#236 ‒ Neurodegenerative disease: pathology, screening, and prevention | Kellyann Niotis, M.D.

Drive with Dr. Peter Attia

Podcast Notes Key Takeaways Our brain needs sensory input and stimulation – if you don’t have it, neuronal circuits don’t get exercised and are more likely to atrophy; keep moving, keep diversifying cognitive experienceParkinson’s disease is the fastest-growing neurodegenerative condition in the USWe’re intervening in neurodegenerative disease too late – the current approach is the equivalent of taking a woman with stage 4 metastatic breast cancer and doing a lumpectomy

Without biomarkers, we don’t know the stages of neurodegenerative disease and when to apply which interventions“There’s probably no activity that you can participate in that will have a greater impact on your brain’s health than exercise.” – Dr. Peter AttiaExercise has the most potential to move the needle on brain health and brain health preventionNothing stimulates BDNF more than exercise: BDNF helps grow and protect new brain cells in memory centers of the brainInsights from continuous glucose monitors are profound, whether you wear it for a month or forever – it will change how you approach food and sleep more than other metrics like blood pressure which you measure at one point in time and don’t know in between

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View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Kellyann Niotis is a neurologist specializing in risk reduction strategies for the prevention or slowing of neurodegenerative disorders. In this episode, Kellyann provides an overview of the various diseases associated with neurodegeneration, including, but not limited to, Alzheimer’s disease, Lewy body dementia, and Parkinson’s disease. She goes in-depth on Parkinson’s disease, explaining its pathology, role in movement capacity, very early warning signs, and the role of anxiety and sleep. Similarly, she provides an in-depth discussion of Alzheimer’s disease, including the latest in screening, genetics, and tools/strategies for prevention. She ties the discussion together by explaining the differences and commonalities among the various diseases of neurodegeneration and the potential causative triggers, and she highlights the importance of early screening, cognitive testing, and taking the proper steps to lowering the risk of disease. We discuss: Kellyann’s background, training, and interest in the brain [2:30]; A primer on neurodegeneration: different types, prevalences, interventions, and more [5:30]; Overview of Parkinson’s disease and neuromuscular disorders including ALS [16:00]; Parkinson’s disease: early signs, diagnosis, genetics, causative triggers, and more [17:30]; Interventions to delay or avoid Parkinson’s disease, and the role of sleep and anxiety [31:15]; The challenge of standardizing early interventions for Parkinson’s disease without a clear biomarker [39:45]; Alzheimer’s disease: pathophysiology and the role of the amyloid and tau proteins [47:45]; Can PET scans be informative for diagnosing Alzheimer’s disease? [51:15]; Tau accumulation in the brain, tau scans, serum biomarkers, and possible early detection of Alzheimer’s disease pathology [57:00]; Cognitive testing explained [1:03:30]; The challenge of identifying the stage of the disease and why drugs have not shown efficacy [1:14:45]; The association between hearing loss and dementia [1:17:45]; The relationship between oral health and neurodegenerative diseases [1:21:30]; Genetic risk for Alzheimer’s disease [1:24:45]; What one’s mitochondrial haplotype can reveal about their risk of neurodegenerative disease [1:32:30]; The positive impact of exercise on brain health [1:37:00]; High blood pressure as a risk factor [1:40:00]; Why women are disproportionately affected by Alzheimer’s disease [1:44:15]; Final takeaways: the future of understanding neurodegenerative disease and further reducing risk [1:46:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube