The Peter Attia Drive - Qualy #16 - How much does cognitive activity ward off cognitive decline？

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00:01:03.120 how much does mental activity ward this off you know we hear so often the anecdote of

00:01:12.300 bernie was working his little tail away beavering away and then when he retired to play golf it all

00:01:18.160 went to hell in a handbasket and then the other one you often hear anecdotally is once so-and-so's 0.69

00:01:24.740 spouse passed away oh my god the remaining spouse just regressed completely and seemed to have this

00:01:30.840 accelerated case of Alzheimer's intervention so the the idea here being once that person retired and

00:01:35.840 they weren't cognitively engaged and they were not to say golf is cognitively bankrupt but presumably

00:01:40.880 it's less cognitively engaging than whatever that person was doing before or once the sense of purpose

00:01:46.240 the social support vanishes again anecdotally this seems overwhelmingly the case is there any data to

00:01:53.360 support that so yes but it's complicated the cognitive reserve can't one thing just be freaking

00:02:00.920 simple no Alzheimer's prevention no no man this is this you sound like me man yeah everything's

00:02:06.680 complicated everything's complicated i wish i could give you a concise bullet point state you know like

00:02:10.320 i want a bumper sticker yeah live tv you got to give them like a quick snapshot not on this topic so

00:02:16.040 early life risk factors for Alzheimer's are different than midlife and late life and early

00:02:21.920 life risk can be mitigated most so by long-term educational attainment that's the best evidence

00:02:29.400 we have we also have to be clear has that been normalized for socioeconomic status it strikes me as

00:02:35.200 almost impossible to normalize that for socioeconomic status above my pay grade don't know the literature as

00:02:40.920 well as i need the point here being like people who go on to get secondary and tertiary education

00:02:46.120 are going to have lower risk is it because of the things that enable them to do that perhaps having

00:02:52.580 more resources lead to them doing other healthy lifestyle things that go beyond the education as i hope

00:02:59.740 the studies have controlled for that but i know it's impossible to control for everything but that being

00:03:03.620 said i think early life educational attainment for example musical experience midlife and midlife

00:03:08.880 musical experience as well as early life absolutely can get built up greater cognitive reserves that

00:03:13.200 when you get Alzheimer's you're more resilient you have this resiliency the other aspect is and i don't

00:03:18.100 know enough about music but when you were the cello playing to bass guitar playing guy what part of the

00:03:24.480 brain is getting exercise when you do that very multimodal it's the parietal lobe is the music side

00:03:29.660 maybe on the right side the you know reading music notes is kind of like language so it'd be the left

00:03:34.520 side of the brain and that's visual it's basically an association cortices basically the whole brain is

00:03:40.140 talking to each other so i think music is a great way to recruit different parts of the brain to work

00:03:45.220 together and the stronger those pathways get the better the person does and again teleologically that

00:03:50.080 makes so much sense i guess it begs the question i would argue we will never know the answer to this

00:03:55.540 question because if we're going to have to rely on very loose epidemiology which can never be fully

00:04:00.960 controlled and suffers from all of the usual problems that epidemiology suffers from the question

00:04:06.420 ought to be is there any harm in believing that the epidemiology is right attaining a higher level

00:04:12.660 of education staying more mentally engaged sustaining more loving social supporting relationships having a

00:04:18.340 greater sense of purpose learning to play a musical instrument i mean is there a chance that doing

00:04:21.700 those things increases your risk well i don't think that there's been any evidence to suggest that it

00:04:25.680 increases risk but then there's this whole you know the naysayers will say but what is the

00:04:29.300 cost what are the trade-offs what's the opportunity cost what's also the how much does it like music

00:04:34.660 lessons you're going to pay money to do music lessons or buy a guitar but shouldn't you be like

00:04:39.220 buying healthy food so there's a lot of confusion and there's when we get reviewers of our papers

00:04:44.100 this comes up all the time so i'm not sure all i can say is when you build a better backup pathway in

00:04:49.980 the brain and you there's a saying if you don't use it you lose it well someone that has alzheimer's

00:04:56.180 is very cognitively engaged and has a good backup pathway they're not going to decline as quickly

00:05:00.740 that being said once the disease takes hold and maybe they stop working or they stop the loser sense

00:05:05.760 of purpose you can have a much more sharper decline so people with high cognitive reserve high cognitive

00:05:10.580 backup systems are resistant to the effects of the amyloid but there's a time that comes when they

00:05:16.740 decline and those people decline much more sharply than others because they had like this emergency backup

00:05:22.260 system but sometimes when the parachute fails the person goes down and an alzheimer's disease

00:05:27.060 that's a subtle that's a nuance i wouldn't have predicted it makes sense the mechanism that you

00:05:32.700 postulate makes sense and you know you gave the other example of the woman whose husband passed away

00:05:38.160 and then she just went downhill because when you have a collaborative relationship and you know when

00:05:42.480 one person's brain isn't working well but you have another person to cover for you and do the dishes

00:05:46.360 and feed you and and then that person has gone aside from depression serotonin you have all that

00:05:51.560 oh i see this all the time like i i knew she had it but then the husband and you know caregivers of

00:05:57.820 alzheimer's patients have terribly higher medical illnesses and when when a husband dies and he was

00:06:04.960 the primary caregiver and the wife has alzheimer's that person will decline absolutely exponentially

00:06:10.380 i saw this in a high school teacher of mine i i mean i see this all the time i hope you enjoyed

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The Peter Attia Drive - August 30, 2019

Qualy #16 - How much does cognitive activity ward off cognitive decline？

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