The Mel Robbins Podcast#1 Neurologists: What You Can Do to Prevent Alzheimer's & Dementia
EVERY SPOKEN WORD
75 min read · 14,835 words- 0:00 – 1:37
Intro
- MRMel Robbins
Today, we are talking about memory, dementia, and the brain health framework you need. You're gonna learn about things that you can do right now that can boost your chance of not getting dementia by 53%.
- DSDr. Dean Sherzai
Every family now has somebody that has Alzheimer's or deme- or some other type of dementia.
- ASDr. Ayesha Sherzai
When the word dementia comes about, we always think that that's a diagnosis that happens later on in life. But when you actually look at brain health, you kind of build your brain, and if you don't take care of it, the wear and tear will, will accumulate over a period of time. Cortisol level is high. You don't get a good night's sleep. You don't have time to walk or to exercise. And a time will come when, kind of, the damage is irreversible.
- MRMel Robbins
Wait. Hold on a second.
- DSDr. Dean Sherzai
If you take care of your brain, you've more than taken care of the rest of the body because the brain demands are tremendous.
- MRMel Robbins
Dr. Ayesha Sherzai and Dr. Dean Sherzai are board-certified neurologists trained in the treatment of Alzheimer's disease, dementia, and cognitive decline. These neurologists are gonna discuss five specific and simple things that you and your loved ones should focus on that will either slow down, pause, and even reverse brain decline.
- ASDr. Ayesha Sherzai
These five pillars, they make a huge difference. N stands for nutrition. E is for exercise. U is for unwind. R stands for restorative s- sleep. O stands for-
- MRMel Robbins
That's all we need to do to take better care of our brains?
- DSDr. Dean Sherzai
We're talking about millions and millions of people whose lives will be changed.
- 1:37 – 12:03
What are the first signs of having dementia?
- MRMel Robbins
Doctors Ayesha and Dean Sherzai, welcome to The Mel Robbins Podcast.
- ASDr. Ayesha Sherzai
It's so wonderful to be here, Mel. Thank you.
- DSDr. Dean Sherzai
Thank you so much.
- MRMel Robbins
Thank you for jumping on a plane. Thank you for taking time out of your busy schedule to fly across country and be here with us in Boston. We are so excited to have you here, and I wanna start by having you speak to me and the person that's with us. What could be different about my life or the life of people that I love based on everything you're about to teach us today?
- DSDr. Dean Sherzai
Uh, I'll tell you that this is the most important, uh, system that we're talking about, the brain. This little brain-
- MRMel Robbins
Oh, and he's picking up a brain. Already, Dr. Dean's got a brain in his hands
- DSDr. Dean Sherzai
... this brain that's supposed to be three pounds, 2% of your body's weight, consumes 25% of your body's energy, as much as 40% of your oxygen at times. This brain is constantly working. It has 86 billion neurons, over one trillion potential connections. It's the most active organ in your body and arguably the most active and adaptive organ in biology. What does that tell you? It's the change organ, and here's the most important part. The change part is in your hand, whether you're nine years old or 90 years old.
- ASDr. Ayesha Sherzai
This is an important topic that we need to talk about, and when the listener leaves this conversation, we want them to feel empowered-
- MRMel Robbins
Mm
- ASDr. Ayesha Sherzai
... to take care of themselves. Nothing magical around it, with things that are easily around them, things that they can start today.
- MRMel Robbins
Beautiful. So, Dr. Ayesha, I wanna stay right there for a second 'cause I think if you're my age, 57, or you're 60 or 70, you're thinking about dementia, you're thinking about memory loss. You may have somebody in your family that has been diagnosed with Alzheimer's, but if the person that's listening right now is in high school or their 20s or their 30s, what could change about their life, and why is it critical that they listen to this episode and share it with people that they care about?
- ASDr. Ayesha Sherzai
I think that's such an important question. Um, when the word dementia comes about, you know, we always think that that's a point, that's a diagnosis that happens later on in life, but when you actually look at brain health, it's like a spectrum. You kind of build your brain, and if you don't take care of it, you... the wear and tear will, will accumulate over a period of time, and a time will come when, kind of, the damage is irreversible.
- MRMel Robbins
Mm.
- ASDr. Ayesha Sherzai
And I'm not trying to scare the listener here.
- MRMel Robbins
Well, I don't mind if you scare us because I think we need to hear the truth 'cause I think most of us start thinking about dementia when we get to midlife or if we have a family member that gets diagnosed or we start to feel concerned about it. But you're here to tell us the facts based on research and your medical expertise, which is that this starts way earlier.
- ASDr. Ayesha Sherzai
It does. It does, and I'm glad that you put it that way, and I'm glad that we're talking about it because, you know, as a neurologist, I sit in my clinic, and I have a schedule day-packed with people coming in with problems with their memory, and then my job is to kind of diagnose them with dementia. And, um, that is a stage where the damage is so profound and so, uh, you know, conspicuous that there's not much one can do. There is a lot you can do at that stage as well, but how wonderful it would be for us to actually start taking care of our brain early on.
- MRMel Robbins
Mm.
- ASDr. Ayesha Sherzai
So if we were in our 20s or our 30s, things like going to sleep on time, waking up on time, making sure we exercise, making sure that we take care of our stress, which is really ravaging our brain, making sure we eat well and have a dietary pattern that we like continuing for longer, those things matter, and they make a huge difference for our brain health.
- MRMel Robbins
I would love to just ask you both, what is dementia?
- ASDr. Ayesha Sherzai
Hmm. Yeah, so dementia is an umbrella category. It's a definition of a condition where your cognition and your memory affects your daily activities, and there are many different types of dementia. 60 to 70% of dementias are Alzheimer's dementias. It's the most prominent type of dementia. That's why the word Alzheimer's is used synonymously with dementia. It's actually a type of dementia. Another type of dementia is vascular dementia, when the blood vessels in the brain are damaged. And then there are other smaller ones like frontotemporal lobe dementia, Huntington's disease, Parkinson's dementia, and Lewy body dementia.And, uh, most of them essentially impact the way you think, your memory, your decision-making, your processing speed, um, and it's something that doesn't start right away, like we were saying it earlier. It's a cumulative damage in the brain that causes this condition. There are multiple different types of protein. It-- one is called amyloid beta protein, another one is called tau, and what happens is, over time, they start damaging the inside of brain cells, on the outside of the brain cells, and there are different ways of actually looking at the brain to understand what kind of dementia people have.
- MRMel Robbins
Dr. Dean, you know, after reading your bestseller that you two wrote together, The Alzheimer's Solution, I'll tell you what caught me was at the top, "Radically reduces risk of Alzheimer's disease by ninety percent." One of the things that I realized is that brain health is just one of those things that you don't even think about until it feels like it's too late. Is it ever too late to consider your brain health?
- DSDr. Dean Sherzai
I wanna approach this carefully, because, uh, there are cases where it is too late, and that's where advanced Alzheimer's. There's a lot of people that are actually making money off of people's fears, and this is the biggest fear. Uh, when a person has the, the Alzheimer's, or the family and the patient are desperate, and guess what? When there's desperation, people go after that desperation. And I wanna make sure that people understand that there is no way to reverse advanced Alzheimer's at this point. You can slow it down, you can work on quality of life, which is as important, helping families with their journey. Ayesha and I sit down with the families for hours, telling them what they're about to face, what to do, and most importantly, how to give this person that's going through this battle-
- MRMel Robbins
Mm
- DSDr. Dean Sherzai
... quality of care. And don't fall for the gimmick of the day. But for the great majority of those that have pre-Alzheimer's or early dementia, or MCI, which is right before dementia, a significant portion of those pop- that population can be helped to prevent or delay significantly. And that's incredibly important. If we p- if we can do that even at sixty percent, which is the number that's been proven, what we-- when we say ninety percent, we are extrapolating. I w- I'm always careful not to separate science from extrapolation. But even sixty percent, we're talking about millions and millions of people whose lives will be changed, and that's very important, and I want the people there to know that every family now has somebody that has Alzheimer's or deme- or some other type of dementia, and all of those can be affected if we get it early enough.
- MRMel Robbins
I love that you can pause or slow it down. You also use this phrase, MCI, that happens before dementia, and I felt myself lean in. What is MCI?
