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Preventing Dementia: Key Factors and Lifestyle Choices with Dr. Clionsky
17th June 2024 • Seek Go Create - The Leadership Journey for Christian Entrepreneurs and Faith-Driven Leaders • Tim Winders - Coach for Leaders in Business & Ministry
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Have you ever wondered how your daily habits could impact your brain health and potentially stave off diseases like dementia? In this eye-opening episode of *Seek Go Create*, Host Tim Winders sits down with Dr. Mitchell Clionsky, a board-certified clinical neuropsychologist, to delve into the intricate connections between exercise, diet, and cognitive decline. Dr. Clionsky unveils practical strategies, such as the "10 by 3 formula," and sheds light on often-overlooked health factors. Join us to explore the art of prevention and the science behind maintaining a healthy brain for life.

"Prevention is far more effective than looking for a cure when it comes to dementia." - Dr. Mitchell Clionsky

Access all show and episode resources HERE

About Our Guest:

Dr. Mitchell Clionsky is a board-certified clinical neuropsychologist with over three decades of experience in treating patients with cognitive disorders. Coauthor of a comprehensive book on dementia prevention, Dr. Clionsky has dedicated his career to understanding and mitigating neurodegenerative diseases. He is renowned for integrating solid scientific evidence with practical health strategies, emphasizing the importance of lifestyle changes and preventive measures. His expertise spans multiple medical disciplines including neurology, psychiatry, and endocrinology, making him a leading authority in the field of cognitive health and dementia prevention.

Reasons to Listen:

1. **Holistic Health Insights**: Discover why a balanced approach to health—including exercise, nutrition, and sleep—is crucial, and learn about Dr. Clionsky's "10 by 3 formula" for integrating easy yet effective physical activity into your daily routine.

2. **Dementia Prevention Insights**: Uncover actionable strategies to lower your risk of dementia by 40% to 60% through 20 evidence-backed factors, including advancements in hearing aids and the importance of active, engaging pursuits.

3. **Stress and Cognitive Health**: Understand the impact of stress on brain functionality and explore methods to alleviate cognitive strain through physical activities and mindfulness, all while gaining insights from an experienced neuropsychologist.

Episode Resources & Action Steps:

### Resources Mentioned:

1. **Dr. Mitchell Clionsky's Book on Dementia Prevention:**

- Coauthored by Dr. Clionsky and his wife, Dr. Emily Clionsky, the book focuses on scientifically backed methods for preventing dementia.

2. **Website for Brain Health Resources:**

- Dr. Mitchell Clionsky provides a website where listeners can access resources on brain health.

### Action Steps to Implement:

1. **Adopt the "10 by 3 Formula":**

- Integrate a 10-minute brisk walk three times a day into your routine to improve overall physical health and potentially reduce disease risk.

2. **Prioritize Sleep Health:**

- Focus on sleep continuity, duration, and consistency to enhance cognitive function and overall well-being. Consider monitoring blood oxygen levels and seeking medical advice if experiencing symptoms of obstructive sleep apnea.

3. **Engage in Thoughtful and Interactive Activities:**

- Reduce passive activities like watching TV for extended periods. Instead, engage in activities that require critical thinking and interpersonal communication to stimulate brain function and improve cognitive health.

Resources for Leaders from Tim Winders & SGC:

🔹 Unlock Your Potential Today!

  • 🎙 Coaching with Tim: Elevate your leadership and align your work with your faith. Learn More
  • 📚 "Coach: A Story of Success Redefined": A transformative read that will challenge your views on success. Grab Your Copy
  • 📝 Faith Driven Leader Quiz: Discover how well you're aligning faith and work with our quick quiz. Take the Quiz

Key Lessons:

1. **Holistic Health Matters**: Eating healthy alone isn't sufficient to negate other risk factors such as lack of exercise, excessive alcohol intake, and usage of over-the-counter sleep aids. Comprehensive health involves integrating various good habits into your lifestyle.

2. **Simple Steps Make a Difference**: Dr. Clionsky introduces the "10 by 3 formula," advocating for just a 10-minute brisk walk three times a day. This simple routine is accessible to almost everyone and significantly impacts overall health.

3. **Long-term Health Consequences**: Maintaining good health habits can often seem consequence-free until problems manifest later in life. Dr. Clionsky stresses the importance of consistency in healthy behaviors to prevent issues like dementia.

4. **The Importance of Sleep**: Proper sleep, including factors like continuity, duration, and consistency, is crucial for cognitive health. Poor quality sleep negatively impacts the glymphatic system, responsible for flushing out toxins during sleep, and can lead to tiredness and impaired thinking.

5. **Preventing Dementia**: Dr. Clionsky shares research suggesting that addressing key health factors can reduce dementia risk by 40% to 60%. There are 20 known factors impacting dementia risk, highlighting the importance of a multifaceted approach for prevention rather than just seeking cures.

Episode Highlights:

00:00 Neuropsychologist measures cognitive abilities through various tests.

10:17 Research identifies multiple factors reducing dementia risk.

15:45 Check dementia risk with free online checklist.

17:01 Cultural tendency for quick solutions and fixes.

25:41 Healthy habits can't always prevent dementia.

30:13 Book explores leadership and Alzheimer's terminology evolution.

36:58 Non-family caregiving varies by location, needs improvement.

43:23 Consistent sleep schedule is vital for health.

46:03 Obstructive sleep apnea: breathing stops during sleep.

50:44 Limit tasks to prevent cognitive resource depletion.

59:20 Engage in activities to keep brain healthy.

01:05:45 Quickly read excellent book; important message for all.

Thank you for listening to Seek Go Create!

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Transcripts

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Dr. Mitchell Clionsky: It's going to become a massive problem in

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the next 10 to 20 years unless we begin preventing dementia.

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It's not going to come from curing it.

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I feel really confident about that.

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It's going to come from preventing it.

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If we could get rid of or avoid even 40 percent of the cases of

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future dimensions, it would be a manageable problem on a societal basis

Tim Winders:

How do we face the daunting challenges of dementia and

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cognitive decline, both as individuals and as families deeply affected

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by these conditions today on seek, go create the leadership journey.

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We have a deeply personal and enlightening conversation lined up with Dr.

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Mitchell Klionsky, a board certified clinical neuropsychologist.

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As someone who has witnessed the impact of dementia within my own family, losing

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my father to this illness 18 months ago, along with its presence with both of his

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parents and most of his siblings, I am particularly eager to gather his insights.

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With over 45 years of experience in more than 30, 000 patients treated, Dr.

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Klionsky has co authored Dementia Prevention.

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Using your head to save your brain with his wife, Dr.

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Emily Klionsky.

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Dr.

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Mitchell, welcome to Seek Go Create.

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Dr. Mitchell Clionsky: Thank you for giving me a chance to

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meet you and your audience, Tim.

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I'm really excited.

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I am excited that you're here too.

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And this is, this is personal for me.

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Let me just go ahead and say, as we get started here, but, let me start with one

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of my icebreaker questions, and then we'll just go ahead and dive into the deep end.

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I think you gave me permission to call you Mitch earlier.

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So I'm going to call you Mitch, if that's okay.

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But I want everyone to know he is Dr.

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Mitchell Kleonski.

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All right.

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So Mitch, let's just say we're out and about somewhere and not at a medical

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conference or anything like that.

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And you bump into someone and you get chit chatting and someone ask you what you do.

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What do you tell people?

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Dr. Mitchell Clionsky: I tell people that I measure how they think,

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and that usually stops them, and they look at me and say, really?

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I said, yeah.

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What I do as a neuropsychologist is we give people a variety of

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different kinds of tests and measures that look at how well you're doing.

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You pay attention in different ways, how well you're able

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to process new information.

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We give tests of short term memory.

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That's oftentimes the biggest question that people come in with, at least.

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We also do tests of what are called executive functions.

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So planning, Judgment, the ability to think in larger ways and to take things

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and adapt them to new circumstances.

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We do measures of intelligence.

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We touch on personality and depression and anxiety.

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And then we take all those scores and compare those scores with what we

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would expect for someone like them.

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Someone with their background, education, their educational level,

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their age, And even their background reading level, we have a test that

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we can give them that helps us to nail what they should be able to do.

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And then we take their real scores, compare them against their

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theoretical scores, and we see if everything lines up the way it should.

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And if it does, we reassure them.

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Things look good.

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You don't have to worry right now.

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Here's some things you can do to increase your chances of avoiding

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dementia as you get older.

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Because I'm all about prevention.

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That's really what this is about.

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And if they're not lining up, we can Use that same information to help

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discover what's going on that's causing those problems and what can be done

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to either stop them from getting worse or potentially improve them.

