Neuroscientist: “Alzheimer's May Be Optional” (95% of Cases Are Preventable)
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White powder in front of speaker is creatine. Phenomenal research shows creatine counters sleep deprivation, protects brain against concussion, stroke, stress. Study on Alzheimer's patients: preserved cognitive functions, more energy, able to exercise more.
Speaker is clinician surrounded by greatest neurosurgeons over last decade studying brain. Tackling Alzheimer's disease, starts in 30s, 60 million worldwide, 70% women. Women lied to, underrepresented, downplay symptoms, scared to ask doctors. Preventable disease, but like end-stage cancer, no cure once diagnosed.
Becoming more sedentary is a disease. Study: 10 air squats every hour compensates for sedentary lifestyle. Several lifestyle factors lower Alzheimer's risk. 5 minutes a day with tennis ball and eye patch improves brain performance.
Louisa studied brain last decade as clinician and academic. Tackling Alzheimer's: 60 million worldwide now, triples by 2050, 110 million women by 2050. Robs identity.
Henry is 2 lb model brain, feels like tofu in real life.
Women disproportionately affected not just because they live longer; dementia/Alzheimer's not part of natural brain aging. Being woman is risk factor.
95% of current Alzheimer's cases preventable; disease of lifestyle, not genetics. Born with genetic makeup (e.g., chromosome 4 mutation causes Huntington's inevitably). Alzheimer's: 20-30 genes involved, only 3% cases from genetic mutations (presenilin 1, presenilin 2, amyloid precursor protein).
Dementia umbrella term; Alzheimer's is form of dementia (others: frontotemporal like Bruce Willis, Lewy body, Parkinson's, vascular). Disease of midlife, starts in 30s, symptoms late 60s/70s+.
Brain fully develops 25-30. Then decline if not cared for. Brain: 87 billion neurons, 5-10,000 connections per neuron (cerebellum Purkinje cells up to 50,000). Takes 20% daily calories, most vascular organ.
Erosion from sleep deprivation, poor diet, lack activity, toxins compounds over time. One night sleep deprivation raises amyloid beta risk (Alzheimer's hallmark) by 4%. Compounding for new mothers, shift workers, residents leads to neuronal loss (mild cognitive impairment, pre-dementia).
Sagittal brain view: healthy brain thick gray matter, voluminous, small ventricles. Alzheimer's: thinning cortex, atrophied gray matter, enlarged spaces/ventricles, brain shrinks.
At 30, doing everything right affects 70-year-old brain variance. Some 60-year-olds razor sharp in articulation, memory, stats/stories understanding.
Cognitive reserve: brain's capacity to overcome stresses (analogy: VO2 max for physical fitness/reserve against infection, sleep deprivation). Woman 80 with head full amyloid beta can retain functions; another with little loses them due to reserve.
5-10,000 connections per cell for thinking/processing. Every thought builds connection. Novelty enriches/stabilizes. Dendrites (branches) with dendritic trees connect to 10,000 cells; fail if unused.
Build reserve: exercise (most potent for brain health/Alzheimer's prevention, enlarges brain). Study: handwriting/reading preserves capacity at 75.
Social media scrolling opposite: short dopamine hits hinder sustained focus/reading/conversation. Brain for survival/reproduction.
80% US population no 30+ min exercise/week. Guidelines: 150-300 min moderate-vigorous/week.
Biggest ROI: resistance training (strength training). SMART trial: mild cognitive impairment group, 2-3x/week resistance preserved/enhanced cognitive functions, processing speed, fluid intelligence, slowed gray matter loss.
Brain: gray matter (outer cell bodies), white matter (inner myelinated neurons; lesions over time).
APOE4 gene: strongest risk factor, not inevitable. Chris Hemsworth has two copies. Variants: APOE2 (protective), APOE3 (neutral, speaker is 3/3), APOE4 (1 copy: 2-3x risk males, 6x females; 2 copies: 10x males, 15x females). Simple blood test via doctor.
Strong legs most important for Alzheimer's prevention. Identical twins study (same genetics, 10 years tracked via cognitive tests/MRIs): twin with greater leg strength/power had bigger brain, larger gray matter, preserved functions, better tests.
