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Asia Is Making a New Billionaire Every Two Days - Duration: 1:02.
For more infomation >> Asia Is Making a New Billionaire Every Two Days - Duration: 1:02. -------------------------------------------
the world is yours - Duration: 0:19.
Chopin was a pop star
learn the piano
dream big
and the world is yours
Bachauer.org
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Vladimir Putin preparing to STEP DOWN…and THIS is who will take over Russia - Duration: 3:55.
Vladimir Putin preparing to STEP DOWN…and THIS is who will take over Russia
The Kremlin strongman has been at the sharp-end of Russian politics since 1999 – serving as the both the President and Prime Minister.
Vlad is reported to be considering finally giving up the reigns of the superpower within the next six years. But don't expect to see the last of Putin.
The 65-year-old is claimed to preparing his daughter Katerina Tikhonova, 31, for leadership. Putin is said to want to establish a new dynasty, and lacks a male heir with which to do so.
"She can provide a calm time in old age for her father and his closest friends" Natalia Gevorkyan Under the Russian constitution, Putin would be disqualified from standing again in 2024, when he will be 71.
He is poised to announce his campaign for reelection in March next year, and would be expected to win in a landslide. Katerina does not have a stake in Russian politics yet, and is better known as a dancer.
However, she is claimed to be a shrewd businesswoman and has married Russia's youngest billionaire oligarch.
Natalia Gevorkyan, a Putin biographer, said: "Putin does not have a male heir - at least officially - but he has two daughters.
"One of them, Katerina, has already entered the public space with several huge and costly projects." She added: "In theory, she can take part in the presidential elections and provide a calm time in old age for her father and his closest friends..
Speculation has raged over Putin's future, with suggestions he is grooming multiple people to take over and rule for him.
No official announcement has been made that Katerina is Putins daughter from his marriage to ex-wife Lyudmila, although this is widely accepted in Moscow. She is married to Russias youngest billionaire Kirill Shamalov, 35 , who is worth $1.25 billion.
Putin has made it his business to assert Moscows power on the world stage – squaring up to the US over Syria, North Korea and Crimea.
Daily Star Online revealed which side Putin would take in a war with North Korea started by Donald Trump. .
From people who have been in touch with her recently, I know that Katerina is really interested, said Gevorkyan. Putin flexed his missile might this week with four ICBM launches across Russia.
He is currently embroiled in feud with the US over allegations the Kremlin worked to swing the presidential election in favour of Donald Trump.
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What is healthy brain aging? - Duration: 53:43.
(upbeat music)
- I'm going to, my job tonight is to introduce you
to our series, which is going to involve six lectures
of which I'm the beginning, so I'm just,
tonight, I'm just going to talk in generalities
and kind of set the tone, okay, talk a little bit about
what I think the issues are.
And then I'm gonna give you just a couple
of tantalizing little tidbits that will be deeply discussed
by my colleagues as they move through the series.
The point of that, of course,
is that I'm, like, showing you a trailer to a movie.
I show you all the good stuff, and then, you know,
you go, "Is that all it is?"
But hopefully that won't be true.
I thought, tonight, we're gonna be a little looser
than usual, which for me, means we're gonna be really loose.
I'd like to hear you guys tell me
what you think healthy aging is about, any thoughts?
What's healthy aging?
Come on, somebody be bold!
- [Woman] Active.
- Active, okay.
- Mentoring. - Doing what you want.
- Ah, I like that, doing what you want, okay.
I think that's important,
'cause I think that has, not only active,
but it means that you can make choices.
You can continue to make choices, right?
- [Man] Don't forget important things.
- Don't forget important things.
Yeah, well, cross that one right off your list.
(audience laughs)
Okay, so my job today is going to do this,
but first, I'm gonna take you through a few things
about what we know the average person looks like
as they get older.
Okay, so we're gonna go through a period.
It may not be the most happiest, okay,
but I want to point out where we sit today, okay.
All right, and of course, the first slide is
to dispel a notion, and that is,
is that older people are dependent.
And in fact, that's not the case.
Although, it is our tendency to think about getting older
as needing others, okay.
And these are real people, actors getting paid millions
of dollars, of course, but they're very busy and happy.
So the first thing I want to talk about is what is,
what happens to our bodies as we age.
And I'm getting very familiar with this
as I approach my social security age.
And so this is just sort of a picture
that you can pull off, any one of you,
who have Google search engines, will find these out there,
and this is our general concept of, you know,
from crawling to, sort of,
you get upright, and then you bend forward.
And some of them continue on into wheelchairs, okay.
This is sort of what happens to our bodies.
We have a very clear sense of what getting older is, right?
Right? - Right.
- This is perfect, right?
- [Audience] Right!
- I hope not.
- [Man] No.
(audience members laugh) - Good.
All right, I hope not, okay.
But this is the concept, okay.
