Sunday Pick: The science on improving your brain health with Dr. Ayesha and Dean Sherzai

0:02Happy Sunday, y 'all. Elise Hugh here. Today, we are bringing you a Sunday pick where we share an episode of another podcast from TED, handpicked by us for you. When does normal aging end and something more concerning begin? To dig into this question, we are sharing a recent episode from TED Health, where host Dr. Shoshana Ungerleider invites neurologists Ayesha and Dean Shirzai to discuss their studies on Alzheimer's and dementia. They debunk myths around Alzheimer's, discuss what a brain-healthy way to eat looks like, and share why good sleep hygiene is more crucial for brain health than you think.

0:41Listen to TED Health wherever you get your podcasts. Learn about all TED's podcasts at podcasts.ted.com. That's coming up right after a short break.

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3:53dementia, the focus was often on what to do after symptoms appeared. There was a quiet assumption that much of this was out of our hands. But over the last decade, that understanding has shifted in really meaningful ways. The science is still evolving, and we're learning that many of the biggest drivers of brain health are connected to how we live our daily lives. Things like nutrition, physical activity, sleep, social connection, and even how we manage stress. So today, I want to have a conversation that explores the science of some of these new developments. Doctors Dean and Aisha Sherzai are neurologists and researchers at the Charles R.

4:32Drew University of Medicine and Science, where Dean serves as Executive Director of Clinical Research and Director of the Community Core of the Clinical and Translational Research Institute, and Aisha leads the Lifestyle Program for the Prevention of Neurological Diseases. They've spent their careers studying how lifestyle shapes brain health, and they study ways to reduce the risk of cognitive decline before it begins. This work is also deeply personal for them. Dean and Aisha both watched their grandparents live with dementia, and early on they made a commitment to focus on prevention, not just treatment.

5:06In our conversation, we talk about the medical findings that brought us to our newest understanding of the brain. We also shift from theory to action, digging into what's actually within our control, and how to translate that into small, meaningful choices in everyday life. Now, I want to stress that the conversation that follows discusses a field of research that's still and rapidly emerging. We're not talking about guarantees. Dean and Aisha's research points to risk reduction. The idea that certain patterns repeated over time may help lower the chances of cognitive decline, delay its onset, or support a healthier brain for longer.

5:43My hope is that this conversation helps us shift from a place of fear and inevitability to one of possibility and agency. Now I want to welcome Drs. Dean and Aisha Shirzai to the show.

5:56Dr. Ayesha Sherzai: Well, thank you so much for having us. We're very happy and delighted to be here with you and with your wonderful audience. You both do this work side by side as neurologists and as partners in life. So I want to start here. Did your work together come first or did your relationship? I think our first conversation was around neurology and about brain health.

6:19Dr. Dean Sherzai: It was about 8 ,000 miles away. We are both very service oriented. I've traveled throughout the world all my life, even during medical school, doing palate surgery assistance for Operation Smile in China and different places. as a neurologist. And about 2003, we were both in Afghanistan, right after the forces went to Afghanistan.

6:41Dr. Ayesha Sherzai: I used to volunteer as a medical student with Doctors Without Borders. Amazing. We were both there at that time.

6:46Dr. Dean Sherzai: Yeah, we met in an expat party, and we sat next to each other. Well, my story is she came and sat next to me. And the first conversation was about the fact that our two amazing grandparents had passed away from Alzheimer's and dementia. And from a year later, We were married after many really unusual dates in a situation like that. And then we came back. And from the very first day, everything has been mission and vision driven.

7:13Dr. Ayesha Sherzai: And we always saw neuroscience from the lens of public health because we were involved in public health even before we wanted to come into dementia and brain health. And once you see the impact of prevention and public health, you can't look the other way. So that's one of the reasons why we are in this field. Well, I will say it's rare to see a partnership that's so deeply aligned in both purpose and practice. It's really beautiful. And you both spend your days helping others protect their brains and prevent disease. So at home, what does that actually look like for the two of you? How do you keep each other on track with the habits that you recommend to patients?

7:54Dr. Dean Sherzai: We live in a beautiful place. We live in Redondo Beach, one street from the beach. And we have two dogs. The kids are now out of the house. And so we walk a lot. We go to the beach. We bike a lot. I'm always talking about a subject that's either neuroscience or public health. It's about making a difference. We are currently leading the Brain Health Initiative in LA, and it's going to be California-wide pretty soon. She's the PI. I'm the director of Brain Health Institute at Charles Drew. So everything is around this. It's not work. It's really not work. No, no.

