How To Prevent Dementia | Lisa Genova
Neuroscientist Lisa Genova, Ph.D., discusses the distinction between normal forgetting and actual memory loss, offering reassuring insights. She highlights practical, evidence-based lifestyle strategies like sleep, exercise, and diet to significantly reduce the risk of Alzheimer's and improve brain health.
Deep Dive Analysis
16 Topic Outline
Distinguishing Normal Forgetfulness from Alzheimer's Concerns
Lisa Genova's Personal Journey into Memory and Dementia
Understanding the Internal Experience of Living with Alzheimer's
Current Medications and Treatments for Alzheimer's Progression
Lifestyle Factors for Preventing Alzheimer's and Dementia
Clarifying the Difference Between Dementia and Alzheimer's
Why Brain Games Don't Work and How to Build Cognitive Reserve
The Role of Meditation in Brain Health and Stress Reduction
Importance of Social Connection and Relationships for Brain Health
The Three Ways Sleep Benefits Memory and Prevents Alzheimer's
Dietary Recommendations and Vitamins for Optimal Brain Health
Best Types of Exercise for Reducing Dementia and Alzheimer's Risk
Making Memories 101: The Four Steps of Memory Creation
Understanding Normal Forgetting and Why Our Brains Forget
The Memory Paradox: Taking Memory Seriously, Holding it Lightly
The Unique Connection Between Music and Memory in Alzheimer's
6 Key Concepts
Dementia
Dementia is an umbrella term for a symptom, characterized by an impairment in memory, language, or cognition that is out of proportion to one's age and education level. It can be caused by various underlying conditions, with Alzheimer's being the most common cause over the age of 70.
Alzheimer's Disease
Alzheimer's is a neurodegenerative disease that causes a progressive loss of access to memories, starting with the most recent and personal history. While it impacts memory and cognitive functions, it notably does not steal the ability to feel human emotion, such as love, sadness, or joy.
Cognitive Reserve
Cognitive reserve refers to the brain's ability to withstand the effects of pathology, like Alzheimer's, without showing clinical symptoms. It is built by learning new and complex things, which creates new neural connections and pathways, providing redundancy and alternative routes around any 'roadblocks' caused by disease.
Memory Creation (Four Steps)
Memory creation involves four basic steps: first, the brain translates perceived information (sights, sounds, emotions) into neurological language. Second, it weaves this disparate neural activity into a single pattern of associated connections. Third, this circuit becomes stable through neural changes. Fourth, later activation of any part of this circuit can retrieve the entire woven memory.
Normal Forgetting
Normal forgetting is the brain's natural tendency to not remember everything, especially routine, predictable, or inconsequential details. Often, what feels like forgetting is actually a failure of attention, meaning the memory was never properly formed in the first place, or it involves proper nouns which are neurologically harder to access.
Memory Paradox
The Memory Paradox describes the dual nature of memory: it is an incredibly important and essential human function, yet it is also fallible and 'a bit of a dunce' because it doesn't retain most of our routine lives. The paradox encourages taking memory seriously by caring for brain health, but holding it lightly by being forgiving of normal, everyday instances of forgetting.
10 Questions Answered
Normal forgetting often occurs because you didn't pay attention when the information was presented, or it involves proper nouns which are neurologically harder to retrieve. Early Alzheimer's, however, involves not remembering how you got somewhere, not recognizing your own car, or being unable to keep track of information you know you should.
Dementia is an umbrella term for symptoms like impaired memory, language, or cognition that are out of proportion to age. Alzheimer's is the most common *cause* of dementia, especially over age 70, but dementia can also stem from other conditions like B12 deficiency or chronic sleep deprivation.
Yes, meditation helps by reducing reactivity to chronic stress, which is detrimental to memory and increases Alzheimer's risk. Chronic stress can shrink the hippocampus (essential for new memories), and meditation can restore cortisol levels and hippocampus size.
These games primarily involve retrieving already known information and don't build new neural pathways. To build a cognitive reserve against Alzheimer's, one needs to learn new, complex things that create new neural connections, like learning an instrument or a new sport.
Sleep is crucial for memory consolidation (linking information into stable neural networks), improving attention for new memory formation, and clearing metabolic debris, including amyloid beta protein, which accumulates to form plaques that trigger Alzheimer's.
The Memory Paradox highlights that while memory is essential and amazing, it's also imperfect and forgets most routine aspects of our lives. The paradox suggests taking memory seriously by caring for brain health, but holding it lightly by being forgiving of normal, everyday forgetting.
Music from a person's past (e.g., their 20s) can activate a woven neural circuit of memories, including the song itself and associated emotions or life events. This is because older memories are often more preserved, and music can serve as a powerful trigger for these emotional and repeated experiences.
Historically, no, but recently, a couple of new FDA-approved intravenous drugs have shown to slow cognitive decline in people with mild cognitive impairment or early Alzheimer's by about 25-30%. These are not 'magic pills' but are encouraging first steps.
Attention. If you don't give something your attention, you cannot form a memory of it, leading to the feeling of forgetting when the memory was never actually made.