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That's what really gets exciting.

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We can say, here's some ways that you can get better.

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So that's what I, that's the nutshell of what I tell people.

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Yeah.

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And there's a lot to that.

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when someone starts off with we, people with the way they think, this

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being more of a longer form interview podcast, I think people listening in

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would be, they consider themselves, Maybe deeper thinkers and the way

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we dive into topics and all that.

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So I think that's fascinating on so many levels and we're going

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to have a great conversation.

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And as I said, when we started this also, this isn't generic

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for me, this is quite personal.

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and I was actually texting with my sister, I'll just go ahead and

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hit this right out of the gate.

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And we'll go ahead and address it because I think it might lead and guide us.

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In December of 22, our father passed away.

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He was 84 at the time and at about at the age of 80.

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ish, he was diagnosed with dementia.

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it was about March of 2020.

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That'll give you a point of when that occurred.

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Now, we have gone back and I've gone through some conversations that I've had

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with him and I, we were recognizing some cognitive decline, years before that.

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so that's one, one thing that's going on and it obviously impacts my, I

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have a sibling, my sister and it's something that we discuss quite a bit.

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I'm 60.

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She's, I think she's 55.

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I hope I got that right.

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She's five years younger than me.

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and so we're looking at that.

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Both my father's parents, his dad passed away with Parkinson's, his

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mother had Alzheimer's dementia and he has five siblings and three of

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them have some degree of Alzheimer's, cognitive decline, whatever, they're

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all in their late 70s, 80s, but still.

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It's, I would be, I would probably be lying if I didn't say it's something

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that is a consideration of ours.

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so so my first big question would be, how concerned should my sister and I be

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that we are now dealing with some type of genetic situation with cognitive decline?

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Dr. Mitchell Clionsky: We've told me a couple important things.

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Number one, there's a high.

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At least on one side of your family, possibly both in terms of risk

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for neurodegenerative diseases, brain diseases as you age, but

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they're also somewhat diverse.

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There's Parkinson's disease.

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There's Alzheimer's disease, which is really different in

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terms of its underlying cause as we currently conceptualize it.

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There's probably some vascular dementia factors because those are really common.

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That wouldn't be surprised if those are in there as well.

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And you have a good reason to be concerned, but not panicked.

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And the reason is that even in the most genetically predetermined ways, unless

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it's very early onset, we're talking about people in their 50s who are

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developing dementia, the actual genetic contribution is probably about 5%.

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Now, you'd rather not have that.

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You'd rather have them say, well, we did some genetic testing and you're

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in the protected range and you can be less concerned, but even there you

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couldn't be because those are only genetic risks for Alzheimer's disease.

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It doesn't protect you against Parkinson's.

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It doesn't protect you against, dementia is due to repeated

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head injuries, alcohol abuse.

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Or vascular factors.

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So while you might say, wow, that's all great from my brain's perspective.

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If you've also got a strong family history of diabetes or high

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blood pressure or untreated sleep apnea, you may have other risks.

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The important thing to understand is it's like golf, the game of golf.

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You play it where it lays.

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Sometimes you're lucky and you're on the fairway.

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Sometimes you're in the rough.

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You don't want to be in the woods.

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If you can avoid it, you definitely don't want to be in the water hazard,

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but you got to play it where it lays.

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So the real issue from my perspective, because I hear this question all the

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time, it's a legit question, but we can't undo our genetic contribution.

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And we know that even for people with very strong genetic contributions,

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lifestyle, health factors approaches to this can make a big difference.

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In their ultimate outcome, so I would reassure you that well, you know

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that it's not the best news It's not damning news either It just means

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that you're going to also want to pay really close attention to what you do.

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This brought up something that was fascinating,

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especially with you saying that you actually study how people think.

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I read a book not long ago called The Art of Thinking Clearly, and I recognize

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that many times we have dogmas, mindsets, et cetera, that are as damaging as

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often some of the physical aspects.

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So So here's the question I've got for you.

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Are we asking the wrong question?

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if you were to talk to my sister and I, what questions would, should we be asking?

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Let's make this personal.

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And then I've got some bigger questions I want to ask.

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Dr. Mitchell Clionsky: Okay.

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We know that there are significant numbers of factors that will reduce your

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risk of dementia by 50 percent or more.

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Now, this is not my data.

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This is much better data that I could ever accumulate.

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back in 2017, there was a very large commission in Great Britain

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called the Lancet Commission.

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It was commissioned by the Lancet, which is their version of the

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New England Journal of Medicine.

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And they put together a blue ribbon panel of experts, about 27 of them,

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including a couple from the United States.

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And they looked at all of the various factors that had proven evidence

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of reducing your risk of getting Alzheimer's disease, vascular dementias.

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Dementia is due to Parkinson's.

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There's a whole bunch of different kinds of things under the category

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of dementia, not just Alzheimer's.

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And what they discovered was that they had nine factors that

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would reduce the risk by 40%.

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wow, that's pretty impressive.

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Three years later in 2020, they published a follow up because

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they'd found three more factors.

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including hearing loss, which they didn't really know about three years before.

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And they said, this bumps it up a little bit.

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Now we're looking at probably about 42 percent or so.

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A couple of years after that, here in the United States, a similar group took

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data from the United States Health And retirement survey applied the Lancet

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Commission 12 factors, and they discovered that we could reduce the risk by 60%.

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So now you got 40 percent on one end, 60 percent on the other.

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I like round numbers because they're more rememberable.

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So I say one out of two.

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But it doesn't stop there because when we wrote the book on dementia prevention,

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using your head to save your brain, we then realized there were more factors.

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We've got 20 factors, including the 12 from the Lancet commission, but adding

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eight more that they did not cover.

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And we found these factors, not by just making them up.

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We being my wife, An internal medicine doctor and psychiatrist who

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specializes in treating brain diseases.

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Her name is Emily Klionsky and one of her strengths, one of her superpowers It's our

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ability to take information and synthesize it from a variety of different sources.

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One of the things about dementia that's really fascinating is that it's

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impacted by a variety of different medical conditions and therefore falls

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into different medical professions.

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So it involves just not neurology and psychiatry and neuropsychology.

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It also involves cardiology because a lot of what is involved with

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our heart also impacts our brain.

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It involves endocrinology.

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So the people with diabetes, that's also a huge risk factor for dementia.

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It involves pulmonology, breathing and sleep medicine, specifically

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obstructive sleep apnea.

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So you have to read that literature.

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Then you have to look over into areas like exercise, physiology, genetics.

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You have to look at a variety of different behavioral types of involvements.

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you have to look at some of the details dealing with chemistry of

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medications that we're taking and things that we're buying over the counter.

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So our goal.

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Was to cast this really broad net to read all of this information

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because the experts in each of these areas are not reading all of that.

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They're reading what they're reading.

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It's like being in this certain, they know more and more about a very

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specific area, which is wonderful.

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If you have that particular problem, but there aren't any dementiologists.

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Think about that.

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There's no particular field for dementia, despite the fact that this

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is an incredibly important problem with huge societal costs and personal

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grievance as a result of this illness.

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And yet there isn't a cure.

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a field of Dementiology.

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I want to coin that term.

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So here it is.

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I'm going to put it out because I'm going to probably go and get a trademark on it.

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Dementia, Dementiology and Dementiologists.

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We need specialists who look at all of this.

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But the important thing was that we came up with all these factors.

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We then made sure that they had high levels of scientific Certainty

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the reason for that is that there's a lot of clickbait out there.

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I'm sure you see it all the time You know eat this don't eat that Do this don't

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do that and this one thing or these two things are going to fix your dementia.

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That's Nonsense, it doesn't work that way and you really can't eat

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your way into dementia prevention either So we got a lot of people

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talking a lot of gibberish out there.

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We wanted to get rid of the fads You Get rid of all the hyperbole and focus on

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things that actually had solid evidence.

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So we put together a model that had 20 factors that show how they're all related.

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And then our goal was to translate the information that's hard science

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Into the communication, like you're sitting, like we're talking right

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now, here's what this is about.

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This is what it means.

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Here's what this is about.

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Here's how you go about finding it out.

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And that was the whole idea about this project was to take this information,

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pull it together and translate it so people could use it because it

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doesn't do any good if you don't understand it and can't use it.

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So that's where we came about this whole project, but it's great

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because we now know that this is a preventable illness for at least

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half of the people who are worried.

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And the question is, you, your sister, other people out there,

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what are your risk factors?

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What's your individual profile?

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And that's where you go up to our website.

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You can take a free dementia prevention checklist, which asks you 25 questions.

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And it gives you where you're on target, where you're off target

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and where you're near target.

