Simple changes to make now to avoid dementia with Dr Ginni Mansberg

0:02 A listener. Production doctor Ginny Mansburg is an easily recognized name and face if. You are from Australia. She's a GP in Sydney who also has an extensive media career spanning decades. You would have no doubt seen her on Channel seven's Sunrise, Embarrassing Bodies down Under on Channel nine, or Medicine or Myth on THEESBS. She's also voted Australia's most trusted health professional in twenty twenty two. She hosts a bunch of her own podcasts. She's written a bunch of books, the most recent of which is called Save Your Brain, and that is what I am talking to her about in today's episode.

0:47 Most of us have. Been touched in some way by dementia, and in fact, Ginny shares that in twenty twenty two to fifty five million people around the globe we're living with dementia. Most of us are worried about our loved one, but we're also really concerned about our own risk of. Developing this disease. The good news is that there are things that we can do to save our brains, and the time to do those things is in our forties, fifties and sixties. I could not wait to dive into this with Ginny and get the answers to the question how do we save our brains? Here is that conversation, Doctor Jenny Mansburg.

1:29 Welcome to the Crappy to Happy Podcast. Love being Crappy to Happiness. So good, Ginny. I was so excited to see the book that you have just written all about how to save your brain and I couldn't wait to get you on the show to talk about it. So I think all of us have been touched by dementia, Like everybody that you speak to has a parent, a parent and in law a grandparent who has experienced dementia. I don't know if it is suddenly more I'd spread that it has been before, if we're just suddenly more aware of it. Can you tell me what is the prevalence of dementia the moment?

2:09 Well, the moment, it's the second biggest killer of Australians and the biggest killer of women. So it does affect four times as many women as men, and of course it goes up the older you are and when living longer, which is why we're seeing so much more of it because Australians in particular you know, and also people all over the West world. We are living so much longer, and with that, of course increases the odds of getting dementia. But it's the biggest cause of death in women, and a lot of people don't realize it causes death. It actually is a fatal disease. Yeah, that's a scary, scary thing. And you talked about in the book something like I don't have it off the top of my head. You'll know it. Thirty something percent of eighty five year old will have dementia.

2:59 Absolutely, and then double that number will have what we call mild cognitive impairment. So it's slight in scale, and when you hit enough kind of brain loss or brain failure, which is how you can think of dementia, it tits over from mild cognitive impairment to dementia. So for everyone who has dementia, there's another number being that same number that are not quite dementia but are on the way. So it's when you get to eighty five, your chances of having a completely normal, fully functioning brain, you're kind of down to around a third. Pretty slim chances. And of course we're talking about eighty five year olds but it normally shows up earlier than that, right, So at what point do we start seeing full blown kind of dementia.

3:49 So if you get dementia before the age of sixty five, it's called early on set. It's unusual to get it before the age of sixty five. Most people will start to get it in their seventies and eighties. So that's the good news because a lot of my patients come and see me in their fifties and sixties and say, you know, I'm you know, I keep forgetting to turn up for coffee with my girlfriend. I think I've got dementia? Can you test me for it? So, you know, the good news is it's possible, it's unlikely. Yes, I think we have all experienced those forgetful moments. We've all had those, like I lose words all the time. And this is the thing, right, So you're obviously you are also known for your work around menopause, and this perimenopausal period affects your brain as well, and so we're constantly going is this something I should be worried about?

4:39 Is this normal? Is this hormonal? Is that what you get as well? With your patients? One hundred percent, like we know that when it comes to pery menopause, which is your transition into menopause, proper eighty percent of women report brain pop. That is a ridiculous amount of brain pop. Like that is a ridiculous amount of lost brain hour. Amongst women our age, you were generally at the peak of their careers, trying to juggle like sick parents, a massive career, teenage children who are driving you not it's the peak time for divorce, and maybe you've got some sort of strain in your relationship, and then on top of that, you can't remember to go and do the shopping and to make a dinner. So, like there's a lot going on for women, and most of them think this is it. I'm at the start.