One thing I can say is that the faces
of aging are around us, and tonight, I see a couple
of people over the age of 50,
(audience laughs)
myself included, a couple over the age of 60,
myself included.
We can keep going, but I'll just stop there.
(audience laughs)
But there are things that we see that is very characteristic
of the aging process in our bodies, okay.
So what I'm talking about, what do your bodies look like?
I'm starting there, because I think that when we think
about the aging process, this is where we focus, okay.
So when we focus on our bodies,
I think about other things that are going on
in terms of when we think of getting older.
What does it mean?
But before I get to those examples,
I wanted to point out why is it important
that we even have this conversation, okay.
And I think that just looking across the folks here tonight,
I can say that we have a changing society
from the 1900s to the 2017.
And here, I use this example all the time,
because, and I say this, I'm sorry for those of you
who've heard this talk before, I apologize, but that's me.
That's why I like this.
It wouldn't be 1945, okay, 'cause that wouldn't be me.
It's all about me, okay.
And so what's important about this particular slide
in this particular picture at this particular moment is
to show you that in 1955, most people were under the age
of 10 or 15, and then as we got older,
particularly around the age of 80,
very, very small proportion of the population was
at that age group, okay.
But what's really going on is that
in the 21st century, this has changed.
And so now what's happening is that I'm
in this group called the Baby Boomers, and I've moved up.
That's no surprise there, but look what's happened
to what we call that aging pyramid, right.
There's the pyramid.
It starts to get, kind of,
got a little bit fat in the middle, but now look at it.
It's squared off, and in fact, by 2035,
the number of individuals 65 years and older will be greater
than the number of individuals 25 and younger, okay.
Not only is that the case, but by 2035,
another thing is happening,
and that is that we will be much more diverse, okay.
I keep wanting to put this in,
but one of the things I find fascinating
about diversity is that there's a great book
by this guy, Robert Page, and what he did
is he did a really simple experiment.
He said, "I'm gonna get a bunch of people together,
"and I'm gonna give them a challenge.
"And then what I'm gonna do is I'm gonna take a bunch
"of white guys.
"I'm gonna take a mixed group of people.
"And I'm gonna give them the same challenge.
"And I'm gonna see two things,
"how fast they resolve the issue,
"the challenge between them,
"and how innovative and creative they are."
Guess what, diversity gives different vantage points
and gets to more creative and innovative solutions.
So I think that diversity is a great thing.
And as our population gets older
and has more diverse opinions,
I think it's going to be beneficial to our society.
Next, it's not working.
There we go, okay.
What else is happening?
So why did that pyramid, by the way, go from here to here.
Well, one of the reasons, of course,
a big reason, is that if you looked at the turn
of the 19th to 20th century, infant mortality was very high.
Well, we discovered antibiotics, and so young people,
children mostly, stopped dying, okay.
But what else is happening is that our life expectancy,
as a population, has increased.
And so what we're seeing, and this is data.
It's a little hard to see, I apologize.
Our life expectancy over the last 50
to 70 years has continued to go up
for the first time in years, okay.
If you go back to the 1700s, for example,
there's very little data, but it looks like,
on the other side of this, it's down to about age 30, 35.
So we've kind of come up.
We hit around the 1800s, and things start to perk up,
but then about the 20th century, things really start to go.
And so what we see is that in the world in general,
which is this one right here, that there's been an increase
from 50 to 80 years old.
That's a, 30 years of average life expectancy,
and of course, it's slightly longer for women
than it is for men, okay.
And that is really a wonderful statistic, in my mind.
However, it's a accompanied by another statistic.
Now this is a little bit of a complicated graph,
and I don't want to get into too many details.
Although, if you have questions, I am happy to answer.
This is people's independence.
So if you're in the red, that means you're
at the top of your ability.
And 100% is completely capable of all activities.
And it's what you see is that there are people
who need care are down here, in the yellow,
and what you see is the proportion of individuals
that are having trouble is increasing
as we go down, as we age, okay.
So one of the consequences
of advancing age is the requirement
for more assistance, okay.
And this comes from the World Health Organization,
and there's a very good pamphlet called,
from the World Health Organization, called World Aging,
and I encourage you to look at it.
I think it's quite provocative and interesting.
We talk about aging in a way that we tend
to think of 65 and older, okay,
and that we think about how does that influence us
in sort of day-to-day activities.
But what I want to point out is that
when you even take elite athletes,
such as marathon runners, and we take world times,
swimming times, running times,
and what we see is that there is,
so these are world record holder swimming time,
and what you see is a percentage increase in this time.
And things go up from the time
that you're at 20 or so, maybe 25,
and if you're really a superior athlete,
maybe you'll get into the 30s, okay.
And it's not uncommon if you think about competitive sports.
It's very rare to see a 40-year-old
in competitive sports today.
That used to be true in tennis, particularly.
