A Story of the Brain, by Sandeep Jauhar, MD, PhD
(As originally featured in the Spring / Summer 2023 Issue of Tracy Anderson Magazine)
When I was growing up, my father, a plant geneticist’s, favorite saying was “Non-science is nonsense.” He wanted me to become a doctor–one trained at Stanford, no less. To him that was the pinnacle of professional attainment. But I wanted nothing to do with his dream. I was more interested in literature and philosophy and many other subjects besides. When I was a freshman at Berkeley, I informed my father that I was not going to pursue a career in medicine but was instead going to major in physics. In the culture I grew up in, youthful rebellion was saying no to a career in medicine–but then majoring in physics!
After a dear friend of mine got sick with lupus, I eventually came around to pursuing medicine. In medicine, I discovered, there was so much fascinating science, much of it unexplored. At the same time, medicine had an essential human dimension that I could explore through storytelling.
My new book, My Father’s Brain, is a mix of the kind of science and storytelling that has motivated me throughout my career as a writer. The book is a memoir of my relationship with my father, especially during the last stage of his life, as he succumbed to dementia, but it is also about the brain and memory and the history and science of brain degeneration. In the book, I set the story of my father’s descent into Alzheimer’s alongside my own intellectual journey to understanding his disease.
So many of us go through the difficult journey of caring for a loved one with Alzheimer’s but then never want to talk about it after it’s over–it is often that painful. This was not the case for me. I felt compelled to write about my family’s journey so that readers going along similar journeys would know that they are not alone. Though the story is personal, it is also in many ways universal–with conversations and conflicts that every family facing the mental erosion of an elder has. Caring for a loved one with dementia can be difficult and isolating. I hope readers will find understanding and perhaps even comfort in my family’s experiences.
At the same time, I felt compelled to dig into the science and history of dementia. In the book, I explore everything from ancient conceptions of the mind to the most cutting-edge neurological–and bioethical–research. I delve into what happens in the brain as we age and our memory falters, how memory gives meaning to our lives, even as it changes with time, how dementia complicates our understanding of what it means to have a self–and what all this means for patients, their families, and society at large.
More than 50 million people around the world, including 6 million in the United States, have Alzheimer’s or related dementias, and these numbers are projected to double in the next 25 years. Understanding this condition at a deeper level can help caregivers make sense of what a loved one is going through, as well as what to expect in the months and years ahead. For me, the times I was most frustrated as a caregiver was when my father behaved in ways that I did not understand. Knowledge gave me insight, a deeper sense of what my father was going through, but also empathy. It not only illuminated my father’s needs, but allowed me to take better care of myself, too.
My Father’s Brain, with its mix of science and storytelling, holds something for every type of reader. It is a book rich with humor and heartbreak, science and philosophy, and history and ideas. It also has some beautiful photographs. I hope people will read it, learn from it, and enjoy it.
What lifestyle and environmental factors contribute to Alzheimer’s?
Because there is such a strong link between the heart and brain, many of the same risk factors for heart disease–smoking, diabetes, obesity, high blood pressure, and a sedentary lifestyle–also operate in dementia. One study estimated that even modest reductions in cardiovascular risk factors could reduce the total number of Alzheimer’s cases by 1 million worldwide.
Do genetics play a role in Alzheimer’s?
Early-onset Alzheimer’s, which usually occurs before the age of 55, is primarily a genetic disease, but more typical, late-onset dementia–like my father’s–also has hereditary risk factors. There’s a gene involved in cholesterol transport in the brain that is found in more than half of patients with late-onset Alzheimer’s, with a frequency more than double that in the general population. This gene confers a threefold risk of developing Alzheimer’s if one copy is present, and an eightfold risk with two copies. It can be tested for by a doctor. Several other genes, most of them controlling immune-system activity in the brain, are also implicated in the development of Alzheimer’s.
Why is Alzeihmer’s sometimes labeled as type 3 diabetes?
There is a lot of evidence that certain genes associated with the development of Alzheimer’s also affect sugar regulation and insulin sensitivity in the brain. When insulin resistance occurs in bodily tissues, it is called type 2 diabetes. When insulin resistance occurs in the brain, it can lead to Alzheimer’s dementia, which is sometimes called type 3 diabetes because there is accumulating evidence that insulin resistance in the brain leads to suboptimal use of glucose, which can damage brain cells.
What impact does sugar have on your mental health and stability?
High consumption of processed sugars can lead to insulin spikes that are associated with poor concentration, anxiety, and impaired problem-solving. My advice is to stay away from processed foods and refined sugars as much as possible!
What are the impacts of sugar on your brain and heart?
Poor regulation of glucose levels in the bloodstream because of insulin resistance, also known as type 2 diabetes, often causes fatty deposits to plug up the pipes supplying blood to both the heart and the brain. Blockages in the heart can lead to heart attacks. Blockages in the brain can cause strokes and dementia. So insulin resistance, no matter whether type 2 or type 3, can result in brain damage.
How detrimental is smoking for your heart and brain?
Study after study have shown a strong association between cigarette smoking and both heart disease and dementia. Recent data suggests that daily or near-daily use of cannabis is also associated with an increased risk of coronary disease and heart attacks.
How do you reduce your risk of Alzheimer’s disease?
There are several measures people can take to lower the risk of developing dementia in the first place: eating a healthy diet, for example, and getting enough exercise. A study in 2015 showed that following a Mediterranean-type diet rich in whole grains, fish, and fruits and vegetables improved cognitive performance and decision-making among older adults over a two-year span. Similar studies have shown that higher levels of physical activity–even simple housework like cooking and cleaning–are associated with better cognition in older adults, even when Alzheimer’s brain lesions are present. Tracy’s approach is key here because it makes exercise fun and a part of a person’s daily routine. That’s essential, because the more we exercise and the more regularly we do it, the healthier we’re going to be.
Other measures that have shown preventive benefits include getting enough sleep, engaging in social and cognitive activities that stimulate the brain, avoiding smoking and heavy drinking, and minimizing stress. Your mind-set, your coping strategies and your capacity to transcend distress are also a matter of life and death.
What is the most common heart problem you see in hospitals today? Is this disease preventable and how?
The most common problem I encounter as a cardiologist is coronary artery disease, which often leads to heart attacks. However, this disease is preventable. Studies have shown that almost 4 out of 5 heart attacks can be prevented through lifestyle changes, such as a healthy diet, moderate alcohol consumption, no smoking, increased physical activity, and maintaining a normal body weight. People who adopted all 5 changes were 86 percent less likely to have a heart attack than those who did not.
My Father’s Brain by Sandeep Jauhar came out on April 11th, 2023. The book is available now at sandeepjauhar.com/my-fathers-brain.
To read more, head to our webshop to purchase the Spring/Summer 2023 Issue of Tracy Anderson Magazine.
