S2E36. Dodging Dementia Bullets

Dementia risk-management was not something that was on my mind when I was 20. Or when I was 30, 40, 50 or even 60, for that matter. Had it been, I would have been shit out of luck because the research had not been done yet and so there were no guidelines to work with.

Looking back at my life, though, it appears that I did a pretty good job of dodging high-risk dementia-related behaviors. Of course, I could not have done it intentionally because I didn’t know what those behaviors were, so basically, I lucked out. But as Pippin’s father Charlemagne told him: ‘It’s smarter to be lucky than it’s lucky to be smart!’

Here’s a partial summary of my smart luck. I’ve highlighted risk factors for dementia in bold.

Let me start with something that’s not a behavior at all: my genetic makeup. First and foremost, I was born a male. For reasons that are still not yet fully understood, women are at higher risk for developing dementia.

Secondly, it appears that I did not inherit the dreaded APOE4 gene which is linked to early onset Alzheimer’s. My mother demented at around the age of 83, but her sister was cognitively spry when she died at 94. Nobody on my father’s side lived long enough to find out if there was any dementia lurking there.

Like most boys growing up in the 50s and 60s, I played tackle football with pads after school every day in the fall. I was pretty small for my age, earning the nickname ‘shrimpotz’ in 4th grade, and I was still only 130 pounds when I got to my sophomore year of high school, so I figured playing football was hopeless and switched to running. The lucky thing here is that I was never knocked unconscious or had a concussion. Another risk factor averted. 

Not only did I dodge that bullet, but running became a lifelong habit. I was in the first cohort of joggers to take to the streets, back when it was considered cool for cars and trucks to try to run you off the road. Unknowingly, I had adopted one of the 5 core behaviors for reducing dementia risk…and I did it at a very early age.

I also lucked out when it came to education. I started school in Newark, NJ, where the quality of the education offered had already begun its decline from the system that produced Philip Roth in the 1940s to the one that failed and was taken over by the State of New Jersey in the 1990s. When I was about to enter 4th grade, my parents were able to move us to a town with some of the best schools in the state. I flourished there and wound up getting into Brown University.

All of that was fortuitous because, as it turns out, attending a high quality elementary school and going to college are both protective factors. Again, lucky me!

But it didn’t stop there. When I was 44, I decided to become a psychologist and so I spent the next 6 years in graduate school, first at Marywood University in Scranton, PA, and then at the University of Connecticut. Once again, I didn’t do it to promote my long-term brain health, but we now know that that kind of intense cognitive challenge involving learning new skills and information is also one of the pillars of dementia risk-reduction.

Along those lines, I suppose it also helped that I changed careers every 10 years and that all of those careers were people-oriented.

With its heavy doses of sugar, refined flour, saturated fats, beef and fried foods, the American diet is a notorious contributor to dementia risk. For a long time, I ate with abandon in service to my taste buds, ignoring calories, cholesterol and fat content. Can you say “large pizza with extra cheese, sausage and pepperoni?” 

Fortunately, I did not have a sweet tooth and my metabolism did not lend itself to excessive weight gain. Thus I dodged two more dementia bullets in spite of myself: diabetes and obesity.

My worst period in terms of unhealthy eating was when we were running our B&B. I was the cook, serving up eggs, bacon and breakfast pastries every day. And every day I ate what I was cooking. By the end of that run, though, I realized that I needed to make some changes. There was a history of heart disease on my father’s side (it killed both him and his father when they were around 60), so I figured I better start eating a heart-smart diet. The research for that was plentiful, so I gave up red meat, began using low-fat products, and ate more vegetables, fish and pasta. As fate would have it, all those changes were helpful in maintaining brain health (and constitute another pillar of a brain-healthy lifestyle). I was in my 40s at the time.

I was never a big drinker. In fact, I was a cheap drunk, getting tipsy on just 2 beers. In college, I tried to become a ‘better’ drinker (you can imagine the peer pressure) and even managed to down a 6-pack of Schlitz one night before passing out. But excessive drinking was not in the cards for me. That doesn’t mean that I never got drunk because I did when the occasion merited it. But I never really liked the taste, whether it was beer, wine or hard liquor. Even now, it’s hard for me to drink a few ounces of red wine with dinner, but I do it for the purported brain-health benefits.

On the other hand, I never had any desire or interest in smoking. I hated it ever since I was in grade school and my parents used to light up at the dinner table at the end of the meal. I became an anti-smoking advocate at an early age, so much so, that people were astonished to learn that I had smoked pot! Oh, I suppose I took in my fair share of second-hand smoke (my first wife of 36 years was a smoker), but I think its safe to put this in the ‘dodged a bullet’ column, too.