There were a lot of young people,
but now that's changed a little bit.
They get a little bit older.
But what I'm pointing out is that things are happening
to our body that begin right at the time
that we have hit our peak abilities,
and then they start to decline a little bit.
And what happens?
We have loss of muscle mass, okay.
We have loss of flexibility.
I can certainly attest to that.
My youngest daughter, who has just graduated from college,
was doing some stretching exercise on the floor.
She stopped off at our hotel for a while,
and then going to move on to post-college.
And I couldn't, you know, I can't even, you know,
it's incredible to touch that.
Joints, we have a lot of loss of cartilage
and stiffening of ligaments and tendons.
I know when I wake up in the morning,
I have stiff hands, very common.
Importantly, and this is something that's well-known.
Our bone density, a lot of us focus on our bone density.
And so these profound changes begin even
when we're in our 20s, and an example of this,
I don't know how many of you exercise regularly,
'cause I kind of laugh when I exercise.
The maximum exercise, the 90th percentile,
for someone my age is, what is it,
somewhere around 150, you know.
And I get the little light, if I put in my age,
it's blink, blink, you're exceeding your maximum,
you know, and it's, well, maybe I'm healthy, you know,
And so all these things, these changes are happening
to our body, and if I said this,
if I was to ask you before this talk,
you probably know all of these things, right?
I think that most of us would agree
that we know about our bones.
We know about our heart.
We know about our lungs.
We know about our speed.
None of us are as fast as we used to be.
I asked about healthy aging at the beginning,
because I wanted to help you understand
what the concept of what people talk about
as normal aging.
So this is the idea of what people think about
in terms of normal aging, okay, a steady decline.
Some people may do a little bit better.
There are some people who are doing well
and that have some kind of event.
And a perfect example of this is a stroke, okay,
or a heart attack or cancer,
all of these big medical problem that can happen in life.
But many of them recover.
Some of them recover right back up
to where they were before.
Some of them have a little bit less than a perfect recovery.
A is this concept of what we call ideal health,
and it has, as part of it, and I'm sorry,
but this is just a medical term that we use,
called compression of morbidity, okay.
So that's a medical term, but what I want
to say is my example of compression of morbidity is
that you're 92 years old, I'm 92 years old,
and I'm playing tennis, and I just hit one
of my best overhand serves of my life, and I drop dead.
(audience laughs)
I haven't bothered anybody.
I've got my trust in order.
The person I'm playing hardly knows who I am,
so there's no emotional consequences.
(audience laughs)
Okay, that's compression of morbidity.
The idea here being is that we live well until the ends
of our life, and that this, and it's got another kind
of unfortunate term, terminal decline is short,
so we continue to contribute.
I like what I heard, do what we want to do
as best we can.
Now we, you know, let's be honest,
we're gonna have to make adjustments.
I'm making adjustments.
Everybody needs to make adjustments in life.
But to be as independent and to enjoy life
as much as possible until that time
in which your life ends.
What does this look like?
We want to move from dependence on others
to actually being independent and maybe leading others
or supporting others or contributing to our society.
Now I have to show this, because it's true.
This is not a Photoshop.
(audience laughs)
I have to say, I never looked that good.
(audience laughs)
Still don't, actually.
This guy could be a GNC commercial.
But the truth of the matter is is that there is the ability
for us to maintain capacity,
ability, physical health, okay.
These people exist.
They're not made up, okay.
I guarantee they're not, if they're Photoshopped,
this thing is all over the internet, and I'm sorry.
But he doesn't look too Photoshopped.
That looks more like me, actually.
Although he has a little more hair.
You can see that these are people
who are active, engaged, okay.
So it's not that I paint this terrible picture
that's all dark, okay.
Why would we benefit from a healthy, older population?
I think, and I will continue to argue this more fervently
as I advance in my own age,
that our aging, individuals who are aging
in our society make substantial contributions.
I think no one would argue
that experience is a wise teacher.
No one would argue that people
with experience can be good mentors.
Not everyone with experience is a good mentor,
but they can be good mentors, okay.
Everyone would probably agree
that there's some skills acquired and knowledge,
particularly perspective, okay.
What I think people don't talk about,
which is absolutely relevant is that, in fact,
our older society, individuals in our older society,
are still contributing with innovation.
There's someone who's been nominated for the Nobel Prize.
He's, I think, 85 years old.
And it's on making lithium batteries more efficient,
not just 3% more efficient
but maybe even 100% more efficient, okay.
Also important to social cohesion, and in fact,
I think people would recognize that that can,
that that's a common aspect of our particularly
in the third generation, the grandparents,
and I have been honored by having my first grandchild.
And she's gonna turn one year in June,
and I'm not gonna be here,
because I'm gonna go see her.
But other things that are really, I think, interesting,
just like innovation, is entrepreneurship and investment.
