Ten Percent Happier with Dan Harris - How To Prevent Dementia | Lisa Genova

Episode Date: October 30, 2023

Understanding the difference between ‘normal’ forgetfulness and actual memory loss, practical ways to stave off Alzheimer’s disease, and meditation’s role in brain health.  ... Lisa Genova has a Ph.D. in Neuroscience from Harvard University. She is the New York Times bestselling author of several novels including Still Alice—which was adapted into a film starring Julianne Moore who won the 2015 Best Actress Oscar for her role as Alice Howland, Love Anthony, and Every Note Played. Her first work of nonfiction is Remember: The Science of Memory and the Art of Forgetting. Genova’s first TED talk, What You Can Do To Prevent Alzheimer's has been viewed over eight million times and her most recent TED talk, How Memory Works--and Why Forgetting is Totally OK was the sixth most watched TED talk of 2021. In this episode we talk about:The difference between ‘normal’ forgetting and actual memory lossThe difference between dementia and Alzheimer’s disease Meditation’s role in brain healthWhat the Memory Paradox is The best foods and types of exercise for staving off Alzheimer'sThe three things happening in your brain while you sleep that are helpful for memory Why brain games (like crossword puzzles and sudoku) don’t actually improve memoryThe first necessary ingredient for creating a memory How memories are formedAnd the relationship between memories and musicRelated Episodes:Ten Percent Happier Podcast Sleep SeriesFull Shownotes: https://www.tenpercent.com/tph/podcast-episode/lisa-genovaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Starting point is 00:00:00 It's the 10% happier podcast. I'm your host, Dan Harris. Hello, my fellow suffering beings. Every once in a while, I'll be rushing around the house, checking things off my to-do list, and I'll stop short and think to myself, what am I doing again? Why am I in this particular room? What mission was I on that propelled me in this direction? And for the life of me, I will not be able to remember. In moments like this, I sometimes worry
Starting point is 00:00:40 is this early onset Alzheimer's? Same for when I run into somebody who I haven't seen in a minute, and I can't remember their name or when I try to bring to mind a word I've been searching for, and I can't do it. In these moments, I tell myself a story about how I've got dementia in my family, and these kinds of things have been happening to me more frequently as I enter my fifties and down the toilet I go. I suspect some of this might sound familiar to you, no matter what age you're at, and I suspect you will find the conversation you are about to hear, extremely reassuring. Many of the things you might suspect to be symptoms of early onset dementia are, in fact,
Starting point is 00:01:15 totally normal. And even if you have dementia in your family, there really are things you can do to prevent it for yourself. My guest today is Lisa Genova. She's got a PhD in neuroscience from Harvard. She's the New York Times bestselling author of several novels, including Still Alice, about a woman with Alzheimer's. That book was adapted into a film starring Julianne Moore. Lisa's first work of nonfiction is now out. It's called Remember, The Science of Memory and the Art of Forgetting.
Starting point is 00:01:42 And in this conversation, we talk about the impact of things like sleep, meditation, and brain games. We talk about the difference between normal forgetting and actual memory loss. And we talk about the best foods and styles of exercise for staving off Alzheimer's. It's a heavy topic, obviously, but as you'll hear, Lisa is delight.
Starting point is 00:02:05 If you've ever stayed at an Airbnb, you know that it can be a fun and affordable way to visit a new place, but have you ever considered whether you could be an Airbnb host? Maybe you're planning a long weekend with friends or family this fall while you're away, you could Airbnb your place and make some extra money to help pay for the trip. Maybe you have an extra bedroom or in-law unit where friends and family come to stay with you, you could air be and be it and make some extra cash while it sits empty. You could be sitting on an air be and be and not even know it. My wife and I have talked about doing something like that before.
Starting point is 00:02:38 We certainly love staying in air be and be especially when we go to the beach. But again, air be and be as an experience isn't all about you staying in somebody else's home. Whether you could use a little extra money to cover some bills or for something a little bit more fun, your home might be worth more than you think. Find out how much at Airbnb.ca slash host. I'm Rob Briden and welcome to my podcast, Briden and we are now in our third series. Among those still to come is some Michael Pailin, the comedy duo Egg and Robbie Williams. The list goes on, so do sit back and enjoy. Bride and And, on Amazon Music, Wondery Plus, or wherever you get your podcasts.
Starting point is 00:03:37 Hello, I'm Hannah. And I'm Suryte. And we are the hosts of A Redhanded, a weekly true crime podcast. Every week on Redhanded, we yet stuck into the most talked about cases. But we also dig into those you might not have heard of, like the Nepali's Royal Massacre and the Nithory Child Sacrifices. Whatever the case, we want to know what pushes people to the extremes of human behaviour. Find, download, and binge Red Handed wherever you listen to your podcasts.
Starting point is 00:04:12 Lisa Genova, welcome to the show. Thank you, Dan. Great to be here. Really happy to have you. I feel some personal urgency fueling this discussion, as I imagine many listeners will feel as well. But before we get into all of my selfish questions, which hopefully are selfish for the listener as well, I'd love to hear a little bit more about you. How and when and why did you get interested
Starting point is 00:04:32 in memory and dementia? Yeah, so I'm a neuroscientist, but I actually never studied memory and Alzheimer's when I was in the lab. My area of expertise was the molecular neurobiology of drug addiction. My interest in memory and Alzheimer's began when my grandmother had Alzheimer's. So I was the neuroscientist in this very big Italian family group just outside of Boston.
Starting point is 00:04:57 And I wasn't one of her caregivers. That responsibility fell to my parents and my aunts. But I loved my grandmother and I lived nearby. And I thought, well, one of the things I can do is learn everything I can about Alzheimer's and pass that education along. And I learned a ton. And some of it was useful. Some of it wasn't like I geeked out on the neuroscience of it.
Starting point is 00:05:18 That wasn't really helpful. But I learned about the clinical disease management. I learned about caregiving. Books like the 36 hour day, were certainly helpful. But what I found was lacking was the perspective of the person with it. So everything was written by a clinician or a scientist or a caregiver, so they were all views from the outside looking in.
Starting point is 00:05:38 And while I spent time with my grandmother, what I noticed was that I had a lot of sympathy for her and for us. I felt so bad for her. She was losing her connection to everyone she knew and loved. This entire beautiful life she lived. She didn't remember any of it anymore eventually. And I felt so bad for us for losing her right in front of us. But that's sympathy.
Starting point is 00:06:01 And sympathy really drives otherization. It's disconnection emotionally, right? So I felt this longing for empathy. I was in my late 20s at the time, and I just didn't know how to be comfortable enough around my grandmother's Alzheimer's. It was really frustrating and heartbreaking and embarrassing at times.
Starting point is 00:06:20 It really unnerving for me. So I didn't know how to really just be present and still next to my grandmother with her Alzheimer's. I didn't know how to get to empathy. And the aha that thankfully I had was, oh well fiction is a place where you can explore empathy. You can walk and someone else's shoes through another character, through story. This is how humans experience what it's like to be someone else. And so I thought, well, someday I'll write a novel about a woman with Alzheimer's until it from her perspective. And that endeavor eventually became still Alice.
