Optimal Aging

Can You Prevent Dementia? Angela Lunde from Mayo Clinic Explains the New Science

• Jay Croft

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Alzheimer’s disease and related dementias now affect more than 55 million people worldwide — and that number is growing fast. But is cognitive decline inevitable? Not anymore.

In this episode, Jay Croft speaks with Angela Lunde, a 24-year Mayo Clinic veteran and co-author of the newly revised Mayo Clinic on Alzheimer’s Disease and Other Dementias. Angela shares powerful insights on how lifestyle choices, early detection, and caregiver support are reshaping the landscape of brain health.

You’ll learn:

  • How lifestyle factors like exercise and social connection impact brain function
  • The latest in dementia risk reduction, including the POINTER study’s findings
  • What new treatments are showing promise — and what still isn’t possible
  • The emotional reality for caregivers, and how they can build resilience
  • How fitness and wellness pros can guide clients over 50 toward better brain health

This conversation is both deeply informative and inspiring for anyone concerned about aging, dementia, and long-term wellbeing.

👤 Guest: Angela Lunde
Bio: Angela Lunde is a dementia care expert and advocate at Mayo Clinic’s Alzheimer’s Disease Research Center. She has worked for over two decades to support individuals and families impacted by cognitive decline and is the co-author of Mayo Clinic’s definitive book on the topic.
Links:
🔗 Mayo Clinic Book: https://a.co/d/0QBlUNh

🧠 Episode Outline:

What’s New in Dementia Research

  • Angela explains how imaging and biomarkers are reshaping early diagnosis
  • New anti-amyloid treatments and their potential (and limits)

Risk Reduction Through Lifestyle

  • Review of the 2024 Lancet Commission findings
  • POINTER study confirms that 4 habits — exercise, diet, social connection, and checkups — make a difference

What This Means for Wellness Pros

  • Jay and Angela explore how health/fitness pros can play a crucial role in prevention and support

The Caregiver Experience

  • Why caregivers are “invisible second patients”
  • Angela’s 4-part “recipe for resilience” every caregiver should know

🎤 Host: Jay Croft
Jay is a content marketing strategist helping fitness and wellness professionals engage the over-50 market.
🌐 https://primefitcontent.com

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📥 Contact – jay@primefitcontent.com

Speaker 1:

We now know that untreated vision and hearing loss can increase risk for dementia and also later in life, social isolation we tend to. Sometimes, as we get older, we may find that our sphere, our number of friends, begins to decline for a variety of reasons, and we can have a tendency, as we get older, to not go out and look for new friendships and to spend more time alone. And oftentimes we're not in a situation where we're working and so replacing those natural ways that we've had relationships seems to, according to the data, have a big impact in the overall health of our brain. So in 19 or 2024, the Lancet Commission on Dementia put out these 14 modifiable risk factors for people to pay attention to. And then, just a few weeks ago, the Alzheimer's Association. And then, just a few weeks ago, the Alzheimer's Association in their international conference that took place in Toronto, canada, shared the results of a major study called the Pointer Study, and the Pointer Study, like the Lancet study, was looking at the overall contribution of lifestyle to one's brain health.

Speaker 2:

Alzheimer's disease and other dementias are right there at the top of our common fears about aging, and today they affect more than 55 million people around the world. That number is expected to more than double in the years ahead, and for a long time these conditions were seen as unavoidable, with little hope for prevention or even meaningful care. But in recent years that's been changing. Research is uncovering more about how lifestyle factors like exercise, diet and social connection can influence brain health. At the same time, we're gaining a deeper understanding of what patients, families and caregivers need to navigate the challenges of dementia with compassion and dignity and effectively for their health. The Mayo Clinic has just released a new edition of its book Mayo Clinic on Alzheimer's Disease and Other Dementias. It blends the latest science with practical, human-centered advice.

