[00:00:00] Carl Lanore: [00:00:00] hey, Hey, welcome back to another episode of super human radio. Today is October 14th, 2020, and we have a really important show today. We're going to be talking about a class of drugs that may actually help progress or Alzheimer's disease, especially if you are predisposed to it in one way or another.

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[00:01:09] Welcome to the show dr. Elisa, Delano wood and Alex weekend. How are you today?

[00:01:16] Dr. Lisa Delano-Wood, Ph.D: [00:01:16] Wonderful. Thank you,

[00:01:17] Carl Lanore: [00:01:17] Carl. Now

[00:01:19] Dr. Lisa Delano-Wood, Ph.D: [00:01:19] made me really hungry, listening to pop tarts.

[00:01:24] Carl Lanore: [00:01:24] Yeah. That

[00:01:24] Alex Weigand - Doctoral Students: [00:01:24] sounds like a good snack

[00:01:26] Carl Lanore: [00:01:26] last long in my home. I could tell you that right now. Um, so, uh, I'm going to start with Alex because I believe that she's actually the lead author on this paper, correct.

[00:01:36] Dr. Lisa Delano-Wood, Ph.D: [00:01:36] Okay.

[00:01:37] Carl Lanore: [00:01:37] So Alex, what research. Preceded this research that made you look at this class of drugs and look for a connection to a Alzheimer's disease.

[00:01:49] Alex Weigand - Doctoral Students: [00:01:49] Yeah, it's a great question. What kind of spurred our research in the first place? Um, so I, and neural and interested in biological [00:02:00] markers and risk factors for Alzheimer's disease, um, and what I'm particularly interested in.

[00:02:05] And, and I think dr. Donna Wood is as well is, um, individuals who are at risk for Alzheimer's disease, but yet have. The disease. Um, and so we really want to know what factors are going to increase the risk and people who are doing okay right now. Right. So that ideally we can intervene early, um, and, and prevent any future decline.

[00:02:26] And so I came to st. Wilbur with that broad research interest. Um, and then I met dr. Delano wood and started working in her memory clinic that she's the director of. Um, and I'll let her kind of explain what spurred her interest in anticholinergic medications in particular, um, that it was kind of the combination of.

[00:02:47] Her clinical interests and my research interests that really got us wanting to look at this more. So,

[00:02:53] Carl Lanore: [00:02:53] so Alex, I have to ask why this topic, did you have someone in your family that succumb to [00:03:00] Alzheimer's disease?

[00:03:02] Alex Weigand - Doctoral Students: [00:03:02] Yeah, I think it's good. Great question. And I think it's something that many of us go into the field for, right.

[00:03:07] Because we have a personal connection to it. Um, so I do have several family members who have Alzheimer's disease, um, grandparents, a parent, other extended family members. And so it's something that is really near and dear to my heart and, um, something that. I definitely want to ideally spend the rest of my life studying and trying to find a cure for, um, and in terms of antiquated medications in particular, it's, it's something that I had kind of began to notice is that some family members who were on a lot of medications, um, seemed to be having a lot more cognitive problems than others and I, at the time, wasn't really sure if there was a connection there.

[00:03:46] Um, but it was something that was kind of in the back of my mind, as I began researching this field.

[00:03:52] Carl Lanore: [00:03:52] So Dr. Donna Woods, please, please explain. Yeah.

[00:03:56] Dr. Lisa Delano-Wood, Ph.D: [00:03:56] Yeah. I was just going to piggyback onto that. Uh, so [00:04:00] as Alex mentioned, I've been directing a memory clinic. It's sort of an interdisciplinary clinic that works with folks who have some concerns about their cognition.

[00:04:10] Um, and so it's, we're housed at UCF and we've been open since 2014. And over time, I just started noticing that there were kind of a, sort of a chunk of patients coming in. Having memory trouble often at younger age is a way out of, kind of whack for what you'd expect based on their age and started noticing that many of them, it was really just kind of like an totally I'm noticing really long medical list of drugs that they're taking daily.

[00:04:45] And started asking more questions about this, started asking about supplements as well. And over the counter medications that they might be taking started to do research on my own, because I'm a, you know, I'm a PhD, I'm not a medical doctor, but I started noticing this link [00:05:00] folks looking like they don't, they didn't have often.

[00:05:02] Other risk factors for Alzheimer's disease there, but they looked like on paper and, and after taking our tests look like they may be in the early stages. And really, it just came down to you kind of what might be explaining this for these individuals. We've ruled out everything else. We will provide them in deficiencies.

[00:05:20] We look for, or, uh, you know, history of stroke, all kinds of things. And I started just wondering more and more about the medication lists. And I noticed that some of them would come up different drugs often in the medication list for the patients I was seeing and found that, that there's actually a fairly large body of work research in this area.

[00:05:41] And this coincided with when Alex joined us here in San Diego, I said, gosh, I'd really like to embark upon this study. Would you want to sort of do this with me? And, you know, she just jumped right on board with this, um, and, and put together a really, um, An elegant study that I wouldn't have thought to put [00:06:00] together.

[00:06:00] It's so well done. The way that she referenced the medication dosages to the older adult population. The analysis that she ran and the way that she tied much of the findings to Alzheimer's biomarkers in each of the participants in this study. So that's sort of a long answer to your question, but it was just anecdotally notice this link in my own clinic work.

[00:06:27] And as we learned in grad school, often our clinical work. Informs our research. And this is really, I think a great example of that.

[00:06:35] Carl Lanore: [00:06:35] Yeah. A lot of great discoveries occur from connecting dots that other people just kind of step over. And when you start to look at the drugs that people are taking and you realize that there's, there seems to be some commonality.

[00:06:50] In the drugs and certain symptoms. It's very fascinating to me. So Alex, what, first of all, we're talking [00:07:00] about anticholinergic drugs. So let's discuss this class of drugs for a second. Anticholinergic drugs are used for a variety of different things from incontinence in women, um, to, uh, you know, nerve function issues to talk about these drugs, Alex.

[00:07:18] Alex Weigand - Doctoral Students: [00:07:18] Yeah. So they're, um, surprisingly common and a lot of people don't know that they all fall under this one class that we call anticholinergic. Um, and so yeah, you mentioned that you knew, you know, potential uses for these drugs. You're right. Urinary incontinence. Um, other common ones are allergies, um, which are available as over the counter medications.

[00:07:38] Um, a lot of. Medication for various heart or cardiovascular conditions. So it's really across a range of different, um, ailments that people may have, and maybe taking these medications. And often these medications are prescribed for these sort of. Um, what we call peripheral types of conditions, something that doesn't really have to do with the brain, right.

[00:07:59] Um, [00:08:00] be it incontinence or cardiovascular disease. But what we know from past research is that these medications actually have a big effect on the brain, even though they're not prescribed for anything related to the brain. And that effect is, um, a negative one. And so the way that anticholinergic medications work is that there is a chemical in the brain called a CDOT Coleen, right.

[00:08:22] And that chemical in the brain helps us with our thinking and memory. So the more of that chemical we have, the better we'll do in our general day to day thinking when we take anticholinergic medications, it actually reduces that chemical. And that's where we think the mechanism is, where it can actually impair our thinking and memory.

[00:08:40] We're taking these medications at too high of dosages or for too long of a time.

[00:08:45] Carl Lanore: [00:08:45] So the funny thing is that, um, we talk a lot about nootropics on the show and some of the nootropics are colon Erdrich they're Coleen based products. And so we know that, uh, Seattle [00:09:00] Coleen and it's donor, uh, co Coleen, you know, improve.

[00:09:05] Brain function, cognition, memory, uh, and so on. So when you think about these drugs, that actually anti-cholinergic, it makes perfect sense that they're affecting the brain. So did you find any, is it, is it well, describe this study, how was, how was this study designed? Let's talk about that.

