Claudia von Boeselager (00:00)
My guest today is doctor Tommy Wood, who is a neuroscientist, elite level professional nerd, and a performance consultant to world class athletes in a dozen sports. He's the author of the forthcoming book The Stimulated Mind Future proof your brain from dementia and stay sharp at any age.

Dr. Wood received an undergraduate degree in biochemistry from the University of Cambridge, a medical degree from the University of Oxford, and a PhD in physiology and neuroscience from the University of Oslo. He is an associate professor of pediatrics and neuroscience at the University of Washington School of Medicine, where his laboratory focuses on brain health

across the lifespan, including in babies born preterm, adults who experience brain trauma, and the confluence of factors that can affect long-term cognitive function and risk of dementia. Dr. Wood has published more than a hundred scientific papers and lectured all over the world about brain health, metabolism, physical activity, and human performance.

Alongside his career in medicine and research, he's also been a performance consultant to professional athletes in multiple sports, including several Olympians and world champions, and helped to found the British Society for Lifestyle Medicine, the fastest growing lifestyle medicine in the world. His experiences include caring for dementia patients, running a team of scientists as part of a large neuroscience research program, and being a health coach to individuals struggling with a range of health conditions.

Working with digital health companies to develop ways to support individuals in building new habits and improve their health with small actions and helping Formula One drivers maintain focus and performance while driving at two hundred miles per hour. This work gives them a broad perspective and an ability to see the big picture and help people support their brain health in a personal and practical manner. As you know, brain health is so important to me. So I hope you enjoyed today's special episode. Please enjoy.

Claudia von Boeselager (01:44)
welcome to the Longevity and Lifestyle Podcast, Tommy. I am very much delighted to have you with us today.

Tommy (01:49)
Thanks so much for having me. I'm super excited to be here with you.

Claudia von Boeselager (01:51)
Yeah, beautiful. So this is actually a really personal topic that I'm so passionate about because my mother passed away last year from Alzheimer's. And so it was really a journey understanding, and obviously my audience will know this that there's so much that you can do to prevent it And some of the tools we found out that were too late and obviously hadn't had the chance to speak to you, but have had like Dr. Dale Bredison, Dr. Kristen Willemeyer, David Perlmutter like Austin Perlmutter and other brain specialists on. So it was high time that we had you on as well, Tommy, to share more about your work.

and I think it's such an important topic, obviously, when I remember looking at the statistic that every three seconds, someone in the world develops dementia, which is just wild. So I think it's such a relevant topic for everyone. So Tommy, can you share a little bit about why you became so passionate about focusing on the brain and helping people to understand why it's so important to take care of our brain and prevent things like neurodegeneration and disease?

Tommy (02:40)
Sure. So my main job is, and I say that because I have several. I get to do lots of fun things, many of which I'm sure we'll touch upon today. But my main job is as a professor of neuroscience at the University of Washington in Seattle. And I kind of fell into neuroscience a little bit. I like specialized in biochemistry for my undergraduate degree. Then I went and did graduate entry medicine.

And sort of along that same time was also, you know, whilst working in medicine was also very interested in athletic performance. you know, increasingly interested in like health and fitness in general. I did a lot of rowing, I coached a lot of rowing. but then when I was trying to figure out what to specialize in as a doctor, I couldn't quite decide. So I ended up getting an offer to do a PhD in neuroscience.

at the University of Oslo. And this is kind of the field that I've continued in is like one chunk of my work. and that work, which we still continue today, is looking at brain injury in babies. and so often rightly so, when I say that, I get asked well, why is a neonatal neuroscientist talking about dementia? Right. great, great question. so yeah, and

Claudia von Boeselager (03:38)
Starts early, that early? Yeah.

Tommy (03:42)
so

Part of it is, you know, we do all this work trying to improve brain development or reverse or treat brain injuries in babies for which happen for a variety of reasons. but then you kind of increasingly appreciate that after that baby leaves hospital, what really drives the majority of the development was not what happened earlier, not necessarily the injury that they experienced, it's the home that they go back to. Like what is the environment that they develop in?

In terms of the cognitive stimuli, the physical development, the motor skills, the social skills, the nutrition. Like we know that sleep and social stresses are really important. And you can start to see, and we were increasingly seeing from the the literature as well, that the trajectory of your entire lifespan of your brain begins, you know, early in life. You only get one brain, right? So does this work that

you

know, started to do in babies. And then I also do a lot of work still with athletes. So I work with a lot of Formula One drivers in particular. And you know, thinking about how do we set this person up for sustained high level cognitive and physical performance? And you see some of the same things, drivers of cognitive function that affect babies are just as important in, you know, professional athletes. yeah.

Claudia von Boeselager (04:51)
Can you give an example?

Tommy (04:52)
So again, sleep, nutrition,

these things are like core parts of brain development, but they're also core parts of maintaining cognitive function long term. We can certainly get into like the individual details of that. but then thinking about athletes that are high risk of things like traumatic brain injuries that affects long-term cognitive function. And so like just seeing all these pieces come together, I then became increasingly interested in like what does the whole trajectory of your brain look like across your entire lifespan? And of course, for many of us.

That may include cognitive decline and dementia later in life, which is affected by what happens early in your life. and so you mentioned every three seconds somebody develops dementia. That person started developing dementia decades before that, right? Before that diagnosis

Claudia von Boeselager (05:33)
Yeah.

Tommy (05:35)
was given, because of largely modifiable factors in the environment. Yes, genetics are important. There are some things that we don't fully understand yet. but the

There is so much that we can modify about all this trajectory. So it was all those different pieces coming together that really really made me sort of interested in this topic.

Claudia von Boeselager (05:49)
Which I think is so fascinating because we don't see it until something happens, right? We focus on our muscles or our skin or a lot of people, right? And then they forget about the supercomputer we have between our ears that actually makes the most sense to optimize because it everything else work so well just going back to babies, I think this is a really interesting component. And obviously, I think some people are maybe concerned, like, you know, did my parents take good enough care of myself, or did I take good enough care of my kids? Have I ruined them for life? So

that would be interesting to understand from the neuroplasticity perspective. But Jim Kwik I'm sure you know was like the brain injured child. and actually, when I had my first startup in Berlin, there was somebody who rented office space from us. His son was born in 26 weeks at Stanford. They said that he would be brain injured his whole life, and then they found the Glenn Doman I think is the method. And at age three, he was speaking three languages, playing instruments, like doing so many things So can you help people who might have

feared that they might have not taken as good enough as possible care of their brain and childhood or of their children that there is hope and walk through what's happening there in terms of neuroplasticity, neurogenesis, etcetera.

