Michael, how are you . I have got my outside voice. Fantastic. Welcome, it is such a beautiful day. We have got snowcapped mountains, we have the desert, clean air and you have got a bunch of people who are just settling down. Youre interested in what we are going to talk about today. I want to thank you for spending time in coming to hear what i have to say. How many of you would like to live to be 100 or beyond . [inaudible] okay settle down. How about living well and healthy two 100 and beyond . There you go. Im going to tell you how to do it. But first meet madame ashe lived in the south of france. She was physically active. Mentally active. Born 1875. Died 1997. Can anyone do the math . 122. You pass your first cognitive test. Give yourselves a big hand. What was extraordinary about this woman, was when she died she did not have dementia. She did not have alzheimers. She was mentally clear. They did an autopsy in her brain and it was the brain of a healthy 80yearold. So there is this connection between how we behave if youre in the south of france you will eat the mediterranean diet. It is good for your heart and brain. Stay physically active. How we behave and how our brains age now, madame calmet was also an astute businesswoman. At the age of 94, she sold to a businessman who agreed to let her live there for the rest of her life. He died 10 years later. [laughter] this is extraordinary because we do not all live that long. And in fact, in the 19th century, Life Expectancy was much shorter. But we have other examples. Ive extreme longevity. Pockets of the world, these socalled blue zones where people live to 100 or beyond. They are centenarians. Places like sardinia italy, okinawa japan, or not far from here loma linda california. And in all of these areas, there is a tendency to share these kinds of healthy brain habits. There are Strong Social ties, people eat a healthy diet and their physically active. And this brings us to the formula for successful brain aging. Physical exercise, mental stimulation, social interactions. Other activities that manage stress. And of course, lets see, what was the other one . I will get to that later. But trust me, there is a formula. There is a book ive written about this and i encourage you to get so you do not forget. Now, this brings us to the whole question of brain health. People think about brain health, they tend to think about memory. No memory is important. Without our memory we have no past, we cannot plan for the future. And we cannot appreciate the present. So clearly, memory defines who we are but brain health is more than just memory. Very important aspect of brain health is being able to think and reason and understand what you have a steady mood. If you can achieve your brain health, and youre going to be able to remember and think about all of those decisions you need to make every day to keep your Brain Healthy. It is critically important. One aspect of brain health you may not be aware of, is inflammation. Now inflammation we know is a normal physiological process. That helps us fight off infection, repair damage. If you sprain an ankle it gets warm and hot and swollen. That means your inflammatory cells are doing their job. The problem is, as we age we get too much inflammation. And that affects our brain. We have heightened inflammation in the brain and those inflammatory cells actually attack normal cells. We can do something about it. In fact, there are many strategies. We will be talking about them today that are antiinflammatory and help us fight inflammation. Get a good night sleep, how do you feel after a good night of sleep . You feel fantastic having your mind clear, more energy, fewer aches and pains. Because of the antiinflammatory aspect of sleep. Your diet can affect your inflammation. Eating fish as an antiinflammatory strategy. One of my best or favorite is physical exercise, critically important. So, you know the other side of brain health, the flipside of it of course is alzheimers disease. We are all very frightened of this. And we read about it a lot in the news, there are celebrities who have been affected, new headlines every day, it is very hard to keep up with it. When they we are saying take vitamin e, the next day we are saying dont take vitamin e. So it is confusing not just for the public but to the scientists. With all of this information. And if we can keep our brains healthy, we can fight off alzheimers disease. One of the, hydration is good for your brain by the way. One of the biggest questions i get when i give a talk is what is the difference between dementia and alzheimers . And i will try to explain the fearless start with alzheimers. It was first described in 1906. By a doctor. And the patient got confused very quickly and died at age 55. He did an autopsy of her brain. For the first time showed abnormal protein deposits called ayou can see them appear on the slide. Their tiny little proteins that actually attack areas of the brain that define brain health. This is where thinking and memory is controlled. The medical community did not think much of this because the woman was in middle age, it was very rare to see this. But in the late 1960s, scientists study socalled senility. They looked inside the brain of these senile people and they saw the same plaque and tangles. So now we have late onset alzheimers and it was quite frightening to the public because now there is an epidemic of alzheimers disease. Because we are all living longer. Now that was frightening but, i will show you why we can do things about it. Here we see two brains. One is an Alzheimer Brain and the other is a normal brain. You can see the Alzheimer Brain is smaller. That is activate, it shrunk. And you can see the insects show you whether high concentrations of the tangles and the plaque in the atrophied Alzheimer Brain. But if you look at this normal brain, if you look closely you can see an occasional plaque and an occasional single. But what we are learning is that alzheimers disease can build up in all of our brains. Many years before we even realize. We have learned that during modern technology. At ucla, we have been using brain imaging tools like aor pet scanning. To understand and see how alzheimers builds up in the brain years ago invented the first brain pet scan to be