Workforce participation, I think most
of you have probably had the experience, I know I have,
when I'm at the Home Depot,
and there's guys who actually know how
to use those tools.
(audience laughs)
And they say, "Yeah, don't turn it on
"without the blade guard on it,"
and those kind of things that,
because they've had this experience.
And many of them were contractors themselves.
But also consumption, and in fact,
it's been determined that in our 65 and plus,
there is a substantial, maybe a $1 trillion of wealth.
So there's a tremendous amount of wealth
and consumer ability, as well as contributions to society,
and that I think I come back to this,
that the wealth of experience
and knowledge can't be, no monetary aspect.
It is priceless.
It can't be measured.
But my point is is that a healthy older society is an aspect
of advantage to any society.
Now, again, I say okay,
I can't run the 50-yard dash.
You know, they don't do 50 yards anymore.
They do 40 yards.
I'm sure somebody came up with that,
because he said, "Man, I could do that under five seconds,
"and doesn't that sound wicked fast?"
Anyway so, I can't do the 50-yard dash as fast.
You know, my hair's receding,
and it's turning a little gray (laughs).
So these body changes are occurring.
But also what else is occurring is
that most diseases are age-specific
or increase in likelihood as we get older.
And you know, the big three are heart disease, cancer,
and I'll talk a little bit, in a second, about dementia.
Those are the, sort of, big three,
heart disease, cancer and dementia.
What's even more complicated, or more troubling,
is that most older adults are likely
to have multiple chronic conditions.
And what are we talking about a chronic condition?
Hypertension, diabetes, COPD,
osteoarthritis with disability
or complications of other, heart failure,
those kind of things.
And the average person who's 70 or 72 years old,
in the United States, is on seven or more medications.
So it's not uncommon
being treated simultaneously for multiple medications.
And then I told you I was gonna get to dementia,
so the other thing, the most significant
overwhelming risk factor for dementia is
that you live long enough.
So we've been told by the Alzheimer's association,
and it's based on the epidemiological evidence
that the prevalence of Alzheimer's disease doubles
every five years after the age of 65,
such that about 30 to 40% of 85-year-olds
and above have some level of cognitive impairment.
What we don't talk about and what we're interested here
at UC Davis is that there does seem
to be some differences among different racial
and ethnic groups in the incidence and prevalence
of dementia as we get older, and what my colleagues
at the Kaiser Health Foundation have discovered is
that there seems to be a difference
between Asian-Americans and African-Americans,
with Caucasians and Latinos being in between those two.
Why is this important?
It's important because there are probably,
just by simply seeing this,
we can probably find genetic differences
that may indicate new pathways
for medical treatment or better yet,
behaviors or environments that we could modify
to improve our healthy aging.
So even in dementia, we get a signal
about how to help make a healthy brain.
So I talked about the chronic illnesses of aging.
And I point out that one of the things
that's happening is that we're doing very well
in treating things like stroke, heart disease
and cancer, that, in fact, the mortality
from these three big diseases have gone down
over the last 20 years by 34% for stroke,
27% for heart disease, and about 20% for cancer,
both for men and women.
That's a huge effect in such a short period of time, okay.
In the interim, unfortunately,
death due to Alzheimer's disease, or demential in general,
has been increasing.
Now part of that is explained by the fact
that our population is getting older.
But another part of it is related to the fact
that we may have some inkling of ideas
about what's going on with dementia,
but we haven't found a disease-modifying treatment
that prevents it or reduces its impact, okay.
We can improve the symptoms somewhat, and that's beneficial.
I'm not arguing that, but we need something more.
An important feature is that I showed you
that dementia is here, and it's increasing as we age, right?
And then I talked to you earlier on
about how our athletic ability changes
and that how physical being changes,
and it begins to change in our 20s, 30s, 40s, okay.
Well, what's happening on the outside
of us is also happening in our mental capacity.
So if you test individuals on some sophisticated test
that have to do with speeded test, particularly,
making very complicated, challenging tests
that they have to be done quickly,
that there's almost a linear decline with age,
in the the performance.
Say, this is a group of 100 people.
This is the average for the whole group.
The younger people tend to do above average, okay.
The older people tend to do below average, okay.
And this means that about here is about 25% above average
and about 25% below average, okay, all right.
Now, so I think why aren't we all just sort
of walking around impaired from this.
Well, one of the things that happens with age,
and thank God, is that there are some things
that are improving, okay.
So our basic information is improving.
Our strategic planning is improving.
Our linguistic abilities are improving.
We have broader ways to describe things.
We're better communicators.
We have more experience.
We know what to expect.
So these things are all improving.
And to be honest with you,
they hugely offset some of these speeded changes.
So it takes us a little longer.
Fine, we get it done.
We get it done right.
And oftentimes, to be honest with you,
we make less mistakes, because we're less impulsive, okay.
That's not for everybody.
Some people stay impulsive until they're 100.
