Dr. Gary Small on "The Alzheimer's Prevention Program"

Financial Sense Newshour recently had the pleasure of speaking with Dr. Gary Small, a neuroscientist and expert on brain aging and health.

Small says that although neurodegenerative diseases are becoming a growing problem for older Americans, things like Alzheimer’s can be prevented, which is why he decided to write his latest book, “The Alzheimer’s Prevention Program.”

One key point that stood out from our recent interview with Dr. Gary Small was this: Alzheimer’s is less about genetics than it is about lifestyle, which means there are a number of steps we can take to keep our brains healthy for longer. Exercise, for example, is important because it stimulates neurons to sprout branches and communicate more effectively—even late in life.

This is a fascinating subject and we highly recommend you listen to our recent interview with Dr. Gary Small (or read the transcript below), which starts in the second half of our Lifetime Income Series podcast at 33:30 here.

Transcript

Jim Puplava: The good news about medicine today is people are living longer. If you take a look at life expectancy, only a few decades ago people weren’t expected to live much beyond their 60s. Now, it’s in the upper 70s for men and in the 80s for women. One of the problems of aging is losing our faculties. We've heard about diseases like Alzheimer’s, which President Reagan had, or dementia. Joining us on the program is Dr. Gary Small of the UCLA Longevity Center who's also authored numerous books, including “The Alzheimer's Prevention Program: Keep Your Brain Healthy…” and also many other books on the subject. Dr., one of the things that I found remarkable about your book, is it was always thought that something like Dementia or Alzheimer's was primarily a hereditary disease, but in your research and studies you found that to be the opposite.

Dr. Gary Small: Yeah, if you look at the MacArthur study, successful aging—and they defined successful aging as mental or cognitive success as well as physical success—there’s a formula. On average, about two-thirds of what determines our health as we age comes from non-genetic factors. That means for the average person, less than half is from what we inherit from our parents. That means that a lot of everyday lifestyle choices we make have a big impact on how long we can expect to live and how well we can expect to live during those remaining years.

Jim: What would you say are some of the most destructive things that we can do along those lifestyle choices? I can imagine Doctor that stress would be one, poor diet, lack of exercise. Are these the common things that bring on the onset of something like dementia or even Alzheimer's?

Dr. Small: Well, it's hard to say that they bring them on but they certainly are modifiable risk factors; and others include smoking, being overweight or obese in mid-life, or not getting proper treatment for illnesses like high blood pressure and high cholesterol. These are simple measures that many of us can take to extend the probability that we'll live longer free of dementia.

Jim: What if you're already much older and lived a stressful life and may have made some of these lifestyle choices that put a person at high risk—Is it too late? Is this something you have to do while you're long, in other words?

Dr. Small: I always say it's never too late to start protecting your brain and start living better longer. Now, certainly the earlier we start the better the outcome because it's not just living a brain healthy lifestyle for a week or two weeks or a month, it's really trying to develop habits that keep our brain healthy for the long-haul. So that is the big challenge is to try and help people develop these habits. But it is possible through the books my wife and I have written, through the programs we've developed at UCLA; we have devised ways of making it easy, making it doable for the average person and they start seeing results right away which motivates them to continue for years to come.

Jim: And, Dr., what are some of these healthy habits? For example, in my wife's family, both her mother and grandmother were bridge masters and lived well into their final years with a very sharp mind. Do these kinds of things make a difference?

Dr. Small: Well, certainly, mental stimulation is good for the brain and whether it's playing bridge or playing brain games, any of these types of approaches can be helpful. But a lot of people try to do some of these things and they don't enjoy them. You've got to find things that work for you, that you enjoy rather than things that other people tell you to do. So bridge is not for everybody. Learning a language is not for everybody. I always recommend that people try to train and not strain their brain; so they find mentally stimulating activities that are engaging, are challenging, but not too challenging so they're difficult and they give up and not too easy that they're boring and not really stimulating.

Jim: So say, for example, doing something different. Let’s say you’re an accountant: taking up a foreign language; taking up painting. There are even programs out there Dr., and I wonder if you might address them—things like Lumosity that are actually brain games that challenge your brain to do things that you’ve never done before.

Dr. Small: So there are things like Lumosity and a program I helped develop called Dakim BrainFitness, and some of these have been tested in scientific ways. I know that Dakim BrainFitness has and a study done by Dr. Karen Miller found that after two months of playing the game, five days a week, there was an improvement in memory and after six months it was even better. Now I don't know about the studies done about Lumosity. I know Posit Science has some positive studies. But we do know that it's possible to teach people in addition to stimulating their minds, we can teach them memory techniques to compensate for age-related decline. And those are the kinds of techniques that we've developed in our books. Techniques like LOOK, SNAP, CONNECT. LOOK is a reminder to focus your attention. The biggest reason people forget is they're simply distracted and not paying attention. SNAP is a reminder to develop mental snapshots or visual images to help you remember. We know the brain is hard-wired to remember visually. It takes advantage of that. And finally CONNECT is a way of making those visual images or snapshots meaningful. Something that is meaningful will be memorable.

Jim: Can you address this issue that some of the chemicals they use in deodorants like aluminum have been found to be harmful to the brain. Do you subscribe to that in your research? Has that proven to be true?

Dr. Small: Yeah, we know as the brain ages a lot of different things happen to it. And some of these things are very disturbing. If you hit your head, it will damage your brain. And we know that we can expose our brains to a toxin and it can be damaging. And what we want to do is try to protect our brains as much as possible and limit different kinds of exposures such as that. So, I always tell people that it's a good idea to be careful. There are even sick buildings where people can maybe not so much their brains but they can develop allergies and other kinds of problems so it's really important to keep in mind that our brains are delicate.

