cover of episode Why 90% of Alzheimer's cases are preventable | Drs. Ayesha and Dean Sherzai

Why 90% of Alzheimer's cases are preventable | Drs. Ayesha and Dean Sherzai

2025/1/30
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Drs. Dean and Ayesha Sherzai
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主持著名true crime播客《Crime Junkie》的播音员和创始人。
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@播音员 :痴呆症是发达国家增长最快的健康危机之一,病例预计在未来几十年内翻一番。最新的研究表明,生活方式的选择对大脑健康的影响远大于基因本身。 @Drs. Dean and Ayesha Sherzai :我们可以控制我们大脑的命运,通过最新的科学方法,我们可以战胜痴呆症。通过五种简单的改变生活方式,可以预防90%的阿尔茨海默病。即使父母都有痴呆症,也不意味着自己注定也会患病;痴呆症目前无法逆转,但我们可以显著降低患痴呆症的风险;有些食物可以降低患痴呆症的风险。 阿尔茨海默病的发生并非突然,而是一个持续数十年累积的过程。阿尔茨海默病的病理过程可能在20到30年前就已开始。目前已知的四个导致阿尔茨海默病的因素是炎症、氧化、脂质失调和葡萄糖失调。即使在阿尔茨海默病早期阶段之前,也可以预防该病;在轻度认知障碍(MCI)阶段,也可以逆转。如果拥有最佳的生活方式,90%的阿尔茨海默病病例可以预防,现有证据表明至少60%可以预防。痴呆症病例的增加部分是因为人口老龄化,但在某些地区,由于人口减少,病例有所下降。大脑是唯一可以持续生长的器官,但需要适宜的环境和条件。即使在中年或老年,也可以建立认知储备,持续提升认知能力。认知储备是指大脑额外的连接能力,这可以通过持续挑战大脑来建立。 Drs. Dean and Ayesha Sherzai: 阿尔茨海默病的四个主要因素是炎症、氧化、脂质失调和葡萄糖失调。许多因素会影响阿尔茨海默病的风险,包括营养、运动、压力管理、睡眠和认知活动。NEURO原则(营养、运动、放松、睡眠和优化认知活动)可以帮助预防阿尔茨海默病。大脑是身体中受代谢影响最大的器官,因此任何影响心脏或其他器官的因素都会直接影响大脑。如果能做到最佳的营养、运动、压力管理和睡眠,以及积极的脑力活动,就可以预防大多数阿尔茨海默病病例。即使是小的生活方式改变,也会对大脑健康产生积极影响。饮食对大脑健康至关重要,可以预防包括阿尔茨海默病在内的多种疾病。富含植物性食物、全谷物和不饱和脂肪酸的饮食对大脑健康有益。坚持MIND饮食可以将阿尔茨海默病的风险降低53%。最佳的大脑饮食与最佳的整体健康饮食基本相同,但需要注意B12、维生素D和omega-3的摄入。omega-3脂肪酸对大脑健康至关重要,因为人体无法自行合成这种脂肪酸。适量饮酒对大脑健康的影响有限,但长期大量饮酒则有害。保持低密度脂蛋白胆固醇水平是维护大脑健康的重要因素。运动对大脑健康至关重要,可以促进大脑生长。腿部运动可以降低MCI患者发展为痴呆症的风险。运动可以增加脑源性神经营养因子(BDNF)等激素的产生,从而促进大脑健康。力量训练,特别是腿部力量训练,对大脑健康特别有益。腿部力量是决定寿命长短的重要因素。压力管理对大脑健康至关重要,因为慢性压力会缩小大脑。慢性压力会增加肾上腺素和皮质醇的分泌,从而缩小大脑,影响认知功能。压力管理可以通过识别和区分良性压力和不良压力来实现。并非所有压力都是有害的,良性压力可以促进大脑生长。充足的恢复性睡眠对大脑健康至关重要,因为睡眠期间大脑会进行自我清洁和记忆整理。在深度睡眠阶段,大脑的微胶质细胞和淋巴系统会清除大脑中的废物。优化认知活动,例如学习乐器、跳舞或学习新语言,可以挑战大脑并促进其生长。遵循NEURO原则可以预防阿尔茨海默病,并促进大脑健康。

Deep Dive

Chapters
This chapter explores the common misconceptions surrounding Alzheimer's and dementia, emphasizing the significant role of lifestyle choices over genetics in preventing the disease. Experts Drs. Ayesha and Dean Sherzai highlight that up to 90% of Alzheimer's cases could be preventable through lifestyle modifications.
  • Dementia cases are expected to double in the coming decades.
  • Lifestyle choices play a greater role in brain health than genetics.
  • Up to 90% of Alzheimer's cases may be preventable with lifestyle changes.
  • Genes affect risk, but are not deterministic for Alzheimer's.

Shownotes Transcript

Dementia is one of the fastest-growing health crises in the developed world, with cases expected to double in the coming decades. But despite common misconceptions, cognitive decline isn’t inevitable. The latest research shows that lifestyle choices play a far greater role in brain health than genetics alone.

In this episode, neurologists Drs. Ayesha and Dean Sherzai share practical, science-backed strategies to help you protect your brain and reduce your risk of dementia.

As co-directors of the Alzheimer’s Prevention Program at Loma Linda University, they’ve spent their careers studying how habits like diet, exercise, sleep, and stress management influence long-term cognitive health.

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Timecodes

00:00 Meet the brain doctors fighting dementia

01:04 Parents have dementia – are you doomed?

02:00 Can dementia be reversed?

02:25 Five lifestyle changes to prevent Alzheimer’s

06:07 What is dementia vs. Alzheimer’s?

08:50 Are your genes to blame?

12:49 Dementia starts 20+ years before diagnosis

14:10 Four biggest causes of Alzheimer’s

19:04 How to build brain reserve & stay sharp

22:50 Are dementia rates rising or falling?

25:30 How the brain declines over decades

29:00 This diet cuts Alzheimer’s risk by 53%

32:40 Three nutrients your brain can’t live without

38:15 The surprising link between LDL cholesterol & dementia

44:10 Leg workouts slash dementia risk by 35%

46:20 Why strength training is critical for brain health

50:36 How stress shrinks your brain

54:00 Sleep: The brain’s natural detox

📚Books by our ZOE Scientists

The Food For Life Cookbook

Every Body Should Know This by Dr Federica Amati

Food For Life by Prof. Tim Spector

Free resources from ZOE

Live Healthier: Top 10 Tips From ZOE Science & Nutrition

Gut Guide - For a Healthier Microbiome in Weeks 

Mentioned in today's episode

Association of Lifestyle and Genetic Risk With Incidence of Dementia, 2019, published in JAMA

Dementia statistics, published by Alzheimer's Disease International (ADI) 

World Alzheimer Report 2015 - The Global Impact of Dementia, published by Alzheimer's Disease International (ADI) 

Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later, 2009, published in Dementia and Geriatric Cognitive Disorders 

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Episode transcripts are available here.