[00:09:26] Alex Weigand - Doctoral Students: [00:09:26] Yeah. So, um, first I want to describe what was really different about our study in the beginning.

[00:09:31] Um, so as dr. Delano would alluded to, there is an existing body of literature and the research, um, that. Talks about how these drugs impact individuals who already have Alzheimer's disease or who have dementia. Um, but as I mentioned before, with mine and dr. Jelena Wood's research interests, we're really interested in people who are at risk for Alzheimer's disease, but don't yet have any cognitive problems.

[00:09:54] So we're, our study was unique in the first place was that we were looking at older adults who weren't having [00:10:00] any memory or thinking problems when they initially started this study. Rather than people who were already having some cognitive problems. Um, so that's kind of where we wanted to start with, to see how these drugs impacted people who were what we call cognitively normal.

[00:10:14] Um, so we took this group of about, I think it was about 700 older adults, um, around age, 70 to 80, um, who were cognitively normal at the beginning of the study. Right. We gave them, um, or they were given a battery of memory and things test to determine where their cognitive level was at. And so what we really wanted to see was over time, how these individuals would progress and their cognition, and whether those who were taking anticholinergic medications would progress at a faster rate or would decline at a faster rate.

[00:10:46] Um, so in our initial phase of the study, we just separated the parts of study participants into those who were taking at least one anticholinergic meditate medication, which was about a third of the sample. And those who were [00:11:00] taking no anticholinergic medications and found that those who were taking anticholinergics, um, actually had almost 50% increased risk of developing mild cognitive impairment, which is a precursor to home.

[00:11:12] That's

[00:11:12] Carl Lanore: [00:11:12] a significant amount. It's a significant

[00:11:15] amount

[00:11:15] Alex Weigand - Doctoral Students: [00:11:15] of it is. Yeah, we were, we were certainly surprised by how about in an effect.

[00:11:22] Dr. Lisa Delano-Wood, Ph.D: [00:11:22] And I'd like to say,

[00:11:25] Alex Weigand - Doctoral Students: [00:11:25] Oh,

[00:11:25] Dr. Lisa Delano-Wood, Ph.D: [00:11:25] first analysis. She showed that 75% of the sample were on two to four times. The recommended dosages, you know, the minimally, what they call the minimally efficacious dose for the medications.

[00:11:39] We didn't even. I think that we'd encounter that

[00:11:42] Carl Lanore: [00:11:42] medicating while they self medicating with higher doses or where they misprescribed higher doses.

[00:11:48] Alex Weigand - Doctoral Students: [00:11:48] So, I mean, I won't make any claims estimates, prescriptions since we aren't medical professionals, but I will say what I think what's happening is that with older adults, um, they're generally more sensitive [00:12:00] to these medications, which means that they need that less of it.

[00:12:03] In order to get the same effect, right? So older adults need less of the medicine,

[00:12:10] Dr. Lisa Delano-Wood, Ph.D: [00:12:10] academic preschool here and yet. Uh,

[00:12:15] Alex Weigand - Doctoral Students: [00:12:15] and, and yet these older adults may have been being prescribed as if they were 40 years old. Say. Right. And it wasn't really taken into account the fact that they're 80 years old and they're more sensitive to these medications and therefore we should be giving them lower dosages.

[00:12:30] So when I, um, when I conducted our study, I was really careful to make sure that we were looking at, at what would be the most effective, effective dose for older adults, rather than for the general adult population and taking that into account since there is that difference there. So it's definitely possible all that there, the, um, dosages were.

[00:12:49] We're too high, just for reasons that really weren't being considered since these drugs, as I mentioned, are often prescribed for conditions that have nothing to do with the brain, you know? Um, and it's [00:13:00] possible that there are some physicians prescribing these medications who aren't aware of their negative effects on the brain.

[00:13:05] And therefore aren't being as careful with their dosing.

[00:13:08] Carl Lanore: [00:13:08] You did blood work to identify markers, right? Is that how you identified the markers that you associate with the onset of Alzheimer's.

[00:13:15] Alex Weigand - Doctoral Students: [00:13:15] Yeah, that's a great question. Um, so we can actually do it through, um, one of the markers we looked at wasn't genetic marker.

[00:13:22] Um, which we can identify through saliva. And then another marker we looked at was a cerebral spinal fluid marker. So that's the fluid that kind of surrounds your brain and your spine. And we can just kind of, you stick a needle in a person's lower back and just extract a little bit of the fluid and a procedure.

[00:13:38] Um, it's a relatively common procedure, um, and you can get a lot of really great biological data that way, because it gives us an insight into what's going on in a person's brain without actually looking in their brain. We're just looking at the fluid that surrounds their brain. And there's a certain protein in that fluid where if you have higher levels of it, it really signifies an increased risk for [00:14:00] Alzheimer's

[00:14:00] Carl Lanore: [00:14:00] disease.

[00:14:00] What is that? What is it? What's the name of it?

[00:14:04] Alex Weigand - Doctoral Students: [00:14:04] So it's a, there are actually two proteins and we looked at the ratio of the two, one of the proteins is called Tao and the other is called amyloid.

[00:14:11] Carl Lanore: [00:14:11] And since associated with Alzheimer's disease and Parkinson's disease.

[00:14:16] Alex Weigand - Doctoral Students: [00:14:16] Yes, yes. Yeah. Since, since the early 19 hundreds they've been considered to be the two primary markers of all the timers disease, as well as other neurodegenerative conditions.

[00:14:25] So definitely an important marker to

[00:14:26] Carl Lanore: [00:14:26] have dr. Delano woods, um, would, I'm sorry. Uh, so acetol Coleen Estrace is the brake where acetylcholine is the gas pedal, right? Right. I mean, simplistically. Um, is there any the evidence that maybe some people overproduced, acetylcholine Estrace, uh, and maybe they're more prone to these anticholinergic drugs causing bad things for them.

[00:14:53] Cause you have, you, you know, you have the brake on real hard and then you removing the gas pedal entirely.

[00:15:00] [00:15:00] Dr. Lisa Delano-Wood, Ph.D: [00:15:00] I haven't seen any data to that effect. Um, you know, clearly we know that there are links to medical conditions, medications, neurodegenerative disorders. Um, but whether, I mean, we know that there is variability and different brain structures that we like that are important for memories.

[00:15:21] So, for example, the HIPAA camp, I, uh, are it's the most important memory structure as in the brain. And it is heavily dependent upon levels of acetylcholine to, to function and some people, I mean, it's, it's an interesting question that you pose. Some people are born with very large hippocampus and we know it's normally distributed in the population.

[00:15:44] Some just have smaller hippocampus. There's a debate, uh, about Duke who maybe are born with smaller hippocampus. Are they more vulnerable? Do they not have as much cognitive reserve to contend with a neurodegeneration over [00:16:00] time collapsed across. Just normal aging anyway. So it's hard to say there may be some sort of link.

[00:16:07] I haven't myself seen any, any data to that effect. Have you Alex?

[00:16:11] Alex Weigand - Doctoral Students: [00:16:11] Um, no, I haven't seen any data either. And I think I agree with you. It's likely that there's. Inter individual variability in those factors just as there are with a lot of different brain processes. Um, and it's certainly true that, you know, there could be differences in, you know, acetylcholine Estrace.

[00:16:28] There could be differences in the number of, um, acetylcholine receptors that are on a certain. Um, brain structure, which will reduce the effect of acetylcholine. Overall, there could be differences in the size of the brain structure that produces a CDOT Coleen. Um, and those are things we don't really know of in terms of existing individual differences, but we do know that all of those things are impacted on the trajectory to Alzheimer's disease.

