Silent Symptoms Of Dementia & Brain Decline: Spot These Early Warning Signs | Dr. David Perlmutter

Added: Mar 14, 2024

Dr. David Perlmutter, a renowned neurologist and author, discusses the early warning signs of Alzheimer's and dementia, emphasizing that these diseases develop over years and even decades before diagnosis. He highlights the importance of monitoring factors like belly fat, blood sugar, blood pressure, and physical activity to assess the risk of developing these neurodegenerative conditions.

Key takeaways


Early detection of Alzheimer's is crucial; brain scans can reveal metabolic deficiencies years before symptoms appear.


Monitor factors like belly fat, blood sugar, blood pressure, and physical activity to assess the risk of developing Alzheimer's and dementia.


Adopt a healthy lifestyle, including maintaining a healthy weight, controlling blood sugar levels, managing blood pressure, and staying physically active, to reduce the risk of neurodegenerative diseases.


Maintain a healthy diet rich in fiber-rich, colorful vegetables to support metabolic health and blood sugar regulation.


Maintain a healthy oral microbiome to support brain health, by avoiding antibacterial mouthwashes and practicing good oral hygiene.

Early Warning Signs and Risk Factors

Dr. Perlmutter explains that the seeds of Alzheimer's are sown 20 to 30 years before clinical symptoms appear. Brain scans can reveal deficiencies in brain metabolism, particularly in areas like the temporal parietal region and the hippocampus. These metabolic issues can be influenced by lifestyle factors such as diet, exercise, and overall metabolic health.

Impact of Lifestyle Choices

Dr. Perlmutter stresses the significance of lifestyle choices in preventing Alzheimer's and dementia. He mentions that maintaining a healthy weight, controlling blood sugar levels, managing blood pressure, and staying physically active can reduce the risk of developing these diseases. He also highlights the role of metabolism in brain health and the importance of addressing metabolic issues early on.

Challenges in Current Treatments

Dr. Perlmutter discusses the limitations of current pharmaceutical treatments for Alzheimer's, noting that drugs targeting beta-amyloid have not shown significant improvements in cognitive decline. He mentions the risks associated with these medications, such as brain shrinkage and adverse effects. He emphasizes the need for innovative approaches to treating Alzheimer's that focus on metabolic health and alternative therapies.

Importance of Blood Sugar and Insulin

Blood sugar levels play a crucial role in brain health, with elevated levels increasing the risk of cognitive decline and Alzheimer's. Dr. Perlmutter recommends monitoring blood sugar levels, including fasting insulin, to assess insulin functionality and sensitivity. He highlights the impact of diet on blood sugar regulation, emphasizing the importance of consuming fiber-rich, colorful vegetables to support metabolic health.

Role of Nitric Oxide and Oral Health

Nitric oxide, a key regulator of blood flow and insulin functionality, is produced by oral bacteria in the mouth. Dr. Perlmutter explains how maintaining a healthy oral microbiome is essential for overall health, including brain health. He warns against using antibacterial mouthwashes that can disrupt the oral microbiome and increase the risk of diabetes and hypertension. He recommends practices like flossing, brushing, and using oral care products that support the oral microbiome.

Tools for Assessing Brain Metabolism

Dr. Perlmutter discusses emerging tools for assessing brain metabolism, such as neurocognitive tests and functional MRI scans. These tools can provide insights into how efficiently the brain is utilizing energy, offering valuable information for early detection and intervention. He mentions ongoing research in this area and the potential for these tools to be more widely available in the future.

Innovative Approaches to Treatment

Dr. Perlmutter highlights the importance of personalized approaches to preventing and treating Alzheimer's, focusing on optimizing metabolic health and brain function. He mentions the work of Dr. Dale Bredesen, who emphasizes a holistic approach to addressing multiple factors that contribute to cognitive decline. Dr. Perlmutter suggests exploring novel therapies targeting metabolism as potential treatments for Alzheimer's in the future.

Exercise and Sedentary Lifestyle

Dr. Perlmutter highlights the risks of a sedentary lifestyle on brain health, linking it to a higher risk of developing Alzheimer's and other neurodegenerative diseases. He mentions studies that show a correlation between increased physical activity and decreased cognitive decline. The ideal benchmark for daily steps is around 10,000 steps per day. Engaging in physical activities like walking, playing sports, or dancing can help improve brain health and reduce the risk of cognitive decline.