5:28 I'm heading from here straight into dementia seamlessly. It's all downhill from here. And the good news is that by the time you hit menopause, for the vast majority of women, your brain will kind of sort itself out. It is really linked to a lot of the other symptoms of perry So it's kind of a lot to do with particularly insomnia and depression at this stage when you're in perimenopause and you're forgetting stuff and he's only a bit boggy in the brain, and you'll generally have like a nice little window of like amazing brain function until eventually you can slip into dementia, if that's what's going to happen. But for some women, for a small subset of women, it is the beginning to decline, and it is hard to know what's happening to you if you're in the middle of it.

6:12 Yeah, what's the gender divide, Jenny? Does it affect one gender more than the other? Yeah? It looks sadly to mention as a women's issue, And we initially thought that because it's so common after the age of eighty, and more women live into their eighties than men. We just thought, listen, it's just because more women are living longer, and if you live long enough, you eventually get dementia. And that's why it's a women's issue rather than a men's issue, because they basically die off before they get an opportunity to get the dementia. But we know that there are estrogen and progesterone, so they're the two principal womens associated with reproduction in women. There are receptors for those all over the brain, particularly in the centers responsible for higher order thinking and for memory.

7:00 We also know that estron and progesterone both directly act as neurotransmitters and heal the brain when it's got a brain injury. We also know, and this is really fascinating, that for women who go into menopause at forty seven, that's not very early. That's not even called early menopause. You know, because the average age of menopause in the UK and Australia is fifty fifty one. It's getting a little bit earlier as we get more migrants into both countries, but you know, generally around fifty one. But at forty seven that's not early. You know, we're for early menopause is forty five and below. But if you go into menopause at forty seven or earlier, you have a twenty percent higher risk of menopause. And we know that early menopause is a significant risk, which is a really interesting unless you go on HIT. So that's a super interesting fact.

7:49 So it's definitely something to do with hormones. And so the natural question is should we just all go on hormone replacement therapy to prevent DEMNTA and the problem is we don't have a really good data on that. For those of us who hit menopause at kind of UBOLGS standard age, I'm fifty four, I haven't quite hit it yet. Is there any point in me going on HRT just to help my brain out a little bit? So I have a hit early menopause? And the evidence is a little bit mixed. Some studies have definitely shown that HRT does prevent dementia, but there are other studies that have actually shown the opposite. Really and in fact, you remember that really massive study the Women's Health Initiative. Now you might not remember that, but just as to jog everybody's memory, back in two thousand and two, there was this huge study and it was a really good study. They were looking to see whether hormone replacement therapy could prevent a whole raft of chronic diseases, but particularly heart disease. And so they took women who were an average age of sixty three, which I don't know about you, but I don't know anybody at sixty three who kind of needs to start HRTDN. They didn't ask some of our hot blushes.

8:58 They just put them on either HRT in an old form that we don't use anymore, or a placebo, and they followed them up and after six years, what they've found was that for every ten thousand women who had a placebo that got thirty breast cancers, and for every ten thousand women who took HART they had SOWD thirty eight breast cancers, just thirty percent increased risk, huge but an almost a thirty percent increased risk, and they stopped the study. They also found slightly high risks of heart disease and also dementia in that study, and what they have worked out now is that it's all about timing. If you wait until your arteries have hardened and your body has got used to being without estrogen, and then you reintroduce it again, it does more hardening good. It looks like from most of the studies, certainly around heart disease, definitely around breast cancer, that if you just keep going as you hit menopause, you hit the ground money. If you start it within a couple of years and while your tissues are still soft, your arteries have not hardened yet, that in fact, in case of heart disease, it could potentially confer some benefits and the same with dementia is wow in terms of breast cancer risty, probably neutral. So that's just to explain everything that happens, you would. At this stage, we don't have the data that says every single one of us should go on HRT to prevent dementia, but that's possible. We're going to get there at some point because that's the way the data is kind of heading right now.