[00:16:52] And that's why actually one of the, um, treatments now for Alzheimer's disease, which just is a symptomatic treatment rather than a cure, [00:17:00] it actually is an acetylcholine esterase inhibitor. There's a lot of double negatives, but essentially just means that it will lead to more acetylcholine in your

[00:17:08] Carl Lanore: [00:17:08] brain.

[00:17:09] At least spare. It will spare the acetylcholine if you know, saffron, Seren gas, which we all heard about years and years ago is a very powerful. Form of acetylcholine Estrace that lets all the subtle Coleen nerve synopsis just run wild and, and every organ fails and you just, you know, that's it you're dead.

[00:17:31] Um, so it, we know that it's a little subtle Coleen Estrace is very powerful, even in very, very small doses. Um, so, uh, when we look at the aging brain, Right. Obviously these drugs doing something that the normal brain shouldn't do because we're using these antiques culinary drugs they're causing the problem.

[00:17:55] Uh, but does your research also possibly point to a [00:18:00] stronger role in a CDOT Coleen in the onset of holes are Alzheimer's disease. You think.

[00:18:08] Alex Weigand - Doctoral Students: [00:18:08] It's a good question. And I'm not quite sure that our research directly points to that. Um, but I do think that in research, in this paper, I was finding a lot of links between acetylcholine and, um, in Alzheimer's disease. And that was a hypothesis. The Culinaria hypothesis of Alzheimer's that was. Pretty popular.

[00:18:28] I think maybe back in the nineties, I'll admit that was before I was born. So I'm, I'm not quite sure. Um, but, uh, but it kind of of died off in favor and we haven't really been looking at it as much as we had in the past. And so I think there is a small contingent of researchers that are really I'm finding.

[00:18:47] That it is a really important factor. And I think there needs to be a resurgence of research into a seagull Coleen and the region in particular that produces acetylcholine, which we know is especially vulnerable to [00:19:00] Alzheimer's disease pathology.

[00:19:01] Dr. Lisa Delano-Wood, Ph.D: [00:19:01] Um,

[00:19:02] Alex Weigand - Doctoral Students: [00:19:02] I think so I think really increases research in that area could lead to a lot of new discoveries.

[00:19:07] And I think our study, although it doesn't directly address it, I think brings people's attention back to the fact that this colon RJ pathway can be really important in Alzheimer's.

[00:19:17] Dr. Lisa Delano-Wood, Ph.D: [00:19:17] And there, and there is, there's more traction, I think for this type of research though, I think the knowledge is just not out there.

[00:19:24] Um, it, as much as we'd like it, particularly in primary care, but we're getting the message out. Alex was so patient, we actually spent a couple years trying to get this published and we wouldn't relent until, you know, we wanted this to be in a high traffic journal, like neurology, because we knew there was.

[00:19:42] Sort of as broad readership and that we would get, uh, you know, attention and, and kind of a light shown on this. The good news is, is that there are a few currently running studies that are called deep prescribing trials at one of our coauthors is, is running one of [00:20:00] those out in Indiana at Purdue. And so it's, it's nice that.

[00:20:05] There is slowly but surely there, there is more recognition, uh, and ways in which they're flagging older adults who may be present in the emergency department to say, Hey, they're on a couple of hard hitting anticholinergics and, uh, let's take a look at this and see a, do they really need to be on that medication and B uh, what, what's the dosing on that?

[00:20:29] And, and let's ask some questions about how they're doing cognitively. So. Um, I think that there is more recognition that acetylcholine is important, um, and that it may have impacts on all aging people, but it particularly on those who have, uh, specific Alzheimer's risk factors, which is what Alex shows

[00:20:49] Carl Lanore: [00:20:49] over the counter anti-cholinergic drugs too.

[00:20:52] That's another problem. So, you know, we talk about what the doctors are prescribing, but I remember there was a. Uh, there was an [00:21:00] article I read from you, men with ed that taking an end set and a large anti-coal or a dose of anti-cholinergic, they named some, some allergy medication you could pick up at Walgreens.

[00:21:10] So we know that these anticholinergic drugs are out there over the counter. So we don't even know some people, you know, when you look at self-reporting. You'll find that people under-report things that they think are bad behavior and over-report things that they think are good behavior. So there may be a lot of people out there who no one realizes they're taking strong anticholinergic drugs and doses that aren't appropriate for their age.

[00:21:33] Dr. Lisa Delano-Wood, Ph.D: [00:21:33] I love that you, that you bring that up, Carl, because I've now trained myself to directly ask every single patient. I, over time, I've gotten more pointed with it. And now I just ask if they have sleeping problems.

[00:21:50] Have you taken Benadryl to sleep and I go right to it because otherwise it doesn't often become uncovered. Sometimes patients say, well, [00:22:00] I would never tell my, my real doctor this. Uh, but yes, I, I take NyQuil every night. Uh, you know, and various other meds that are out there. And so it is something that I think in fairness, a lot of physicians just don't know about what kind of meds patients are taking over the counter.

[00:22:17] Uh, I think maybe they're not asking, but maybe patients are thinking to tell them, and I've never met a patient in all these years who has known about this link. Uh, that they have, there are some medications that they are taking that are quote anticholinergic and, and they don't really know what that, what that means.

[00:22:34] So we spend a lot of time in the clinic trying to educate folks around that, but it is really important because I think that just as much as we're seeing a lot of people on what was the mean, and you're in the study, Alex mean number of anticholinergics, was it almost six?

[00:22:49] Alex Weigand - Doctoral Students: [00:22:49] Yeah, I think it was about six or seven.

[00:22:51] Carl Lanore: [00:22:51] Hey, macro.

[00:22:53] Dr. Lisa Delano-Wood, Ph.D: [00:22:53] People were on there just on like a laundry

[00:22:55] Carl Lanore: [00:22:55] list, realize it, right. They taking all these drugs and they happen to have anticholinergics [00:23:00] and hang all of these over the counter remedies. And they all, you know, cause nowadays everything's a kitchen sink blend, you know? Oh, you know, cough cold expectorant, you know, fever.

[00:23:11] Anti-piracy it's like they, they put 16 different drugs in something you go home and you take it for one reason and the other 15 you didn't need. And so, and they got I'm sorry.

[00:23:22] Dr. Lisa Delano-Wood, Ph.D: [00:23:22] No. And that's what we're seeing is that patients are, so for example, major class of drugs that are, that are being taken by folks who are taking medical energetics, you know, their first sort of nerve neuropathic pain or nerve pain and they back pain.

[00:23:39] And these can be pretty hard, hard hitting as far as anti-cholinergic stores. And. They're not getting benefit. You know, many, many studies have Sean about a third of patients will get clinically significant benefit from these meds. So that means that, you know, another two thirds are taking these medications, really not [00:24:00] seeing much of an if any benefit.

[00:24:01] And so that what, what people are starting to ask is okay. Are you taking these meds? Are they helping you? Um, how long have you been on these? That's a lot of patients wouldn't even be able to tell us why they're still taking these particular medications if they're really benefiting the patient or not.

[00:24:19] And so, uh, as something that we're really hoping for is that physicians and patients work we'll sort of talk more, do things like what we call a medication reconciliation, sort of revisit often the medications that they're on, really look at that clinical benefit. Uh, try a junk therapies, uh, you know, like for depression psychotherapy, for example, and meditation, yoga, um, and, and, and be thinking about these effects, particularly when patients are on more.

[00:24:50] Then one anti-cholinergic, but we don't want to downplay. I think these medications can be really important for a lot of people and benefit many people. And, and that, you know, patients who [00:25:00] are thinking about trying to come off, some of these medications really need to do it in concert with their physician and taper off, but really have that conversation.