Starting point is 00:06:52 And everything else followed from there. How much do we know about what it's like to have Alzheimer's? We know a lot. So I think that the general public's sort of conception and actually misconception of this disease for a long time. with the general public sort of conception and actually misconception of this disease for a long time. Again, people tended not to talk about this until recently. It was a lot like cancer was 40, 50 years ago
Starting point is 00:07:13 where people called it the big C and should we never spoke of cancer, so we didn't really know what it was like to live with that. Same with Alzheimer's, there's a lot of taboo and stigma, surrounding anything going on from the neck up, really. Any mental illness, any neurodegenerative disease, there's a lot of shame and stigma that carry with that. But the misconception was like, oh, well, this is a disease of the dying elderly. If you picture someone with Alzheimer's, you might picture someone really elderly 80s, 90s. They're in a nursing home bed. They don't know anyone anymore. They may not be speaking. But what people weren't imagining and what people might not still be
Starting point is 00:07:48 imagining is, well, what is living with Alzheimer's looking sound and feel like? And by the way, you can be diagnosed in your 40s and 50s. You can get early onset Alzheimer's. 60s and 70s are not as old as we used to think they are maybe. Like you said, people living vibrant lives, we were learning how to match brain span with lifespan, and we're living a really long time compared to, 1900, the average life expectancy in the US was 47. And so there are examples of us now living with Alzheimer's, whereas before I think the conception
Starting point is 00:08:21 was we're dying of Alzheimer's. So we have a lot of people who are living with this, who are more and more speaking up and sharing what it's like to live with it. So I think we're either personally, we'll know someone with it, and so we'll know what it feels like because they can share it,
Starting point is 00:08:35 or there are more people talking about it. I get all of that, and I'm still curious what we know about what it's like from the inside to have Alzheimer's. I have a close family member who was diagnosed in his 60s and was very rapid decline from there and it looked awful. It still looks awful. I'm searching for somebody to tell me it's not that bad. Well, it's tough. We rely on memory for pretty much everything we do all day, just the logistics
Starting point is 00:09:03 of our lives rely on memories. So everything from your memories for how to do things. So it's, you know, get dressed, brush your teeth, how to work the coffee machine, how to drive the car, how to send your emails. Those are all memories, all the information. So what's your name, where do you live? Who is the first president, you know,
Starting point is 00:09:22 information and facts, the Wikipedia of your life? All of the people you know and how you know them. So all your loved ones, all that relational information, what happened in your life, all your episodic memories that narrative that gives you a sense of identity and self is memory. And so, with Alzheimer's, you're losing access to your most recent memories and personal history first and that it sort of peels back like layers of an onion from there. And it's very scary. I know a lot of people very well who have Alzheimer's and are living with it. And there are a lot of losses and compensations and new new realities to be adjusted to.
Starting point is 00:10:01 And it's very scary and it's difficult for sure. And I think one of the biggest lessons I've learned in knowing all of the people I know who have Alzheimer's and doing the research when I wrote the book Still Alice, what people want us to know is that memory does not define what it means to be human. I mean, despite all of what I said about how important and crucial memory is, interestingly, Alzheimer's never steals your ability to feel human emotion. So if I have Alzheimer's, I can lose access to all of the memories I've ever made in my life.
Starting point is 00:10:35 I won't know who you are, any of the people I love. I won't remember my earliest memories, but I'll still know how to love and what it feels like to feel loved. I'll still have the full range of human emotions. So I can still feel sad, happy, angry, afraid. I can feel everything still. So that part of being human never leaves us. So I tell people like, well, if you have Alzheimer's
Starting point is 00:10:56 and you're not gonna remember this conversation I'm having with you, Dan, it doesn't mean that our conversation didn't matter. It doesn't mean that I didn't enjoy it while I had it. And maybe 10 minutes later, I don't remember ever having met you, but that doesn't mean that in the moment, in the present moment, that my life still didn't matter.
Starting point is 00:11:16 Actually, the more we're talking, the more I realize that I've had several relatives with Alzheimer's as have many people listening. And I'm thinking of this story that I've told before of my uncle Martin, who was very smart man. And he and I were sitting next to each other post diagnosis at a dinner. And he said to me, what's more exciting to you reality or memory? And I thought about it. And I said, well, I'd like to say reality as a meditator, like what's happening right now, but I suspect
Starting point is 00:11:44 it might be memory. It's such an interesting question. What do you think, Martin? And he said, what was the question? That's fantastic. Yeah. So, and reality is interesting, right? Because if you have Alzheimer's, the reality for someone living with Alzheimer's is not
Starting point is 00:12:01 the reality for someone who doesn't, right? So if I have Alzheimer's, my access to the information that you understand in front of us might not be available to me, right. I might not know that this is called a microphone. I might not know how to use the keyboard. I might not understand what you're saying, or I might be cheering a conversation with you about a memory I had from 30 years ago. And I'm thinking it's happening, you know, yesterday or today. And so reality for me with Alzheimer's is going to be very different than you.
Starting point is 00:12:30 And one of the key ways to stay emotionally connected to someone with Alzheimer's is to sort of be an improv actor. It's to use that first rule of improv acting is to say yes and to whatever reality the actor creates. And so that way you can build a relationship. And so it doesn't matter if it's nonsense. It's all about agreeing to what's said and going along with it. So for someone with Alzheimer's, the reality is, you know, if my grandmother says, oh, I'm
Starting point is 00:12:56 waiting for my mother, she's going to be here any minute. It's not my job to reality or answer to what's, quote, real and say, well, you know, your mother died 30 years ago, because now she's gonna be reliving that as new information right now. Instead, I can agree to it. I can say, yes, Anne, I can say, sure, I'll wait for you. Well, you wait for your mother.
Starting point is 00:13:17 Can you tell me a bit about her? Or, oh, let's have a cup of tea while we wait. And then, you know, we go from there. Yeah, I volunteered in a hospice for several years. And one of the first lessons I learned was don't argue with somebody who has dementia or Alzheimer's. I remember sitting next to this guy who was very, very ill and he asked me for 20 bucks to take a cab. And I learned not to try to talk them out of it or to redirect him to what's happening right now. I just kind of went along with it. It's improv. Absolutely. It's improv. Let me just go back to what we know about what it's like
Starting point is 00:13:50 internally for people with Alzheimer's to the extent that we can know anything about it. Sorry, I'm going to tell a little bit of a personal story again and I apologize to long-time listeners because this is a story I've told before, but it's relevant directly, I believe, which is that my first panic attack of my life, and I've had many, was when I was smoking weed outside of Newton South High School in Newton, Massachusetts, one town over from you, Lisa, and I then went into the gym to watch a basketball game. And the reality of my existence came down upon me like a avalanche, and I realized that everything was, that was happening, was happening rightche. And I realized that everything was happening,
Starting point is 00:14:25 was happening right now. Oh no, no, no, no, now it's now. Oh no, now it's now. And I just keep waking up in the present moment in a way that was incredibly scary for me. And I wonder is that what it's like to have Alzheimer's or paradoxically is it actually bliss because in meditative traditions, we're
Starting point is 00:14:46 always talking about living in the now. Again, it depends. This is a neurodegenerative disease, which means that it's changing over time. So it's not just a flip of a switch, and you have full blown Alzheimer's, and you've lost access to all of your memories, and you are in this state of just accepting what's in front of you. And that's personal, too, because again, like I said, you don't lose access to all of your memories and you are in this state of just accepting what's in front of you. And that's personal too, because again, like I said, you don't lose access to your emotions, right?
Starting point is 00:15:09 And if anything, the disease doesn't just stay in the parts of your brain that are involved in memory, they also infiltrate, for example, your frontal cortex, your decision-making problem-solving area and also the neurons that then inhibit your amygdala, your primitive emotion center. So a lot of people with Alzheimer's become disinhibited with respect to emotion.