Speaker 2:

One of its authors, dementia care expert Angela Lundy, is my guest today on Optimal Aging the show for fitness, health and well-being professionals who want to reach more people over 50. Now I'll be talking soon with her co-author, dr Jonathan Graff-Radford, a Mayo Clinic neurologist, but today Angela and I discuss what's new in dementia research, how caregiving is evolving and why prevention and lifestyle are now at the center of the conversation. What does that mean for you in the fitness, health and well-being industry? A lot. I'm Jay Croft of Prime Fit Content. I'm glad you're here. Let's dive in. Angela Lundy, hello, nice to see you today.

Speaker 1:

Yeah, nice to see you and be with you, Jay.

Speaker 2:

Well, I'm really honored and jazzed that you're here with me, because to have this new book that you all have put together on Alzheimer's and other dementias is extremely interesting to me and to the folks listening to this show, because of all the really exciting advancements that are being made in how we're learning that our lifestyle choices and our habits, including exercise, can play a role in our brain health, including exercise can play a role in our brain health. So before we get into all of that, please tell me a little bit about yourself and your role at the Mayo Clinic and then a little bit about the book and what's happening with that.

Speaker 1:

Yeah, happy to. So. Yeah, I've been with the Mayo Clinic here in Rochester, minnesota, and specifically with the Alzheimer's Disease Research Center now for the past couple of decades I think I'm 24 years-ish and my role is I do some research in the area of caregiving. I've also have found myself as a strong advocate for persons living and impacted by different causes of dementia. The most, I think, common cause and the one that people think about oftentimes when they hear the word dementia is Alzheimer's disease.

Speaker 1:

And I think when we hear the word Alzheimer's disease, we get pictures and ideas and images in our mind oftentimes of older adults, sometimes individuals who can no longer do things or have disabilities or deficits, and it can really paint, I think, a message of despair.

Speaker 1:

And I share that up front when you asked me to introduce myself, because one of the things that I've had the privilege of over the past two decades is to truly be mentored and taught, not necessarily by my medical colleagues and professionals, who are brilliant and who have taught me a lot, but I think what's most relevant and has been most impactful to me is just how much I've learned about the true experience of living with dementia by surrounding myself and listening to the situations and the stories of those impacted by dementia. So, in my role, I try to understand the experience of dementia from the perspective of those who are impacted, as well as their care partners, and I've, through those lessons learned, I've tried to pass on information that I think is most relevant and helpful to those who are impacted. Today, these diseases sound devastating, but there are ways that people have found to live alongside these diseases in a way that doesn't derail their overall well-being, but in a way that can preserve it. So, in the multitude of things that I do, I think that's the most important.

Speaker 2:

So tell me about the book and what's revised in it regarding these topics that we're talking about, regarding lifestyle choices and caregiving.

Speaker 1:

Yeah. So you know, I think it's great to have a new, revised book come out, because the field of Alzheimer's disease and related dementias has really had a lot of forward movement, I would say, in the last five years, since the last book came out, to understand this disease and what's happening in the brains of individuals who have the pathology for something like Alzheimer's disease, decades before they have symptoms. So in the past, our understanding and diagnosing of these diseases usually occurs because somebody goes into the offices and is complaining of some kind of oftentimes memory-based symptoms. And while that's still going to be the way that is going to contribute to us diagnosing, what we now can do through the help of imaging and something referred to as biomarkers, is our scientists and our doctors now have the opportunity to begin to see the disease in the brains of individuals decades, probably 20 years or more, before they're going to start to have memory problems and other related symptoms.

Speaker 1:

Significant and pivotal, because part of the reason we may not have been able to land on really good treatments for this disease may be, and probably is, because the disease is so far progressed by the time somebody is sitting in their doctor's office presenting with symptoms.

Speaker 1:

So at least right now in research, we could image the brain of somebody and see whether or not the pathology, these plaques and tangles, are present in the brain, because that's likely going to be and is leading to, I think, big breakthroughs, and how, ultimately, we will be able to treat maybe not stop the progression of the disease altogether, but maybe we can treat the disease so that, even though the pathology may be present in the brain, it may not get so far down the road as to actually have people presenting with the kinds of symptoms that you and I see in individuals impacted by dementia. So the book's going to go out and I think the book will do a really nice job of beginning to help people understand why this is so significant. In addition to that, it will talk about some of the new therapies that are currently available that were not available five years ago.

