Book review: The Ageless Brain: How to Sharpen and Protect Your Mind for a Lifetime, by Dale E. Bredesen.
As expected, The Ageless Brain repeats a good deal of information from Bredesen’s prior groundbreaking books about Alzheimer’s. Maybe 10% of the book seemed like ideas that I hadn’t seen elsewhere.
This time, he’s focused a bit more on cognitive decline in people who are young enough to not be at much risk yet for full-fledged Alzheimer’s. But that doesn’t create much of a difference in his advice for brain health.
It continues the trend of his books being increasingly about improving general health, rather than avoiding a specific disease. More than his prior books, it prioritizes lifestyle improvements over detecting problems.
I see a good deal of variation in the quality of his advice, but nearly all of it is worth trying if your risk seems high.
Exercise has a great risk / reward ratio, and is backed by RCTs.
Bredesen has gotten pretty ambitious about pushing exercise (recommending more of it than does exercise nut Peter Attia!). I exercise more, and more regularly, than do most people, but I’m not going to manage to do as much as Bredesen suggests as long as my mind continues to function well above average levels.
Other suggestions are more poorly supported:
media sources that tell people how to think and encourage them to believe that people who are not exactly like them are wrong (or even “evil”) are robbing their consumers of the cognitive challenge of adjusting their ideas and expectations of others over time. That may be why highly partisan people (on any part of the political spectrum) are more likely to suffer from faulty memories, struggle with perception of reality, and difficulty distinguishing fact from fiction. [16]
I expect there’s some sort of correlation there, but I don’t see a serious attempt to figure out how the causality works here. Avoiding partisanship seems like advice that has a great risk / reward ratio, but I’m unclear on whether preventing cognitive decline is an important part of why we should adopt it.
The book has a frustrating chapter on why the mainstream medical establishment hasn’t adopted Bredesen’s approach. It’s about half right. I wish he’d written less on this topic.
At least one third of the problem is that there’s almost no way to fund impressive studies of treatments that aren’t protected by patents. There’s at least a book worth of additional problems that could be written about what’s wrong with the medical establishment, but Bredesen doesn’t seem like the right person to write that book.
Note that the establishment hasn’t completely ignored Bredesen’s ideas: Back when Bredesen’s first book was published, the Alzheimer’s Association website said that Alzheimer’s “cannot be prevented, cured or even slowed.” Now it says:
evidence is strong that people can reduce their risk by making key lifestyle changes, including participating in regular activity and maintaining good heart health. Based on this research, the Alzheimer’s Association offers 10 Healthy Habits for Your Brain — a collection of tips that can reduce the risk of cognitive decline.
That’s a watered-down version of Bredesen’s message, presumably aiming at people who are only conscientious enough to follow a small fraction of Bredesen’s advice.
Most people should read Bredesen’s The End of Alzheimer’s first, and only read both if you’re at significant risk of cognitive decline.