Tommy (06:47)
Yeah, sure. so there's many ways to come at this. the first thing to say, just like the more I look at the literature and the more studies we do, the more actually I am filled with hope. Because you can see that regardless of when you start to intervene, and regardless of what happens has happened previously, there's still capacity for the brain to change its trajectory and it improve and then maintain function over time. So

you mentioned this baby born at twenty-six weeks. So that's what we would call extremely preterm. So any baby born before twenty eight weeks, you know, a standard pregnancy is forty weeks. Term is sort of thirty-seven weeks and beyond. Less than twenty-eight weeks is extremely preterm. we've actually done studies in one of the largest cohorts of extremely preterm babies in the US. There's a thousand babies are included in a clinical trial that I helped take part in. I

Particularly did lot the statistical analyses. and for example, we looked at one paper, we wrote one paper to see what is it that affects long-term neurodevelopment in these babies? Because not only are they born early, but they have a high risk of brain injury. So they have bleeds into the brain, in particular, something called intracranial or intraventricular hemorrhage. They get exposed to tons of drugs, morphine, benzodiazepines, because you know, pain.

and various other things that they need. fluctuations in oxygen and fluids and all this kind of stuff, like the physiology is crazy. and what you see is that even in these very, you know, vulnerable babies, of which about 50% on average experience death or disability later in life, there's obviously 50% who don't. And some of those kids end up with,

sort of high, even for a normal, you know, somebody born at term, you know, cognitive function. and when we looked at all the different factors, so we had all the stuff that happened in the hospital, their blood tests, all these other things, particularly when it came to cognition. So we could look at language, cognition, like sort of broad cognitive function and motor skills. There's an assessment called the Bailey Scales of Infant Development, which is kind of standard in the field that's done in a few years of age. And

The most important predictor of cognitive function was a proxy of home environment. and what we could use in this data set was maternal education, because the higher your level of educational attainment in the mother, right, that usually tells you something about the family income. It tells you about access to healthcare, it tells you probably about nutrition, it tells you about the things that this kid gets exposure to, right? So, in the example that you gave, a home that gives you exposure to

multiple languages that you get to learn and all these other things, right? That becomes this environment that helps to drive development in the first place. So we know that the home environment is even in these babies is the primary driver. And you and you gave a very very nice example of that. So different people have different abilities to modify this environment, right? But at least we know that this environment is modifiable. If we can you know help support this kid's nutrition, motor skill development, physical activity,

Educational

exposure, learning to read, learning languages, right, interacting with other kids, stuff like that. you mentioned neurogenesis and neuroplasticity. and I think these are two very important concepts to think about when we're thinking about improving or maintaining cognitive function. yeah, absolutely.

Claudia von Boeselager (09:42)
Can you define them maybe in case people are not familiar with they are yet?

Tommy (09:45)
And their definitions are also important because I think

Thinking about these two different concepts has held us back in terms of really realizing how much capacity the brain has for change later in life. So neurogenesis is the production of new neurons. From neural progenitor cells or neural stem cells, you are making new, fully functional neurons. The process of neurogenesis really stops in early childhood.

Sort of two to three years old. After that, you're kind of refining connections, you're building structure. There are other cell types that expand, but really most neurogenesis happens very, very early in life. And because of that, so there are two parts of the adult brain, or you know, the sort of adolescent and adult brain that do make new neurons. One is the dentate gyrus of the hippocampus. the hippocampus is very important for memory, it's very susceptible to the late stages of dementia, particularly Alzheimer's disease.

And then in the olfactory bulbs, which is right at front of the brain, that's that's where we smell. We can make new neurons in our smell center.

like just right behind your nose.

Claudia von Boeselager (10:46)
Okay.

Tommy (10:47)
So those two areas of the brain can make new neurons, but the rest of the brain doesn't. and so because of that, going like all the way back to the original histories of neuroscience, like Cajal.

Roman Santiago Icahal, who got in 1906 got the Nobel Prize for Understanding the Nervous System. he said the adult brain is immutable. like essentially telling us the adult brain is fixed and like there's nothing we can do to change it. although he did kind of change his mind a little bit later, and he talked about neuroplasticity explaining learning, which is how we would think about it now. But like people have kind of

Absorb this idea that the adult brain is fixed and there's nothing we can do about it. however, just because the number of neurons you have doesn't really change, that doesn't mean you can't change the connections between them. That is the process of neuroplasticity, right? and so your brain is constantly developing new connections, refining them, removing ones that it doesn't need. And this is all driven.

By

the experience that we have interacting with the world and the inputs that we give our brain. And that happens in the adult brain essentially all the way into the end of life. one of the sort of theories around the idea of dementia is that end stage dementia is the final loss of neuroplasticity, which says that up until that point, our brains still have capacity for neuroplasticity, which is making new connections, developing new skills, learning new languages, making new memories, etc.

So that is the process that we really want to encourage and drive in whatever direction it is that we want to do that. So our brains are capable of this change if we provide it the right environment and stimulus to do so. So with adults in particular.

We do know that, say you're trying to learn some new skill. Kids will, on average, learn a little bit faster than adults. There's two reasons for this. One is life, and the other is some aspect of biology. So the life reason, which I think is actually the major reason, is when your three-year-old, your kid who was born extremely preterm, is learning three languages, pretty much all they're doing is learning.

They're learning and sleeping. Like when you're a kid and you're in

Claudia von Boeselager (12:45)
Yeah. Yeah. I need it, yeah. Yeah.

Tommy (12:48)
school, like it's your job to learn, right? When you're an adult trying to learn three languages, it's 30 minutes on Duolingo when you can find time between all the other stuff that you're trying to do. Right. So usually adults thinking that they can't learn as well as you know younger kids can, it's because

We're not giving it the time and focus that we did when we were younger, rather than because we can't. There is a small aspect of saying that the adult brain has become fixed to an extent, but that's actually an important thing because you want your brain to be shaped by the environment it's in, because then that allows you to do all the things you want to do on a daily basis, right? That's the whole point of the brain, is to allow you to survive in your environment.

Claudia von Boeselager (13:28)
And it that's like autopilot almost, so you don't need to think about everything. Like let's say driving a stick shift car, you don't need to have to think about everything. Is that your can you associate like that? Yeah.

Tommy (13:38)
there are some things, some skills you've developed that do become relatively fixed and ingrained. And that helps you navigate the world. But what that then means is if you do want to develop new skills, you do want to you really activate the pathways of neuroplasticity, it just requires some focus and effort to do so. Cause you're just like telling your brain, hey, it's important that we start to focus some resources on this new thing. and

When again, you think about the process of learning as an adult, often we're distracted, we're stressed, we're sleep deprived. We're not really engaging in these processes that drive neuroplasticity, which require focus and attention and sort of pushing ourselves a little bit. So the brain is still capable as long as we kind of give it the right signals that it should do that.

Claudia von Boeselager (14:23)
And the right environment around it too, which I think is super fascinating. And I want to touch on a different topics, including psychedelics. I'm very curious to hear your take on that about how to shake up the whole system, right? But before we get to that what are some of the things that when you work with the Formula One drivers? And I mean they need to be sharp. They're 200 miles an hour plus, right? High speed, focus, you know, navigating multiple things at the same time. What are some of the secrets or tools that you support them with that

people listening could also start incorporating into their lives. Walk us through through that.