(audience laughs)
- [Audience Member] Exactly.
- Wouldn't be me but others, others, others.
So that's what our abilities are doing
within our thinking abilities,
what's happening with our brain, okay.
So one of the things
that's happening is our brain is changing dramatically.
So this is a brain of a 27-year-old.
And this is a brain of a 97-year-old.
And this is data looking at the, sort of think about this
as that it's the percentage of their head
that's filled with brain, okay.
So this person's percentage is about 85 to 90%.
This person's is more like 60%.
Now it may be okay for my gas tank
to be down a quarter to 30%,
but I don't want my brain to be down a quarter to 30%, okay.
In addition, as we age, and this is data
from a community study, the Framingham Heart Study.
So these are people living out
in the community doing just what everyone here
in the room is doing.
They're also the same person.
This person and this person are the same,
and these are a different kind of picture.
This is looking at vascular brain injury.
And white, if you can see it here,
is the injury, and you see very little white, if none,
if any at all here, and you see a lot here.
And it's very common to see these white changes there, okay.
So this is happening with our thinking ability
as well as our brain.
It changes, the physical physicality of our brain.
So a kind of way to think about it,
and I read this in The Oldest Living Confederate Widow.
Has anybody read that book?
Oh it was a great book, because it starts off by saying,
"I understand that the wrinkles
"in the brain means you're smarter.
"If my brain looks anything like the wrinkles on my face,
"I must be a genius."
(audience laughs)
Okay, but this is very important.
Not everybody ages the same way, okay.
And as you saw the buff 70-plus-year-old guy,
there are some people who are mentally buff, okay.
So this is a study from the Rush Healthy Aging study.
And basically what it is is people's ability
to remember items from a story.
So you're told the story.
Then you're asked, 20 minutes later,
you're asked to tell the story again,
and how many of the items do you recall from the story?
And they do this repeatedly over time.
And what you see, I hope, is you see there's a whole bunch
of people who are kind of flat.
There's some people who are actually
getting a little bit better.
And then there's these people
who aren't doing very well at all, okay.
So there's a lot of variability in here.
And in fact, I like to point out, well,
I want to be this person, right,
who started off at age 90 and is getting better to 95
and is actually doing, you know, above,
so this is average, by the way.
So this is about 25% above average.
That's pretty dang good.
Went from slightly above average to 25% above average.
And it doesn't matter.
Some of those people start out a little low
and continued to improve, in this mix.
The same thing is happening with the brain size.
There are some people whose, this is the hippocampus.
It's the memory organ of the brain.
There's some people whose brains are, over eight,
nine years, they're not really changing that much.
And then there's some people
who are going down dramatically.
So I want to give you an example of this brain shape change.
And I'm using the brain shape change,
because I want you to think about thinking
and brain shape as being kind of the same thing, okay.
So it's just a better graphic, okay.
So here's a person who's been followed for seven years.
They're about 73 years old, I believe.
And what you see are those two pictures,
and they're seven years apart.
And I've circled the center part here.
That's where the fluid is, in the brain,
and that's a very good indicator of brain shrinkage,
as you'll see in just a second.
But what you see is that if you look at this picture
and this picture, they're almost identical.
That person hasn't changed much in seven years, okay.
Now in the next picture, you see someone doesn't have quite
as much of that black fluid in it,
at the baseline, in this circle.
You see that?
But look what happened.
I think many of you can see
that in seven years that person's has changed.
Okay, and in addition, there's little pieces
that are turning dark out here, too,
that are getting a little bit darker.
And that's other parts of shrinkage that's going on.
So people, they do this differently, okay.
So the way I sort of conceptualize brain aging, okay,
is that there's probably a group of individuals
that you would say are average, okay.
And then there's some people
who are doing a little bit better than average.
And there's some people who are doing very well.
And when we think about our abilities,
and this is important, we don't know
that we go through a period of development,
and we don't know, but we assume, and I would bet,
that how well that development is going on has something
to do with how well our brain is aging, too, okay.
But this is our average group.
Look what we could be doing, in terms of ability,
by just changing this a little bit,
change that trajectory just a tiny bit.
Now there are many things that influence it.
I said genetics, okay.
And you say, "Well, yeah."
I mean, you know, yeah, there's smart people.
You see that in elementary shool.
There's kids that are very smart, okay.
I'm talking about the fact
that genetics influence your brain all the way
through your life.
So I had the opportunity to study twins.
And I was looking at them at seven years of age,
and I knew something was up when my analyst came back
to me and said, "I think you're giving me
"the same scans twice,"
because they were monozygotic, or identical, twins,
and they're brains looked so much alike at age 70.
So there must be something going on genetically, okay.
There must be.
What is it?
Have absolutely no idea, okay.
But you think if we knew,
maybe we could do something about it, right?
Another thing that we don't talk much
about is nutrition in early life and early life development,
in the early life environment.