There are a few other risk factors I haven’t covered here. You can see them all at this link to see how lucky you’ve been:


Finally, there is one risk factor I haven’t yet dodged, and it’s the biggest one: age. The older you are, the greater your chances of dementing. But dodging that bullet is a good thing, isn’t it?  šŸ™‚


S2E30. Can Vaccinations Prevent Dementia?

An interesting study published last month reported a 40% reduction in the risk of getting Alzheimer’s dementia for people 65 and over who regularly receive flu shots. What’s more, the earlier you start getting your annual shot (i.e., before the age of 60), the greater the protective benefit.

That’s a fascinating and wonderful finding, but it begs the question: why? Why would getting a vaccine that trains your immune system to fight off the flu virus protect you from developing dementia? Especially when the dementing process has probably been active in your brain for a number of years?

Immunology is a field of science that is way out of my comfort zone, but I read some journal articles anyway to see if I could make any sense of it. So please take what I say with a few grains of salt, as I may be wildly misinterpreting the data.

It seems that flu vaccine isn’t the only vaccine that is protective against dementia. Tuberculosis, tetanus, pneumonia, and herpes vaccines are also beneficial…but direct links between the viruses involved and dementia have not been found.

Perhaps, I theorized, the vaccines prevent you from getting the targeted illnesses which, in turn, means that you have fewer incidents of extreme immune-response inflammation which, in turn, minimize your brain’s production of beta amyloid and tau proteins. Sounds reasonable, right? But this study controlled for the number of times people actually got the flu and there was no correlation.

I thought, maybe, that people who get their annual flu shots are, in general, more health conscious and engage in other lifestyle habits that are protective (e.g., diet and exercise). But that didn’t turn out to be a factor, either.

The study’s authors suggested a couple of possible explanations, all of which require a significant amount of further research before any causal conclusions can be drawn. And—to be honest—in some instances, I had trouble understanding what they were proposing. The one hypothesis that made the most sense to me posited that vaccinations for specific viruses also have a general effect on one’s immune system, modifying it in a way that enhances its ability to deal with the chemical compounds that really are at the root of dementia, whether they be beta amyloid and tau or some other as yet unidentified compounds.

If this turns out to be the case, then it’s possible that the COVID pandemic has a silver lining for all of us who faithfully received our two shots and follow-up boosters. We should know in about 5-10 years.

Given these findings, it’s not surprising that there are trials currently underway to test vaccines specifically designed to train your immune system to recognize and attack beta amyloid plaques. As I’m not a big fan of that theory, I have my doubts that it will actually work as intended, but it might be beneficial because of the general effect that vaccines have on the immune system. I wonder: How will the researches tell the difference if, indeed, a significant effect is found?

Another thing about this recent study that caught my attention was the finding that it reduced the risk of developing Alzheimer’s by 40%. Other studies have shown that exercise reduces your risk by 30-45%. Adherence to the Mediterranean Diet has been shown to reduce one’s risk by somewhere between 30-72%. And don’t forget the benefits of regular cognitive challenge, good sleep hygiene and social engagement. Yet most experts say that you can reduce your risk of dementia by only 40-50% by implementing all of these strategies. How can that be? Why isn’t the protection rate up around 75% or more if you implement all of the strategies the research has identified?

There are some studies that tried to simultaneously measure the impact of two or more of these factors and they show the effects to be independent of each other…yet the total effect doesn’t seem to increase as you add more levels of protection. That seems odd to me.

Is it possible that each factor impacts the same unknown dynamic that causes dementia but by different means? Or are there a variety of different etiologies for the cluster of symptoms we have defined as ‘dementia’ and each of these factors are protective against some but not all of them? Do some strategies go after the root cause while others build resilience to compensate for damage that occurs elsewhere?

It’s mind boggling (no pun intended).

I just hope my brain is still in good enough shape to appreciate it when the research finally reveals the answers. In the meantime, I’ll faithfully show up for every vaccination that Medicare and my insurance cover!


S2E23. Re-Paving Your Cognitive Infrastructure

Last week I watched a presentation sponsored by the University of Texas’ Center for Brain Health about brain connectivity.

The discussion described the shift in cognitive neuroscience research from identifying what areas of the brain perform which functions to identifying the pathways that connect those different areas. These connections were compared to an airlines’ flight map which shows numerous flights routed through various hubs (e.g., New York, Chicago and Los Angeles) in order to more efficiently service the entire nation. In the case of the brain, though, the connections are between the various lobes and functional areas.

The presenter specializes in recovery from strokes and his research indicates that there is one particular pattern of connectivity that predicts how well a patient will respond to treatment. Interestingly, rehab treatments can strengthen the desired pathways, leading to continued gains of function over the long haul. This directly contradicts the accepted wisdom when I was in graduate school that stroke victims will experience 90% of their gains in the first 3 months after the stroke and that there will be no further recovery of functions after the 1-year mark.

