An Interview with Neurologist and Neuroscientist, Dr. Dean Sherzai
Dean and Ayesha Sherzai, neurologists and neuroscientists, husband and wife, are passionate advocates for lifestyle intervention to enhance brain health and prevent dementia. Parvati Magazine spoke with Dr. Dean Sherzai this month about the myths, facts, and science of Alzheimer’s dementia.
Parvati Magazine: There is a common perception that the risk of Alzheimer’s dementia (AD) increases with age. But you argue that this is not necessarily the case. What is the relationship between aging and AD?
Dr. Dean Sherzai: There is a direct risk relationship with age, but just getting older does not mean that you will get AD—we have to decouple those concepts. Chronic diseases of aging are cumulative pathology at the molecular level. While there is a balance between rejuvenation and chronic metabolic abnormalities, cells that do not regenerate (or regenerate at nominal levels), such as neurons, have to rely on rejuvenating capacity, such as getting rid of waste products. Cumulative lipid and glucose dysregulation, inflammation, and oxidation overwhelm the cell and its rejuvenating capacity. So instead, what we can do is to rebuild the cell by giving our bodies the right food, restorative sleep, and mental activity. You need more of these things as you get older, particularly if you are living up to 80 or 90 years old.
Parvati Magazine: Research into Alzheimer’s therapies has been disappointing, with few highly effective therapies. Why do you feel this is?
Dr. Dean Sherzai: We all want a drug that stops or even reverses the disease, but we don’t see that happening. There might be drugs that are disease-modifying, or that slow down the disease, but we do not think for a complex disease such as AD—which starts 20-30 years earlier with multiple prongs—that one drug is going to be the answer. A drug might be an adjunct in AD treatment, but it may not be able to affect the disease to the extent that we could with a lifestyle approach. While I think that drug studies should continue, we should understand that a more complex approach with lifestyle intervention at the population level can be very powerful.
Is Alzheimer’s Hereditary?
Parvati Magazine: How much do genes determine our risk of developing AD?
Dr. Dean Sherzai: For 3% of AD cases, particular genes are the driving force—in those cases, these genes are that powerful. For the other 97% of cases, the genes give you a risk range, meaning that if you have those genes, the risk is higher but the genes are not the sole or major determinant of outcome. For example, of those who have two copies of the presenilin gene (associated with genetic forms of Alzheimer’s disease), 50% never develop the disease—because of lifestyle intervention.
Parvati Magazine: You have developed the NEURO plan for optimum brain health. Why is this an effective model? Does it work for those individuals whose genetic profile may place them at higher risk for AD?
Dr. Dean Sherzai: Absolutely. The NEURO plan is an acronym for nutrition, exercise, unwind, restorative sleep, and optimizing mental activity. The first four are directly related to the four aspects: glucose and lipid dysregulation, inflammation, and oxidation. For example, nutrition can improve these. Studies consistently support both short-term and long-term benefit with a plant-based whole foods diet. Exercise also affects all four of these components positively. Sleep definitely has a relationship with these components; if you get one night’s bad sleep, inflammatory markers in the body and brain go up on the next day. Optimizing mental and social activity affects the connections between neurons; people who exercise and who are mentally active throughout life have more connected neurons and bigger, more connected brains. This connectivity has been shown to be protective against AD. We have profound control over our brain health.
Parvati Magazine: There are several “brain games” available today for people to play on their computers or phones. Do you recommend them? Do they play any role in helping to prevent AD?
Dr. Dean Sherzai: I was surprised (by our research), but these games that people play on the computer, Sudoku, and crosswords are helpful. More importantly, real life complex activities are much more helpful at engaging multiple areas of your brain. So interact socially with friends, which also increases emotional engagement.
Dr. Dean Sherzai is co-director of the Alzheimer’s Prevention Program at Loma Linda University Medical Center, and is dedicated to educating people on the simple steps to long-term health and wellness through research, online writing, videos, and books.