Tommy (14:52)
Yeah, so I think there are a couple of things that translate very well. Actually many things translate very like surprisingly well. You know,

Claudia von Boeselager (15:00)
Yeah.

Tommy (15:01)
the these guys, at least right now they are all guys. Hopefully that that changes in the future. But they travel a lot, they're busy, they've got a huge sort of huge demands on their time. so then, you know.

Sleep is easy to compromise because you know they're always traveling and and jet lagged. And sometimes nutrition or training even can be easy to compromise because you know, you're sat on a plane, it's very difficult to go for a run or bike ride or whatever. so actually juggling all these different things that we know are important for health is something that they experience too, particularly during the season when when actually like they're they spend half their time traveling and then driving.

So the way that we approach it in general, and so I should say up front that I do all my work with Formula One drivers through a company called Hints at Performance. and I do this. So I'm head scientist for motorsport. So I oversee like performance programs, making sure we're sort of right at the cutting edge of science, doing the best in terms of performance and learning and building on that over time.

But I work with expert coaches who spend all their time with the drivers. We have a number of different performance specialists, performance psychologists, doctors, right? So I'm part of a team that does all of this, right? It's not just me doing it.

And I think about this in two different phases. So one is how do we kind of build a foundation from which to perform? Right. And then how do we build the actual performance itself? So

The foundation is very much all the stuff that people would be familiar with. And again and again, the best athletes that I've worked with, particularly those that are successful for years or decades at a time, are

Claudia von Boeselager (16:31)
Mm-hmm.

Tommy (16:32)
the people who consistently do the boring stuff. Right? They Yeah, yeah, yeah. So like they

Claudia von Boeselager (16:35)
Like what? Give us give us some examples, Tommy. Yeah.

Tommy (16:38)
attend to their nutrition. They are constantly making sure that they're

training to develop whatever function they need to develop. So maybe they need to improve their cardiovascular fitness a little bit, or maybe they need to improve their strength a little bit. That's you know, certain parts of the body, like the neck, and like sort of weird kind of parts of the leg need to be really strong because of how you're like sitting in the car. So

that they're constantly focusing on that. and then, you know, really attending to recovery and sleep when they can. So, how can we make sure that?

We minimize the effect of jet lag. how can we get elements of recovery even when they're traveling? So like sometimes we're using virtual reality or other kinds of you know setups to kind of force elements of breath work or meditation that are sometimes harder for people to kind of engage with? just because having them down regulate and relax is often very difficult. So

These kind of things really consistently. And then also they're making sure they can travel with their family or partners, right? So they get that kind of continuous social support and connection throughout the season. some of this we do tailor. So a lot of my job is focusing on looking at blood tests two or three times a year and and tinkering with nutrition in response. So we do all the kind of basic stuff, you know.

a complete blood count, red blood cells, white blood cells, metabolic panels. So we're looking at liver, kidney, proteins, all that kind of stuff, lipids, blood sugar. and then we'll measure things like vitamin D, B vitamin status, magnesium, and you know, omega 3s, because they can help with some aspects of recovery and performance, as well as

Claudia von Boeselager (18:08)
Right. Mm-hmm.

Tommy (18:10)
you know, being important for cognitive function.

And so then like tinkering with the diet or supplements if we need to in response. So it's kind of just like making sure they're in good physical health, attending to kind of like the core lifestyle practices and then sort of adjusting as needed based on the physiology they're measuring. So we also get, you know, wearable data. We do track their sleep, we do track HRV. we obvious we we track the blood tests, like I said, making tweaks based on the individual where needed. So that kind of gives us that platform to perform

from. And

then when we're thinking about how you can set this person up to perform as best as possible in the car, obviously

psychologists play a big role here because you know everybody has their own different set of things that they need to kind of feel ready to perform. but we often talk a lot about arousal state as the kind of the means to performance. So in exercise science, there's a lot of

talk of this thing called the Yerkes Dodson arousal curve, if anybody's heard of that. But it's basically just like a bell curve. and on one side you have performance, and on the bottom you have arousal. and there's some perfect amount of arousal for a certain type of performance. And by that I mean just like how like amped up you are. And and people might realize or you know, recognize that if you have low arousal,

And this works for other things that need arousal. But when we're thinking about, you know, athletic performance, low arousal, you kind of disengage, you're a little bit bored, you're not really into it, right? you might be a bit sleepy. But you could if you have very high arousal, you're kind of anxious, sweaty, you can't really make decisions because you're really nervous, right? But

somewhere in between, there's this level of arousal that allows you to access your skills and perform at your best. And so some people

And you know, this is the same like if we're giving a presentation, you're on a podcast, right? you're performing a musical instrument, you're performing in an athletic event. some people need to amp themselves up to get aroused. So we might think about caffeine, creatine, tyrosine. Like there are some supplements we could certainly tinker with, and and some people do. or we might think about like high ventilation breath work, we might think about.

cold, we might think about loud, upbeat music, we might think about like sprints or some kind of very fast-paced physical activity. All of these things can kind of get you in that right zone if you're sort of a bit low on arousal to start with. And and each driver, part of kind of getting into the mode to perform, has a set of rituals or things that they do that makes them feel like they're in the right spot.

Claudia von Boeselager (20:28)
In the zone.

Tommy (20:29)
yeah, in the zone. Like some of that is the physiology. And then some of it's also like

The placebo effect of knowing that you've done what you think you need to do in order to perform. Right. that's an important part of it too. And

Claudia von Boeselager (20:37)
Yeah.

Tommy (20:38)
then on the other end, you still might have people who are very nervous, because, right, they're professional drivers, but there's millions of people watching and their seat is on the line and they might not get their contract renewed and stuff like this is the race they have to perform in. So then

we might think about like how can we decrease arousal? So slow paced breathing or meditation or maybe you know calming music. We can manipulate light exposure. Like these are other things that we can do to kind of bring them down. and again, sort of like mental visualization and things can help here too. So those are kind of the things that I think that are relevant to all of us. How do we build this kind of like healthy foundation that we can perform from and then how do we get ourselves in the right mode in the moment in order to to perform with it

Whatever it is that we want to perform.

Claudia von Boeselager (21:19)
Super powerful. Tell me, what are you some of your personal favorites? Walk us through that. I'm curious. And what situations do you use them in?

Tommy (21:25)
so in terms of like the performance aspect.

Claudia von Boeselager (21:28)
Performance, keeping sharp, like your daily, weekly, monthly routines, but also when you have particular events where you know you need to be like super, super sharp, especially 'cause people know you are the experts, so they're looking especially at you versus the next person. No pressure, no pressure, but

Tommy (21:43)
very much try and follow the the same thing. So when I'm you know at home, I'm able to do all the things that I want to do. And I think that we should all have like a plan A and a plan B and a plan C, depending on whether we're traveling or we're busy, right? And then that also, and maybe I'll get into that a little bit, but that also takes off some of the mental burden of right.

If you always think that you should always be doing everything for your health, but then stuff gets in the way, you get stressed, you get busy, and then you're worrying about the stuff you're not doing, that's like a double whammy of badness because not only

Claudia von Boeselager (22:14)
Yeah.