And we did a study where we asked a simple question.
What happens if you grow up in a family where one
of your siblings died?
Turns out you don't do as well, okay,
'cause your early life environment,
it's an indicator of something going on
in your early life environment.
Education, we live in California.
Okay, as my wife says, I'm on my soapbox now, okay.
But we live in California, one of the most liberal states
in the country, and yet we do horrible with our education.
Very few of you are old enough to have been in World War II,
but the one thing that happened
after World War II was the GI Bill.
And it brought on the greatest growth in our country,
that has ever seen before or since.
Education is powerful, and we don't spend enough on it,
particularly in early life.
Okay, I'm off my soapbox.
(audience laughs)
I talked about medical problems.
Medical comorbidities are contributing to this,
things we don't think about, though,
that are very important, social network, okay.
Are you active?
Do you stay engaged?
And in fact, there's evidence now
that people who retire early die younger.
Now it could be they retired early, because they were sick,
and so that increases the likelihood they're gonna die.
But it may be that people retire early,
and the begin to isolate.
And I will tell you that among individuals 85 and older,
isolation is very common.
Loneliness is very common,
as is depression.
Another is exercising creativity.
I put these two together.
I don't know why.
I can do the exercise, forget the creativity.
- [Woman] Yeah, that does happen (laughs).
- There's good evidence that if we learn new things
as we're getting older, that we learn a new language
or we learn how to play a new instrument,
or we do something that really stresses our brains,
in terms of creative, not doing the crossword puzzles, okay,
not doing Sudoku, things like that, over and over again,
'cause they get rote very fast, but doing creative things
that tax our brains can be very helpful.
Why might this be happening, and what can we do about it?
So how do we solve this puzzle of the aging brain?
Well, one hypothesis begins with this concept,
as I showed you, that diseases are common
as we get older, right?
So we have increasing amounts
of brain injury as we get older.
So one thing we could do very easily is to say,
"All right, let's reduce this brain injury."
I think that we're seeing a little bit of evidence of this,
in that there's some data coming out that the incidence,
so the slope of which dementia's increasing
is actually kind of turning down a little bit.
Why might that be?
It's because there's less hypertension.
People are treating their diabetes, et cetera, okay.
I don't know if that's the fact,
but that may be part of it, okay.
Another is to build a better brain,
or what we kind of say, increase resilience.
There are many ways to do this.
And I think most of you are here tonight
to have me answer that question, ha ha ha!
(audience laughs)
Not gonna happen.
You have to come back to the other five.
(audience laughs)
If you don't come to those events,
you won't know how to do that.
I'm gonna give you a little hint though.
I'm just gonna give you a little tantalizing nibble.
But the other thing I think that's really important is
that technologies are advancing at a rapid pace
that can help us with managing our disability,
so a phone that reminds you to do things,
and let me tell you, I'm really good at asking my wife out
on a date every week, okay, why?
Because I have an alarm set on my phone,
and on Wednesday night at 8:30, it goes off.
I know what that alarm means, but I might not do it
on Wednesday night, unless I hear that alarm.
So we're already using these devices,
and these devices will be helpful.
I think there's more yet to come, okay.
Now why should we care about healthy brain aging?
Why not just fight dementia, right?
Why not just fight dementia?
We'll take care of dementia, and everything's gonna be okay.
That comes from the premise, a lot of times,
where people think I've got a disease process like the flu.
It came on to me on Tuesday.
I've got a cough.
I'm gonna treat the flu, and by Thursday, I'm gonna be okay.
All right, and as I say to my patients over and over again,
nobody wakes up with dementia on a Tuesday afternoon, okay,
and that right now, today, this is,
I showed you that picture about how the brain ages.
This is normal brain aging.
This is an example of one part of the brain,
this part of the brain, called the temporal lobe,
in people who are absolutely, cognitively normal,
living up to 100 years of age, okay,
and you're seeing that these numbers are just,
this is above average, and this is below average
for their predicted age, okay.
So you see that it's declining with age, okay.
This is, again, my 27-year-old going to 97-years-old, okay.
Now I want to make sure you guys note,
this isn't this person going to there.
I have not been doing MRI research for 65 or 70 years.
We haven't even had MRI scanners for 65 or 70 years.
We have had them for 30, though.
One aspect of this, so you understand it,
I'm gonna show you what happened,
is this is what happens to people who have dementia,
and we look at the relationship between
that same brain region and age in people who have dementia,
and what do you see?
It doesn't change with age.
It's flat, okay.
All right, and what does that mean?
Well, it means that for a 60-year-old, okay,
you've got to make a great change
in your brain to become demented.
You've got to lose a lot of brain to get demented, okay.
Does this make sense?
But as you get older,
you don't have to lose quite as much.
Do you see that?
Now there are other parts of the brain
that are not doing quite the same thing.