[00:25:08] So it's a real balance, right? I mean, these medications are critical for a lot of people, but for many they're not, they're not helpful and actually harmful,

[00:25:17] Carl Lanore: [00:25:17] you know, Alex, I'm going to go to you before we take a break, but this is a lot bigger than I thought it was. Okay. And I'll tell you why I say that. I know so many older people.

[00:25:31] No. Now I realize anticholinergics to help them sleep at night and they're not, and they're not aging well, and you know, I know young people that are using them, you know, and so that, I don't know how many. Doses of, you know, NyQuil is sold every year, but it's really scary. So many people use these drugs and they are drugs, uh, for inappropriate reasons, you know, they're using them because they want to sleep as [00:26:00] opposed to the real call, the real reason, like the flu or something like that.

[00:26:04] Um, it's really scary. Cause you know, Dr. Dale Bredesen has been on this show. Uh, 14 times the first time he was on the show was when he first published the first 22 patient study from UCLA. I believe it was, uh, and now he's written a fantastic book and, uh, end of Alzheimer's, you know, uh, I've never talked to him about this, you know, we've talked about.

[00:26:27] Genetic predispositions, you know, inflammatory park, uh, or Alzheimer's wet, all that, you know, we talked about all these different things that we talk about lifestyles, uh, which I have a question on when we come back from the bar, I think about that, but I've never heard him talk about it, anticholinergic drugs.

[00:26:43] And he's, you know, he's top of the food chain right now in the old center. And I think you guys have been, didn't do something that is like unbelievable right now. This is really amazing course. And it's not even the culinary tricks that are being prescribed. It's the stuff that people are just buying at the grocery store or [00:27:00] Walgreens and just Downing on their own.

[00:27:04] Dr. Lisa Delano-Wood, Ph.D: [00:27:04] I think it's a good point. I, you know, we've kind of got problems on both sides of it, sort of the prescription, but the over, over the counter as well and the dosing, but you have sometimes older adults, like I think you alluded to this call kind of tweaking their own. Dosages themselves. I'll just double up, you know, I'm not sleeping very well, whether it's over the counter or prescription.

[00:27:25] So it's very complicated,

[00:27:27] Carl Lanore: [00:27:27] Alex. So the, the effects of the anti-cholinergic were fairly acute. Right. Did it take there, was there a long onset to start to see cognitive changes or were they relatively short?

[00:27:37] Alex Weigand - Doctoral Students: [00:27:37] Mmm, that it was relatively short. So when we looked at people who progressed to mild cognitive impairment, we looked over a period of 10 years, but there were a number of number of people who progressed within the first two to three years.

[00:27:50] Um, and then beyond that, we also looked at individuals rate of decline in certain domains of cognition. So in their memory and their language and [00:28:00] their, um, thinking abilities, and we found that. People who are on anticholinergics even within a two to three year period, we're showing a faster rate of decline on these different cognitive abilities, um, which really suggests that it is a pretty fast onset and something that we don't know that I would love to study in the future is really looking at the cumulative effect of these medications.

[00:28:20] So we were just examining people who we saw were on these medics. Patients at one time point for at least a few months. Um, but it's possible, some people were taking these medications for 10, 20 years. You mentioned young people take these medications. I know I take allergy medications. And, um, and, and so it really makes you question, you know, At what point should we start considering these effects and not just in older adults, but also in younger adults.

[00:28:45] And I know reflecting on it for myself, I've thought, well, I would just kind of take an allergy medication every day, just because I didn't think it really mattered. And just in case I had a bad day and since doing this study, I've realized, well, maybe I should kind of [00:29:00] start to be more, um, More take into more consideration when I should take the medication when I shouldn't, instead of just absentmindedly taking it every day, same thing for sleep medications, right?

[00:29:10] Maybe it's less important to take them on the weekend if you don't have to get up early for an appointment. Um, so I think these medications, we have a powerful effect than we really need to consider. The time course. Um, and, and making sure we're intervening with these things early and overall, it's just increased in everyone's awareness of these medications and their negative effects

[00:29:28] Carl Lanore: [00:29:28] because people think if they could pick it up, you know, over the counter it's innocuous, it's no big deal.

[00:29:32] Oh, well this is over the counter. I don't have to worry about it. I can take it as much as I want. And, and that's just not true. We're going to take a quick commercial break. When we come back, I want to talk about, um, metabolic disorders. And how it correlates with the effects of these, uh, anti, uh, culinary magic, uh, drugs, because I'm wondering sometimes, you know, we know that people [00:30:00] who are metabolically deranged, they tend to develop Alzheimer's more frequently.

[00:30:04] So there has to be an intersect somewhere and maybe they're not taking anticholinergic drugs. Uh, or, but, but in fact, you know, maybe there's some sort of intersect between these, uh, these two domains. So let's do this. Let's take a quick commercial break. We'll be right back. Stay tuned. You're listening to superhuman radio.

[00:30:23] You are listening to the superhuman channel. We're ripped and we're ready.

[00:30:33] welcome back. We're talking with dr. Lisa Delano wood. And Alex Wiegand, who is a doctoral student. So obviously this situation of, uh, developing Alzheimer's diseases is multifactorial. We know that now, and this obviously plays a role, [00:31:00] uh, anticholinergic drugs play a strong role. We know that. What, what about, uh, the.

[00:31:08] Metabolically deranged individual, right? Somebody who is, you know, these are the people who tend to develop, um, these types of problems. Where is the intersect in your research? And some of the other research out there that shows what happens to the metabolically deranged brain.

[00:31:30] Alex Weigand - Doctoral Students: [00:31:30] When I go first, Alex or?

[00:31:32] Sure. I'll go ahead. Um, so yeah, so I'll admit that I don't do very much direct research interest into this area, but, but can speak to what I know about it. Um, and we do know in general that. Metabolic condition. Um, the gut microbiome that all of these things have an impact on the brain, right? You wouldn't know, they're not directly related to the brain.

[00:31:54] The brain doesn't work in isolation. It works in concert with the rest of the body. Um, similar to how we know that [00:32:00] cardiovascular conditions that affect the heart can also affect the brain or blood flow. Um, So I think all of these sort of peripheral factors are really important to consider in the pathogenesis or the onset of Alzheimer's disease.

[00:32:13] I think interestingly, where, um, metabolism may intersect with our research on anticholinergic medications is that metabolic disorders can really affect, um, the way that these medications are metabolized. Right. So the way that they're absorbed, the way that they're excluded the way that they're distributed throughout the body.

[00:32:30] Um, and it's possible that individuals with certain metabolic conditions that may either lower the levels of Oracle and orthopedic patients they're taking, or it may exacerbate them. Um, and of course that will have downstream effects and affecting the brain and the potential for Alzheimer's disease.

[00:32:49] Dr. Lisa Delano-Wood, Ph.D: [00:32:49] Interesting. A thought. Alex. Yeah, I hadn't thought about that, that individual variability on that, but I think this is a really good point call and we, you know, we didn't spend much time in the [00:33:00] paper and linking to it.  um, and I, part of that is sort of word limits and either the study was, yeah, it's already really enormous.

[00:33:11] And I'm thinking you've given us a good, a good idea for maybe a, a followup study, because we know that there is a link between sort of. Metabolic deterioration and, and neuro inflammation and what we see in Alzheimer's disease and other neurodegenerative disorders. I think it's pretty, the good news is, is that this is growing area of research.

[00:33:34] There are more folks, uh, you know, devoting time to trying to study the link between inflammation and neurodegeneration. It's poorly understood at this time. Uh, but it's. Something certainly that we can look into, we know acetylcholine dampens down inflammation. And so perhaps if you're on these medications that are blocking acetylcholine production and, and the [00:34:00] effects between synopsis that then maybe, then you're allowing more inflammation to, to sort of take over.