10:25 So interesting those of us who have a family member like my husband, so my mother in law died of Alzheimer's. Oh, well, before we go there, there are different types of dementia. We all think about Alzheimer's. Is it worth discussing all the different kinds or is that really not that relevant? We don't do it anymore. And I'll tell you why. The way to diagnose the different forms of dementia, and there are lots of them, and I've sort of addressed them in my book, and I've diffected them all at his Parkinson's disease and his lowy body dementia and vascular and his But what they've done in autopsy studies is that they look to people with Alzheimer's disease and you can kind of see Alzheimer's disease. On certain scans, if you do an autopsy of them, seventy five percent of them also have vascular dementia. But what we know is that if you add two types of dementia together, one plus one equals more dementia, worse dementia, earlier dementia. And in a way, as terrible as that sounds, it's kind of good news because that's the stuff you can prevent the vascular dementia. Which is what I need by that is you've actually damaged your arteries and supply your brain all of the nutrients it needs, the beautiful blood, their fresh fluids, your nutrients, your oxygen. If you damage those arteries so you start your brain, that actually causes untold damage to your brain and makes your Alzheimer's worse. Well, happy days. We can actually prevent that stuff. That is

11:55 the really good news. The big thing that I think what happy to crappy want to know is it's all about what you do now. If you wait till you're seventy five to start trying to take the trains on a different track, you have totally missed that boat. I mean, it's sort of never too late to start trying to get healthier. Don't get me wrong, But if you really want banks to your buck, if you really want to prevent dementia, it's what you do in your forties and fifties. Then it's just going to make all of the difference. And we don't think about it enough, but we've got to start. We've got to start doing this now, and for free. I'm going to chuck in better mental health, less heart attacks, less cancer, you know, so many other things that we're going to chuck in for free, less diabetes, better wait control, all the things that matter to us, for the same price as preventing dementia. Like it's such a bargain.

12:48 Yeah, And I really want to get to all of that because what I was going to say earlier was, you know, for anybody who has a family history, there's this fear that this is inevitable, it's in my genes somehow. But obviously what you're presenting is that. A huge proportion of this of the risk factor is lifestyles. One hundred percent. Now we now know like there are nearly three hundred genes that have been identified for Alzheimer's disease alone, and there's a really big one that APO eat little equo, So that's the big gene, and everybody's sort of studied. And if you have two genes, so one from one and one from dad, really increases your risk of getting Alzheimer's disease. It's almost an inevitability at that point. Although like, if you've got dementia at ninety two, like you kind of could live in it, right if you started going down the track at that point. But what we know is that those genes are carried by a huge number of people in the population with those genes don't get dementia, and there are a lot of people without the genes who do get to dementia. But while so many of us think that if you numbers up, numbers up in dementia is just something that can't be prevented, nothing could be further from the truth. And back to Australian data suggests bird of dementia could be prevented altogether.

14:03 And even if you can't prevent it all together, if you could push it out by like ten, fifteen, twenty years and you get that extra time with your family at work contributing, like, is that not a no brainer? I think it's a bit of a no brainer. But there's no point waiting till your only sixties and seventies. You've got to start earlier to actually prevent dementia. That's the key. So, Ginny, one thing that I've just heard around the place, and I know you address this in your book, is like this this idea of gut health and inflammation Alzheimer's being like an autoimmune condition that I don't know if am I saying that correctly? What can we do as far as diet and is concerned? How much of a factor is that?

14:48 So what we have never done is put people on a prospective trial and randomize them and said, you guys got a Mediterranean type, you guys do a kido, you guys go vegetarian, and we'll keep following you up and doing brain scans and blood tests, and in fortieth time we'll see how you go, and we'll compare like with like. So we've got to look at different studies often asking people to recall what they've eaten, and we are all notoriously bad at remembering what we ate yesterday, let alone a year ago. And I know with my patients, I'll say to them, so, what's your diet like, and I'll go, oh, fish and salad. Fish and salad is what I hear every single day. You know, if you've got a body mass index of over forty, which let's just say that's very bar I'm not calling you a liar, but there's something that's escaping your memories.

