MASTERCLASS 1: Understanding the Aging Brain, What Is Normal and When to Worry

we are absolutely petrified of dementia as a culture when you ask older adults things that they're scared about dementia actually outranks things like fear of snakes and fear of a terrorist attack the vast majority of the brain Health Products on the market today have no scientific basis whatsoever and some of the most popular ones have even been accused of fraud by state attorneys the only true way to achieve brain health is going to be by behaviors driven by you you have to get involved it's not going to come to you in a pill it's not going to come to you from playing games after getting my PhD in Clinical Psychology I completed three additional years of training to really hone my expertise in the brain I promise you there are so many things that you can start doing today that are free or low cost that will truly improve the quality of your brain I want you to take your power back take your money back take your time back and I know you want this too the problem is you haven't been told exactly what to do I want you to get excited and empowered about brain health let's get started [Music] today [Music] hi everybody Dr Sullivan back with you thank you so much for joining me I really really appreciate you being here I'm so excited to tell you about my program today we're going to spend about 30 minutes together with this lecture and we're going to cut cover six different areas the first thing I want to talk to you about is what do older adults care about the second one are the six problems that I see with the brain Fitness industry as it is the third part is my solution if you're going to complain about a problem I think you need to offer a solution so my idea is the iare for your brain program and I want you to understand exactly what it is that I'm inviting you to be a part of over the last 2 years I've actually been running the iare for your brain program in person and what I'm doing now is bringing that same program to you online so I want to tell you a little bit about where I've been to date and the things that I'm really excited that we're going to do together as part of this online program so do you want to know what older adults care about research tells us they care about their brain study after study when they ask older adults what are their priorities brain health Rises to the absolute top it's above Social Security reform and it's even above physical health a 2013 a ARP study asked these folks where are you getting your information and of course most of them said where I'd really like to get this information from is from a doctor but the sad truth is you know where you're getting your information from it's from the media corporations selling a product often sponsor these messages and doesn't that bring their truthfulness into question supplements computer games and phone apps all promis to enhance brain health memory and sometimes even prevent a reverse demension the vast majority of the brain Health Products on the market today have no scientific basis whatsoever and some of the most popular ones have even been accused of fraud by state attorneys the big concern is that they're robbing you of the three most precious resources you have which is your time your money and your hope so let's talk about the six problems with the brain health industry the first problem is that it's really an industry that's based on fear it's really based on the anxiety that older adults have about developing dementia we are absolutely petrified of dementia as a culture when you ask older adults things that they're scared about dementia actually outranks things like fear of snakes and fear of a terrorist attack the American Psychological Association has predicted in the next few years with the Aging of the Baby Boomers that dementia related anxiety could actually become its own disorder and marketers know this and this is exactly what they're praying on this second problem is that they treat brain health as if it's totally separate from other aspects of your health this includes your physical health your emotional health your social health and your spiritual health the brain cannot be decontextualized from the rest of your being it's all integrated it's all part of you so to really get at brain health we really have to address all different aspects of health and well-being the third problem is that it really offers a one siiz fits-all or a one app fits-all type of solution this is just not realistic at all the brain is immensely complicated we all know this so how could it possibly be that one little pill that you take every day or working on an app 30 minutes a day how could that possibly affect such a complex biological system as the brain the true solution to brain health is going to have to be multifaceted it's just not realistic to think that you're going to get a big result from something so small the four point is that all of the smart drugs that are marketed for better brain health have no scientific basis whatsoever if there was one that actually proved itself I guarantee you that a pharmaceutical company would be selling it to you and you wouldn't be able to get it in your local convenience store this one really bothers me as a practicing neuroschistosomiasis that have absolutely no scientific basis whatsoever the fifth one is really important for older adults because the brain Fitness industry as it is right now does not value the impact of social health think of how many things that are sold for brain health are actually activities that you're meant to do alone in your house this goes for all the brain games this goes for the apps the brain training games all of them are marketed to you to do a loan in your house that is fundamentally incorrect with the way brain scientists think about the brain we know that the impact of social health is absolutely critical do you remember many years ago when they came out with the big finding that crossword puzzles really improve brain health and maybe they could even ward off dementia well those studies that were done were done in the context of community centers and what they found when they redid the studies but had the individuals do the brain training the crossword puzzles at home is that they totally lost the effect and so what we can infer from that is that it was actually the social Gathering the interpersonal interaction that was really providing the therapeutic brain value the sixth problem is a lack of objectivity and who is delivering these messages when your primary objective is to sell someone a pill to sell someone a magic cure what do we really think about what's motivating them is it truly to Enlighten someone about brain health or is it to make a buck I wonder if you know this in 2014 73 neuroscientists and psychologists got together and wrote an open letter to the brain Fitness industry in which they told them flat out you are making exaggerated claims and we are very worried that this is a public health crisis the main point of their letter was to say that all of their claims are not based on sound scientific information they ended their letter by saying our biggest concern is that older adults are making choices about how to spend their time how to spend their money and they're getting no return back on their investment the final sentence of their letter said this is a serious concern and it can really feel that people are getting exploited so the question has to be asked why has this 8 to10 billion doll brain Fitness industry taken hold well first of all we're living a lot longer than we ever did nowadays it's really common for people to get into their 80s and 90s what happens when people live longer is that we're going to see more incidents of dementia you've probably heard of the silver tsunami the wave of dementia that we're expecting to take over the world this brings with it a lot of anxiety and a lot of fear as I told you earlier dementia is the number one fear of older adults and when you have a group of people who are misinformed and are very very afraid they are right for the taking they're all ready for your sales pitch and they're going to dish out that money because they are petrified and they don't know what else to do the second reason I think this industry has taken hold is that there's been fascinating and truly impressive advances in the field of neuroplasticity we know from animal studies and even human studies that animals including us in an enriched environment have the ability to change our brain By changes in our environment we have the power to make our brain stronger to make our brain more resistant to the effects of brain disease this excitement about our power to change the brain is absolutely On Target the problem is the methods that are currently being used are wrong so I want to let you in on the secret that all brain scientists know the only true way to achieve brain health is going to be by behaviors driven by you you have to get involved it's not going to come to you in a pill it's not going to come to you from playing games there are many many things that you need to be doing to truly achieve brain health the problem that we have with the brain Fitness industry as it stands now is you don't have a trusted resource to give you this information a large part of what I'm going to be teaching you in the iare for the brain program is to understand the relationship between lowering your personal risk factors for brain related changes with age and increasing something called cognitive Reserve successful aging largely depends on the interactions between our genes the DNA that we're born with and our environment nearly all diseases