8:27Dr. Ayesha Sherzai: I don't feel like it's work. is just a lot of fun. And there's so many wonderful opportunities to make a difference. And, you know, just the science, it's growing, and we have so much information. And it's wonderful to be involved in research as well. So between research, academics, patient care, public health, I don't think we have time for anything else.

8:50Dr. Dean Sherzai: It's a lot of fun. It is a lot of fun. I want to come back to something that you mentioned, and you share that this work is personal and shaped by your own family's experiences. How did those early experiences influence the way that you practice medicine today? Quite massively. My grandfather was a brilliant giant of a man, the sector of education and ambassador to multiple countries. Brilliant person. He was an amazing chess player. All the cousins are around, he would be on one side, he forgot how to move the knight. And so the knight in chess is a weird little move, L-shaped move. He forgot.

9:24Dr. Dean Sherzai: And everybody was taking a bath. And that moment is in every cousin, every family member's mind. But I saw him develop Alzheimer's and lose bits of himself. And in that, this fear, this shame, this loss of identity, of dignity, which especially back then, nobody knew what was happening. It was devastating to watch this. And you have a similar story.

9:50Dr. Ayesha Sherzai: Yeah, we deal with a lot of statistics and numbers and we look at amyloid and tau pathology and MRIs. It's quite humbling to look at it from a human perspective, because every one of that is a person, every one of that is a story. And I think having experienced that in my grandfather and my grandmother and so many other family members, it keeps me grounded. And it has strengthened our mission to dedicate our lives to understanding this disease and finding a treatment and preventing it. Incredible. And when something is this personal, it certainly shifts how we talk about it with others. And I would say that you all do that.

10:34For someone listening who hears the word dementia and feels a sense of fear, can you start by grounding us? What is dementia and what is it not?

10:44Dr. Ayesha Sherzai: Dementia is a condition where an individual experiences forgetfulness and other problems with cognition to the point where it starts affecting their daily activities. when it affects their, say, for example, taking care of their finances, taking care of the house, driving, taking care of their bodily habits. There are multiple different stages, and it is a progressive condition. There are multiple different types of dementia. So dementia is an umbrella term. There is Alzheimer's disease, which is about 60 to 70 % of all dementias. There's vascular dementia, which is the second most common type of dementia.

11:25Dr. Ayesha Sherzai: Then we have Parkinson's dementia, frontotemporal lobe dementia, and some of the other rarer forms as well. And as far as its prevalence is concerned, it's pretty scary. We have these slides and PowerPoint presentations for medical students and our faculty every year. Unfortunately, we have to change the numbers every time because the numbers are increasing rapidly. Currently, 7 million people in the United States are experiencing Alzheimer's dementia. Sometimes dementia and Alzheimer's disease are used synonymously because Alzheimer's is the main type of dementia. About two-thirds of all Alzheimer's disease cases are women.

12:03Dr. Ayesha Sherzai: Two-thirds of all caregivers are also women. So it's definitely something that is affecting women predominantly. When does normal aging end and something more concerning begin? And what are the early signs people should pay attention to?

12:18Dr. Dean Sherzai: Dementia, especially Alzheimer's dementia, vascular dementia, and these others, they don't start at the point where you first start forgetting. They've started many years earlier. And although that's a little scary, it's also empowering. Because if you catch it at those stages, you can significantly alter its trajectory. So it's important for people to know that you don't have to wait till there's memory loss. You have to assume that you're either building the brain or you're doing things that are really negatively affecting the brain. But the powerful part of this is that if you do the net positive things, you really change the trajectory independent of genetics.

12:56Dr. Dean Sherzai: Yes, genetics is involved. Everything is genetic. Even behavioral factors are genetic. But the penetrance of genes matter. So for certain genes, for certain diseases like Huntington's disease, it's 100 % penetrant. Meaning if you have that gene on chromosome 4, 100 % of the time, you're going to get it at about 30 to 40 years of age. In Alzheimer's, that's not the case. 90 % plus is a combination of genes and environment. There lies the optimism. So if we do the things that can significantly reduce risk, the vascular factors, the diabetes, the prediabetes, the cholesterol, the high blood pressure, the inflammation, you will significantly reduce risk going forward.

13:39Thank you for pointing that out. I think what I learned in medical school was largely that a dementia is mostly inevitable. There are certainly modifiable risk factors, but that genes played a big part and then the rest was just keep your fingers crossed. I wanna come back to something you said earlier. What does the research actually tell us about how much is within our control?