15:42 It's something in addition to the fish and something. There is a little bit more happening than the fish and salad, and you genuinely don't don't remember it, but it's going down the hatch. And I think what happens is we give ourselves permission, because we think we eat nothing but fish and salad, to just have an occasional chocolate, an occasional coke or occasional McDonald's, and don't realize that that's become like a second daily event. And that's why you're getting weight same you think with these kind of trials around, you know, diet. So now that I've heavily shoved all the cadets on top of it, I can tell you that it kind of doesn't matter. All good diets contribute to less dementia, all of them. I don't care if you want to do a Mediterranean diet there's even evidence for a keto diet. It's not my favorite diet.

16:30 It makes me very constipated. It can give you very bad bread, it can give you keto rage. And you know, if you have not great kidney function, that can put a lot of strain on your kidneys. But if you like a keto diet. There's evidence for Thataria Ginny, I just find the keto is just really hard to sustain. Yeah, I mean I had to tap out. I mean, and I can't even do time restricted diet because I just get too hang grand. Then my poor patients are likely to get an ABU simple interruption, which is just some good I feel like we can split hairs between Have you ever heard of this mind diet only in your book? Yeah, So the mind diet is specifically formulated to take some of the things of the Mediterranean diet and adapt it a little bit, specifically to prevent Alzheimer's disease.

17:19 But like, rather than just giving you free rain or whatever veggies you wanted, you need to have like four to six serves of green leafy vegetables a day. I'm dying at the thought of this. And you can have lots and lots of berries, the Mediterranean lets you have red wine? Oh no, not with the mind diet. You're not having the red wine on the mind diet. So on every level, I'm just like tapping out. It's just not for me, right, But I'm not dogmatic about what diet you do. But I can tell you what's not going to work. It's not going to work as eating macas every day. What's not going to work as having chocolate and chips and having your soft drinks every day. Like that stuff is not only going to give you dementia, it's also going to give you depression. And it's also and then the depression is going to make your dementia worse.

18:00 And it's going to give you a heart disease, and your heart disease will make dementia worse. Like, there are just so many levels on which having a bad diet is bad for you. And if you're in a split hairs about whether you have Brussels sprouts or collea flower, you're in a really good space. Don't worry about it. You're fine. I love your honesty, Ginny. I love that when you present these options, you're very realistic about what is going to be workable for most people, yourself included. So healthy diet is. One thing we can all we can all do, we can all implement. So what are some of the other things that we know for sure are likely to reduce your risk of dementia? Okay, so not all of these are going to be like people champion it the bit to like get off the couch and run and do DC. But if you're the sort of person who's gone to the doctor and the doctor's gone, what pressure is a little bit high, and then they mention it again when you see them again in six nine, can I tell you that the data in now in we now know for sure that the higher your blood pressure, the higher risk of dementia. True, and that the targets that we have had until now, which is the top number that we call the systolic blood pressure we used to say when I was in medical school was one hundred plus your age. So if you're forty, so my age at fifty four, I could have a one hundred and fifty systolic blood pressure. Well that's just definitely not all we know. We need to be actually aiming for a one hundred and twenty systolic blood pressure. If you have been given a prescription for

19:30 a blood pressure medication and just like whatever, not taking it pol not good. I would be taking it. And if someone has made a passing comment that your blood pressure is a little bit high, and again you just haven't taken it seriously, I would say, hang on, go and get yourself a blood pressure and monitor. They are not that expensive, and I would go and get it monitored and actually follow it up because you want your blood pressure as well as possible. That's step one. Step number two. None of us want to be in the heart of hearing category because let's face it, it makes you feel old and you can go to a restaurant and basically not be able to hear anybody at the restaurant and you feel old, and nobody wants a hearing aid.

20:11 But the studies are definitely in that being death is very bad for your brain, and that having a hearing aid if you are death is excellent for your brain. The third thing that I'm going to say, and this will really cast resonate with you, is that depression is bad for your brain. It shrinks your brain. And there are so many people who are in denial about what is happening with their mental health. They are very biased against people who get treatments for mental health. They are quite self flagellating and think you should just be able to snap out of it, and you should just be able to You're weak if you have poor mental health.

