Superstar neurologist and CNN journalist, Dr. Sanjay Gupta, has just written a riveting new book about brain health. KEEP SHARP is filled with all sorts of useful myth-busting and brain-building tips for us all. Undoubtedly a must-read!
An Excerpt From KEEP SHARP: Build a Better Brain at Any Age by Sanjay Gupta, MD
By many measures, an Alzheimer’s diagnosis stirs more fear than any other major life-threatening disease, including cancer and stroke. Each of us at some point will know someone who is living with a form of dementia, be it a family member, friend, or oneself, and the diagnosis will likely be the most devastating that person has ever received. At the time someone hears the news, the awful statistics around Alzheimer’s really start to set in. There is no cure, and no new drugs to treat symptoms of dementia have been approved for fifteen years, as 99.6 percent of drug trials terminate in failure and well over four hundred dead ends have cost billions of dollars.
We’ve known about Alzheimer’s for more than a century and cannot treat it easily, let alone cure it. It’s a difficult, complex disease that remains a killer. Dementia also takes a devastating emotional, financial, and physical toll on the families of those who are diagnosed with it. In 2016, nearly 16 million family members and friends provided more than 18 billion hours of unpaid caregiving assistance to those with Alzheimer’s and other types of dementia.
That’s all bad news, no question, but while writing my latest book, many people reminded me of the signs of hope that are starting to emerge. Remember, every form of cancer was incurable forty years ago, but now people are surviving. In 1981, HIV came on to the scene and even that’s now survivable—some would say close to curable. Researchers strongly believe that we will see not only new treatments for dementia in the near future but also novel diagnostic approaches to detect problems early and intervene much sooner for better outcomes. They believe there may be some sea changes coming that will improve both the length and quality of life for those living with dementia. Dementia doesn’t have to be a conversation ender; the old notion of “diagnose and adios” needs to be reframed. Life doesn’t end for people with dementia. Much to the contrary, many people can find renewed purpose and a zest for life after the diagnosis, though most do have to go through a grieving period as they accept their diagnosis and plan for their future. That future can feel like the great unknown that involves a lot of uncertainty. Everyone’s journey is different, but everyone can personalize it to match their unique needs and resources.
When I started in the world of journalism, I thought I’d be reporting on health policy and the direction of our health care systems. It was the sort of work that I had done at the White House and formed the basis of much of my writing earlier in my career. As much as I have planned my life, though, my pivotal moments have happened suddenly and completely unexpectedly. I started at CNN in August 2001, and three weeks later, the tragic attacks of 9/11 happened. Immediately, I was the only doctor working at an international news network during the unfolding crisis. Shortly after that, I was covering the conflict in Afghanistan, the anthrax attacks, and the war in Iraq. It was a case of professional and personal whiplash. Having come from a tiny town in rural Michigan, and having had no exposure to war zones or the military, it was a challenging experience to be completely immersed in a foreign world where the stakes were so high and personal safety was a real concern. I was instantly struck by the first responders, nurses, and doctors who so often rushed in to save other people’s lives while putting themselves in the line of fire. To this day, I will never forget the first time I saw that complete and genuine selflessness. And in this past year, while reporting on the pandemic, I’ve seen such a scene over and over again.
Writing a book about brain health has been no different from writing about my experiences out on the battlefield or in an area devastated by a disaster. When it comes to dementia, we are at war. Some people bristle at metaphors that conjure up battle. But I’ve witnessed the disease cause as much devastation and darkness in families as any other type of calamity. There are numerous casualties when it comes to any neurodegenerative disease. Not only does the individual patient suffer; so does everyone else around him or her—from family members and friends to additional caregivers brought in to help (many of whom volunteer). It’s emotionally and physically draining. And then there are the costs in time and money. Adding to the toll is the sheer frustration from a general lack of progress in research circles to arrive at a cure. Victims languish in the limbo of a long-drawn-out disease that can go on for years or even decades with no hope for a cure. Conversations always teeter awkwardly between hope and honesty. But the approach to treatment for dementia is beginning to change. The conversation no longer needs to be solely one of desperation. Instead, we can focus on improvements in care and reshape the experience—particularly with early diagnosis and interventions—showing those with dementia and their caregivers that it is possible to live well with the disease until the elusive cure is found.
The key to treating dementia is prevention, and it just so happens that the same things you can do to reduce your risk for the disease are what you can do to improve your quality of life as you live with the disease. Alzheimer’s disease typically begins in the brain up to twenty to thirty years before symptoms develop. This presents an opportunity to intervene and delay or even prevent Alzheimer’s disease altogether. Remember this because the gap of time between brain changes occurring and symptoms surfacing was mentioned by every expert I spoke to while doing my research. It’s called the preclinical time, and studies of lifestyle interventions are beginning to show that patients can gain improvements in their prognosis with attention to diet, exercise, sleep, supplements and drugs when necessary, intellectual stimulation, and stress reduction—all the strategies I’ve built into a 12-week program. The goal is to turn back the clock and delay the progression of the disease. If you can’t entirely prevent the illness from developing, then at least you can stave it off for as long as possible.
It’s estimated that delaying the onset of dementia by only five years can cut the incidence rate in half, vastly improving life and well-being for people and reducing health care costs for families and society. Over the next few years, I believe there will be significant progress in early detection techniques for Alzheimer’s with the help of technologies like artificial intelligence and big data mining to find biomarkers in a simple blood draw.
I’m excited for what the future will bring us in our understanding and treatment of diseases as complex as Alzheimer’s and other forms of dementia. Even that word, dementia, may one day be forgotten. With new therapies on the horizon, I don’t think it will be fair to label anyone with “dementia” if they can go on to live a life with an ailment that is kept at bay. Our entire vocabulary and the narrative around degenerative brain diseases will change with promising new preventive solutions and treatments for symptoms. Preventing and treating brain ailments will not be reduced to a single action, but will entail a multipronged approach. The solutions will probably encompass an array of things, from modifiable lifestyle strategies and daily habits to medications and gene therapies.
My teenaged kids will probably be among the first of many generations to come who will push the limits of human longevity—living long and sharply into their nineties and beyond. With the dawn of personalized medicine upon us and the explosion of new drugs and therapies that can revolutionize and democratize medicine, we’re on the precipice of a new era in our evolution as a species. The pace of change will only grow faster.
There will always be a place for good old-fashioned habits like eating more vegetables and working out regularly. But those time-tested habits coupled with what’s in store for us tomorrow will ultimately make for the best life—one that we will want to remember and will be able to remember.
From Keep Sharp by Sanjay Gupta, MD. Copyright © 2021 by Sanjay Gupta, MD. Reprinted by permission of Simon & Schuster, Inc. All rights reserved.