including those related to the brain are due to a complex interaction of having a predisposition genetically to a certain disease and something in the environment activates that Gene there are big differences in the ages at which brain related changes happen suggesting that it's not just an aging process there are many things that happen above and beyond normal aging that you have total and complete control over you just need to know what these are a broader conception of brain health is desperately needed one that goes beyond the simplistic approach of the current Marketplace one that puts older adults in charge of their own brain health one thing that really inspired me to do this program is the vast Gap that currently exists between what brain scientists know about the brain and what is communicated to the general public when I was in graduate school and finishing up my training I was absolutely amazed every single day at the things that I was reading in brain health journals I would then go do my clinical hours and meet with actual people and it was amazing to me how little of this information was generally known that experience really shaped the kind of neuroschistosomiasis and deserve to know a comprehensive background on what is going on with this really important part of themselves in 2015 I developed the iare for your brain program to specifically address this Gap in how brain scientists think and what is communicated to the general public the ingredients that go into my program are science objectivity power and choice so now let me answer the question that you've been dying to know what is the solution what is the ey care for your brain program ey care for your brain is a scientifically based education program empowering adults and people that care about them with engaging easy to follow information that is motivating for Action the philosophy underlying my program is kind of counterintuitive when you think about brain health but I really want you to start thinking about it this way if you're going to get somewhere your brain is not the whole story successful cognitive aging has to be based in a multi multi-dimensional approach that yes respects brain health but also respects physical health social health and spiritual health and maybe most importantly a vital engagement with life so I think a totally normal question to be asking yourself at this point is okay sounds good but why should I listen to this woman well let me take a couple minutes of your time to just tell you a little bit more about me so I feel very fortunate to know what I think I'm best at from a pretty young age when I was around 15 years old my grandmother started showing signs of Alzheimer's disease through that Journey with her I was very profoundly moved about the effect of brain diseases on individuals on them as people from the time I was 15 until I started college at 21 I worked in a variety of settings with older adults very happily in different types of nursing facilities as an activities director uh part of an adult day health program as a therapeutic companion and a caregiver when I started college I knew that I was interested in some type of helping profession but it wasn't until I took a class on physiological psychology that it hit me that I could be a brain scientist fast forward a couple years down the road I've got my PhD from Boston University finished up my training at the Boston VA and Harvard Medical School had an assistant professorship at UNCC Chapel Hill school of medicine and have started my own private practice the thing that I've always liked throughout all my Education and Training is the helping part I'm very very excited to be sharing my expertise with you in this program my thought is that you have a right to know as much as I do as much as other brain scientists do about what's happening to your brain so how does the I care for your brain program work so let me get into the nitty-gritty of what it is I'm offering you so it's a science-based curriculum that's delivered in nine lectures each of the nine lectures has two components the first half of the lecture is always getting you on board with a solid scientific base about the topic the second part of the lecture we transition into the recommendations this is where you take the wheel you are going to understand by the end of every lecture exactly what it is that brain scientists know will truly help that aspect of your health remember what I said before about social health that a huge part of brain health is remaining connected with other people well that's part of what we're going to also try to build online together we have a Facebook group that is really vibrant where adults gather to ask me questions to interface with each other everyone is there with the same goal they want high quality information about the brain and they want to know exactly what it is that they're supposed to be doing so let's go through the curriculum briefly and see if this interests you the first lecture that I'm going to offer you is understanding the Aging brain I'm going to help you understand the complexities of Neuroscience science in a way that you're really going to get we're going to talk about when to be worried what's normal in the brain what is dementia what's the difference between normal aging and dementia really give you a solid educational base to process and understand the rest of the curriculum in lecture number two we're going to talk about how to minimize your risk factors for dementia throughout the lifespan it's really not something that should matter to you once you cross that threshold of 5 believe it or not there are actually in utero risk factors that will affect people as they get into older adulthood I want you to understand from conception all the way up to older older adulthood 90 years old what are the specific risk factors and most importantly what is it that you can be doing right now to minimize those risk factors for yourself or somebody that you care about in lecture number three we're going to be talking about heart health and how that intimately Rel relates to brain health this is another perfect example of how it's really not scientifically correct for us to take the brain health away from other aspects of Health the heart and the Brain have a very intimate and very important relationship many adults get diagnosed with things like high blood pressure type 2 diabetes and high cholesterol these diagnoses have a very significant impact on brain health and you need to know exactly what the steps are that you can be taking to minimize the damage from those conditions on your brain lecture number four is a very popular one how do substances affect the Aging brain what we're going to talk about there is all the way from diet to supplements to prescription drugs to alcohol how are these things processed uniquely by the older adult in lecture number five we're going to talk about the psychology of Aging we cannot talk about brain health and separate it from how we feel as people who are aging and who are going through different phases of Life the lecture is going to specifically focus on the effects of stress on the body and specifically the brain I'm going to teach you coping skills that are going to dramatically improve the way that you handle stress and that will improve the health of your brain absolutely in lecture number six we're going to talk about that importance of social connection you've heard that phrase it takes a village it really really does take a village as we start to get a little bit older we need people around us that love us that are concerned about us but sometimes those people don't know what to do what I want to do in this lecture is explain to older adults but also the people that care about them exactly what is it that they need in terms of social health what are the things that people should be doing that will genuinely make an impact in the quality of someone's life including their brain health so in lecture s we are going to get to memory and what are some evidencebased tips for you to truly truly improve your memory and guess what it's not going to come in a pill and it's not going to come in an app there are many many things that brain scientists know truly improve your memory and I'm going to teach them all to you lecture eight is a really really important topic this is about how sleep changes as we get older if you're listening to this and you're over 50 you know that your sleep is changing what my patients tell me is that as you get older you do not sleep as well and you tend to get up a little little bit more early in the morning never mind the multiple trips to the bathroom throughout the night so what I'm going to teach you is why is this happening there is a scientific basis for it there's a lot of different things that you can be doing that will genuinely improve the quality of your sleep and the reason why this is so important is because sleep is absolutely vital to the health of our immune system to our mood and to the way that our brain processes and remembers information in the ninth lecture what we're going to do is recap everything to really reinforce those most important teaching points so you feel like you end the program truly thinking like a brand scientist knowing exactly what to do so now that I've gotten you on board with the content of our lectures let me just tell you a little bit more about how we're going to turn learning into action because after all that's really what this program is about I want to help you get on board with really high quality knowledge and information about the brain but if we don't do anything with it what does it really matter what I really care about