Ten Percent Happier with Dan Harris - How To Prevent Dementia | Lisa Genova
Episode Date: October 30, 2023Understanding 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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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
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,
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.
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.
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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
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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
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.
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.
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.
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.
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.
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.
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
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
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
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,
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
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,
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.
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.
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
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.
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
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
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.
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
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.
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
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,
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
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?
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.
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.
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
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.
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
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.
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
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
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
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.
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
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
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.
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,
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.
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
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.
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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,
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
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
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.
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.
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,
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.
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.
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
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.
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.
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,
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,
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
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.
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.
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,
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.
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.
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
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.
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
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.
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.
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
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
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.
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,
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
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,
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
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.
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?
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,
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
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.
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
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.
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.
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
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,
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
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
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.
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.
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.
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.
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,
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.
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
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.
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.
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.
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
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?
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.
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
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.
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.
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,
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.
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,
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
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
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.
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.
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
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
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
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
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,
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.
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.
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,
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.
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,
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
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.
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
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
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,
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
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
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.
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
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,
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.
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?
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.
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,
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.
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.
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.
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.
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