Starting point is 00:15:30 And some of that is lovely because you might be disinhibited with respect to joy. A lot of us aren't free to express our full blown, giddy joy because we've been socialized to be neat and tidy with our emotions. A lot of people with Alzheimer's are explosive with respect to anger. It can be lust. Any of those that we've been taught, like not to express can get full blown with Alzheimer's.
Starting point is 00:15:53 But in the beginning, like, you know, so I think we're about the same age. I'm 52. And this is an age where neuro transmission slows down a little bit. Our processing speeds start to slow as we age. And I tell everybody, you know, it's sort of like your skin. That's an organ. You can wear a sunblock and stay out of the sun, do all the right things, eat healthy. Your 52-year-old skin is not going to look like your 22-year-old skin, no matter how good you take care of it. Well, same with the brain. There's tons
Starting point is 00:16:21 we can do to take care of the health of our brain. I have a lot of agency there, but my 52 year old brain is not going to be as fast as my 22 year old brain no matter what I do. So that's starting to happen and we're like, oh, like mortality is sort of on our radar now. Like what's happening? Am I getting Alzheimer's? So if I were to start showing signs of actual Alzheimer's right now, it would be things like, I drive to the mall and I park in the garage and I go to shop for an hour and I come back out and I can't remember where I parked. Now the distinction here is if it's normal forgetting, it's probably because I didn't actually pay attention to where I parked Dan.
Starting point is 00:16:59 So it actually doesn't even involve my memory because the first necessary ingredient in creating a memory that lasts longer than this present moment is attention. Neurologically, if you don't give the thing your attention, you can't form a memory. So if I just zipped off and went into the mall and I was texting or is thinking about something and I didn't pay attention to, oh, I parked in 4B, I never could make a memory of that. So I come out and I think I've forgotten it, but I actually never put that in my brain. Five Alzheimer's, I come out, I could have paid all the attention
Starting point is 00:17:29 to where I parked my car. I come out and I might have this thought, I don't remember how I got here. Or I might have this other thought, I'm actually standing in front of my car, but I don't recognize it as mine because I can't remember what kind of car I drive. And so those moments will happen in the beginning of Alzheimer's and it's very terrifying.
Starting point is 00:17:48 It's jarring. You can't keep track of information. You know you should keep track of. So it's the sense of, you know, am I going crazy? Can I be relied on? Can I trust myself? You identify as a smart person who's capable and you start to lose access to what you can normally rely
Starting point is 00:18:05 on to function. So in the beginning stages, it's actually very scary and it's incredibly helpful to know what's going on to have other people to talk to about it, to not hide it. A lot of people feel they have to hide it. So the more open we can be and supportive and the safer and better equipped we are to deal with the changes that are going to occur with your memory, language, and cognition as this disease progresses. So are there medications or other forms of treatment that can be brought to bear to
Starting point is 00:18:38 slow the progression of the disease and or make it all more bearable and livable? So historically, there have been no medications that alter the progression of this disease. There are a couple of medications that improve the quality of your life for a while. They help you with the activities of daily living for a little longer. They work on parts of the brain that aren't yet bombarded
Starting point is 00:19:03 by Alzheimer's disease to help enhance your ability to function cognitively. So those are aeroceptin-demenda. And so they help for a little while, and then they don't, because again, the disease keeps marching on, and you lose all that neural substrate that those drugs are actually working on.
Starting point is 00:19:19 There are a couple of new drugs that have been FDA-approved just within the last year that are disease modifying. These are the first drugs that actually look like they might change the course of the disease and slow it down. They are not home runs, which is okay. I think a lot of people are upset and calling them controversial
Starting point is 00:19:39 because they don't do everything all at once. Like everybody just wants the magic pill, right? And we can talk about this too. Like everybody just wants the magic pill, right? And we can talk about this too. Like everybody just give me the drug that's kind of reverse Alzheimer's or prevent it. And we're not there yet. The drugs that are available, slow cognitive decline in people
Starting point is 00:19:56 who have mild cognitive impairment or early Alzheimer's, buy about 25 to 30%, which is exciting. It's significant. I'm genuinely encouraged and excited about this development, but it's an intravenous infusion, so it requires you to go to a medical facility to have the treatment after Medicare pays for it. It's still, I think, like, $26,000 a year, so it's not accessible for a lot of folks. It's not an over-the-counter pill yet. So we're not there for the majority of people, but these developments are what needs to happen for us to get to version 2.0 and 3.0.
Starting point is 00:20:34 So that's encouraging for sure. But really what we want to do to prevent it and to slow it down in what we've actually shown is not the magic pill, Dan, it's lifestyle, and it's not particularly sexy, but the date is there and it works. And in fact, it's things like seven to nine hours of sleep a night. We know that that clears Amaloid beta and reduces your risk of Alzheimer's by about a half,
Starting point is 00:20:58 if you can accomplish that. Exercise, so it's like 30 minutes a day, five days a week, a Robic exercise, walking like you're in a hurry. That's been shown to reduce your risk of Alzheimer's and dementia by a third to a half. And the Mediterranean and mine diet folks who are on that. I know there's a new study out recently that wasn't very encouraging, but there were big problems with it. The lion's share of all of that research is very compelling and again shows anywhere from like 40 to 60% reduction in risk of dementia by eating regularly the Mediterranean or mine diet.
Starting point is 00:21:32 So if I told you a pill did that, everyone would take it. And it's also about folks understanding that they have an influence over their brain health and the health of their memory. I think everybody has gotten the memo about their heart health, so people know that if I walk 10,000 steps, if I eat right, if I exercise, I can keep my heart healthy, but the message hasn't really translated as much about brain health. And that's important, that we start to understand, like, oh, the things I'm doing are actually
Starting point is 00:22:01 contributing to my ability to remember what happens today tomorrow. So in the short term, we need to do these things. And there's a biology to it and there's a reason behind it. Happy to talk about any of those if you want. And it also can help future me from getting Alzheimer's. I want to live a long life, but I want to match my brain span to my life span, for sure. Coming up, Lisa Junova talks about the three things that happen in your brain while you sleep that are helpful for your memory and why brain games don't actually improve your memory. What a life these celebrities lead. Imagine walking the red carpet, the cameras in
Starting point is 00:22:44 your face, the designer clothes, the worst dress list, big house, the world constantly peering in, the bursting bank account, the people trying to get the grubby mitts on it. What's he all about? I'm just saying, being really, really famous. It's not always easy. I'm Emily Lloyd-Sainey, and I'm Annelion Groffey, and we're the hosts of Terribly Famous from Wondery, the podcast which tells the stories of our favourite celebrities from their perspective. Each season we show you what it's really like being famous by taking you inside the
Starting point is 00:23:16 life of a British icon. We walk you through their glittering highs and eyebrow raising lows and ask, is fame and fortune really worth it? Follow terribly famous now wherever you get your podcasts or listen early and add free on Wondry Plus on Apple Podcasts or the Wondry app. Go SoundReal! At least as a journalist, that's what I've always believed. Sure, odd things happened in my childhood bedroom, but ultimately, I shrugged it all off.