20:53 You really need to get over that. You need to accept embrace the help you have. Depression in shrinking your brain. Every day that you are depressed is bad for your cognition. It brings you closer to dementia. And you can see treatment for depression as a measure to prevent an even reverse dementia. And that's really critical, particularly for women in midlife, because those of us like you and I, who are in mid life, one in three of us will get anxiety and depression at this time, particularly around perimenopause. It is peak time for suicide for women between forty five and fifty five. We are not getting the help that we need. We see it as weakness. We have got to get over that because it is so critical for the people around us to save our marriages, our partnerships, for the sake of our children, for the sake of our careers. You can have torrential, horrible fights to people at work because you are just not yourself and then down the track you're going to get dementia much much more profoundly. I would really urge everybody just to accept and be okay with asking for help. And the floord thing that I'm going to say is, once you fix your mental health, stay in the workforce, because we know that staying in the workforce is actually a really interesting one because it actually does help you stay younger in the brain Pew reasons Number one. Most of us tend to be quite social in the workplace, and don't think

22:24 you need to have an intellectually challenging job. If we can be very snooty about you know, I don't care if you are holding a stop go sign. I don't care if you are checking people out at a supermarket. That is great. It's great for your brain because you're chatting, you're talking, You're having to think about the things that you're doing. You're having to maintain a certain circadian rhythm. So we know that you're having to get up the same time every day, have a shower the same time every day, have your breakfast, your lunch, your dinner at particular times during the day. That's going to be good for your sleep. We know that one to go into retirement, all of your circadian rhythms all go out the window. And we think we're going to take up Portuguese and start doing backgam and then we're going to learn, you know, of secure Russian poetry. We don't. You tend to just do nothing and your days like just become about a day at the supermarket, and that is really bad for your brain. So even if I think it will be some people who are retrenched and don't have that option to stay in the workplace the way they wanted to, particularly if they're depressed, that has a big impact on your confidence and that confidence. Cliff can just see a lot of women in particular just hit a wall and sky on'em out. I'm quitting, and then can't find their way back into the workforce. Volunteer, do whatever you need to do to keep a regular routine and a regular rhythm to your day, even if it's not in the paid work force. My preference is the paid workforce because you notice something every day. Mun's learn some money for it.

23:54 But I would try and remain engaged and live a life of meaning purpose as long as you possibly possibly can there might be quotips. I hope that you're enjoying this conversation and realizing the benefits of positivity in your own life. If you are enjoying the show, please be sure to like and subscribe so that you get notified when you EPPS drop and head on over to Apple Podcasts or wherever you listen and leave. Us a rating and review. I was really interested in what you said about depression, Ginny, because I remember when I was studying my psychology degree way back when you know you have to study geriatric psychology, and what they say is that depression in older people can look like dementia, like depression mimics cognitive decline. Is that still kind of the case or is it that the depression is causing it?

24:56 A little bit of both. So we know that in older onset dementia because personality changers come along with the forgetfulness, which I think is what everybody thinks of when they think of dementia. A lot of people can have a severe about of depression for the first time at let's say seventy five, and you know, Mum just all of a sudden doesn't go to book club anymore, doesn't go to bridge, doesn't do much, just sits around and watches television, seems to be disengaged, doesn't qutch up with their girlfriends anymore, And we don't necessarily see what's going on until it eventually declares its hand. And it's obviously was the first signs of dementia. And that's very, very very common. What we tend to say when it comes to distinguishing a dementia that is presenting as a mood disorder versus a depression, is that somebody who's depressed, if you say to them, what's five plus five, they'll say, oh, I don't know, I can't be bothered, Whereas the person who's just got dementia will go they'll actually try and answer, and they'll give you a wrong question and then get quite defensive about the fact that you must be wrong if you tell them they're wrong. So people with dementia often they are quite defensive. And very few people come to me and say I think I've got dementia and I go, yeah, I think I agree. Mostly it's their family members will bring them in and go. Was just reprieting herself all the time, and she got lost yesterday at the shopping center and couldn't get home. And that's the sort of thing where the family members noticed that the house was a bit of a mess. Shouldn't seem to be doing