Speaker 1:

There's therapies in a category called anti-amyloid treatment and they are treating and actually getting rid of one of the culprits of Alzheimer's disease, which is amyloid. So again, five years ago this treatment was not available. Today it may be and often is available to individuals. We believe it can be done safely. It's not a home run, though. I mean this is not going to reverse the disease, it may not even stop the progression of the disease, but it's a Pretty significant treatment and likely for many people having the potential to truly slow down how fast the disease progresses. We think that's important. It's a really important step that we have that we weren't able to talk about five years ago. You'll see, in the book is there is much more about our understanding of who is at risk for Alzheimer's disease and related dementias and helps to ultimately get at Jay.

Speaker 1:

I think one of the most common questions that I get asked, and that question is can I prevent dementia, or what can I do to prevent dementia?

Speaker 1:

And we may come back and chat a little bit more about that. And then the third thing that I would say that the book does is it lays out a roadmap or a path, as best as we can, to assist those individuals who they themselves were diagnosed or their family member or friend were diagnosed, and living alongside these diseases in a way that preserves your own wellbeing, in a way that doesn't derail you down a path of darkness, which I think it can sometimes feel like for people, especially when they're first diagnosed. But once you begin to understand a bit about what you can do to preserve your own well-being, what you can do to leverage and pay attention to the parts of your brain and your functioning that aren't as impacted, you know the thing is with dementia we tend to focus on what's wrong and where the changes are and where the deficits are, and you know, and that makes sense, right, Because something has gone wrong and so many people have spent months going to the doctor and going through testing to figure out what is wrong with them.

Speaker 1:

And then our focus is so narrowly into this area of what's wrong that we can forget about the fact that we have tens of thousands, of millions of neurons, some of them impacted by these diseases and some of them not so much. So I think the book really helps people figure out how can I focus on my strengths, my abilities and what's preserved and do some workarounds in those parts of the brain that aren't working so well.

Speaker 2:

You mentioned prevention and perhaps slowing symptoms, not just through treatments, but perhaps through lifestyle factors. Through treatments, but perhaps through lifestyle factors. Tell me a little bit more about that. If I'm in, the listeners of this audience of this podcast tend to be in fitness, healthcare, wellbeing, that kind of thing, typically with people 50 and over, and I think there's a growing awareness among them that how you eat, sleep, drink, exercise, manage your stress all these things have a role to play in your brain health. Can you tell me a little bit about that and how it fits into this idea of I don't want to say prevention, because I know it's not as simple as do this and you'll never get Alzheimer's disease? It's not what I mean to suggest, but tell us a little bit about that, if it's, if it's relevant to the book about these lifestyle changes that people can adopt.

Speaker 1:

Yeah, I, I, you know I think this is a great conversation to have right now too. You know, for so long we've been talking about the importance of lifestyle changes for for brain health. This isn't a new topic per se, but I think what's new is that over the last five, six years, and even just over the last six months, we're beginning to see more data that's supporting this idea. It's not just a good idea. We think we're really able to put some data to that idea and show that there is evidence that lifestyle makes a difference. And I like something else you said, jay.

Speaker 1:

It's likely not one thing we're not going after, just dissecting well, is it diet or is it sleep? It likely is the combination of all of that. Some we may weigh a little bit more heavy than others in terms of the data we have to support it. And I'll kind of give you, you know, an idea of what might you know if you were to only focus on a few things, what they might be. So I love the fact that we don't just get to have a conversation about what we think is good for your brain when it comes to lifestyle. I think we now have more evidence to say we're pretty sure that these things contribute to good brain health. Before I talk about what some of those things are, I do want to just mention that the number one risk factor, the number one risk factor for dementia, will not surprise you, right, and you probably know what it is. Right, jay.