Resistance at 80% 1RM (heavy) for neural effects. Heavy vs light: both build muscle, but heavy best for brain.
Lifting heavy releases myokines from muscle to brain: boost cognition, grow/proliferate new neurons in hippocampus (first shrinks in Alzheimer's, memory/learning area; short-term memory first lost).
BDNF (brain-derived neurotrophic factor) growth factor released in aerobic (running/cycling) and resistance. Irisin myokine helps BDNF expression, crosses blood-brain barrier.
IL-6 (interleukin-6, pro-inflammatory cytokine normally) from exercise acts anti-inflammatory, lowers brain inflammation, downregulates tumor growth (exercise anti-cancer).
30 min/day aerobic downregulates 13 cancers (breast, colon, prostate most studied) via myokines/natural killer cells that target tumors.
Motor cortex real estate: heavier lifts require more neural drive, better for brain.
One exercise for life/brain: deadlift (uses nearly every muscle: glutes, quads, serratus anterior, calves; barbell squat comparable).
WHO: increasingly sedentary due to technology. Cleveland Clinic 2025 study: active sedentary (30-60 min exercise but 10+ hours sitting/day) raises cardiovascular risk despite goals; prolonged sitting shuts down lipoprotein lipase (burns fat, cleans blood glucose).
10 air squats every hour changes trajectory, compensates sedentary life (beats 30 min power walk over 8 hours). Helps post-meal glucose spikes.
Aerobic great for prevention. Women dilemma: zone 2 debate.
Zones: Zone 1 conversational rest. Zone 2: ~60% max heart rate, jogging (conversation possible but huffing). Energy from mitochondria (ATP). Zone 3-5: cytoplasmic glycolysis, produces lactate (brain fuel, myokine).
Zone 3, zone 4, zone 5 exercise is recommended for women over zone 2. All forms of exercise are beneficial, but midlife women are time-poor and get less return on investment from zone 2 compared to men. Prioritize zone 5, then zone 3/4/5; add 2-3 resistance training sessions weekly. This totals around 4 hours; add zone 2 only if time allows. Zone 2 provides BDNF secretion, sustained blood flow delivering oxygen and nutrients to the brain, but lacks complete effect on heart chambers.
Outdoor exercise stimulates the brain more than treadmill due to visual, auditory, sensory inputs, forward ambulation boosting drive, motivation, dopamine, and downregulating inflammation. However, 20 minutes of zone 5 high-intensity is better for the brain than 5 km outside.
Zone 5 benefits heart chambers, especially left ventricle, which pumps oxygenated blood prioritizing the brain. Aging causes arterial stiffening and left ventricular hypertrophy, thickening the ventricle and reducing pumping strength. Dr. Ben Levine's landmark study on sedentary males (average age 47-55) used ~4 hours weekly exercise: 1 resistance session, high-intensity at 90% max heart rate (VO2 max), moderate/rigorous sessions over 2 years. Results: remodeled hearts by 20 years, reversing age-related defects to 30-year-old hearts.
VO2 max is strongest predictor of all-cause mortality, declines from age 35. Maintain with 20 minutes weekly; increase via Norwegian 4x4: 90-95% max heart rate for 4 minutes on, 4 minutes off, repeat 4 times (twice weekly ideal, e.g., on stepper at level 14). Provides blood shunting to brain, myokines/exerkines release, heart remodeling, tumor cell growth downregulation, cognitive improvement.
Levine's protocol: 1x high-intensity 4x4, ~2 hours at 70% max heart rate, 1 resistance session. Heart plasticity for remodeling until age 65; start in late midlife. Midlife is key window for brain health and longevity.
Brain is most vascular organ. Vertebral arteries supply posterior brain/cerebellum; carotid arteries supply frontal/middle brain from aorta. Hypertension kills brain capillaries (one cell thick), feeding neurons and blood-brain barrier (BBB), causing breakdown ("leaky brain"). BBB acts as nightclub bouncer with tight junctions preventing unwanted molecules.
SPRINT trial established 120/80 gold standard. Measure blood pressure daily (automatic monitor ~$25 on Amazon). Systolic >135 causes capillary breakdown. Aggressive management (e.g., ACE inhibitors) preserved gray matter and cognition.