26:27 the washing or it seems you know. That kind of thing is what the family members will pick up and Mum sitting and going, there's something wrong with me. You're the one who's just you've got problems, you're issues, and whereas the depressed person will be the one presenting for the saying I'm forgetting everything and not even trying to answer a question. We used to think that the dementia pausing depression was the big issue in psychogeriatrics. We now know that depression in mid life is a huge risk for dementia and it's partly driven by the changes in cicadian rhythms. A lot of people with depression don't sleep well, yes, and we know that a lack of sleep will definitely contribute to dementia. But the depression itself, you can actually scan people's brains and watch their amigndala and hippocampus actually start to shrink, because that's what depression does. It's a brain shrinking disease.

27:20 Yeah, wow, that's so interesting. The other thing that I found really interesting, Ginny in your book in terms of the things we can do to prevent dementia, gardening, of all things, can we talk about gardening? Yeah, yeah. So there was a really great study out of Dubbo that looked a different wine intake, which was quite good. So any alcohol taking that double studies seem to be protective, which I love personally. But in terms of exercise, which is very interesting, is actually really hard to find conclusive proof that any exercise actually prevents dementia. Even though we know that exercise will help prevent heart disease, and it's good for depression, and it's good for blood pressure, it's good for diabetes, and all of those things individually contribute to you know, particularly DA vascular dementia. But really hard to actually find good studies that demonstrate a really big difference from exercising in terms of preventing dementia. I'm not saying not to do it, but the studies show very small differences. But the Dubos study actually showed that if you compare things like dancing and walking, actually the best exercise for preventing dementia is gardening. And there are quite a few theories around that, but it looks like it's partly the rigorous exercise. It also could be that people who own a garden are possibly slightly wealthier than people who maybe you live in an apartment block that's urban, and so that could be part of it as well, because in an apartment, if you are poorer, we know

28:51 that you have much higher rates of a whole lot of preventable diseases. But the other thing is it's exposure to nature and exposure to greener rich which is so good your brain. And we know that on so many levels. We have lots of studies that link exposure to nature with better mental health. I know for myself when I go on holidays, I'm not as keen to go into an urban setting and just go immerse myself in New York or Paris. I know their great cities, and I'm going to go to New York one day, but I would prefer to go hiking and just be out in nature because to me, I can just feel my brain just relaxing. It's a very very good seeing for your mind and for your body to be exposed to greenery.

29:35 And it seems that gardening combines that exposure to nature and plants in greenery with that bit of vigorous exercise as well, So that's possibly that's a theory. At any rate. I took my dogs out for a walk yesterday, brought out to dogs with us to the UK, and we are living in a very built up area at the moment. I live in a skyscraper. The weather's pretty crappy outside a lot of the time here in London, and I will my dogs and thought, I'm so glad to have these dogs because they forced me to get outside. It doesn't matter what the weather, rain, snow, we have to take them out. They forced me to get that green space and I feel better every single time, regardless of the weather. And I know that if I didn't have them, there's no way I would walk out in the pouring rain.

30:19 But I do. So are there benefits of having a pet too? Just for that, like for that having to get out there. So the pet ownership has been studied in smaller studies in relation to like cardiovascular eiskin, stroke, ory skin things like that, and the assumption is that, yes, pet ownership does seem to matter for you. But one of the things that pet ownership does as well is. It does give you a genuine connectedness, and particularly if you are if you live alone or if you are in a community at times where you feel a little bit disconnected from others, your dog in particular, and if it even cats. I think people underestimate how loving cats are. I love cats too, but they sort if they really make you feel connected. And I know it for myself. When I walk my dogs, I just they are so happy, and happiness is so contagious and I and you know, they just smile as they're like, we live very close to a park, so they just run around this park with these enormous grims on their face. I like, how can you not feel happy when you just see these happy dogs just they're wagging their tails and running around. They're just having such a good time. And it just does make you surel good. It gives you a spring in your step. You do walk a bit bath because you're excited to be around these little things. So I really recommend pet ownership for a number of reasons. Also because it's that human touch, you know, and also because they get you up in the morning, yes, you know they do, and they help you keep that circadian rhythm because you

