How to Future-Proof Your Brain from Dementia — Dr. Tommy Wood

Human babies are uniquely born with significant fat stores, primarily to serve as a repository for DHA (an omega-3 fatty acid) and a source of ketones. Both DHA and ketones are preferred synthetic precursors and energy sources for the rapidly developing brain, particularly important in the early weeks and months of life.

For hypoxic-ischemic encephalopathy (HIE), cooling babies to 33.5°C for 72 hours within hours of birth is the state-of-the-art treatment, significantly reducing death and disability. For pre-term brain injury, cooling can be detrimental, and caffeine has shown significant improvements in cognitive function.

Post-concussion strategies include managing fevers (e.g., with acetaminophen), avoiding high glucose spikes, and supplementing with creatine, omega-3s, exogenous ketones, B vitamins like riboflavin, and branch-chain amino acids. Early return to low-level aerobic physical activity that doesn't worsen symptoms is also crucial.

Omega-3s, particularly DHA, are essential for brain structure and function, especially within neuronal membranes. B vitamins (B12, folate, riboflavin, B6) are crucial for methylation, a biochemical process that enables DHA to be properly incorporated into cell membranes. Both are required; deficiency in one can negate the benefits of the other, leading to elevated homocysteine levels, a risk factor for cognitive decline.

Open-skill or coordinative exercises, which require constant adaptation to the environment, are particularly beneficial. Examples include dancing, martial arts (with caution), and ball sports. These activities improve brain structure and cognitive function, with dancing showing a strong effect size due to its combined physical, social, and musical components.

Learning new languages or musical instruments, and even engaging in attentive music listening, can improve brain structure and network discreteness, which are typically susceptible to aging. Bilingualism (even if acquired later in life through apps like Duolingo) has been linked to improved executive function and delayed dementia onset, likely due to the brain's enhanced ability to suppress one language while activating another.

Sensory loss (e.g., cataracts, age-related hearing loss) is associated with increased dementia risk, partly because it leads to reduced engagement with the world. This risk is reversible with interventions like cataract surgery or hearing aids. Neuroplasticity, the brain's ability to adapt, is driven by encountering challenges and making errors, which signal the need for change and new connections, much like training to muscular failure.

Dr. Wood emphasizes consistent, high-quality sleep as paramount, noting that occasional poor sleep has less negative impact on performance than often believed. Other crucial aspects include avoiding excessive alcohol and smoking, improving air quality with filters, and maintaining excellent oral health to prevent gum disease, which is linked to systemic inflammation.

CDP Choline (citicoline) is important for fat attachment in brain membranes and has shown improvements in cognitive function in older adults and after traumatic brain injury. Core nutrients like various B vitamins, Vitamin D, iron (especially for anemia), and magnesium are also critical.

Gum disease, particularly periodontitis, is strongly linked to increased dementia risk due to systemic inflammatory effects and bacteria found in amyloid plaques. Addressing gum disease (e.g., with xylitol) and incorporating anti-inflammatory approaches like ketogenic diets are beneficial, especially for APOE4 carriers.

DORAs are drugs that improve sleep quality and quantity by targeting orexin receptors. Improved sleep assists with amyloid clearance from the brain, a process central to Alzheimer's pathology. While not a first-line treatment for everyone, they can be beneficial for individuals with insomnia or other sleep disorders that compromise high-quality sleep.