the another reason why I think we one of the another reason why I think we have this hopeful message for dementia have this hopeful message for dementia have this hopeful message for dementia prevention and decreasing population prevention and decreasing population prevention and decreasing population dementia burden in the future is because dementia burden in the future is because dementia burden in the future is because over the past 100 years we've seen a over the past 100 years we've seen a over the past 100 years we've seen a decrease in the age specific instance of decrease in the age specific instance of decrease in the age specific instance of dementia dementia dementia and that that's measured in a very and that that's measured in a very and that that's measured in a very specific way. But what we hear all the specific way. But what we hear all the specific way. But what we hear all the time is dementia cases are going to time is dementia cases are going to time is dementia cases are going to triple in the next 10 or 20 years. Um triple in the next 10 or 20 years. Um triple in the next 10 or 20 years. Um you know the the risk of dementia is you know the the risk of dementia is you know the the risk of dementia is constantly increasing. And those things constantly increasing. And those things constantly increasing. And those things are technically true because the the the are technically true because the the the are technically true because the the the world is you know the population is world is you know the population is world is you know the population is living longer and if you live longer living longer and if you live longer living longer and if you live longer without dying of something else then without dying of something else then without dying of something else then you're more likely to get dementia. We you're more likely to get dementia. We you're more likely to get dementia. We know that. But you are less likely to be know that. But you are less likely to be know that. But you are less likely to be diagnosed with dementia at the age of 70 diagnosed with dementia at the age of 70 diagnosed with dementia at the age of 70 like today than you ever have been in in like today than you ever have been in in like today than you ever have been in in in in previous history. And people don't in in previous history. And people don't in in previous history. And people don't people don't realize that. So what that people don't realize that. So what that people don't realize that. So what that means is means is means is over time age specific incidence of of over time age specific incidence of of over time age specific incidence of of dementia has decreased. dementia has decreased. dementia has decreased. >> What does that mean specific incident? >> What does that mean specific incident? >> What does that mean specific incident? So that's exactly so exactly what I was So that's exactly so exactly what I was So that's exactly so exactly what I was saying is so like if you pick up a saying is so like if you pick up a saying is so like if you pick up a specific age 60 years old 70 years old specific age 60 years old 70 years old specific age 60 years old 70 years old you're now less likely to have dementia you're now less likely to have dementia you're now less likely to have dementia at 70 years old than you were 20 or 30 at 70 years old than you were 20 or 30 at 70 years old than you were 20 or 30 years ago. years ago. years ago. >> So just and I just want to make sure >> So just and I just want to make sure >> So just and I just want to make sure everyone's got this. So why is there everyone's got this. So why is there everyone's got this. So why is there this apparent discrepancy then between this apparent discrepancy then between this apparent discrepancy then between you know rates going up but our you know rates going up but our you know rates going up but our individual risk at any given age going individual risk at any given age going individual risk at any given age going down? down? down? >> It's because we're living longer. So it >> It's because we're living longer. So it >> It's because we're living longer. So it is true that um because now we're more is true that um because now we're more is true that um because now we're more likely to live to be 80 or 90 likely to live to be 80 or 90 likely to live to be 80 or 90 that yes the the the risk of having that yes the the the risk of having that yes the the the risk of having dementia at 80 is lower than it was dementia at 80 is lower than it was dementia at 80 is lower than it was previously but because more of us will previously but because more of us will previously but because more of us will live to 80 more of us will have will live to 80 more of us will have will live to 80 more of us will have will have dementia at some point in our lives have dementia at some point in our lives have dementia at some point in our lives but it will just happen later in life if but it will just happen later in life if but it will just happen later in life if that makes sense. So both of those both that makes sense. So both of those both that makes sense. So both of those both of those things are happening at the of those things are happening at the of those things are happening at the same time which is complicated like I I same time which is complicated like I I same time which is complicated like I I understand it understand it understand it >> but what's then interesting is is you >> but what's then interesting is is you >> but what's then interesting is is you see that it is possible to move the see that it is possible to move the see that it is possible to move the needle on the incidence of dementia at needle on the incidence of dementia at needle on the incidence of dementia at any any given age which then means that any any given age which then means that any any given age which then means that it's probably also possible to move the it's probably also possible to move the it's probably also possible to move the needle on dementia overall right which needle on dementia overall right which needle on dementia overall right which is goes back to the fact that dementias is goes back to the fact that dementias is goes back to the fact that dementias are preventable are preventable are preventable >> or some pro proportion of dementias are >> or some pro proportion of dementias are >> or some pro proportion of dementias are preventable but when you think about preventable but when you think about preventable but when you think about well why might this be? Because it well why might this be? Because it well why might this be? Because it because it kind of goes against some of because it kind of goes against some of because it kind of goes against some of the narrative and one is an improvement the narrative and one is an improvement the narrative and one is an improvement in cardiovascular health and this seems in cardiovascular health and this seems in cardiovascular health and this seems to be particularly been beneficial for to be particularly been beneficial for to be particularly been beneficial for men decreasing the um age specific men decreasing the um age specific men decreasing the um age specific incidence of dementia for men because uh incidence of dementia for men because uh incidence of dementia for men because uh uh heart disease risk factors overlap um uh heart disease risk factors overlap um uh heart disease risk factors overlap um very tightly with dementia risk factors. very tightly with dementia risk factors. very tightly with dementia risk factors. We've already talked about um blood We've already talked about um blood We've already talked about um blood pressure, blood sugar, but um smoking um pressure, blood sugar, but um smoking um pressure, blood sugar, but um smoking um blood lipids play a role here too. We've blood lipids play a role here too. We've blood lipids play a role here too. We've become much better at treating and become much better at treating and become much better at treating and preventing heart disease. And that seems preventing heart disease. And that seems preventing heart disease. And that seems to have translated to a a lower age to have translated to a a lower age to have translated to a a lower age specific instance of of dementia, maybe specific instance of of dementia, maybe specific instance of of dementia, maybe more so in men because men tend to have more so in men because men tend to have more so in men because men tend to have higher, you know, heart disease risks uh higher, you know, heart disease risks uh higher, you know, heart disease risks uh than women. But we do also see some of than women. But we do also see some of than women. But we do also see some of this shift happening in women as And this shift happening in women as And this shift happening in women as And there were these big meta analyses that there were these big meta analyses that there were these big meta analyses that have been done in studies using data have been done in studies using data have been done in studies using data from the US, from the UK, uh from from the US, from the UK, uh from from the US, from the UK, uh from multiple European countries. And I multiple European countries. And I multiple European countries. And I wonder if some of what we're seeing wonder if some of what we're seeing wonder if some of what we're seeing particularly in women is uh the changing particularly in women is uh the changing particularly in women is uh the changing role of women in society which has been role of women in society which has been role of women in society which has been you know overwhelmingly beneficial. So you know overwhelmingly beneficial. So you know overwhelmingly beneficial. So if you think back to uh I mentioned uh if you think back to uh I mentioned uh if you think back to uh I mentioned uh Warner Shai's uh Seattle longitudinal Warner Shai's uh Seattle longitudinal Warner Shai's uh Seattle longitudinal study um and one of the things that they study um and one of the things that they study um and one of the things that they looked at in the in the Seattle looked at in the in the Seattle looked at in the in the Seattle longitudinal study was um environmental longitudinal study was um environmental longitudinal study was um environmental enrichment or an enriched environment enrichment or an enriched environment enrichment or an enriched environment which basically meant how complex and which basically meant how complex and which basically meant how complex and cognitive stimulating is the world that cognitive stimulating is the world that cognitive stimulating is the world that you exist in largely related to your you exist in largely related to your you exist in largely related to your work and your hobbies. And the more work and your hobbies. And the more work and your hobbies. And the more enriched or complex your environment, enriched or complex your environment, enriched or complex your environment, the lower your risk of dementia, the lower your risk of dementia, the lower your risk of dementia, cognitive decline in the Seattle cognitive decline in the Seattle cognitive decline in the Seattle longitudinal study. But there were a longitudinal study. But there were a longitudinal study. But there were a group of um individuals who had low group of um individuals who had low group of um individuals who had low environmental complexity and a higher environmental complexity and a higher environmental complexity and a higher risk of cognitive decline dementia risk of cognitive decline dementia risk of cognitive decline dementia um and they were all overwhelmingly um and they were all overwhelmingly um and they were all overwhelmingly women, which was the housewife. Um and women, which was the housewife. Um and women, which was the housewife. Um and this in the 1950s was a very traditional this in the 1950s was a very traditional this in the 1950s was a very traditional thing, right? um and the way that they thing, right? um and the way that they thing, right? um and the way that they measured these things and the way that measured these things and the way that measured these things and the way that they wrote about them, you know, is part they wrote about them, you know, is part they wrote about them, you know, is part partly of their time right now 60 70 partly of their time right now 60 70 partly of their time right now 60 70 years ago. But something that they saw years ago. But something that they saw years ago. But something that they saw in that study was that that environment in that study was that that environment in that study was that that environment was not necessarily as um stimulating or was not necessarily as um stimulating or was not necessarily as um stimulating or complex as you know the work environment complex as you know the work environment complex as you know the work environment or that that other people might have or that that other people might have or that that other people might have access to. But we've seen both within access to. But we've seen both within access to. But we've seen both within you know westernized um societies but you know westernized um societies but you know westernized um societies but also globally as education has become also globally as education has become also globally as education has become more accessible and equitable um to more accessible and equitable um to more accessible and equitable um to women in particular dementia rates and women in particular dementia rates and women in particular dementia rates and dementia risks have decreased. Right? dementia risks have decreased. Right? dementia risks have decreased. Right? That's one of the reasons why education That's one of the reasons why education That's one of the reasons why education is actually the the the risk factor in is actually the the the risk factor in is actually the the the risk factor in the Lancet uh commission report that has the Lancet uh commission report that has the Lancet uh commission report that has the biggest number 7% of dementia the biggest number 7% of dementia the biggest number 7% of dementia related to to education. And then we related to to education. And then we related to to education. And then we think about the work environment. So um think about the work environment. So um think about the work environment. So um women like women's presence in the women like women's presence in the women like women's presence in the workplace only really started to expand workplace only really started to expand workplace only really started to expand in the 1970s. This is based on like US in the 1970s. This is based on like US in the 1970s. This is based on like US labor and statistics data. Um, and so labor and statistics data. Um, and so labor and statistics data. Um, and so there's been this big shift from, you there's been this big shift from, you there's been this big shift from, you know, what was maybe um the potential know, what was maybe um the potential know, what was maybe um the potential for a less cognitively stimulating for a less cognitively stimulating for a less cognitively stimulating environment and and and I realize that environment and and and I realize that environment and and and I realize that that doesn't have to be the case, right? that doesn't have to be the case, right? that doesn't have to be the case, right? People can um, you know, be primarily at People can um, you know, be primarily at People can um, you know, be primarily at home and, you know, the the most of home and, you know, the the most of home and, you know, the the most of their work and commitments are at home their work and commitments are at home their work and commitments are at home with their children or family or family with their children or family or family with their children or family or family members, right? And that's that's that's members, right? And that's that's that's members, right? And that's that's that's what they do. And that can be incredibly what they do. And that can be incredibly what they do. And that can be incredibly stimulating and incredibly enriching and stimulating and incredibly enriching and stimulating and incredibly enriching and incredibly um like satisfying of course, incredibly um like satisfying of course, incredibly um like satisfying of course, right? So we're talking like averages right? So we're talking like averages right? So we're talking like averages and maybe how things looked 60 or 70 and maybe how things looked 60 or 70 and maybe how things looked 60 or 70 years ago. years ago. years ago. >> Um but as those things have shifted, >> Um but as those things have shifted, >> Um but as those things have shifted, right? Um women have been allowed access right? Um women have been allowed access right? Um women have been allowed access to more complex um higher higher powered to more complex um higher higher powered to more complex um higher higher powered