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Just need a little nudge.

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Just need to lower your blood pressure a little bit or just need to reduce

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your hemoglobin A1c and go from being pre diabetic to not being diabetic.

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So those are the things I would encourage you and your sister and

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other people to do is it's out there.

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You can find out right, not right this moment, but in the next hour

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What your dementia risk is simply by filling out a questionnaire

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and discovering along the way.

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Ooh, I actually don't know the answer to that.

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I don't know the answer that I got to figure that out.

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Got to talk to my doctor about running that test.

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That's where I'd encourage you to go because then you're really

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working with not just information, but the beginnings of a plan.

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Right.

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Yeah, one of the things that I noticed about us as we went on this journey

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with my father, and I think it's also an issue culturally, is that people

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are looking for a quick answer.

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what caused it with dad, with his family, they lived near a chemical

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plant or they all drank the same water or, we're looking for quick answers.

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Number one, if we're in a situation.

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And then I also think we're looking for quick fixes when it comes to prevention.

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Now, one of the things I don't have it pulled up on my screen right here,

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but I've got it pulled up behind this window is within your book, that

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diagram that you mentioned with all of those 20, and I showed it to my wife

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last night while I was reading this in bed, I said, take a look at this.

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Diagram here.

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And y'all also, you talked about how there's an interconnectivity

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between all of these.

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It's not as if take this pill and everything will be better.

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And I observed this quite a bit, not to get controversial, back with COVID,

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there was this thought, Oh, if we have a vaccine, then it'll solve all

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this and the world will be greater.

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And it wasn't quite that simple.

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factors involved with that were obesity and general health and

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all those things like that.

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I get, I'll pose this as a question.

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I'm making that statement, but it appears as if even myself and I'm aware of it.

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I'm looking for simple answers and I'm an engineer by training.

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I know this is complex, but it seems like culturally we're not looking for

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those 20 factors with that diagram that you and your wife laid out, how.

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Can we address that in our culture that is looking for the quick fixes?

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Dr. Mitchell Clionsky: You're right.

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And most of the quick fixes usually involve.

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One of the things that just gets me is I look at, where are the top

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selling books on dementia prevention and most of our diet books.

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And we know that while eating things like a Mediterranean diet, that's

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got a lot of legumes and green leafy vegetables, and not a lot of

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beef and more fish and chicken and lean protein and vegetable based.

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All that stuff is probably from a prevention perspective, the

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best diet that you could eat.

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It doesn't account for much of the data, much of the

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variance in terms of prediction.

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And the other thing is it's not really demonstrably better than the next.

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Best normal diet.

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It is clearly better than a horrible diet.

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A horrible diet filled with lots of fast food and over ultra processed things.

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The Mediterranean diet is clearly better than that, but it's not better

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than just a good solid varied diet.

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But people like to buy cookbooks because they think, I don't have to worry about

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this now because I'm eating healthy.

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And people look at me all the time and tell me that, but I eat so healthy.

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How could I be at risk?

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And I say, that's great that you eat healthy.

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I encourage you to do that, but you're not exercising.

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You're drinking more alcohol than is healthy.

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You are taking an over the counter sleep aid because you can't fall

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asleep for a variety of reasons.

Tim Winders:

All of those things you have to factor in as well.

Tim Winders:

And Oh, what about the fact that you're.

Tim Winders:

overweight, and that's putting more stress on your blood pressure.

Tim Winders:

So they don't necessarily like you're the complexity, but I guess the one

Tim Winders:

saving grace, and we talked about it in the book that it's sort of like

Tim Winders:

an intertwined ball of knots, and you can't just cut it through the middle.

Tim Winders:

You can't just clear out the knot with one stroke.

Tim Winders:

But the cool thing is if you start pulling on some of the threads, some

Tim Winders:

of the strings, what you find is that makes the other ones easier to approach.

Tim Winders:

So let's take the case of exercise.

Tim Winders:

I have a formula for getting people to exercise, which I'll share right now.

Tim Winders:

I call it the 10 by 3 formula.

Tim Winders:

You take a 10 minute brisk walk three times a day.

Tim Winders:

And here's why it works.

Tim Winders:

it's not the optimal.

Tim Winders:

I mean, you see this stuff all the time on the internet, what to do to

Tim Winders:

get this great body if you're 50 and 60 and people say, should I exercise

Tim Winders:

for this or exercise for that?

Tim Winders:

Those are all people who are at the high end of exercising.

Tim Winders:

Those are not the people I see.

Tim Winders:

I see the people where I ask them, what do you do for exercise?

Tim Winders:

And they avert their eyes because they don't want to tell me.

Tim Winders:

Or they tell me things like, I have an exercise bicycle.

Tim Winders:

And I said, it doesn't tell me anything.

Tim Winders:

Are you on the exercise bicycle?

Tim Winders:

How long, how often?

Tim Winders:

So we're looking for people who are more often not doing enough, enough regularly.

Tim Winders:

So the reason that the 10 by three formula works is number one, it's hard

Tim Winders:

to talk yourself out of it's only 10 minutes, so you're never too busy.

Tim Winders:

You're never too bored to do 10 minutes of exercise.

Tim Winders:

You never need special equipment.

Tim Winders:

You don't have to wait for this machine to come in.

Tim Winders:

You don't have to be in a class.

Tim Winders:

You don't have to join a gym.

Tim Winders:

For most people, it's available around where they live or where

Tim Winders:

they can get to pretty easily.

Tim Winders:

It adds up.

Tim Winders:

So the 10 minutes, three times a day is 30 minutes a day.

Tim Winders:

That's 210 minutes a week.

Tim Winders:

So what are the major medical society saying 150 to 300 minutes a week is

Tim Winders:

gonna reduce your risk of dementia, your risk of dying too young, your

Tim Winders:

risk of cardiovascular disease.

Tim Winders:

They all come together at that 150 to 300.

Tim Winders:

Great.

Tim Winders:

Two 10s in the middle.

Tim Winders:

Second thing is if you're moving fast enough.

Tim Winders:

We talk about brisk.

Tim Winders:

What is brisk?

Tim Winders:

brisk walking is walking fast enough that your heart rate increases, but not so fast

Tim Winders:

that you can't talk while you're walking.

Tim Winders:

So it's a great conversational thing, a social thing to do as well.

Tim Winders:

If you could do that, you're going to walk about 9 10 miles a week.

Tim Winders:

That's pretty cool.

Tim Winders:

And you're going to be able to do it, even if it's hot.

Tim Winders:

And even if it's cold, I tell people, don't go out.

Tim Winders:

If it's icy, find something else to do.

Tim Winders:

Cause I don't want you slipping and falling, but you can do this.

Tim Winders:

And then you can decide once you're doing that consistently, is that enough

Tim Winders:

for me now, because it might not be, you might say, I can up my game here.

Tim Winders:

I know that I can't.

Tim Winders:

Over exercise in the sense.

Tim Winders:

Sure, you can go out and try to run a marathon.

Tim Winders:

I'm not suggesting people do that, but they can go from 30 minutes to 45 minutes.

Tim Winders:

Then go from that up to an hour a day.

Tim Winders:

And that's going to give them about 10, 000 steps a day.

Tim Winders:

And that's really optimal in terms of the dementia prevention

Tim Winders:

literature and how it translates.

Tim Winders:

So one, one thing that I noticed as I was reading through that,

Tim Winders:

and I think that's great info, I was just thinking as you were talking, I

Tim Winders:

said, yeah, I went out yesterday and I played 90 minutes of pickleball.

Tim Winders:

And I measured my heart rate at, I got it up to about 150.

Tim Winders:

sometimes pickleball, you don't do that, but, but I do love, I've

Tim Winders:

actually gotten to where I love just going out on a long walk.

Tim Winders:

And to me, that's as much of a mental exercise as it is for physical.

Tim Winders:

One of the things that, and I hate to, this is going to extremely

Tim Winders:

sound like I'm oversimplifying, which is what I discussed earlier.

Tim Winders:

Almost everything that I read.

Tim Winders:

In your book, I don't say common sense.

Tim Winders:

That's not the right word because common sense isn't super common,

Tim Winders:

but it's just healthy habits.

Tim Winders:

It's just like good health.

Tim Winders:

If we were talking about, you discuss a lot about sleep.

Tim Winders:

I do want to address that in a little while.

Tim Winders:

We'll talk more about sleep and different things like that.

Tim Winders:

But it's just, if you've got diabetes, if you're obese, if you're overweight,

Tim Winders:

if you're trying to, isn't this stuff what we should be doing anyway?