Starting point is 00:23:47 That is, until a couple of years ago, when I discovered that every subsequent occupant of that house is convinced they've experienced something inexplicable too, including the most recent inhabitant who says she was visited at night by the ghost of a faceless woman. And it gets even stranger. It just so happens that the alleged ghost haunted my childhood room might just be my wife's great-grandmother. It was murdered in the house next door, by two gunshots, to the face. From wandering in Pineapple Street Studios comes Ghost Story, a podcast about family secrets
Starting point is 00:24:18 overwhelming coincidence and the things that come back to haunt us. Follow Ghost Story on the wandering app, wherever you get your podcasts. You can binge all episodes at free right now by joining Wondry Plus. Remember, you can learn to apply all the nuggets of wisdom you hear on this show to your own life over on the 10% happier app with guided meditations, courses,
Starting point is 00:24:43 and ad-free versions of this show. Download the 10% happier app today guided meditations, courses, and add free versions of this show. Download the 10% happier app today wherever you get your apps and get started with a free trial. Since you brought up all the things that we can do to improve our brain health, I think that's going to trigger a lot of interest among listeners. So let's stay with that for a second. Before we marched through the list of things we can do, some of which you've already mentioned, let me just ask a clarifying definitional question, which is, if I understand it correctly,
Starting point is 00:25:09 there is dementia, which is cognitive decline writ large, and Alzheimer's is a kind of dementia. So dementia is the larger category. Am I right about that? Almost. And this, I get this, I know, it's okay, you know, I get this at every single top I've ever done. So they tend to be used interchangeably. And I think the statistic that's out there is that, and the Alzheimer's Association
Starting point is 00:25:34 did this study, 45% of people who have a diagnosis of Alzheimer's are not told so by their doctor for fear of upsetting them or stressing them out. And their told instead they have dementia, feels a little softer. So dementia is, you're right, it's the sombrella term, it's a symptom. So much like high blood pressure and high cholesterol is a symptom of heart disease, dementia, which is an impairment in memory, language, or cognition that is out of proportion to your age and education level. So this symptom of dementia can be a symptom of a lot of different things. So it's the hallmark symptom of Alzheimer's, but it could also be a symptom of something
Starting point is 00:26:18 else. It could be a symptom of a B12 deficiency, which we can treat. It could be a symptom of chronic sleep deprivation. It could be a symptom of lots of different sort of cousins of Alzheimer's, like Louis body dementia, vascular dementia, frontal temporal lobe dementia. So if you are showing symptoms, impairment and memory, language and cognition, your doctor's job is going to be to figure out what's causing that dementia. And Alzheimer's could be the cause. And it is the most common cause over the age of 70.
Starting point is 00:26:48 I appreciate that clarification. One more, as we go through these things we can do to improve our brain health, they will work on reducing the odds of dementia writ large, as well as Alzheimer's or just Alzheimer's. It really depends. But certainly, we know for Alzheimer's and vascular dementia, these things that we're going to talk about will reduce your odds of developing those. But if you're dementia is from alcoholism, that's separate. Dementia is a symptom of a lot of different things. Yes, I'm just thinking about my own familial and friend orbit.
Starting point is 00:27:23 I've seen many kinds of dementia from Alzheimer's to alcohol related, forgetting to lube body. It's an unpleasant horn of plenty. All right, so let's pick up on all those fascinating things you said about what we can and cannot do about this. But what are the things you say is that brain games don't help? I know people don't love hearing that one. I know there are companies that they're trying to make money off of people's fears. And by the way, if anybody's offering anyone a supplement that says,
Starting point is 00:27:52 this will improve your memory or this will prevent Alzheimer's, they are snake oil salesmen and they're probably being sued. Because that has not been shown. The clinical trials have not borne that out. If there's something available that actually improves your memory and cognition and prevents Alzheimer's, you're gonna hear about it from Maria Shriver.
Starting point is 00:28:11 You're gonna hear about it from Rudy Tancy. You're gonna hear about it from respected news journalist. You're not gonna see somebody on YouTube. So the brain games, the crossword puzzles, the Sudoku, you're gonna get really good at doing those games. But it doesn't cross train or cross translate to being good at remembering what happened last month or remembering where you put your phone or remembering that you need to buy milk at the grocery store.
Starting point is 00:28:37 You're going to get very good at doing those things. And it actually doesn't lead to what we call a cognitive reserve. So in order to build an Alzheimer's resistant brain through doing things, you really want to learn new things and you want to learn complex things. So crossword puzzles are mostly retrieving information you already know. You're not actually building new neural pathways. So Dan, every time you learn something new and so all of your listeners are actually building bigger brains every time they listen to your podcast because every time we learn something
Starting point is 00:29:10 new we're building new neural connections. So if you think about it, that information didn't exist in your brain before you learned it. If it lives in your brain now, if it's information you can access and use, that means your brain had to change. And so if you build more neural connections, think of them as like neural roads or branches of a tree, if you're building more of those branches, and you end up developing some Alzheimer's pathology that's blocking some connections in your brain. So you have some roadblocks.
Starting point is 00:29:41 You might not even notice it's there, because you have a lot of excess rows, you have an abundance and a redundancy and neural connection so you can detour any of those road blocks. So we talk about neural plasticity and building a cognitive reserve as a way to prevent you from being diagnosed with Alzheimer's even if you've got some in there. So learning new things, it's not crosswords. It's reading a book, listening to a podcast, it's learning a new instrument, it's learning a new sport. A lot of people took up pickleball in the past year or so.
Starting point is 00:30:13 It's going to a new city, going on vacation. Anytime you can really wake up your brain, your senses, to experiencing something new that you didn't understand or know before, that is going to build new neural connections in a way that is preventative for Alzheimer's. So you're saying that the health of my listeners depends on them continuing to listen to the show. Absolutely, yes. This is the best advertisement I've ever had. Okay, so that all makes sense. And actually what I hear from that is have a great life,
Starting point is 00:30:49 you know, an interesting life consists of travel, reading, listening to great podcasts, learning a sport, learning how to play an instrument. So if you do life well, actually it's gonna contribute to a reduction in the possibility of Alzheimer's. That's incredibly reassuring. It does put me in mind possibility of Alzheimer's, that's incredibly reassuring. It does put me in mind, though, of meditation, because meditation does, in my experience,
Starting point is 00:31:10 open up the senses. You are deliberately trying to go south of your intra-cranial noise and into the data of your senses. Is there any evidence to suggest that this practice might help with brain health? Absolutely. I mean, the biggest way that we've seen that meditation helps brain health is reducing
Starting point is 00:31:33 your reactivity to chronic stress. So we know that chronic stress is really bad for your memory today. So it's bad for your ability to make new memories today. It's bad for your ability to make new memories today. It's bad for your ability to retrieve memories that you've already made. And it puts your brain at risk for developing Alzheimer's in the future. So something is stressful.
Starting point is 00:31:54 Something is dangerous or it's critical. It's urgent. So my brain then sends signals to my pituitary, which sends hormone to my adrenal glands, which releases stress hormone. And then I can show up to the event. So you're releasing adrenaline and cortisol when you wake up in the morning. I got to face the day when the car in front of me stopped short.
Starting point is 00:32:14 And I have to hit the brakes. If something really dangerous is happening, like a lion is chasing me. So those are the, I'm running for my life kind of thing. Modern day, a lot of it is, you know, it's not a predator. Your predator is the thoughts in your head that are constantly running. So if it's what we call an acute stressor, it happens and then it's gone,
Starting point is 00:32:34 well, that's actually not so bad. Like we need that stress response to function, to like show up for a presentation, to get out of bed, like I said. But if the stress doesn't go away, and this is where the, as you mentioned, like the chatter in your head comes in, you know, we're not constantly being chased by a lion, but the thoughts in our heads can be chronic.
Starting point is 00:32:55 So it's, you know, the top three psychological stressors are social isolation, perceived lack of control, and uncertainty, you know, since the pandemic, we tend to tick all of those boxes. So what happens in chronic stress is cortisol and adrenaline get released by the adrenals your heart rate goes your breathing is accelerated your muscles are ready for action But then cortisol comes on board it acts on receptors back in the brain and it shuts the whole thing off and then you calm down back in the brain and it shuts the whole thing off, and then you calm down.