able to provide a measure of the physical evidence of alzheimers disease in living people. Here we see an animation 20 scans put together and you see how the brain gets more yellow and eventually more red, that shows you where the alzheimers is building up in the brain. And as there is more alzheimers the memory score gets worse. And these are people have traces of the plaques and tangles. But will not symptoms for 10 or 20 years. Now when i tell this to people usually they freak out. This a oh my gosh i have alzheimers building up in the brain. I see the positive side. And that is that with these kinds of tools, we can identify problems very early. So we can do things about it before there are chances of symptoms. Now, i talked about, just for a moment the formula for keeping your brain young. Some of the things we can do. I will emphasize that today. Genetics comes into play to some extent. There are very rare genes called mutation that actually cause the disease. It is extremely rare and it occurs in families where have relatives get the disease often in middle age. Now that is important for our research to try and understand how to help people. But for most of us, those kinds of genetic causes are not an issue. There are genetic risks and the one that has been studied the most is called a1 5 list has this genetic risk. It means that we are more likely to get alzheimers at an earlier age. But it is not an absolute. So we do not recommend genetic testing for the average person. Because lots of people never get alzheimers. And lots of people without it did get alzheimers. So it is just a risk factor. Not an absolute. And it turns out that studies looking at genetics versus nongenetic factors so that for the average person, genetics is not as important as lifestyle choices and nongenetic factors. Now if you look at Cognitive Health versus age, pc it is a downhill slope. [laughter] we have some control over it. Doctors and scientists have come up with different stages of decline. And the first one we call normal aging. This is where we are forgetting what we put our keys or i will walk into the kitchen and say why did i walk into the kitchen . I am sure we have all experienced these things. Now, generally we joke about it and it does not progress to rapidly. It can be relatively stable with these kinds of categorizations or categorizations tend to be confusing. I have come up with my own scientific graph based on my own experience. It helps us understand the aging brain. So we have about one third of the time we are sleeping. About one third of the time we are working. And one third of the time what are we doing . Oh yes, we are looking for things we just had a moment ago. I find this a little moment ago. But if we go back to the more conventional approach, if normal aging worsens, the experience is mild this is where we are able to compensate. We are able to fill in and function independently. When the compensation breaks down, that is what we call dementia. That is where someones memory is so bad that they need help from others. They no longer are independent. There is a lot of causes for dementia. Alzheimers disease, what i described a moment ago is the most common cause. About two thirds of dementia are caused by alzheimers disease. But you could have a depression and it could look like dementia. And that can be treated. Or you can have a medication side effect or thyroid imbalance. So it is very important, anybody who is concerned about their memory should check in with their dr. To find out whats going on. Now, we know the common memory complaints, right five names and faces, where you put things, forgetting an appointment or plan. It can be very annoying. You know the word you blurted out later a different looksee like youre crazy. It turns out that we have developed methods to compensate for all of these problems. 85 percent of people to complain about agerelated memory issues complain about names and faces. That is a very annoying but i will share with you today some of the strategies we developed that are very easy and will very quickly help you compensate for these normal issues. Now, i wanted to just give you another example of successful brain aging. This is a photograph that my wife took of myself and her 104yearold grandmother. Now in the interest of transparency, i just want to disclose those not injecting myself with anabolic steroids. And by the way, this is before i started painting my hair white. [laughter] grandma was very short and she was very feisty. A very spirited woman. When she was on the phone she would talk to relatives and family all the time. That spoke to her social engagement. She was in an apartment in new york where there was no elevators. She had lots of physical exercise. So she was practicing the Brain Healthy lifestyle. And she was mentally very clear. Throughout her life. But every time we visited, i would be concerned knowing her age as a risk factor for alzheimers, i would want to do a mental status. But she was too proud to let me do that. So i remember this visit, i said, grandma how old are you now and five and she said shut up. [laughter] so she passed her mental status exam very well. Unfortunately, not all of us do that well. We do not live to 104 122, mentally clear and we have this downhill slope. What our goal is, to identify problems early, intervene early so we can slow that down. Unfortunately, doctors tend to do too little too late. We wait until somebody already has dementia. We can help them, there are medicines and other strategies to help but it is easier to protect the healthy brain than to try and repair damage once that damage is extensive. So if you take someone who has alzheimers disease and to give them is placebo or sugar pill, is not going to help. Theyre going to go down a certain rate. Now we have medicines that are close symptomatic drugs. You see them advertise on television now. Have been around for quite some time. And they do help to some extent. They do not cure the disease, to provide temporary relief. Often they can keep patients in the community longer because you can stabilize the symptoms. And that is helpful. But what we are searching for right now and the research is what is called a disease modifying treatment. So you can slow down that slope of decline. Now, the