- DSDr. Dean Sherzai
MCI stands for mild cognitive impairment, and this is where a person is having significant memory issues, significant focus issues. But, but everybody has that, so as soon as I say that, people gets scared. No. Significant to the point that it's really, to some extent, affecting dail- their daily activities. They can still drive, they can still do, do their finances, but themselves and the family is noticing that it, this is a little different than the past.
- MRMel Robbins
And give me a couple examples of what might be MCI, and 'cause I think we've all, like, I love that you said every one of us has somebody in our family-
- DSDr. Dean Sherzai
Yes
- MRMel Robbins
... that is diagnosed with dementia or careening right into it. And I think we've all been at that point, whether you're talking about your grandparents or your parents, where you're like, "Well, they're just kinda losing it. They're not really themselves anymore. They're slowing-" Like, there are ways we talk about it, but could you give a couple examples of just, like, what you might see in this MCI stage or super early stage?
- DSDr. Dean Sherzai
So, uh, let me tell you what's normal.
- 12:03 – 19:03
Is stress bad for your brain health?
- DSDr. Dean Sherzai
hopeful.
- MRMel Robbins
Uh, Dr. Dean, do you believe that our overall brain health as a society is getting worse?
- DSDr. Dean Sherzai
In many ways, yes. The reason it, it feels like it's getting worse, and it is, the numbers are there, uh, it's not necessarily dementia increasing, but that, that risk is increasing as well. It's because we have so much more happening to us, to our brain, to our focus. Our focus, as I said, is the gatekeeper. It's the currency of our consciousness.So the way you spend that currency matters. I want everybody in the audience to recognize that you have to be aware of your focus and where it's being spent. And in a world where your focus is being stolen systematically, uh, through the social media, um, um, systems and machinery that tries to pull your focus, we, we, we have to be careful. Because if your focus is three me- three seconds at a time-
- MRMel Robbins
Yes
- DSDr. Dean Sherzai
... you're never going to get to better memory. Because without a focus that goes deeper, memory doesn't happen. Without a focus that goes deeper, deep thinking and executive function doesn't happen. Without a focus that can go deeper and sustain, your emotional stability actually is flipped to an urgency living, which is this, this fight or flight state, which is incredibly destructive. So it starts with that in world we live in, which is constant attack on your focus.
- MRMel Robbins
What do you think the most common habit that you both see is that's harming people's, like, brain function, and we may not even realize it?
- ASDr. Ayesha Sherzai
I'm making a generalized statement, but something that I see quite often is stress. And we define stress in different ways in our lives, but stress is such a powerful contributor to cognitive decline.
- MRMel Robbins
Why? How it, why is that a, a, a contributing to cognitive decline, Dr. Ayesha?
- ASDr. Ayesha Sherzai
Yeah. So, so it, it, it essentially changes your biology.
- MRMel Robbins
Okay.
- ASDr. Ayesha Sherzai
You know, when people are under stress, um, and I have to say bad stress, because there is such a thing as good stress, and we'll talk about that later. When people are experiencing bad stress, your body starts creating specific neurochemicals and hormones that don't allow information to be stored in your brain.
- MRMel Robbins
Huh.
- ASDr. Ayesha Sherzai
So you basically are kind of closing all the gates for creativity, for memory, for processing information, and you're in this constant fight or flight situation where your heart rate is up and you're chronically going through biological shifts in your body. Inflammation goes up, oxidative damage goes up. Even if you're quiet, if you, even if it's not really showing on the surface, on the inside, stress literally eats up your brain. As a matter of fact, there have been some studies that show that when people are under chronic stress, they actually have smaller brains. There's a part of the brain called the hippocampus, and the hippocampus is responsible for many things, but the primary function of hippocampus is encoding memory. That shrinks when people are under chronic stress and cortisol is up. So it affects your brain, it affects your heart, it affects your arteries, and it's really important for people to kind of take it, take an account of what their bad stressors are and do something about it.
- MRMel Robbins
Is this why, if you just think personally, and as you're listening or watching right now, think to a moment in your life where you were under so much pressure. Is this why those periods of your life, you sometimes look back on 'em later and you're like, "I don't even remember what was going on because my life was so stressful?"
- DSDr. Dean Sherzai
A- absolutely. Stress basically is fight or flight. So you have these two primal states, fight or flight, and reproduce and br- um, and build, which is the parasympathetic system and synthetic system. These two systems are the primary driving force of the brain. When you're in constant stress, you're in fight or flight. Fight or flight means your GI system shuts down, your growth as a hormone shut down, your cortisol goes up, your bones actually starts resorbing and not building. Every system you can think of, including immune system, sexual s- uh, activity, everything closes. And in during that state, your frontal lobe closes because you are not worried about thinking your way out of the grip of a tiger. You're just running. It's a, it's fighting the tiger. And if you're fighting the tiger constantly, none of the growth states matter, and the brain kn- and the body knows that, shuts them down. So chronic stress is that s- that bad. And then the second part, secondary part of that is when you're in constant stress, nobody is going to be able to stick to a very disciplined, uh, nutritional program, because you're gonna go to survival nutrition, which is eating the bad food just to get the calories, right? You're not going to be doing exercise. It's about doing what makes you just comfortable. You're not gonna sleep well. What's the number one factor that affects sleep? Stress. Mental activity, your frontal lobe closes, everywhere else closes except the limbic emotional brain. Stress is that destructive, both within the body in general, the brain, and with habits.
- MRMel Robbins
You know, one of the things that, um, I love about your work is not only the fact that you're doing research and you're in these big clinical practices, but you're also in community outreach programs. You've built the largest brain outreach program in communities nationwide, which means you're seeing people of all different ages, because I think probably if you looked at the data, you got more people going into hospitals for screenings that are older. But I'm curious, how young are you both starting to see the effects of cognitive decline in brain health in people?
- DSDr. Dean Sherzai
I love that you said cognitive decline, because I have to be h- be honest, um, we don't see dementia earlier, because, th- that's later on, but cognitive decline, definitely. Uh, and we're seeing quite a few i- in the communities. Right now, we're in, in, in community churches, community kind of states, and, uh, we, we thought that we were going to see people in their 60s, 70s, or, or later. We're seeing people in their 40s come to us and saying they're having cognitive decline. And me- and when we test them, we detect the cognitive decline.
- MRMel Robbins
Wow.
- DSDr. Dean Sherzai
Now, that doesn't mean that they have dementia. That might make them at risk for dementia down the stream, but we know that they're having these cognitive issues early on. And, and a- at the same time, it's incredibly positive because we catch it early.In, in the hospital and clinic, because hospitals and clinics are fantastic, but they're fantastic for sick care, which means you see people at the point of disease, once they have dementia, once they've had stroke, once they've had heart attack. You see people way earlier in the communities when they haven't had that yet, but they're seeing the beginnings of it, or if we detect the beginnings. That's the powerful work in the community.
- 19:03 – 22:32
The first stage of dementia, explained
- MRMel Robbins
I love that. You know, one other thing that I read in your book, Dr. Ayesha, is that there are seven stages to dementia. You've already taught us that Alzheimer's is a slice of dementia, even though they seem to be used interchangeably, and that we can be in the first stage, so pre-clinical stage, 20 years or longer, and I wanna read to you from your bestselling book, The Alzheimer's Solution. This is on page 61, "A person in stage one has no impairment, no memory disorder, or cognitive deficits, though," oh, I'm gonna say this word wrong, but a- a- amyloid?
- ASDr. Ayesha Sherzai
Yes.
- MRMel Robbins
Okay. I said that right? Okay.
- ASDr. Ayesha Sherzai
You said it right.
- MRMel Robbins
"Amyloid plaques and tau tangles may be accumulating in the brain. Alzheimer's and other dementias begin to form years and often decades before they manifest. There may also be inflammation, vascular changes, and atrophy in certain parts of the brain, but not enough to cause symptoms. And this first of the seven stages of dementia can last 20 years or longer."
- ASDr. Ayesha Sherzai
Mm-hmm. Yeah, that sounds scary, doesn't it?
- MRMel Robbins
Yes.
- ASDr. Ayesha Sherzai
Um-
- MRMel Robbins
I'm, I'm like, am I already in it? Like, probably, but ...
- ASDr. Ayesha Sherzai
I think it kind of ties back to what I was saying earlier. Um, I think if we think about brain health as a spectrum and not something as, like, healthy versus non-healthy-
- MRMel Robbins
Yes
- ASDr. Ayesha Sherzai
... it will make sense.