Non-pharmacological: build strength via exercise, manage stress/cortisol/chronic inflammation, prioritize sleep.
- High-intensity: 4x4
- Long aerobic: 60 minutes once weekly (hiking, tennis, cycling)
- Moderate: 30 minutes once weekly (sweat but can talk)
- Strength training: once weekly
Variety drove profound heart impact. Cardiovascular disease is top killer; dementia #1 killer of women in UK, #1 cause of death in Australia for both sexes.
Alzheimer's not direct cause of death: leads to asphyxiation (loss of swallow signal), falls (loss of balance). Diagnosis irreversible, like end-stage cancer; slows mild cognitive impairment (20-year progression) but no cure post-diagnosis.
Post-diagnosis strategy: aggressive exercise, monitor diet (potentially ketogenic for metabolic crisis where brain can't use glucose), high omega-3s, manage lipids, socialize, cognitive activities (e.g., throw tennis balls at wall).
Brain prefers ketones over glucose in crisis (e.g., Alzheimer's, perimenopause). Astrocyctes break down myelin sheath for ketone production. 30% reduction in brain glucose metabolism in perimenopause due to estrogen decline, causing myelin breakdown, brain fog, poor sleep (60-65% women report hot flashes/night sweats).
Recommend ketogenic diet for perimenopausal women: ketones alternative fuel brain utilizes more effectively.
Being female is #2 risk factor for Alzheimer's after age, due to menopausal estrogen drop (starts ~30-45, perimenopause ~42-45 lasts 10 years; check with doctor at 40). HRT neutral stance (no large RCTs prove dementia prevention), but reduces risk up to 30% indirectly: eliminates hot flashes/night sweats (hypothalamus dysregulation causes temperature spikes), improves sleep (sleep deprivation accumulates amyloid beta), anabolic to muscle/bone (estrogen receptors aid protein synthesis, density).
Women's Health Initiative scared women off HRT (40% to 4% usage) over breast cancer fears, but risks of heart events/Alzheimer's rise at menopause onset. Forms: estradiol/progesterone capsules, vaginal estrogen cream (also for skin: elasticity, collagen, dermal thickness), transdermal patch (easiest, preferred).
Distinguished by amyloid beta plaques and tau protein. First patient: Auguste (52, 1901), word-finding issues, memory loss ("I don't know who I am anymore"). Died 1906; postmortem revealed plaques. 2000s amyloid cascade hypothesis demonized amyloid beta, leading to IV drugs promising clearance.
But what they
When removing amyloid from brains, treatments also took brain tissue, causing microhemorrhages and death in some patients. Amyloid is not the problem; amyloid beta is an antimicrobial peptide that protects brain cells.
During deep sleep, the glymphatic system activates. Glial cells (from 'glia') are the brain's chief immune response cells outside neurons. They shrink, allowing amyloid beta in cerebral spinal fluid to wash out like a washing machine. Alzheimer's patients don't get deep sleep to clear amyloid. In perimenopause and menopause, hot flashes and night sweats fragment sleep, causing amyloid buildup.
Tau protein lives in the axon, covered in myelin sheath. Under stress, tau hyperphosphorylates, breaks off, and forms neurofibrillary tangles. Tau stabilizes microtubules (railroad tracks in the axon, like the trunk of a tree). Phosphorylated tau causes tangles, collapsing axons and microtubules, disrupting information processing speed. Brain under attack inside (axons) and outside cells (cerebral spinal fluid).
Estrogen's Role and Stress Factors
Estrogen receptors on brain cells and axons block the enzyme that phosphorylates tau. Low estrogen allows tau phosphorylation and tangles. Testosterone is neuroprotective and aromatizes into estrogen. Stress also causes this.
Sleep is the most underrated Alzheimer's prevention tool. Train for sleep like a marathon. Many don't reach deep sleep to activate glymphatic system. Speaker sleeps 7.5 hours nightly. One night of sleep deprivation raises amyloid beta risk by 4-5%. Chronic short sleep (e.g., 5 hours) accumulates risk, increases type 2 diabetes, disrupts hunger/satiety hormones. Cannot reverse compound effects by weekend catch-up; not like repayable debt.