Tommy (22:16)
you're not doing the thing, you're worrying about the fact that you're not doing the thing. Right. So

Claudia von Boeselager (22:19)
And then you never

get started. You could jump off the bandwagon completely. Yeah. Yeah.

Tommy (22:22)
Exactly. Yeah, yeah, exactly.

So, things that I try and consistently do when I'm able to. you know, I have a very consistent bedtime, try and be in bed by nine PM every night. the way that I do this, yeah, so I know I

Claudia von Boeselager (22:31)
Amazing.

Tommy (22:33)
usually function best on eight hours of sleep. It's different from person to person. It could be anywhere between six and ten hours based on the research. Usually seven to nine hours, right? but my dogs are gonna wake up at six AM.

regardless of when I went to bed. So if I want to get eight hours of sleep, I should spend nine hours in bed. So I need to be in bed by around nine.

then most of my food I cook and prepare at home. we grow our own vegetables. we cook a lot of sort of whole nutrient dense foods. So l eat a lot of veggies, meat, fish, eggs,

Most of it prepared by me. So I try and, you know, follow as nutrient dense a diet as possible. I exercise every day. and then those are really the cool things. I tinker with some stuff. So I do measure, I do get my blood test done. I do take some supplements based on those, we have some pretty good targets in terms of where you should be in terms of vitamin D status, omega-3 status, et cetera. So if I need to supplement, then I do.

also track things like my blood pressure and stuff like that that we know are important risk factors for long-term cognitive function. But that's basically it. And you might think that's a lot, or you might think it's not very much, but that kind of gives me a good core base to work from. and then particularly when I'm thinking about performing. So I compete in strongman. that's like my sport of choice.

Claudia von Boeselager (23:42)
Is that like Iron Man? I'm not that familiar with strongman, but is it like an Iron Man?

Tommy (23:45)
have you ever watched World's Strongest Man? Or you like see those guys like pulling trucks and lifting rocks and lifting logs?

Claudia von Boeselager (23:49)
Yes.

Tommy (23:51)
small old guy version of that. That's what I do.

Claudia von Boeselager (23:53)
Ha

Tommy (23:53)
so I compete two or three times a year. That's that's what I train for. it's usually lifting things, pulling things, throwing things.

That kind stuff.

Claudia von Boeselager (24:00)
Okay, very good.

Tommy (24:02)
and the two main things that I do when I'm sort of I usually need to sort of increase my arousal. So like there's like some very specific warmups I do. and then I do some like visualization of the event. And usually for me, I draw confidence from knowing that I've done it in training. And so if I've done it in training that I can, then I can definitely do it

Like in the competition. There are a few times, and this is very common even in Formula One drivers, where like I don't do it at home because I train in the afternoon. So I don't consume caffeine or a pre-workout supplement before I work out because then I it makes it harder for me to sleep that night. But there are a few times where I've competed where I'm like, well, I need to do my best. So let me slam all this caffeine and all these stimulants and all this kind of stuff. And then that's when I make mistakes, I drop stuff, I'm not paying attention, right? I've pushed myself too far up.

the the arousal curve. So I've learned you know, by trial and error that actually what I do at home in the gym during normal training should be as close as possible to what I'm going to do in the competition so I don't change anything during the event. So those are the things that I do.

Claudia von Boeselager (25:00)
Those are the big learnings and I think that you were talking about a plan A, plan B, plan C. Can you

Tommy (25:04)
Mm.

Claudia von Boeselager (25:04)
just touch on that briefly? Cause I think that's a really interesting concept that I definitely know what my plan A is. And I know if like a few things go off and obviously like this is my space and I don't share normally my full routine because people are just like, my god, she's crazy, right? But like there is a plan A, plan B, plan C, and there's somewhere it just hasn't been that structured. So what goes to the concept of plan A, plan B, plan C?

Tommy (25:24)
Yeah, so actually the way that I normally talk about it is in terms of a traffic light system. And this is something that I directly stole from my good friend behavioral psychologist, Dr. Simon Marshall. and his work was really with people working on behavior change, but he was also a performance psychologist to like Tour de France teams, like working with elite-level athletes. so we could kind of like span that full spectrum. And

The traffic light system is so like plan A is green. Like what are all the things that you do when when you have the time? So the way you like to eat, the way you like to exercise, the way you like to sleep and how much, your meditation routine, like the supplements, all that kind of stuff. And then Amber, which is, you know, our plan B, is, you know, what about when work gets really busy or you have family commitments or you have to travel? Like, what does that look like? What things can you just skip?

Right. So like maybe you don't do the meditation. Maybe there's a couple of supplements that you focus on. when I travel, I will usually take my creatine with me, but I'll leave all the other supplements at home. I just don't just don't worry about it. so is there something like that for you? It could be a vitamin, right? That's important or a medication, right? You just make sure that you get that. You don't worry about the other stuff. you'll take it again when you get home. and then maybe it's something like

How do you adapt your exercise routine? So when I'm at home, I have a gym at home full of all the fancy gear that you might need if you're lifting rocks for fun, right? I don't have that when I travel, although sometimes I can find rocks. Yeah. but what I'll

Claudia von Boeselager (26:44)
So you have rocks. You have rocks, right?

Tommy (26:48)
usually do is I'll take some blood flow restriction cuffs and some resistance bands, and they fit in my bag, and I can do a 10-minute exercise session in my hotel room. And

It's not perfect, but it absolutely makes me feel good, gives me a little bit of a stimulus, you know, gives me a bit of a cognitive boost. That's enough. And I've kind of like in my head, I'm like, that's good. I've done my training for the day. and you could even have this strategy at home, right? When things get busy, you don't have time to get to the gym, what can you do at home in 30 minutes or 15 minutes? so what's plan B there? maybe you have the same for food. You can't like cook everything yourself. So like

Is there something pre-prepared? Can you use frozen pre-chopped vegetables? You know, maybe do you have protein bars and tins of sardines, right? Just because they're shelf stable and they're kind of like sitting there if you need to have them. that's your kind of plan B. And then red or plan C, this is, you know, you have to spend 18 hours at work, your spouse is sick in the hospitals, like you've got nothing, like you've got time for nothing.

What's one thing that you can do to like anchor you in your day? and it could be five minutes of breath work, or it could be a 10 minute workout, or could just be like spending five minutes walking outside. Like, what have one thing that doesn't take that much time that kind of allows you to still sort of maintain that connection to your other health practices? And then you can kind of dial up and down as you need. But the most important thing is when you recognize that you're

In your amber stage or your red stage, you forget about the stuff that you're not doing, right? Because like we said, if you're worrying about you're not doing it, you're not getting the benefits from this putting this plan in place. and then the final part of this is we know from the literature, for example, that if you only can work out on weekends, like the weekend warrior kind of person.