14:03Dr. Dean Sherzai: I think before we go any further, is that we're a very interesting time. There's a lot of noise and a lot of pseudoscience. You cannot reverse Alzheimer's. once that tau pathology, at least at this point, I'm very optimistic. I'm the eternal optimist. I think within our lifetime, we'll have a cure for Alzheimer's, even people who have advanced Alzheimer's. But right now, you can't reverse it. And there are very prominent, not even neurologists, doctors that have made claims and small little self-driven studies that show that they reverse Alzheimer's and then they make millions off of it. That's the most irresponsible thing you can do for people who are scared, people who are desperate.

14:45Dr. Dean Sherzai: And what do charlatans do? They pick on people's desperation. And for the two of us who've done this for 20 years and everything we do is about this, we're going to fight that pseudoscience, no matter who they are. So I want people to know, please don't fall for the gimmicks. Now, not even complex lifestyle interventions or this diet or that diet or this pill or that pill, that's not gonna work but pre-alzheimer's at mci stage which is mild cognitive impairment and everything else you can significantly affect the disease progression and that's important if we just take 60 on its face value 60 of 7 million people would not develop dementia within five years or so you delay it for five years that's millions of life given quality for years going forward.

15:35Dr. Dean Sherzai: Millions of families experiencing their loved one for a longer period of time. So I think that people should know that start now. And by the way, it's not a gimmick. You don't have to buy some vitamin concoction. Most of the things you can do to curtail this is in your home right now. More of my conversation with Drs. Dean and Aisha Sherzai after a quick break from our sponsors.

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18:13You've developed the neuro plan as a framework for prevention. Can you walk us through that in a way that someone at home can begin to picture in their own daily life?

18:23Dr. Ayesha Sherzai: Absolutely. So neuro is an acronym. It kind of sounds self-serving because we're neurologists, but we created it for our patients so that they can remember.

18:33Dr. Dean Sherzai: A little self-serving. A little, just a tiny bit. A little, yeah, two neurologists, yeah.

18:36Dr. Ayesha Sherzai: Just a tiny bit. But we wanted them to have a tangible plan whenever they left the room or whenever they left the conference room to say, neuro. N is for nutrition. E is for exercise. U is for unwind or stress management. R is for restorative sleep. And O is for optimizing cognitive activity. And for a lot of our patients, we say neuro plus, which also includes addressing their vascular risk factors, things like blood pressure, cholesterol, and glucose regulation, which is addressing diabetes, pre-diabetes or insulin resistance. And you just mentioned this, food is a big part of your work. What does a brain healthy way of eating actually look like?

19:23Dr. Dean Sherzai: When Aisha was doing her fellowship in stroke and vascular disease at Columbia University, in the mornings she would be in the ICU. And then at nights she would be in culinary school because we realized very early that just telling people to do X, Y, and Z is not enough. You have to show them how easy, tasty, and healthy looks on a daily basis. One of the big part of what we do in communities, and you can see these videos, we go to people's homes and cook and talk to them and show them in their own environment, not some contrived way, but in a way that's familiar to themselves. Food is critical.

19:58Dr. Dean Sherzai: Food is the substance. Food is the elements of what makes the brain. For example, omega-3s, which the body doesn't make. So you need to get that in food. If you're a meat eater, fish, fatty fish, that's your source. If you're not, algae, which is actually the source for the fish as well of algae and algae foods or chia, flaxseeds and walnuts. But the key is to be aware because it's that critical. We're honored to be asked to do multiple reviews this year. We've done 15 reviews with experts on different aspects of brain health. And a couple of years ago, we did a comprehensive review on omega-3 and brain health.

20:35Dr. Dean Sherzai: and it is critical, especially for the young age, younger children, and for the elderly over the age of 50. So people have to know where their omega-3 is coming from. But the big thing is we don't tell people to take anything away. No, we add things. And the things we add are the things that are proven. Here is the magic. If there's any magic. If there's any magic. If there's any magic. You want to know the magic food? Yes. It's very fancy. It's greens. adding one serving of greens big studies have shown it improves your brain health by 11 years

21:11Dr. Ayesha Sherzai: over time it's just greens green leafy vegetables so like spinach arugula kale you know bok choy or collard greens just leafy green vegetables is absolutely wonderful and if you do enough of it

21:26Dr. Dean Sherzai: if you do two servings of course your stomach only has so much space it also takes more space and also makes you eat more healthy. So just adding greens is absolutely incredible.

