The Peter Attia Drive

#251 - AMA #46: Optimizing brain health: Alzheimer's disease risk factors, APOE, prevention strategies, and more

Apr 17, 2023

This AMA dives deep into brain health, unraveling the complexities of Alzheimer's disease diagnosis and the significance of blood-based biomarkers. Discover how APOE gene variants alter your risk and explore strategies for prevention. Beyond exercise, Peter reveals surprising factors such as nutrition, lipid management, and even oral health that impact cognitive function. Learn about the intricacies of diagnosing neurodegeneration and the role of lifestyle choices in managing risks. It’s an enlightening talk full of actionable insights!

34:17

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Quick takeaways

Genetic testing reveals APOE4 gene increases Alzheimer's risk but isn't deterministic, other genes and lifestyle influence risk levels.

Healthy lifestyle choices, including not smoking, adequate sleep, exercise, and balanced diet, can significantly impact cognitive health.

Deep dives

Diagnosing Alzheimer's Disease

Diagnosing Alzheimer's disease starts with a clinical assessment, typically done by neurologists, involving evaluation of symptoms like memory loss, confusion, and language problems. Lab tests are used to rule out other possible causes, but a conclusive diagnosis often requires an autopsy. Modern diagnostic tools include serum amyloid and tau biomarkers, improving diagnostic accuracy. Comparatively, Alzheimer's diagnosis lacks a straightforward genetic biomarker like Apo B in cardiovascular disease, making it more complex.

The 3 Genetic Mutations that Account for 1% of Alzheimer's Disease Cases

01:47

Diagnosing and Preventing Alzheimer's: Blood-Based Biomarkers and APOE Genes

01:20

Intro

3min

Exploring Brain Health: A Deep Dive into Alzheimer's and Neurodegeneration

2min

Understanding Alzheimer's Disease Diagnosis

3min

Understanding Alzheimer's Risk Factors

23min

Strategies for Brain Health: Preventing Alzheimer's Disease

4min

View the Show Notes Page for This Episode

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In this “Ask Me Anything” (AMA) episode, Peter goes into depth on the topic of brain health, starting with how Alzheimer's disease is diagnosed, the significance of blood-based biomarkers in diagnosis, and what the various APOE gene variants mean in terms of a person's risk of developing Alzheimer's disease. Next, Peter discusses the various strategies for preventing Alzheimer's disease and neurodegeneration. He touches briefly on exercise as a potent tool, but focuses more on lesser-known factors that could impact brain health, such as nutrition supplementation, lipid management, brain games, sauna, oral health, hearing loss, and more.

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We discuss:

Diagnosing Alzheimer's disease [2:45];
Biomarkers for Alzheimer’s disease, the C2N test, and other tools for diagnosis [7:30];
Genetic component of Alzheimer’s disease: genes that confer risk [12:45];
Understanding your APOE status and why it’s important to know [17:15];
The prevalence of Alzheimer’s disease and other forms of dementia, and who is at higher risk [21:15];
Can the risk of Alzheimer’s disease be decreased with behavioral changes? [24:15];
Overview of modifiable behaviors that potentially play a role in risk reduction of neurodegeneration [30:15];
Things that clearly impact brain health: smoking, alcohol, sleep, head injuries, blood pressure, and more [34:15];
How nutrition impacts brain health: common diets, metabolic health, energy balance, and more [46:15];
Comparing common diets: data showing the association between the incidence of Alzheimer’s disease and specific diets [59:45];
Supplements: EPA and DHA, vitamin D, and B vitamins [1:13:00];
Supplements: theracurmin, cocoa flavonols, and magnesium L-threonate [1:25:15];
Impact of exercise on brain health, minimum effective dose, and the most important types of exercise [1:33:00];
Challenging the mind with brain games—does it impact neurodegeneration? [1:43:00];
The data on sauna and brain health [1:49:45];
Oral health and its association with brain health [1:52:45];
How reducing lipids can improve brain health and prevent neurodegeneration [1:55:30];
The potential impact of hearing loss on brain health and neurodegeneration [2:04:30]; and
More.