is teaching you how to flip the switch and take control of your brain health all on your own so one of the ways that we're going to do this is by offering you a companion workbook that goes along with every lecture let me tell you a little bit about what's going to be in this workbook so what we have are all of the presentation slides that I base my lecture on next to every slide what you're going to have is a notetaking section because I I want you to be actively involved with this information one of the best ways that we learn is by hearing it and writing it so I really want you to be taking notes really acting as if we are in a university setting and I'm the professor and you're the eager student and we are working together collaborating together to learn this amazing new information the other thing that the workbook is going to have is tools to help you put this information into action there's Behavior tracking sheets there's motivating support to really help you understand how to follow through with these recommendations so I want you to use this companion workbook as a way of making the iare for your brain program personalized this is a place for you to record how what I talk about is relevant to you specifically or someone you care about specifically I want you to use it as a resource guide far into the future that you can come back to time and time again when you're curious or concerned about a specific problem so in 201 16 after a year of research and collaboration I debuted the iare for your brain program at pck Village a Life Plan community in Southern Pines North Carolina and it was an amazing experience every time we offered a lecture to the community more and more people started coming to the point where we didn't have enough chairs to fit all the people that wanted to learn about the brain to date we've had over 1,500 adults participate in the program what was really important to me is how I was doing using four benchmarks of success the four markers of success that mattered most to me was was I educating people were people feeling engaged with the material was it having a true impact in their quality of life and what they did every day and were they feeling more empowered and in control of their brain health during the first lecture we pulled people before and after the lecture and we asked them do you understand what the term dementia means prior to the lecture about 44% of people told us that they either knew what it meant or they thought they knew what it meant after the lecture we pulled these folks again and we got that number up to 83% of people feeling really confident that they knew what that term dementia meant we also asked people do you understand really how your genes and your lifestyle choices come together to raise your risk of dementia before the lecture about 39% of people said they felt like they had a good understanding I'm really proud to say that afterwards 90% of those same people felt that they could readily explain it to a friend when we asked the participants in the program if they enjoyed it and what they thought the quality of the lectures were 100% of people rated it excellent to very good 94% of people said that they would return for another program 95% of the people who attended told me that they felt that the program really impacted positively on the community and 99% of people told me that they felt more empowered to talk to their medical providers about their brain than they did before the lecture series about 89% of people who attended said that they were talking about brain health with their friends and family and maybe most important to me was this last set of data in which I asked people if they felt more empowered as a part of participating in the I care for your brain program 94% of people told me that they felt that they were a more critical consumer of brain health news as a result of participating in the program 94% of adults said that they felt that they were less likely to be taken advantage of by claims from the brain Fitness industry on products and supplements that are supposed to help their brain one of the most rewarding Parts about doing this program is hearing back from people how it's impacted them and people have been so gracious to come up to me after and tell me that it's truly made a difference in their overall well-being that they feel so much more confident about this part of their health and that they work were genuinely curious they just didn't know who to believe so why am I here with you today because the reach that I have by doing this program in person is somewhat limited I really want to reach as many of you that are out there that want to know this information so I'm bringing the iare for your brain program to the online world so I think I can ask you where do you want to get your brain health information from would you prefer to get it from a brain scientist or a corporate Market exec there are some differences in how we're going to approach brain health on my side everything that I talk about is based on Research I strive to be objective and to keep the hype really really low the recommendations that I'm going to teach you have been proven to work in scientific settings and the vast majority of them are free or little to no cost I want to empower you through education my concern is that corporate execs who are trying to sell you a product product might not be based on some of these similar values as I've shared with you my idea is that I really think that that industry is built on fear it's very product oriented there's a lot of Scare Tactics that are used and I can promise you that there is no return on your investment with the vast majority of brain Health products that are on the market today so after this lecture if this feels like something that's interesting to you something that's exciting to you something that you think could really work something that puts you in the drive seat please join me on my online community it would truly be my privilege to help you think like a brain [Music] scientist hey everybody it's Dr Sullivan welcome to the first lecture in the ey care for your brain series I'm really really pleased that you're here with me today and I promise I'm going to teach you everything that I know today about the Aging brain the first thing I want to do is Define successful aging then we have to understand some basic aspects of the brain to understand some of the later Concepts we're going to talk in detail about structural and functional changes that happens in the brain and what that means is we want to know what happens at the cellular level but also what changes in terms of our everyday lives the last thing that we're going to talk about is dementia what exactly does that term mean when people talk about it and what are all the different types of dementia we're going to close up by talking about what you should do to get a gold standard evaluation of the brain if that's something that you're worried about for you or a loved one when we we think about the seven elements of successful aging I wonder what it is that comes up in your mind for me I think that these are the critical pieces the first one is a low level of physical disability of course as we get older we know that we do get a little bit slower and it can be hard to move around sometimes but the idea is we want to keep this to the most minimum level possible the next one is maximum Independence I think that this is important to all of us and maybe even more so as we get older of course intact cognitive functioning is the reason that we're here together today we all want to be operating from the best most healthiest brain possible the next one is active engagement in life we all want to be vitally involved with activities that are meaningful to us the fifth one is social and spiritual connectedness we are social beings we need to be around other people now the degree to which we need to be around other people is really different for all of us but essentially we know that we all all do need each other the fifth one is positive Life review as we get older it's really important to look back on our lives and feel that we lived a life full of value that we're really proud of that we left some type of positive Legacy behind and the final one is self-determination and that's really a big part of what I'm doing with the iare for your brain program I really want to put you in the driver seat of your own brain health it's very important that we make our own decisions and that we exert as much power and control as we can about modifiable aspects of our health and what I mean by that are what are the things that you can actually control on your own successful aging depends so much on the interaction between our genes and our lifestyle choices this is really the case for all aspects of physical and mental health and brain health is no exception the secret that brain scientists know is that only you can truly determine the health of your brain true brain health involves behaviors that have to be initiated by you you just need need to know what to do what we're going to be focusing on in this lecture series is The Sweet Spot between lowering the modifiable risk factors that you can actually change and increasing what we call your cognitive reserve and I'm going to explain both of those Concepts in really good detail so there's two types of risk factors when you think of brain health there's non-modifiable which just means the things that you can't change and there's modifiable which are the things that you can change what I want you to pay attention to here is the fact that the list in the non-modifiable group is very very small really the only two