You still get significant benefits in terms of your cardiovascular health. If you don't sleep well during the week and you have to get catch-up sleep on the weekend, is that perfect from a circadian rhythm kind of stuff? No. But it's still better than not getting that sleep at all. So even when we're sort of stressed or sleep deprived for short periods, we can actually function pretty well because of that kind of baseline foundation we've built. So spend time building that foundation when you can and then rely on it.

When you need to, and that's fine. And don't worry about what you can't control or what you can't do in those periods when you're under significant pressure.

Claudia von Boeselager (29:01)
Phenomenal. So I think this is advice for all of us. and before we go to dementia, which is such an important topic you were mentioning about visualization. And I think this is so interesting. What's happening in the brain during visualization and why would you recommend that everyone embrace some sort of visualization practice and what could that look like? I know I've stacked a few questions there, so

Tommy (29:20)
Yes,

so there are several kind of basic neuroscience studies that measure electrical activity in the brain or magnetic activity in the brain. So you can do an EEG, which is an electroencephalogra graph, or an MEG, which is a magnetoencephalograph, but it's basically measuring electroactivity in the brain during some process. And so that includes visualization.

So when you're trying to learn some specific skill, several studies have shown that if you then visualize performing that activity afterwards, you reactivate those same neural pathways as when you're actually doing that, learning that skill it itself as well. so you're kind of strengthening those new connections as part of that neuroplastic process of building that.

skill. the one kind of downside is you do need to do the real thing itself. because you can't

Claudia von Boeselager (30:06)
Can't just visualize all day.

Tommy (30:07)
just visualize it because there's something about the real time feedback

that is really critical

Claudia von Boeselager (30:12)
but is it because it's multi sensory that you're having that real time feedback or that's why you need it? It's not just the visualization component?

Tommy (30:18)
Yeah, so obviously whenever you're doing some kind of complex skill, it requires a full like neuromuscular coordination. And

you're just sort of training those core neural pathways and not the sort of full system. So yes, that's part of it. And then the other part is usually when we're doing something, so say I think driving a car is a good example, like

The drivers could visualize what happens in a specific corner, preparing for a specific corner, like preparing for certain parts of the track. But there's always going to be like, well, what if like the tailwind shifted slightly? Or what if what I expected to happen in the corner doesn't quite happen the right way? You you have to kind of constantly adapt. plus, especially in the learning process, we need the process of making mistakes and errors to kind of correct,

Some of those connections that we're building. So actually doing the thing and trying and failing is a really

critical component of neuroplasticity. But we can get some aspects of those learnings through visualization. So it allows you to get some additional reps in, even if you can't actually do the thing. Or it's the same with so visualization may even help for other aspects of physical performance, lifting weights, things like that.

And because there's only so many reps you can do in the gym, but you can still visualize that kind of connection, the setup, you know, which muscles you're activating, how you're kind of going through that process.

You still can build some of that skill through visualization without putting the stress on the body that you know, because there might be a limit that you can take there. So it's definitely an important add-on in terms of skill building. and

it

doesn't require any equipment or anything like that, which is great too. so then the final part is it can also be an important like psychological process, kind of like getting ready for it. then it's less about the learning the skill, because it can help learn the skill. but it's also about getting sort of into the right part of the arousal curve, getting yourself sort of like in the zone. Maybe it's

helping you kind of ignore what's happening around you, just sort of like being in the moment in terms of having to perform the thing you're trying to perform. So there's those psychological aspects of it.

Claudia von Boeselager (32:18)
yeah, phenomenal. I think, you know, a lot of athletes that I've spoken to, I've had a few also Olympians, et cetera, on the podcast. It's always visualizing obviously the positive, right? A lot of us focus on the negative, but it's training your mind to focus on the positive and expecting that. So even if the negative happens, at least you haven't been worrying about it the whole time. And you have the positive

Tommy (32:34)
but it can go the other way too. this might depend from person to person, but some people can benefit from visualizing the worst possible happening. But

the next step is what am I gonna do when this happens? So then you feel psychologically prepared. So when it does happen, you're like, Well, I already I already visualized this and I know what I'm gonna do next. So it can

Claudia von Boeselager (32:52)
Mm.

Tommy (32:52)
also be helpful on on that front.

Claudia von Boeselager (32:53)
What would be an example of that? I'm just trying to think of like worst case I don't know, you quit your job or you're getting fired by your boss, you visualize the worst case thing so you when it happens it's not that bad.

Tommy (33:02)
so that is a good example, but it's maybe less about visualization, which also about planning. also just like

being confident that if something happens, and so for an athletic event, it could be you're doing a triathlon and the chain comes off your bike or

Like there's some issue with your shoes in transition. Or

something happens with the car if you're on an F one track and like you start to lose the positions that you thought you would have. Like what are you gonna do in that scenario? So like it could be stuff like that too.

Claudia von Boeselager (33:27)
Mm-hmm.

Okay, got it. so with dementia and obviously with what's happened with my mother, et cetera, I've spoken to a lot of people and there's a typical consensus of it's genetic, I can't do anything about it, I don't want to know. it's if it's gonna happen, it's gonna happen. What do you want people to understand with dementia? And, you know, why should they be getting on top of things now so that they don't go down that path?

Tommy (33:51)
Yeah,

so this is really again sort of we think about earlier I was talking about the idea the adult brain is fixed and there's nothing we can do to change it. The next part of that is also it will then decline and there's nothing I can do about that either. Right. this is kind of something that we've embraced for whatever reason as a society, that you get old and then your brain stops working. That's just kind of like what we've been taught to expect. And

before I sort of get into that later bit, the reason why I think it's interesting that this is something that we just kind of think we expect to happen is because of this idea of something called stereotype embodiment theory, which is if you expect aging to look a certain way, in particular cognitive and physical decline, then you won't do anything to prevent that from happening, and it becomes a self-fulfilling prophecy. So

Almost this idea that we've told people that they should expect to lose physical and cognitive function with age, then sort of becomes a feed forward effect. So, like, I'm gonna be too old to lift that thing or do that thing or learn that thing. So what I'm not even gonna bother doing it. And then, they accelerate decline as a result.

Claudia von Boeselager (34:55)
that's such an important point. Tommy, I just want to reiterate that for people listening. That I think, the pre idea, I guess, that everyone has or the main idea is that it's inevitable. But actually what you're saying is almost the opposite. If you think that you could get fitter with age and smarter and sharper and faster, that will more likely be your trajectory because you're gonna proactively do things to

Tommy (35:14)
Yeah.

Claudia von Boeselager (35:14)
achieve that goal, essentially, right? Yeah.

Tommy (35:16)
Yeah, and you know, once you get to a certain stage, maybe we're talking sixties, seventies, eighties, it should be normal to expect to maintain function in that time period. But you can't keep getting smarter and fitter and stronger forever, right?

Claudia von Boeselager (35:28)
I'm gonna challenge that with a few questions in a moment, but yeah, keep going.

Tommy (35:30)
Yeah. So

right now we cannot fully prevent the processes of aging. Right. But we can

Claudia von Boeselager (35:34)
Yeah. Mm-hmm.