jobs and you more education again both jobs and you more education again both jobs and you more education again both within westernized countries and within westernized countries and within westernized countries and globally. globally. globally. um we've seen age specific instance of um we've seen age specific instance of um we've seen age specific instance of dementia decrease. So I think as society dementia decrease. So I think as society dementia decrease. So I think as society becomes more equitable across the sexes, becomes more equitable across the sexes, becomes more equitable across the sexes, we may start to see some of those we may start to see some of those we may start to see some of those benefits pay off in terms of dementia benefits pay off in terms of dementia benefits pay off in terms of dementia rates because right now right about rates because right now right about rates because right now right about twothirds of of Alzheimer's disease twothirds of of Alzheimer's disease twothirds of of Alzheimer's disease burden is in women, right? We know that. burden is in women, right? We know that. burden is in women, right? We know that. But the those statistics come from women But the those statistics come from women But the those statistics come from women who are who are largely of that period. who are who are largely of that period. who are who are largely of that period. And so I so my hope is that yes, we And so I so my hope is that yes, we And so I so my hope is that yes, we should do a a whole um bunch of should do a a whole um bunch of should do a a whole um bunch of additional research where you women have additional research where you women have additional research where you women have been left out of neuroscience and been left out of neuroscience and been left out of neuroscience and neurology research for decades. And I'm neurology research for decades. And I'm neurology research for decades. And I'm so happy that that's changing. But I so happy that that's changing. But I so happy that that's changing. But I also wonder if like this shift in in also wonder if like this shift in in also wonder if like this shift in in society will pay off in a beneficial way society will pay off in a beneficial way society will pay off in a beneficial way uh because of the the stimulus that you uh because of the the stimulus that you uh because of the the stimulus that you can get from from work and education can get from from work and education can get from from work and education that now more people have access to. that now more people have access to. that now more people have access to. It's so fascinating to to think about It's so fascinating to to think about It's so fascinating to to think about that and it all feeds back to this idea that and it all feeds back to this idea that and it all feeds back to this idea that that that the stimulus to the brain is the most the stimulus to the brain is the most the stimulus to the brain is the most important thing. important thing. important thing. Going back to women's health again and Going back to women's health again and Going back to women's health again and specifically women's brain health, specifically women's brain health, specifically women's brain health, how do you think about the menopause and how do you think about the menopause and how do you think about the menopause and the hormonal changes that occur in the the hormonal changes that occur in the the hormonal changes that occur in the menopause menopause menopause >> and risk of cognitive decline? >> and risk of cognitive decline? >> and risk of cognitive decline? This is an area that still right now is This is an area that still right now is This is an area that still right now is is hotly debated. is hotly debated. is hotly debated. >> Yeah. >> Yeah. >> Yeah. >> Um and this is probably the most >> Um and this is probably the most >> Um and this is probably the most challenging part of the book for me to challenging part of the book for me to challenging part of the book for me to write. Um, mainly because I want it to write. Um, mainly because I want it to write. Um, mainly because I want it to be very evidence-based, but equally like be very evidence-based, but equally like be very evidence-based, but equally like women should feel supported by men. I am women should feel supported by men. I am women should feel supported by men. I am absolutely a feminist and I and I want I absolutely a feminist and I and I want I absolutely a feminist and I and I want I want that I want that to come across. want that I want that to come across. want that I want that to come across. Um, Um, Um, >> and so, first of all, there's a whole >> and so, first of all, there's a whole >> and so, first of all, there's a whole bunch of studies that that need to be bunch of studies that that need to be bunch of studies that that need to be done. Um, things like uh Lisa Moscone's done. Um, things like uh Lisa Moscone's done. Um, things like uh Lisa Moscone's care initiative funded by the Welcome care initiative funded by the Welcome care initiative funded by the Welcome Trust. Like fantastic. Like really Trust. Like fantastic. Like really Trust. Like fantastic. Like really excited. I'm really excited to see those excited. I'm really excited to see those excited. I'm really excited to see those things happen. Um but right so right now things happen. Um but right so right now things happen. Um but right so right now we know that um just like really we know that um just like really we know that um just like really simplify it if you live long enough simplify it if you live long enough simplify it if you live long enough as a woman all women will experience the as a woman all women will experience the as a woman all women will experience the menopause right but only about 20% will menopause right but only about 20% will menopause right but only about 20% will experience dementia. So that means that experience dementia. So that means that experience dementia. So that means that that decrease in um hormones is not that decrease in um hormones is not that decrease in um hormones is not going to automatically result in going to automatically result in going to automatically result in cognitive decline and dementia. Right. cognitive decline and dementia. Right. cognitive decline and dementia. Right. >> Exactly right. We know we know that from >> Exactly right. We know we know that from >> Exactly right. We know we know that from the from the data. Now the from the data. Now the from the data. Now if um somebody is experiencing symptoms if um somebody is experiencing symptoms if um somebody is experiencing symptoms related to permenopause and menopause related to permenopause and menopause related to permenopause and menopause particularly vasa motor symptoms you particularly vasa motor symptoms you particularly vasa motor symptoms you know night sweats hot flushes um you know night sweats hot flushes um you know night sweats hot flushes um you know problems with sleep even even even know problems with sleep even even even know problems with sleep even even even cognitive changes which which do happen cognitive changes which which do happen cognitive changes which which do happen then I think things like menopausal then I think things like menopausal then I think things like menopausal hormone therapy can be incredibly hormone therapy can be incredibly hormone therapy can be incredibly powerful by by improving quality of life powerful by by improving quality of life powerful by by improving quality of life by improving sleep by improving your by improving sleep by improving your by improving sleep by improving your well-being sexual function mental well-being sexual function mental well-being sexual function mental health, how likely people are to engage health, how likely people are to engage health, how likely people are to engage in other important aspects of lifestyle, in other important aspects of lifestyle, in other important aspects of lifestyle, you know, critically important. And you know, critically important. And you know, critically important. And that's what the current guidelines say that's what the current guidelines say that's what the current guidelines say that um to address symptoms and quality that um to address symptoms and quality that um to address symptoms and quality of life for menopausal hormone therapy of life for menopausal hormone therapy of life for menopausal hormone therapy is is an incredibly powerful tool and is is an incredibly powerful tool and is is an incredibly powerful tool and for other things. You know, bone health, for other things. You know, bone health, for other things. You know, bone health, cardiovascular health when used, you cardiovascular health when used, you cardiovascular health when used, you know, in that way in in, you know, in know, in that way in in, you know, in know, in that way in in, you know, in collaboration with your physician. collaboration with your physician. collaboration with your physician. But the hormonal changes don't seem to But the hormonal changes don't seem to But the hormonal changes don't seem to be enough to explain cognitive changes. be enough to explain cognitive changes. be enough to explain cognitive changes. And and actually And and actually And and actually um the data seem to suggest a couple of um the data seem to suggest a couple of um the data seem to suggest a couple of things. One is that vasa motor symptoms things. One is that vasa motor symptoms things. One is that vasa motor symptoms are better predictors of cognitive are better predictors of cognitive are better predictors of cognitive changes than hormonal shifts are. changes than hormonal shifts are. changes than hormonal shifts are. >> And for people who don't understand the >> And for people who don't understand the >> And for people who don't understand the term vasa motor. term vasa motor. term vasa motor. >> Yeah. So like like I mentioned the the >> Yeah. So like like I mentioned the the >> Yeah. So like like I mentioned the the hot flushes, night sweats, that kind of hot flushes, night sweats, that kind of hot flushes, night sweats, that kind of stuff like those those kind of symptoms stuff like those those kind of symptoms stuff like those those kind of symptoms that the women get during the during the that the women get during the during the that the women get during the during the menopausal transition. menopausal transition. menopausal transition. And there was so like one example is And there was so like one example is And there was so like one example is there was a very interesting study where there was a very interesting study where there was a very interesting study where they used nerve blocks to so like you they used nerve blocks to so like you they used nerve blocks to so like you you sort of like inject an anesthetic you sort of like inject an anesthetic you sort of like inject an anesthetic around nerves in the neck which around nerves in the neck which around nerves in the neck which decreases some of these symptoms and in decreases some of these symptoms and in decreases some of these symptoms and in those uh who those who had significant those uh who those who had significant those uh who those who had significant symptoms and they they saw that by symptoms and they they saw that by symptoms and they they saw that by blocking these nerves that affected vasa blocking these nerves that affected vasa blocking these nerves that affected vasa motor symptoms they saw improvements in motor symptoms they saw improvements in motor symptoms they saw improvements in cognitive function nothing to do with cognitive function nothing to do with cognitive function nothing to do with hormones right and this is probably hormones right and this is probably hormones right and this is probably because changes in uh body temperature because changes in uh body temperature because changes in uh body temperature regulation and blood flow and um you you regulation and blood flow and um you you regulation and blood flow and um you you know activation of stress hormones these know activation of stress hormones these know activation of stress hormones these can then affect certain parts of the can then affect certain parts of the can then affect certain parts of the brain that might affect cognitive brain that might affect cognitive brain that might affect cognitive function. So we know that there are a function. So we know that there are a function. So we know that there are a whole host of lifestyle factors that whole host of lifestyle factors that whole host of lifestyle factors that relate to um those symptoms, right? So relate to um those symptoms, right? So relate to um those symptoms, right? So we know that you can improve them by we know that you can improve them by we know that you can improve them by improving diet quality. You can improve improving diet quality. You can improve improving diet quality. You can improve them by um improving physical activity, them by um improving physical activity, them by um improving physical activity, right? So yes, hormones play a role and right? So yes, hormones play a role and right? So yes, hormones play a role and that is part of that. But we know that that is part of that. But we know that that is part of that. But we know that other lifestyle factors are critically other lifestyle factors are critically other lifestyle factors are critically important as well. We also know that important as well. We also know that important as well. We also know that this is the this is the period when the this is the this is the period when the this is the this is the period when the the risk of Alzheimer's disease diverges the risk of Alzheimer's disease diverges the risk of Alzheimer's disease diverges between men and women, right? And so between men and women, right? And so between men and women, right? And so it seems like the menopausal transition it seems like the menopausal transition it seems like the menopausal transition is a risk amplification period. Um and is a risk amplification period. Um and is a risk amplification period. Um and what I mean by that is that other risk what I mean by that is that other risk what I mean by that is that other risk factors for dementia and cognitive factors for dementia and cognitive factors for dementia and cognitive decline, their effect seems to get decline, their effect seems to get decline, their effect seems to get larger in women as they enter that that larger in women as they enter that that larger in women as they enter that that that transitional period. Um so one that transitional period. Um so one that transitional period. Um so one example is there was a study done in the example is there was a study done in the example is there was a study done in the US where um the largest cognitive US where um the largest cognitive US where um the largest cognitive changes seem to be in women who had changes seem to be in women who had changes seem to be in women who had evidence of metabolic disease. So that's evidence of metabolic disease. So that's evidence of metabolic disease. So that's um again we know that metabolic disease um again we know that metabolic disease um again we know that metabolic disease is a risk factor for for dementia and is a risk factor for for dementia and is a risk factor for for dementia and cognitive decline cognitive decline cognitive decline >> during that transition in those who had >> during that transition in those who had >> during that transition in those who had metabolic disease they saw a bigger metabolic disease they saw a bigger metabolic disease they saw a bigger impact on their cognitive function. So I impact on their cognitive function. So I impact on their cognitive function. So I tend to think of it as a as a risk tend to think of it as a as a risk tend to think of it as a as a risk amplification period such that if we if amplification period such that if we if amplification period such that if we if we think about all the things we've we think about all the things we've we think about all the things we've talked about today talked about today talked about today um any any ongoing risk factors may have um any any ongoing risk factors may have um any any ongoing risk factors may have a larger effect as you as you enter a larger effect as you as you enter a larger effect as you as you enter menopause. But that also means that menopause. But that also means that menopause. But that also means that those are things that you have control those are things that you have control those are things that you have control over because by the same token we know over because by the same token we know over because by the same token we know that if you improve uh your diet quality that if you improve uh your diet quality that if you improve uh your diet quality or if you improve your movement then you or if you improve your movement then you or if you improve your movement