Alzheimer's Starts Decades Before You Forget Anything

JJ Virgin (0:00)

We tend to think we get worried about Alzheimer's when we walk into the bedroom and forget why we're there, or we can't remember someone's name. But you're saying in your book that this is starting decades earlier, and I'm assuming a lot of that is sending the wrong signals.

How is this happening? Is it starting, what, 20 years earlier, 30 years earlier? What's going on here?

David Perlmutter (0:25)

I think the narrative for me is we've got to pay attention to the 30- and 40-year-olds, i.e., they need to be paying attention to what we're talking about right now. Because that is when the seeds of Alzheimer's and other neurodegenerative conditions are sown, not when you're walking into the room and forgetting why, and forgetting Wi-Fi codes and grandchildren's names. At that point, this disease is well on its way, and there's trouble in the near term. So we've really got to emphasize getting people back intact metabolically in their 30s and 40s.

Again, that's the narrative that I'm using, but the reality is when you think about it, we need to be targeting adolescents, we need to be targeting teenagers, we need to be targeting newborns. Think about it because we need to be targeting mothers prior to birth when they are gestating a newborn, a child, a fetus. Because all of those signals are very important in setting up that individual's metabolism for later in life. Even how a child is born, the cesarean section versus vaginal delivery has a role to play in this discussion that we are having today. Who knew? But I think the biggest traction is going to be to tell those 30 and 40-year-olds, yeah, you might look okay right now when you look in the mirror, but metabolically, there are some things already established in your body that you need to be paying attention to right now because you will blink your eyes and you will be my age before you know it and wishing that you had taken better care of yourself, wishing that you had really heard this message and made it an action plan.

That's what this new book is all about. It's the action plan to keep that immune system on your side. These cells want to do everything they can to nurture a wonderful brain. But when again, we choose to signal them in the wrong way via increasing inflammation, via changes in our microbiome or having elevated blood sugar, loss of insulin functionality, trauma, all of these things that influence these microglial cells, the brain immune cells, they start doing things to the brain that are not salubrious, that are not paving the way for brain health in decades, as you well characterized.

JJ Virgin (2:49)

So, for the person listening to this podcast, because the title is Well Beyond 40, who is thinking, well shoot, I'm not 30 or 40, I'm 50, 60 or 70, is it too late for me?

David Perlmutter (3:03)

No, and in fact, let's play on your title a little bit. Well Beyond 40 Okay, if you want to be well beyond 40, and I'm 31 years beyond 40, if you want to be well beyond 40, you've got to make the changes when you're 40, and not wait till you're 60 and wait till you're 70, because there's a lot that passes under the bridge between being 30 and being 71, as it is in my case, that are to some degree not as easily reversed. So it's really all about what you've been talking about. Your new book, for example, talks about this fundamental importance of not becoming sarcopenic. What does that mean? Not losing muscle mass. Who knew that muscles create chemicals, like an endocrine gland, which they are, that go throughout the body to regulate our metabolism, to regulate brain metabolism, and to nurture the growth of new brain cells just based upon chemicals that our muscles produce. If you want more of those chemicals, you need bigger muscles. And I'm not talking about really pumping up, but I'm at least talking about stemming the tide of muscle wasting that is seemingly a natural occurrence as we age. And that's what your messaging has been for so long. How do we maintain muscle mass? And how do we harvest what those muscles are trying to send to our bodies to keep our metabolism on track? It matters for health throughout the body, for cardiovascular health, for insulin health, for glucose regulation. Of course it does. We can unpack how that works and why that works. But it matters for brain health. Physical exercise and maintaining muscle mass are absolutely some of the important pillars for paving the way for brain health as we age. So in a very real sense, this is messaging to allow you to be the architect of your brain's destiny by doing these things right now.