Banking Sleep
Matthew Walker: Cannot make up lost sleep, but pre-bank by oversleeping weekends before known deprivation (e.g., long-haul flights to Australia).
Examine lifestyle day before. Distinguish: trouble falling asleep (racing mind, default mode network) vs. staying asleep (heat, stress, bad dreams).
For Falling Asleep
- GABA (gamma aminobutyric acid), chief inhibitory neurotransmitter, stabilizes thoughts, calms racing mind.
- Backload carbs with starchy vegetables (e.g., sweet potatoes).
- From 8 PM: no email, hard conversations, crazy content; settle mind/nervous system.
Sleep Optimization
Core body temperature must drop 2° to fall/stay asleep. Use temperature-controlled mattress, feet out of sheets, AC to cool room. Glycine supplements lower core temperature, aids sleep, has great longevity benefits for lifespan.
For Staying Asleep
Adaptogens: Ashwagandha, rhodiola stabilize cortisol (elevated daytime/nighttime). Adapt to body's needs: lower high cortisol, raise low. Take 3x/day without fatigue; pairs with caffeine/theanine.
Evening Wind-Down (8 PM, Mimic Circadian Rhythm/Sun)
Mimic sun setting ~8 PM for natural melatonin release (sleepy hormone from darkness). Biohacks: red light mask, dim lights, replace bulbs with red light (remove blue/junk light), blue light blocking glasses (minor benefit). Downregulate nervous system.
Check label: 95% of popular US omega-3s (85 tested) exceeded oxidation levels (rancid from heat, fish oil). Rules:
- Credible, certified manufacturer (NSF: heavy metals, oxidation, contents match label).
- Source locally (e.g., California).
- Refrigerate immediately, like olive oil away from stove.
Omega-3 benefits: cell membrane fluidity for synaptic transmission (dopamine, serotonin, calcium, potassium influx); anti-inflammatory like NSAID (FDA drug safety, only benefits); 60% brain is fat, 70% DHA (from omega-3). Trials: most effective for mild cognitive impairment, APOE4 gene, Alzheimer's (repairs blood-brain barrier; DHA transporter into brain).
Receptors in brainstem, hippocampus, memory centers. Chinese centenarian women study: high vitamin D preserved cognition, avoided Alzheimer's. Deficiency raises all-cause dementia risk 40%; 60 ng/dL level lowers Alzheimer's risk ~80%.
Most widely studied supplement. Speaker has 71-year-old parents on it (high-dose dad, low-dose mom). Cheap physiology/neurophysiology upgrade. Fears: kidney damage, hair loss (both unfounded).
What It Is and Dosing
Naturally occurring; body produces 2-3g/day (brain/liver). 5g/day (standard scoop) saturates muscles first, little left for brain (reduced bioavailability crossing blood-brain barrier). For brain: higher doses.
Pilot study (last year): Alzheimer's patients (energetic crisis, skewed ATP/glucose metabolism, cognitive decline) on 20g/day (4 scoops, spaced e.g., 5g morning, 5g mid-morning, 10g). Preserved cognition, more energy/exercise.
Non-discriminatory: age, gender, weight, pathology, ethnicity. All reward, no risk. Boosts cell energy (ATP).
Benefits
Low energy/brain fog: take it. Protective: high-dose (30g/day) against concussion, stroke, stress (works in stress background). Anti-cancer: recent study, 0.36g/kg body weight (e.g., 70kg = 25g/day). NANUS 2025 study (25,000+ adults): linear negative association dietary creatine-cancer prevalence; +1 SD intake = 5-18% risk drop (strongest >50yo for cellular health/immune surveillance). Energy fights infections, stress, tumors, preserves functions; low energy crisis worsens diseases.
Creatine works in the background of stress. Research shows you can creatine your way out of sleep deprivation. If sleep deprived (e.g., 4-6 hours), take high-dose creatine at 15-20 grams per day to reverse negative effects.
Timing and Usage
Timing doesn't matter. Creatine doesn't degrade in hot water. Take anytime, before/during/after exercise. Researchers explore taking it at night before bed for sleep performance.