31:52 know you ain't sleep until ten am. If you've got a dog or a cat, they gonna be out you for food. It's so true, so true, And you made the point there, Jinny. About social connectedness, I wrote my third book was about improving your social connections and really dug into the impact of social isolation and loneliness on mental health and physical health. I'm assuming dementia comes into that as well. One hundred percent. So socializing is a really big preventor of dementia. And it's really interesting. It doesn't need to be deep and meaningful, poor your heart out, beaus. Some of my patients will say to me, I'm just not that kind of person, and I really get that social connectedness as Cassie or the expert on this, But it can just be sitting on a couch next to somebody and feeling really comfortable. That can be social connectedness. It can just be somebody that you send a text message with warm and fuzzy feelings, you know, a nice emoji to somebody can make you feel really connected. You can be at work and you can just have a laugh for some of you or share a joke at the at work, and that will it's just it doesn't need to be that difficult. But what I would encourage everybody to do who's feeling maybe a little bit lonely right now, is when you go to a shop and somebody is helping to check out your groceries, why don't you make eye contact with them and just see if you can connect, ever so briefly with that person. But that's so good

33:23 for your brain and so good for your soul. And you can see most of us. If you take a load to everybody that you see in the street, few people will be very gruff or treat you like an idiot. She will say hello back and smile at you and lift your mood, and you can actually make the briefest of social connections. But they are so good for your brain. But one of the reasons why staying in the workforce is really good, yeah, because some of us, as we get older, it's hard to maintain friendships. People move. You move to London. My brothers moved to Melbourne. Like older family members pass away. This is our children move out of home. So you've got to work harder to get your social connectedness. So it's those little moments you don't have to make a patchwork quilt of lots of little moments of connecting it and a lot of those from work as.

34:10 Well, And that's really interesting, Ginny. I think number one the point I would really emphasize there is the power of those micro moments of connection. I've seen some really interesting studies in. Psychology as well about the impact that that has on your whole physical, your cellular health. Just those eye contact moments. They don't have to be you know, huge big social events, just those micro moments of connection. But also this whole staying in. The workplace, whatever the job is, it doesn't have to be intellectually challenging at all. So this brings me to how important is it to be doing like stimulating our brain, like doing the Sodoku puzzles or the crosswords or whatever it is to keep our brain active.

34:56 So there's a whole industry cass that has throw on telling people that they need to do this or that particular puzzle that's an app online that you need to download and pay for and once you mastered that, you've mastered it, and there's no further dividends from doing it. What we know you should be doing is just continuing to challenge your brain, because what that does is your brain will build new connections between different parts of the brain, and that growing new nerve connections is actually what we call neuroplasticity, and it does help keep your brain young. But it can be something as simple as if you always brush your teeth with your right hand. If you try and brush your teeth with your left hand, the first time you do it, you will feel really weird and you'll probably shut your teeth up your nose and you'll do a terrible job on your teeth. But if you did that for two weeks, because there are some people who break their arm and they can't brush their teeth with the right arm, by the time they are like two weeks into it, they're really good at brushing their teeth with it. That's done a whole lot of new not new nerves, new connections between existing nerves, and that is helping to keep their brain young. So nobody needs to learn Russian, or no one needs to start to go to the opera. You don't need to start reading Tolstoy. What you do need to do is just learn to do something that you haven't done before, and not every day. It's just regularly give your brain a challenge.

36:22 Try a new recipe that you haven't tried before. If you always do crosswords, try and do notts and crosses. If you've done lots and crosses, try and read the sports section of the paper. I know that to miamas or be reading great how I can't understand a word of the sport section, But you know, I reckon within a week I'd be all over to sports section. I would even be able to understand the racing, which is just really look do my head in. But what we're trying to get you to do is just to experience things differently. But one of the ways in which you improve your neuroplasticities by studying faces and having eye contact with people, because you are actually reading people's faces and try trying to work out is that a happy face? Is that a sad pace? How have they reacted to what I've just said? Are they bored? Are they thick?

