These 5 things reduce your probability of developing Alzheimer's | Lisa Genova

Main Ideas

Alzheimer’s Disease and Memory Changes

Lisa Genova describes Alzheimer’s as beginning with an imbalance in amyloid beta: either too much is produced or too little is cleared. It can accumulate into plaques, and after reaching a tipping point, trigger further brain changes associated with the disease’s symptoms.

The buildup may take 15–20 years. Genova says Alzheimer’s is not inevitable for most people: genes contribute to risk, but lifestyle also matters. She says about 2% of cases are fully inherited.

Ordinary lapses—such as forgetting why you entered a room, where you parked when you weren’t paying attention, or someone’s name—are common and do not, by themselves, indicate Alzheimer’s.

More concerning patterns include repeatedly losing common words, forgetting recent conversations or important events, not recognizing your own car, or not remembering how you arrived somewhere. Genova notes that memory problems can also have treatable causes, including B12 deficiency, chronic sleep deprivation, and depression.

The disease may progress beyond the hippocampus, affecting problem-solving and decision-making, spatial orientation, language, and emotional regulation.

Five Lifestyle Factors Genova Says Can Reduce Risk

1. Sleep

   • During sleep, the hippocampus consolidates attended-to and meaningful experiences into lasting memories.
   • Sleep also supports attention the following day. Poor sleep can make it harder to form new memories.
   • Brain glial cells clear metabolic waste, including amyloid beta. Genova says chronic sleep deprivation may interfere with this clearance and contribute to plaque accumulation over time.

2. Diet

   • Genova cites studies associating Mediterranean- or MIND-style diets with a lower risk of Alzheimer’s.
   • Foods she recommends include leafy greens, brightly colored fruits and berries, fatty fish, nuts, beans, and olive oil—“eating the rainbow.”

3. Exercise

   • She highlights aerobic exercise, giving the example of a brisk 30-minute walk four to five times a week.
   • She says studies link exercise with lower amyloid plaque levels and reduced Alzheimer’s risk.

4. Stress Management

   • Short-term stress can sometimes help attention and performance, but prolonged, unmanaged stress can impair memory.
   • Genova explains that chronic stress may disrupt the body’s cortisol feedback system, keep the body in a fight-or-flight state, shrink the hippocampus, and inhibit the growth of new neurons.
   • She names exercise, yoga, meditation, and mindfulness as approaches that studies have associated with restoring hippocampal size and improving stress-related effects.
   • A brief breathing exercise she demonstrates:
     1. Close your eyes if it is safe and appropriate.
     2. Breathe in through your nose for a count of four.
     3. Hold briefly.
     4. Breathe out through your nose for a count of four.
     5. Notice how you feel.

Her explanation is that slow, calm breathing can signal safety to the brain and body.

1. Learning New Things
   • Learning builds synapses and neural connections, creating what Genova calls cognitive reserve.
   • If Alzheimer’s-related pathology blocks some connections, a more connected brain may have alternate routes for retrieving information.
   • Regular cognitive activity, in her account, can help build a more resilient brain.

Overall Message

Genova’s central point is that Alzheimer’s risk is influenced by more than inherited genes. She encourages supporting brain health through sleep, diet, exercise, stress management, and continued learning, while distinguishing ordinary forgetfulness from persistent changes in memory and thinking.

Speakers and Sources Featured

• Lisa Genova — author and neuroscientist; the interview’s principal speaker.
• Unidentified Big Think promotional voiceover — membership and magazine promotions at the beginning and end.