Watching the presentation got me thinking that perhaps one of the benefits of living a brain-healthy lifestyle is that it strengthens these connections or, at the very least, delays their atrophy. Diet and exercise, in particular, have been shown to strengthen the myelin sheath around axons which form the transmission cables of these connections.

And perhaps its ability to strengthen these connections is why learning to play a musical instrument is so highly recommended as a brain-healthy activity.

For my part, I decided to try to learn to play the recorder because it is a relatively simple instrument to learn and you don’t have to tune it. These were very compelling attributes for someone with no ear for music and a singing range of about six notes! 

I try to practice about 30 minutes each day and I’m starting to make some progress. I only attempt to play songs with which I am familiar so I’ll know if I’m playing them correctly. At this point, I can play tunes in four different keys and, just this week, I discovered that I can now play some songs by ear. Something is definitely changing inside my head!

Cognitively, playing any instrument is a pretty complicated activity. First you use your visual cortex to see the notes. Then you have to associate those images with specific finger positions on the instrument. Then you use your motor cortex to move your fingers into position and your sense of touch to tell you that you have reached your target. Your auditory cortex in your temporal lobes hears the sound you produce and your prefrontal cortex compares it to the tune you’ve stored in your memory and orders the necessary adjustments when you make a mistake. 

And these are just the cortical activities! Let’s not overlook the contribution of the limbic system that allows you to play with emotion instead of just hitting a series of notes and the brainstem which, in the case of wind instruments, controls your breathing. Just about the only system that isn’t engaged is olfaction.

The astounding thing about all this, though, is that it’s not just about using all these different areas of your brain. You have to use them all at the same time and it all has to be coordinated. That takes a lot of synapses firing harmoniously and it requires those signals to travel long distances back and forth throughout your brain.

It would seem, then, that learning to play an instrument will strengthen a variety of functional areas and, perhaps even more importantly, the axons connecting them. It’s quite a workout. No wonder I’m sweating by the time I finish my practice sessions!

Unfortunately, I have no proof that my musical efforts are strengthening the long-distance connections in my brain. That would require before and after fMRI imaging. And I would need pre- and post- cognitive testing to see if those strengthened pathways were linked to improved performance, or at least a slower rate of atrophy than my age-sex peers. Lacking both, I’ll just take it on faith that I’m re-paving the road on my journey to nowhere and that that’s a good thing!


S2E22. An Abundance Of Caution

Every few days, it seems, a public figure issues a statement saying that although they are fully vaccinated, they just tested positive for COVID. And, although they are asymptomatic at this time, out of “an abundance of caution” they will quarantine for five days.

I just love the phrase “an abundance of caution.” Is that like a gaggle of geese? Or a congress of baboons? In any event, I appreciate the sentiment.

It is out of an abundance of caution, then, that I am switching to organic toiletries: soap, shampoo, hair conditioner, toothpaste, deodorant and shaving cream. The links between these products and dementia are weak at best, but I figure it can’t hurt, so why not?


Gum disease and gingivitis are both risk factors for dementia. Daily brushing, therefore, is important. As the old Crest carton and tv ad reminded us: ‘…when used in a conscientiously applied program of oral hygiene and regular professional care.’

The primary concern about toothpaste seems to be the presence of fluoride. From what I can gather, though, the best documented effects involve embryonic neurodevelopment and young children. Deposits have also been found post-mortem in the brains of those with Alzheimer’s, but no correlational or causal links have been proposed.

Other ingredients in toothpaste (e.g., artificial sweeteners, artificial coloring, parabens, propylene glycol) might harm you in various ways, but my concern here is brain health. But…out of an abundance of caution…I made the switch. 

It appears that a solution of equal parts baking soda and water will work just fine as a daily toothpaste and it’s as inexpensive as it gets. Alternatively, there are a variety of organic toothpastes available online, although most are on the pricey side.

Shampoo and hair conditioner

Did you know that there are emissary veins in your scalp that provide a conduit into your brain? Their presence means that what you rub into your scalp has the potential to get into your brain…and that’s cause for concern.

A few chemicals in the United States have been banned from use in hair dyes for this reason, but there are many others that are suspect but for which there are inadequate studies to establish the danger. The European Union, on the other hand, has banned some 1,300 chemicals from cosmetics.

Since we massage shampoo and hair conditioner into our scalps on a regular basis, and the potential exists for it to be absorbed into our brains, then I think it makes sense to pay attention to what we’re using.

I used Pert shampoo with conditioner for years. It always burned my eyes, but I didn’t think anything about it. After all, at an early age we were taught to close our eyes when shampooing. Now, though, I figure that that isn’t such a good thing after all, and so I tried organic products and…lo and behold…no more eye irritation!