21:37Dr. Ayesha Sherzai: Or for example, berries. I know that sometimes people don't have access to berries and access is such an important aspect of nutrition. But there have been studies that show that when people consume berries, whether they're strawberries or blueberries, the polyphenols in those berries actually protect the brain. And when they did neuropsychological testing, They had brains that were two years younger compared to controls who didn't consume berries. So something like that, you know, having some frozen berries in your freezer can actually protect your brain. And berries are delicious. They are. And so on the flip side, is there one common nutrition habit that quietly increases risk over time?

22:19Dr. Ayesha Sherzai: Yeah, there have been multiple studies that have shown that ultra processed foods have been associated with higher risk of dementia. And I know that the definition of ultra-processed foods is being contested. It's a bit murky, you know, using the NOVA classifications, but we're not going to go into all of that detail right now. The idea of ultra-processed foods essentially means that these are foods that are high in refined sugar, high in salt, high in poor quality fats, specifically saturated fats or trans fatty acids. These things can actually damage our health if they're consumed over a long period of time.

22:56Dr. Ayesha Sherzai: And so if we stay away from those, that in itself is a huge bonus for the brain. Yeah, I often like to think about it as the sticking to the outside aisles of the grocery store and the middle aisles just tend to be with the packaged foods that are ultra processed. So you touched on movement. This is huge. I'm somebody that's hardcore into exercise and we talk about it a lot on this show. And I think many people think of exercise as something that needs to be intense or time consuming. What actually matters most for the brain?

23:27Dr. Dean Sherzai: It's not the intensity. And as far as exercise is concerned, limitation of space is not a thing. I tell people here, the best thing you can do is pick your favorite show, half an hour show. And while you're watching the show, do quick steps right in front, right there, stand in place and do quick steps in place. And it is critical because exercise increases blood flow, it increases cleansing, and a good morning walk does so much psychologically for your sleep cycle, for your metabolism. And here's the most important part. exercise also increases these incredible hormones called BDNF, GDNF, and VGF, which are hormones that are growth factors for your neuronal connections, for your glial cells, which are the cleansing agents, as well as VGF, which is the vascular hormone that increases vascular health.

24:20Dr. Dean Sherzai: And that's why exercise, we say that it's probably more important for the brain than anything else. I think that one of the most important things people can start with, if they start with one seminal central habit as a simple walk. You touched on this again earlier, but there's the piece that often gets squeezed out first, and that's sleep, right? We know it plays a huge role in brain health. You touched on the cleansing and the glymphatics. What's happening in the brain during sleep, and what are we still learning?

24:50Dr. Ayesha Sherzai: Two very important processes happen when we get to the deeper stages of sleep. The first thing that happens is the glymphatic system, and then there are these cells called the microglia, they become active. And they're like the genitorial system of your brain. They start getting rid of all of the byproducts that have been created over the day. And the brain being so active, it creates a lot of byproducts. Let's just call it garbage material. When they accumulate, sometimes the brain has difficulty processing information or working properly. And so it's really important for these to be dumped into the lymphatic system and to the venous system and out of the body.

25:29Dr. Ayesha Sherzai: As a matter of fact, there have been studies where they can measure those byproducts in the cerebrospinal fluid. When people don't get enough sleep, so the hours, or they don't go to the deeper stages of sleep, which is quality, there is less of those byproducts in your cerebrospinal fluid, which means they haven't been dumped out of the brain. They're still in the brain, as opposed to people who actually have good sleep. And so it's really important for people to remember that the number of hours that you need are seven to eight hours of deep restorative sleep. And that doesn't change as you age.

26:02Dr. Ayesha Sherzai: You know, there's this misnomer or this misunderstanding that, you know, you don't need as much sleep as you get older. You do. You actually do. And there are ways to improve it. And again, I don't want to scare anybody here. There are different methods to do it. Sleep hygiene is really important. So going to bed at the same time, waking up at the same time, getting some sunshine, hopefully with a brisk walk in the morning, cutting out food and drinks at least two hours before going to bed, creating a ritual to turn down the lights at night so that your brain is used to understanding that this is time for you to wind down.

26:36Dr. Ayesha Sherzai: And then caffeine comes into play as well. Cutting it out earlier during the day is important. So all of these small little things are important to institute. And then for people who have stress, There are cognitive behavioral therapists out there that can work with them to improve their sleep pattern, but it is so important and literally improves cognition. It prevents dementia. It makes you a better person because it has major, major role in mood and feelings as well. We'll be back in a moment.

