<p><a href="https://peterattiamd.com/Tommywood/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230605-pod-Tommywood&utm_content=230605-pod-Tommywood-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230605-pod-Tommywood&utm_content=230605-pod-Tommywood-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230605-pod-Tommywood&utm_content=230605-pod-Tommywood-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Tommy Wood is an Assistant Professor of Pediatrics at the University of Washington, where he studies brain injury and how lifestyle choices and environmental factors contribute to brain health, cognitive function, and chronic disease. In this episode, Tommy delves into the complexities of age-related cognitive decline and explores interventions to counteract it. Drawing from his experience working with Formula 1 drivers, he highlights the connection between cognitive function and the right type of demands and training leading to improvement. Next, he explores the various theories on the different types of pathology in dementia and neurodegeneration. He makes the case that a large fraction of dementia is preventable through lifestyle choices and nutrient status, and provides an in-depth overview of interventions and supplements that support cognitive function. Finally, he provides a comprehensive overview of head injuries, including concussions and traumatic brain injuries (TBIs), discussing symptoms, how to mitigate damage following an incident, and long-term management.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Tommy's professional work, unique skill sets, and interests [3:00];</li> <li>Age-related decline in cognitive function and memory [5:45];</li> <li>Improving brain function with the right level and type of demand [20:15];</li> <li>Formula 1 as a model for how to perform under high cognitive demand and how to increase multitasking capacity [31:30];</li> <li>Advice for the person reaching middle life looking to mitigate cognitive decline [37:45];</li> <li>Tasks and activities that support and improve cognitive function [45:30];</li> <li>Neuropathology of Alzheimer's disease: exploring the role of amyloid and tau proteins [49:30];</li> <li>Why Tommy believes dementia research funding should be focused on environmental and lifestyle-based risk factors [1:05:15];</li> <li>Benefits of lowering homocysteine and boosting omega-3's, and evidence-based supplements that support cognitive function [1:09:00];</li> <li>A unifying theory of dementia [1:20:45];</li> <li>How muscular strength can help with both the prevention and survivability of dementia [1:24:15];</li> <li>Head injuries: comparing concussions against traumatic brain injuries (TBIs), mitigating the damage after an incident, and the long-term management of head injuries [1:29:15];</li> <li>Is hyperbaric oxygen treatment helpful after a TBI? [1:45:45];</li> <li>Supplements that aid recovery from a TBI: creatine, DHA, and choline [1:49:30];</li> <li>Demands faced by F1 drivers, and testing interventions to improve their performance [1:57:30]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
1. Lower Homocysteine, Boost DHA
To significantly reduce the risk of cognitive decline and brain atrophy (by 20% or more for each factor), measure your homocysteine and omega-3 (DHA) levels. If homocysteine is above 11-13, supplement with methylfolate, methyl B12, and B6; simultaneously, ensure 1-2 grams of high-quality DHA daily, as these nutrients synergistically support neuronal membrane health.
2. Engage in Resistance Training
Implement a basic resistance training program, even in older adulthood, to improve white matter connectivity, cognitive function, regulate blood sugar, and reduce systemic inflammation through myokine release and hormetic effects. This intervention offers significant benefits for both cognitive and physical health.
3. Sustain Lifelong Cognitive Demand
Actively work to increase cognitive headroom and absolute capacity throughout your lifespan by continually learning new skills and engaging in cognitively stimulating activities, especially after retirement, to mitigate age-related decline. Early life education and late-life cognitive activity are the most protective factors.
4. Prioritize Quality Sleep
Optimize your sleep quality and avoid sleep deprivation, as suboptimal sleep significantly impairs memory retrieval and overall cognitive function. Improving sleep can help improve the speed at which you access stored memories.
5. Cultivate Social Connections
Prioritize social interaction, as it is critically important for long-term cognitive function and is often under-discussed as a protective factor against cognitive decline.
6. Avoid Multitasking, Focus Deeply
Avoid traditional work-based multitasking and constant task switching, as it leads to a significant loss of focus time (around 20 seconds to refocus) and does not provide the beneficial cognitive stimulus needed for skill development or functional brain change. Instead, dedicate focused attention to single tasks.
7. Choose Complex Cognitive Activities
When engaging in cognitive activities, select those that are complex, interactive, and involve problem-solving (e.g., learning a new language, playing 3D video games, or complex dance) over repetitive, predictable tasks like crossword puzzles, as they drive greater improvements in cognitive function.
8. Opt for Open-Skill Physical Activity
Incorporate open-skill physical activities (e.g., dancing, table tennis, badminton) into your routine, as they involve reacting to the environment and others, leading to greater improvements in cognitive abilities compared to closed-skill, repetitive exercises.
9. Manage Post-Injury Body Temperature
After a head injury, immediately move out of heat-stressed environments and actively cool down if needed, using external methods or Tylenol to regulate body temperature (ideally below 36.5°C) for 24-72 hours, as preventing fever is critical for better outcomes.
10. Prophylactic Creatine for TBI
For individuals at high risk of TBI, consider a creatine loading phase of 20 grams per day for one week to significantly increase brain creatine levels, which has demonstrated neuroprotective effects in animal models.
11. Daily Creatine for Brain Resilience
Maintain brain creatine levels by taking 5 grams of creatine monohydrate daily, as this can offer neuroprotection against TBI impacts, mitigate cognitive deficits from sleep deprivation, and may improve mood.
12. DHA Supplementation for TBI
Supplement with 2-6 grams of DHA daily to mitigate neuronal injury from concussive impacts, as studies in athletes showed a decrease in circulating neurofilament light, a marker of neuronal injury.
13. Choline Post-Head Impact
After a head impact, consider supplementing with 1-2 grams of citicoline (CDP choline) daily, as evidence suggests it may improve neuropsychological outcomes in TBI survivors.
14. Consider Chronic Hyperbaric Oxygen
In the chronic phase (weeks after injury), hyperbaric oxygen therapy (e.g., 30+ exposures over several months at 2 atmospheres, 1 hour, twice weekly) shows potential for improving cognitive function after concussion or TBI, though current evidence is mostly from uncontrolled studies.
15. Optimize Reaction Time
To improve reaction time and overall performance, consider specific training for reaction time, optimizing caffeine timing and dose, and potentially supplementing with tyrosine or creatine. This is particularly relevant for high-demand cognitive tasks.