Starting point is 00:33:24 But in chronic stress, the receptors become desensitized. They either down, regulate, or they don't react anymore to cortisol. Now I'm just in a chronic state of dumping a adrenaline cortisol. And when you do that, you actually shrink the size of your hippocampus. Now, the hippocampus is a part of your brain
Starting point is 00:33:41 that is essential for the formation of new, consciously held memories. So if I don't have a hippocampus, I can't remember any new information or anything that happened. The hippocampus is also the place that's under attack first by Alzheimer's. So this is why people who have Alzheimer's can't remember what they said a minute ago. They can't remember if they already ate lunch. They repeat themselves. They can't remember if they already ate lunch, they repeat themselves, they can't find words.
Starting point is 00:34:05 So if you meditate, even in the face of all of that same amount of stress, you'll restore cortisol levels and you'll restore the size of your hippocampus. And in fact, if we compare studies have been done, people who meditate for 30 minutes a day, I think it was for eight weeks versus age-matched controls who did not meditate, the meditators, their hippocampus were bigger than the people who did not. And so we do know that meditation is fantastic for your memory today and reducing the cortisol levels
Starting point is 00:34:36 that can be detrimental to your memory and risk of Alzheimer's. Brian, the engineer who's producing this episode here in the studio with me was telling me before we started rolling that he dropped off the meditation train. So I think you've scared the shit out of him and he's going to get back in the game. I hope that this, like, I love this kind of information because it doesn't so much scare me as like, oh, there's actually a biology to this. Like, that's so helpful to me.
Starting point is 00:35:00 I think a lot of people in understanding that there is a physiological effect of something like meditation and to understand why the thoughts that are running around in the background are stressful. Like they're really modern day predators. You're being chased and attacked all day, and so you need some kind of defense against that, or it's going to cause physiological damage. Sometimes we'll talk about the fact that we develop these physiological mechanisms to run away from a tiger, but now we're both the person running away from the tiger and the tiger we're doing it to ourselves.
Starting point is 00:35:34 Right, it's all inside ourselves, yeah. There are other ways to reduce stress from what I can tell, the most powerful mechanism is having good relationships in your life. Robert Wildinger, also a Boston guy, I've been running this, I guess he's the most recent guy to run this multi-generational study that's looked at people in the Boston area and figured out what contributes to longevity and what comes screaming out of the data to the extent that I understand it is that
Starting point is 00:36:05 people who live the longest are the people who have the best relationships and the mechanism is that good relationships help you handle the natural ups and downs of life. As Robert says, never worry alone. I think that's a brilliant expression. And so I throw that to you to see what you think about this. I love that. Although my dad would say don't worry because it doesn't do any good. Fair enough. I love that. And that jibes with a lot of other data with blue zones and multi-generational community in a sense of relational. We know that social isolation is a risk factor for Alzheimer's and memory loss. And I also think that if you have community, if you're in relationship, then you also have opportunities for collaborative play. So exercise, right? Or going for a walk
Starting point is 00:36:53 with someone. I always tell people, your 30-minute walk is great. But can we make a bigger bang for that buck? Can you go for a walk with someone? Then you're in conversation, that conversation's never happened before. So you're waking your brain up. If you're really listening, then you're building new neural connections because you're talking about something that hasn't happened before. And you're not isolated anymore. So you're in relation and you're connected to someone you care about.
Starting point is 00:37:19 And then I also add another, a third layer on that walk somewhere you haven't been before or get out of your routine. So if you're always walking the neighborhood, go downtown. Or if you're always walking the beach, go into the mountains, or try a new neighborhood, and look at the houses in a different scenery. So our brains have evolved to remember what's meaningful, emotional, surprising, or new,
Starting point is 00:37:42 or what we've repeated practice. And they forget what isn't. Our brains forget what is routine, predictable, inconsequential, same old, same old. And so whenever you can do something with someone that's not same old, same old, you're really giving your brain some good stuff. This is awesome. Let's talk about sleep. I, as somebody who has struggled with insomnia, here, seven and nine hours a night of sleep. And just to say to the listeners, especially if you're new, we've done a lot of episodes on sleep, and I'll put some links in the show notes, because I've voiced this concern before. But people who are asleep evangelists will say, I can do all this good stuff for you, most notably, it can help you reduce the odds of dementia
Starting point is 00:38:22 and Alzheimer's. And I hear that as kind of terrifying because there are not a few nights where I can't sleep and that if I recall that information, it makes me even more fucked. So what advice do you have? I'm so glad you're bringing this up because I talk about this a lot all over the world. And sleep is the thing that people are scared of the most because a lot of people struggle with this. And to your point Dan, I mean, I think throughout life, if we just look at women, if you've had children, there's the pregnancy where you probably didn't sleep well,
Starting point is 00:38:53 and then there's the newborn phase where you probably didn't sleep well, and then there's paramanopause and menopause, and then the man is like all of the reasons that you have with the stress and anxieties of your lives, and then there's enlarged prostate, and you're up all night, going to the bathroom to pee. So there's all these reasons why we humans at different phases of life have disrupted sleep. The good news I want to lead off with is we're very resilient. So we don't get Alzheimer's overnight
Starting point is 00:39:18 if we had a bad night's sleep last night. The way I like to look at it is every night that I can give myself seven to nine hours of sleep, I'm doing something really good for my brain that's helpful. And so let me just explain three things that are happening in your brain while you sleep, that are helpful for memory and preventing your risk of Alzheimer's. And again, you have to remember that you're not going to wake up tomorrow with amnesia if you don't get a good night's sleep tonight.
Starting point is 00:39:46 So we just want to do the best we can. Dan, I think it's still a worthy goal. And I understand that it's tough for a lot of us. And in different phases of life, it will be harder than others. But I still want folks to not be demoralized here. Because here's the deal. Sleep is not an unconscious state of doing nothing. We're so biologically busy while we sleep, right?
Starting point is 00:40:05 Why would we spend a third of our lives unconscious being vulnerable to attack, right? And predators, it's because so many important things are happening. And so with respect to memory, three things. The first is all of the information that you perceived and paid attention to, that you cared about today,
Starting point is 00:40:25 things that, you know, were meaningful, emotional, surprising, new, or whatever you practiced today, become consolidated into memory. What does that mean? It means it becomes linked together into a stable neural network while you sleep. Okay? So if you don't get a full-night sleep and it's both quality and quantity, there are certain stages of sleep It happened through the night that knit that information together into a memory Then tomorrow when I wake up that memory might not be fully formed or it might not be formed at all It might be something that I end up forgetting So that's one thing the other is it has to do with attention
Starting point is 00:41:03 So I already told you that the first necessary ingredient in creating a memory that's going to last longer than right now is my attention. If I got a crappy night's sleep last night, my frontal lobe is going to have a hard time coming to its day job today. I'm going to be really groggy and like, oh, I can't, I've got to have a hard time paying attention to what you're saying to me because I'm tired. And so if I can't, I got to have a hard time paying attention to what you're saying to me because I'm tired. And so if I can't pay attention to what's happening today because I'm tired, I can't make new memories today. And the third thing has to do with Alzheimer's. So while we sleep, the sewage and sanitation department of your brain, these are your glial cells.