Tim Winders:

Dr. Mitchell Clionsky: Yes you know we talk at the beginning of the book about

Tim Winders:

how books like this typically make a promise And the promise we make is if

Tim Winders:

you do these things you will be healthier We can't promise that this will prevent

Tim Winders:

you from getting dementia Because there are just cases that exist that no matter

Tim Winders:

what you do, I've got patients like this and man, does it frustrate me because

Tim Winders:

most of the time I'm thinking that the things I do are going to really make a

Tim Winders:

difference in my patient's lives and I see some of these people and they've got it.

Tim Winders:

Especially Alzheimer's type dementia, and they're on current medications,

Tim Winders:

which for most people, slow down the decline in many cases, stop it

Tim Winders:

from progressing for some years.

Tim Winders:

And we've had these pills out for 20, 25 years.

Tim Winders:

And I know that when they get on them, that's going to be good.

Tim Winders:

And they're, they've got good habits and they exercise, they

Tim Winders:

don't drink too much and they don't have major medical problems.

Tim Winders:

They still get worse.

Tim Winders:

And that's just the way life is, unfortunately.

Tim Winders:

And we all know people who never spoke, get lung cancer.

Tim Winders:

We know people who get cirrhosis of the liver, never had a drop of alcohol

Tim Winders:

in their life, it's just life, but you're right about the fact that

Tim Winders:

these have a lot to do, it turns out that a lot of the things our mothers

Tim Winders:

taught us years ago really were good.

Tim Winders:

We just thought we could work around them and we didn't, and because our behavior

Tim Winders:

and our health are separated in time,

Tim Winders:

this is a really important concept because I was talking about this

Tim Winders:

with one of my patients this morning.

Tim Winders:

I said, if every time you ate something, which you really shouldn't

Tim Winders:

eat, you gained a pound, you would quickly get in control of that.

Tim Winders:

Nobody would ever be too heavy or too light.

Tim Winders:

If the result was immediate.

Tim Winders:

The same way you're not going to leave your hand on a hot stove

Tim Winders:

because it's an immediate feedback.

Tim Winders:

The problem with most health behaviors is it seems like there's no consequence.

Tim Winders:

You smoke cigarettes in your 20s.

Tim Winders:

Chances are you're not going to experience much in the way except perhaps financial

Tim Winders:

problems because of your cigarette habit and people don't want to get close

Tim Winders:

to you because you smell like smoke.

Tim Winders:

if you hang out with other people I'm not even going to bother with that.

Tim Winders:

It's only when you get to be in your fifties and sixties and seventies of the

Tim Winders:

chickens come home to roost that those problems, those things that you started

Tim Winders:

and continue to do end up being a problem.

Tim Winders:

So that's why those health habits are really important, both to reinforce, but

Tim Winders:

also to show the data, why it happens.

Tim Winders:

And then most importantly, I think help people to then figure

Tim Winders:

out how to make that change.

Tim Winders:

Nobody argues with me.

Tim Winders:

If I say, Exercise is good.

Tim Winders:

a gimme.

Tim Winders:

Sure, I know that.

Tim Winders:

Nobody who is significantly overweight argues that's not a problem.

Tim Winders:

They all know it is.

Tim Winders:

They can rationalize it and say, you're just shaming me because No, I'm not.

Tim Winders:

I'm just telling you your body was built for a certain size.

Tim Winders:

That's where it works efficiently.

Tim Winders:

If you're making a carry around a lot more and do a lot more

Tim Winders:

work, it's going to break on you.

Tim Winders:

It's pretty simple.

Tim Winders:

Same way.

Tim Winders:

If you loaded your car up with bricks and tried to drive it long

Tim Winders:

distances, it's going to break down faster than the car that is lighter.

Tim Winders:

It's just the way physics works.

Tim Winders:

So you can do that and that's your choice, but it's not going to work

Tim Winders:

out for you very well in the long run.

Tim Winders:

So a lot of those things, it's that the people don't know, it's

Tim Winders:

that they don't know how to do it.

Tim Winders:

And that's why the last part of the book is all about using what I learned

Tim Winders:

as a psychologist and a therapist very early in my career to help

Tim Winders:

people to recognize areas of change to figure out how do we think those

Tim Winders:

problems and then implement them.

Tim Winders:

Because it's, we see people all the time.

Tim Winders:

They try to analyze why they do this thing.

Tim Winders:

That's a problem.

Tim Winders:

I don't like that very much.

Tim Winders:

I get bored with that.

Tim Winders:

We can sit around all day wondering why you're doing the things you shouldn't do.

Tim Winders:

I'd really rather put our effort into helping you to

Tim Winders:

do the things you should do.

Tim Winders:

That's going to get you somewhere.

Tim Winders:

The

Tim Winders:

about that, as I was reading through that section of the

Tim Winders:

book, it was basically what I do with leaders and leadership teams.

Tim Winders:

Establish the problem, develop a plan, and then you stick to the

Tim Winders:

strategic plan and move forward to have some degree of impact.

Tim Winders:

Do you adjust and tweak along the way?

Tim Winders:

I like the golf analogy you use, you play it where it lays, uh, that type thing.

Tim Winders:

that's really good.

Tim Winders:

Another great thing I really in the book.

Tim Winders:

I think there's so many, I think there's terminologies that people

Tim Winders:

struggle with, like they call everything Alzheimer's when, it's a big, I learned

Tim Winders:

that early on is there's dementia.

Tim Winders:

And then there's the categories that are underneath that there's

Tim Winders:

cognitive issues, things like that.

Tim Winders:

But one of the things I wanted to ask about here is you gave a great, it was a

Tim Winders:

short history of Alzheimer's and dementia.

Tim Winders:

And I think we're at A little over a hundred years ago is when it

Tim Winders:

started coming into our vocabulary.

Tim Winders:

And then you mentioned, I think in the seventies or eighties, there

Tim Winders:

was, a wealthy businessman that his wife was suffering some things and it

Tim Winders:

really came more into the forefront.

Tim Winders:

and I know this is you and your wife, Emily's it's your life as society,

Tim Winders:

as culture, are we getting better?

Tim Winders:

Is this getting worse?

Tim Winders:

Is it?

Tim Winders:

Epidemic proportions.

Tim Winders:

when you've just gone through what we've done the last three, four, five

Tim Winders:

years, it seems as if it's everywhere, you look around and you've got

Tim Winders:

where you see it all over the place.

Tim Winders:

And so in your mind, you go, this is everywhere.

Tim Winders:

What does the data tell us?

Tim Winders:

And how are we doing, as a society with this?

Tim Winders:

Dr. Mitchell Clionsky: data tells us it's increasing.

Tim Winders:

And the reason it's increasing is not that dementia has become more virulent.

Tim Winders:

It's that we're getting older as a society.

Tim Winders:

So I'm a baby boomer.

Tim Winders:

And because of that, I've been in this wonderful bump in the population that has

Tim Winders:

fueled most Of the big changes in society.

Tim Winders:

It's our rock and roll music that you're still hearing on so

Tim Winders:

many of the commercials on TV.

Tim Winders:

It's our, we're fueling the pickleball revolution, because a lot of people my

Tim Winders:

age can't run to play tennis anymore.

Tim Winders:

There's this whole bump in population.

Tim Winders:

That's now 65 and older.

Tim Winders:

And we know that the risk of dementia increases.

Tim Winders:

proportionately as we get older.

Tim Winders:

If you're in your mid sixties, you have about a 10 percent

Tim Winders:

chance of having dementia.

Tim Winders:

You get to your mid seventies.

Tim Winders:

It doubles.

Tim Winders:

It's now about 20%.

Tim Winders:

You make it to your mid eighties, it's now about 40% Now.

Tim Winders:

It levels off after that, largely due to the fact that other things are killing

Tim Winders:

people, so the healthiest people are now surviving, and so you don't really get

Tim Winders:

that, 60% in your nineties kind of thing.

Tim Winders:

There's a lot of people who, once they make it there, don't succumb to dementia.

Tim Winders:

They, until the very, very end of their lives.

Tim Winders:

I hear this all the time.

Tim Winders:

Yeah.

Tim Winders:

My dad lived to be 92.

Tim Winders:

He was demented for the last two months.

Tim Winders:

that wasn't really dementia.

Tim Winders:

That was just a breakdown in his systems at that point showed up in

Tim Winders:

terms of his confusion, but it's this growing, Older population that's

Tim Winders:

causing a whole balance change.

Tim Winders:

it used to be that there were enough new people, enough young people earning money

Tim Winders:

that those who put in their money to the social security system were pretty short.

Tim Winders:

There was enough new money coming in to pay for them in retirement.

Tim Winders:

Plus they didn't live that long into retirement.