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29:49So when you step back and look across different communities and outcomes, patterns start to emerge. You've both worked with very sick patients and some of the healthiest populations in the world. So when you compare those groups, what stands out most to you?

30:05Dr. Ayesha Sherzai: Just to kind of take away the burden from the individual, some of these communities are very privileged. They have access to health care. They have access to information. And from a public health perspective, the differences in social determinants of health also has a major role in dementia prevalence and the incidence and the propagation of this idea. In some of the communities where you see higher prevalence of dementia, or it's not just dementia, you actually see more chronic diseases of aging. A lot of the issue is access to information as well in public health.

30:39Dr. Dean Sherzai: And resources. And some of the communities we're at, finding a place where you can get vegetables, fresh vegetables is way more difficult than finding fast food, which is in every other block. So that access is critical. I appreciate that you brought that up.

30:55Dr. Ayesha Sherzai: Zip code has a lot to do with your brain health as well. Huge. Building on community, social connection comes up again and again in the research. So for someone who feels isolated or stretched really thin, what does meaningful connection look like in a practical sense?

31:11Dr. Dean Sherzai: It's such an important factor. Now, this is a little tough because some people are, they consider themselves introverts. And they say that, what am I going to do? Reality is the data shows that even introverts need connection. It's just the dose is different. By the way, it's not just introvert, extrovert. It's a spectrum, right? I maybe fall a little bit on the introvert side. I'm the greatest half an hour extrovert. After that half hour, I'm pretty good. But after an hour, I need my space. So everybody needs connection. You just have to figure out your dose. But you need to make the connection.

31:47Dr. Dean Sherzai: The connections could be made with your neighbors, with your friends, with your family members. And here's the misconception that we incredibly overestimate our failure rate. People think that if they do reach out, they're going to fail. And the study after study shows that even a small little reach out most of the time is a success. And in the world of connectivity, you can connect online with your communities of different proclivity. Maybe it's around a book. Maybe it's around an idea. Maybe it's a class that you can take online with others and you can interact. So whatever it is, that connectivity is important, not just for the emotional component of it.

32:25Dr. Dean Sherzai: By the way, that kind of social connection is the ultimate cognitive activity. So coming back to something you said earlier, a lot of us have grown up hearing that doing crossword puzzles, for example, or playing brain games can help prevent dementia. And there is some data there, but it can also be confusing. So what do we actually know at this point about these kinds of activities? Recently, a paper came out, a very robust and meaningful study that showed that people who worked on particular games that worked on processing speed actually reduced their chance of Alzheimer's by 25%. Whenever we hear data like that, we're kind of incredulous.

33:06Dr. Dean Sherzai: So we look at the data. Every piece of data doesn't mean that it's an outcome. You have to show repeatability of that data to then say, okay, I have a little bit more confidence. This was strong data.

33:17Dr. Ayesha Sherzai: Yeah, it was pretty strong data. It was exciting. And, you know, we used to say brain games are, you know, whatever. But now we have this piece of data. Does this mean that everybody should start playing games to protect their brain? Yes and no. Yes, because it's something that can challenge your brain. No, because sometimes people just get stuck on games and they don't do anything else. And I've seen that in my patients and in my community members. All they do is just pull out their app and they're sitting there quietly on their couch and they're just playing their games for 20 or 30 minutes and they think that's good enough.

33:50Dr. Ayesha Sherzai: That's not good enough. I think sometimes the side effect of being on a tablet or on a phone is you're completely disconnected from everything around you. The way we speak with our patients and our community members is do something that is complex, do something that is challenging, that really pushes you to learn a new skill or actually just brush up on an old skill and try to do something that is more real life.

34:15Dr. Dean Sherzai: Yeah, and purpose-driven.

34:16Dr. Ayesha Sherzai: And purpose-driven. So for example, if somebody has an inclination towards music, learning a new musical instrument is phenomenal. And we have so much data showing that when people play a musical instrument, parts of their brain light up that don't necessarily light up in doing any other activity. And musicians are people who play an instrument. Not good. We have to say like, you know, any kind of... We were laughing because we don't want people to think that they have to master a piano or a guitar. Just playing a musical instrument is great.

34:48Dr. Dean Sherzai: Let me just give you an example. I'm the worst guitar player that has played guitar for 30 years. I probably damage people's hearing and brain cells when they hear me. But I enjoy it. And it is absolutely the most riveting, the most connected. I mean, when you play, let's say you're playing music from a note. You're reading the notation, right? That's your left prior to low. You're processing it intellectually. That's your frontal low. You're processing it visually. It's your occipital low. You're being creative. I'm very creative in all kinds of ways. It's your right prior to low. You're being dexterous.