way of looking at it is, if you had pneumonia and symptomatic treatment would be an aspirin. He would feel better but it would not get rid of the pneumonia. You need to take an antibiotic which is the disease modifying treatment. Unfortunately, all of the research that has been done so far for that kind of treatment, that research has failed. Thereve been a lot of studies looking at infusions, new pills, we are starting, im optimistic that ucla we are starting a new study with focused ultrasounds. We take that diagnostic tool and take those waves and focus them on Memory Centers of the brain to see if we can stimulate some of the neural connections. This research is very important. We have to continue it and we are in the midst of it and i will describe some of what we have done. But while we are waiting for science to catch up, there is a lot we can do. To keep our brains healthy. I want to focus on that in just a moment. Here is just an example of the kind of research we have been doing and ive been emphasizing how important it is to control inflammation. A few years ago thanks to the help of the National Institutes of health, we did a study where we look at antiinflammatory drug and people middleaged and older who were having normal memory complaints. And we found that after 18 months, those who took the antiinflammatory drugs actually had better memory. When he did brain pet scans are so there was better brain function in front part of the brain. The thinking brain. That is able to understand and solve problems. So this was a positive study. It was controlled with placebo. Was he had a group taking a sugar coat. The problem is, that it was a small study. In these drugs have side effects. And other studies have found that if you give these drugs to people who already have dementia, actually have the opposite effect. It can accelerate. So theres a Tipping Point when certain interventions help or hinder brain health. So we have been trying to explore other safer ways to dampen inflammation. Now, by the way this is what i would like to be doing when i am 100. But i probably will not be doing it because ive never a as i said, you do not need the polevaulting gene. There are nongenetic strategies that make the difference. Probably number one, if you do nothing else after today, make sure you exercise every day. Not to become a triathlete, one study found that 20 minutes of walking can lower your risk for alzheimers. If you cannot walk, your lower extremities are bothering you, go swimming or do anything to get your heart pumping oxygen and nutrients to your brain cells. The exercise will increase the circulation of endorphins. Which causes the runners high. It improves your mood. It also gives your body to secrete chemicals that get your brain cells to sprout branches and communicate more effectively. So exercise is tremendously important. Weve done studies, others have done studies. In fact, a lot of them were done at the university of illinois. This is an example of one study where they had older people start walking every day a bit. They had a control that justin stretching and tony. You can see in this graph, we have the size of the campus, this is a very important Memory Center of the brain. Underneath the temples. And you can see after six months, and after a year the campus keeps growing in size. Critically important. It turns out a bigger brain is a better brain. So somebody called you a fat head is actually a compliment. [laughter] so what about Brain Fitness and brain exercise . We hear a lot about that and how we can build the muscle is very important. If you speak several languages have a low risk for all summers. Or people who attend college and graduate from college have a lower risk. We know that is definitely true about ucla. [laughter] we are still tallying the results of ufc. By the way did go to their medical school. If you never went to college what you are doing here the book festival, lifelong learning. Educating yourself. That protects your brain from alzheimers. So anything that you like to do, games, conversations, that is probably going to be good for your brain. But you know we are in an age right now where everything is hightech. We have all of these devices. People come to my office and is a doctor small, i cant remember phone numbers anymore. Im very frightened. And i will tell them look, dont worry about your memory because your memory will be worse and pick and choose what you commit to memory. To get into this whole area of the pros and cons of the technology. And there are pros and their archons. You know it is a challenge for older people. We know that they tend to use computers and devices less than younger people. Although there are no starting to engage in it. But they still like oldschool kinds of devices. [laughter] know i should and i love it so much it was falling apart and attached it together with scotch tape as long as i can have it. There is debate in the media. Is google making us stupid . If there are Digital Natives in the room i want to point out that stupid is misspelled. So we were curious about this. To understand it better. At ucla we did a study called your brain on google. Wanted to understand what the brain looks like when searching online. I was particularly interested to see what the brain look like the first time someone searches online. And i had to get some volunteers for this. Quickly linda cannot recruit them online. [laughter] i found people exist. Congratulations you are the last person to get an email account. He succeeded. We recruited a lot in the libraries. And what we did, we put them into the mri scanner. We had the more special goggles and we could show them images that look like online sites. And they had a little mouse at their side so they could Search Online in the scanner. So we can measure their brain activity from moment to moment. I will cut to the chase. The colored areas show you where the brain was engaged. This first group, these were people who were internet nacve. They were searching online for the first time. You see, there is some red and important areas but there is not a whole lot. We had the people with internet experience Search Online. Their brains were having a party. It was more than twofold increase activation in the brain. So just searching online can be