[00:34:06] But definitely an interesting question and something that we're w w. We want to study more in the future.

[00:34:13] Carl Lanore: [00:34:13] Were you able to look at dietary Coleen intake and these individuals, you know, so, so many people are afraid of eggs today. I mean, I ate, I just ate a half a dozen eggs before the show today. I eat a lot of eggs.

[00:34:25] I love eggs. They're a great source of protein. They're magic. Um, but you know, so many people, you know, they won't eat an egg because they they're afraid of cholesterol, you know? It's like, so what about, what about dietary Coleen intake? Is it possible that could offset some of these problems possible that because people are so, uh, Coleen scared that they, they, they could be different, but how come with somebody who's consuming more colon in their diet?

[00:34:55] What do you think? I'm

[00:34:56] Dr. Lisa Delano-Wood, Ph.D: [00:34:56] glad I did. That's a third, a third paper, Alex.

[00:34:59] Carl Lanore: [00:34:59] I want [00:35:00] to be, I want to be, I want to be on the paper. I want to know my name. I'm a big, and you know, you have this big dummy and then you put my name underneath it. No, but what do you think? Do you think

[00:35:11] Dr. Lisa Delano-Wood, Ph.D: [00:35:11] that

[00:35:13] Carl Lanore: [00:35:13] the fear of Colin, what do you think Alex?

[00:35:17] Alex Weigand - Doctoral Students: [00:35:17] Yeah, I think there it's good things to think about the really just in general, the effect of nutrition and, and what we can gain from these lifestyle factors on, on how it impacts, um, you know, on how it impacts the brain and our cognitive health. Um, I'm not, I'm not very familiar to be honest with the, the notion of, you know, Calling and food and, and people avoiding it, but it makes sense, like you say, people avoiding certain foods because they have connotations of it.

[00:35:43] Um, and what we do know of diet impacting Alzheimer's is that there is a link there, right? We do know that nutrition is really important, especially since that's. One of the areas where we can intervene and Alzheimer's, there are so many areas that can't intervene yet. It's because we don't have the medical treatments for it.

[00:35:59] Um, but [00:36:00] diet we can, and, you know, a Mediterranean diet, so lots of Omega threes, fish, nuts seeds, um, and of course, you know, eating your leafy greens, we know that that can have a positive impact on the brain and may do so through things like dr. Lee Delano would mentioned such as inflammation. Um, but I'll let, let dr.

[00:36:19] Dewana would speak to speak to this more if she has anything to add.

[00:36:22] Dr. Lisa Delano-Wood, Ph.D: [00:36:22] I think that that was all wonderful. And I would say that I, you know, as Alex was being born, um, it was becoming more, uh, when I, when I entered the field, it was funny. We used to think of the brain is so separate from the heart. And so this idea that vascular risk factors like high blood pressure, high cholesterol, all these things might impact the brain was really shockingly.

[00:36:44] It really was. And it's really kind of gained so much favor it's now, like not really debated anymore that there are these important links between vascular risk factors and brain health. And even links to Alzheimer's disease more recently. So once I [00:37:00] say, Alex kind of started moving into this field, there has been this new site guys through this pendulum swing to, uh, and it really dovetails with what you're doing.

[00:37:08] Carl, trying to get the word out that as, as Alex said, sort of these environmental factors are really critical. So the national institutes of health for example, is kind of going all in on, on diet and exercise as modifiers of brain function. Uh, and some, some of the really promising studies, these are showing you can bend the curve on it, on Alzheimer's disease, even in people who have, or clinically they're on the path.

[00:37:33] Uh, so, and she references sort of a one die, the Mediterranean diet. And so we recommend all of our patients. Yeah. Hey, there are like a hundred books out there. Go find one, try to stick to something like this. There's the mind diet, you know, there's Dale Bredesen's, you know, um, diet, but certainly there is a strong, long link, but I will admit our field is kind of new on the scene.

[00:37:55] Yeah. And your idea called it to sort of say, well, what, what [00:38:00] supplements are people well taking that might have Coleen in them? And how are they eating? Uh, is, is an understudied question in general, but it is something that we really should look more at it when we're trying to look at these analyses and make these conclusions know in terms of implications of the science.

[00:38:16] Carl Lanore: [00:38:16] So sleep is critical for memory consolidation, obviously. And we would talk about Alzheimer's disease and stuff like that. We're talking about memory consolidation, things get fragmented, the brain isn't storing things. The way it's supposed to short term memory is gone, but you can remember something that happened to you when you were four years old.

[00:38:32] So obviously the brain is functioning, but it's like, it needs to be defragged or everything needs to go be in re retagged again. So what about. Sleep in the role. I say this specifically because a lot of people take NyQuil. You know, they take these drugs that are

[00:38:53] Dr. Lisa Delano-Wood, Ph.D: [00:38:53] the one I was forgetting. Yeah.

[00:38:55] Carl Lanore: [00:38:55] They take these drugs to sleep.

[00:38:57] My father did it, and he [00:39:00] really declined when he started using that. Now that I think back. But what about these drugs? What if the real harm that these drugs are doing is at night when memory consolidation actually occurs, when your, when your hard drive gets defragged and everything gets indexed. If the effect is at night time, do we know that.

[00:39:21] Dr. Lisa Delano-Wood, Ph.D: [00:39:21] I think that's genius. That's a fourth paper now, are you taking notes, Alex?

[00:39:26] Carl Lanore: [00:39:26] Okay.

[00:39:26] Alex Weigand - Doctoral Students: [00:39:26] No stupid sleep is such an important area in such a growing area of research. Um, for lots of different reasons, you brought up the notion of memory consolidation, which is really important, right? We can form these memories throughout the day, but they don't really.

[00:39:40] Turn into longterm memories unless we consolidate them. And that happens really rapidly during sleep. Um, and so it's kind of a tricky balance because we want someone to get a good night's sleep because we know if they have poor sleep that will lead to an increase in Alzheimer's pathology, amyloid, and tau that I mentioned earlier.

[00:39:57] Um, but then we also don't necessarily want them [00:40:00] to be taking. Too many medications, they put themselves to sleep. If those medications are going to also increase their risks, right. So it's a delicate balance. And I think it's up to being careful about. Not self-medicating, but make sure you're working with a doctor, um, and also examining an options for sleep that don't have an impact on, um, the culinary brick system.

[00:40:22] So, you know, one that's over the counter with melatonin, right. And that can be a good option.

[00:40:27] Carl Lanore: [00:40:27] 20, 25 years I've been using melatonin. 25.

[00:40:31] Alex Weigand - Doctoral Students: [00:40:31] I think melatonin is great. And if people find that that isn't working for them, there are other sleep drugs you can get through a prescription, um, that don't really impact the call energetic system as strongly.

[00:40:41] And, and I, you know, would, if you're having sleep difficulties, I would encourage anyone to. Explore alternative options other than Benadryl or NyQuil, for example, and really considered working with a doctor because we do know the importance of, uh, sleep in, um, in reducing Alzheimer's [00:41:00] pathology. And then it's a feedback loop where if you have more Alzheimer's pathology, it's more likely to affect.

[00:41:05] The brains region that produces a CDOT colon. And so if you're attacking the brain region that produces acetylcholine, you're going to have even less. And that leads to effectively what would be the same as taking an anticholinergic medication. Um, so it's a really interesting dynamics between sleep and medications.

[00:41:21] Um, and I think the bottom line is that. Sleep is really important. So if you need to take medications to get a good sleep that's okay. But just make sure you're doing it with your doctor and being really cognizant of the type of medications you were taking.

[00:41:33] Carl Lanore: [00:41:33] The problem is a lot of these I'm sorry, go ahead, please, please.