Creatinine Concerns and Kidney Markers
High creatinine levels (a marker of kidney function) rise during stress, intense activity, or with high muscle mass. Don't stop creatine based on high creatinine alone. Better marker is cystatin C (GFR test). Request cystatin C blood work from doctor; stop creatine only if elevated and out of normal range. Everyone, regardless of age, should supplement creatine daily.
Study on Perimenopausal Women
Recent small randomized control trial on perimenopausal women: groups - low dose (750 mg/day), medium dose (1.5 g/day), creatine monohydrate and hydrochloride, placebo. Medium dose group (1.5 g) showed substantial mood and cognitive function increases. Creatine explored across female lifespan: perimenopause, pregnancy, menopause, dementia.
Choosing Creatine
Look for NSF certified and Creapure (gold standard from Germany). Non-Creapure often has anti-caking agents making it powdery (mixes well but may cause GI distress). For GI issues, take 2-3 grams at a time; don't stop.
Test every 3-4 months, comprehensive lab work (e.g., December 15th pre-birthday). Test biological age annually; recent result: 22.
Key Tests Everyone Should Do
- Lipoprotein(a): Hereditary, raises heart event and cardiovascular disease risk.
- For dementia (US): Blood tests for tau protein, p-tau 217, amyloid beta detect mild cognitive impairment and Alzheimer's hallmarks with 90% PET scan accuracy.
Brain processes visual info 15x faster than words. Test: Say color of card, not word (e.g., green, orange, yellow, green, orange, green, orange, yellow, pink, orange, green). Reverse: Say word (yellow, blue, green, black, purple, brown). Both participants performed well.
Best physical exercises: hand-eye coordination (tennis, racket sports). 5 minutes/day builds cognitive reserve, brain performance using tennis ball and eye patch.
Drill Steps
- Throw tennis ball overhand, right arm to right hand catch.
- Right throw to left catch, alternate.
- Add eye patch (blocks 50% vision, e.g., left eye) - harder, ~8 catches initially.
- Alternate left/right hands.
- Stand on one leg (engages cerebellum, spatial awareness).
Engages executive functions, processing speed, reaction time, hand-eye coordination, visual cortex (occipital lobe). Used with NBA players to improve executive function, decrease reaction time. Frequent practice builds new brain connections, strengthens neural networks, improves cognitive reserve.
Doing hard things improves brain function lifelong, signals brain you can handle hard things.
AMCC Role
Larger in superagers (age well: low cardiovascular disease, maintain cognition at 80-90 with 50-60 year old V2 max). Grows when doing hard things (e.g., gym above threshold). Reserve for life's hardships: welcomes challenges, pushes through.
Anterior mid-singular cortex shrinks in sedentary lives or avoiding challenges. It atrophies if you play safe too often. Growth only during resistance.
Ice bath example: No AMCC change if you love cold; grows if you hate it but do it. Seat of will to live; size/activity predicts survival post-setback (health, surgery). Called willpower muscle, but it's neurobiology, not just willpower.
Superagers
Age well biologically, multiple facets including larger AMCC.
Examples
- Athletes: Larger AMCC volume.
- Obesity: Smaller AMCC, grows with successful challenging diet/exercise.
Stimulus on system causes adaptation/growth (neurobiology). Dendritic spines break down without challenge (5,000-10,000 to 2,000/no connections). Cycle: No hard things → no AMCC growth → avoid hard things → failure loop (e.g., New Year's resolutions fail by Feb 1, obesity epidemic, goal crisis).
Evolutionary View
Evolved for hunting in starvation; scale down in easy times to conserve energy.
2024 Oxford word: brain rot. Mindless scrolling trains small dopamine hits from nothing. Chatbots (e.g., ChatGPT): Incredible but harmful. Personal example: Former mathematician now uses for 20% tip calc, notes declining math skills. Declining book reading, brain exercise, cognition.
Society doesn't allow women to ask for needs → 70% Alzheimer's cases women, 80% autoimmune diseases female (largely preventable). Women underrepresented in literature, downplay symptoms, scared/ashamed to ask doctors.
Personal Story
Named after grandmother Louisa (best friend, died ~20 years ago of ovarian cancer metastasized to pancreatic). Spent every day together. Hid symptoms (stomach pain, stopped eating), prioritized family. Final plea to doctor: "Please, is there something I can do? I don't want to die." Doctor: "Nothing you can do." Regret not getting scan sooner. Mother (Cyprus migrant) also puts self second.