Tim Winders:

You retired maybe at 65 and a lot of you'd be dead by your early to mid seventies.

Tim Winders:

Not so much anymore.

Tim Winders:

Fewer people putting money in.

Tim Winders:

More people living longer.

Tim Winders:

It's the same way with caretaking and dementia.

Tim Winders:

And so we're seeing this increase that is going to be a real problem.

Tim Winders:

It's not that it isn't a real problem now.

Tim Winders:

It's going to become a massive problem in the next 10 to 20 years

Tim Winders:

unless we begin preventing dementia.

Tim Winders:

It's not going to come from curing it.

Tim Winders:

I feel really confident about that.

Tim Winders:

It's going to come from preventing it.

Tim Winders:

If we could get rid of or avoid even 40 percent of the cases of future dimensions,

Tim Winders:

it would be a manageable problem on a societal basis, wouldn't be manageable

Tim Winders:

anymore from an individual basis.

Tim Winders:

Cause you still got your families.

Tim Winders:

And by the way, I'm in the same club as you.

Tim Winders:

My mom had dementia.

Tim Winders:

I've sat in that seat.

Tim Winders:

I understand that.

Tim Winders:

I tell my patients that, which most of the time really helps because I

Tim Winders:

tell them this is something where no matter how much knowledge you have,

Tim Winders:

no matter what you're doing for your job, that is a very powerless feeling

Tim Winders:

to see your parent change from who they were when they raised you.

Tim Winders:

To who they became when they developed dementia.

Tim Winders:

And it's a, it shakes you to your core as you well know.

Tim Winders:

So again, it's aging and we got to do something now that's going to show

Tim Winders:

up five years later, 10 years later, that's going to make a difference.

Tim Winders:

and I think another reason for the call to action, and this is

Tim Winders:

a topic that was very challenging for us as we were going through it.

Tim Winders:

Uh, my sister and my mother attempted to be a caretaker for a while, but

Tim Winders:

until it got to where she couldn't, And then my sister and her family

Tim Winders:

were caretakers for a while.

Tim Winders:

And then we had to look at facilities and we had some means.

Tim Winders:

So we were able to look at some facilities that were not the low end or anything like

Tim Winders:

that, definitely probably not the highest end, but they would have been respectable

Tim Winders:

facilities, Atlanta metro area.

Tim Winders:

I do not think we are equipped to take care.

Tim Winders:

of the current population that's dealing with these cognitive issues.

Tim Winders:

And I definitely know that we're not prepared to do it

Tim Winders:

if the numbers grow as aging.

Tim Winders:

Do you want to say anything about that or have a comment about that

Tim Winders:

without getting way off into the weeds on the care issue related to it?

Tim Winders:

Dr. Mitchell Clionsky: I think you're right.

Tim Winders:

I do know that.

Tim Winders:

Caregiving from a other than family perspective is different depending

Tim Winders:

on where you are in this country.

Tim Winders:

California has some interesting models for people who basically

Tim Winders:

have a home and take care of.

Tim Winders:

Elderly people with dementia that they bring into the home.

Tim Winders:

I know that in Europe, there are some other models.

Tim Winders:

I don't think we have the best model in terms of, assisted living or continue

Tim Winders:

continuity of care kinds of communities.

Tim Winders:

I think it's for many people, a godsend.

Tim Winders:

beyond family care.

Tim Winders:

When my mother developed dementia, it was pretty clear both my brother and I,

Tim Winders:

because we're the only siblings, that neither of us were prepared, given where

Tim Winders:

we were with our lives and our careers, to have our mother live with either of us.

Tim Winders:

And she knew that as well.

Tim Winders:

She didn't want to do that.

Tim Winders:

We just all decided she had enough with it at that point.

Tim Winders:

We decided that one of us would kill the other person at some point.

Tim Winders:

So that seemed to be a bad idea.

Tim Winders:

And I wanted to remain as her son.

Tim Winders:

I didn't want to be her caregiver.

Tim Winders:

I wanted to be able to go over to the assisted living place close by where I

Tim Winders:

lived and take her out, take her to my house for dinner, for family gatherings,

Tim Winders:

take her out for drives, take her to the restaurant, take her places on trips.

Tim Winders:

do things that were really positive But didn't require me to have to

Tim Winders:

worry about was she up in the middle of the night And did I have to

Tim Winders:

bathe her or anything like that?

Tim Winders:

So I think it's and for some families that's not a problem for them.

Tim Winders:

They approach it very differently They want mom or dad to live with them.

Tim Winders:

They want to provide all that care.

Tim Winders:

That's wonderful There's different ways of going about this But I think that

Tim Winders:

getting back to your original point, we're really going to stress the fabric

Tim Winders:

of society if we continue to have more and more people getting older and getting

Tim Winders:

demented with the current resources.

Tim Winders:

Because it's not just, you, it's also the people you have to hire

Tim Winders:

to be able to provide the care.

Tim Winders:

Where does that come from?

Tim Winders:

Yeah.

Tim Winders:

And almost every facility we interact with was short staffed, constant churn,

Tim Winders:

very difficult to keep people around.

Tim Winders:

And I felt for him, being a business guy, leadership guy, I kept looking at

Tim Winders:

it going, this business model is just unsustainable as far as employees.

Tim Winders:

And a lot of this was, tail end of COVID it was, I could just see that it could

Tim Winders:

be an extreme strain and that we're.

Tim Winders:

Probably not equipped to handle it,

Tim Winders:

Dr. Mitchell Clionsky: We're also not looking at it.

Tim Winders:

I don't think as well as we should.

Tim Winders:

Everyone's still pouring money into pharmaceuticals.

Tim Winders:

And that's where, a lot of the, it's driven by the finances

Tim Winders:

is driven by stock prices.

Tim Winders:

It's driven by, A lot of things, which are at a distance from actual care

Tim Winders:

for this condition, this disease, it's not like other diseases.

Tim Winders:

there's people who have other diseases, who still live at home and

Tim Winders:

go about their lives and still work.

Tim Winders:

In many cases, this is a disease that robs that person of their

Tim Winders:

ability to take care of themselves.

Tim Winders:

And live their own lives.

Tim Winders:

They require care and no matter what, unless we find something, I, I hope

Tim Winders:

that we're going to see something maybe in genetic, recoding like CRISPR

Tim Winders:

technology or perhaps something that is in fact a, a prevention through an

Tim Winders:

inoculation, but we're not there yet.

Tim Winders:

And we're some distance away right now.

Tim Winders:

We really have to work on the other parts of this.

Tim Winders:

right?

Tim Winders:

One of the things I'd love to do here, I'm trying to watch my time.

Tim Winders:

Cause I know that I could probably talk to you for hours about this.

Tim Winders:

I would love to hit what I would consider to be rapid fire topics

Tim Winders:

and just have you comment.

Tim Winders:

And I know that there may be a lot of data and things behind all this, but I'd

Tim Winders:

love to hit as many of these as I can.

Tim Winders:

And some of them are covered in the book.

Tim Winders:

And then one of the things we're going to hit really hard as

Tim Winders:

we wrap up is for people to go and do, I think y'all call it.

Tim Winders:

The most, the test and drive them to your site.

Tim Winders:

Or is that what they do face to face with you guys?

Tim Winders:

Or is that on the site?

Tim Winders:

Dr. Mitchell Clionsky: Okay, so the most is not deployable at this point.

Tim Winders:

It was only for physicians and it's not currently available.

Tim Winders:

We're going to be rolling it out again as an early test that doctors can use

Tim Winders:

and possibly a version of it that you can give for mom or dad in your home,

Tim Winders:

but that's at least Till the end of this is the summer of the most for me.

Tim Winders:

Last year was the summer for first talking about this book and things.

Tim Winders:

This summer, we're going to get that up and running again.

Tim Winders:

So it's out there.

Tim Winders:

It's, but the prevention checklist is where I'm really hoping people

Tim Winders:

are going to pay attention because that's going to really give them the

Tim Winders:

armamentarium to go after this problem.

Tim Winders:

very good.

Tim Winders:

We'll hit that again at the end and remind people where they can go.

Tim Winders:

So there's one thing that's been extremely.

Tim Winders:

in my forefront for some time now, and that is my sleep health.

Tim Winders:

Um, my wife makes fun of me.

Tim Winders:

I've got this Apple watch and I've got this app that tells me my blood

Tim Winders:

oxygen level and how many hours of deep sleep and all this type stuff.

Tim Winders:

I also noticed this is interesting for people that travel like we do in RVs.

Tim Winders:

Altitude impacts it and whether I'm in the desert or higher humidity, we're

Tim Winders:

in the black hills of South Dakota now.