So I am giving the sort of most obvious scenario,
but I want to make this point, okay.
And therefore, there seems to be something
about how much tissue you lose in certain parts
of the brain that really are the threshold
that tips you over, okay.
And that the closer you get to this,
the less likely you are to have,
remember that picture I showed you
where someone has an event, takes a dip
and then comes back up, okay?
The closer you are to this,
the less likely you are to come back
from those events, okay, and the more vulnerable you are
to the cognitive consequences of any event, okay.
This is this guy.
Actually, I don't know if it's a guy.
This is, yeah, my youngest has taught me not
to talk in gender-specific terms.
This is this person, okay.
(audience laughs)
Okay, this is this person, right there, okay.
It's an average 97-year-old.
This is that person.
I don't know about you, but if I was to have a choice,
I think I'd want to be this person, okay.
And this shows you that you can be this person, okay,
all right, that there are people out there
that are like this.
This is not made up.
And in fact, if you look at this graph,
you see that there's a lot of scatter up here, okay.
It's not so much scatter up here.
There's a lot of scatter up here.
And there are a few people that are up there,
that are doing pretty well.
And again, I use the brain size,
'cause it's a much more vivid image.
I'm kind of image-oriented.
So think if this as it's going to be associated
with the thinking part, too.
So this person is likely to be do better on the tests, okay.
So that's my little background.
Now comes the tantalizing, okay.
So what can we do about this?
All right, well, we're gonna talk to you about
how vitamins can prevent age-related, cognitive decline,
our colleague, Joshua Miller.
Eating to Prevent Alzheimer's Disease, Rosane Oliveira.
Alternative medical approaches to brain health,
Juliana Baldo, which will be really interesting, I think.
That's gonna be an interesting talk.
Behavioral Contributions to Cognitive Health, Robert Wilson,
and he's part of the group that initiated this notion
about sociology, social networking and creativity.
And I'll show you some of his data.
And exercise by a colleague, Jeff Burns, okay.
So maybe let me recap.
Here's the thing.
We get older, okay.
Our hair gets gray.
We get a few wrinkles.
We're not quite as strong.
We're not quite as fast, and we don't think as well, right.
That's what aging's about, okay.
I'm here to say that some people can still lift 120 pounds
over their head at age 80, okay.
Less common, but it can still happen.
Some people can think well at age 85 and 90, okay.
And that actually, there's a lot of changes that happen
in the brain before dementia occurs, okay.
And that my feeling is, and this is why we're doing this,
is that the more we work on keeping our brains healthy,
just like we talk about keeping our hearts healthy,
our bones healthy, okay, watch our cholesterol,
exercise regularly, take our blood pressure medicine,
watch our sugars, blah, blah, blah, blah, blah,
we should be doing the same thing for our brains, okay.
And so the following events
that we're gonna have are all gonna be talking about this.
Remember, my job is just to get you to the point
of why are we even doing this?
I'm trying to make that point.
I don't know how successful I am, but...
(audience laughs)
Okay, so what do we know?
Well, here's a couple of things we do know, okay.
So when we look in individuals who have vitamin,
when we measure the vitamin, vitamin D, and this is
what Dr. Miller's gonna be talking about next, okay.
If we measure that, particularly if we measure that
in non-Caucasian populations,
and the reason why we measure this
in non-Caucasian populations is
'cause your darker skin doesn't absorb sunlight,
which is the number one, slash, number two,
diet is the second one, generator of vitamin D,
that non-Caucasians have a higher incidence
of deficiency in vitamin D, okay.
Common thing, we get it checked, okay.
This is what happens if you're adequate over,
this is your memory performance,
you're adequate in your vitamin D over five years,
almost no change.
You're insufficient, which means that you're kind
of just below the number, you start to decline.
If you're deficient, okay,
you start out about the same way, but if you're deficient,
that means you've probably been deficient for a long time,
and you're actually accelerating in your decline.
So just a simple vitamin, and this is not the only one.
And Dr. Miller will talk about this.
There are other vitamins, vitamin B12,
and things like that, okay, that are important
to our brain health.
Is there a brain diet, okay?
We all want to believe there's a brain diet.
And the answer is there seems to be evidence
that eating certain things do help you,
and it's called the Mediterranean diet.
Now I'm going to just put a little asterisk near this.
What I don't want to convey to you is that
if you eat this on Tuesday, and you have three Big Macs
on Wednesday, that suddenly everything is fine.
(audience laughs)
Or you say, "Hey, I know that there are these fish pills.
"I'm gonna take the fish pills,
"and I'm gonna eat my three Big Macs."
But there is new evidence that's come out
that suggests, and I'm not gonna go through this,
but the bottom line is is that people
who don't eat the Mediterranean diet
have average lower brain sizes than people who do.
So this is average, and these are the people
who don't use the Mediterranean diet frequently,
and they're lower on average.