37:07 Are they healthy? Your brain is giving you so much information just by looking at fates, and if you want to look at how brain works, look at a baby's face when they study a new face. And this happens to me every day in my surgery because I've got to do examinations of a new two month old, or a new six weeth old, or a new four month old. And even in my mask, my patience, my little baby, four month old babies, they study my face and then inevitably they start to smile. They don't need to see me smiling. They can't see my mouth, all my nose. They see my eyes, and they are responding to my smiley eyes with a smile back. They are studying and observing all the time. So much information is imparted by a face. And if you're not studying faces in the street, behind the counter of your cafe, at your workplace, you are missing out on so many opportunities to challenge your brain and to make connections at the same time. It's such a bargain.

38:10 Yeah, such good advice. Last, but not least, Ginny, alcohol, You're very clear in the book that you're the person who hates exercise loves wine, and you did not want to do this research and find out that you had to start exercising and give up drinking. So for the people, Ginny, what's the verdict? So, look, I think I do need to start exercising. I actually interviewed twenty two experts around the world to find out what they were doing. These were the people who were leading the research into dementia prevention and management, and every single one of them is exercising is the only thing that they absolutely all agreed on. So yes, I do have to start exercising. Sadly, for me, I've elected tai Chi because love it. I think it's very serene and it's also out in the green. It gives me mind son as it gives me balance. I don't want to fall over. So I'm an old lady, so I've elected tai Chi. That's my go to. In terms of the white I have good news. Okay, I had to have stacks of wine every single night. But if I want to have a glass of red wine every night every other night, I'm okay. It's in the Mediterranean diet.

39:09 It was in the double study. We don't have a lot of evidence that mild drinking, so a standard drink in Australia is ten grams of alcohol, which is in one hundred miles of wine, and red wine seems to be the thing that is in the Mediterranean diet, so it seems to be the best that happens to it very well with my love of shrass. So I can do that, and I can the NH and MRC guidelines, which is the National Health and Medical Research Council, which is like a peak body in Australia that kind of opines and all things. Hell, they have said ten standard drinks a week is safe and it might even be beneficial for your brain. It might not, but some studies are showing that it is beneficial for your brain. I would not be hitting the bottle with gay ban and then just thinking that you can just you know, down ten scotches or half a dozen Med's cows and pain at price for it. But I think if all you want to do is have a glass of wine and Vinada and every other night, go for it. And I've certainly heeded my own advice, or let's just say, continued to heed the advice today. I didn't even know I had before I read this book Very good.

40:11 I knew that people would be wanting to know the answer to that question, so I thought about it to make sure I get that one in there. Jinny. I think that we have covered all of the key important factors. The book is called Save your Brain. I really loved it. I wanted to share with listeners that for the science nerds, there's plenty of science in there, like if you really want to look into the research and the different trials and medications and the brain chemistry, it's all there. But it is not a dense, heavy hard read. It's also very accessible, very digestible, and loads of little practical takeaway tips. So I think we are all affected by this, not only concerned for ourselves, but our parents, our in laws, you know, extended family.

40:55 It is everywhere. So if you were confused like I was, then I would really recommend that you go grab this book. Ginny, thank you so much for your time today. Has thanks so much for having me on. Save Your Brain is out now in all bookstores. You can connect with Ginny at her social media Doctor Ginny dot com is her website. I'll drop all the links to her social media channels in the show notes. Obviously, I would love you to come and connect with me. I am cast Done underscore XO. I am mostly on Instagram and you'll find me on TikTok. My Facebook is castone dot xo and my website is cast done dot com. If you enjoyed this episode.

41:35 If you like the show, please do you think about leaving us a five star rating and a review. It really does help to. Get us into the ears of more listeners and make sure you hit that plus button to subscribe so that you never miss a new episode. And I can't wait to catch. You on the next episode of Crappy to Happy Listener