Speaker 2:

Oh, now you're putting me on the spot.

Speaker 1:

I'm putting you on the spot.

Speaker 2:

Genetics.

Speaker 1:

Well, that's another risk factor, for sure, but the number one risk factor is age.

Speaker 2:

Well, okay, of course right, yeah, yeah, yeah.

Speaker 1:

Say that people are like yep, of course. So I think that's probably why your audience as well, right, is interested in this topic, because as we get into our late 50s and 60s and 70s, we're beginning to get worried because we know that you know more and more perhaps of our peers are having these kinds of struggles and getting diagnosed. Getting diagnosed Genetics is number two, but I think what we've really begun to learn about genetics especially for the typical later onset dementia that might happen in somebody's you know, late 70s, early 80s that genes may play a role, but what probably plays more of a role is one's lifestyle. And back in 19, or 19, back in 2024, there was a report that was out by the Lancet Commission on Dementia and Prevention, and what this report did is it helped us to understand more of what these modifiable risk factors are, and so there's actually 14 of them that the Lancet report outlined, and these are lifestyle risk factors that are correlated with different points in our life. So their report was called the Life Risk Profile, something like that, but what it showed was there are certain things we do when we're young that impact the overall health of our brain and certain things we do more in middle age and certain things that we can do later in life that impact the health of our brain. So, for example, when we're young young ish, you know there is an association between the amount of education that we receive and the impact that it might have on preventing dementia.

Speaker 1:

And then when we get into our mid years, it may be things like whether or not we're smoking and our diet and risk for diabetes, et cetera. And then when we get into the later stages, there may be some other things that play a role. For example, managing blood pressure is big, both middle and later stages in life. Treating hearing loss, treating vision loss we now know that untreated vision and hearing loss can increase risk for dementia and also, later in life, social isolation we tend to. Sometimes, as we get older, we may find that our sphere, our number of friends, begins to decline for a variety of reasons, and we can have a tendency, as we get older, to not go out and look for new friendships and to spend more time alone, and oftentimes we're not in a situation where we're working, and so replacing those natural ways that we've had relationships seems to, according to the data, have a big impact in the overall health of our brain.

Speaker 1:

So in 19 or 2024, the Lancet Commission on Dementia put out these 14 modifiable risk factors for people to pay attention to. And then, just a few weeks ago, the Alzheimer's Association, in their international conference that took place in Toronto, canada, shared the results of a major study called the Pointer Study was looking at the overall contribution of lifestyle to one's brain health, and so this was a two-year clinical trial, and it found that engaging in a few things simultaneously had a protective effect to the brain. And these few three or four things I think it was four things I'm just going to read from my notes here, so I make sure that I get them right they found that regular physical activity probably not a surprise to you and your audience, jay right a brain, healthy diet.

Speaker 1:

Three was cognitive and social engagement. And four was health monitoring and by that I mean just going to your doctor for regular physical checkups to make sure everything looks okay that if individuals do these four things kind of at the same time as part of their overall everyday lifestyle, they can improve the function of their brain as they grow older. So it really did the same thing, or shared the same thing, that the Lancet study did, but I think it helped us drill down even further what those maybe most impactful things are.

Speaker 2:

Hey, are you a fitness professional trying to grow your business with people over 50? If you are, then you need to know how to communicate with them, how to market to them and how to get them to trust you with their fitness, well-being and money. We're talking about millions of people who are a little older than the typical market that the fitness industry usually pursues. They have more money, more time and better motivation to make the best long-term fitness consumers you'll find anywhere. If you're not focusing on them, you should be. Prime Fit Content is the only content marketing company designed specifically to help you engage people in this group and to help you distinguish yourself from competitors in your community. It's effective, affordable and super easy to use. Check it out at primefitcontentcom. That's prime like prime of your life, fitcontentcom. Back to the show. I read about the Toronto study a couple of weeks ago and I shared it with my readers and it seemed to be more, not different, but more right. Is that a fair way to put it? How much more do we need? And then I guess what I mean when I mean we. I'm not talking about the medical establishment like the Mayo Clinic. I guess I'm talking about I don't know, as ordinary folks out here. When do we start getting the message that there's more to it than just being a sitting duck? You know that we can help our parents and our grandparents and ourselves by adopting better habits.