Tommy (35:35)
accelerate them. And so when we're thinking about building and maintaining function, there's huge gains to be had by maintaining a level of function from our fifties into our eighties or nineties, because the alternative is a significant drop. So over time, even if you're not getting stronger, if you're staying as strong.

two, three decades, you're staying as cognitively sharp for two or three decades, that benefit is compounding over time because if you would have lost more and more function over time instead, right? That gap is getting bigger and bigger and bigger, even if you're staying relatively flat, if that makes sense.

Claudia von Boeselager (36:06)
Yeah. Yeah.

Tommy (36:08)
so with that, we have data going back now, really from the 1950s, that shows that the majority of people

Should be able to maintain cognitive function from their 50s into their 80s at least. one example is the Seattle Longitudinal Study. It was actually done at the University of Washington, where I now work. we think that this is so surprising that nowadays we invented a term for it. We call it the superager, somebody who maintains cognitive function from their 50s into their 80s, right? But this should be the average.

Right. We know that's possible because that you know we've seen that in the data. So it shouldn't be surprising. We just haven't really allowed ourselves to think that. At the same time, we now know that some significant proportion of dementias are preventable. depending on the study that you read, it might be 45%. This is the Lancet Commission on Dementia Prevention. It might

Claudia von Boeselager (36:53)
The Lancet one, yeah.

Tommy (36:55)
be over 70%. So there are studies done in the UK Biobank by Professor Yin Tai Yu.

we found university suggests maybe more than 70% of dementias are preventable. Some of that, particularly at the higher end, would require significant societal change. Because we know that socioeconomic status, socioeconomic deprivation play a big part here too. Access to education, nutrition, all those kinds of things. but if we focus on, say, the 45% that come from the Lancet report, then we're just talking about things like blood pressure.

Lipids, preventing brain trauma, preventing or treating obesity, diabetes, avoiding smoking, excessive alcohol, right? These are kind of like the standard public health advice could be enough to prevent 50% of dementia if sort of everybody did it. I will say that when we talk about dementia prevention.

We're really talking about it at the population level, right? Right now, I think it would be impossible to say, I can definitely prevent dementia in this one person, right? because it's still a complicated system and multiple risk factors interact in different ways in different people. but we can dramatically decrease dementia risk individually by engaging in physical activity, quitting smoking, avoiding brain trauma, you know, hearing aids and

cataract surgery if we need them, right? Because we know these cognitive impets are important. you know, social connection, sleep, all these things, and nutritional status, again, all these things sort of really can stack up to dramatically decrease dementia risk. So this combination of knowing, expecting that we can maintain function, knowing that there's a lot that we can do to decrease our risk of decline over time, I think these are really important takeaways.

The the final piece of that, because you mentioned genetics, and obviously genetics do play a role, you can look at genetics in multiple different ways. So one is you could look at major genetic risk factors like your ApoE status, you know, your ApoE4 gene in particular.

Claudia von Boeselager (38:44)
I have a single copy,

yeah. So from Dale Bredison's work he says it's a thirty percent lifetime chance if you do nothing about it. right. I don't know what your view is.

Tommy (38:51)
Yeah, so that's one way to look at it. Another way to look at it is compared to people who don't have any copies, you have something like a two to six fold increased risk. Again, if you don't do anything. This increases to six to twenty fold, maybe around fourteen fold on average if you have two copies. now, what's interesting is that all of the data that I've seen on Apo E4 says it's not a fixed risk factor.

It's a risk multiplier. So people who have at least one copy of ApoE4 who smoke have a much higher risk associated with that smoking. Same with excessive alcohol intake, same with being sedentary, same with having a poor quality diet. What that means is you also get more benefit if you address those risk factors, right? Because you've offset that.

greater risk that comes from this risk multiplier of having ApoE4. so there are studies that suggest that people who have at least one copy of ApoE4 may get more benefit from dementia prevention standpoint from exercise, for example, Exercise is great for everybody, but for people who have elevated baseline risk because of their genetics, they may get more benefit. which is good news, right?

Claudia von Boeselager (39:53)
This is good news. Okay, thank you. this is great.

Tommy (39:56)
Because coming at it from another way, there are several populations around the world where having one or two copies of Apo E4 does not increase your dementia risk. So this tells us it has to be an interaction between genetics and other risk factors. so for those who are interested, examples include the Bolivian Chumane, the Nigerian Yoruba, certain indigenous populations in the US. and there's even some evidence for people of Sicilian Italian heritage.

Where ApoE4 doesn't increase risk of heart disease and mortality. This is the paper they looked at, which is another risk factor with Apo E4 if you live in Sicily, but it does if you live in the US. it's really this

Claudia von Boeselager (40:33)
I wonder why.

Tommy (40:35)
interaction between ApoE4 and environment. And there seems to be a lot that people can do about that. In particular for ApoE4s, it seems that neuroinflammation, so inflammation in response to these risk factors is amplified.

By ApoE4. So there are anti-inflammatory interventions that seem to have more benefit in people who have at least one copy of ApoE4. So statins are a good example. There's a recent meta-analysis that found that ApoE4s may be more likely to benefit from a statin, but that's probably because of the anti-inflammatory effect rather than the cholesterol effect. And there are some randomized control trials that actually show something similar. So that's one way of looking at genetic risk. Another way is looking at polygenic risk scores, right? So

You can have thousands of genes that add or decrease your risk of dementia, and that they all kind of add up to some overall risk score, which you can get from some places. Mainly right now they're mainly useful for research. I wouldn't usually recommend that people get them done because I don't think they're that good. but in the studies that have done that have looked at this, you get benefit from making basic lifestyle changes, you know, exercise, sleep.

et cetera, regardless of your polygenic risk. So even if you're at elevated genetic risk, you can still decrease that risk of dementia by engaging some of these basic lifestyle behaviors. And the final thing is you could think about genetic risk in terms of family history. If you have a family member who has dementia, you have an increased risk of getting dementia. and some of that is related to genetics, but actually a lot of it is related to shared risk factors. So if

you're had a parent who had dementia, you are probably, statistically on average, likely to eat like them, move like them, sleep like them, right? So there may be risk factors in the environment that we assume it's driven by genetics, but actually it's driven by the environment. We just have similar environments to it to our family. So an example for me, my grandfather had dementia, died with dementia. He was an alcoholic. So

If I drank a lot of alcohol, which I don't, but if I did, that would be a shared risk factor that I would really pay attention to because I know that there's susceptibility for me in my sort of like family context. So

one way to think about it is think about what risk factors did my family member have that may have contributed to their dementia. Can

Claudia von Boeselager (42:43)
Mm-hmm.

Tommy (42:43)
I pay special attention to those for me because I know that could be important in terms of my own risk?