And these are the people who do it.
And they're higher on average, and they stay higher
over a three-years period of time, okay,
so that, actually, it may be good for your brain, okay.
And there's some evidence it might even prevent
Alzheimer's disease, but again, some of these things
are a little bit difficult to distinguish and dissociate.
The other thing is this medical comorbidities I talked
to you about, treatment of your medical health.
So this is a paper that was done by Matt Pase
and my colleague, Sudha Seshadri,
and they looked at, he just asked a simple question.
If you are healthy, if you have good cardiovascular health,
what's gonna happen to your brain,
and what's gonna happen to dementia?
And the bottom line is is that, first off,
very few people are terribly sick that they're,
zero means they have, every medical illness leading
to cardiovascular health is bad, okay, less than 1%.
Very few people are in excellent cardiovascular health.
This group was about age 65, I think, on average, okay.
If you have hypertension,
you want to have a normal blood pressure.
If you've got diabetes,
you want to have a low hemoglobin A1c.
If you have high cholesterol, you want it to be treated
so that it's in the normal range, okay.
When you have these problems,
the more ideally treated you are,
the less likely you are, by 20% less, 20% less likely
to get demential, 20% less likely to get a stroke,
and it seems if, it's a little hard to know,
but it seems like maybe it works
for both Alzheimer's disease and for vascular disease.
Now I told you a little bit
about my colleague, Dr. Wilson, who's gonna talk about
how our behaviors influence our brain health.
This is an example, and again, it's a little bit tricky,
and I feel like kind of a ding-dong now that I'm doing this.
So here's the idea, is that over time,
you don't want to be in this red line, okay.
That's the bottom line, okay.
You don't want to be the red line.
The reason these people are in this red line,
that means that the risk is going up
for getting impairment as they get older, over six years.
The reason that these people are
in this line, on this red line,
is 'cause they had negative social interactions.
And that really has to do with their lifestyle, okay.
So it has to do with certain behavioral lifestyles
that causes them to have negative social interactions.
He goes through, and he defines that,
and I hope he'll get into that.
I'm just giving you these little snippets, okay.
So the important point is
is that the red line looks a lot worse than the green line.
Okay, the green line, yeah,
you're getting a little bit greater risk
for having some cognitive impairment as years go by,
but it's a lot less than being in the red line.
The other is that if you have social networks,
now these are a little bit easier to understand,
since the more socially you're engaged,
the more people you talk to
in a given day, week or month, okay,
the better your brain is,
and in fact, it looks like,
that it may even help.
This is your thinking ability.
And this is a measure of brain injury at death.
It really seems that
if you have strong social support networks,
that you can tolerate a lot more brain injury
without having any cognitive impairment.
So our behaviors directly affect
how we tolerate injury and aging.
The last is that Dr. Burns is gonna talk about exercise,
and again, some colleagues of mine have worked on this
in the Framingham Heart Study, and Dr. Tan has done this.
And basically, what Dr. Tan showed is that if you look
at your brain size in relationship
to activities you did 10 years earlier,
that your estimated age of brain, so in other words,
the way your brain looks young or old,
so the more you exercise, particularly if you exercise mild,
moderate or vigorous, your brain actually looks a year
or two younger, so it looks better
than it would be predicted by your chronological age.
More importantly, it looks like that if you are sedentary,
you don't exercise at all, your risk goes up,
of getting Alzheimer's disease, as the time goes by.
And that risk goes down by this much, about two to 4%,
if you do exercise at all, minimally.
And Dr. Burns is gonna get into that
and talk a little bit more about that.
My goal here is to sort of just get you enticed.
Okay, what can we do?
What more can we do?
Well, I think we need to understand what aging's all about.
And we need to understand it
from the basic molecular aspects
of how cells talk to each other, how they develop,
how they connect, to the what we call neuroscience,
or systems neuroscience, how they're connected,
how they function as a network, to clinical trials,
either being with medicines or with interventions at home,
on to even system level care, with the goal
to build a stronger brain so that we can age gracefully
on the inside as we do on the outside.
How can UC Davis make a difference?
I want to just do this, end on this not,
'cause I think it's important.
We actually have a lot of resources here.
We have a tremendous amount of resources.
And right now, what's happening is most of that,
we talk to each other, but we don't have a unified force,
and that one of the things that the university has decided
to do is actually make an effort
to bring all of these together,
and it's called the Healthy Brain Aging Initiative, okay.
And that's something that is going on
at the university level, and it's something
that I'm excited about, and my colleague,
Dr. McAllister is right over here.
And we're working together on this.
She's the molecules, and I don't know what I am.
(audience laughs)
Our goal, I believe, is to improve your brain health.
You age better, you will not get demented as quickly.
There will be less dementia.
Your lives will be more joyful.
And I really like it.
You'll be more likely to do what you wish to do.
Thank you very much.
(audience applauds)
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