I’ve been using Zest for as long as I can remember, and, just like with my shampoo, the fumes burned my eyes. That was enough to get me to try an organic milled soap. And just like with the shampoo, the burning disappeared.

One theory about Alzheimer’s posits that an ineffective immune system can be responsible for the disease. The thinking behind it is somewhat counter-intuitive: we are so germ-conscious that we sanitize ourselves to the extent that our bodies don’t learn how to fight off a range of bacteria, and it is our under-developed immune systems that fail us when it comes to preventing dementia caused by bacteria.

One of the recommendations that this suggests is to stop using anti-bacterial soap. Fascinating!

In addition, chemicals can be absorbed through our skin, some of which can cross the blood-brain barrier, so it makes sense to pay attention to the ingredients in your soap…out of an abundance of caution!


The suspect chemicals to be avoided in deodorants are parabens, triclosan, phthalates, propylene glycol and aluminum. Their effects are linked to cancer more than dementia, but as long as we’re protecting ourselves, we might as well go all in.

It turns out I was already using a safe deodorant: unscented Arm & Hammer Essentials, so no need to change.

Shaving soap

The ill effects of the chemicals that might be found in shaving soaps are generally not too severe except for aerosols which may contain carcinogens. But just like with deodorant, we’ve come this far, so we might as well finish the job. In this case, too, I was already using a natural, unscented shaving soap.

So for me, it wasn’t that hard to make the switch to natural toiletries. The fact that I only use 6 items certainly helped! Did I really have to do it? No. Will it decrease my likelihood of getting dementia by a significant degree? Probably not. But out of an abundance of caution, I did it anyway.  šŸ˜€


S1E48. Winter Air

“Close the door! You’re letting all the heat out!”

I can hear my father’s words echoing down the decades. He’d chastise us like this on winter days whenever we came in to warm up from playing in the snow.

“In or out…make up your minds!”

There’s a fine line between cheap and frugal. In hindsight, I suppose he met criteria for frugal. I recalled his words this week as I wrestled with trying to regulate the air quality in the apartment.

If you’ve been following this blog for a while, you’ll remember from Episode 36 that I bought an air quality measuring device to see if there were any hidden environmental dangers in our new apartment.

Although I was able to take measurements, I didn’t see how I could improve the air quality if it was problematic, and so I decided to return the monitor the next day. Thankfully, I never did. By a process of trial and error, I learned to keep the air in the apartment pristine by leaving a window open to provide ventilation that flushed away elevations in formaldehyde and total volatile organic compounds (TVOC). And it seemed to work without running up a big air conditioning bill, too.

Now that we’re into the heating season, though, the problem has re-emerged.

Honoring my father’s wishes and respecting my own desire not to waste energy, I closed all the windows when it got cold outside. When I did, I saw that the air pollutants spiked as soon as the heat kicked on. It didn’t get up to dangerous or unhealthy levels, but the readings for both formaldehyde and TVOC were significantly higher.

What to do?

My first thought was that, since we want the bedroom relatively cool at night (~65 degrees) to promote a good night’s sleep, maybe I could open one of its windows and close the door to the rest of the apartment. This would give us clean air overnight air without triggering the thermostat in the living room.

Both of those goals were achieved, but at the cost of forfeiting our sleep: the second I opened the window, the din from the steady stream of cars on Route 202 flooded the room. I did my best to give it a fair shot, but I finally closed the window at around 3am after the driver of a car without a muffler gunned it when the light at the intersection turned green.


This would be easy if my father hadn’t taught me so well.

This would be easy if I didn’t care about conserving energy.

I’d just open the window, crank up the heat, and pay the bloated electric bill each month.

But he did teach me well and I do care about energy conservation, so back to the drawing board I went.

I came up with the idea of leaving the bedroom window  open a little (~2 inches) during the day, from noon to 4pm when it’s as warm as it will get, and leaving the door into the living room open as well.

It worked. Air quality was good all day and the cold air flowing in from outside only triggered the heat once or twice. It remains to be seen, though, what will happen when it gets down into the teens during the day instead of the mid-40s that we had this week.

“What, are you crazy? Close the window…you’re letting the heat out!”

I went back to the bedroom problem and tried something a little different. I opened the window at 7:30pm (about 3 hours before our bedtime) and closed the door. I figured this would chill the room and lock-in good overnight air quality without triggering the thermostat.

Although it got a little too cold in there, the concept clearly worked. Over the next few days, I’ll play around with how long I refrigerate the bedroom before bedtime in order to get a good sleeping temperature.

My father would never have embraced the idea of opening a window in the winter with the heat on, not even for the worthy purpose of preventing cognitive decline. Knowing that I used an electric mattress pad to warm the bed in the room I just chilled would have driven him to distraction!