Jim: Let's talk about your book because there are things that you talk about in developing healthy habits that can prevent the onset of the disease. What are some of those things that we can do?

Dr. Small: Well, what we do is get people on a program and we might recommend daily exercise so if somebody can get into the habit of taking a walk after breakfast or after dinner. Another thing you can do is walk with a friend or your spouse. Then you can have a conversation and the conversation can be brain stimulating as well so you're getting your heart to pump oxygen and nutrients to your brain cells. You're getting your body to produce a chemical called BDNF—brain-derived neurotrophic factor—this is from the exercise. And BDNF is like fertilizer for your brain cells—it gets them to sprout branches and communicate more effectively. The conversation will stimulate your brain cells. And if you talk about something that is important to you and disturbing to you and it's an empathic ear, that can lower your stress level. And we know that stress is not good for the brain. It can actually shrink the memory centers of the brain. So just taking a walk with a friend every day is in a way a triple prevention against Alzheimer's disease. When you get home you want to eat a healthy lunch and a healthy dinner. And what I recommend in terms of diet are several suggestions: first, to try to curtail the number of calories we ingest each day. We have a worldwide epidemic of people being overweight and having obesity and these illnesses can increase your risk for diabetes, for high blood pressure, and in and of themselves they can increase the risk for Alzheimer's. People who are overweight have a two-fold increase risk for Alzheimer's. If they're obese, it's a four-fold increase. So eating smaller meals throughout the day and having mid-morning and mid-afternoon snacks helps people to not feel too hungry and not binge and go off their diet. Every meal should have a combination of a healthy protein and healthy carbohydrates. Proteins help maintain lean muscle mass and help sustain your sense of satiety so you don't get hungry too quickly. Carbohydrates give you energy and the healthy carbohydrates are fresh fruits and vegetables. Try to avoid those processed foods and refined sugars, which tend to increase risk for diabetes. So there is a kind of brain healthy diet that is very important.

Jim: Are there any medications in a development stage that can prevent or seriously reverse Alzheimer's or maybe put it into remission?

Dr. Small: Right now there isn't anything like that. We do have drugs that help people stay at a higher level of functioning longer. These are the medicines that have been around for a number of years that we prescribe for patients with Alzheimer's...and these drugs can sometimes give you a temporary improvement but keep people at a higher level of functioning longer and they help a lot of individuals. Unfortunately, we can't stop the progression of the disease. There are many studies that are ongoing that are trying to do that but we don't have a magic cure yet.

Jim: Let's address a situation where someone has just been diagnosed with Alzheimer's or dementia. What can be done at that point to improve their quality of life?

Dr. Small: The first thing is to go to the doctor sooner rather than later. We find that the earlier that we can help people, the better the outcome. It's much easier to protect a healthy brain than try to repair damage once it's present. So when people come to our programs…we find out if there's any medical issue that can be contributing to the problem: drug toxicity, thyroid imbalance, and so forth. If it's indicated, we put them on the medicines that help with the symptoms...and then we also alter their lifestyles so that they're exercising and eating right and having an appropriate level of stimulation so that they can enjoy their lives as much as possible for as long as possible.

Jim: So, outside of doing some of these things, is there anything else that you have found to be especially helpful? I guess the issue of understanding from others, whether it's a spouse, children, because one of the things that we come across sometimes, where somebody is dealing with their finances and they're making decisions that they're not cognizant of making, they forget that they do something. What are some of the things that should be done there? I would suspect that having durable medical powers or things where you can act on the others behalf. Are there other things like that?

Dr. Small: I think it's critically important for family members to really look at all the issues, become educated and really understand what's going on. Because that has a big impact on the patient and the disease has a big impact on the family. And, yes, looking at durable power of attorney, looking at advance directives, having a conversation sooner rather than later allows the patient to be involved in these discussions so that their wishes are carried out. And caregiving is a tough one: 50% or more of primary caregivers of dementia patients become depressed. So we've got to make sure that the caregivers are taking care of their own needs and not getting burned out because depression can be infectious in a way. You're around someone who's down—that’s going to affect their own mood. And it works the other way too: dementia patients or Alzheimer patients develop depression as well and that can affect the caregivers. So it's really a family disease that we have to pay attention to.

Jim: So, Dr., as we close, you've written a number of books; the one that comes to mind is “The Alzheimer’s Prevention Program.” You also have several others: the Memory Prescription and the iBrain. If someone has Alzheimer's running in the family, has a spouse or maybe it's a child that has a parent, if you were to recommend the book that you think would be the most helpful, which one would it be?

Dr. Small: Well, I think from my portfolio of books I would recommend “The Alzheimer's Prevention Program” because anybody that has the disease in their family is going to be concerned about it. They are going to want to know the facts about their genetic risk; they want to know the science behind what they should do and the book provides that. And it also translates the latest science into practical strategies and offers a one week program that you can follow to get started, to give you a sense of what it's like to live a brain healthy lifestyle. And that's just the beginning of protecting your brain for the rest of your life.

Jim: Well, Dr., I want to thank you for joining us on Financial Sense Newshour. And, once again, the name of the book that Dr. Gary Small mentioned is called “The Alzheimer's Prevention Program.” Doctor, thanks again and keep up the great work!

End Transcript

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