things that influence brain health as we change that we have no control over whatsoever are specific gene mutations and our age age is the number one factor for dementia as we get older it doesn't mean that you're invariably going to get dementia as you get older sure the older you get the more you are at risk for getting it but it does not mean that dementia is a normal part of aging on the other hand we have modifiable risk factors these are the things that you can do something about and this is really the backbone of the ey care for your brain program I want to teach you how these risk factors specifically affect brain health and I want to teach you what it is that you can do to scientifically try to outsmart these risk factors so let's just go through these one by one and as you're listening I want you to think about yourself or somebody that you care about and do we think that maybe they are at increased risk for less than optimal brain health because they have some of these risk factors the first group have to do with our cardiovascular health high blood pressure also called hypertension is probably the number one risk factor for reduced blood and oxygen getting to the brain in one of our later lectures we're going to talk all about how heart health equals brain health and anyone who's affected by any of the top three cardiovascular risk factors which are high blood pressure high cholesterol and type 2 diabetes I really want you to tune into that one because there's some really important information that you need to know so getting through our modifiable list we have high blood pressure high cholesterol type 2 diabetes obstructive sleep apnea but only when it's not treated repeat head injury um one or two concussions is typically not something to worry about but when we get into people having four five six that is when we do get a bit concerned untreated sensory loss so this is hearing loss or vision loss that is not adequately treated so many of you might know people who don't like to wear those hearing aids every day that's exactly what I'm talking about one other modifiable risk factor is too much alcohol and what's important to know about that is that our body's ability to metabolize alcohol really does change with age but if we don't know that we might keep throwing back the drinks like it's still 20 30 years ago smoking also presents a significant impact on all aspects of physical health and of course brain health poor diet social isolation and low mental stimulation these are the things that brain scientists know truly impact brain health you just need to know more specifics and what to do about it I want to talk to you about this concept of cognitive Reserve it's actually really really interesting and critically important if you're going to understand brain health this idea of cognitive Reserve was pushed forward by a scientist from New York called Dr Stern and he became really interested in the concept after looking at some data of people who had passed away and had their brains donated to science what he figured out was that about 25% of these people's brains had clinically diagnosable Alzheimer's disease they had the pathological plaques and Tangles that we associate with Alzheimer's disease but here's the catch none of these people demonstrated Alzheimer's disease while living so it led to this really important discussion in brain science this was about maybe 15 20 years ago to come up with an explanation for this why was this the case and he set forth the idea of cognitive reserve and so much of what is marketed to you in terms of brain Fitness is based on this concept but the methods are not exactly right so let me tell you just a little bit more about it so the idea is that our lifetime of experiences specifically those that happen at a younger age our education our job experiences our interpersonal relationships that they create stronger brain networks that over time as we get older can combat the effects of brain disease more and more so what that means is two different people could have the same level of Alzheimer's disease in their brain and one may show symptoms and one may not now of course it's not that easy we also have to think about the genetic burden that each person holds and all that that means is we inherit a certain percentage a certain likelihood of developing a type of dementia over time and it's something in the environment that turns on those genes just to put it in simplistic terms if somebody has an 80% chance likelihood of developing dementia probably very little has to happen in their life to make those genes active and to make that person develop dementia on the other hand if someone only has a 10% genetic risk it's going to take a lot more risk factor in the environment lot more of those modifiable risk factors to actually result in having the disease in everyday life so what Stern's theory is and I think that it's absolutely true is that the more you put into your brain Bank this is the idea of the cognitive reserve the more withdrawals can happen as a result of brain disease until you go into the red until you feel that effect so why is this important this is the essence of all the brain training proc products on the market use it or lose it let's make that brain stronger the problem is the methods that are being offered to you are really not based in science we know that there are certain principles of neuroplasticity that you need to abide by in order to get that effect and the vast majority of products on the market today just don't follow those rules okay so let's talk a little bit about the brain what is this amazing three-b organ that we have in our heads I think most people understand that there are different lobes in the brain right we have our frontal loes we have our temporal loes we have our parietal loes back here and far in the back we have our occipital loes many years ago we used to believe that the brains regions acted separately and we're very very specialized for different types of information while there's some degree of Truth in this what we really know now is that the brain is an incredibly interconnected Communication System another aspect of the brain that doesn't get nearly the pr as all the different loes get but is maybe even more important is the distinction between our gray matter and our white matter so I want to teach you about the white matter and the gray matter cuz it's absolutely fascinating and also it's really important that you understand these two things because depending on different things that happen in the brain as we age you're going to see changes in these two different parts of the brain so let's just talk a little bit about the gray matter since we're more familiar with that typically this is the outside of the brain the cortex and like I said it makes up about 40% of the brain this is where our information is stored this is where information lives if you think about the concept of a librarian looking for her books her books are stored in the gray matter the white matter in contrast makes up about 60% of our brain and this is actually the librarian going out and trying to find her books now some of you might know as you get a little bit older the information that you're searching for for let's say acquaintance's name or the name of a famous movie actor you know you know the name but you just can't find it this is a perfect example of the librarian is getting a little bit slower but once she finds her book she knows exactly that that was the book that she was looking for in our brain we have over a hundred billion neurons let's just talk a little bit about the different pieces of the neurons because again I really want you to understand the specifics of what we're going to be talking about in this program if you're familiar with Biology you know that all cells in the body have a nucleus that nucleus and the little tiny arms or dendrites that extend from the nucleus are stored in the gray matter the tail or the axon of the cell is the white matter and different chemical signals pass in and out of these cells which tell them to either do something or to not do something a lot of what happens in the brain can be thought of through the metaphor of a gap gas pedal and a brake pedal different parts of the brain tell us go ahead do that it's good go for it other parts of the brain tell us hold on pump the brakes you need a minute here the brain is a very intricate complicated interplay between red lights and green lights so what is the main fuel for the brain this is a critical concept you absolutely have to understand how important oxygen and glucose are for the brain now even though the brain only makes up about 2% of our overall body weight it uses much more of our body's proportion of oxygen and glucose when I say glucose what I mean is blood sugar so the brain needs about 20% of the overall oxygen in the body and about 50% of all the glucose in the body now here's what's critical is the brain cannot hold on to any of these fuels it cannot adequately store enough supplies of these fuels so it needs to be constant ly replenished it needs to always have access to an adequate amount of oxygen and glucose in order to properly work the fuel delivery system for the brain is blood so we need to understand how is it that the blood is moving throughout the brain and there's two primary systems we've got two sets of pretty big blood vessels that go into the brain what we have in the front is Our kateed arteries you probably heard about those but then we have an equally sized set in the back called the vertebral arteries and what these arteries do is provide the biggest amount of blood that enters into the brain