then you can you help control those symptoms and can you help control those symptoms and can you help control those symptoms and those symptoms are the things that those symptoms are the things that those symptoms are the things that correlate with changing changes in correlate with changing changes in correlate with changing changes in cognition. And the final piece that I cognition. And the final piece that I cognition. And the final piece that I think is important is that it is a think is important is that it is a think is important is that it is a transitional period. So there was the transitional period. So there was the transitional period. So there was the the Swan study in the US found that in the Swan study in the US found that in the Swan study in the US found that in women who did experience some cognitive women who did experience some cognitive women who did experience some cognitive changes during the menopausal changes during the menopausal changes during the menopausal transition, they actually went back to transition, they actually went back to transition, they actually went back to almost exactly where they were almost exactly where they were almost exactly where they were beforehand, you know, once the beforehand, you know, once the beforehand, you know, once the transition was completed. So if you do transition was completed. So if you do transition was completed. So if you do experience some cognitive changes during experience some cognitive changes during experience some cognitive changes during um you know parmenopause, menopause, um you know parmenopause, menopause, um you know parmenopause, menopause, it's not um it is it is a transition. it's not um it is it is a transition. it's not um it is it is a transition. you may you like they may well improve you may you like they may well improve you may you like they may well improve later. And of course like in the later. And of course like in the later. And of course like in the meantime if menopausal hor menopausal meantime if menopausal hor menopausal meantime if menopausal hor menopausal hormone therapy or other lifestyle hormone therapy or other lifestyle hormone therapy or other lifestyle environmental interventions improve that environmental interventions improve that environmental interventions improve that that's great and you should absolutely that's great and you should absolutely that's great and you should absolutely do that to focus on quality of life and do that to focus on quality of life and do that to focus on quality of life and a whole host of other things but it's a whole host of other things but it's a whole host of other things but it's not um it's not guaranteed that those not um it's not guaranteed that those not um it's not guaranteed that those any changes are going to be uh any changes are going to be uh any changes are going to be uh permanent. Um and there are several permanent. Um and there are several permanent. Um and there are several cognitive functions that continue to cognitive functions that continue to cognitive functions that continue to improve as we get into our 50s, 60s and improve as we get into our 50s, 60s and improve as we get into our 50s, 60s and 70s and well-being as well in both men 70s and well-being as well in both men 70s and well-being as well in both men and women. Um where you know the the and women. Um where you know the the and women. Um where you know the the components of um crystallized uh components of um crystallized uh components of um crystallized uh intelligence which is a fancy word way intelligence which is a fancy word way intelligence which is a fancy word way for saying wisdom um you know elements for saying wisdom um you know elements for saying wisdom um you know elements of you taking in a bigger picture um of you taking in a bigger picture um of you taking in a bigger picture um thinking about all the things that we thinking about all the things that we thinking about all the things that we know putting them in context they know putting them in context they know putting them in context they actually improve um as does well-being. actually improve um as does well-being. actually improve um as does well-being. So So So >> a different type of cognition. >> a different type of cognition. >> a different type of cognition. >> It's a different Yeah. So, so cognition >> It's a different Yeah. So, so cognition >> It's a different Yeah. So, so cognition doesn't get worse as we get older, it doesn't get worse as we get older, it doesn't get worse as we get older, it just shifts, right? So, some things just shifts, right? So, some things just shifts, right? So, some things change, right? And you can measure change, right? And you can measure change, right? And you can measure reaction time or something, maybe that reaction time or something, maybe that reaction time or something, maybe that decreases, but we get better at other decreases, but we get better at other decreases, but we get better at other things. So, like all that to say that things. So, like all that to say that things. So, like all that to say that this is an incredibly important topic this is an incredibly important topic this is an incredibly important topic and I want everybody to feel amazing and I want everybody to feel amazing and I want everybody to feel amazing every day regardless of where they are every day regardless of where they are every day regardless of where they are in that in that period. But we've kind in that in that period. But we've kind in that in that period. But we've kind of boiled it down to of boiled it down to of boiled it down to two groups who are like um hormones are two groups who are like um hormones are two groups who are like um hormones are everything and we need hormonal hormonal everything and we need hormonal hormonal everything and we need hormonal hormonal um like menopausal hormone therapy um like menopausal hormone therapy um like menopausal hormone therapy because if we don't we're going to have because if we don't we're going to have because if we don't we're going to have cognitive changes and experience cognitive changes and experience cognitive changes and experience dementia and the other group are saying dementia and the other group are saying dementia and the other group are saying well there's no evidence for any of that well there's no evidence for any of that well there's no evidence for any of that because and the second group is actually because and the second group is actually because and the second group is actually more right I will say based on the more right I will say based on the more right I will say based on the available data because there are studies available data because there are studies available data because there are studies where they give um bioidentical hormones where they give um bioidentical hormones where they give um bioidentical hormones to women in the in the menopausal to women in the in the menopausal to women in the in the menopausal transition. and they don't see any transition. and they don't see any transition. and they don't see any effect on cognitive function, right? effect on cognitive function, right? effect on cognitive function, right? Like the keep like the keeps trial keeps Like the keep like the keeps trial keeps Like the keep like the keeps trial keeps cog done in Canada. Um but they can have cog done in Canada. Um but they can have cog done in Canada. Um but they can have a massive impact on quality of life and a massive impact on quality of life and a massive impact on quality of life and all those other things that I mentioned. all those other things that I mentioned. all those other things that I mentioned. So it is incredibly nuanced. So it is incredibly nuanced. So it is incredibly nuanced. >> Yeah. >> Yeah. >> Yeah. >> Um and I the the main thing that I've >> Um and I the the main thing that I've >> Um and I the the main thing that I've seen is that there have been two sort of seen is that there have been two sort of seen is that there have been two sort of very black and white pictures of it and very black and white pictures of it and very black and white pictures of it and the person who doesn't benefit is the the person who doesn't benefit is the the person who doesn't benefit is the woman in the middle who's just like I woman in the middle who's just like I woman in the middle who's just like I just I just want to feel better. I want just I just want to feel better. I want just I just want to feel better. I want I want my brain to work better. Um, and I want my brain to work better. Um, and I want my brain to work better. Um, and that's the person that I that I I really that's the person that I that I I really that's the person that I that I I really feel for and I hope that they understand feel for and I hope that they understand feel for and I hope that they understand that there are all these different parts that there are all these different parts that there are all these different parts and actually a whole bunch of things and actually a whole bunch of things and actually a whole bunch of things that they can potentially do including that they can potentially do including that they can potentially do including related to to hormonal therapy um if related to to hormonal therapy um if related to to hormonal therapy um if that makes sense for them. But also that makes sense for them. But also that makes sense for them. But also there's a lot of power to improve there's a lot of power to improve there's a lot of power to improve physical health um you know start physical health um you know start physical health um you know start resistance training which we know can resistance training which we know can resistance training which we know can improve uh symptoms. You know start to improve uh symptoms. You know start to improve uh symptoms. You know start to focus on sleep if you can or maybe the focus on sleep if you can or maybe the focus on sleep if you can or maybe the maybe the hormones help you sleep and maybe the hormones help you sleep and maybe the hormones help you sleep and then you sleep better. So all these then you sleep better. So all these then you sleep better. So all these things should be kind of taken into things should be kind of taken into things should be kind of taken into account when we're having these complex account when we're having these complex account when we're having these complex conversations about menopause and conversations about menopause and conversations about menopause and cognitive function. cognitive function. cognitive function. >> Yeah. Hence the importance of women >> Yeah. Hence the importance of women >> Yeah. Hence the importance of women having better access to well-educated having better access to well-educated having better access to well-educated health care professionals who know the health care professionals who know the health care professionals who know the nuances, right? Because that's something nuances, right? Because that's something nuances, right? Because that's something probably that hasn't been there. probably that hasn't been there. probably that hasn't been there. >> But what as you said at the start, it's >> But what as you said at the start, it's >> But what as you said at the start, it's kind of like well if you live long kind of like well if you live long kind of like well if you live long enough as a woman, you're going to go enough as a woman, you're going to go enough as a woman, you're going to go through the menopause. So everyone has through the menopause. So everyone has through the menopause. So everyone has hormonal changes. hormonal changes. hormonal changes. >> Yeah. >> Yeah. >> Yeah. >> And a hormonal decline, but not everyone >> And a hormonal decline, but not everyone >> And a hormonal decline, but not everyone gets dementia, right? So it can't just gets dementia, right? So it can't just gets dementia, right? So it can't just be that that is solely responsible. And be that that is solely responsible. And be that that is solely responsible. And could genetics play a role? Could other could genetics play a role? Could other could genetics play a role? Could other factors play a role? It is incredibly factors play a role? It is incredibly factors play a role? It is incredibly nuance. So of course, we want more data nuance. So of course, we want more data nuance. So of course, we want more data and more research. Let's talk about and more research. Let's talk about and more research. Let's talk about exercise. exercise. exercise. >> I know we've spoken before about the >> I know we've spoken before about the >> I know we've spoken before about the importance of exercise for our brains. importance of exercise for our brains. importance of exercise for our brains. perhaps you can give us an overview of perhaps you can give us an overview of perhaps you can give us an overview of that. But today I I thought it'd be that. But today I I thought it'd be that. But today I I thought it'd be interesting to specifically go into what interesting to specifically go into what interesting to specifically go into what do the different types of exercise do to do the different types of exercise do to do the different types of exercise do to our brain? And also is it fair to say our brain? And also is it fair to say our brain? And also is it fair to say that exercise just fits in that second S that exercise just fits in that second S that exercise just fits in that second S supply? Cuz I I kind of feel supply? Cuz I I kind of feel supply? Cuz I I kind of feel some exercise could count as some exercise could count as some exercise could count as stimulation. stimulation. stimulation. And of course, like we've already said, And of course, like we've already said, And of course, like we've already said, and if you exercise enough, it's going and if you exercise enough, it's going and if you exercise enough, it's going to help you with your support and to help you with your support and to help you with your support and recovering from it. recovering from it. recovering from it. >> Yes. Yes. So, lots of yeses. >> Yes. Yes. So, lots of yeses. >> Yes. Yes. So, lots of yeses. >> Yeah. Lots of yeses. So, one one of the >> Yeah. Lots of yeses. So, one one of the >> Yeah. Lots of yeses. So, one one of the one of the potential downsides of one of the potential downsides of one of the potential downsides of thinking about and and and I've thinking about and and and I've thinking about and and and I've experienced this when trying to explain experienced this when trying to explain experienced this when trying to explain the the 3S model to some people is they the the 3S model to some people is they the the 3S model to some people is they they expect that any given activity only they expect that any given activity only they expect that any given activity only fits in one bucket when of course they fits in one bucket when of course they fits in one bucket when of course they don't, right? So, Um, I think that there don't, right? So, Um, I think that there don't, right? So, Um, I think that there are types of exercise that could are types of exercise that could are types of exercise that could absolutely hit all three S's at the same absolutely hit all three S's at the same absolutely hit all three S's at the same time, right? So, if we're thinking about time, right? So, if we're thinking about time, right? So, if we're thinking about big leverage points, there are things big leverage points, there are things big leverage points, there are things that we can do that hit multiple buckets that we can do that hit multiple buckets that we can do that hit multiple buckets at the same time, right? So, like that's at the same time, right? So, like that's at the same time, right? So, like that's definitely something we could take into definitely something we could take into definitely something we could take into consideration. But when consideration. But when consideration. But when you think about exercise in the brain, you think about exercise in the brain, you think about exercise in the brain, it it's the it largely comes in three it it's the it largely comes in three it it's the it largely comes in three flavors. Um so like aerobic type flavors. Um so like aerobic type flavors. Um so like aerobic type exercise um resistance training or exercise um resistance training or exercise um resistance training or weightlifting and then coordinative weightlifting and then coordinative weightlifting and then coordinative exercise. And in in the research they exercise. And in in the research they exercise. And in in the research they might call it open skill exercise. And might call it open skill exercise. And might call it open skill exercise. And I'll I'll get to that kind of last. But I'll I'll get to that kind of last. But I'll I'll get to that kind of last. But the first the most important thing to the first the most important thing to the first the most important