Healthy Lifestyle Choices

A study published in the Journal of the American Medical Association found that individuals who maintained a healthy lifestyle had a significantly lower risk of cognitive decline. This included factors such as physical activity, socialization, cognitive challenges, smoking, alcohol consumption, and nutrition. Even individuals carrying the APOE4 gene, a known risk factor for Alzheimer's, could offset their risk by adopting a healthy lifestyle. Dr. Perlmutter emphasizes the importance of making good choices to protect the brain and prevent neurodegenerative diseases.

Alzheimer's Prevention Day

To raise awareness about Alzheimer's prevention, Dr. Perlmutter and other thought leaders have created Alzheimer's Prevention Day, scheduled for May 15, 2024. This initiative aims to provide information, resources, and interviews with experts to educate people on lifestyle choices that can safeguard their brain health. The focus is on empowering individuals to take control of their brain health through proactive measures.

The Influence of Media and Pharmaceutical Companies

Dr. Perlmutter discusses how pharmaceutical companies influence medical practices through advertising and marketing. He emphasizes the need for balanced information and critical thinking when it comes to healthcare decisions. While he acknowledges the potential benefits of pharmaceuticals, he advocates for a holistic approach that includes lifestyle interventions alongside medical treatments.

Tools in the Toolbox

Dr. Perlmutter emphasizes the importance of lifestyle factors as the foundation for brain health. He discusses the free and accessible tools individuals can use to maintain cognitive function, such as exercise, diet, sleep, mental stimulation, and community engagement. These lifestyle choices play a crucial role in reducing the risk of neurodegenerative diseases and preserving brain health over time.

Supplements and Brain Health

Among the supplements that support brain health, Dr. Perlmutter highlights the significance of DHA, a component of fish oil. DHA is essential for building brain cell membranes, reducing inflammation, and promoting the growth of new brain cells. He recommends incorporating DHA into daily supplementation, with an optimal dosage of 1,000 milligrams for cognitive support. Fish oil supplements containing DHA can be a valuable addition to a brain-healthy protocol, especially for individuals looking to prioritize their cognitive well-being.

Vitamin D and Glutathione Importance

Dr. Perlmutter highlights the significance of vitamin D in maintaining optimal health, especially for individuals with low levels. He recommends increasing vitamin D levels through supplementation to support brain health. Additionally, he discusses the role of glutathione as a master antioxidant and detoxifier in the body. Low glutathione levels have been linked to cognitive decline and neurodegenerative diseases, making it essential to boost glutathione through supplements like NAC and alpha-lipoic acid.

Environmental Toxins and Brain Health

The conversation shifts to the impact of environmental toxins, such as air pollution and pesticides, on brain health. Dr. Perlmutter emphasizes the need to minimize exposure to these toxins to reduce the risk of neurodegenerative diseases like Parkinson's and Alzheimer's. He discusses the importance of living a lower-toxin lifestyle and avoiding harmful chemicals that can deplete glutathione levels in the body.

Potential Therapeutics for Brain Health

Dr. Perlmutter introduces the concept of using nitric oxide as a therapeutic intervention to improve brain metabolism and cognitive function. He discusses ongoing research with a pharmaceutical intervention aimed at targeting insulin functionality and blood flow regulation through nitric oxide. This approach shows promise in slowing cognitive decline and potentially offering significant benefits for individuals with neurodegenerative diseases.

Coffee Consumption and Protein Intake

The discussion touches on the trend of quitting coffee for health benefits and the importance of protein intake for maintaining muscle mass and metabolic health, especially as individuals age. Dr. Perlmutter acknowledges the benefits of protein in preserving muscle mass and shares his personal experience of consuming more protein to support his health goals. He also addresses the impact of caffeine curfews and the quality of coffee consumed to avoid potential health risks.

Personal Health Journey

Dr. Perlmutter reflects on a significant health event he experienced in the past year, where he underwent a cardiac ablation procedure to address atrial fibrillation. He shares how his history of long-distance running may have contributed to the condition and emphasizes the importance of maintaining muscle mass and overall health as individuals age. Additionally, he mentions incorporating new supplements like acromania and increasing his consumption of allulose for health benefits.


Full episode

Episode summary