these two sets of blood vessels come together in the middle of the brain and make a circle this is called The Circle of Willis and what is so cool about this is it's really a backup system so that way if there is a breakdown or a block in any one of the main blood vessels different parts of the brain can be supplied by other inroads to get that blood and oxygen into to parts of the brain but this doesn't apply to the entire brain and this might be the most critical concept for you to understand normal brain Aging in the middle part of the brain remember that white matter the subcortical part of the brain there's a whole another system of blood vessels and these don't have any collateral support they don't have any friends who are going to kick in and give over a blood supply if their runs out these are a series of little tiny blood vessels tinier than even a highquality microscope can see that are so so so small that they're very vulnerable to things like high blood pressure and dramatic changes in blood sugar levels and what happens to many folks as they get older is that due to different medical conditions that are modifiable we get irreversible damage in this part of the brain and how this shows up for most people is if they get an MRI or a CT scan of the brain they're typically told something like well you have a couple white spots in your brain or we see a little small vessel disease this type of Brain Change goes by many different names probably the most uh common name that you're going to hear is chronic eseicinquantasei with those annoying retrieval problems that come along with aging and part of this is because this is so common particularly in Western culture where we have a very rich diet in saturated fats this is the brain problem that is absolutely related to you not being able to come up with those words that you know darn well that you know but they just don't come up as quick as you want it's very very likely related to this problem so this is a perfect example of why we want to get adults thinking about brain health earlier and earlier we don't want to wait until someone is in their 80s and 90s to start thinking about what is it we can do to preserve our brain it's never too late to start but the truth is you have your most power to affect the health of your brain the earlier you start so let's talk about some normal changes that happen in the brain with age there are really big differences in the range of Ages at which people experience brain changes which really suggests that it's not just age there's something else that's going on what we know is that younger older folks so 50 to 60 60 to 70 they are doing better on average in terms of physical health and brain health and what we attribute this to is advances in Physical Medicine we are more health conscious these days we know so much more about how to keep our bodies specifically our cardiovascular health stronger and that has such a powerful effect on the brain also people have had more access to things like education and the ability to participate in complex hobbies and that's really what scientists think is the difference in the age changes that we see in brain health over time now most people will experience some minor changes with age in the way that they process and retrieve information but what I want to convince you about today is that this really needs to stay in the mild range before someone gets worried by the time we're 80 we are going to be getting a little bit more changes in the way we think about things the way we learn the way we remember but it really should not rise to the level of impacting your everyday life and when we get to that part of the lecture I'm really excited to teach you all that I know about dementia and what that that actually means many of the changes that happen above and beyond normal aging are related to these modifiable risk factors so one thing that's really important as we talk about the brain is I want you to understand the difference between structure and function function and this is a key concept there are normal changes that happen in brain structure and there's also normal changes that happen in the way the brain works there isn't necessarily a significant relationship between these two things you might think that the health of the brain as you see it physically would dictate the way that it works in real life but that's not actually the case so what we know from different brain Imaging studies is that there are physiological or structural changes that happen with age so let's just talk about those for a little bit the first thing that happens that is totally normal is that we do lose a little bit of our brain volume and this is typically more of the white matter than it is the gray matter so what does that mean that means that we're going to get a little bit more slowness in our retrieval the information is still in there it's just sometimes a little bit harder to find the other thing that happens is we lose connections between the cells and this is probably due to a little bit of a decrease in our overall brain chemistry we also know that less blood and oxygen travels to the brain as we get older and it's probably related to the blood vessels becoming a little bit narrower due to the cardiovascular issues that I talked about earlier the final change that we know happens normally in most people's brain as they get older is they actually have more inflammation in their brain and this is probably due to two things that we're going to talk about in this series diet and stress there's also normal changes that happen in the way the brain functions so how does the brain actually work in real life now this is an interesting area of research because there is a group of researchers that feel that everything is related to a decline in vision and hearing now they think that if we could just compensate for normal vision and hearing loss everything else that goes wrong in the brain as we get older those mild changes would really be completely normalized other brain scientists feel that that's probably not as accurate and what they see is changing most significantly are things like your processing speed your ability toine those words specifically names your ability to multitask and your ability to learn new information over time but don't go getting depressed because what I really want you to hear is that these changes when they're normal are very very mild let's talk about these changes in a little bit more detail the vision changes are very very common you can see I'm wearing glasses I've been wearing them since the second grade as I look out into the crowds at my talks I would say about 90 95% of older folks are wearing glasses so the first thing that we know is that Acuity which means our ability to perceive small texts and fonts changes over time we have more and more difficulty focusing up close we also know that our peripheral vision does decrease a little bit we know that there are structural changes in the lenses and the pupil and the retina and of course we have age related Vision disorders like cataracts macular degeneration glaucoma and even structural changes like eyelid skin falling down over the eye making it difficult to see hearing loss is another common change that happens with age by the time we're 75 years old over half of us are going to have clinically diagnosable hearing loss and what is so important about this is that if we don't hear what someone said we're not giving our brain any information to work on the other thing that you need to know about untreated hearing loss so these are people who either don't have hearing aids or have them and are not exactly wearing them as they should there's some new research that's come out that's very very important that you know and what it's told us is that when people don't have their hearing loss treated that creates a risk factor for dementia in a couple years down the road and the idea is that if those brain cells in the auditory cortex the hearing part of our brain are not getting stimulated they don't think they have any work to do and they shrivel up and die once the process of cell death has initiated in the brain it can sometimes be the beginning of a downward spiral I think if more people knew this it would create a lot more motivation for people to actually wear their hearing aids to say nothing of the irritation that it can also cause people's spouses by having to repeat them M themselves over and over again the other thing I want you to know about hearing loss is that it is critically important to social health when people can't hear people stop talking to them they stop participating in activities and what we see is that their social world gets smaller and smaller and smaller one of the things I want to convince you of in my brain series is the critical importance of social health this is not okay that we get less social and less connected as we get older it's actually a time in our lives where we need to be more vitally engaged with with each other and if you have hearing loss that's not treated you're absolutely not going to be as connected as you should be the ability to process information quickly and multitask does mildly decline with age and this is related to that subcortical part of the brain that I taught you about earlier remember those little teeny tiny blood vessels that are so fragile they're so vulnerable to high blood pressure and high cholesterol if you know anyone or you yourself has one of those medical conditions I almost guarantee you you also have other cardiovascular conditions they tend to travel together most people start off with a little bit of high cholesterol then the hypertension the