thing to say first is that any physical activity say first is that any physical activity say first is that any physical activity that you do will will improve cognitive that you do will will improve cognitive that you do will will improve cognitive function if if you're starting from a a function if if you're starting from a a function if if you're starting from a a you a low level of initial physical you a low level of initial physical you a low level of initial physical activity. Right? So, um, we know that activity. Right? So, um, we know that activity. Right? So, um, we know that the more steps you take per day, the the more steps you take per day, the the more steps you take per day, the lower your risk of dementia up to sort lower your risk of dementia up to sort lower your risk of dementia up to sort of somewhere around 8 to 12,000 steps of somewhere around 8 to 12,000 steps of somewhere around 8 to 12,000 steps per day. Um, the the first time we per day. Um, the the first time we per day. Um, the the first time we really saw that exercise could improve really saw that exercise could improve really saw that exercise could improve the the structure and function of the the the structure and function of the the the structure and function of the brain, particularly the hippocampus, brain, particularly the hippocampus, brain, particularly the hippocampus, which is important for memory and is which is important for memory and is which is important for memory and is vulnerable in Alzheimer's disease, was vulnerable in Alzheimer's disease, was vulnerable in Alzheimer's disease, was with a brisk walking intervention. Brisk with a brisk walking intervention. Brisk with a brisk walking intervention. Brisk walking 40 minutes three times a week. walking 40 minutes three times a week. walking 40 minutes three times a week. So, so like anywhere you start that just So, so like anywhere you start that just So, so like anywhere you start that just like starts you moving your body like starts you moving your body like starts you moving your body regularly is is great. Um, but aerobic regularly is is great. Um, but aerobic regularly is is great. Um, but aerobic exercise exercise exercise with it like across the scale of with it like across the scale of with it like across the scale of intensities uh because where at the top intensities uh because where at the top intensities uh because where at the top you the low end you might just have like you the low end you might just have like you the low end you might just have like walking and the top end you might have walking and the top end you might have walking and the top end you might have high intensity interval training you high intensity interval training you high intensity interval training you know where you do uh sprinting on a bike know where you do uh sprinting on a bike know where you do uh sprinting on a bike or a treadmill or a row machine for some or a treadmill or a row machine for some or a treadmill or a row machine for some period of time and then you recover and period of time and then you recover and period of time and then you recover and you do that do a few rounds. Those types you do that do a few rounds. Those types you do that do a few rounds. Those types of exercise um seem to be particularly of exercise um seem to be particularly of exercise um seem to be particularly beneficial for the gray matter of the beneficial for the gray matter of the beneficial for the gray matter of the brain uh which is sort of like the brain uh which is sort of like the brain uh which is sort of like the wrinkly outside the cortex as well as wrinkly outside the cortex as well as wrinkly outside the cortex as well as like some stuff inside like the hypoc like some stuff inside like the hypoc like some stuff inside like the hypoc campus and particularly beneficial for campus and particularly beneficial for campus and particularly beneficial for memory. So if you're looking at memory. So if you're looking at memory. So if you're looking at different cognitive functions and different cognitive functions and different cognitive functions and at the at the higher levels of at the at the higher levels of at the at the higher levels of intensity, intensity, intensity, we see uh greater benefit probably we see uh greater benefit probably we see uh greater benefit probably because of the production of lactate um because of the production of lactate um because of the production of lactate um which has been um sort of derided as a which has been um sort of derided as a which has been um sort of derided as a molecule that we want to avoid that's molecule that we want to avoid that's molecule that we want to avoid that's somehow bad for us uh for long periods somehow bad for us uh for long periods somehow bad for us uh for long periods of time. But what we're what we're of time. But what we're what we're of time. But what we're what we're seeing increasingly is that it's a very seeing increasingly is that it's a very seeing increasingly is that it's a very powerful signaling molecule particularly powerful signaling molecule particularly powerful signaling molecule particularly in the brain. So when you make lactate in the brain. So when you make lactate in the brain. So when you make lactate by you know you feel the burn right and by you know you feel the burn right and by you know you feel the burn right and lactate is part of the buffering system lactate is part of the buffering system lactate is part of the buffering system that that we use when we're doing you that that we use when we're doing you that that we use when we're doing you know anorobic type exercise or like very know anorobic type exercise or like very know anorobic type exercise or like very high intensity exercise um and lactate high intensity exercise um and lactate high intensity exercise um and lactate goes into the brain and it switches on goes into the brain and it switches on goes into the brain and it switches on the production of BDNF brain derived the production of BDNF brain derived the production of BDNF brain derived neurotrphic factor which supports the neurotrphic factor which supports the neurotrphic factor which supports the function of recently activated neurons. function of recently activated neurons. function of recently activated neurons. So like supports the process of So like supports the process of So like supports the process of neuroplasticity which is what is neuroplasticity which is what is neuroplasticity which is what is underpins you know learning and you know underpins you know learning and you know underpins you know learning and you know improving function in the brain. So improving function in the brain. So improving function in the brain. So and and again uh when you look at and and again uh when you look at and and again uh when you look at studies where they do high intensity studies where they do high intensity studies where they do high intensity interval training um interventions for interval training um interventions for interval training um interventions for long periods of time you see long periods of time you see long periods of time you see improvements in the structure and improvements in the structure and improvements in the structure and function structure and function of the function structure and function of the function structure and function of the hippocampus in particular. Um so you can hippocampus in particular. Um so you can hippocampus in particular. Um so you can see that on a brain scan. Then you also see that on a brain scan. Then you also see that on a brain scan. Then you also see improvements in memory specifically. see improvements in memory specifically. see improvements in memory specifically. So that's like the aerobic bucket. Um So that's like the aerobic bucket. Um So that's like the aerobic bucket. Um then the next bucket is is resistance then the next bucket is is resistance then the next bucket is is resistance training. So training. So training. So a lot of what's different across these a lot of what's different across these a lot of what's different across these different types of exercises is what different types of exercises is what different types of exercises is what gets released while we exercise. Um and gets released while we exercise. Um and gets released while we exercise. Um and so while we might think about something so while we might think about something so while we might think about something like lactate brain derived neurotrophic like lactate brain derived neurotrophic like lactate brain derived neurotrophic factor with aerobic type exercise with factor with aerobic type exercise with factor with aerobic type exercise with resistance training we release more resistance training we release more resistance training we release more things like IGF-1 insulin length growth things like IGF-1 insulin length growth things like IGF-1 insulin length growth factor one which is really critical for factor one which is really critical for factor one which is really critical for white matter. So this is something that white matter. So this is something that white matter. So this is something that uh we see even in babies born pre-term uh we see even in babies born pre-term uh we see even in babies born pre-term who are at um risk of injury to their who are at um risk of injury to their who are at um risk of injury to their white matter and then uh associated white matter and then uh associated white matter and then uh associated increased risk of things like cerebal increased risk of things like cerebal increased risk of things like cerebal palsy and palsy and palsy and IGF-1 is really critical for the white IGF-1 is really critical for the white IGF-1 is really critical for the white matter. Um and one reason why babies matter. Um and one reason why babies matter. Um and one reason why babies born pre-term have issues with white born pre-term have issues with white born pre-term have issues with white matter development is because the matter development is because the matter development is because the placenta normally provides the IGF-1 placenta normally provides the IGF-1 placenta normally provides the IGF-1 that they use to grow their white that they use to grow their white that they use to grow their white matter. Um but then we see the same matter. Um but then we see the same matter. Um but then we see the same thing later in life where um if you do thing later in life where um if you do thing later in life where um if you do resistance training you release IGF-1 resistance training you release IGF-1 resistance training you release IGF-1 and the structure and function of the and the structure and function of the and the structure and function of the white matter improves. So it's critical white matter improves. So it's critical white matter improves. So it's critical like throughout the entire life that like throughout the entire life that like throughout the entire life that this is a very important molecule for this is a very important molecule for this is a very important molecule for white matter. So the white matter kind white matter. So the white matter kind white matter. So the white matter kind of sits in the middle of our brains. It of sits in the middle of our brains. It of sits in the middle of our brains. It makes up about 60% of our the human makes up about 60% of our the human makes up about 60% of our the human brain and it's responsible for these brain and it's responsible for these brain and it's responsible for these fast connections between different parts fast connections between different parts fast connections between different parts of the brain and the brain and the body. of the brain and the brain and the body. of the brain and the brain and the body. Um and so when we do resistance training Um and so when we do resistance training Um and so when we do resistance training and we do the randomized control trials, and we do the randomized control trials, and we do the randomized control trials, you take older individuals, you have you take older individuals, you have you take older individuals, you have them do a resistance training program them do a resistance training program them do a resistance training program for a few months, you see improvements for a few months, you see improvements for a few months, you see improvements in the structure of the white matter and in the structure of the white matter and in the structure of the white matter and then improvements in sort of like then improvements in sort of like then improvements in sort of like overall cognitive function, but overall cognitive function, but overall cognitive function, but particularly things like executive particularly things like executive particularly things like executive function or or rapid decision-m. Um and function or or rapid decision-m. Um and function or or rapid decision-m. Um and so and that's that's because of uh the so and that's that's because of uh the so and that's that's because of uh the the effects on white matter we think. Um the effects on white matter we think. Um the effects on white matter we think. Um and actually white matter changes the and actually white matter changes the and actually white matter changes the changes in structure and function of changes in structure and function of changes in structure and function of white matter better predict cognitive white matter better predict cognitive white matter better predict cognitive decline and loss of cognitive function decline and loss of cognitive function decline and loss of cognitive function than some other things that we've tended than some other things that we've tended than some other things that we've tended to focus on more as a community like to focus on more as a community like to focus on more as a community like amaloid protein in the brain. Um white amaloid protein in the brain. Um white amaloid protein in the brain. Um white matter changes seem to preede that and matter changes seem to preede that and matter changes seem to preede that and and actually predict some of those and actually predict some of those and actually predict some of those cognitive changes better. cognitive changes better. cognitive changes better. >> So that's where resistance training >> So that's where resistance training >> So that's where resistance training becomes really important. becomes really important. becomes really important. >> Um and then sort of like the final piece >> Um and then sort of like the final piece >> Um and then sort of like the final piece is this coordinative movement. So it's is this coordinative movement. So it's is this coordinative movement. So it's uh you know there are now a huge number uh you know there are now a huge number uh you know there are now a huge number of studies where you take two different of studies where you take two different of studies where you take two different types of exercise that have the same types of exercise that have the same types of exercise that have the same physical intensity right they raise the physical intensity right they raise the physical intensity right they raise the heart rate the same amount for example heart rate the same amount for example heart rate the same amount for example but those that then have a complex um but those that then have a complex um but those that then have a complex um movement component on top seem to have movement component on top seem to have movement component on top seem to have an additional benefit for the brain. Um, an additional benefit for the brain. Um, an additional benefit for the brain. Um, so it's like comparing dancing to so it's like comparing dancing to so it's like comparing dancing to cycling or you know they've done table cycling or you know they've done table cycling or you know they've done table tennis and badminton compared to cycling tennis and badminton compared to cycling tennis and badminton compared to cycling and they've done uh running around an and they've done uh running around an and they've done uh running around an obstacle course compared to just running obstacle course compared to just running obstacle course compared to just running around a track and and presumably the around a track and and presumably the around a track and and presumably the table tennis, the badminton, the table tennis, the badminton, the table tennis, the badminton, the dancing, these are these complex tasks dancing, these are these complex tasks dancing, these are these complex tasks where as well as fitness where as well as fitness where as well as fitness you're doing other things as well. So so you're doing other things as well. So so you're doing other things as well. So so more complex stimuli to the brain. more complex stimuli to the brain. more complex stimuli to the brain. >> Exactly. Yeah. So all activity is great >> Exactly. Yeah. So all activity is great >> Exactly. Yeah. So all activity is great for the brain, right? But there seems to for the