Claudia von Boeselager (42:48)
No, I think that epigenetic factor, right? The environmental is so important In my mother's case, when we did all the different diagnostics using Dale Bredison's protocol, he's the end of Alzheimer's program. And I want to talk about your book also shortly. my mother had multiple head trauma events. and one that really expedited her dementia, which we only then figured out actually there were telltale signs before that we just didn't pay attention to, that had we known then what we know now, like we could have

gotten on top of things and hopefully she would have been in a better place. But that

and then lack of HRT, lack of estrogen and postahysterectomy in Ireland in the 1990s

And I think, you know, that's the complexity of it. There's so many different underlying potential drivers and factors it's not the one magic pill that everyone is hoping for. but you actually have to do something about it right?

Tommy (43:31)
yeah, absolutely.

Claudia von Boeselager (43:32)
great.

I want to touch on sort of more frontier areas, looking at things like, you know, exosome stem cells, looking at peptides, psychedelic,

I'm curious as to what you're seeing, what you're excited about, what you would caution about. Obviously, it's all quite new. And there was the study that just came out of Brazil of the non-speaking Alzheimer patient, N of one, right? So not a representative double blind placebo trial, but who was given a psilocybin and was then speaking after 16 hours and then was given a second dose later on. So can you walk us through what you're seeing, hearing, what's making you excited, if at all?

Tommy (44:06)
we actually do some exosome or extracellular vesicle research in my lab as as potential neuroprotection neuroprotectants. these are being used in various different longevity clinics around the world. And right now I would say that there's basically no evidence for them whatsoever.

That doesn't mean that they're not interesting. but where did they come from? What cells did they come from? Who did those cells come from? How were they stored? How were they administered? Like what's inside them? All of this we still haven't figured out. so it's coming, but anybody who says that they know what exosomes are doing right now, I would probably say they don't they don't really know, right?

but I understand that people are sort of like looking for therapy. So I understand why there's a drive to take them. But right now I don't think we're close enough with exosomes, for example. And like for anybody who doesn't know, exosomes are like little vesicles that bud off of cells that have a bunch of stuff inside them. So like some proteins, some RNAs or things like that that can have some sort of like biological effects. So growth factors, yeah, yeah. So

Claudia von Boeselager (44:59)
And growth factor as well, I think, right?

Tommy (45:02)
we are testing them in the lab, but like I'm testing them in like literally in a test tube, in a dish, right? And so like

We're decades. At least one decade from it being useful clinically, at least for the stuff that we study. peptides, similarly, just so little high quality data on most peptides in humans. there are two like depending on how you classify your peptides, because it's actually just like a really generic term of something that has some number of amino acids in it. That's basically what peptide means.

Claudia von Boeselager (45:29)
Yeah. Signalling molecules, yeah.

Tommy (45:30)
so obviously often the GLP one receptor agonists are lumped into the peptide group and they're the ones that we have some of the best evidence for. I think for those who have evidence of metabolic disease, that hasn't been addressed or can't be addressed through other factors, I think you can significantly improve chronic disease risk and dementia risk you see large improvements in

Body weight, blood pressure, blood sugar, we know these are significant risk factors. So like insulin sensitivity, like super important. So

Claudia von Boeselager (45:55)
Insulin sensitivity, right? Yeah.

Tommy (45:59)
I mean, there have been recent studies. So the evoke studies used oral semaglutide to see if it could treat Alzheimer's didn't seem to have much of an effect. I think it's just too late. This is something that you want to address earlier in life. so I think judicious use of those in the right case, very, very important. Dramatically improve metabolic health.

and then the other one is cerebralysin in the setting of moderate to severe traumatic brain injury. we have several randomized control trials that suggest benefit there. So no, they haven't really been tested in sort of like concussions or milder traumatic brain injuries, but people have been like hospitalized because of a significant traumatic brain injury. I think there's some very interesting data on cerebralysin.

then psychedelics. I think again, super promising on multiple fronts, depression, other behavioral health or mental health disorders, would certainly be interesting to see how it comes along in terms of

dementia prevention treatment and prevention. We know that particularly in macro doses, they can have significant effects on neuroplasticity. Like a lot of that comes from animal research. But like when you do like connectivity measures on MRI and stuff, you can see significant changes in brain structure and connectivity after even a single dose of certain psychedelics.

And because I do strongly believe that the brain retains capacity for neuroplasticity even in the early processes of Alzheimer's, this is something that we could leverage. the question that I have, and this relates also to the technologies that I think are the most interesting right now, which are the like external stimulation technologies, transcranial magnetic stimulation, transcranial alternating current or direct current stimulation, random noise stimulation.

photobiomodulation with different frequencies of light, which there is increasing evidence for. Again, I don't think it's right at the stage where I would say people should start getting this, but we're getting close with some of them. A lot of what they do is by stimulating the brain directly, you're opening up the gateways of neuroplasticity. And just like psychedelics do, the problem is that once you've activated these processes, you need to direct them.

Somewhere. Like

so if you're trying to improve or reverse aspects of cognitive decline or improve aspects of cognitive function, you need to direct your neural resources to the right processes related to information processing, memory, executive function, decision making, et cetera. So I'll give you an example. A very good friend and colleague of mine at the University of Washington studies trying

transcranial magnetic stimulation in older adults who have either MCI, malocognitive impairment, or early stages of Alzheimer's disease. They

Claudia von Boeselager (48:24)
Can you explain what

that is, transcranial magnetic simulation? Just

Tommy (48:27)
Yes.

Claudia von Boeselager (48:27)
so people are like, What's this term? What is this? Just briefly before you dive in.

Tommy (48:30)
Absolutely. it's basically just stimulating electrical activity in the brain by shooting your brain with magnets or a magnetic field. you basically

Claudia von Boeselager (48:37)
So there's like magnets in here that are

Tommy (48:40)
put a helmet on and then you have a very directed magnetic field. so like if you're ever like a kid like me and you took a magnet and you like put it by your TV screen and you can kind of like see that it like warped.

the color because it like warped the rays in the tube. Right. So you can basically direct pulses of magnetic activity, which directs which actually stimulates action potentials in neurons in the brain. So you can like stimulate activity in the brain with magnets. And it requires you to have an MRI scan to figure out exactly this the right region of the brain to stimulate. And so they figured out.

That if you stimulate one part of the outside of the cortex, it actually feeds into the default mode network, which is interesting because that's where psychedelics primarily act by shutting down the default mode network. But because the default mode network is usually quite deep, you can't access it by putting like helmets on the skull, right? It's too deep in there. But there's one part of the brain where that kind of connects into the default mode network that they can stimulate with magnets.

But again, it requires a an MRI scan to know exactly where that is on your skull. but when they do this, every day, they see significant improvements in memory for about a week. And then it starts to kind of go back to where it was before. and so what I think.

You would need in this setting, and this is something that he and I have talked about. He came, so I have a podcast called the Better Brain Fitness Podcast. We interviewed him about this. So if anybody's interested in listening to it, they can listen to it there. But one thing that most of these stimulating technologies don't have yet is, all right, I've stimulated the brain, but then I don't tell that person what they should do with their brain afterwards. Right. And so I

think the next step is.

thinking about how can we open the gates for neuroplasticity in the brain? And there are other ways to do it. Exercise does it too, right? You don't need to shoot your brain with magnets, which sounds way scarier than it actually is. But if you're gonna open the gates for neuroplasticity, what are you then gonna do with your brain? What cognitive activity are you gonna engage in order to take like to get the most benefit out of this stimulation? And I would probably say the same thing about psychedelics, right? The people who really know psychedelics would say.