high blood pressure develops to compensate for that and over time this can lead to less blood flow to different parts of the brain different parts of the body have different diameters of blood vessels I think it makes sense to all of us that the smaller the diameter of the blood vessel the easier it's going to be to sustain damage so where in the body do we find the smallest blood vessels they're in the feet the kidneys the eyes and the brain and if you think about something like type 2 diabetes that's where we see a lot of the consequences we have neuropathy that starts in the feet that burning and itchy and achy feeling we get kidney disease we have retinal neuropathy we have brain changes so that's a critical example of sometimes when people think of type 2 diabetes they just think of it as a blood sugar problem but it's absolutely a brain health problem so the last thing we're going to talk about in this section is that learning does get a little bit more difficult and why we think this is is that in the normally aging brain the memory centers called the hippocampus do shrink a little bit more than the rest of the brain with age this absolutely does not mean that older adults are not able to learn it just means that they need to hear information repeated numerous times times until it sinks in so we are not going to be negative about aging in this series I absolutely think that brain aging can happen very successfully so let's talk about what doesn't change with age older adults have extensive life experience on which to draw so absolutely things like wisdom and crystallized knowledge just keep increasing the longer and longer someone lives we know that judgment and verbal reasoning absolutely remain exactly as they were before in the normal Ally aging person's brain our ability to pay attention to things that we're interested Remains the Same and our social cognition increases now this is a super interesting area this means we get better and better at dealing with people as we get older when we talk about brain health I want you to understand it across the whole Spectrum from absolutely normal aging all the way through the different diseases that cause dementia when we look across the Spectrum I want you to think about it in three different categ categories the first one is normal aging the next one is something that we call Mild cognitive impairment and the next one is dementia and I'm going to explain each one of these in really good detail let's talk about mild cognitive impairment this is actually a somewhat controversial diagnosis mild cognitive impairment is considered to be a cognitive disorder in which aspects of thinking are worse than we would expect for age but they're not at the point where they affect everyday life that's the crossroads into dementia once a cognitive problem like learning or memory or a language problem crosses over into affecting everyday life that's when we consider it to be dementia so to meet criteria for a diagnosis of mild cognitive impairment you have to go through a process called neuros pychological testing and that is what people like me as neuropsychologists do for a living we give standardized tests in-depth clinical interviews and and a review of medical records to figure out exactly what is going on with someone's brain mild cognitive impairment is a diagnosis that I might use if someone who's come to see me in my clinic has a memory problem that's about 1.5 standard deviations from the mean and what that means is that they're definitely a little bit lower than I would like to see them for their age but they're not so low that I know that they're having problems remembering to take their medicines driving or managing their money so why this diagnosis is somewhat controversial is because brain scientists are not decided on what it actually means and where people who have this diagnosis are going to wind up so some people believe that mild cognitive impairment is a stable problem meaning you drop down a little bit from age but you're going to stay there it's not a progressive condition there's other groups of scientists that think that what we're actually capturing is the very early stages of a brain condition like Alzheimer's disease the way to really get around this is to have someone tested at two time points at least 9 to 12 months apart so you can really judge if there's been an objective change in their brain functioning over time dementia is not a normal part of aging this is a huge misconception and we all remember some of the names that people used to use old timer's disease hardening of the arteries what's inherent in some of those names is this idea that it's inevitable that if you live long enough you're going to develop dementia and that's just not true as I told you before age is the number one risk factor for developing dementia but there are plenty of people out there who are 105 who have no signs of dementia whatsoever so it's absolutely not a normal part of aging I just told you a few minutes ago that the definition of dementia is when cognitive problems are to the degree that they have difficulty doing things in everyday life without assistance and what's critical is that this is a change for the person if this is someone who always had a hard time balancing the checkbook uh you you can't get overly worried about them it has to be that it was something they used to be able to do and now they're having difficulty the number one question I get as a neurosystem mentia and something like Alzheimer's disease I I want you to think about dementia as an umbrella term okay it's a very broad construct and underneath the umbrella there's 90 different types of brain diseases that cause dementia all dementias are due to different diseases in the brain that cause injury or death to the cells in the brain or their ability to communicate with one another when you think about dementia I want you to know that it's not just a cognitive problem it's really easy to just chalk it up up to well someone can't remember as well as they used to or this one can't remember names like she used to dementia really has three parts and until we understand these three parts we're not going to be able to give the care that people with dementia deserve of course there is a cognitive component for most people with dementia the first sign that we see is difficulty with new learning the next problem is difficulty with things like multitasking and reasoning someone who used to be able to do all sorts of things seems to be having trouble keeping all those balls in the air language is another aspect that's often hit with dementia and what you see is difficulty finding words and difficulty comprehending but the symptoms of dementia are so much more than just cognitive there's always a mood or behavior component and there's also what we call a functional or an everyday component the mood or behavior changes can actually happen even before the memory changes and what we typically see is an increase in frustration irritability and part of this is because something is new and different and more difficult in a way than it was for someone's whole life but it is also related to just the biology of the changes that are happening in the brain a very common thing that can happen for individuals with dementia very early on is a decrease in interest or their ability to engage in their hobbies and sometimes like I said this can even predate the memory symptoms the third part of dementia is that everyday life piece and I've said this a few times now the cognitive symptoms have to be at the level that they interfere with people's instrumental activities of daily living and those are considered to be three different sets of skills driving medication management and finances the most complicated of those three by far is finances if somebody can manage a checkbook balance a checkbook and be handling Investments and bills there is no way that they can meet criteria for dementia brain scientists disagree on the most common form of dementia typically we think about Alzheimer's disease but if we're just going by strict autopsy studies what is probably more realistic is that many people with dementia have what we call a mixed dementia meaning that they have a few different types of dementia that are combining together to give that person and their unique symptoms you've probably heard of some other types of dementia vascular dementia is due to people having one or more significant Strokes some people with Parkinson's disease develop dementia there's something called Louis body dementia which is actually very common but very underdiagnosed and there's about 80 or 90 other types of dementia this is why neuros pychology feel so strongly about people undergoing our assessments because really it's only the tools that we use that can can figure out what type of dementia someone has until you know exactly what the problem is you don't really know what you're treating so we need to get the map very clear on the contributions to the dementia the type of dementia and then we're going to be in a much better position to do something realistically helpful about it so let me give you some examples of what's normal and when to worry if you're finding yourself or you're noticing in a loved one or maybe even a resident they're putting sticky notes all over the place to try to remember that in and of itself is actually fine the problem becomes when the sticky notes become a city unto themselves and actually create more confusion to remembering than they do help if you sometimes have that tip of the tongue phenomenon or you notice that in a parent but in a few minutes the information pops back into someone's mind