- MRMel Robbins
Now, are we all gonna get dementia?
- ASDr. Ayesha Sherzai
Um, no. The, that's, that's the whole point of having this conversation, right?
- MRMel Robbins
Okay.
- ASDr. Ayesha Sherzai
Uh, what we do is, throughout our life, you're either living a life that is taking care of that magnificent organ or you're contributing to its damage. If you're doing things that are damaging to that brain, if you kind of, like, think about it, it's like a wear and tear. You have this beautiful machine, right? You have to oil it. You have to keep it away from moisture. You have to make sure that it's not exposed directly to the sun. You have to make sure that you keep it clean, right? Like-
- MRMel Robbins
Yeah
- ASDr. Ayesha Sherzai
... I don't know, I just got myself a Cuisinart, like, the, that's, you know, the, that mixer stand, and it requires a little bit of maintenance.
- MRMel Robbins
Yes.
- ASDr. Ayesha Sherzai
I don't know why I'm bringing that analogy, but you have to take care of that thing.
- MRMel Robbins
'Cause it's a Panini and a clean, that's why. [laughs]
- ASDr. Ayesha Sherzai
Yes, right? Yeah. If you kind of just let it be, then it's going to not work properly. Same goes for the brain. You really have to put in the work to take care of it, and so if we don't, even if we're in our 20s and 30s, uh, like we were saying earlier, a bad night's sleep, uh, not eating well, choosing a sedentary life, having poor relationships that is constantly creating stress in our life, not really pushing ourselves to learn something new, to experience something new and be creative, what happens is your brain starts accumulating these bad proteins that you just talked about, amyloid beta protein and tau tangle. And after a while, that damage really shows itself. Like, when we actually do MRI imaging of our patient's brain, right, you can actually see white spots. We call it white matter disease, and that could be related to bad blood pressure. Uh, it could be related to high cholesterol. It could be related to loneliness and social withdrawal, not treating sleep apnea, and not living a healthy lifestyle. So you can actually be in that stage for decades before the first symptom of, like, forgetfulness comes about. That's what we meant in the book.
- 22:32 – 27:26
What happens to your brain when you have a concussion
- MRMel Robbins
Now, if you've had concussion damage, 'cause I keep thinking about the fact that so many people listen to this podcast within families, does that put you at greater risk for developing dementia or any cognitive com- decline later in life?
- DSDr. Dean Sherzai
It does. It does. And, and, uh, but there are different degrees. Um, acu- uh, if people had a significant head trauma, of course the risk goes higher.
- MRMel Robbins
Yes.
- DSDr. Dean Sherzai
Or if you had multiple smaller, uh, head traumas, again, same thing. So I want people to know that, that, that, that head trauma is a major contributor, and we have to take life, uh, with that in mind. Um, we, we, we, we took it for granted that the brain was, uh, going to be fine because it's inside that bony skull. That bony skull is, has ridges, and the fluid that covers the brain is not viscous, so it's not, you know, slow motion. It doesn't slow the... It's literally bouncing off the bone. So we have to be careful with the activities we're involved in. Uh, um, sadly, even I played soccer. I, um, and Sheriff stuck to tennis. Uh, even soccer players that do multiple headers, they've seen that that actually affects the brain. And, um, activities like boxing and traumatic brain injuries absolutely contribute to that. Now, the good news is, if it's a few head traumas, like the things that Ayesha just said, a, a few things that happened during youth, we can reverse that. The good things that you do can significantly offset the bad things. I would rather that people don't do the bad things because we don't know when you'll a- be overwhelmed, but the two are, have to be taken into consideration.
- ASDr. Ayesha Sherzai
I wanted to add something.
- MRMel Robbins
Yes, please.
- ASDr. Ayesha Sherzai
And I think this is really important, and people might find it useful. When we expose our brain to something that could potentially harm it, we don't feel it when we're younger. We actually don't have any pain receptors in our brain.
- MRMel Robbins
You don't?
- ASDr. Ayesha Sherzai
We don't.
- MRMel Robbins
Really?
- ASDr. Ayesha Sherzai
So that's why, I don't know if you've actually seen these neurosurgery videos where, you know, they have somebody's skull open up and they have their eyes open and they just kind of poke at the brain, and the person is playing the violin to see which part of the brain [laughs] they're touching. The brain itself doesn't have any pain receptors. The coverings do.But my point here is the brain has so much reserve and capacity to kind of make up for a deficit earlier in our life-
- MRMel Robbins
Yep
- ASDr. Ayesha Sherzai
... that you actually don't feel it. One of the reasons why people don't care about their brain health is, like, even if they drink too much, even-
- MRMel Robbins
Right
- ASDr. Ayesha Sherzai
... if they miss many nights of sleep, they're fine, right? They, they don't f- feel it. Had it been your skin, if you keep on slapping your skin, you're gonna get a bruise. You're gonna be able to like, "Oh, gosh, I see it."
- MRMel Robbins
Right.
- ASDr. Ayesha Sherzai
"I see the damage."
- MRMel Robbins
Right.
- ASDr. Ayesha Sherzai
But we don't see or feel the damage to our brain because it has such resilience. A very, very, quote-unquote, plastic organ. It makes up for those deficits, but the damage is happening, unfortunately.
- MRMel Robbins
Well, I love that you said that, and here's why. Because common sense, I think we all know if you're smoking, you're damaging your lungs. If you're eating ultra-processed food, you're damaging your GI tract and some of your other organs. If you are, um, sedentary, you're not doing a lot for your overall health and your muscles. And what I'm gathering from this conversation, and also from the lifestyle interventions you're about to talk about that are within all of our reach to be able to take better care of ourselves and our brains, that just like smoking damages your lungs, it's damaging your brain. Just like alcohol is damaging your liver, and you may feel the hangover in your body, it's damaging your brain. And just thinking about it holistically, that this organ that is literally what's keeping you alive is affected by everything you do, but we're not thinking about it, and that's why this is so important.
- DSDr. Dean Sherzai
Incredibly well said. And, and I would go as far as say you probably affect the brain more, because remember-
- MRMel Robbins
Really?
- DSDr. Dean Sherzai
Oh, it's a three-pound organ, but it consumes 25% of your body's energy. It c- it is the most vascular organ; you would think that the heart is the most vascular. The brain is the most vascular organ in the body. So we're talking about smoking, so smoking affects the lungs. The vasculature of the brain is affected significantly more because there's more of it. And when blood pressure affects the, the peripheral organs, the brain is profoundly more affected because of the vasculature. When you're having alcohol, it directly kills neurons. And s- more than killing neurons, it affects the connections between neurons and affects sleep and everything else. So we usually say if you take care of your brain, you've more than taken care of the rest of the body, because the brain's demands are... They're, it's resilient, but its demands are tremendous.
- 27:26 – 33:38
How neurons communicate
- MRMel Robbins
Dr. Dean, how much control do people have over their cognitive future?
- DSDr. Dean Sherzai
More than any other organ. Your brain is at your control. It's, uh, it's there to answer to you constantly. Your brain is growing constantly, and it's growing in relation to what you do to it, and it's also shrinking in relation to what you do to it.
- MRMel Robbins
Ooh, I don't like that. When you said shrinking, it made me feel bad, 'cause you know what it made me think about? It's like if I... This may be too much information, but, but, you know, you think about hydration. We all need water. If I go to the bathroom and I see that the urine's a certain color, I'm, "Oh, I'm, I'm, like, not hydrated," but I'm not thinking that my brain needs water, and if I'm not hydrated, my brain's shrinking a little bit, and I think that's a really compelling thing to think about.
- DSDr. Dean Sherzai
It is. It's beautifully stated and, and it's compelling because it's visual, but it's even more real for the brain. So nutrition, sleep, and, and stress management creates the environment for the brain to grow or shrink. The two things that grow the brain, and, and by grow, I mean connections between neurons. Your neurons can have two connections.
- MRMel Robbins
Oh, they're pulling out a visual. I'm excited to see this. Okay, let me describe this for-
- ASDr. Ayesha Sherzai
Yes
- MRMel Robbins
... for the person who's listening. They're holding up just a, kind of a white board, and you've got two blue dots on either end, and then they're connected, these two blue dots, by just two red strings, strings.
- DSDr. Dean Sherzai
Yes. And, and the strings, the blue dots, or the blue things are l- imaginary. It's, it's the neurons.