Tim Winders:

So I know you cover it extensively in the book, but say a few things

Tim Winders:

about how important sleep is.

Tim Winders:

Dr. Mitchell Clionsky: Great question.

Tim Winders:

There's sleep, which has to do with continuity.

Tim Winders:

Which has to do with the amount of sleep that you're getting,

Tim Winders:

you can get too little sleep.

Tim Winders:

That's a problem.

Tim Winders:

Five hours or less is not enough sleep.

Tim Winders:

Nine hours or more is too much sleep.

Tim Winders:

You want to be in that six to eight, nine hour range.

Tim Winders:

The continuity is important, not only because it's important to go

Tim Winders:

through the different sleep stages, but your awakening during the night.

Tim Winders:

Maybe due to other problems that are we're also going to look at and

Tim Winders:

the third part is the consistency of when you sleep Can be real important

Tim Winders:

There's a real nice study that looked at that and they found that If people

Tim Winders:

went to bed and got up at all kinds of different hours That oftentimes that

Tim Winders:

increased their risk whereas you don't have to be rigid about it But having

Tim Winders:

generally, this is the time I go to sleep.

Tim Winders:

And this is the time I wake up can be a real advantage for you.

Tim Winders:

Now, the issue about why is sleep better at different places may have

Tim Winders:

to do with the amount of oxygen, because when you're up in the

Tim Winders:

mountains, you may be a mile high and your oxygen saturation is lowering.

Tim Winders:

And so while you're waking up is because you're not breathing while

Tim Winders:

you're sleeping, you're waking up because you're gasping for air.

Tim Winders:

You can see the same phenomenon when you fly transatlantic or transpacific.

Tim Winders:

They have the, the atmospheres set at about 8, 000 feet back where all

Tim Winders:

of the people, the passengers are.

Tim Winders:

They have it set at a lower level up in the cockpit.

Tim Winders:

Why is that?

Tim Winders:

it's okay if you fall asleep because you're not getting enough oxygen.

Tim Winders:

You don't want the pilot to fall asleep.

Tim Winders:

So one time Emily and I flew to Europe and she brought along little pulse oximeters

Tim Winders:

like you see in the doctor's offices.

Tim Winders:

These were her pulse oximeters and we put them on people's fingers sitting

Tim Winders:

next to us in the plane and watched their oxygen saturation decline.

Tim Winders:

And then we gave it to the flight attendants.

Tim Winders:

And they were incredibly amazed at how their oxygen levels went down.

Tim Winders:

Now, the transatlantic trans pacific flights are the plum flights.

Tim Winders:

So they're the ones that the older flight attendants get.

Tim Winders:

So they're taking these long flights at the highest altitude.

Tim Winders:

And they're also more likely to have a problem with that drop in oxygen.

Tim Winders:

So there's a lot there between sleep and oxygen.

Tim Winders:

So the oxygen question, are we suffocating our brains?

Tim Winders:

Are some of us suffocating our brains because we're not getting enough oxygen?

Tim Winders:

I w real quick, I wasn't really aware of the blood oxygen.

Tim Winders:

COVID because when I first got COVID, someone said, I just need to keep

Tim Winders:

an eye on your blood oxygen level.

Tim Winders:

So we got one of those finger pulsometers and I would watch it.

Tim Winders:

I think it got down to 88, which I was like going, okay, I need to watch this.

Tim Winders:

But my watch is supposedly measuring my blood oxygen.

Tim Winders:

Like last night I was at 94%.

Tim Winders:

I don't sleep well if it gets much slower than that.

Tim Winders:

And also are we suffocating our brains to some extent?

Tim Winders:

Dr. Mitchell Clionsky: the issue is something called obstructive sleep

Tim Winders:

apnea osa obstructive sleep apnea is a condition whereby While we're sleeping

Tim Winders:

we either stop breathing Or our oxygen level drops by four percent A total of,

Tim Winders:

or average of five times or more per hour.

Tim Winders:

So you find this out by taking a home sleep study usually, which is painless and

Tim Winders:

easy to do, and you can do it in your own bed and it's going to tell you over the

Tim Winders:

course of the night, how many times did you stop breathing for 10 seconds and how

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many times did your oxygen level drop by 4 percent and then you average that with

Tim Winders:

the number of hours that you slept, if it's five or more, you've got sleep apnea.

Tim Winders:

Now, how common is that?

Tim Winders:

there's some really cool data that's come out since we published the book.

Tim Winders:

It was just about four months ago.

Tim Winders:

This is data that came out on normal people, 6, 000 quote normal people.

Tim Winders:

I put that was always in quotes because none of us is really normal.

Tim Winders:

People from the general population, people go into studies that look

Tim Winders:

at how people are doing over the course of years, the Framingham

Tim Winders:

Heart Study is one of these studies.

Tim Winders:

The Mayo Clinic does different studies, a bunch of different places.

Tim Winders:

these preventive health places all decided to band together and

Tim Winders:

give everyone in their 6, 000 new cohort an overnight sleep study.

Tim Winders:

People 58 and older, half of them had sleep apnea.

Tim Winders:

Most of them had no clue that they had sleep apnea.

Tim Winders:

And yet if you're not getting enough air down your lungs, you're not getting

Tim Winders:

enough oxygen pulled out of the air.

Tim Winders:

Oxygen is only 20 percent of our air.

Tim Winders:

The rest of it's nitrogen, some other things.

Tim Winders:

So you're not getting enough oxygen pulled out.

Tim Winders:

The oxygen molecules then can't hook onto the red blood cells.

Tim Winders:

And make their way up to our brains.

Tim Winders:

And that's the problem.

Tim Winders:

Not enough air, not enough oxygen.

Tim Winders:

Our brains don't work properly.

Tim Winders:

We don't think well while we're sleeping.

Tim Winders:

Our brains cannot clear out the toxins that accumulate while

Tim Winders:

we're thinking during the day.

Tim Winders:

There's a system.

Tim Winders:

Another thing only discovered in the past couple of years called the glymphatic

Tim Winders:

system that flushes out the byproducts.

Tim Winders:

Okay.

Tim Winders:

I tell people it's like the night cleaning crew comes in, empties

Tim Winders:

my trash can, cleans off my desk.

Tim Winders:

Our brains have a system like that.

Tim Winders:

It doesn't work in a low oxygen environment.

Tim Winders:

So toxins build up.

Tim Winders:

We don't think well.

Tim Winders:

It's a whole variety of other things, but we tend to be Tired

Tim Winders:

during the day, oftentimes grumpy.

Tim Winders:

We could fall asleep at times.

Tim Winders:

We don't want to occasionally, even while driving a car and watching TV.

Tim Winders:

If you're that person who's waking up like this, because you're watching it while

Tim Winders:

you're sitting down and you're dozing off.

Tim Winders:

So there's a lot of reasons why we need to pay attention to that.

Tim Winders:

So there's something related to that, that I've had a theory on.

Tim Winders:

I don't know exactly how to prove this with people that I work with.

Tim Winders:

And typically they're entrepreneurs, leaders, CEOs, things like that.

Tim Winders:

and and it's related to what you just said, but maybe it's a cousin of it, and

Tim Winders:

that is this thing of capacity or the amount of stress and what we could handle.

Tim Winders:

Uh, within our brain and with your study, this may be related

Tim Winders:

to, uh, the dementia thing.

Tim Winders:

It may be related to cognitive.

Tim Winders:

But one thing I've observed is if I'm working with a leader and they are under a

Tim Winders:

lot of what we would call stress, there's a lot going on, a lot coming at them.

Tim Winders:

I recognize that they're oftentimes less creative.

Tim Winders:

They decision making sometimes is a little bit, I hate to use

Tim Winders:

the word impaired, but it's not.

Tim Winders:

As healthy as it should be.

Tim Winders:

And so I didn't see a lot of it in the book.

Tim Winders:

I may have missed it, but like just stress.

Tim Winders:

one of the things we know, if we go back 30 years, you and I are old enough

Tim Winders:

to remember this, we had a few hundred stimuli coming at us on a daily basis.

Tim Winders:

Now we've got thousands of stuff coming at us.

Tim Winders:

So just capacity wise, does that feed into this?

Tim Winders:

can we just use up our brain and all of a sudden it starts shutting down on us or

Tim Winders:

overstress it or have too much going on?

Tim Winders:

just take whatever you want to from that rant and go with it.

Tim Winders:

Dr. Mitchell Clionsky: Yeah, we didn't cover this very much in the book because

Tim Winders:

our goal was dementia prevention.

Tim Winders:

And so what you're asking, I think, is a question of bandwidth.