Starting point is 00:41:39 They go to work. So all the janitors go to their jobs and they start clearing away all the metabolic debris that accumulated in your brain while you were in the business of being awake. And one of the critical things that clears away is a protein called amyloid beta. Now if amyloid beta is not cleared away, it's a sticky protein and it'll bind to itself and form plaques. And so if you do this over and over again, if you don't clear away your amyloid beta and it's allowed to accumulate, again, not overnight, we think it takes 10 to 20 years of accumulation, it will then reach a tipping point that triggers a molecular cascade that causes what we experience as dementia and Alzheimer's. So the good news here is that we have a lot of room with that
Starting point is 00:42:25 amyloid plaque accumulation. Sleep can help clear the amyloid away and so does exercise and meditation and eating and meditating and diet. So there's lots of ways we can clear it away. Sleep is just one of the tools in your tool belt for clearing amyloid away so that you don't reach that tipping point and you might never get Alzheimer's. I was reflecting while listening to you on the irony of the fact that one of the most pleasant and engaging guests we've had on the show in a long time is the Alzheimer's lady.
Starting point is 00:42:53 So, Akudos to you for making all this fun to talk about. But just to pick up on what you're actually saying there, what I hear is, yes, sleep is really important, not only for long-term brain health, as it relates to Alzheimer's, but only for long-term brain health, as it relates to Alzheimer's, but also for your day-to-day function. And you wanna just do your best without freaking out about it.
Starting point is 00:43:13 And there are many other levers we can pull from exercise to meditation that will have similar benefits. So do your best, but don't freak out. Absolutely, yeah, because freaking out is going to then lead to a problem, right? So as I tell people like, oh, if every time you forget something, you freak out and become stressed out and anxious and embarrassed and upset and judge mental and all that and you're head off, I have a horrible memory. I'm probably going to get Alzheimer's and you're worried. Well, all of that stress, if it's chronic, is going to lead to actual memory
Starting point is 00:43:44 problems. So yes, just like you said, is going to lead to actual memory problems. So, yes, just like you said, we need to give ourselves a break. So, have the best of intentions, and we want to make this a priority, and it's not going to go perfectly. That's okay. We've got room. To put a fine point on it and take us back into a little bit of a darker territory here, and I say this, hopefully, in the spirit of a PSA,
Starting point is 00:44:02 I have two very close relatives, both male, both with severe dementia right now, both of whom had decades long untreated sleep apnea. And I'm not a doctor, although I'm married to one, and I have a pretty strong suspicion that that untreated sleep apnea was the very least a contributor to their current conditions. Yeah, I'd agree. It contributed. Yeah, and it's not, unless you have familial early onset Alzheimer's like the kind of gave to Alice and still Alice
Starting point is 00:44:32 where a single genetic mutation is going to cause this disease no matter what you do. And that's a very small percentage, like 2% of Alzheimer's is that. For the rest of us, for 98% of folks, you have a lot of agency over getting this disease. And so there's a, you know, sleep apnea. If you think of it like a seesaw scale and you're piling things on it when that hits the floor, you're going to get Alzheimer's. Well, sleep apnea was
Starting point is 00:44:56 on that side of the scale that tipped it a bit, but that alone wasn't the reason. There's likely more things that contributed to the development of that. Coming up Lisa talks about the foods that are the best fuel for your brain and the best exercises for reducing the risk of dementia and Alzheimer's. Bosch legacy, now streaming. Matt has been taken.
Starting point is 00:45:26 Oh God. His daughter. He's in the hands of a madman. What are the police have been looking for me? But nothing can stop a father. We want to find her just as much as you do. I doubt that very much. From doing what the law can't.
Starting point is 00:45:41 And we have to do this a by way. You have to. I don't. Bosch Legacy watched the new season now streaming exclusively on FreeVee. Today, hip-hop dominates pop culture, but it wasn't always like that. And to tell the story of how that changed, I want to take you back to a very special year in rap. 88, it was too much good music.
Starting point is 00:46:05 The world was on fire. I'm Will Smith. This is Class of 88. My new podcast about the moments, albums, and artists that inspired a sonic revolution. And Secured 1988 as one of hip-hop's most important years, we'll talk to the people who were there. And most of all, we'll bring you some amazing stories. You know what my biggest memory from that tour is? It was your birthday.
Starting point is 00:46:32 Yes, and you brought me to Shoday Life Size hard work. This is Class of 88, the story of a year that changed hip hop. Listen to Class of 88 wherever you get your podcasts. You can binge the entire series right now on the Amazon Music app or Audible. You have references already, but I suspect there's more to say about both diet and vitamins. Mostly, if you're actually eating the right diet,
Starting point is 00:47:03 you're getting all of the vitamins and the micronutrients that you need. That said, we know you need B12, we know you need vitamin D for good cognition and memory. So if as long as your vitamin D levels aren't low and your B12 isn't low, there aren't any recommended vitamins that enhance memory that have been shown in any clinical study. Okay. So what do you need to eat? Well, can I stop you on the vitamins for a second? Yeah. So I don't know why or how I got into this habit, but I take vitamin B 12 and vitamin D every morning. I guess the D is because I had benign tumor on my face.
Starting point is 00:47:39 And so I wear a lot of sunscreen. And so I try to get outside a lot, but I'm also very careful about not getting direct sunlight. So I do that. And then the B12, I think I started taking when I was a vegan and then a vegetarian. So should I stop doing that? Keep doing it. I mean, you're not a physician, but generally speaking, are these good things to investigate? Again, if you go to your annual physical and you can ask your doctor if you need to continue or not, they're not going to hurt you. You're not going to use more of it. It's like, well, if I have more B12, then I'll remember more. It's like, no, you're just going to pee it out. So you just have expensive pee if you don't need it. Yeah. So omega three fatty acids or another supplement
Starting point is 00:48:22 folks can take that is actually very good for your brain, but you can get that in diet. Again, I think that getting these vitamins in a diet that are surrounded by fiber and other micronucutrients we might not have even figured out yet, it's always the way to go. Because we've evolved our brains, our bodies, it's all evolved to use what is in nature.
Starting point is 00:48:44 So if you can eat the Mediterranean and mine diet, basically this is a way of eating that focuses on sort of like sleep, again, folks, you're not gonna be perfect at this. This isn't like, oh, I'm not gonna try it because I can't give up donuts and bacon. It's like, no, you're gonna eat, you know, I'm gonna eat a canoli when I'm in the north end of Boston.
Starting point is 00:49:05 Like it's okay to enjoy these things that aren't on the diet, it's not perfect. But whenever you can, when can you incorporate these things into your day-to-day lives? So it's green leafy vegetables, it's brightly colored fruits and vegetables, it's the berries, it's nuts and beans, it's olive oil, it's fatty fish like salmon.
Starting point is 00:49:27 Those are the foods that are going to really be the high octane fuel for your brain, both today and preventing Alzheimer's in the future. The studies have been shown. They're really good. We know this. This is the science evidence-based knowledge that we have. So not the supplements you're seeing on YouTube. It's this. Whole foods, folks, get in the habit of buying vegetables and fruits and
Starting point is 00:49:49 beans and nuts and figuring out ways to toss those in your salad or your tomato sauce or get some good recipes on Instagram. It's delicious. It's a great way to live. Feels good. Yes, and have a donut once in a while. Oh, of course. It's not about perfection. It's about, can you give your brain something that's really great for it today? One of the meals today. Can you throw some blueberries on your breakfast? Can you eat a handful of berries instead of a handful of potato chips?