- MRMel Robbins
Okay, so the blue dots are neurons.
- DSDr. Dean Sherzai
And the connections are the axonal connections between the neurons.
- MRMel Robbins
The-
- DSDr. Dean Sherzai
That's how they com- they com- What are they called? The axonal connections.
- MRMel Robbins
Axonal connections.
- DSDr. Dean Sherzai
Yeah, that's how they communicate with each other. That's how we actually think. It's the communication between neurons.
- MRMel Robbins
Got it. Now, do I need the re- I n- do I need the neurons to be connected-
- DSDr. Dean Sherzai
You need-
- MRMel Robbins
... in order for my brain to grow?
- DSDr. Dean Sherzai
Oh, absolutely.
- MRMel Robbins
Okay.
- DSDr. Dean Sherzai
In order for your brain to even survive.
- MRMel Robbins
So brain health requires your neurons to be able to connect to each other.
- ASDr. Ayesha Sherzai
Yes.
- MRMel Robbins
Okay.
- ASDr. Ayesha Sherzai
And these connections can be made at any stage of our life. That's the cool thing about it, you know? We may not be able to grow many brain cells, but we can make so many connections between the brain cells that we already have. Each cell can make as little as one or two connections, or as many as 30,000 connections.
- MRMel Robbins
Depending on how you take care of it.
- DSDr. Dean Sherzai
Correct.
- MRMel Robbins
Okay. Hold on. You're holding scissors.
- DSDr. Dean Sherzai
Yes.
- MRMel Robbins
So I don't know what you're about to do.
- DSDr. Dean Sherzai
Well, this is, this is what happens. If you haven't eaten well, if you haven't challenged your brain, if you haven't exercised, your neurons are connected a couple of connections, right?
- 33:38 – 38:46
How dementia impacts caregivers
- ASDr. Ayesha Sherzai
It's so wonderful to actually see people recover even after major injuries or major strokes when they start living a healthy life and implement these lifestyle factors.
- MRMel Robbins
Can you bring that visual back real quick? 'Cause I wanna ask you a question related to stress, the visual that has a bunch of different connections. So let's say you've been taking very good care of yourself, but now you're in a caregiver role, and you talked about the fact that, you know, Dr. Ayesha, when you were talking about the things that create, uh, damage to your brain health, one of the biggest ones is stress and chronic stress. And we now know that caregiving is its own form of chronic stress, and I was startled reading your bestselling book, The Alzheimer's Solution. This is page 46. "Partners of those who develop dementia have a 600% greater risk of developing the disease themselves compared to the general matched population, and this isn't attributable solely to stress, that shared lifestyle risks are also a major factor in the health outcomes of long-term couples." I'd love to have you just grab the scissors and just show us kind of like how stress and caregiving really can break apart these connections and neurons because you're not... You're, you're so focused on somebody else, you stop taking care of yourself.
- ASDr. Ayesha Sherzai
So when caregivers are under tremendous stress, let's say their cortisol level is high, that kind of cuts off two or three different connections-
- MRMel Robbins
Oh my gosh
- ASDr. Ayesha Sherzai
... between cells. Let's say, for example, they don't get a good night's sleep. We know how common that is among caregivers. Your brain didn't get enough time to cleanse itself and to function properly. Let's say four or five other connections got cut off. Let's say you don't have time to walk or to exercise. Forget about it. You have some other connections cut off. Let's say you never really get time to do something creative because you're just stuck in this constant, you know, mundane lifestyle of doing something over and over again. Creativity doesn't allow for your brain to grow at all. And then on top of that, just the s- the, the sadness and this pressure of taking care of another person, the guilt that comes with it, the shame that comes with it, all of that actually just severs the beautiful connection between brain cells, and that's what puts people at a high risk. The other thing is, when you live with someone who has Alzheimer's disease or some sort of dementia, lifestyle matters, too. So you kind of share the same environment, too.
- MRMel Robbins
Right.
- ASDr. Ayesha Sherzai
You kind of eat the same foods that they do. Let's say, for example, if they were not eating healthy foods-
- MRMel Robbins
Yes
- ASDr. Ayesha Sherzai
... there you go.
- MRMel Robbins
Wow.
- ASDr. Ayesha Sherzai
More connections severed. They were not really into exercising. There you go. You kind of follow that pattern. And as you can see, there's accumulation of all of these risk factors on top of the stress that you're experiencing, and caregivers suffer a lot.
- MRMel Robbins
I am so...Grateful that you brought this visual example, and if you're listening, what just happened is every time Dr. Ayesha talked about those very real circumstances that caregivers are experiencing, she was cutting one of the strings that connected the neurons in your brain, and it was extremely compelling and dramatic to see the connections and the strings hanging down, because this is the first visual example that I've ever experienced that really demonstrates to you as a caregiver why taking care of yourself, getting sleep, eating right, staying connected to friends, that... You know, you hear the adage, "Put your oxygen mask on."
- DSDr. Dean Sherzai
Mm-hmm.
- MRMel Robbins
It does matter because while you're caregiving, if you don't take care of yourself, your brain is shrinking, and there are things that you can do to stop that from happening or to build more neurons back if you've been in a period of caregiving and now you're coming out of it so that you can... But this to me raises the stakes in why the interventions we're about to talk about matter so much.
- DSDr. Dean Sherzai
One other point that I have to make here-
- MRMel Robbins
Yes
- DSDr. Dean Sherzai
... a large percentage of population, uh, uh, your population is women.
- MRMel Robbins
Yes.
- DSDr. Dean Sherzai
Two-third of all caregivers are women, and two-thirds of all Alzheimer's patients and dementia patients are women, and, and they're usually caregivers when they're midlife. They're, they're going through menopause and everything else. That's not a sad thing. Here's the positive part of that: If they just are aware of that fact and they do one or two positive, you know, uh, behaviors and activities in their life, that is a significant change in respect. So for women especially, they should know, majority of the women that we deal with are... You know, they're taking care of their children and their mothers.
- ASDr. Ayesha Sherzai
And then they're going through their 40s and 50s, like you said.
- MRMel Robbins
As estrogen drops, yes.
- ASDr. Ayesha Sherzai
And your hormonal system and the expectations that are put on you from, on the so- from the society, all of
- 38:46 – 48:46
Five Pillars of Brain Health: NEURO
- ASDr. Ayesha Sherzai
that takes a toll.
- MRMel Robbins
Well, I really appreciate your work because you have simplified the things that we need to focus on down to five things. Dr. Ayesha, it's a word, NEURO, N-E-U-R-O.
- ASDr. Ayesha Sherzai
Yes.
- MRMel Robbins
Can you walk us through the five things-
- ASDr. Ayesha Sherzai
Absolutely
- MRMel Robbins
... that we should focus on, and if you're a caregiver, ladies, wake up. Like, this is what we need to do to keep our brains healthy.
- ASDr. Ayesha Sherzai
Uh, thank you for bringing that up, Mel. We kind of kept it simple for our patients and our community me- members to remember these five pillars, because they make a huge difference. So N stands for nutrition. It's not about superfoods, it's about what kind of dietary pattern you choose, and I'd be happy to talk about it later. E is for exercise, moving. Movement is life. It's connected deeply to how we feel about ourselves and how our brain grows. U is for unwind, which is stress management-
- MRMel Robbins
Mm
- ASDr. Ayesha Sherzai
... reducing bad stress, increasing your good stress. R stands for restorative sleep, which basically means the deep kind of restoring sleep that cleanses your brain and makes it ready to memorize and be creative. And O stands for optimizing cognitive activity, doing specific kind of activities, liv- living a meaningful and a purposeful life, and engaging with your, with your environment and your social life so that you can grow the brain.
- MRMel Robbins
So doctors, you're saying all we have to do is focus on better nutrition, moving our bodies, unwinding, meaning just address some of the big stressors in your life, mindfulness, deeper rest, prioritizing sleep, and then optimizing some of the cognitive functioning in terms of just learning something or engaging in things that expand the way that you think. That's all we need to do to take better care of our brains?
- ASDr. Ayesha Sherzai
These are the core lifestyle measures that you can address, and yes, you can take care of your brain.
- MRMel Robbins
This is how we can pause the onset of dementia?
- DSDr. Dean Sherzai
Let's put it this way, take nutrition alone. If you eat a nutrition that's healthy, and it's simple. It's not any you have to buy anything from anybody. These are simple things from any grocery store. We, we work in Crenshaw, we work in, in, in Central LA, things that you can find anywhere. The studies have shown, mind study, that just good nutrition reduce your chance of Alzheimer's by 53%.