that for the most part is pretty normal needing to reduce distractions to focus on a task is very normal as we get older you might have been able to balance the checkbook 10 years ago with the TV on maybe even taking an occasional phone call you might find now that you really need to keep distractions to a minimum in order to do the task quickly and accurately in contrast I want you to think a little bit more seriously and maybe get a little bit concerned if these things start happening to you or somebody that you care about if somebody mentions something to you and you have absolutely no memory of having had that experience even after they give you cues and prompts that is pretty concerning because when we forget whole experiences that is usually a sign that there's something abnormal going on in the brain if you ever have feelings of being confused or ever feel like you see that in someone that you care about that's typically not normal sometimes when people are first coming out of sleep or if they've been in the hospital or they've had a surgery a little bit of transient confusion can be okay but if if the person is clearly disoriented and has difficulty figuring out what's going on that is something to be concerned about I also want you to raise your level of concern if you have a strong family history of dementia the younger someone is when they develop symptoms of dementia the more likely it is to be genetic there's a big difference in having a family member who started showing signs of Alzheimer's disease at 55 or 60 than there is in someone who started showing signs at 8 80 or 85 the older we are when we get dementia the more likely it is due to these modifiable risk factors that's kind of an indirect way of being able to judge how strong is your genetic load what is the genetic likelihood of you developing dementia as you get older and remember the most important thing to keep an eye on is everyday life if you or someone you care about starts to have difficulty getting from point A to point B in the car getting lost not remembering to take medications double taking medications paying the wrong bills forgetting to pay bills as a pattern this is concerning we're all human we all occasionally make mistakes or forget about things when it's dementia it's not going to be a one-time experience you're going to see this as a pattern over and over again and that's when you really need to take it serious so what are you going to do if you are worried if you were just listening to me and you're nodding your head yep yep okay worried about that what are you supposed to do well I want to tell you about the five elements of a gold standard evaluation for the brain so you know exactly what to ask for when you go to your doctor the five elements are a physical examination and laboratory studies a picture of your brain called neuroimaging This is either an MRI or a CT scan of the brain an in-depth interview with you a family member or someone that knows that person in great detail a review of the person's medical records including all the medications that they take and all of their medical diagnoses and standardized pen and paper testing so let me tell you about each one of these in more detail your primary care doctor is a great first stop this should be a trusted Medical Professional that you feel really comfortable with that takes the time to understand your concerns the first thing that typically happens is they're going to take a blood test and maybe also a urine test and what they're really looking for are treatable conditions that commonly cause older adults confusion very typical examples are low vitamin B12 or also high blood sugar levels in the urine test we get very concerned when older adults have any type of infection and specifically a urinary tract infection if any of you have had those or care about someone who has you know the number that they can play on the way people think on the way that they behave so the first pass is we have to make sure that there's nothing going on that would be an easy fix when people come to see me as a neurosync them over to us or to a neurologist I want to teach you a little bit about the types of brain pictures that get taken that help your doctors understand what's going on with your brain now remember what I said a little while ago there's a big difference between structure and function and my personal opinion is that I think people overestimate the information that neuroimaging or pictures of the brain give us they're very good for ruling out some things but you cannot diagnose dementia as a result of a picture of the brain you can absolutely tell if someone has a brain tumor if they've had a bigger stroke if they've had a skull fracture after a fall if they've had a brain bleed but you really really cannot diagnose dementia and remember what I've taught you part of a diagnosis of dementia is how that person is doing an everyday life and no picture is going to be able to tell you that the two main types of neuroim Imaging that we think about are CT scans of the head and MRIs of the brain now both of those can be done with and without contrast and all that that means is they've injected a radioactive dye sounds great into someone's arm and you can actually see the blood as it's moving through throughout the brain I want you to think about a CT scan of the brain kind of like a black and white photograph it definitely gives you a lot of information but it's not very rich and it doesn't have a lot of details it's quick it's inexpensive and this is what you're going to get if you had a fall and you went into the emergency room for example and all your doctors are trying to figure out is is there a bleed did this person crack their skull it's a perfectly acceptable and the right thing to do at that time to figure out the question if on the other hand you're not in an emergency and your doctors really want to get a much better understanding of the structure of your brain an MRI of the brain is absolutely the way to go I kind of think of it like a color photograph it gives a lot more richness there's a lot more detail you can see a lot of the structures in the brain a lot better and typically what I use it for is a rule out to make sure there isn't anything very specific but there's also two other areas that neuroschistosomiasis the first one is what we call atrophy remember what I taught you earlier as we get older all aspects of the body shrink a little bit you know some people as they get a little bit older they shrink down well the same thing happens in our brain but there's a normal degree of atrophy that should happen so the first thing I want to know when I read an MRI report is what is the degree of shrinkage in the brain is it normal for that person's age there's two aspects of atrophy that are important to know you want to know the general eneral or the global atrophy how is the overall brain doing but sometimes different parts of the brain shrink quicker than other parts or more significantly than other parts and I want to know that too because there's types of dementia that are very specific to different parts of the brain fronto temporal dementia is a perfect example this is a type of dementia that in which someone's frontal loes are undergoing a disease process and they're shrinking faster than the rest of their brain the other thing that I care about is that blood flow so I want to know if the person has ever had a stroke and this goes from the big Strokes all the way to those smaller silent Strokes you might be amazed how many adults are walking around who've had silent Strokes who have no idea what you need to know as a brain scientist is where in the brain the stroke has happened and how big is it where in the brain is critical because we know what different parts of the brain do so if I look at someone's brain scan and I can can tell that they've had a stroke in the left frontal lobe well I know that they're going to have difficulty starting activities sticking with activities maybe they're going to have some behavior problems in that our frontal lobes are kind of like our impulse control center so sometimes you know we were all thinking things but it doesn't exactly get blurted out that's what your frontal loes do they help kind of pump the brakes a little bit when people have strokes or different types of brain changes that affect the frontal Lo they're not as able to inhibit their responses as they once were what I also want to know in terms of blood flow gets back to those little teeny tiny blood vessels remember before we talked about chronic es schic small vessel disease you are actually able to grade that as well on a brain picture so I want to know is that normal for the person's age or is it more moderate or is it more severe so these are tools that the neuropsychologist and the neurologist uses to understand brain health but it's absolutely not the total picture the next element to a gold standard brain evaluation is a comprehensive interview with the person and someone who knows them very well in my practice all of our appointments are 60 Minutes in my opinion it's very hard to understand a complex clinical problem in less than 60 minutes I need to know the person's life history so I can understand what has changed recently that has brought them into my office you cannot figure out something like dementia in a 5 to 10minute interview it's just not possible furthermore we absolutely have to include a family member or a friend or even someone who might live in the person's residential Community to be a part of that interview one of the biological aspects of different types of dementia is an inability for the person to have insight into