Starting point is 00:50:20 Can you swap something out? Just to be mindful of it again, getting to like meditation and mindfulness and how this can translate to everything we do, are you mindful of what you're putting in your body? Or is it just a habit? Is it just a mindless, oh, I'm hungry, I'm going to go grab a bag of tortilla chips. It's like if you can be mindful about, well, what do I want to feed my brain today? What do I want to feed my brain today? What do I want to feed my body today can make different choices. And finally, let's talk about exercise.
Starting point is 00:50:50 Not everybody is able-bodied, so if you can't go running, I would imagine walking is a good replacement. If you're in a wheelchair, it's about doing some trips in your wheelchair up and down the block or whatever. But all of this counselors, there's some form of exercise that's better than another. The data show that aerobic exercise and leg weight-bearing exercise has been shown to reduce the risk of dementia
Starting point is 00:51:17 and Alzheimer's significantly. So you're right, you don't have to go for a run. The data shows that it's a brisk walk and that means like walk like you're in a hurry, walk like you're trying, you don't have to go for a run. The data shows that it's a brisk walk, and that means like, walk like you're in a hurry, walk like you're trying to catch a flight. It's not a stroll at the very least. Or if you're able-bodied enough, can you involve physical activity that involves play? Because then you're using your brain in a more complicated way.
Starting point is 00:51:40 So like I take a dance class three days a week. I play pickleball, play tennis, a lot of people pick up golf on their older. Are there activities that you can do? Can you go swimming? So anything that feels a little more maybe playful might be a fun way to incorporate exercise that actually is a way to stick with it too. Because also if it's social, it's helping tick that box again too, relational, right? If we feel like we're part of a community, if we're in relationship, and if you're using your brain, like I go to dance class and I see people there who I love, and I'm using my brain to try and figure out that choreography.
Starting point is 00:52:16 And when we learn a new dance, it's cognitively exhausting in a really wonderful way. And that's just great aerobic workout. So I am always looking for ways to get a bigger bang for the buck. As you walk us through this incredibly helpful list of things we can do to improve our brain health, I keep thinking, and this may be just incredibly obvious, but I keep thinking that there's a social, cultural, political piece to this because there are many people who don't have access to healthy food, who don't have access to things that might reduce stress like a meditation app or a therapist,
Starting point is 00:52:50 whose lives are just inherently more stressful because they're surrounded by violence or they're being abused. And I don't know if there's a question here, but just to acknowledge that there's some structural unfairness. For sure. I think, as much as possible, it's helpful to share information that doesn't require signing up for a class that doesn't require anything expensive.
Starting point is 00:53:16 So yeah, I mean, the food piece, it can be expensive. If you buy seasonally, it's not. I mean, if you buy corn when it's in season or tomatoes when they're in season, their local produce tends to be cheap. If you have a yard, can you start a garden? Again, it's about prioritizing. And I get that in the moment fast food might seem like,
Starting point is 00:53:38 okay, it's the cheapest easiest thing. I gotta feed me and my family. If there's a way to do it economically now, you might be saving yourself some medical bills in the future. But yeah, that's a tough one, Dan. I mean, I need to burn the whole system down and start over for all the reasons. Yeah, I appreciate that acknowledgement. We're not trying to fix it necessarily, but just pointing it out, I think, is helpful. Let me just go back to some questions. I probably should have asked at the top of the interview, but I was just going with your flow and you said so many interesting things. In the book, you talk about
Starting point is 00:54:18 how we remember and you have a whole section called Making Memories 101. Can you give us the TLDR quick summary on that? Okay, so memory creation takes place in four basic steps. The first is your brain takes in all the sites, the sounds, the smells, the taste, the emotion, the language of whatever you perceived and paid attention to, and it translates all of that into neurological language. So basically the information from out there
Starting point is 00:54:43 goes into your brain. The second step is your brain takes all of the disparate neural activity, all of those different sites and sounds by neural activity in different parts of your brain. Your brain is taking all of that neural activity and weaving it into a single pattern of associated connections. So your brain's weaving all that information together. The third step is through changes in neural chemistry and neural architecture, that woven circuit actually becomes stable over time.
Starting point is 00:55:14 So it becomes a stable connected unit. And the fourth is either tomorrow or next week or 30 years from now, when any part of that neural circuit, that woven neural circuit is activated, it has the potential to activate the whole circuit and you can retrieve that woven information and that's remembering.
Starting point is 00:55:36 And as you said before, a necessary precondition, if you're gonna remember anything, is to pay attention. So if you're walking through your life as I often do, looking at your phone, thinking about something else, planning a homicide, whatever it is, you're going to be less likely to remember the shit that's actually happening to you. Yes, and this plagues us every day. And I think that there's this misconception out there that memory is supposed to be perfect, and we're
Starting point is 00:56:01 supposed to remember everything. And this is why people freak out when they can't find their glasses or their phone or you're driving in your car, Dan, and all of a sudden you realize you don't remember the last 20 minutes of the trip. You're like, oh my god, what just happened? I've been in my car, I've been unconscious. These are moments where it's actually all about attention. And this is why again, things like meditation can help you get really good at paying attention. You don't remember where you put your glasses and your keys in your phone because you
Starting point is 00:56:31 weren't paying attention to where you put them, has nothing to do with forgetting, because you never made the memory in the first place. Driving, if you're driving a familiar stretch of road, the example I use in the book is I regularly cross the Sagamore bridge on my way from Boston to Cape Cod. This is a huge bridge. It's four lanes. It's like you cannot miss this structure. And I will be 10 minutes past the bridge and suddenly have the freaked out moment where I think, wait, where am I? Did I already go over the bridge? Like, what happened? And so what did happen here? So my eyes were open. The visual information
Starting point is 00:57:06 of the bridge went into my brain. It went into the occipital cortex in the back. That's where you see. You don't see in your eyes. You see in your brain. So the bridge went into my brain. And I didn't forget how to drive. You know, I didn't crash the car. I made it safely over the bridge. So that was online. My memory for how to drive was fine. That's not like I'm asking my brain to remember something that happened 30 years ago. This happened 10 minutes ago. I have no recollection of it. It's because I wasn't paying attention, because I've gone over that bridge so many times. So it wasn't meaningful emotional surprising or new to me. All right. And because I was probably lost in thought, or as listening to an audiobook, the experience of going over it
Starting point is 00:57:48 goes out of my brain and it's gone within seconds. It's not woven into a memory. But just to pick up on something, you said this at the beginning of the interview, but I failed to put a pin in it then, but I'm gonna do it now. There is such a thing as normal forgetting and we don't need to worry too much about it,
Starting point is 00:58:06 and think that if we're forgetting some stuff, we are on the fast track to Alzheimer's. Right, so again, people think our brains are supposed to be able to remember everything, and our human brains were not designed to remember people's names, to do something later, or to catalog everything we encounter.
Starting point is 00:58:28 I mean, those are really just the factory settings. And so to expect more of it is not reasonable. And so it's helpful to know what's happening and why our brains aren't good at remembering names and why I'm not gonna remember to pick up the five things you need at the grocery store later unless you make a list or have some kind of memory device to remember them. You should write down everything you need to do later.
Starting point is 00:58:51 You should have checklists to do lists. You should outsource. It's called your prospective memory. It's terrible. It is not reliable in any human being. No matter how good your brain is, no matter how smart you are. This is why surgeons now use checklists and pilots use checklists, so they remember to lower the wheels of the plane before landing. Like if they use checklists for such important things, we should probably use them too. Like for getting someone's name,
Starting point is 00:59:17 people freak out about this one all the time. Like, oh my God, there must be something wrong with my memory or maybe I'm getting Alzheimer's because I can't remember the name of the Netflix show. My friend recommended this morning and I'm trying to watch it tonight. I don't know what it was and I can't remember this guy's name. He just introduced himself to me and I'm in conversation with him 30 seconds later and I can't remember what he told me. But our brains aren't designed to remember names. So proper nouns. So cities, book titles, movie titles, names, think of them as living in neurological cul-de-sacs. These words are super hard to reach.