[00:41:37] Dr. Lisa Delano-Wood, Ph.D: [00:41:37] I'm just going to piggyback on that car, what you were, what you were getting, which is that, um, often what the sleep agents, uh, do is they block stage four, sleep. People think they're sleeping better because of these medications, but they're not actually getting in that restorative stage for sleep. And that's when we know the brain is, is, is really doing the most work declare itself of the very proteins that we know are [00:42:00] building up in Alzheimer's disease, amyloid and towel.

[00:42:02] I just want to make sure to say that. Sorry to

[00:42:04] Carl Lanore: [00:42:04] interrupt. No, no, no, no. And I was actually about to speak to that. I was about to say, you know, uh, sleep is when the brain defrags and, you know, and taking a drug that I've said for years on this show, like taking a drug that makes you lay still for eight hours is in sleep.

[00:42:21] I can hit you in the head with a hammer and you can lay still for five or six hours. You're not going to wake up from that go. Wow. I feel great. You know, I mean, sleep has an architecture and if you don't adhere to that architecture, certain things start to go wonky in the body. And so I think that I also wonder if the combination of some of these sleep drugs, uh, in combination with some other things that you may be looking at could be like the push pole, you know, but he's using a strong sleep drug.

[00:42:52] A lot of times they disrupt sleep architecture and when memories are supposed to be stored and the [00:43:00] brain is supposed to be defragged, it's not. And when they, if they play a role. And some of the outcomes, cause obviously some people don't suffer from anticholinergics. Some people, you know, it's not like a hundred percent of the people use the anticholinergics all develop memory problems.

[00:43:15] So the people that don't are the most interesting to me, like, okay, what are you doing differently? You know, what's different about you.

[00:43:23] Alex Weigand - Doctoral Students: [00:43:23] Well, yeah, it's a really good one. What you bring up about the medications and how, you know, they may or may not have a positive effect. And one thing I want to mention since we are psychologists first, dr.

[00:43:34] Donna Wood, and I, um, is that there are psychological interventions for sleep as well that you can do. And, um, and replacement of medications, or as you're kind of reducing your medications, um, because we don't really want to take a medication that's going to. You know, make us lay still, but really disrupt our sleep in general.

[00:43:54] And so there's, there's interventions, um, through cognitive behavioral therapy, um, and sleep [00:44:00] hygiene as we call it that can really help improve your sleep. And so some of the simple things are to, um, not. Do things in your bed that aren't sleeping. So don't watch TV in your bed. Don't eat in your bed. Um, you're having trouble falling asleep.

[00:44:12] Don't just lay in bed awake. Don't keep looking at the phone, but maybe get up and go sit the quiet area until you start feeling drowsy and then go back to bed so that we can really associate the bed with sleep and just making that association with bed with. Sleep can really help improve your sleep architecture and your sleep quality.

[00:44:28] Um, so considering even, you know, not just alternative medications, but also alternative interventions or strategies is another really important thing to consider across a range of the conditions that anticholinergics are prescribed for.

[00:44:41] Carl Lanore: [00:44:41] Yeah. I want to take our last commercial break. And did you have something you wanted to throw in there?

[00:44:45] Dr. Delano wood?

[00:44:46] Dr. Lisa Delano-Wood, Ph.D: [00:44:46] No, I was saying I couldn't have said it any better. I think that often we reach for maybe. The quickest answer or maybe the easiest thing, which is to get a script from our doctor or, you know, take some sort of medication. Uh, but there [00:45:00] are so many studies out there showing that a lot of these more behavioral strategies actually have more longer term benefits and sort of lasts longer, uh, in helping improve sleep quality.

[00:45:12] And a lot of individuals. So, uh, and then it's also, I think, important to be if sleep is such a problem to be assessed and you can, they have these things, you can sort of take home and, and you kind of wear it while you're sleeping and it can sort of show the sleep specialist exactly where of the 20 issues.

[00:45:28] This could be exactly what it is, is going on. Is this apnea, for example, which we know is pretty treatable. So, um, yeah, thinking outside of the box, I think is really important.

[00:45:37] Carl Lanore: [00:45:37] When we come back, I want to pick up on all of that. Actually. I want to talk about that. I want to talk about it. Apps that people could download, um, that I've used for years.

[00:45:45] I, I measure my sleep three different ways because I know it's that important to my longevity and me keeping my job. Because if I can't remember things that I talked about years ago, I'm screwed. So let's talk about that on the, uh, on the other side of the break, stay tuned. [00:46:00] We'll be right back with your superhuman radio, the superhuman channel where brawn and brains finally meet.

[00:46:11] welcome back to super human radio. We're talking with dr. Lisa Delano wood and Alex Wiegand about a study linking, uh, some anticholinergic drugs to 'em. Problems and development of Alzheimer's disease. It makes perfect sense. You know, thanks to dr. Bell Bredesen's research. We know that all timers disease in a lot of cases can be reversed.

[00:46:35] If you remove all of the different insults that's everything from going to sleep. On time, not eating right before bed time, uh, hormone, uh, adjustments sometimes for some people, dietary adjustments for some people. So the nice thing about, uh Alzheimer's, uh, and some of these, uh, cognitive declines that we see in people is that they, they respond pretty [00:47:00] effectively to lifestyle changes.

[00:47:02] Then that's exciting to me because it's, you know, it doesn't mean that. You've got this and you, you have to have it for the rest of your life, if you a well-informed. So some of the things that I use at bedtime to help me sleep that don't impair cognition. At least for me, I use a fairly moderate dose of melatonin.

[00:47:23] Uh, three, three milligrams. Um, I use three grams of glycine. Um, glycine is an amino acid that increases brain Gabba. But it works better than just taking Gabba. Because taking GABA by itself can have some excitatory effects for some people, but glycine makes you, makes you tired and sleepy. And then the other thing is I take a very, very low dose of, of magnesium citrate, uh, because magnesium is another one of those.

[00:47:53] Uh, um, it's a mineral, but it's, it seems to have a kind of, uh, relaxes the [00:48:00] brain a little bit. And I use these I've used these for years and my, my, my stock and trade is my memory. Being able to re you know, talk about an interview and then think about an interview. I did six years and, and, and inject it. Um, I think that there's lots of beneficial things that people do you can use to help sleep.

[00:48:20] But one of the most profound things that I discovered, which most people will shutter at the idea of not having their cell phone on all night long on their nightstand, because I know we're all brain surgeons and all of us have a brain coming in on the frozen brain that we have to replace tomorrow morning.

[00:48:37] And we can't sleep through that phone call, but, you know, There's so much good research out there that shows that a RF generally above 900 megahertz has such a profound excitatory effect on the brain that it will even cause deep sleep, late sleep latency up to an hour. If you take a phone call on a cell phone or holding up [00:49:00] against your head, and it's a 20 minute phone call that will keep you from getting into deep sleep by almost an hour.

[00:49:08] I mean, there's so many things that we do. That are causing some of these memory problems that we have because the nighttime bedtime that's when the brain, defrags the hard drive. That's what it does. All its hard work and, and, and, and indexes stuff. So you can remember it in it later on. And it's just amazing to me, how many things we do today, right up to, you know, I put blue blockers on at night, two hours before I want to go to bed.

[00:49:33] So that. That blue light. Isn't telling my, my, my adrenal glands. Hey, it's still daytime now. Now I want to just shut her off and go bed. And I'm laying there thinking about every single thing I did that day. So there's a lot of things that we can do to help preserve a memory storage and, and cognition. But unfortunately they're not popular in today's high tech environment.

[00:49:54] Alex Weigand - Doctoral Students: [00:49:54] What do you think? Yeah, I think, um, I am not [00:50:00] very familiar with the research area, but I think it makes sense that the radio frequency oscillations can impact your brain oscillations. Right? I mean, it's all in the end at an electrical current. Um, and I do think where having your phone away from bed at night can help is also if you're having difficulty falling asleep.