brain, right? But there seems to for the brain, right? But there seems to be an even greater benefit and you can be an even greater benefit and you can be an even greater benefit and you can measure this in terms of cognitive measure this in terms of cognitive measure this in terms of cognitive function. You can measure this in terms function. You can measure this in terms function. You can measure this in terms sometimes they've looked at brain scans sometimes they've looked at brain scans sometimes they've looked at brain scans like changes on a brain scan that if you like changes on a brain scan that if you like changes on a brain scan that if you have a complex movement component on top have a complex movement component on top have a complex movement component on top of the physical component, there's of the physical component, there's of the physical component, there's additional benefits for the brain. So additional benefits for the brain. So additional benefits for the brain. So we're yeah with um we're talking we're yeah with um we're talking we're yeah with um we're talking dancing, martial arts, ball sports, dancing, martial arts, ball sports, dancing, martial arts, ball sports, racket sports, um any kind of team sport racket sports, um any kind of team sport racket sports, um any kind of team sport and what all these things involve is and what all these things involve is and what all these things involve is learning complex motor skills, right? learning complex motor skills, right? learning complex motor skills, right? Movement skills, Movement skills, Movement skills, >> but also often there's a social >> but also often there's a social >> but also often there's a social component. Um there's also a requirement component. Um there's also a requirement component. Um there's also a requirement to respond to the environment, respond to respond to the environment, respond to respond to the environment, respond to other people, react to the ball being to other people, react to the ball being to other people, react to the ball being hit at you. um and strategize hit at you. um and strategize hit at you. um and strategize um quickly and in real time, right? So, um quickly and in real time, right? So, um quickly and in real time, right? So, if you're playing tennis, um I'm a if you're playing tennis, um I'm a if you're playing tennis, um I'm a terrible tennis player, so like not me terrible tennis player, so like not me terrible tennis player, so like not me playing tennis, but a good person playing tennis, but a good person playing tennis, but a good person playing tennis, right? You're you're playing tennis, right? You're you're playing tennis, right? You're you're trying to not only respond to the the trying to not only respond to the the trying to not only respond to the the ball being hit at you and and moving ball being hit at you and and moving ball being hit at you and and moving your own way around the court, but your own way around the court, but your own way around the court, but you're trying to manipulate the you're trying to manipulate the you're trying to manipulate the positioning of your opponent so that you positioning of your opponent so that you positioning of your opponent so that you can hit the ball past them, right? can hit the ball past them, right? can hit the ball past them, right? >> And you're doing this at high speed. And >> And you're doing this at high speed. And >> And you're doing this at high speed. And so, um you know, challenging multiple so, um you know, challenging multiple so, um you know, challenging multiple senses. And so it's these kinds of senses. And so it's these kinds of senses. And so it's these kinds of complex movements that seem to have an complex movements that seem to have an complex movements that seem to have an outsized benefit um for for the brain. outsized benefit um for for the brain. outsized benefit um for for the brain. So again, I've you know, across the So again, I've you know, across the So again, I've you know, across the things I mentioned, there could be 12 20 things I mentioned, there could be 12 20 things I mentioned, there could be 12 20 different things that you could do that different things that you could do that different things that you could do that that that right challenge the brain in that that right challenge the brain in that that right challenge the brain in the same way. So like pick one that you the same way. So like pick one that you the same way. So like pick one that you enjoy. Um, and if we were thinking about enjoy. Um, and if we were thinking about enjoy. Um, and if we were thinking about like really high impact or um activities like really high impact or um activities like really high impact or um activities that maybe hit all the different um that maybe hit all the different um that maybe hit all the different um nodes of um nodes of the 3S model, nodes of um nodes of the 3S model, nodes of um nodes of the 3S model, right? You might think of something like right? You might think of something like right? You might think of something like dancing or paddle or pickle ball in in dancing or paddle or pickle ball in in dancing or paddle or pickle ball in in the US, right? There's a social the US, right? There's a social the US, right? There's a social component. There's a complex movement. component. There's a complex movement. component. There's a complex movement. So, you're getting physical activity, So, you're getting physical activity, So, you're getting physical activity, you're getting cognitive stimulus, you're getting cognitive stimulus, you're getting cognitive stimulus, you're going to sleep better afterwards, you're going to sleep better afterwards, you're going to sleep better afterwards, right? right? right? >> All of those things you're doing at the >> All of those things you're doing at the >> All of those things you're doing at the same time. So when when people do same time. So when when people do same time. So when when people do inevitably ask me like, well, what's the inevitably ask me like, well, what's the inevitably ask me like, well, what's the one thing I should do? These kinds of one thing I should do? These kinds of one thing I should do? These kinds of activities are the one thing that that I activities are the one thing that that I activities are the one thing that that I would if you're going to pick one thing, would if you're going to pick one thing, would if you're going to pick one thing, pick a new sport that requires you to pick a new sport that requires you to pick a new sport that requires you to use a to learn a complex skill and do it use a to learn a complex skill and do it use a to learn a complex skill and do it in a social setting. You've hit all in a social setting. You've hit all in a social setting. You've hit all those different everything in one go. those different everything in one go. those different everything in one go. >> God, I love that. So many thoughts came >> God, I love that. So many thoughts came >> God, I love that. So many thoughts came up for me. First thing is to reinforce up for me. First thing is to reinforce up for me. First thing is to reinforce this message that the brain can adapt to this message that the brain can adapt to this message that the brain can adapt to any age. any age. any age. >> Yeah. Um, last summer my son broke his >> Yeah. Um, last summer my son broke his >> Yeah. Um, last summer my son broke his wrist at the end of end of the summer wrist at the end of end of the summer wrist at the end of end of the summer holidays and um, had to wear a cast and holidays and um, had to wear a cast and holidays and um, had to wear a cast and one of the things we like to do one of the things we like to do one of the things we like to do particularly in the summer, we had this particularly in the summer, we had this particularly in the summer, we had this outdoor table tennis table and we outdoor table tennis table and we outdoor table tennis table and we basically decided with a bit of cajoling basically decided with a bit of cajoling basically decided with a bit of cajoling from me that we were going to play from me that we were going to play from me that we were going to play left-handed table tennis while his cast left-handed table tennis while his cast left-handed table tennis while his cast was healing. was healing. was healing. >> Yeah, >> Yeah, >> Yeah, >> I'm kidding you. Like we started off the >> I'm kidding you. Like we started off the >> I'm kidding you. Like we started off the first time as man this is and you know first time as man this is and you know first time as man this is and you know we're decent players with our right we're decent players with our right we're decent players with our right hands. hands. hands. >> Yeah. >> Yeah. >> Yeah. >> And it was a bit tricky with the left >> And it was a bit tricky with the left >> And it was a bit tricky with the left hand. Literally within about two days hand. Literally within about two days hand. Literally within about two days we're having good rallies. And after we're having good rallies. And after we're having good rallies. And after about 10 days he was going and playing about 10 days he was going and playing about 10 days he was going and playing table at school and he was beating other table at school and he was beating other table at school and he was beating other people who were playing with their right people who were playing with their right people who were playing with their right hands. He's a decent player. But hands. He's a decent player. But hands. He's a decent player. But >> I just thought wow. >> I just thought wow. >> I just thought wow. >> And and I think that speaks to this >> And and I think that speaks to this >> And and I think that speaks to this broader point doesn't it about how broader point doesn't it about how broader point doesn't it about how quickly our brain can adapt and respond. quickly our brain can adapt and respond. quickly our brain can adapt and respond. And I've also read some stuff that And I've also read some stuff that And I've also read some stuff that perhaps learning it with it with the perhaps learning it with it with the perhaps learning it with it with the weaker hand then improves your ability weaker hand then improves your ability weaker hand then improves your ability with the stronger hand because different with the stronger hand because different with the stronger hand because different regions of the brain are connected. So regions of the brain are connected. So regions of the brain are connected. So that was that was that was >> one thing I thought about. >> one thing I thought about. >> one thing I thought about. >> The second thing I thought about was in >> The second thing I thought about was in >> The second thing I thought about was in relation to this. I know we've not relation to this. I know we've not relation to this. I know we've not spoken today about headroom and spoken today about headroom and spoken today about headroom and cognitive reserve. I know we've spoken cognitive reserve. I know we've spoken cognitive reserve. I know we've spoken about that before and and obviously you about that before and and obviously you about that before and and obviously you write a lot about it in in the new book. write a lot about it in in the new book. write a lot about it in in the new book. I thought about Novak Jovovic. Oh yeah. I thought about Novak Jovovic. Oh yeah. I thought about Novak Jovovic. Oh yeah. Okay. So, Okay. So, Okay. So, >> he's still getting to Grand Slam finals. >> he's still getting to Grand Slam finals. >> he's still getting to Grand Slam finals. I think he's 38. He's in phenomenal I think he's 38. He's in phenomenal I think he's 38. He's in phenomenal shape. Arguably the greatest tennis shape. Arguably the greatest tennis shape. Arguably the greatest tennis player of all time. >> I'm wondering if as a thought experiment >> I'm wondering if as a thought experiment if he was to retire let's say at the age if he was to retire let's say at the age if he was to retire let's say at the age of 40. So for many many years he's been of 40. So for many many years he's been of 40. So for many many years he's been learning these skills, right? So, and learning these skills, right? So, and learning these skills, right? So, and also he's he pays attention to detail. also he's he pays attention to detail. also he's he pays attention to detail. Like he he leaves no stone unturned in Like he he leaves no stone unturned in Like he he leaves no stone unturned in his desire to get better, whether that's his desire to get better, whether that's his desire to get better, whether that's eye training, um you know, juggling eye training, um you know, juggling eye training, um you know, juggling before he might go out onto the core, um before he might go out onto the core, um before he might go out onto the core, um you know, mindsets, nutrition, movement, you know, mindsets, nutrition, movement, you know, mindsets, nutrition, movement, recovery, all these things that you recovery, all these things that you recovery, all these things that you probably see with your Formula 1 probably see with your Formula 1 probably see with your Formula 1 drivers, right? drivers, right? drivers, right? >> So, let's say at 40 he just stopped. >> So, let's say at 40 he just stopped. >> So, let's say at 40 he just stopped. hypothetical scenario. hypothetical scenario. hypothetical scenario. >> So, he's had all this incredible >> So, he's had all this incredible >> So, he's had all this incredible stimulus, supply, and support for the stimulus, supply, and support for the stimulus, supply, and support for the first 40 years of his life. So, he first 40 years of his life. So, he first 40 years of his life. So, he probably has a huge amount of cognitive probably has a huge amount of cognitive probably has a huge amount of cognitive reserve and headroom. reserve and headroom. reserve and headroom. If the day after he retired, If the day after he retired, If the day after he retired, he he he and I'm almost certain he wouldn't do and I'm almost certain he wouldn't do and I'm almost certain he wouldn't do this, but let's say the day after he this, but let's say the day after he this, but let's say the day after he retired, retired, retired, I use the word retire cuz this is kind I use the word retire cuz this is kind I use the word retire cuz this is kind of what happens to people at 65, right? of what happens to people at 65, right? of what happens to people at 65, right? He stopped doing anything. He stopped doing anything. He stopped doing anything. >> Yeah. >> Yeah. >> Yeah. >> So, he just sat at home in his nice >> So, he just sat at home in his nice >> So, he just sat at home in his nice house watching box sets on Netflix. house watching box sets on Netflix. house watching box sets on Netflix. They're not even called box sets They're not even called box sets They're not even called box sets anymore, are they? But streaming. He was anymore, are they? But streaming. He was anymore, are they? But streaming. He was streaming streaming streaming on Netflix. on Netflix. on Netflix. >> Is it fair to say that because he's >> Is it fair to say that because he's >> Is it fair to say that because he's worked that capacity for so much, worked that capacity for so much, worked that capacity for so much, >> it will take him longer >> it will take him longer >> it will take him longer to have a decline in function that is to have a decline in function that is to have a decline in function that is noticeable compared to someone who has noticeable compared to someone who has noticeable compared to someone who has not stimulated their brain as much or do not stimulated their brain as much or do not stimulated their brain as much or do we not know? Well, so there's there's we not know? Well, so there's there's we not know? Well, so there's there's two competing parts to this that two competing parts to this that two competing parts to this that um make me say maybe and I'll explain um make me say maybe and I'll explain um make me say maybe and I'll explain I'll explain them. I'll I'll explain I'll explain them. I'll I'll explain I'll explain them. I'll I'll explain them both. So because you've you've them both. So because you've you've them both. So because you've you've built so much additional capacity with built so much additional capacity with built so much additional capacity with all this training, do you then have a all this training, do you then have a all this training, do you then have a longer trajectory before you've lost so longer trajectory before you've lost so longer trajectory before you've lost so much function? Right. And much function? Right. And much function? Right. And the the the there's probably again there's probably there's probably again there's probably there's probably again there's probably two areas of this. One could be like two areas of this. One could be like two areas of this. One could be like tennis specific skills, right? Even if tennis specific skills, right? Even if tennis specific skills, right? Even if he doesn't play for 10 years and like he doesn't play for 10 years and like he doesn't play for 10 years and like when he's 50, when he's 50, when he's 50, >> he's still going to be a better tennis >> he's still going to be a better tennis >> he's still going to be a better tennis player than me, right? player than me, right? player than me, right? >> Even if he's although we're I mean we're >> Even if he's although we're I mean we're >> Even if he's although we're I mean we're roughly the same age, so maybe that's roughly the same age, so maybe that's roughly the same age, so maybe that's about comparison. He's going to be he'll about comparison. He's going to be he'll about comparison. He's going to be he'll still be a better tennis player than still be a better tennis player than still be a better tennis player than like some 20-year-old off the street. like some 20-year-old off the street. like some 20-year-old off the street. >> Yeah. >> Yeah. >> Yeah. But he the the the amount of skill that But he the the the amount of skill that But he the the the amount of skill that he's lost will be massive. Like the he's lost will be massive. Like the he's lost will be massive. Like the relative loss of skill will be huge relative loss of skill will be huge relative loss of skill will be huge because he had so much previously. because he had so much previously. because he had so much previously. >> Um but if we're thinking about this more >> Um but if we're thinking about this more >> Um but if we're thinking about this more broadly in terms of like broader broadly in terms of like broader broadly in terms of like broader cognitive decline and dementia, cognitive decline and dementia, cognitive decline and dementia, >> one of the biggest changes I've made >> one of the biggest changes I've made >> one of the biggest changes I've made over the past few months is to start over the past few months is to start over the past few months is to start each day using the way. And I absolutely each day using the way. And I absolutely each day using the way. And I absolutely love it. Meditation has so many benefits love it. Meditation has so many benefits love it. 