- MRMel Robbins
53%?
- DSDr. Dean Sherzai
Your brain is incredibly forgiving and resilient, and I mean that in a physiological sense, because this brain doesn't hold guilt or memories of, of, of blame or, "Why did you do..." You know, it, it recognizes the thing that's in front of it. So if you put the right thing in front of it, it literally overnight changes.
- MRMel Robbins
It's sort of like a plant, so you might have a sad plant in the corner, but if you give it a little sun and some water, it'll perk right up. Is that what you're saying?
- DSDr. Dean Sherzai
It's a perfect analogy.
- ASDr. Ayesha Sherzai
Mm-hmm.
- DSDr. Dean Sherzai
It's a perfect analogy.
- MRMel Robbins
Now, Dr. Dean, before we go deeper into each one of these habits, because once you said 53%, like, like, that, that was incredible, just talking about nutrition. Can you share more about why each one of these five habits matter so much for your brain health?
- DSDr. Dean Sherzai
A- absolutely, because they're cumulative. At the, at the same time, you could do one or two of them and you would still benefit, but if you do several of them, and there's, there's a study that actually shows this, when people did one or two of these habits, they reduced their chance of Alzheimer's by 30% or so. When they did four of them, they actually reduced it by 60%.
- MRMel Robbins
60% reduction?
- DSDr. Dean Sherzai
Yes.
- ASDr. Ayesha Sherzai
Yeah.
- MRMel Robbins
By following these five simple habits?
- DSDr. Dean Sherzai
Correct, and it is, a- and, and it, and it's powerful because it's cumulative. So if you, uh, uh, do just walking, exercise, we're not talking about some kind of marathon running, just daily walk, you've reduced your chance significantly. In fact, one Harvard study showed that if people walked, brisk walk-25 minutes a day, just a brisk walk, 25 minutes a day, they reduce their chance of Alzheimer's by 40%.
- MRMel Robbins
Wait, hold on a second.
- DSDr. Dean Sherzai
Yes, yes.
- MRMel Robbins
I mean, that just sounds honestly insane, that you could reduce your risk of Alzheimer's by 40% by taking a 25-minute brisk walk, how many days? Just every day?
- DSDr. Dean Sherzai
Five days a week.
- 48:46 – 54:20
The best foods for your brain
- MRMel Robbins
Dr. Ayesha, one of the things that I think is super cool about you is that during your neurology training at Columbia University, you became a professionally trained chef.
- ASDr. Ayesha Sherzai
I did.
- MRMel Robbins
Why?
- ASDr. Ayesha Sherzai
Because I spent a lot of time in my clinic talking to my patients about nutrition, and I felt so disempowering to kind of just pat them on the back and say, "Eat healthy." What does that even mean, eat healthy? It, it, it means different things for different people. Or, you know, I always took pride in being very evidence-based, and I would bring up MIND diet or Mediterranean diet, but what does Mediterranean diet mean for someone who lives in Crenshaw, Los Angeles, California? And so I thought, "No, I think, I think I need to know this better," because at the end of the day, it's you in your kitchen, it's you in front of your fridge making decisions about what to put in your body, and if I'm not specific and if I'm not empowering, I'm not doing anything. So I'd be in the ICU in the mornings at, uh, Columbia Presbyterian, and then, you know, right after work at 7:00 PM, in my scrubs, I would run down to, uh, you know, the cooking school in New York City, and I got my degree in two years, and I've been teaching my patients and my communities how to cook.
- MRMel Robbins
So let's put us right at that spot that we all plan what we're eating, which is standing in front of the fridge with the doors open [laughs]
- ASDr. Ayesha Sherzai
Yep
- MRMel Robbins
... or standing in front of the cupboard with the door open. What do you want us to have in our fridge or our cupboards in terms of the options and what we should focus on for better brain health?
- ASDr. Ayesha Sherzai
So when you look at the different studies that have been done, the, that, that show what kind of foods matter for brain health, it's not, you know, one or two foods that stand out. It's not a super food of the day, because y- we all hear that in infomercials, and, you know, people stock up on specific foods. It's the kind of dietary pattern that you have, the different types of food that you eat. And, um, whether it's the MIND diet or Mediterranean diet or all these dietary patterns that have been studied extensively, it's a variation of the same theme. They're mostly plants, so you have your greens, leafy green vegetables. You have your cruciferous vegetables like broccoli, cabbage, cauliflower. You have nuts like walnuts and almonds. You have seeds like flax seeds and chia seed. You have legume, which are phenomenal, beans, lentils, uh, tofu, tempeh. Then you have coffee and tea that are so potent in their anti-inflammatory compounds. You have spices that give flavor and have anti-inflammatory effect. All of this, if it's in your bowl, if it's just soup, or if it's a sandwich, they're great. And like we were saying, s- studies have shown that people who eat a healthy dietary pattern, MIND diet, they reduce their risk of Alzheimer's disease by 53%. But even if you actually take some foods that stand out, like for example, studies have shown that people who add one serving of leafy green vegetables like spinach or kale or collard greens to their diet, right? It could be raw, cooked, frozen, whatever. If they ate that on a regular basis, they had a brain that was 11 years younger.
- MRMel Robbins
What? What?
- ASDr. Ayesha Sherzai
Yeah. It's like-
- MRMel Robbins
With just one-
- ASDr. Ayesha Sherzai
Top it on top of your food
- MRMel Robbins
... lame spinach or kale-
- ASDr. Ayesha Sherzai
Yes
- MRMel Robbins
... or collard green salad?
- ASDr. Ayesha Sherzai
Just open the bag, fistful of spinach, put it in your soup, or just toss some olive oil and some lemon on it and just eat it, and your brain looks 11 years younger. It looks good on a neuroimaging, and it functions better as well. How wonderful is that? Just greens. Even if, if somebody's listening to this podcast and the only thing that they take out of this episode is just eating leafy green vegetables, I've done my job.
- MRMel Robbins
I think that's extraordinary.
- ASDr. Ayesha Sherzai
It really is extraordinary. And then you add other things on top of it. Like, for example, if you eat beans on a regular basis-
- MRMel Robbins
Mm-hmm
- ASDr. Ayesha Sherzai
... they have so much fiber. They have complex carbohydrates. Everybody's scared of carbs, but complex carbohydrates are important for you. Your brain runs on glucose, and you, if you give it the right kind of carbohydrate, it's functions beautifully. So when you eat lentils and beans, they provide protein, they provide complex carbohydrates. It's good for your brain. It's good for your gut. It actually manages your insulin levels, your glucose levels. Because at the end of the day, there are four things that start impacting your brain health when it comes to nutrition: inflammation, oxidation, glucose or sugar dysregulation, like pre-diabetes and diabetes, and then lipid dysregulation or fat dysregulation, which means bad cholesterol, too high LDL. All of this kind of starts damaging the brain. And what you eat impacts all four of these things. So I would love for the person who's listening to make sure they're having some green leafy vegetables, to make sure that they're having some nuts or seeds. Maybe they can put it in a jar on their counter. Add some walnuts to your oats. For them to eat whole grains like oats, brown rice, uh, let's say quinoa. For them to actually have some anti-inflammatories in the form of blueberries and strawberries and raspberries, because these are potent compounds that cross the blood-brain barrier, and they actually fix the inflammatory changes and the oxidative damage in the brain, for them to drink some coffee if they can handle it or some green tea. And, you know, I know it sounds cliché, but when they say eat the rainbow, there's something to it. These colored compounds, the fruits and vegetables that you eat, they really provide the right kind of environment for your brain to grow and thrive.
- MRMel Robbins
I also love that kind of cliché thing, but it's really true, to just shop the perimeter of the grocery store, because that's where the vegetables and the meats and the fish and all the good stuff
- 54:20 – 1:00:04
How to exercise for a better brain
- MRMel Robbins
are. So Dr. Dean, let's move on to exercise, because you have said, well, both of you have said, that your legs protect your memory.