It's perfectly fine to look up information. Your brain isn't doing anything useful when it's stuck trying to retrieve a word in a 'neurological cul-de-sac.' Looking it up allows your brain to stop expending energy in the wrong neural neighborhood and gives correct neurons a chance to activate.
21 Actionable Insights
1. Recognize Agency Over Brain Health
Understand that you have significant influence over your brain health and memory through lifestyle choices, which can contribute to your ability to remember today and prevent future Alzheimer’s.
2. Embrace Memory Paradox: Act & Forgive
Take memory seriously by prioritizing brain-healthy habits (exercise, sleep, diet, social connection, stress reduction), but hold it lightly by forgiving yourself for normal forgetting, as this reduces stress that can harm memory.
3. Prioritize 7-9 Hours Sleep
Aim for seven to nine hours of sleep per night, as this helps clear amyloid beta from the brain and can reduce the risk of Alzheimer’s by about half.
4. Engage in Aerobic Exercise Daily
Perform 30 minutes of aerobic exercise, such as brisk walking (like you’re in a hurry), five days a week, to reduce your risk of Alzheimer’s and dementia by a third to a half.
5. Adopt Mediterranean or MIND Diet
Regularly follow the Mediterranean or MIND diet, which has been shown to reduce the risk of dementia by 40-60%.
6. Meditate to Reduce Chronic Stress
Meditation helps reduce your reactivity to chronic stress, restoring cortisol levels and hippocampus size, thereby protecting memory and reducing Alzheimer’s risk.
7. Cultivate Strong Social Relationships
Prioritize and maintain good social relationships, as strong connections help manage stress, combat social isolation (a risk factor for Alzheimer’s), and contribute to longevity and brain health.
8. Learn New, Complex Things
Instead of brain games, build an Alzheimer’s-resistant brain by learning new and complex things like reading books, listening to podcasts, learning an instrument or sport, or visiting new places, as this creates new neural connections.
9. Cultivate Attention for Memory
Consciously pay attention to what you want to remember, as attention is the first necessary ingredient for creating a lasting memory, preventing everyday forgetfulness like misplacing items.
10. Outsource Prospective Memory with Lists
Use checklists, to-do lists, or other external tools to outsource your prospective memory (remembering to do things later), as it is inherently unreliable for all humans.
11. Don’t Stress Over Imperfect Sleep
While aiming for 7-9 hours of sleep is important, avoid stressing over occasional bad nights, as chronic stress itself can harm memory; instead, focus on doing your best each night, recognizing your resilience.
12. Accept Normal Forgetting, Reduce Stress
Recognize that normal forgetting (like names or where you put things) is common and not a sign of Alzheimer’s; stressing about it chronically can actually lead to memory problems, so give yourself a break.
13. Treat Untreated Sleep Apnea
If you suspect or have untreated sleep apnea, address it, as it can be a significant contributor to the development of dementia and Alzheimer’s.
14. Eat Brain-Boosting Whole Foods
Incorporate green leafy vegetables, brightly colored fruits and berries, nuts, beans, olive oil, and fatty fish like salmon into your diet for high-octane brain fuel, both for daily function and Alzheimer’s prevention.
15. Engage in Aerobic & Playful Exercise
Prioritize aerobic and leg weight-bearing exercises like brisk walking, or engage in playful physical activities such as dance, pickleball, or swimming, which use your brain in a more complex way and reduce dementia risk.
16. Enhance Walks with Social & Novelty
Maximize the benefits of exercise by walking with someone to engage in conversation and choosing new, unfamiliar routes or locations to stimulate your brain and build new neural connections.
17. Practice Mindful Eating Habits
Be mindful of your food choices, consciously deciding what to feed your brain and body rather than mindlessly grabbing habitual snacks, to make healthier dietary decisions.
18. Google Forgotten Information
Don’t hesitate to Google names, facts, or words you can’t recall, as your brain isn’t doing anything useful by staying stuck on the ’tip of the tongue’ and looking it up is not cheating or weakening your memory.
19. Obtain Vitamins from Diet, Check D/B12
Focus on getting necessary vitamins and micronutrients from a balanced diet, as supplements beyond B12 and Vitamin D (if deficient) are generally not proven to enhance memory and may just result in expensive waste.
20. Practice Improv with Alzheimer’s Patients
When interacting with someone with Alzheimer’s, agree to their reality (‘yes, and…’) rather than correcting them, to maintain emotional connection and build a relationship.
21. Use Music for Alzheimer’s Connection
Play music from an Alzheimer’s patient’s younger years, as familiar songs can activate related memories and emotions, bringing joy and connection even when other memories are inaccessible.
6 Key Quotes
Memory does not define what it means to be human.
Lisa Genova
The first necessary ingredient in creating a memory that lasts longer than this present moment is attention.
Lisa Genova
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.
Lisa Genova
Your predator is the thoughts in your head that are constantly running.
Lisa Genova
Take it seriously, but hold it lightly.
Lisa Genova
It's not my job to reality orient her to what's quote real and say, 'Well, you know, your mother died 30 years ago' because now she's going to be reliving that as new information right now. Instead, I can agree to it.
Lisa Genova