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Editor's Note: Chief Medical Correspondent Dr. Sanjay Gupta is a neurosurgeon and Best-selling author on mental health. “The Last Alzheimer's Patient” premieres Sunday, May 19, at 8 p.m. on and “The Full Story with Anderson Cooper” on June 18 on MAX.
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I've been reporting on Alzheimer's disease for more than two decades, and any progress in the field seems to be incremental for the better, leaving most patients and their loved ones with few options. But in the process of filming a new documentary called “The Last Alzheimer's Patient,” I met with people all over the country who have the disease or are at high risk for it. Just by making lifestyle changes, I saw a reduction in the amount of amyloid plaques in their brains, an improvement in their cognition, and even signs of a reversal of the disease.
It was unusual and made me think about my own brain, because I have a family history of Alzheimer's disease.
So with some trepidation, I decided to learn more about my dementia risk. It was one of the most personal and revealing experiences I have ever had.
To begin, I did a deeper exploration of my mind than I thought possible. It wasn't easy considering my anatomy or genetics predisposed me to the type of mental disorder. The goal was to get the full story of my mind from the earliest days of my education and formative years to now: a man in his mid-50s. More importantly, the deeper challenge can give me a clearer idea of where I'm headed and how to steer my path in the most favorable direction.
Even as a brain surgeon myself, I am amazed at how much your brain health measures up. The fact that a battery of tests can give us a clear understanding of how to predict, prevent and treat heart disease is heartening. Until recently, however, we could not say the same about the brain. Many neurologists still struggle to define the criteria for a healthy brain. The general consensus is that the “black box” inside your skull is finely tuned and there is little you can do to evaluate it, let alone optimize it.
Dr. Richard Isaacson, a neurologist, convinced me otherwise, and it led to one of the most amazing — and somewhat terrifying — days of my life. I have known Richard for a long time, and we are friends. We've had great conversations about our shared love of the brain, and I return to him often to get his thoughts on neurological developments in the news. What always amazes me about Richard is his constant refusal to accept the status quo in medicine, almost less a matter of justice than a pursuit of science, although he is a rare individual who is making a difference in both.
For more information about Alzheimer's disease and brain health
So when I thought of the idea, I immediately thought of him Defense nerve to visit
To be clear, I wasn't going to Richard because I thought I was in any trouble. But here's the point: When people refer to the American medical field as a “sick care” system rather than a health care system, I think they mean it. Richard would of course see me when I was sick, but he chose to see me now when I was healthy. Fully believing that it would help me keep my sanity, reduce my chances of forgetting and even help me Improve my performanceAs stated in the 2018 study.
I flew to Boca Raton, Florida to see Richard Florida Institute of Neurodegenerative Diseases Clinic on a beautiful day in March. He advised me in advance not to exercise or eat that morning and prepare for a day of intense mental gymnastics. Although this is not an IQ test, in some ways, it is more personal.
I have to say I felt very meta to assess my own brain and see if it was working properly or if there were problems I hadn't noticed yet. Was I rustling? Maybe I was making mistakes that my family, friends, and colleagues wouldn't be too polite to tell me about. If there are gaps in processing speed or executive judgment, they may now be uncovered and uncovered.
When I got to the clinic, I first had my blood tested and took a battery. Phosphorylated tau ratio, better known as the Alzheimer's blood test, and my lipids, inflammation and glucose measurements, to name a few. He also tested my genetic risk for Alzheimer's. If I am a carrier The APOE4 gene may carry a higher risk of the disease.. I spit into a tube to test my oral health. I then got on a body composition scale to find out how much bone, fat and muscle I had in my body.
“Interesting…” I said as I cornered Richard, looking at the reading, rubbing his chin. No one likes to see their doctors do it. Even doctors don't like to see other doctors do it. “What?” I asked him from across the room. “Oh,” he replied. “I don't know, maybe it's good,” he told me later that he saw evidence of an old left arm injury and correctly predicted that I had a tough leg workout the day before. It was a real reminder of how the body keeps score. Although I didn't think about that injury for years, it clearly left a mark on my body and still led to a discovery in this investigation.