- DSDr. Dean Sherzai
I, I don't want to compare exercise to any other of the neuro factors, but we're beginning to believe that exercise is central. You have to move. You have to create a life of movement, because when you move, both aerobic and anaerobic, both exercises that make you tired and exercises that strengthen your muscles, both are now found to be critically important. When you move, believe it or not, it's the number one factor that affects your emotionsWhether it's anxiety, depression, it's, it's incredibly potent. I'm not saying as a replacement for medications, but as a powerful adjunct, it's incredibly important. But on the brain itself, when you move, it creates m- a chemical such as BDNF, GDNF, and VEGF. These are growth factors that grow the v- vasculature, that grow the connections between neurons. They're incredibly powerful. When you move, it's the biggest pump in your body. It's not your heart, it's your legs. Legs push the blood to the h- to the brain. So they've done studies that people who moved regularly had better blood flow to the brain. When you move, it actually helps with the cleansing of the brain later on because your lymphatic system, which is the cleansing mechanism, works better. The list goes on and on and on. I don't care if you're gonna be z- nowadays, it's popular to say zone one and zone this or... Forget about that.
- MRMel Robbins
[laughs]
- DSDr. Dean Sherzai
Do a brisk walk. The zone stuff is for people to sell their programs. Eat salad, greens, and walk a brisk walk 20 to 25 minutes a day. That's nothing extraordinary, but it's extraordinary as far as what it does for your brain. Now, the strengthening, strength exercises are even more powerful, especially leg exercises. [laughs] When I was younger, w- even when you and I worked out, uh, they said, "Don't skip leg day." I hated leg day. But-
- MRMel Robbins
I still do. [laughs]
- DSDr. Dean Sherzai
Oh, I- I- most of us do. But leg days are important. Let's start from the other end of the l- life spectrum. When you're older, the number one reason that people end up in emergency room is falls. In fact, we lost our healthy, incredibly healthy grandma, M- Ayesha's mom, uh, just recently within last month because of a fall. We lost my mom originally because of a fall and injury, and then COVID, uh, was a subsequent factor, but falls are incredibly common. Guess what stops falls? Leg strength. Now, let's get a little closer, at a younger age. Leg strength builds brain volume.
- MRMel Robbins
What does that mean?
- DSDr. Dean Sherzai
It grows your brain. So there's a study, there's a twin study, and there's no better studies than twins because genetically, they're identical, so it's not genetics.
- MRMel Robbins
Right.
- DSDr. Dean Sherzai
Often, even environmentally, they're the same, right? Often. They did studies in MCI patients, mild cognitive impairment, pre-dementia, seeing there's a control group. One sibling did leg strength, the other one did stretching. Not that stretching is bad, but compared to leg strength, they looked at w- the percentage of MCIs that went on to develop dementia. Those that did leg-strengthening exercises reduced their chance of Alzheimer's by 47%. 47%, leg strength.
- MRMel Robbins
Hold on. I just wanna make sure that as you're watching or listening, that you really got what Dr. Dean just said to you. So, so far, and this makes sense, that your legs are critically important because they're an even bigger pump of blood than your heart, and when you have good leg strength, when you go for a walk, 25-minute brisk walk five days a week, you reduce your risk for Alzheimer's by how much?
- ASDr. Ayesha Sherzai
So the siblings who exercise and had stronger legs, 47% of them actually had normal memory testing after that period. And it wasn't even extensive. It was just a six-month study, and they exercised for about 30 to 45 minutes, and they were doing things like, you know, the resistance training, leg press, lunges, and squat.
- MRMel Robbins
How many days a week do I have to do this?
- ASDr. Ayesha Sherzai
Three or four times a week.
- DSDr. Dean Sherzai
Three.
- MRMel Robbins
That's it?
- ASDr. Ayesha Sherzai
Three is, is, is great, yeah.
- MRMel Robbins
Like, why wouldn't you do this if you knew that you decreased your risk for Alzheimer's significantly and if you have any type of mild cognitive impairment, the study is showing that you might actually reverse it?
- ASDr. Ayesha Sherzai
Yeah. Well, then that's-
- MRMel Robbins
I- and like, that's why I'm, I'm saying, like, as a whisper. I'm like, "Really?"
- DSDr. Dean Sherzai
Yes.
- ASDr. Ayesha Sherzai
Yeah.
- DSDr. Dean Sherzai
Yes. These are-
- ASDr. Ayesha Sherzai
They'd have speaker, you know, the speakers on our hands just yelling at the top of our lungs to say, "This is such a wonderful way of taking care of your brain."
- MRMel Robbins
And even if you're 80, even if you're 90.
- DSDr. Dean Sherzai
Yes. You don't have to do leg presses with weights on your shoulder. I tell people, "Do mini squats." You're s- you're watching your favorite show. Make, make that your leg day. Uh, you s- uh, stand up, your couch is behind you. Don't go all the way 90 degrees. Go 60 degrees and do a few of those. Write it down. And even if you fall, you fall, falling on your couch, but you've started. You've started in a place, not a gym, where you have to get all dressed up. In your own home, in front of your favorite show, you just did 10 squats.
- ASDr. Ayesha Sherzai
Or if you're waiting for your microwave, if you're warming something up-
- MRMel Robbins
[laughs]
- ASDr. Ayesha Sherzai
... instead of just, like, standing there, just hold onto something and do some mini squats for 60 seconds, and you'll see the benefits. It's as simple as that.
- MRMel Robbins
This is incredible.
- 1:00:04 – 1:05:30
Why stress can be good for your brain
- MRMel Robbins
Dr. Dean, let's move on to the third one. We've done nutrition, we've done exercise. The next one is unwind, and it's about the intentional effort to de-stress.
- DSDr. Dean Sherzai
Correct. Uh, there's a reason why U is in the middle of NEURO. As I said earlier, s- uh, stress management is central. But here's the thing, there's good stress and bad stress, and good stress is critical. There's a reason that you have 86 billion neurons and a quadrillion connections. If it was reproduction and getting food, you would stop at, at, as a bacteria. They do a great job. They get food and they reproduce. It's for more than that. That brain demands good stress. It needs to be challenged. In fact, studies have shown that people who are very mentally active and then they retired, and then for the next two years they didn't do anything, guess who had the steepest decline? Them.
- MRMel Robbins
But we've seen it.
- DSDr. Dean Sherzai
Yes.
- MRMel Robbins
Like, you've probably seen your parents retire or somebody in your family retire and they were active and alive and interested and engaged, and then-Two years later, it's like, who are you?
- DSDr. Dean Sherzai
Yes, but the ones that maintain the level, the same level of activity, but maybe around things that they always wanted to-
- MRMel Robbins
Right, right
- DSDr. Dean Sherzai
... they maintain the cognitive capacity.
- MRMel Robbins
So about, though, the unwind, why is it important to really take minimizing the bad stress, the constant pressure, the negative self-talk, the endless perfectionism, and the to-do list, the things that we do that we may be able to dial down, why is unwinding that stress really important, and how do we do it for brain health?
- DSDr. Dean Sherzai
Because, uh, stress used to be a one-time thing or m- less frequent, right? There would be... A tiger was after you.
- MRMel Robbins
Right.
- DSDr. Dean Sherzai
You either died or stressed.
- MRMel Robbins
Right.
- DSDr. Dean Sherzai
Uh, uh, so, or, or both. Uh, and, and then now in the modern world, it's everywhere.
- MRMel Robbins
Everywhere.
- DSDr. Dean Sherzai
Every single system in your body is affected because when you're under stress, your body is telling you, "I don't have time, enough energy to spend on this, this, and this. These are, uh, a luxury states. My entire focus is going to be on survival."
- MRMel Robbins
Yes.
- DSDr. Dean Sherzai
And everything shuts down. That's why people in chronic stress have higher degrees of cancers. Immune system is lower, right? So that's why it's critical to address stress centrally.
- MRMel Robbins
And how do you recommend, when it comes to brain health, Dr. Dean, what is one important thing that somebody should really start to think about or to do in their life for better brain health when it comes to stress?
- DSDr. Dean Sherzai
Very, very non-neurological way, make lists.
- MRMel Robbins
Okay.
- DSDr. Dean Sherzai
Identify bad stressors in your life, meaning activities, um, behaviors, and thoughts that are not driven by your purpose, that are external to your purpose, that don't have good timelines, that are just taking over your life, and you have no control over them. Literally write them down specifically. The other side of the paper, write the good stressors, the activities that you would want to do or you're doing that have meaning for you, that have purpose, that are well-defined, that have clear timelines of victory. Write those down significantly, uh, specifically. And your life purpose should be reducing, eliminating, and delegating the negative stress, increasing, empowering, and tooling, and strategizing towards good stress.