Right, you have your trip, but set and setting matters. the

Claudia von Boeselager (50:43)
Integration.

Tommy (50:44)
the debrief really matters, like working through all the things you experienced and what you saw, right? This is how are you leveraging the neuroplasticity that you developed during that period of time. So those are the things that I'm excited about, but we've still got a lot to figure out in terms of how to really get the most out.

Claudia von Boeselager (51:01)
This is a really interesting point, because I've had other psychedelic experts, et cetera, on set and setting and the integration after, et cetera. But it's true that, even with Ibogain, really interesting, the late Dr. Nolan Williams out of Stanford had researched that it can in open up sort of neuroplasticity for up to three months time, which is a huge window in opportunity. and so yeah, I think this is super fundamental. Actually, what is the protocol?

Protocol, right? It sounds a bit boring, but like what are the opportune things to be integrating and making sure that you're avoiding in that time? what would you say?

Tommy (51:28)
Yeah. And

I'll say this expands even further, right? There are decades of failures in Alzheimer's disease treatment, right? And could it be that right, so say you had a drug that removed amyloid, which we're very good at, doesn't seem to do that much. Is it just that you need to direct that brain to repair and improve?

On top of whatever therapy you've applied. It's the same if you give a supplement or a you know omega-3s or something. The brain doesn't just use them. You need to direct it to use them in a certain way if you want it to improve. So I think that this stimulus in the setting of removing risk factors, addressing risk factors, you know, other you know, psychedelics, anything else that we that we put in there, I think the primary

driver of improvements in brain function is still going to be how do you know how do we use that neuroplasticity once we've activated it. So you're engaging in physically or cognitively complex tasks that require us to use our working memory, use our decision making, process information more quickly. So one of the interventions we have the best evidence for, which is actually used in Dale Bredison's protocol, I did his training several years ago.

Claudia von Boeselager (52:32)
brilliant.

Tommy (52:33)
something like Brain HQ, right? the brain training platform. It was included in the pointer trial, which recently showed several benefits. it was used in the active study, which just showed that processing speed training can decrease dementia risks 20 years later. That paper just came out. And this is part of the brain HQ platform. But what it requires you to do, and what they have is it challenges you to process information more and more quickly. And that could be visual information, that can be auditory information.

And one of the things that we don't do as we get older is do things that require us to process information really quickly. Driving is maybe the only one where that isn't the case. But we don't play complex sports or, you know, do these things that require us to like constantly adapt to the environment or like you know very quickly process information because we just kind of do things at a little bit more sedate pace. So we do the same thing again and again and again.

Claudia von Boeselager (53:23)
They say racket sports are really good, right, for longevity

and the brain 'cause it's high speed balls coming at you and you need to react, right?

Tommy (53:29)
Exactly. And there are very few things in life where we really do these things that require us to rapidly process information. And I think that's one reason why some of these brain training platforms, the right ones, could be beneficial, is because it forces you to process information quickly. So that's one thing that I would definitely include in these protocols is as we remove risk factors or maybe as we stimulate the brain, how am I challenging the brain to recover lost function?

And processing speed is one of the critical ones.

Claudia von Boeselager (53:55)
I know we're well over time. I'd love to do round two at some point let's talk about your book briefly that's forthcoming. and then we'll close up for today and reconnect again.

Tommy (54:03)
Yeah,

sure. thanks so much. my book is The Stimulated Mind. It is out now, actually. It's available wherever you buy books. and really it covers all of the different things that we talked about today in terms of improving cognitive function on a daily basis and then decreasing the risk of dementia long term. everything from the way that different types of exercise improve different functions in the brain to

The importance of sleep to the the effects of hormones and menopausal hormone therapy, smoking, alcohol, the psychology of all of this, blood tests, all of that is in there. And so I sort of like try and bring it together in a framework where people can really figure out what's useful for them, where should they start, and kind of try and make it fun and approachable. Though if anybody wants the science, all the references are, you know.

directly listed in the book. So at the end of the sentence, I have a little number. You can go on

Claudia von Boeselager (54:48)
Yeah.

Tommy (54:48)
my website. There are two thousand papers on my website that are all the evidence that are in the book. If anybody wants to dig into, you know, a little deeper.

Claudia von Boeselager (54:55)
To no doubt.

I love it. Tell me, what are some of the things you're most excited about looking forward in the next two to five to even ten years time, in the space of cognition and neuroplasticity and brain function?

Tommy (55:07)
So two things mainly one is just at the population and you know government level, people realising that there's so much that can be done to change the trajectory of cognitive decline, prevent dementia at the individual and population level. And as people realize that, they're more likely to engage and support these different things that we that we know are going to be important.

because really realizing that it's possible is the first step. And I think that's

just starting to happen now. Obviously, we've had people like Dale who've been working on this for a long period of time. it's starting to kind of come to the forefront a little bit, which is great. and I think we can also improve access to some of this stuff. So there's a company in the US that I'm chief science officer of called BetterBrain.

Where you can get brain health coaching covered by health insurance. There's also a fully free version that has this AI tool that's trained on hundreds of papers on cognitive function and dementia prevention. So you can kind of say, How should I exercise? I have this much time, you know, here are my blood test results, what supplements should I take? And it's actually surprisingly good. and so that's available to anybody for free. and then

The final part of this, I think, is we'll increasingly realize that cognitive function is something that we can measure and track over time rather, you know, just like your blood pressure, right? your doctor measures your blood pressure so that ideally you can prevent having high blood pressure for long periods of time. Same with cholesterol, blood sugar, et cetera. and that's improving as well.

But with cognitive function right now, you can't get a cognitive function test until somebody thinks you have cognitive decline, right? And the cognitive tests that do exist only really look for deficits. They don't kind of allow you to kind of say, here's what your brain looks like, and let's just make sure it stays that way for the next 50 years, right? I think, you know, hopefully there's gonna be more of that, which is gonna be a really critical piece to all of this.

Claudia von Boeselager (56:56)
Very, very exciting. Tommy, thank you so so much for coming on. Thank you to audience for tuning in. Do you have any parting thoughts or message or inspiration for our audience today?

Tommy (57:05)
hopefully I already gave it.

Claudia von Boeselager (57:06)
Any parting thoughts?

Tommy (57:07)
thanks for listening and I hope that you can take away, you know, how much power we have to change over our cognitive function on a day to day basis, including if we have some increased risk, or maybe especially if we have increased risk. There's actually a lot we can do.

We have and hopefully that gives some agency and hope in that process.

Claudia von Boeselager (57:25)
Beautiful. Thank you so so much, Tommy, for coming on. Thank you, everyone, for tuning in. Beautiful conversation, Tommy. Thank you so much.

Tommy (57:31)
Thank you, for having me