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If that's his the tennis court, right? If that's his primary mode of stimulus. Um and so when primary mode of stimulus. Um and so when primary mode of stimulus. Um and so when we look at uh cognitive trajectories we look at uh cognitive trajectories we look at uh cognitive trajectories over over a lifetime, over over a lifetime, over over a lifetime, those who have higher levels of those who have higher levels of those who have higher levels of educational attainment, they have a educational attainment, they have a educational attainment, they have a higher peak of cognitive function, higher peak of cognitive function, higher peak of cognitive function, right? Happens slightly later. They do right? Happens slightly later. They do right? Happens slightly later. They do have a they have a lower risk of have a they have a lower risk of have a they have a lower risk of dementia and they tend to get dementia dementia and they tend to get dementia dementia and they tend to get dementia later because they've started at the the later because they've started at the the later because they've started at the the same peak. And but the the early same peak. And but the the early same peak. And but the the early stimulus doesn't change the rate of stimulus doesn't change the rate of stimulus doesn't change the rate of decline, right? So if you remove um uh decline, right? So if you remove um uh decline, right? So if you remove um uh if you remove that stimulus, right, if you remove that stimulus, right, if you remove that stimulus, right, you're still you're still going to you're still you're still going to you're still you're still going to you're still going to decline, right? It you're still going to decline, right? It you're still going to decline, right? It doesn't doesn't prevent that. doesn't doesn't prevent that. doesn't doesn't prevent that. >> There are some studies that suggest that >> There are some studies that suggest that >> There are some studies that suggest that those who have um the highest levels of those who have um the highest levels of those who have um the highest levels of educational attainment or the highest educational attainment or the highest educational attainment or the highest job complexity job complexity job complexity lose function relative function like lose function relative function like lose function relative function like relative to where they were. they lose relative to where they were. they lose relative to where they were. they lose it faster after retirement because their it faster after retirement because their it faster after retirement because their body was so used to performing at high body was so used to performing at high body was so used to performing at high level and having high levels of stimulus level and having high levels of stimulus level and having high levels of stimulus >> that they actually have a a a higher >> that they actually have a a a higher >> that they actually have a a a higher drop off rate. Um so one could say that drop off rate. Um so one could say that drop off rate. Um so one could say that NovakJokovic's uh tennis related skills NovakJokovic's uh tennis related skills NovakJokovic's uh tennis related skills are going to drop off faster than most are going to drop off faster than most are going to drop off faster than most other people's because he had so much other people's because he had so much other people's because he had so much and he was so used to getting so much. and he was so used to getting so much. and he was so used to getting so much. So so the relative drop off rate is So so the relative drop off rate is So so the relative drop off rate is going to be faster. Um, and so there's a going to be faster. Um, and so there's a going to be faster. Um, and so there's a few different things that you have to few different things that you have to few different things that you have to balance there. One is yes, you built balance there. One is yes, you built balance there. One is yes, you built overall capacity, but the system may overall capacity, but the system may overall capacity, but the system may adapt such that it requires greater adapt such that it requires greater adapt such that it requires greater ongoing stimulus in order to maintain ongoing stimulus in order to maintain ongoing stimulus in order to maintain that capacity, if that makes sense, that capacity, if that makes sense, that capacity, if that makes sense, because you like that's what you you because you like that's what you you because you like that's what you you have more to lose because of what you've have more to lose because of what you've have more to lose because of what you've because of what you've built. So you do because of what you've built. So you do because of what you've built. So you do have some buffer, but it doesn't mean have some buffer, but it doesn't mean have some buffer, but it doesn't mean that you can't you can rest on your that you can't you can rest on your that you can't you can rest on your laurels because you built all this laurels because you built all this laurels because you built all this capacity, right? That ongoing stimulus capacity, right? That ongoing stimulus capacity, right? That ongoing stimulus is required. Um, and then where you end is required. Um, and then where you end is required. Um, and then where you end up um, in terms of that final trajectory up um, in terms of that final trajectory up um, in terms of that final trajectory is probably going to depend on a whole, is probably going to depend on a whole, is probably going to depend on a whole, you know, the the whole kind of network. you know, the the whole kind of network. you know, the the whole kind of network. So, it's actually quite a complicated So, it's actually quite a complicated So, it's actually quite a complicated answer to to to your question because answer to to to your question because answer to to to your question because you're going to have all these competing you're going to have all these competing you're going to have all these competing things going on. things going on. things going on. >> Yeah. It's interesting to think about >> Yeah. It's interesting to think about >> Yeah. It's interesting to think about that, you know, no matter what your job that, you know, no matter what your job that, you know, no matter what your job is, no matter where you are, you know, is, no matter where you are, you know, is, no matter where you are, you know, you got to keep using it, right? you got to keep using it, right? you got to keep using it, right? Basically, like you said at the start, Basically, like you said at the start, Basically, like you said at the start, use it or lose it. Maybe overly use it or lose it. Maybe overly use it or lose it. Maybe overly simplistic, but people get that, you simplistic, but people get that, you simplistic, but people get that, you know. You have to keep giving your brain know. You have to keep giving your brain know. You have to keep giving your brain a reason to adapt. a reason to adapt. a reason to adapt. >> Yeah. >> Yeah. >> Yeah. >> Um, and you know, as it happens, I think >> Um, and you know, as it happens, I think >> Um, and you know, as it happens, I think he speaks maybe seven or eight different he speaks maybe seven or eight different he speaks maybe seven or eight different languages. I think he's a very very languages. I think he's a very very languages. I think he's a very very rounded and intelligent individual. So, rounded and intelligent individual. So, rounded and intelligent individual. So, I I suspect I can't imagine he's going I I suspect I can't imagine he's going I I suspect I can't imagine he's going to retire and then do nothing. But to retire and then do nothing. But to retire and then do nothing. But >> it's it's an interesting thought >> it's it's an interesting thought >> it's it's an interesting thought experiment just going to those three experiment just going to those three experiment just going to those three types of exercise. types of exercise. types of exercise. >> I just want to, as you said, the >> I just want to, as you said, the >> I just want to, as you said, the practical takehome is move, right? practical takehome is move, right? practical takehome is move, right? Um, you know, and as you said, I think Um, you know, and as you said, I think Um, you know, and as you said, I think you said dementia risk goes down up to you said dementia risk goes down up to you said dementia risk goes down up to about 8 to 12,000 sets. Doesn't mean you about 8 to 12,000 sets. Doesn't mean you about 8 to 12,000 sets. Doesn't mean you can't do more than that, but you may not can't do more than that, but you may not can't do more than that, but you may not get the benefits in the same way get the benefits in the same way get the benefits in the same way >> or you just you don't see additional >> or you just you don't see additional >> or you just you don't see additional benefit. benefit. benefit. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. >> When it comes to lactate, and I think >> When it comes to lactate, and I think >> When it comes to lactate, and I think you spoke about in the context of you spoke about in the context of you spoke about in the context of highintensity movement, highintensity movement, highintensity movement, >> lactate has particular benefits for the >> lactate has particular benefits for the >> lactate has particular benefits for the brain. brain. brain. >> Yeah. That doesn't mean that people >> Yeah. That doesn't mean that people >> Yeah. That doesn't mean that people shouldn't do low inensity training shouldn't do low inensity training shouldn't do low inensity training because it's, you know, because it's, you know, because it's, you know, >> keeping your lactate low for an hour and >> keeping your lactate low for an hour and >> keeping your lactate low for an hour and a half walk also has benefits for a half walk also has benefits for a half walk also has benefits for mitochondria and, you know, your ability mitochondria and, you know, your ability mitochondria and, you know, your ability to burn fat and your metabolic health, to burn fat and your metabolic health, to burn fat and your metabolic health, right? So, you know, how do you see right? So, you know, how do you see right? So, you know, how do you see that? I want I want to make sure that that? I want I want to make sure that that? I want I want to make sure that everyone listening understands that when everyone listening understands that when everyone listening understands that when it comes to brain health, how do they it comes to brain health, how do they it comes to brain health, how do they interpret those three buckets that you interpret those three buckets that you interpret those three buckets that you spoke about and introduce it into their spoke about and introduce it into their spoke about and introduce it into their lives? lives? lives? >> Yeah. So, >> Yeah. So, >> Yeah. So, if I'm honest, I feel like if I'm honest, I feel like if I'm honest, I feel like people in the health sphere, podcasting people in the health sphere, podcasting people in the health sphere, podcasting sphere, spend way too much time talking sphere, spend way too much time talking sphere, spend way too much time talking about exercise strategies that are only about exercise strategies that are only about exercise strategies that are only relevant to elite athletes and people relevant to elite athletes and people relevant to elite athletes and people who spend all their time exercising. who spend all their time exercising. who spend all their time exercising. um if you can only exercise in a formal um if you can only exercise in a formal um if you can only exercise in a formal way two or three times a week, which is way two or three times a week, which is way two or three times a week, which is the case for most people, then the case for most people, then the case for most people, then getting like getting in a little bit of getting like getting in a little bit of getting like getting in a little bit of structured resistance training and maybe structured resistance training and maybe structured resistance training and maybe the the occasional sprint session, the the occasional sprint session, the the occasional sprint session, right? That's where I would focus. The right? That's where I would focus. The right? That's where I would focus. The rest of the time, I just be like during rest of the time, I just be like during rest of the time, I just be like during the day, how much can I just move around the day, how much can I just move around the day, how much can I just move around as much as possible? Like break up as much as possible? Like break up as much as possible? Like break up periods of sitting, take the stairs, periods of sitting, take the stairs, periods of sitting, take the stairs, walk for 20 or 30 minutes a day. I have walk for 20 or 30 minutes a day. I have walk for 20 or 30 minutes a day. I have in in the book I have this movement in in the book I have this movement in in the book I have this movement funnel that I think people should work funnel that I think people should work funnel that I think people should work through and the first level is snack through and the first level is snack through and the first level is snack which basically is just break up periods which basically is just break up periods which basically is just break up periods of being sedentary during the day of being sedentary during the day of being sedentary during the day however you do it stand up walk around however you do it stand up walk around however you do it stand up walk around take the stairs anything um then the take the stairs anything um then the take the stairs anything um then the next level is propel which is basically next level is propel which is basically next level is propel which is basically just do some low-level movement whatever just do some low-level movement whatever just do some low-level movement whatever you can um and so it can be cycling it you can um and so it can be cycling it you can um and so it can be cycling it can be rowing it can be walking it could can be rowing it can be walking it could can be rowing it can be walking it could be propelling a wheelchair right be propelling a wheelchair right be propelling a wheelchair right anything like that lowle activity that's anything like that lowle activity that's anything like that lowle activity that's what most of us should spend most of our what most of us should spend most of our what most