Tim Winders:

How many things can we do at once and divide our resources?

Tim Winders:

It's like setting up your Wi Fi in your house, and you have a certain

Tim Winders:

number of nodes to your Wi Fi, and you have to divide how much gets what.

Tim Winders:

And the more you add and the more people you have sitting in the other room

Tim Winders:

downloading movies or playing games or listening to music or being on a zoom

Tim Winders:

call depletes it same way with your brain.

Tim Winders:

And they say, can you walk, chew gum at the same time?

Tim Winders:

actually, it turns out that one of the ways we should be testing for

Tim Winders:

dementia, and I've not done this research yet, but I know what it's based

Tim Winders:

on is we should have cognitive tests that we give when someone's sitting.

Tim Winders:

And then while they're walking briskly, because at that point, they have to

Tim Winders:

divide their resources to be able to handle the balance and avoidance of

Tim Winders:

process, things in their way, obstacles.

Tim Winders:

And we know that their oxygen level also declines as they're

Tim Winders:

walking for most people, unless you're really in great shape.

Tim Winders:

And then we would see the difference, the decline in their capacity to

Tim Winders:

process information, whether it's things like, counting backwards, reciting

Tim Winders:

the months of the year backwards.

Tim Winders:

I thought of all kinds of different tests we might give them.

Tim Winders:

I don't right now have the capacity, the bandwidth to do this study, but

Tim Winders:

boy, I would love someone to do it because I think the contrast between

Tim Winders:

how you think while you're sitting and how you think when you're under stress.

Tim Winders:

Would be a really important marker for what your abilities

Tim Winders:

are going to be going forward.

Tim Winders:

years ago, I used to do a lot of work in stress management way in the early

Tim Winders:

part of my career back in the 70s.

Tim Winders:

I used to do stress management for executives.

Tim Winders:

Actually used to do workshops for them on communication, assertiveness,

Tim Winders:

training, and stress management.

Tim Winders:

And there was all this dynamic between how much stress and how

Tim Winders:

much coping does the person have.

Tim Winders:

Because if you have no stress, but a lot of coping capacity, that's not good.

Tim Winders:

That's what I see in people who retire and don't have a plan for retirement.

Tim Winders:

They're bored.

Tim Winders:

They're unhappy.

Tim Winders:

They don't know what's going on.

Tim Winders:

Then you have the opposite where they've got a ton of stress and not much coping

Tim Winders:

ability and those people are breaking down emotionally and physically.

Tim Winders:

Physically, because they're just juggling too many balls.

Tim Winders:

And where you really want this is somewhere in the middle where you

Tim Winders:

have enough stress that it keeps life interesting and challenging and growth

Tim Winders:

producing, but enough coping ability that you revel in that, that you like

Tim Winders:

to do that, that you grow from it as opposed to being overwhelmed by it.

Tim Winders:

So that's really the, the great balancing act in this.

Tim Winders:

I've always, one of the things that I speak about when I do

Tim Winders:

coaching is I, and if I'm wrong on this, please correct me as I say, sometimes

Tim Winders:

we've got almost like a pressure cooker going on here within our brain.

Tim Winders:

And that one of the things we need to do is identify, the, People that know

Tim Winders:

the old pressure cooker, it starts, you it starts making the noises.

Tim Winders:

We need to find ways to relieve that pressure.

Tim Winders:

And what you brought up was fascinating.

Tim Winders:

Just a walk.

Tim Winders:

I would notice when I would swim or even pickleball.

Tim Winders:

It's it's just a clearing, it's like an eraser.

Tim Winders:

It erases some things that are hanging out there.

Tim Winders:

None of the things are any different.

Tim Winders:

When I come back to them, but it just releases, it just releases

Tim Winders:

some of that pressure so that I can look at it with a fresher look.

Tim Winders:

I think, I've got a deep spiritual thought.

Tim Winders:

I think oftentimes prayer for those that meditate different things, I

Tim Winders:

just quiet time, just being still and quiet is something that I really

Tim Winders:

promote with a lot of my clients, just find some space to where you can

Tim Winders:

clear the decks is, is a good thing.

Tim Winders:

So I.

Tim Winders:

I appreciate all that feedback and input.

Tim Winders:

All right, the next kind of bigger topic you mentioned in the book,

Tim Winders:

and I'll let people go check this out, hearing impairment, and you

Tim Winders:

even used some visual impairment.

Tim Winders:

And we do believe that my father had some hearing issues that he was

Tim Winders:

not wanting to get diagnosed, didn't want, and here's the reason why, this

Tim Winders:

is one reason I'm bringing this up.

Tim Winders:

He had a ringing in his ears.

Tim Winders:

The tinnitus or tinnitus, whatever it's called.

Tim Winders:

I actually have some degree of that.

Tim Winders:

I've spoken to a number of people my age.

Tim Winders:

That's, I think that might be more common than uncommon.

Tim Winders:

I don't know.

Tim Winders:

I've done a little bit of research on it, but he didn't want to have his

Tim Winders:

hearing tested and to have anything that would magnify it, because he thought it

Tim Winders:

would just increase that noise of the.

Tim Winders:

The ringing, it's obviously not a ringing in the ears.

Tim Winders:

It's something internal.

Tim Winders:

So I guess if you want to say anything about hearing, even though it's covered

Tim Winders:

in the book, but specifically the tinnitus or the tinnitus, however it's

Tim Winders:

pronounced any thoughts or comments or data on that, as it relates to this topic.

Tim Winders:

Dr. Mitchell Clionsky: Tinnitus is really common and it, it can be from a number

Tim Winders:

of sources, both injuries, some people after auto accidents, some people through

Tim Winders:

exposure to loud noises, some people who we don't even know why they just developed

Tim Winders:

this quote ringing in the ears, but it's usually at a certain decibel level or

Tim Winders:

a shushing kind of sound or something that can be really distracting, but it's

Tim Winders:

worse when there's no background noise.

Tim Winders:

people experience it as they're falling asleep.

Tim Winders:

a lot of folks find that having white noise in the background

Tim Winders:

or a TV in the other room or something like that is actually

Tim Winders:

better than having no noise at all.

Tim Winders:

There's some work that is done with hearing aids.

Tim Winders:

Paradoxically, they're able to actually improve the tinnitus by the hearing aids.

Tim Winders:

But a lot of times it just doesn't make a difference.

Tim Winders:

It's a shame that your dad was at a point.

Tim Winders:

I see this all the time when people decide what it's going to be before

Tim Winders:

they ever try it out, which I try to talk them out of because it

Tim Winders:

keeps them stuck where they are.

Tim Winders:

But the worst that could happen is you get your hearing tested.

Tim Winders:

if you have a hearing loss.

Tim Winders:

These days, hearing aids are remarkably cheaper than they used to be.

Tim Winders:

They're remarkably smaller than they used to be.

Tim Winders:

Oftentimes, unless you're really staring in someone's ear, you can't

Tim Winders:

even tell they're wearing a hearing aid.

Tim Winders:

Because it used to be that people would say to me, Oh, I want to

Tim Winders:

do that, it's going to make, and it was usually a vanity issue.

Tim Winders:

And I'd say, you don't want to look old.

Tim Winders:

And they say, that's right.

Tim Winders:

I don't want anyone to think I'm old.

Tim Winders:

I said, what makes you look really old?

Tim Winders:

They say, what said, what makes you look really old?

Tim Winders:

They say, what is it exactly?

Tim Winders:

what that really makes you look old said hearing.

Tim Winders:

Is something we don't perceive externally.

Tim Winders:

It's what you're dealing with.

Tim Winders:

So if you're answering the question, we're not going to know that you're not

Tim Winders:

hearing until you know, if you're wearing hearing aids, we're not gonna see them.

Tim Winders:

You're gonna look younger.

Tim Winders:

Actually, because of that, they said, Oh, then I get them to go get a hearing test.

Tim Winders:

And because we know that not only is it a cause, but we can

Tim Winders:

increase people's cognition.

Tim Winders:

in the moment by improving their hearing.

Tim Winders:

if I test people without and with their hearing aids, they do better even

Tim Winders:

on non verbal tests when they hear.

Tim Winders:

I'm a huge fan of those.

Tim Winders:

It also really makes for better relationships.

Tim Winders:

Yeah, definitely.

Tim Winders:

we sometimes will refer to this brain that we've got in our head as maybe a muscle.

Tim Winders:

I don't think that's the correct term, but sometimes I do wonder if

Tim Winders:

there is this, if you don't use it, you might lose it atrophy type thing.

Tim Winders:

And one of the things we would go back and forth, I recall with my mom,

Tim Winders:

they would have a, They would have a certain news channel on most of the

Tim Winders:

time and I don't care which one it is, by the way, I'm not prone to it.