- MRMel Robbins
But I love the fact that you're talking about lists because you're right, we do tend to manage it all in our minds, and we began this conversation by you saying that we are living in a moment in time when there's so much bombarding you that your speed of retrieval for what matters is slowing down because you have to wade through all this junk that the world is throwing at your brain. And so making the list forces you to get on paper what's actually going on in your life. If you really get intentional around dialing down the stress, what are the implications for slowing down dementia or growing a better brain? Like, what happens?
- DSDr. Dean Sherzai
Uh, purpose. Good stress is activities, behaviors, and thoughts that are driven by your purpose. Let's just take that one component.
- MRMel Robbins
Yes.
- DSDr. Dean Sherzai
Studies have shown that people that were purpose-driven have significant better brain health. Significant. So I don't want... I want to make sure that I, uh, demystify the word purpose. In my case, purpose is neurologic. Purpose has direction. Purpose is a well-defined thing that I'm going towards. When a life has got that kind of vector, that kind of direction, that kind of power pulling it, and you've organized it well, it is the ultimate in good stress.
- MRMel Robbins
And it makes sense because, you know, if you think about when you get in a rut in your life, where you're just in a period where everything is work, where everything is taking care of other people, and then you start slipping into these habits where you're wasting hours every day on social media and just doing dumb things that actually kind of stress you out and make you depressed, you start to tell yourself, "Well, I don't have time to volunteer at hospice. I don't have time to go to church or synagogue or mosque this weekend. I don't have time to work in the community garden." And the list, and getting everything going on in your life, and crossing off some stressors also opens up space for you to find a Thursday night to go back to book club. And, you know, I kind of think about this, like, do you have something you're looking forward to every week? And that direction is really important, you're saying, for your brain health.
- 1:05:30 – 1:10:42
What happens to your brain when you sleep
- DSDr. Dean Sherzai
Yes.
- MRMel Robbins
Dr. Ayesha, let's talk about our rest. How can the person listening improve the quality of their sleep?
- ASDr. Ayesha Sherzai
It's so important, and I feel like a hypocrite right now talking to you about restorative sleep because I flew in from Los Angeles last night, and I haven't had a good night's sleep, but I'm caffeinated. Um, sleep is something we don't talk about enough, and it's always an afterthought, isn't it? It's like, "Oh, I'll sleep later." It's as if you're taking away time from such a precious thing, and you're being selfish to go to sleep. But sleep is a time when your brain actually does its most important task.
- MRMel Robbins
Hmm.
- ASDr. Ayesha Sherzai
Two things happen when we sleep. The first thing that happens is you actually start cleansing your brain. There's a very elegant system that gets activated when we go to the deeper stages of sleep. It's called the glymphatic system, and it is made of a type of a fluid that literally washes your brain and gets rid of the debris, and there are very specialized cells. They're these tiny cells called microglia. These are the janitor cells of your brain. They get activated. You know how when you're in a building and during the day there's business and people come and go-
- MRMel Robbins
Mm-hmm
- ASDr. Ayesha Sherzai
... there's a pile of trash that accumulates in the trash cans? This janitorial system, you know, comes into the building, and then it cleans up, so when you come back the next day, everything is spotless and clean, and it smells great. That's exactly what happens when we go to sleep. Your brain gets rid of all of this debris, the amyloid beta protein that has been associated with Alzheimer's disease, the tau tangles, and so many other things. They get washed away. The second thing that happens is your memories get organized from short-term... to long-term memory. You know how during the day when you come up with ideas, you write them, you scribble them, you were scribbling on some papers in the corners-
- MRMel Robbins
Yeah
- ASDr. Ayesha Sherzai
... and you probably have some Post-it Notes in your computer in your office. When we go to our sleep, all of this information gets beautifully written into a nice Word document, it goes into the right file, and then the folder, and then the cabinet. I'm giving you examples, so you know where it is the next day. You're not, like, thinking about, like, "Oh, what was that thought that I had? Where did I put it? Oh, it's neatly in the right file folder cabinet, I can retrieve it." That's what happens in our brain. The, the, the defragging system of the c- of the brain actually gets activated during deeper stages. So when we don't sleep, when we don't get at least seven to eight hours of deep sleep, when we don't hit those deeper stages of sleep where this process gets activated, when we keep waking up over and over again because we have to go to the bathroom, or if we have sleep apnea, or if we have restless leg syndrome, or if we're worrying constantly and we keep waking up because of that, all of this, um, byproducts, these byproducts, they accumulate in the brain.
- MRMel Robbins
Mm.
- ASDr. Ayesha Sherzai
And over a long period of time, they've seen that people who have major sleep d- disorders, chronic disorders, they are at a higher risk of developing Alzheimer's disease and dementia.
- MRMel Robbins
Well, it makes perfect sense, and it also ties back to what you were talking about earlier, about the speed of recovery, that if you're not getting a deep, restful night's sleep and you can't go through that phase where the brain cleans out the garbage, you're having to sift through it all day long, and you also aren't filing away anything that happened into long-term memory. Is there any recommendation that you have for your patients in terms of, like, just one thing that you could do starting tonight that might help you get a better night's sleep?
- ASDr. Ayesha Sherzai
There's so many things that you hear on the internet about sleep. One thing that is extremely helpful, and it has been validated by sleep specialists and scientists, is just set a time to wake up the same time every single day. Why? Because, say, for example, if you decide to wake up at 7:00 in the morning or 6:00 in the morning, even if you haven't had enough sleep the night before that, you're going to slowly and gradually fix that. Your body will need to sleep more. And so you don't have to, like, you know, assign a time to go to bed, just wake up at the same time. There are so many other things as well, and it's indepen- it's dependent on the person as well. So for example, going for a walk first thing in the morning, it resets your circadian rhythm, it actually exposes you to sunlight, it gets you to exercise a little bit more so you kind of get tired during the day to go to sleep. And then there's some environmental factors as well, making sure that your room is dark, making sure that your bedroom is only for sex and sleep, and it's not a living room or a dining room or a social gathering place, that it's cool, that it's not noisy. All of these environmental factors make us... And then for stress management, it, that in itself is a huge topic, but cognitive behavioral therapy for insomnia works really well. This is something that people can get help from with a psychologist or a sleep specialist, and it kind of helps you shut down that noise that is associated with stress.
- MRMel Robbins
What I love about the walk first thing in the morning in terms of resetting your circadian rhythm is it's a twofer. See, I like to bundle things.
- ASDr. Ayesha Sherzai
But-
- MRMel Robbins
If you do a 25-minute brisk walk first thing, we reset the circadian rhythm and we reduce our risk by 45% for Alzheimer's based on the research. See, I'm listening. I'm doing this.
- 1:10:42 – 1:17:02
Your brain wants to be challenged
- ASDr. Ayesha Sherzai
You got it.
- MRMel Robbins
Let's talk about the final recommendation of the five things in NEURO, and that is O, optimize.
- ASDr. Ayesha Sherzai
Optimize is good stress, and it is critical. Your brain wants to be creative. The ultimate byproduct, the ultimate purpose and direction of brain is creativity. Creativity is central, and creativity means pushing the brain to do new things. And study after study shows that people who kept their brain active late in life actually grew their brain. There are some really cool studies, two studies. One is the nun study. The nun study is a, a several hundred nuns dedicated their body, their brain, their tissue, their blood cells, and their diaries to science. And after they passed away, their brains were autopsied and, and, uh, analyzed. And they saw that some of the nuns, they all did pretty much the same thing, some of the nuns, despite having significant pathology, lots of shrinkage, lots of little, uh, uh, uh, amyloid and tau, as well as little microvasculature, they were normal during life. Another group that had very minimal pathology, a pretty full brain, and they had Alzheimer's right before death. And it wasn't genetics, so what's going on? Why is this group that has so much pathology yet normal, this group that has minimal pathology and already succumbed to Alzheimer's? After doing much of the work as far as genetics and study and blood tests and everything else, they looked at their diaries. The group that had significant pathology, yet was protected, their diaries demonstrated incredibly complex language. They had greater vocabulary.
- MRMel Robbins
What does that tell you?
- ASDr. Ayesha Sherzai
Idea density, that means they challenged their brain. They learned more. They pushed themselves to study more, to learn more, to have more vocabulary. Idea density is a lovely, lovely concept. I said if I... I'm a terrible guitarist, but if I ever have a band, I'm gonna call it Idea Density, which is gonna be even worse.