of us should spend most of our time doing but just because it's part of time doing but just because it's part of time doing but just because it's part of our day Then on top of that, I would our day Then on top of that, I would our day Then on top of that, I would layer in some some kind of structured layer in some some kind of structured layer in some some kind of structured higher intensity stuff. So maybe it's higher intensity stuff. So maybe it's higher intensity stuff. So maybe it's right, you go for a walk and then you right, you go for a walk and then you right, you go for a walk and then you make it brisker and then towards the make it brisker and then towards the make it brisker and then towards the end, maybe you just like sprint for a end, maybe you just like sprint for a end, maybe you just like sprint for a little bit or something. You sort of little bit or something. You sort of little bit or something. You sort of like layer on little bits of intensity like layer on little bits of intensity like layer on little bits of intensity because we know that that has additional because we know that that has additional because we know that that has additional benefit. And then once or twice a week, benefit. And then once or twice a week, benefit. And then once or twice a week, I'd go and lift do some kind of I'd go and lift do some kind of I'd go and lift do some kind of resistance training. Um, and that's resistance training. Um, and that's resistance training. Um, and that's that's what we think the minimum that's what we think the minimum that's what we think the minimum effective dose to build strength, muscle effective dose to build strength, muscle effective dose to build strength, muscle mass, and then also um improve uh brain mass, and then also um improve uh brain mass, and then also um improve uh brain health at least, you know, once a week health at least, you know, once a week health at least, you know, once a week probably. We're very basic uh six or probably. We're very basic uh six or probably. We're very basic uh six or eight exercises that cover the whole eight exercises that cover the whole eight exercises that cover the whole body, three sets of 8 to 12 reps, like body, three sets of 8 to 12 reps, like body, three sets of 8 to 12 reps, like the the basics, like maybe maybe the the the basics, like maybe maybe the the the basics, like maybe maybe the best is twice a week if you can. best is twice a week if you can. best is twice a week if you can. Um, but then in reality, if you're going Um, but then in reality, if you're going Um, but then in reality, if you're going to try and tick multiple boxes in in to try and tick multiple boxes in in to try and tick multiple boxes in in just like a a normal person's schedule, just like a a normal person's schedule, just like a a normal person's schedule, I would make some of my aerobic type I would make some of my aerobic type I would make some of my aerobic type exercise something that's more exercise something that's more exercise something that's more coordinative, right? So, like rather coordinative, right? So, like rather coordinative, right? So, like rather than going for a jog, go and play than going for a jog, go and play than going for a jog, go and play football, go and play table tennis, go football, go and play table tennis, go football, go and play table tennis, go to a dance class, right? So, you're to a dance class, right? So, you're to a dance class, right? So, you're getting that aerobic training, but getting that aerobic training, but getting that aerobic training, but you're also getting, you know, you're also getting, you know, you're also getting, you know, additional benefit. and you you know all additional benefit. and you you know all additional benefit. and you you know all the other things that we've talked about the other things that we've talked about the other things that we've talked about like that's it like that's it like that's it >> super helpful and that's one of the >> super helpful and that's one of the >> super helpful and that's one of the things Tommy I also I've always liked things Tommy I also I've always liked things Tommy I also I've always liked about your approach it's very very about your approach it's very very about your approach it's very very pragmatic and practical it's really pragmatic and practical it's really pragmatic and practical it's really trying to look at the big picture and trying to look at the big picture and trying to look at the big picture and and see where the most where most people and see where the most where most people and see where the most where most people are at and are at and are at and >> acknowledging that we have this >> acknowledging that we have this >> acknowledging that we have this healthcare crisis and actually if we healthcare crisis and actually if we healthcare crisis and actually if we make it too difficult and if people feel make it too difficult and if people feel make it too difficult and if people feel it's too difficult in the context of it's too difficult in the context of it's too difficult in the context of their everyday life their everyday life their everyday life >> they're not going to do anything it's >> they're not going to do anything it's >> they're not going to do anything it's going to be paralyzing right And um going to be paralyzing right And um going to be paralyzing right And um yeah, I think sometimes yeah, I think sometimes yeah, I think sometimes I think sometimes what happens is that I think sometimes what happens is that I think sometimes what happens is that researchers talk about optimal or what researchers talk about optimal or what researchers talk about optimal or what they've seen in the in the lab. they've seen in the in the lab. they've seen in the in the lab. >> Yeah. >> Yeah. >> Yeah. >> Which is great. And I love reading about >> Which is great. And I love reading about >> Which is great. And I love reading about all that stuff, but it also needs that all that stuff, but it also needs that all that stuff, but it also needs that conversion to conversion to conversion to >> the man or woman on the street who's >> the man or woman on the street who's >> the man or woman on the street who's just trying to get a little bit just trying to get a little bit just trying to get a little bit healthier. healthier. healthier. >> Exactly. Right. Um Tommy, I could talk >> Exactly. Right. Um Tommy, I could talk >> Exactly. Right. Um Tommy, I could talk to you for hours and um there's just of to you for hours and um there's just of to you for hours and um there's just of course because you wrote such a thorough course because you wrote such a thorough course because you wrote such a thorough book, we we've barely scratched the book, we we've barely scratched the book, we we've barely scratched the surface of what's in it. I want to surface of what's in it. I want to surface of what's in it. I want to reiterate, I think it's one of the best reiterate, I think it's one of the best reiterate, I think it's one of the best health books I've read. It's so good. Um health books I've read. It's so good. Um health books I've read. It's so good. Um I love the title. I love the subtitle. I love the title. I love the subtitle. I love the title. I love the subtitle. The stimulating minds, future proof your The stimulating minds, future proof your The stimulating minds, future proof your brain from dementia and stay sharp at brain from dementia and stay sharp at brain from dementia and stay sharp at any age. any age. any age. On a personal level, how has it been for On a personal level, how has it been for On a personal level, how has it been for you doing all these interviews about you doing all these interviews about you doing all these interviews about your book? You're traveling a lot. your book? You're traveling a lot. your book? You're traveling a lot. You're doing a lot of podcasts. That You're doing a lot of podcasts. That You're doing a lot of podcasts. That takes its toll. Yeah, it's um takes its toll. Yeah, it's um takes its toll. Yeah, it's um Well, maybe before I get before I get to Well, maybe before I get before I get to Well, maybe before I get before I get to that part, I'll I wanted to say that that part, I'll I wanted to say that that part, I'll I wanted to say that this book exists because of you and I this book exists because of you and I this book exists because of you and I wanted to say thank you for that. So, wanted to say thank you for that. So, wanted to say thank you for that. So, for for two main reasons. Um the the for for two main reasons. Um the the for for two main reasons. Um the the first being that you were the first first being that you were the first first being that you were the first person that I think I really spoke to person that I think I really spoke to person that I think I really spoke to about wanting to write a book several about wanting to write a book several about wanting to write a book several years ago, right? We we talked about years ago, right? We we talked about years ago, right? We we talked about this. Um, and I had various ideas and this. Um, and I had various ideas and this. Um, and I had various ideas and those ideas have shifted over time, but those ideas have shifted over time, but those ideas have shifted over time, but that you were sort of the first person that you were sort of the first person that you were sort of the first person to kind of encourage me to to do that to kind of encourage me to to do that to kind of encourage me to to do that and I really appreciated that. Um, and and I really appreciated that. Um, and and I really appreciated that. Um, and then, um, then, um, then, um, one of the previous episodes that we one of the previous episodes that we one of the previous episodes that we did, I think it was the second time I did, I think it was the second time I did, I think it was the second time I was on I was on the podcast. Um, there was on I was on the podcast. Um, there was on I was on the podcast. Um, there was somebody uh, she used to work at Eb, was somebody uh, she used to work at Eb, was somebody uh, she used to work at Eb, which is a penguin imprint. She's called which is a penguin imprint. She's called which is a penguin imprint. She's called Ana Hayes. she now works for Hay House, Ana Hayes. she now works for Hay House, Ana Hayes. she now works for Hay House, but she sent me an email and was like, I but she sent me an email and was like, I but she sent me an email and was like, I listened to your uh episode with Rangan. listened to your uh episode with Rangan. listened to your uh episode with Rangan. I think you should write a book. Um, and I think you should write a book. Um, and I think you should write a book. Um, and that was the first time that I actually that was the first time that I actually that was the first time that I actually took it seriously and started to work on took it seriously and started to work on took it seriously and started to work on a proposal and all the kind of stuff a proposal and all the kind of stuff a proposal and all the kind of stuff that that kind of brought us to to here that that kind of brought us to to here that that kind of brought us to to here today. So, like thank you. Like th this today. So, like thank you. Like th this today. So, like thank you. Like th this exists um largely because of you and and exists um largely because of you and and exists um largely because of you and and and I wanted to like really and I wanted to like really and I wanted to like really >> Well, I really appreciate and it's my >> Well, I really appreciate and it's my >> Well, I really appreciate and it's my absolute pleasure and uh I take no absolute pleasure and uh I take no absolute pleasure and uh I take no credit for how great the book is. Um but credit for how great the book is. Um but credit for how great the book is. Um but thank you. Um so so yeah then like thank you. Um so so yeah then like thank you. Um so so yeah then like writing the book I loved it. It's it's writing the book I loved it. It's it's writing the book I loved it. It's it's hard. It's it's a very different type of hard. It's it's a very different type of hard. It's it's a very different type of writing from how I normally write which writing from how I normally write which writing from how I normally write which is very academic and dry and all that is very academic and dry and all that is very academic and dry and all that kind of stuff. So like it took me a kind of stuff. So like it took me a kind of stuff. So like it took me a while to kind of find that voice but while to kind of find that voice but while to kind of find that voice but it's still you know reading research it's still you know reading research it's still you know reading research thinking about ideas how to bring them thinking about ideas how to bring them thinking about ideas how to bring them together how to make them practical together how to make them practical together how to make them practical which was which is really important to which was which is really important to which was which is really important to me. um like I loved it. But the hard me. um like I loved it. But the hard me. um like I loved it. But the hard part is then you have to go out and you part is then you have to go out and you part is then you have to go out and you have to tell people about it, right? And have to tell people about it, right? And have to tell people about it, right? And you you obviously have done a lot more you you obviously have done a lot more you you obviously have done a lot more of this than than I have. Um but yeah, I of this than than I have. Um but yeah, I of this than than I have. Um but yeah, I in general I I quite like uh being at in general I I quite like uh being at in general I I quite like uh being at home. I like working with the people home. I like working with the people home. I like working with the people that I have uh in my lab. I like that I have uh in my lab. I like that I have uh in my lab. I like spending time with my wife and my dogs. spending time with my wife and my dogs. spending time with my wife and my dogs. Um and it is also an incredible Um and it is also an incredible Um and it is also an incredible experience to come out like come and experience to come out like come and experience to come out like come and visit you and talk about these things visit you and talk about these things visit you and talk about these things and do some of the shows that I've done. and do some of the shows that I've done. and do some of the shows that I've done. um you know be on podcasts that I've um you know be on podcasts that I've um you know be on podcasts that I've listened to for more than a decade is an listened to for more than a decade is an listened to for more than a decade is an incredible experience but you're right incredible experience but you're right incredible experience but you're right there's jet lag travel you know stress there's jet lag travel you know stress there's jet lag travel you know stress not not not being able to do the things not not not being able to do the things not not not being able to do the things that you normally do to kind of like that you normally do to kind of like that you normally do to kind of like look after your look after your health look after your look after your health look after your look after your health um it's it's been a bit of a it's um it's it's been a bit of a it's um it's it's been a bit of a it's definitely been a bit of a roller definitely been a bit of a roller definitely been a bit of a roller coaster and and whirlwind and like I'm coaster and and whirlwind and like I'm coaster and and whirlwind and like I'm incredibly grateful for all of it but incredibly grateful for all of it but incredibly grateful for all of it but you're right like there's only so much you're right like there's only so much you're right like there's only so much of this that that one person can can do of this that that one person can can do of this that that one person can can do because it does it it takes a lot of because it does it it takes a lot of because it does it it takes a lot of effort effort effort >> and if we look at Uh I just had a >> and if we look at Uh I just had a >> and if we look at Uh I just had a thought there if we look at that through thought there if we look at that through thought there if we look at that through your 3S model which we can apply on a your 3S model which we can apply on a your 3S model which we can apply on a daily basis a weekly basis but I guess daily basis a weekly basis but I guess daily basis a weekly basis but I guess you could also apply it across a period you could also apply it across a period you could also apply it across a period of months right so we could say let's of months right so we could say let's of months right so we could say let's forget about the writing of the book forget about the