35:22Dr. Dean Sherzai: It's your motor cortex and your cerebellum. You're emotionally involved. It's your limbic system. That's not Sudoku. It's your brain on fire. It's all aspects of your brain, including your passion, your purpose, your meaning in it. That's not a video game. That's a life lived well and a life that's being pushed with meaning.

35:43Dr. Ayesha Sherzai: And for people who are not into music and they don't enjoy it, it could be activities like creating a project at home, building something, painting, sewing, crocheting, dancing. I had a lovely patient who started quilting. Quilting is amazing because it involves pattern recognition and math. And especially when you do it in a social gathering, that's social connectivity. So there's so many things that people can do. I also want to point out that there's humility in recognizing how much is still unfolding around this work. We've talked about what helps, but I also want to talk about the limits here.

36:24Where is the science still evolving and what do we not yet fully understand about preventing diseases like dementia?

36:33Dr. Dean Sherzai: At the molecular level, there's a lot that we still need to forget. For example, in Alzheimer's, it's amyloid and tau. And those two proteins had misled us for quite a bit because we just focused on those. Those need to be focused. Those are the end process of Alzheimer's. But you can get to that either because of genetic reasons, because you have a particular gene, those high prevalence genes that I talked about, or what happens is the vascular risks and the trauma of the brain and everything else creates those proteins that accumulate and then they get out of hand. We haven't figured out how they truly work.

37:11Dr. Dean Sherzai: So once we figure out how amyloid and tau start manifesting and where and when do they get out of control, then we will really truly address not just slowing down and stopping the disease, but also potentially reversing it. We're not there yet. And there's a lot of work that still needs to be done. Okay, so finally here, I want to bring this back to the individual. If somebody listening is in their 30s, 40s, 50s, maybe beyond, how can they begin to embrace brain health? Is there a right time or a right way to start thinking about this?

37:49Dr. Ayesha Sherzai: We always thought that people start thinking about their brain health when you're 60 and because you've seen a loved one go through memory problems. And the common understanding is it starts then. But we now have shifted that. As a matter of fact, there was a scientist who essentially said that Alzheimer's disease is a disease of midlife. And now with all of the different information coming about vascular health, we know that people who are in their 30s should start looking at their vascular risk factors and things like LDL cholesterol or ApoB or blood pressure or their glucose metabolism. Nobody thinks about Alzheimer's disease when they're in their 30s, but that's when the process essentially starts.

38:34Dr. Ayesha Sherzai: And so I think we should all at least be aware of where we are as far as our risk factors are concerned.

38:41Dr. Dean Sherzai: Fully agree. And as the answer to you, as far as when they should start, now, whatever age they are. The brain is incredibly sensitive. It is 86 billion neurons. This is just an incredible organ and it consumes 25 % of your body's energy. So it is always working. In fact, it does some of its best work while you're sleeping. But it's also incredibly resilient when you take care of blood pressure, cholesterol, and diabetes or pre-diabetes. And then maybe on top of that, check your B12 level make sure that you're not b12 deficient make sure that vitamin d is not low check that once a year and omega-3 there it is those are simple things that pattern of eating more healthy which is greens and fruits whatever else but those are important walking more doing some leg exercises as well sleeping well challenging your brain being social and everything else we talked about it is going to significantly turn around the pattern from one of destruction to one of construction, which the brain has shown to regrow connections, even in people in their 90s.

39:51Dr. Dean Sherzai: That's empowering. But here's the thing. It's not going to take a gimmick on social media. You don't even need us. Just start those things at home and it will have tremendous returns. so much wisdom in this conversation thank you both for helping make this issue feel both hopeful and doable i so appreciate your time it's our pleasure thank you for having us

40:21and that's our show for today thank you again to dr aisha and dean shurzai for joining us you can check out their podcast your brain on which i'm a huge fan of wherever you get your podcasts. TED Health is a podcast from TED, and I'd love to hear your thoughts about this episode. Send me a message on Instagram at ShoshanaMD. This episode was produced by me, Shoshana Ungerleiter, and Jess Shane. Edited by Alejandra Salazar and fact-checked by Vanessa Garcia-Woodworth. Special thanks to Maria Lages, Farrah Degrunge, Daniela Balarezo, Constanza Gallardo, Tansika Sungmarniwang and Roxanne Heilash.

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