Starting point is 00:59:49 It's ultimately only one road that leads to that address. I'm like common nouns, which you can think of living on Main Street. And there's lots of neural connections, lots of roads that lead to them. So we can give ourselves a break. It's normal for us to have that tip of the tongue, like, oh, what's this name? I can't get to it. And then by the way, folks, totally okay to Google it. I think that Dan, like, people our age and older,
Starting point is 01:00:11 we think we've got a muscle through. And like, if I look this up, I'm gonna make my memory worse. I'm gonna weaken my brain. If I look it up and it's cheating, it's not. Your brain isn't doing anything useful when it can't get to that word in the cul-de-sac. It's actually probably on a related word. So it's usually like the same first letter
Starting point is 01:00:31 or something similar in sound or meaning, but it's not. So like the example I used is I was trying to come up with a name of a famous surfer. And I said, is it Lance? Like no, it's not Lance, but that sent my brain to Lance Armstrong. So now I'm like in the neighborhood of my brain where there's like Tour de France and Cheryl Crow and and and that.
Starting point is 01:00:51 And it's not that. So if I stay trying to find that I'm just in the wrong neighborhood, I'm not doing anything useful. And this is why once you stop trying to find the name that you can't come up with, like you're in the car or you're in the shower later and all of a sudden, you're like, oh my God, it's layered Hamilton. That's because by calling off the hunt, I can stop putting energy in the wrong neural neighborhood and I can give the correct set of neurons a chance to get activated. Or I can just look it up, which is what young people do because they've had their smartphones
Starting point is 01:01:19 forever. So yeah, you can Google what you can't remember. In the closing section of your book, you talk about the memory paradox. What is that? So the memory paradox is this idea. We touched on it a little before where memory is this incredibly important essential thing that we use all day long every day. It's very much essential to the business of being human. And yet, it's also a bit of a dance, right? Because you don't remember most of your own life, Dan, because most
Starting point is 01:01:50 of our lives are spent doing routine, predictable things, right? We get up, dressed, coffee, three meals, do the business of what we do every day, it's similar. So unless something meaningful happens, like I will remember this, this is not my usual day to day, but we don't remember most of our own lives. So, like, memory is amazing, but it's also kind of dumb. So, my take home is like, maybe we can take it seriously, but hold it lightly. Like, maybe we can, you know,
Starting point is 01:02:15 if we recognize that memory is awesome and limitless, by the way. At any age, I can learn a new language, play guitar, I can learn all the words to the latest Taylor Swift song like at NEA, right? I'm also gonna forget things like, where I put my phone and I can't remember my fourth grade teacher
Starting point is 01:02:32 and I forgot to pick up the dry cleaning and it's gonna do the, you know, oh, who played, who was in the movie with so and so. Like, it's gonna do those things. So if we recognize, well, it's awesome, I should take care of it. So I will do things like regularly exercise, try to get a good night's sleep, try to eat foods on the Mediterranean diet, stay socially connected, and reduce my reactivity to chronic
Starting point is 01:02:57 stress, make those priorities. So I think we can be more relaxed and forgiving of ourselves when we have these moments of forgetting that are normal and when recognizing that they are normal gives us a chance to sort of exhale and be less stressed about forgetting, which is lovely because if we stress about forgetting, it will happen more often. I love that. Take it seriously. Hold it lightly.
Starting point is 01:03:21 One last little question here, Brian, the aforementioned engineer on this episode. He pointed out something that I knew, but I had to be a little cute, forgotten to ask about, which is that, and I've seen this, Alzheimer's patients, often people who aren't responsive too much, they will often respond to music. Why is that? Such a great question. And it's so true, and it's really magical when you see it happen. So, again, I remember I told you that memory is a circuit. It's a woven circuit and it's sites and sounds and emotion and language. It's all of those nodules, all of those elements woven together. An activation of any one of those nodules can serve to activate the rest
Starting point is 01:04:04 of the circuit. So they weren't playing the latest Taylor Swift song to this person with Alzheimer's. My bet is that they were playing a song from back when this person was in their 20s maybe, right? So your most recent memories in personal history go first. So what you said two minutes ago is shaved away. What happened yesterday might get shaved away. What happened last year is harder for me or might be no longer accessible. But 30 years ago might be totally fine. So if I can play a song from that part of their lives,
Starting point is 01:04:36 not only do I remember the song, but I might remember those other nodules that that song's attached to, right? So if you are driving in your car and a song comes on the radio, you haven't heard since you were a teenager. You still know all the lyrics to this song. You haven't practiced in 30, 40 years.
Starting point is 01:04:52 And like, oh, no, I remember the guy who was seeing I was living in Bethesda, blah, blah, blah. Like it's all those memories come back. We remember the lyrics to these songs because the radios overplay them. So you had a lot of practice. We remember what we repeat in practice. And there might be an emotional element, right?
Starting point is 01:05:10 We remember what's meaningful, emotional, surprising, new, and what we repeat in practice. So for the person with Alzheimer's, songs from the past can unlock the joy of that song for that person and any memories related to that song. Because I think we can all understand that experience of like, oh, that's the song that I used to love and I used to go for runs to or I used to dance to or I used to hear on the radio when I was driving when I was at this point in my life.
Starting point is 01:05:39 So that's how that works. You've been such a pleasure to talk to, which is again, so counterintuitive given the subject matter. Before I let you go, is there anything else you want to cover that I didn't give you a chance to? No, I think we did great. Thanks, Dan. You did great. Can you just please shamelessly plug, remember, and any other books, or any other resources at all that you want us to know about? So, yeah, my most recent book is Remember what we're talking about now,
Starting point is 01:06:04 and I'm back to writing fiction. I just finished a novel about a young woman with bipolar disorder, that will be out late next year. And we might push it a little because I don't want it to come out in the middle of the election, which we might all be very distracted by. But yeah, I'm very excited to use story as a vehicle for empathy and conversation about mental illness and bipolar in particular, that's next up for me.
Starting point is 01:06:28 But people can follow me on social media. I'm on Instagram and Facebook and my website'slesigenova.com. Thank you so much, Lisa. Great job with this, really appreciate it. Oh, you're welcome, Dan. My pleasure, I'm a huge fan. I love what you do.
Starting point is 01:06:41 I love that you're devoting your time and energy and heart to something so helpful. Like you've helped me, so thank you. I really appreciate that. Thank you. Thanks again to Lisa Genova. Ran into her actually a few weeks after we recorded this interview and she was just as awesome in person as she is on Zoom. Thank you to you for listening. I could not and would not do any of this without you, so I'm genuinely grateful.
Starting point is 01:07:04 And most of all, I want to thank everybody who worked so hard on this show. 10% happier is produced by Gabrielle Zuckerman, Justinian Davey Lauren Smith and Tara Anderson. DJ Cashmere is our senior producer, Marissa Schneiderman is our senior editor. And Kimmy Regler is our executive producer, scoring and mixing by Peter Bonnaventure of Ultraviolet audio and Nick Thorburn of the band Islands wrote our theme. We'll see you all on Wednesday for some Dharma with Lama Radoens. Hey, hey prime members, you can listen to 10% happier early and ad-free on Amazon music. Download the Amazon Music app today,
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