Speaker 2:

Maybe that's not a question we're going to answer today, but it's the kind of thing we talk a lot about in fitness for people over 50. It's not just about going to the gym and lifting weights. It's about maintaining social contacts. It's about getting out of the house, it's about getting your heart rate up and managing your blood pressure and encouraging people to get their eyes checked and go to the dentist and all of these things that can really fall off later in life. Or maybe when they fall off and you're 30, you don't really notice or you bounce back or you just get your teeth checked next time or what have you.

Speaker 2:

But they're more important in the overall picture. So I guess I'm wondering what you can tell me. What can I do to help gym owners and people in this consumer facing hands-on business reach out to people and help them. Help them connect going to the gym and lifting weights to protecting their brain health, without without being silly about it? I mean, I don't want to suggest that, oh, go go to the gym and you'll be fine. That's not it. But there is some something really valuable here that I don't think is getting out to people.

Speaker 1:

Yeah, I mean, I think you know for so long. Sometimes it just feels like you know, I remember so often looking at these studies and year after year it kind of said, well, it looks like you know it's, it's really good to just the studies show that exercise is good for you. The next study showed that exercise, you know, we've heard that message that I'm just wondering if we've just become, you know, a little bit immune to it, because how many more studies do we need to do to prove that physical activity actually is a really big deal in the overall, our overall health and well-being? But I think we're in a different place, because I think the evidence we have around how physical activity and social engagement and good diet actually does play a role in the day-to-day operations of how well our brain is functioning, and if we're trying to convince people now, I think we have more evidence than ever before. So people really want to read. You know, and there's always, you know, the science around lifestyle is never perfect science, right? So we also have to, we have to tell consumers and especially those who are really savvy in the research space. It's not like a clinical trial where you give one group a pill and you give the other group a placebo and you can clearly see the differences. Oftentimes, when it comes to lifestyle, many times we're asking people to tell us, to self-report what they're doing and what they're eating. So we know that there's a little bit of messiness in the data, but I think what we really look for in lifestyle based data is well, what are the trends? Are we seeing that there are some things, self-reported or not that seem to land some people in the good brain health category and others not so much? And that's where I think we're at right now. I think we can say with more confidence and certainty that doing these things will impact the overall health of your brain.

Speaker 1:

Now I'm also going to say something because I'm guessing some of your readers or listeners are also going to be they themselves, or maybe they know somebody who does everything right, who's like I've been going to the gym forever and I eat a Mediterranean diet and I'm, you know, engaged and have people around me and have dinner with you know, my family and my grandchildren. And yet look at me, I just received a diagnosis of Alzheimer's disease. So this isn't foolproof, but when I share an example that I, that I hope will be meaningful to to to the listeners here. I was chatting with this couple a couple of years ago and the wife was was recently diagnosed with Alzheimer's disease and I was talking about all the things that they could be doing for the betterment of their brain. And they came up to me afterwards and they were annoyed and frustrated and they said to me hey, listen. So my wife this was what the gentleman said, and she said this about herself. You know. She said I have I got diagnosed with Alzheimer's disease, but I am a professor at a liberal arts college and I teach seven languages.

Speaker 1:

She was an amateur tennis player. She, even though she lives in Minnesota, she they have a year round greenhouse where they can grow their own organic vegetables. They traveled the world. Her husband was a marathon runner, also a professor at the college. So they were just saying we should not be here. Everything you've said, I should not be here.