writing of the book forget about the writing of the book just for a moment let's say all this just for a moment let's say all this just for a moment let's say all this travel and uh being asked questions travel and uh being asked questions travel and uh being asked questions about you know it's such a thorough book about you know it's such a thorough book about you know it's such a thorough book people could ask you something from people could ask you something from people could ask you something from anywhere and you've got to answer anywhere and you've got to answer anywhere and you've got to answer questions and have something to say questions and have something to say questions and have something to say right right right >> you're getting a lot of stimulation I know you. So, you'll be to the best of I know you. So, you'll be to the best of your ability trying to um make sure the your ability trying to um make sure the your ability trying to um make sure the supply is good. So, you'll try and eat supply is good. So, you'll try and eat supply is good. So, you'll try and eat well. well. well. >> We haven't spoken about blood flow >> We haven't spoken about blood flow >> We haven't spoken about blood flow restriction today, but we're going to do restriction today, but we're going to do restriction today, but we're going to do that next time for sure. Right. So, that next time for sure. Right. So, that next time for sure. Right. So, you'll be doing things about exercise you'll be doing things about exercise you'll be doing things about exercise and making sure that there's enough flow and making sure that there's enough flow and making sure that there's enough flow to the brain. to the brain. to the brain. >> Yeah. But I guess when I think about >> Yeah. But I guess when I think about >> Yeah. But I guess when I think about support and how you can rest and sleep support and how you can rest and sleep support and how you can rest and sleep and and and integrate all of this into your brain integrate all of this into your brain integrate all of this into your brain and your and your and your life, I guess and your and your and your life, I guess and your and your and your life, I guess the thing that comes to me is once this the thing that comes to me is once this the thing that comes to me is once this is done or this initial batch, is done or this initial batch, is done or this initial batch, have you planned in a period of have you planned in a period of have you planned in a period of prolonged support so you can adapt, prolonged support so you can adapt, prolonged support so you can adapt, rest, sleep, get all the benefits? Do rest, sleep, get all the benefits? Do rest, sleep, get all the benefits? Do you know what I mean? you know what I mean? you know what I mean? >> Yeah, absolutely. And that is that that >> Yeah, absolutely. And that is that that >> Yeah, absolutely. And that is that that is uh definitely in the plan. Like you is uh definitely in the plan. Like you is uh definitely in the plan. Like you know my wife and I we've sort of sat know my wife and I we've sort of sat know my wife and I we've sort of sat down and there's been a a big burden on down and there's been a a big burden on down and there's been a a big burden on her to like um there's more that she has her to like um there's more that she has her to like um there's more that she has to do when I'm not at home, right? So um to do when I'm not at home, right? So um to do when I'm not at home, right? So um it's it it's been a burden on on both of it's it it's been a burden on on both of it's it it's been a burden on on both of us and then figure out like when's this us and then figure out like when's this us and then figure out like when's this hopefully going to wind down? What are hopefully going to wind down? What are hopefully going to wind down? What are we going to do to kind of take some time we going to do to kind of take some time we going to do to kind of take some time to ourselves and spend time together? So to ourselves and spend time together? So to ourselves and spend time together? So like that that's a big part of it. Um like that that's a big part of it. Um like that that's a big part of it. Um but I I think that your your point is but I I think that your your point is but I I think that your your point is really really important because really really important because really really important because all of these things integrate over all of these things integrate over all of these things integrate over incredibly long time periods, right? We incredibly long time periods, right? We incredibly long time periods, right? We have decades over which that we can um have decades over which that we can um have decades over which that we can um influence our our health, you know, both influence our our health, you know, both influence our our health, you know, both good and bad. But what it means is that good and bad. But what it means is that good and bad. But what it means is that you don't need to worry about it on as you don't need to worry about it on as you don't need to worry about it on as much on like a day-to-day basis. Yeah. much on like a day-to-day basis. Yeah. much on like a day-to-day basis. Yeah. If you if you can then use it to say, If you if you can then use it to say, If you if you can then use it to say, "Oh yeah, today I'm going to do a little "Oh yeah, today I'm going to do a little "Oh yeah, today I'm going to do a little bit of this. I'm going to do a little bit of this. I'm going to do a little bit of this. I'm going to do a little bit of this." That's great. But I bit of this." That's great. But I bit of this." That's great. But I certainly go into this knowing, hey, do certainly go into this knowing, hey, do certainly go into this knowing, hey, do you know what? There's going to be a few you know what? There's going to be a few you know what? There's going to be a few months where I'm I'm not going to move months where I'm I'm not going to move months where I'm I'm not going to move as much as I would otherwise and I'm not as much as I would otherwise and I'm not as much as I would otherwise and I'm not going to sleep as well as I would going to sleep as well as I would going to sleep as well as I would otherwise. But actually, because I spend otherwise. But actually, because I spend otherwise. But actually, because I spend so much time, you creating that so much time, you creating that so much time, you creating that foundation and I know I'll go back to foundation and I know I'll go back to foundation and I know I'll go back to it, you know, I know I'll be just fine. it, you know, I know I'll be just fine. it, you know, I know I'll be just fine. Um, and I think that that's something Um, and I think that that's something Um, and I think that that's something you we can give ourselves a little bit you we can give ourselves a little bit you we can give ourselves a little bit of grace on that as well because we of grace on that as well because we of grace on that as well because we just, it's not always going to be just, it's not always going to be just, it's not always going to be perfect. We're not going to be able to perfect. We're not going to be able to perfect. We're not going to be able to do everything. Um, and know that these do everything. Um, and know that these do everything. Um, and know that these things integrate over long periods of things integrate over long periods of things integrate over long periods of time. time. time. for that person who has listened to us, for that person who has listened to us, for that person who has listened to us, Tommy, and is really, really scared that Tommy, and is really, really scared that Tommy, and is really, really scared that they're going to get dementia because a they're going to get dementia because a they're going to get dementia because a lot of people in their family have had lot of people in their family have had lot of people in their family have had it, and let's assume they don't have one it, and let's assume they don't have one it, and let's assume they don't have one of these predeterministic genes. of these predeterministic genes. of these predeterministic genes. >> Okay. >> Okay. >> Okay. >> What are your final words for that >> What are your final words for that >> What are your final words for that individual? individual? individual? I would want I want them to know that I would want I want them to know that I would want I want them to know that we each have huge power over we each have huge power over we each have huge power over our long-term risk of dementia and our our long-term risk of dementia and our our long-term risk of dementia and our cognitive trajectory cognitive trajectory cognitive trajectory and and and regardless of where a family history may regardless of where a family history may regardless of where a family history may come from and sometimes it's genetic come from and sometimes it's genetic come from and sometimes it's genetic could be related to aoe genotype right could be related to aoe genotype right could be related to aoe genotype right which is a a common risk factor for which is a a common risk factor for which is a a common risk factor for dementia it could be related to you know dementia it could be related to you know dementia it could be related to you know there's a whole host genes that come there's a whole host genes that come there's a whole host genes that come together, you know, thousands of genes. together, you know, thousands of genes. together, you know, thousands of genes. You get like risk increases and You get like risk increases and You get like risk increases and decreases related to that. A lot of um decreases related to that. A lot of um decreases related to that. A lot of um family history of dementia and risk family history of dementia and risk family history of dementia and risk comes from shared environments and and comes from shared environments and and comes from shared environments and and shared behaviors. Across all of those, shared behaviors. Across all of those, shared behaviors. Across all of those, you can dramatically decrease your risk you can dramatically decrease your risk you can dramatically decrease your risk by starting to engage in some of the by starting to engage in some of the by starting to engage in some of the things um that that we've talked about things um that that we've talked about things um that that we've talked about today. And I I think the today. And I I think the today. And I I think the the two things or maybe three things the two things or maybe three things the two things or maybe three things that I would want to say is one know that I would want to say is one know that I would want to say is one know that this is possible right know that that this is possible right know that that this is possible right know that you have massive capacity to change um you have massive capacity to change um you have massive capacity to change um cognitive function that decline is not cognitive function that decline is not cognitive function that decline is not inevitable. inevitable. inevitable. Then um know that Then um know that Then um know that just starting with very simple things just starting with very simple things just starting with very simple things can have a big impact, right? For the can have a big impact, right? For the can have a big impact, right? For the reasons that that um that we talked reasons that that um that we talked reasons that that um that we talked about. And know that even if you if you about. And know that even if you if you about. And know that even if you if you have some previous risk, you can have some previous risk, you can have some previous risk, you can mitigate the majority of that risk mitigate the majority of that risk mitigate the majority of that risk regardless of where that risk comes from regardless of where that risk comes from regardless of where that risk comes from by engaging in those behaviors. And by engaging in those behaviors. And by engaging in those behaviors. And maybe that's that's one way that you maybe that's that's one way that you maybe that's that's one way that you might look at it. So if you have a might look at it. So if you have a might look at it. So if you have a family member who had dementia, my uh family member who had dementia, my uh family member who had dementia, my uh grandfather died of dementia. Um I know grandfather died of dementia. Um I know grandfather died of dementia. Um I know that so far knock on wood I've avoided that so far knock on wood I've avoided that so far knock on wood I've avoided his major risk factor. He was an his major risk factor. He was an his major risk factor. He was an alcoholic right. So alcoholic right. So alcoholic right. So the the the if if you think about you know my mother if if you think about you know my mother if if you think about you know my mother my grandparent sibling had cognitive my grandparent sibling had cognitive my grandparent sibling had cognitive decline dementia. What were the things decline dementia. What were the things decline dementia. What were the things that that that um um um they did or didn't do that maybe map they did or didn't do that maybe map they did or didn't do that maybe map onto some of the stuff we've talked onto some of the stuff we've talked onto some of the stuff we've talked about today? maybe that's a place to about today? maybe that's a place to about today? maybe that's a place to start, right? Because those shared risk start, right? Because those shared risk start, right? Because those shared risk factors are a lot of things that sort of factors are a lot of things that sort of factors are a lot of things that sort of come across in families come across in families come across in families >> and then know that by changing that, by >> and then know that by changing that, by >> and then know that by changing that, by starting to move that needle and it's starting to move that needle and it's starting to move that needle and it's just, you know, I say in the book, just, you know, I say in the book, just, you know, I say in the book, everything counts, right? Each little everything counts, right? Each little everything counts, right? Each little bit that you can do to work on that will bit that you can do to work on that will bit that you can do to work on that will will have an impact. um know that you will have an impact. um know that you will have an impact. um know that you have control over that and focus on the have control over that and focus on the have control over that and focus on the things that you have the ability and things that you have the ability and things that you have the ability and resources and time to to focus on resources and time to to focus on resources and time to to focus on because anywhere you start right in in because anywhere you start right in in because anywhere you start right in in the model anywhere you start the whole the model anywhere you start the whole the model anywhere you start the whole network starts to shift in your favor. network starts to shift in your favor. network starts to shift in your favor. >> Tommy, I love it. It's a very hopeful >> Tommy, I love it. It's a very hopeful >> Tommy, I love it. It's a very hopeful message. It's a very empowering message. message. It's a very empowering message. message. It's a very empowering message. Guys, get the book. It's really really Guys, get the book. It's really really Guys, get the book. It's really really good. The stimulating mind. Tommy, good. The stimulating mind. Tommy, good. The stimulating mind. Tommy, thanks for coming back on the show and thanks for coming back on the show and thanks for coming back on the show and let's do another one very soon. let's do another one very soon. let's do another one very soon. >> Yeah, I would love to. Thanks so much >> Yeah, I would love to. Thanks so much >> Yeah, I would love to. Thanks so much for having me. A blast as always. for having me. A blast as always. for having me. A blast as always. >> If you enjoyed that conversation, then I >> If you enjoyed that conversation, then I >> If you enjoyed that conversation, then I think you are really going to enjoy this think you are really going to enjoy this think you are really going to enjoy this one. one. one. >> This is probably the most effective diet >> This is probably the most effective diet >> This is probably the most effective diet that's ever been promoted on the planet. that's ever been promoted on the planet. that's ever been promoted on the planet. This protects our body against decay, This protects our body against decay, This protects our body against decay, disease, and the root causes of aging. disease, and the root causes of aging. disease, and the root causes of aging. is not only good for you but will make is not only good for you but will make is not only good for you but will make you live longer.