what's changed about their brain and the the way that they act sometimes it's easy to think that maybe the person's in denial or it's kind of a psychological defense but in the case of Alzheimer's disease it really is a biological symptom for many people and they genuinely do not see the problem in the same way that somebody else might see as an outsider I want to strongly encourage you to be a part of an evaluation if someone that you care about goes to a neuroschistosomiasis it really really is important that the doctor understand what you've been noticing now I know that this can be an incredibly sensitive topic to bring up but I think that a good brain doctor can set the stage and make everyone in the room understand that I need to be able to hear what's going on I need to know the truth in order for me to help you my personal philosophy is that if something's really going wrong in the brain like dementia it's happening whether or not we give it a name but it's critical that we do give it a proper name because that's how we're going to know what it is we need to do about it and the information that a family member brings to me is invaluable it really is better than even some of the medical tests I need to know from an expert who knows that person what is normal for them and what has changed so let me tell you a little bit about a neuros pychological evaluation this is those paper and pencil test that I was talking about earlier if you were with me from the beginning of this program you know that I'm Aur psychologist and we are phds in Clinical Psychology who go on to do an additional three years of training in the brain we're licensed state byst state to assess and treat people with different brain conditions we basically use three tools to achieve our goal of helping people the first thing we do is we're really good listeners we try really really hard to understand the unique symptoms that are happening within that unique person the next thing we do is we get a lot of medical records we want to understand what medications have been started what are people's different diagnoses what surgeries have they had all that stuff matters but probably our biggest tool is standardized pen and paper tests these are things like asking people to read words out loud listening to a short story and telling us what they remember looking at different pictures and telling us what is the name of that object we also want to understand things like mood behavior and of course that critically important part how is someone really doing in their everyday life what we do after someone completes the test which typically takes about 2 to three hours is that we score the test and what this means is we score how that person did but we compare it to a reference group that is as close to that person as possible so we have these big book of norms and what we try to do when I say Norms I mean normative data and what we try to do is compare that person's score to let's say other 7 71y old women with a bachelor's degree this is one of the ways that we can make statements about well is this normal for age or is it not what neuroschistosomiasis treed sleep apnea there's a pattern for vascular changes there's an Alzheimer's pattern and of course you sometimes get mixes of different patterns this is why we're in school for so long we have to be able to figure all this stuff out but neuros evaluation is the gold standard in the field of truly understanding the brain and what our real job is as neuropsychologists is to bring all of this information together I very rarely evaluated someone who all imer's disease as an example is the only problem going on there's almost always something else for example maybe someone had a hip replacement a year ago and they've never really been quite the same since maybe they've been home more because they can't get around as much and they're drinking a little bit more wine maybe they've also been on pain medication since that time maybe there's a very strong family history of Strokes maybe as a consequence of not being able to get around a lot in pain we also o have a new problem of depression maybe there's also been a couple small Strokes what neuroschistosomiasis back session this is when we get to communicate exactly what we think is going on with you or someone that you care about and really what a privilege that has been for me to be able to use my experience to make people feel more clear about what's going on with them and give them the tools to know exactly what it is that they need to do to get better or to at least keep themselves at the same level of functioning that they did before we then write up all of our findings into a report and send it back to people's medical team typically this is a primary care doctor maybe a neurologist maybe a cardiologist CU we want everybody in the person's care team to understand what were the results of this very comprehensive evaluation because it's critical for all aspects of the person's care not just their brain health so I want to close with four strategies for getting the most that you can out of the eye care for your brain program the first one is I really want you to engage with this material please don't just sit there and listen to me go on and on I really want you to pay attention I really want you to tie it back to your own life this is the way that we make meaning out of the things that we hear this is how we learn by making it relevant to us personally so when I'm talking I really want you to try to tie back my examples to your own life or to somebody that you know or care about the second one is I really want you to interact with the companion workbook that goes along with these lectures what they're going to contain is all the PowerPoint slides that I use you're going to have a section for note writing what you're also going to find in the workbook is behavior tracking sheets and I want to tell you a little bit about these so the whole idea is that the way you change behavior is actually paying attention to your behavior as it is now you need to just start to pay attention so let's just take alcohol as an example you might not really be aware of how many glasses of wine you're having a week when we get to the the lecture on substances and how they affect the Aging brain we're going to talk all about what are the recommendations that have just been recently put out to guide you in making these important decisions but until you know what you're doing now it's going to be really hard to know what your goals are so included in the workbook are going to be a lot of tracking sheets and you're going to start to become your own brain scientist you are going to start to understand what is it that you're doing that might be good or maybe not so good for the health of your brain one thing that was really important to me when I put together this program is that at the end of every one of my lectures what you're going to see is a few slides that are just my references I want to encourage you to go seek out these primary sources on your own if you're a computer person I want to make sure that you know about Google Scholar this is a really cool free program that's on the internet where you can put in any of the articles that I reference and actually get the original article one of the criticisms I have of the brain Fitness industry is that they deliver news in these little tiny Snippets and they're skewed for profit what I want to do is present that information to you in a more objective and measured way helping you understand the power of the results without over amplifying their possible effects so if you get excited by something I'm talking about you're always going to be able to go into the reference Pages find the scientific citation and look it up yourself the third thing is I want you to figure out why are you doing this why are you spending your time with me today I want you to Define your motivation early and often I want you to make your motivation Crystal Clear why are you doing this and I want you to make it very personal any Behavior change takes some effort I told you before brain health is not a quick fix you're really going to have to do things day in and day out things that aren't too hard things that are definitely not that expensive but it's going to take effort you need to know why you're doing it one example that I heard that I thought was so great is I had a 82-year-old patient and he said to me I want to live five more years so I can see my great-granddaughter graduate from high school so what we had him do was to put her picture on the refrigerator and every day when he's trying to make better choices about what he eats in light of his type to diabetes that's not very well controlled he keeps thinking of that beautiful face and that keeps him on track so you have to take that responsibility of figuring out what is it that is going to fuel this mission for you and the last thing is I want you to stay calm remember you're going to be thinking like a brain scientist in no time I know that this was a lot of information coming at you this was our first time together every time we're going to be getting more and more in depth you're going to keep learning more and more and by the end I promise you you are going to feel so in charge of your brain health it's going to feel awesome thank you so much for joining me and I really hope to see you [Music] again

Channel: I CARE FOR YOUR BRAIN with DR. SULLIVAN

Views: 4,761

Keywords: masterclass, brain, brain health, dementia, aging brain, alzheimers, neuropsychology, dr karen d sullivan, i care for your brain

Id: aFt22rfgQNA

Length: 81min 18sec (4878 seconds)

Published: Wed Feb 14 2024