Speaker 1:

And so my question to them was well, can I ask you how old you are? And they were both in their early 90s and I know this isn't always the case. But my comment to them was I am pretty sure your diagnosis could have occurred 10 or 15 years earlier had you not been living the kind of lifestyle that you had. Now that doesn't necessarily explain why somebody who has a really great brain healthy lifestyle gets a diagnosis in their 60s. I think in those situations we probably are faring a little bit more on what's going on genetically that may have had them predisposition to have this disease earlier than most. But I think if we're living a brain healthy lifestyle, there's a really good chance that we may push back the point at which we start to have symptoms.

Speaker 1:

It may not mean that we'll never get dementia but it may mean instead of having symptoms at the age of 75, or having it at 80 or 85. And that is better than any medication we have available right now. Even the new anti-amyloid treatments that are now available will not delay the progression of symptoms as much, I do not believe, as the kind of lifestyle factors that we're talking about today, Jay.

Speaker 2:

That's profound and I want to be respectful of your time and wrap this up by asking you to describe for me the recipe for resilience, because the message to caregivers is super important and I love the way you put it with the recipe. What do caregivers need to be doing to take care of themselves and how can they get over the? I'm guessing there might be some guilt associated with self-care. How can I take care of myself? I've got to take care of my husband or my wife or parent or what have you.

Speaker 1:

Yeah, I love that Guilt with self-care is a real thing. In fact, if I were to describe to you the two emotions that I think are often talked about and most prevalent in dementia caregivers, it's guilt and grief. Those two are truly heightened. So you know the book outlines this a bit more, but let me just go through those sort of the four things that I think are key, and the first one is acceptance. And when I talk about acceptance, I'm not talking about as a caregiver that you're agreeing with or liking the situation or giving in or giving up. What I'm talking about with acceptance means that you've transitioned from this place of a little bit of denial which, by the way, is a very effective coping strategy for us in difficult times to truly seeing things as they are. I had a family say to me a few months ago we had to stop dwelling on the way our mom used to be and be fully present for who she is today. That's a great example of what acceptance sounds like Letting go of who they used to be and being fully present, and all the heartache as well as the beauty that can be before you. So acceptance is transformative. Acceptance means being honest about what you can and cannot control. Acceptance means believing that good enough is good enough.

Speaker 1:

The second thing that I would say is in that recipe we spoke about already, and that is caregivers will feel grief.

Speaker 1:

Caregivers feel grief, and it's important for caregivers to actually acknowledge and feel their grief, versus push it aside or suppress it. Grief cannot be ignored, nor can sadness or guilt or any other tough emotion. There's a saying out there that goes what we resist persists, and in order to transform difficult feelings, we first have to acknowledge them. We have to give them space to breathe, and so helping caregivers find a way to live alongside their grief, I think, is the next step to a recipe to resilience. The third is that caregivers need to find new ways of communicating, and we could have a whole conversation on this, jay, so I'm just going to sort of plant the seed that oftentimes, especially with couples who've been married a long time, they have acclimated into patterns of communicating that have worked for them over the years, and now we have dementia and some cognitive changes really upsetting that. So finding new ways to reframe and to be in communication is something, is a skills that caregivers can learn, and can actually play a significant role in preserving the relationship.

Speaker 1:

And the fourth thing in finding that in recipe, I would say, is that caregivers need to find their people. No caregiver can do this alone. I'm going to repeat that no caregiver can do this alone in a way where they can preserve their well-being along the way, whether that's a good friend, whether it's a neighbor, whether it's somebody at church, whether it's participating in a support group. We need to find one another, to validate this experience, not to necessarily fix problems that can't be fixed, but to validate the heartache and the difficulty that caregivers are experiencing. They need to be validated with one another. They need to know they're not alone. Those are the four things that I think are that roadmap and that recipe for caregiver well-being.

Speaker 2:

Thank you. Thank you, it's very helpful and this has all been illuminating, and I want to thank you and your colleagues for working on this book and thank you for making the time to talk to us today.

Speaker 1:

Thank you so much for having me, Jay.

Speaker 2:

Have a great day.

Speaker 1:

Thank you.

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