[00:50:16] I think we all have a tendency to keep track. In our phone, right. Or right before bed, we kind of scroll through our emails or social media or something. And, and one, the blue light, as you mentioned, it confuses our brand. And it makes us think that it's daytime and not nighttime. And two, it really keeps our brain kind of active and alert, right.

[00:50:35] Because we're, we're engaging in these, these things with our phone, um, rather than kind of calming down doing some breathing exercises, you know, and, and making sure that our body is really ready for sleep. Um, And as we mentioned before, we know that sleep is so important in the progression of Alzheimer's disease and, and modifying your sleep to make it have a higher quality can really reduce the progression and slow the progression of [00:51:00] Alzheimer's.

[00:51:00] So I think you're absolutely right that working on these environmental modifiable risk factors is the best thing we can do for Alzheimer's right now, at this time where we don't have a medical cure for it. What do you think

[00:51:13] Carl Lanore: [00:51:13] dr. Delano would.

[00:51:15] Dr. Lisa Delano-Wood, Ph.D: [00:51:15] Yeah, I couldn't have said that any better. I agree. Um, and then you have the additional.

[00:51:20] People watching TV from their beds, you know, late and, uh, you know, and that can, can definitely interfere as well. And I think Alex's point about just, you know, checking email before bed and, you know, even if you're not, if you think you can consciously block that stuff out, it's still there. You're still, you know, worrying about, Oh gosh, tomorrow.

[00:51:40] Well, I've got X, Y, and Z going on and I have this deadline over here and that's there and that can. I can definitely interfere, but, um, yeah, I don't know as much about radio-frequency work, but, and I don't know how much that that truly is being studied or at least in a clinically like translate later in a [00:52:00] way, but definitely interesting thoughts.

[00:52:02] Carl Lanore: [00:52:02] It is. And you know, where most of the good researchers coming from Scandinavia because they've had cell phones way longer than we have. And they, and you know, every Scandinavian person in Sweden, they know you don't leave your cell phone on next to your bed. Cause even if you have it on silent, that thing is talking to the cell tower all night long.

[00:52:21] And I know when I accidentally leave my cell phone on, cause I wake up in the morning and I go, I feel like I didn't sleep. And Oh my God, I left my cell phone on. I know it for a fact. Um, but you know, I blame for all of these problems. Michael Douglas and Charlie sheen. Because in the movie wall street, Gordon gecko is walking on the beach and Pacific Palisades and it's like five o'clock in the morning and the sun's coming up and he's on his cell phone and bud Fox is still asleep and he says, You don't make money while you're asleep.

[00:52:54] And people heard that and they thought, Oh, wow. Yeah. It's like now, now I [00:53:00] have, I have a friend I'm not gonna mention his name. He was building a company and he was not sleeping like for a couple years. And he got colon cancer. And I swear to God, I'm telling you, I was, you know, when you become metabolically deranged cancer and all these other diseases, just come in and swoop down on you.

[00:53:18] Um, But people today think sleep is optional. Oh yeah, I'm good. I don't have to sleep. You know, I'm going to wake up, stay all night and I'm sleep three hours. Trust me, you do that long enough. You that's, you know, that's one of the things that dr. Dale Bredesen, one of his interventions, you go to sleep at nine o'clock every single night, and you don't eat three hours before bedtime.

[00:53:39] So. Anyway, that's my

[00:53:42] Dr. Lisa Delano-Wood, Ph.D: [00:53:42] in academia, you have a contingent, sometimes the folks who they kind of wear it as a badge of honor, you know, I, I only requires three hours of sleep at night.

[00:53:51] Carl Lanore: [00:53:51] Yeah. Good luck with that. Yeah.

[00:53:54] Dr. Lisa Delano-Wood, Ph.D: [00:53:54] Yeah. I think it's a good point. And you know, that's one thing I can

[00:53:56] Alex Weigand - Doctoral Students: [00:53:56] say about our field

[00:53:57] Dr. Lisa Delano-Wood, Ph.D: [00:53:57] of neuropsychology is that [00:54:00] we are pretty up on.

[00:54:01] Sleep, uh, sleep deprivation, quality. What does this mean for brain health? Uh, and trying to better understand those links because it, it, it is, it is all very complicated. There are a number of variables that are sort of intervening there, including negative mood. How does that impact sleep? Um, in, in this pandemic, we're not getting as much exercise.

[00:54:21] You're not getting outside as much vitamin D levels, you know? Uh, it's, there's just so much to, to consider, but it's a clear. There is no debate that poor sleep, uh, is predictive of, of Alzheimer's onset general population.

[00:54:37] Carl Lanore: [00:54:37] I showed up here and I don't expect you guys to answer it, but, but, um, so you do, you know, a deep sleep inducing.

[00:54:43] Peptide is. We did a show about it about four years ago. Right?

[00:54:47] Dr. Lisa Delano-Wood, Ph.D: [00:54:47] It's educating a lot here.

[00:54:51] Carl Lanore: [00:54:51] It's a gray area peptide that, uh, if you, but you have to inject it first thing in the morning, this is what people don't get. They buy a DSIP and they [00:55:00] inject it before bed and it wrecks your sleep. But what it does is it synchronizes circadian rhythm.

[00:55:04] So you take it first thing in the morning and you get deeper sleep that evening and it does work. So Danny Geraldo who lives in, uh, Columbia and watches the show. He said, would it be useful to include DSIP and melatonin to improve sleep? I don't, I don't think you guys want to talk about DSIP, but what about melatonin?

[00:55:23] Are you, are you fans of melatonin?

[00:55:26] Dr. Lisa Delano-Wood, Ph.D: [00:55:26] You know, it's not our area of expertise. Um, we might know a little bit from just what we've heard in the media. Uh, I, for me, uh, I would say. The data that I'm aware of. And this may be a few years old are kind of equivocal, some studies showing a link to improve sleep and other studies showing, uh, not so much.

[00:55:49] And so, um, that's sort of what I recall. I bet I certainly have seen in the clinic. Patients who swear by it and really believe that this has [00:56:00] done more for them than any other medication. They've tried. Alex, are you familiar with the melatonin?

[00:56:05] Alex Weigand - Doctoral Students: [00:56:05] I'm not so familiar with the literature, but what I can say is, and speaking to our study is that we.

[00:56:11] Are worth that melatonin does not affect the culinary Dick system, whereas some other sleep drugs do. Um, so in that sense, I think it can be a, um, a possible good alternative to maybe some of the other options or at least a good starting point.

[00:56:25] Carl Lanore: [00:56:25] So Peter, we're talking about anticholinergic drugs, so he's asking what class of drugs he came in late.

[00:56:31] And then the last question that I don't think we can answer about small percentage of people who. Who require less sleep than the rest of the population. I've read that before, but I don't buy it to be honest with you. I think there's some people who can get by with less sleep, but metabolically, you know, sleep is so profoundly important.

[00:56:50] It creates onset of type two diabetes. Like even just one night. They did a study in Colorado [00:57:00] with Olympic. Athletes. And they, they forced them to have only five hours of sleep, two nights in a row. And their blood sugar management was that of an 80 year old. They became completely metabolic drains after two nights of short sleep.

[00:57:15] So when it comes to sleep, I think that, you know, I'm sure there's some rats that like to be up in the daytime, but most of them are up at night and I'm sure there's some humans that maybe they can get by with a little less sleep, but by and large, now, listen, I want to thank you both for being on the show today.

[00:57:30] This is fascinating. And I really think this is very, very important research because. There's a lot of people who take these drugs over the counter and prescribed, they may be, that's why they may be overdosing on it. They've got this drug with it. Then they got this over the counter product that they're using.

