How do I lower my risk of cognitive decline?

Our read is that the medical field is increasingly focused on preventative neurology and promoting health in healthy brains, as cognitive function generally shows a linear decrease with increasing age.

Experts suggest that maintaining neuronal function, managing inflammatory responses, and engaging in activities that recruit neuromodulators can support cognitive health.

Conversely, factors such as excessive screen time, nicotine use, and certain injuries or substance use are seen as detrimental to brain health and development.

To lower the risk of cognitive decline, consider engaging in ambulation to recruit neuromodulators like epinephrine and dopamine, which may increase alertness and cognitive improvements, as noted by Andrew Huberman. Developing a theory of mind that understands other players' mindsets is also crucial for development, according to Andrew Huberman. For individuals with ADHD, Peter Attia suggests that switching between different formulations of methylphenidate can lead to improved outcomes if the initial formulation was not effective, and Andrew Huberman adds that ADHD stimulant medications can provide excellent relief when prescribed appropriately.

• 01The medical field is shifting towards preventative neurology and promoting health in healthy brains (Peter Attia, Andrew Huberman, 2x).
• 02Cognitive function generally shows a linear decrease with increasing age across large population sets (Peter Attia, 2x).
• 03Estrogen is important for neuronal function, joint health, and libido in both males and females (Andrew Huberman, 1x).
• 04APOE4 can accelerate inflammatory responses in the brain following injury, amplifying risk (Paul Saladino, 1x).
• 05Ambulation recruits the release of neuromodulators like epinephrine and dopamine, which increase alertness and may explain cognitive improvements (Andrew Huberman, 1x).
• 06Developing a theory of mind that understands other players' mindsets is crucial for development (Andrew Huberman, 1x).
• 07In the earliest stages of dementia, the primary issue is a functional deficit in the dorsolateral prefrontal cortex, interfering with working memory (Peter Attia, 1x).
• 08ADHD stimulant medications can provide excellent relief for many individuals when prescribed at appropriate dosages by a qualified medical professional (Andrew Huberman, 1x).
• 09Switching between different formulations of methylphenidate can lead to improved outcomes for children with ADHD who did not respond well to the initial formulation (Peter Attia, 1x).

Our experts caution against several factors that may increase the risk of cognitive decline. Nicotine use is detrimental to adolescent brain development and can lead to brain rewiring (Andrew Huberman, Paul Saladino, 4x). Excessive smartphone use in early childhood can lead to increased rates of suicide, depression, anxiety, and diminished learning and adaptive behaviors (Andrew Huberman, 2x), with Paul Saladino adding that giving children iPads as a digital babysitter may hinder healthy development. Bryan Johnson also notes that excessive exposure to smartphone addiction, internet gaming, and binge-watching can lead to scatteredness, anxiety, reactivity, and physiological changes in the brain. Sustaining severe injuries like orbital fractures in professional fighting may lead to quitting due to brain damage concerns (Peter Attia, 1x), and clinicians unaware of recent advances in concussion treatment can lead to mismanagement (Peter Attia, 2x). Peter Attia also warns that regular use of ketamine can lead to severe bladder problems and a psychiatric state mimicking schizophrenia, while Andrew Huberman advises caution regarding stem cell therapy abroad for stroke or head injury due to unknown cell sources and potential complications. Resistance training workouts longer than 75 minutes can lead to fatigue that impairs cognitive function (Andrew Huberman, 1x), and missed sleep leads to lost memory consolidation opportunities (Andrew Huberman, 1x). Paul Saladino highlights that post-finasteride syndrome can cause a wide range of severe symptoms including memory problems and slow thinking. Bryan Johnson also points out that PFAS can lead to neurodevelopmental issues.

The verdict would change if new evidence emerged demonstrating that preventative neurology is ineffective, or if large-scale studies showed that cognitive function does not linearly decrease with age. Additionally, if the long-term effects of chronic, non-clinical use of stimulants were better understood and found to be beneficial, or if ketogenic diets were definitively proven effective for all patients with cognitive issues, this could alter our understanding.