Sees patients/caregivers unaware of actions. Anger at spending on Mars rockets over preventable disease cure.
Emotions Driving Passion
- Anger at society burdening women (mother, caregiver, worker, family rep; 51% population).
- Political: Healthcare inaccessible to low socioeconomic status (policies set it so); woman in need is apolitical.
- Frustration: Only 4% women on HRT fearing breast cancer/Alzheimer's, despite admin promises.
When government figures like Secretary Kennedy in 2014 stated on national television, "Vaccines are totally safe. I had all my kids vaccinated. They've eradicated some of the most deadliest diseases that have plagued this world. Vaccines are so safe," but by 2025 say vaccines are unsafe and urge not trusting medical doctors, people lose trust. It's not lack of information but confusion from mixed messages: vaccines are bad, good, really good, take them, don't vaccinate kids. Many women don't know how to order blood tests online, yet are expected to take health into their own hands. Vulnerable women are sold a vaccine lie, missing potential protection from flu, hepatitis B, meningitis—recently eradicated from the vaccine schedule. This is not political or propaganda; as a scientist, the speaker advocates for better treatment of women.
Louisa passed away around when the speaker was 18-19; diagnosis to death was within two months. Watching her ask the doctor for options drove obsession with disease management. At 21 in a lab, seeing a brain harvested from a donated cadaver in the pathology lab solidified dedication to neuroscience, where the speaker feels most alive. The brain controls life and can be used to overcome obstacles. Metacognition—thinking about thoughts—allows daily challenge to overcome adversity.
Cost of Passion
Moved from family and a 22-million population in Australia to New York City, the hardest city, to be surrounded by the greatest neurosurgeons. Still paying costs: health suffers, misses family events, travels for career. Wouldn't have it otherwise—met incredible thought leaders in health and medicine forging the desired life.
Success means controlling brain states: switching on with norepinephrine, adrenaline, dopamine when needed, avoiding constant overdrive, knowing when to switch off, and recovering. Ultimate high performance is moving between brain states, as in Flow by Mihaly Csikszentmihalyi, mastering the flow state.
Goals include kids and family—tough, as kids don't just appear; women bear the children, a big sacrifice, honor, and privilege. Hopeful for professional endeavors because in control. Hopeful society moves positively on Alzheimer's; social media provides free education, agency over brains. Not hopeful for easy external salvation.
Reflections on Obsession
Sometimes wishes to be less obsessed—might be back in Australia living averagely. Obsessed brain makes detachment hard; if given a knob to turn down obsession, the obsessed brain says turn it up. Wonders if slightly less obsession would mean overall happiness, but life's point is to know thyself in pursuit of something bigger.
Worries about sacrifices; on deathbed at 80, might regret bad trade. If world collapsed tomorrow, regrets not making more memories with loved ones. Imagine losing memories, not recognizing wife, kids, self in mirror—Alzheimer's is disgusting, sinister, horrific: losing someone while alive, losing yourself. One woman looks in mirror saying "Who's that?" Two years ago knew speaker; now asks if speaker is her daughter. Confronted daily, drives thinking about medicine, history, diseases, life, loved ones—no average life.
God is the unseen power felt with faith, guiding with a path. Speaker is Christian, Greek Orthodox. Brain deterioration tests prayer amid hopelessness and injustice, like losing a child. People pray trivially (finding keys, sports wins) while Alzheimer's cures go unanswered.
Science Leading to Faith
Human formation from conception, neural development's precision is miraculous, rare—turns from biology to something bigger. Initially gung-ho materialist (born in body, die in body), but deep science/medicine literature makes ignoring God and higher power hard. Hospitals have chapels for alternatives science can't offer; faith believes in the not-yet. In neurosurgery, improbable survivals occur: 78-year-old woman from France had massive facial tumor resected, walks cognitively normal next day without medication. Some things medicine can't answer—requires faith.
Speaker's passion, obsession, communication help average people access wisdom, research, make better choices, preserve brains and everything that matters. Gratitude as normal person for vital work despite costs.
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