[00:57:46] And, um, and this is many of them could, if they remove this insult, they could re regain their normal cognition, perhaps.

[00:57:56] Dr. Lisa Delano-Wood, Ph.D: [00:57:56] We went, we wonder about that. And we would recommend that, uh, a [00:58:00] talk to their physicians ask about the meds that they're on. Ask about the dosing, uh, and then be, there is you can find on the internet, it's called the anticholinergic burden scale.

[00:58:09] Is that right? I have to call it cognitive anti-cholinergic burden scale, a B S and it'll list, all the medications that have known anticholinergic effects, and then better than that, it kind of ranks them from sort of. Least bad to the very worst, um, and sort of coded either a number one, a two or a three, three being the worst.

[00:58:32] And so some of the like tricyclic medications for depression are on there. Benadryl is a three, uh, I believe drama mean even is there. Of course NyQuil those kinds of things. So, uh, it could be very useful, could be very helpful for people to be empowered in that way, understand what they're taking and then engage frequently with their physicians about the medications.

[00:58:51] Yeah.

[00:58:51] Carl Lanore: [00:58:51] Don't just not take it. Don't just stop taking it.

[00:58:56] Alex Weigand - Doctoral Students: [00:58:56] Yeah, exactly. I completely echo what dr. Delano would said, you know, do your own [00:59:00] research kind of, and empower yourself. Um, but make sure to talk to your physician, to work out a plan. If you plan to switch any of these medications or stop taking any of these medications,

[00:59:10] Carl Lanore: [00:59:10] and especially if you're starting to notice memory decline, if you're starting a routine, I forgot where I put my keys six days in a row, you know, definitely have this conversation with your physician.

[00:59:20] In fact, have a conversation and say, am I on any anti-cholinergic drugs that you've prescribed for me? You know, you may not realize they're anti-cholinergic, there's so many of them, the ones for women, that bladder incontinence, this is some powerful anticholinergic drugs that women are taking for bladder incontinence.

[00:59:35] So,

[00:59:35] Dr. Lisa Delano-Wood, Ph.D: [00:59:35] yeah. And to, yeah, Oxy oxybutynin is, is a big one that there is starting to get more widespread awareness about that particular medication, thankfully, um, recognizing when people are on that and immediately making changes.

[00:59:49] Alex Weigand - Doctoral Students: [00:59:49] And I'll also just say, if anyone is experiencing memory decline or cognitive problems, in addition to talking with your primary care physician and you can consider seeking out a neuropsychologist, which is what [01:00:00] dr.

[01:00:00] Delano would is and what I'm training to be. Um, because we really do specialize in assessing your cognitive and daily function to try to figure out if there's something that may be going on and what we can do to help.

[01:00:11] Carl Lanore: [01:00:11] Okay, well, right

[01:00:12] Dr. Lisa Delano-Wood, Ph.D: [01:00:12] sooner rather than later. Yeah. We see, we often see folks coming into the clinic and there there's already been kind of a lot of, um, you know, insult to the brain.

[01:00:20] And so yes, I was going to say exactly what Alex said in closing. Definitely bring it up. Um, even if it might be kind of scary to say, Hey, I don't know, my memory doesn't seem as, as good as it used to be. And I wonder if it's outside of what you would expect for normal aging. Can you refer me to a neurologist or neuropsychologist?

[01:00:38] I think that that's an important question to ask and make sure to bring that up. That's your next Val.

[01:00:45] Carl Lanore: [01:00:45] Very good. Very good, great interview. I love the research. I hope that if you discover something new, um, that you come back and talk about it, and if you happen to use one of the ideas discussed on the show, maybe you could put my name on something who knows.

[01:01:00] [01:00:59] Dr. Lisa Delano-Wood, Ph.D: [01:00:59] Yeah. We'll circle back to you. I think Alex says you're right. I think we have your contact information and yeah.

[01:01:06] Carl Lanore: [01:01:06] You don't want my name on your paper? You don't want my name on your paper. Thanks for being

[01:01:11] Dr. Lisa Delano-Wood, Ph.D: [01:01:11] certainly given us a lot of food for thought you've given us. We really appreciate this is really, really,

[01:01:17] Alex Weigand - Doctoral Students: [01:01:17] yeah.

[01:01:17] We appreciate the platform.

[01:01:18] Carl Lanore: [01:01:18] Thank you. Take care. Take

[01:01:21] Dr. Lisa Delano-Wood, Ph.D: [01:01:21] care, guys.

[01:01:22] All right, we're going to take one quick commercial break. And when we come back, we have, uh, a couple things to talk about, about the show. So stay tuned. We shall return. We'll gain with it. This is the superhuman channel where we use oxygen for the power of doing

[01:01:45] welcome back.

[01:01:49] Sleep is probably the most important thing in memory function. When we talk about Alzheimer's disease and dementia, almost all of these people. [01:02:00] They either drink alcohol before bed to help them get to sleep. Um, or they drink a lot of alcohol and they think it's helping them sleep. Um, we, we have destroyed our sleep in this country.

[01:02:16] Uh, you know, when I was young, man, I'm 62 years old. Now when I was a young man TV stations went off at midnight. So there was nothing to watch after midnight people didn't have the option of. Turning their TV on at two o'clock in the morning and watching something and more, more and more people got it, good sleep.

[01:02:37] And I really think a lot of it has to do with the amount of RF that we live in today. The studies on how RF excites the brain at night. When you have your cell phone next to your bed, or you don't unplug your router, like I do. I know people think I'm crazy. I unplugged the router. I unplugged the cordless phone, you know, no cell phones on now, [01:03:00] nothing I can do about that router and my neighbor's house, the new home we just bought, we just bought a new home and it's on an acre of land.

[01:03:09] And so we have a definitely a lot more space between us and the neighbor, but RF travels. It's not like as though that space is going to save me. I'm going to do an experiment that a new bedroom, the new master bedroom is going to be completely RF retardant. There'll be no RF getting into the bedroom and I'll divulge more of this and I'm even going to do a little plan.

[01:03:36] So you can do it yourself at home, but you can completely block radio-frequency from getting into your room. If you want to. And then, then, you know how people go on vacation? They go camping. They say, Oh, I slept so good. Oh, cause I was off the grid. You can create a room in your home where [01:04:00] you can be off the grid.

[01:04:01] I'm going to do it. And I'm going to take all of you with me when I do it and show you how I do it. And these are all things that you can buy on your own. I've already put together a shopping list and. You could actually make an RF free room. Boom. I predict I'm going to sleep better, is going to sleep better.

[01:04:23] And I predict that I'm going to notice a difference in how I feel after sleeping in it for a couple months. So I will take you on that journey with me very shortly, and we should be moving into the new house in a couple of weeks, maybe two or three weeks. And, uh, I'm going to have the painter use a special paint that I've acquired, and we're going to put a window dressings up that RF repellent, and we are going to put something they're going to be, it's a hardwood floor, but we're going to put an area rug in.

[01:04:58] I'll probably have a small [01:05:00] space around the periphery of the room. I mean, maybe I can block it from beneath. As opposed to on top, but I think I'll be able to get about 90% of all the RF out of my environment when I sleep. And I'm really excited about this. So they tuned, I will share the blueprint if you will.

[01:05:19] So you can do it yourself as well. I experiment with it and do it myself. And that's really it for today's show. Um, I hope you enjoyed it. You know, anticholinergic drugs. They're everywhere. So if you have an elderly loved one, find out if they're taking any of these drugs to sleep for anything like that.

[01:05:39] And if you notice their memory declining, you need to help them stop using those drugs. I will see you tomorrow with more superhuman radio. Thank you for watching. And listening today. [01:06:00] .