- MRMel Robbins
[laughs]
- ASDr. Ayesha Sherzai
But nonetheless, it's an incredible concept. The group that succumbed, in spite of normal, had much less sophisticated vocabulary, had challenged, challenged their brain much less.
- MRMel Robbins
So what are the top recommendations of things that you can do to challenge your brain? Because I'm, I'm sitting here thinking about some of the people in my life who are, like, always doing Sudoku or the crossword puzzle or passing wordl- Like, are we doing word games? Are we reading? Are we learning new skills? Are we learning languages? Like, what is the biggest bang for the buck in terms of keeping your mind active and optimizing the brain's natural desire to create, to grow, to learn?
- DSDr. Dean Sherzai
E, all of the above
- MRMel Robbins
[laughs]
- DSDr. Dean Sherzai
But, but reality is, um, the more complex, the better. We did a meta-analysis. We write papers. We, we, we did a meta-analysis a couple of years ago, looking at everybody else's papers who gave it to us, and we've looked at the bigger data, and we saw that three things matter: complexity, purpose, and challenge. And what does that mean? Activities that have a purpose for you and have complexity, meaning multi-domains, and you're pushing yourself, are by far the best.
- MRMel Robbins
Okay.
- DSDr. Dean Sherzai
What does that mean?
- MRMel Robbins
I have no idea what that means.
- DSDr. Dean Sherzai
Yeah.
- MRMel Robbins
Does that mean we could be doing a puzzle as a family?
- DSDr. Dean Sherzai
Those are great, but learning a musical instrument. So when you're learning guitar, you're reading the notes-
- MRMel Robbins
Yes
- DSDr. Dean Sherzai
... that's your, uh, language centers.
- MRMel Robbins
Okay.
- DSDr. Dean Sherzai
You're processing it. It's your oc- uh, prefrontal lobe. You're visually processing it, your occipital lobe. You're actually being creative, that's your parietal lobe. You're emotionally involved. Uh, if they're listening to me, it's bad, negative emotion, but for me, it's good emotions. You're emotionally involved. It's your limbic system. And you're dexterous, so it's your motor cortex. It's the entire brain being active at the same time, and that's complexity. It's purpose, because I love the music. And what you do is, if w- if for a couple of weeks you learned a Beatles song that has four chords, next week, do five chords. That's pushing yourself, uh, forward. If you're learning dancing, if it's a three-step dance, next week, do five-step dance. So real-life activities are much more meaningful because they serve your purpose.
- MRMel Robbins
Wow. Anything else that counts? Reading books, book clubs, staying active? Because I know people are gonna be like, "Well, how do I engage my brain? I'm 70. I'm 80. I'm this. I'm the other thing."
- DSDr. Dean Sherzai
All of those. All of those have complexity in them, right?
- MRMel Robbins
Right.
- DSDr. Dean Sherzai
So, but, but if you're reading, read, recite, and rewrite. That gives another level of complexity. You just read a book, not a whole book, but a chapter. Now, think about it. Process it. Rethink it and rewrite it. That brings the entire brain into effect. Uh, if you have book clubs, amazing, because now you're social.
- MRMel Robbins
Yes.
- DSDr. Dean Sherzai
So it's the social interaction, the conversation, the thinking, the processing. There's an incredible thing about dual task. So example, if you're on a treadmill, people w- that exercise on a treadmill and then they listen to a Mel Robbins, uh, podcast, which everybody should do-
- MRMel Robbins
[laughs]
- DSDr. Dean Sherzai
... they actually did significantly better than just exercise alone.
- MRMel Robbins
So you get a twofer if you're walking on a treadmill and you're listening to a podcast because you're expanding your mind, and it makes you think about new things, and you're moving your legs, which we now know your legs pump all this blood to your brain, and it's one of the most important things you can be doing.
- 1:17:02 – 1:22:23
You can always build a better brain
- MRMel Robbins
I have learned so much from the two of you. It is so cool what you're doing. Dr. Dean, Dr. Ayesha, what are your parting words? 20 years from now, you're not going to remember this conversation, but your brain is going to remember the changes that you're going to make today and tomorrow, and that's what matters. It could be a walk. It could be joining a book club. It could be joining your children or your grandchildren to play games once or twice a week. Those things will determine how you are going to be you in this beautiful story of your life, and your 75, 85, 95, 105-year-old will thank you.
- DSDr. Dean Sherzai
Beautiful. I don't know if I can top that, but, uh-
- MRMel Robbins
[laughs]
- DSDr. Dean Sherzai
... I will, I will, I will-
- MRMel Robbins
You'll contribute to it. Yes, exactly
- DSDr. Dean Sherzai
... I'll add. A cathedral was not built right away. It was one brick at a time. People forget that, because they think it's not enough. It is enough. When you're standing in front of TV during your favorite show, and at the beginning, just standing and s- making small steps in place, that is profoundly powerful for multiple reasons. One is your reward system, which is built on dopamine, is both reward and movement. There's a reason why dopamine affects both of those. Now you've created the foundation, the first brick that everything else can be built on. That's as powerful as that entire building. You've just started. Just do that every day. If you just add one serving of greens a day, that's, that's not a brick, that's a wall.
- MRMel Robbins
[laughs] That is awesome.
- DSDr. Dean Sherzai
That is a wall.
- MRMel Robbins
Wall of a fort.
- DSDr. Dean Sherzai
Now you see that the cathedral, these are cathedrals you're building with small, simple, incredible bricks of daily activity that will change your life, your family's life. When they talk about genetic, it's not genetics, it's shared habits. You've just changed-
- MRMel Robbins
Mm
- DSDr. Dean Sherzai
... your children's habits and your parents' habits. You've just shi- built cathedrals in your communities. That's our purpose in life.
- MRMel Robbins
Well, Dr. Dean, Dr. Ayesha, ladies and gentlemen, the Sherzais are here. It is, it is a real, uh, privilege in life to be in the presence of someone's genius, and, um, it's so moving to see your passion.And the gift that you have for boiling all of this down in both a simple way and in an urgent way. I believe you when you say that there are small things we can start doing and our loved ones can start doing right now that will forever change your brain health. And you have taught me so much today. I'm sharing this not only with my family group chat with Chris and the three, you know, adult kids, but the larger ones with cousins and aunts and uncles, because everybody deserves this information and research and these simple recommendations and the reasons why they matter so much. It's literally your life, and you've just put the power back in our hands to improve it. So thank you, thank you, thank you for the work that you're doing, and thank you for flying all the way here and spending this time with us to help us improve our lives. And I wanna thank you. Thank you for making the time to listen to something that one thousand percent is gonna improve your life and the life of absolutely everybody that you love, that you share this with. I am convinced that the way that you take care of your brain is gonna determine how you feel in your life. I learned so much. I know you did, too. I wanna thank you for listening and watching all the way to the end. I also wanna thank you for sharing this generously, because we all deserve to have access to this information and the reasons why the things that these amazing doctors are recommending are gonna work. And in case no one else tells you today, I wanted to be sure to tell you that I love you and I believe in you, and I believe in your ability to create a better life. And paying attention to and taking your brain health seriously, there is no doubt based on the research and everything you learned today, that that is the way you create a better life. All righty, I will see you in the very next episode. I'm gonna welcome you in the moment you hit play. Thank you so much for watching all the way to the end. Didn't you just love this? And you know what I love? I'd love if you would be generous with this episode and share it with your family. Share it with friends that are caring for aging parents. Share it with that work colleague that is a caregiver. Share it with the younger people in your life. I mean, can you imagine how different your life would be if you started doing these things sooner and now you know the research? Holy cow, I can't see what happens in your life and your family's life when you share this, so thanks for doing that. One more thing, before I tell you what video you should watch next, if that subscribe button is lit up, please hit subscribe. It's free. It's the best way for you to say, "Hey, Mel, and hey, Mel's team, thanks for bringing these world-renowned experts. Thanks for these life-changing resources that I can share with my family and the people that I care about." That way, when you hit subscribe, you're not gonna miss a thing, and it's the best way that you can support me and the team. So thank you so much for taking the time to do that. I really appreciate it. All right, the next video that you should watch is this one, and I'm gonna welcome you in the moment you hit play.
Episode duration: 1:22:26
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