Tim Winders:

And we would say, stop leaving the television going.

Tim Winders:

It can't be good for the brain.

Tim Winders:

So is there any accuracy in that statement or did we just want them

Tim Winders:

to turn off the Fox, CNN, MSN, again, I don't care which one it is channel

Tim Winders:

because that can't be good for you.

Tim Winders:

Any thoughts on that?

Tim Winders:

Dr. Mitchell Clionsky: It's usually a default position.

Tim Winders:

It's usually this fills the time, makes me feel like interacting in some ways.

Tim Winders:

And these people are my friends.

Tim Winders:

now, therefore, I can feel comfortable just sitting here all day looking at this

Tim Winders:

and having this go on in the background even though the same story is usually

Tim Winders:

repeating itself every hour or two.

Tim Winders:

It's really important to use the brain even though there aren't

Tim Winders:

any specific computer generated exercises or games that by themselves

Tim Winders:

are known to prevent dementia.

Tim Winders:

what we find is with most, and this is a field that's really in flux, because

Tim Winders:

there are some newer information that suggests maybe sub games for some

Tim Winders:

people may do something, but the rule has generally been, and the reason

Tim Winders:

I have not put in a therapist in my office to do brain games with people, is

Tim Winders:

that usually people who practice brain games get better at doing brain games.

Tim Winders:

And that's not really what the purpose is.

Tim Winders:

It's really to make your brain better.

Tim Winders:

But your brain is not a muscle.

Tim Winders:

It doesn't work by the same kind of rules that your biceps do, for example.

Tim Winders:

But we do want people to be interacting.

Tim Winders:

And they say, what if I play these games on my computer?

Tim Winders:

So if you enjoy playing them, sure.

Tim Winders:

But that's not where you want to be limited.

Tim Winders:

You certainly don't want to be in front of the TV all day.

Tim Winders:

You really want to be interacting with other people.

Tim Winders:

I don't care if you're playing cards.

Tim Winders:

Or checkers, or mahjong, or percheesy.

Tim Winders:

I don't care whether you're going to the senior center and playing

Tim Winders:

pool or sitting around talking.

Tim Winders:

It really doesn't matter, but I want an interpersonal element and I want

Tim Winders:

things to be stuff you have to solve.

Tim Winders:

Or you have to think about.

Tim Winders:

Not just things that you have to repeat.

Tim Winders:

So I'm trying to get people as active and interpersonally

Tim Winders:

connected as we possibly can.

Tim Winders:

Which is odd in a culture where people are interacting some with the

Tim Winders:

social media, AI, all the things we have.

Tim Winders:

But I don't think it's showing our age that just some of that personal

Tim Winders:

interaction, communications and things like that is powerful.

Tim Winders:

Mitch, is there anything I should have asked that I may have missed?

Tim Winders:

Dr. Mitchell Clionsky: Oh, there's tons we could talk about.

Tim Winders:

I got nothing else going on in my life.

Tim Winders:

I can come back some other time.

Tim Winders:

I'd

Tim Winders:

love

Tim Winders:

Dr. Mitchell Clionsky: there's a lot of, I can talk about

Tim Winders:

this all day long, literally.

Tim Winders:

And that's why Emily and I get along so well, because we can both talk about it.

Tim Winders:

Ad nauseum with each other.

Tim Winders:

And I say to her, look, we're going out.

Tim Winders:

We're going to meet these people.

Tim Winders:

we don't do anything in this area.

Tim Winders:

Let's talk about something

Tim Winders:

Yeah, maybe we could do another one where we really focus on

Tim Winders:

leaders and leaders of organizations and what to happen as this starts

Tim Winders:

to, I don't know, creep in or to be mindful of it and things like that.

Tim Winders:

I didn't even get into the situation that we identified with my dad with what

Tim Winders:

he was doing with the financial aspect of things before it was identified.

Tim Winders:

My sister had to step in and all that.

Tim Winders:

there's so many things to this that spill over that.

Tim Winders:

leaders of

Tim Winders:

organizations and all can have to deal with.

Tim Winders:

Dr. Mitchell Clionsky: I definitely want to do that with you because

Tim Winders:

that's a real focus for me.

Tim Winders:

Because if you can keep your leadership.

Tim Winders:

Thinking better and working longer in that position rather than having to

Tim Winders:

retire because they can't keep up with it.

Tim Winders:

That's going to be a real advantage to that organization.

Tim Winders:

I definitely think that's doable.

Tim Winders:

the

Tim Winders:

powerful thing again, I just hit 60 and I'm recognizing, you know what, I

Tim Winders:

can't do what I used to do physically.

Tim Winders:

I'm in pretty good shape fit.

Tim Winders:

Um, and mentally I just don't try to put as much in here as I used to for

Tim Winders:

capacity, but boy, we've got some wisdom and experiences that we need

Tim Winders:

to keep sharp so we could share that.

Tim Winders:

And so anyway, All right, Mitch, this is our call to action.

Tim Winders:

What does someone need to do that has just listened to all of this?

Tim Winders:

We've mentioned the assessment a few times.

Tim Winders:

Let's drive them to that.

Tim Winders:

Give them all the info for that.

Tim Winders:

And maybe if they need to connect with you and get the book, where

Tim Winders:

can they get all of that info?

Tim Winders:

Dr. Mitchell Clionsky: B R A I N D O C dot com.

Tim Winders:

Real basic.

Tim Winders:

We picked up this website, this, name 30 years ago.

Tim Winders:

I got it when it was available and I've kept it all this time.

Tim Winders:

And it's as easy to remember brain doc.

Tim Winders:

It talks about, this is what we do.

Tim Winders:

We're doctors who deal with the brain.

Tim Winders:

It's got a link to our book.

Tim Winders:

It's got a link to our checklist that you can get.

Tim Winders:

There's a bunch of other, not as good podcasts on there, but

Tim Winders:

they can listen to those as well.

Tim Winders:

There's a couple articles, that we've written or been written about us.

Tim Winders:

There's a whole bunch of stuff.

Tim Winders:

So that's the place.

Tim Winders:

And also there's a way of connecting, my, there's an email connection there as well.

Tim Winders:

Yeah, very good.

Tim Winders:

We'll make sure we include all those notes down below and, the, places

Tim Winders:

that you can go to find all that.

Tim Winders:

Mitch, we are seek go create those three words and, they mean a lot to

Tim Winders:

us, but Those three words, if I were to allow you to choose one that just meant

Tim Winders:

more than the other two at this time, which word would you choose and why?

Tim Winders:

Dr. Mitchell Clionsky: They're all tough because they're all great.

Tim Winders:

I would choose Seek.

Tim Winders:

And it's relates to me.

Tim Winders:

It's something I used to tell my postdoctoral residents.

Tim Winders:

And at one point I had three of them and I said to them, you

Tim Winders:

got to ask the next question.

Tim Winders:

You got to be curious.

Tim Winders:

I can't teach you to be curious, but if you're someone who seeks, if you're

Tim Winders:

someone who is curious about how people tick or how you tick, if you're

Tim Winders:

curious about what makes things work or not work, just answer questions, and

Tim Winders:

you'll You're going to go a long way.

Tim Winders:

So constantly be looking.

Tim Winders:

What can I learn today?

Tim Winders:

That makes it a great day.

Tim Winders:

If you learn something new, that's a success.

Tim Winders:

Amen.

Tim Winders:

Dr.

Tim Winders:

Mitchell Kleonski.

Tim Winders:

I so appreciate you taking the time.

Tim Winders:

I appreciate, and make sure you share this with your wife, Emily.

Tim Winders:

I appreciate you guys.

Tim Winders:

Putting the book together, dementia prevention, and I love the subtitle

Tim Winders:

using your head to save your brain.

Tim Winders:

So, again, I did a quick read through.

Tim Winders:

I'm actually going to go back and do a deeper read through it.

Tim Winders:

I, in the last few days, I read it quickly just to get the gist of it.

Tim Winders:

Excellent book.

Tim Winders:

I believe it's a book that.

Tim Winders:

Everyone should read just because of the general nature of the

Tim Winders:

health and why we need that.

Tim Winders:

And I just appreciate the conversation.

Tim Winders:

I appreciate you listening in on this sort of a personal conversation

Tim Winders:

that I've had for you, the listener, but I believe it's something that

Tim Winders:

impacts probably almost everyone.

Tim Winders:

So you've been able to listen in on me, ask some personal

Tim Winders:

things, and I appreciate that.

Tim Winders:

We have new episodes every Monday until next time continue being

Tim Winders:

all that you are created to be.

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