After that came the cognitive test. This was perhaps the most surprising. At first I was told to relax and listen to a short story about the captain of the Atlanta football team, the quarterback who hurt his finger on a fishing trip before the big game. I thought I was paying attention, but suddenly I realized that I wasn't as engaged as I thought. “What day did he injure himself, and how many stitches did he need? What was the player's name?” I was asked after 15 minutes. Can I be sure if it's his thumb or his left ring finger?
Quick: Read as many words as you can starting with the letter “G” and then add and subtract as many animal names as possible in one minute. The longer the words and the more unusual animals, the better. There were lists of words to memorize, three-dimensional cubes and clocks to draw, and dozens of faces to match their names. I had to scratch and smell 50 different odors and in one instance I had to decide if something smelled like gasoline, acetone, or forest fire. In another example, it was lavender or lilac. I found myself suddenly unsure, trying to summon the memory of that smell to give a proper answer.
I felt my mind being cross-examined by a highly trained prosecutor.
It wasn't just about the number of mistakes I made, but the type of mistakes, how long I took to react, and whether I simply lost focus. There are obvious red flags that go out if someone puts the clock back or loses the ability to detect certain smells. The more subtle concerns are the view-space construction or the Stroop color and verbal testIdentify as red, even if this word appears on the screen in purple.
Although I have never been diagnosed with dyslexia, Richard thinks it might be something I have. “Can you count on your fingers?” he asked me. I've always done that and never considered it a celebrity or signifier of anything significant. In the end, words with lots of Bs and Ds were less likely to be remembered because I always avoided letters that I easily confused. These kinds of insights into my brain, big and small, were all fascinating (and a little unsettling). But for Richard, they represent opportunities for early intervention, some of which are surprisingly simple.
“A lot of doctors look at your results and say you're doing great,” Richard said before showing me my lab results. But what they're really saying is that you're probably fine—for the next few years. I'm playing the long game here, and right now, I think you see a lot of areas that we can talk about today. I'm a pretty competitive person, so I'm used to having all the “greens” pop up when I review my lab test results. After all, I am very proud of my health and approach it with the same intensity as when I graduated from medical school. Great, I definitely wanted to do what I could.
So when Richard flipped over my lab results and showed me a page with not only a lot of yellow, but some red, my heart sank.
Mine Homocytin level It was high, but mine B12 The level was low. That was no surprise to Richard because he found a mutation in my MTHFR gene, which probably means I don't process homocysteine very well. My omega-3 levels were about right, but not when you compare them to my omega-6 levels. Mine DHEA levels It was a little lower, which partially explains why I had a harder time putting on muscle than I did ten years ago. And I was surprised to find that I had more swelling in my body than I expected, especially since I felt so good.
What really shows me is how closely related these blood test abnormalities can be to neurological function. Richard told me the metabolic issues were even minor. Insulin resistance can accelerate the accumulation of amyloidIt can lead to amyloid plaques, those symptoms of Alzheimer's disease, down the line. He also said that in his experience, cholesterol and lipid disorders can be related to problems related to executive function and the speed of the process. He says he associates depression with poor concentration and slowed processing.
I've been practicing neurosurgery for 30 years, and I've never heard of this. Richard was able to draw connections between the most functional aspects of the brain to specific problems in the body. And above all, it is scientifically presented Evidence Facilitating those physical targets has been shown to be associated with improved cognitive function.
Richard also wanted to address my daily activity: walking my neighborhood with my three dogs. “Keep doing that,” he said, “but now with a cloak of scales.” why? Not having enough lean muscle is problematic. He told me that people typically do a good job of talking to their arms and legs, but adding weight to the spine helps activate muscles like the abs and obliques and encourages the growth of new bone cells. This could lead to a critical redistribution…