Brain Savers and the New Dementia-Prevention Paradigm with Neurologist Paul Bendheim, MD

Brain Savers and the New Dementia-Prevention Paradigm with Neurologist Paul Bendheim, MD

Season eight of Villages Vitality Life: Seniors Life Unscripted features an interview with Paul Bendheim, MD, clinical professor of neurology at the University of Arizona College of Medicine–Phoenix and founder of BrainSavers, an evidence-based, multimodal brain-and-body fitness program aimed at reducing Alzheimer’s risk. Bendheim explains how the FINGER trial (about 1,200 participants) and the US POINTER trial (over 2,000, with diverse populations) shifted the old “inevitable decline” dogma by showing cognitive benefits from structured lifestyle interventions, with instructor-led groups outperforming self-directed approaches. He describes Brain Savers’ instructor-led, twice-weekly curriculum combining relaxation, cognitive-movement activities, physical exercise, memory techniques, and rotating lessons across six lifestyle pillars, emphasizing social connection. The discussion covers normal vs concerning forgetfulness, starting exercise from a sedentary baseline, treatable Alzheimer’s mimics, limited but real effects of approved monoclonal antibodies, vascular dementia overlap, neuroplasticity/cognitive reserve, and becoming one’s own “healthy brain quarterback.”

00:00 Season Eight Welcome
00:27 Meet Dr Paul Bendheim
00:59 FINGER And POINTER Explained
05:07 Why Brain Savers Started
07:33 Inside The Brain Savers Class
10:22 Starting From Sedentary
11:34 Alzheimers Tip Break
12:59 Memory Slips And MCI
14:24 World Brain Gym Activities
16:38 Book Title And Prevention
17:46 Treatable Mimics And Depression
19:31 Drugs And Lifestyle Power
22:52 Neurogenesis And Cognitive Reserve
25:25 Music And Daily Practice
26:17 Final Advice And Resources
28:01 Credits And Next Episode

Villages Vitality Listeners, I've got some good news for you. In season 8 most new episodes will released as both audio & video versions. Videos on Apple Podcasts, Busssprout.com and YouTube. If you're listening via our Buzzsprout feed, you can ask questions via the Fan Mail button or leave me comments as a text or in our new feature, you can send it as a voicemail. If you'd like a response, make sure you leave your name, email address and cell phone number.

Transcript

Speaker: 0:00

Welcome to season eight of Villages Vitality

Life: 0:03

Seniors Life Unscripted. In this new season, we talk to leaders of clubs and interesting folks who live in and around The Villages. We also talk to people who have information vital to seniors. You will get perspectives of what is happening in and around The Villages, Florida. In addition, we will add more information for all seniors

Mike: 0:24

Village's Vitality, Senior Life Unscripted. here today with Paul Bendheim, MD. a clinical professor of neurology at the University of Arizona College of Medicine Phoenix, and founder of Brain Savers . We'll talk a lot about Brain Savers , which is an evidence-based, multimodal brain plus body total fitness and wellness program. Brain Saver's pioneering approach aligns with multi-domain lifestyle interventions subsequently validated in the FINGER and US POINTER trials and the World Health Organization's twenty twenty-six dementia risk reduction guidelines. Paul, thanks for joining us.

Paul Bendheim: 1:07

My mission in life is to help our aging population reduce their risk of Alzheimer's disease.

Mike: 1:13

Good. The first question, natural question from our audience is what is the Finger and US Pointer?

Paul Bendheim: 1:21

Those were two major multimillion-dollar studies that completely turned the previous central dogma of the aging brain upside down. The FINGER study was done in Scandinavia, led by a group of Finnish investigators, and they looked at twelve hundred at-risk aging Scandinavians. Half of that group were entered into a multimodal, multi-component lifestyle program, as well as getting medical advice to control diabetes if it was present or hypertension. The control group only got general medical advice. After two years, the active group showed significantly better cognitive function than the control group. That was published in The Lancet in twenty fifteen Last year, in fact, it's almost exactly a one-year anniversary, July twenty-eighth, twenty twenty-five, the US Alzheimer's Association, headquartered in Chicago, announced the results of their fifty million dollar study, and the NIH contributed up to another fifty million to look at biomarkers. And that study was not duplicative of the FINGER study, but another multi-component lifestyle trial. The difference is the a-- there were two active arms i-in the POINTER study. One arm attended s-group sessions led by an instructor in which they did these multi-component aspects of lifestyle, socialization, cognitive exercises, physical exercise, healthy nutrition. The other group got the same material, but they did it on their own. Both groups improved, but the active group with an instructor improved more. So this has now completely changed the paradigm on how we approach the risk of dementia and cognitive impairment with age. We were taught the dogma was that you had this amazing organ you were born with, nothing like it in the universe. But about the age of forty, it started to unravel. And if you were unlucky, it unraveled more quickly, and you became, back then, the term was senile, senility. Now that term

Mike: 3:40

that

Paul Bendheim: 3:41

If you were more fortunate, your brain did not unravel, and you lived to a ripe old age with your memories intact, your cognition intact, and all the positive aspects of a healthy brain So when I first came up with the idea of Brain , I quickly found out didn't speak up among my academic neurology colleagues because it was considered voodoo science to say that lifestyle could perhaps change that slope of unhealthy brain aging. But thanks to the FINGER study and then the POINTER study now this is front and center , . And as you mentioned, the W H O guidelines, which just came out last week, the 2026 version, I think the last time they did this was in twenty nineteen . They now make front and center that a multimodal, a multicomponent lifestyle program should be implemented around the world to reduce the increasing global burden of cognitive impairment with age and specifically dementia, of which Alzheimer's is the primary cause.

Mike: 4:47

Paul, do you know how large those studies were? How many individuals were

Paul Bendheim: 4:51

Yeah. So the Finger study, if I remember correctly, was about 1,200, 600 in each arm. The US POINTER study was over 2,000 people. One of the important aspects of the POINTER study done in this country is that they looked at diverse groups, different ethnicities, different races, different socioeconomic backgrounds. So it's applicable by extension to a much larger audience than the Finger study in which the Scandinavian population was much more homogeneous.

Mike: 5:22

A-and Paul, why did you start Brain

Paul Bendheim: 5:24

So, you know, I was taught by no less a luminary than Houston Merritt, who was the professor and chairman of neurology in Manhattan at Columbia. I went there as a student in my fourth year thinking I might wanna do my residency there. He would meet with the students every week. We would sit on the floor of the auditorium, and he would sit in his chair and entertain us with stories of his long and illustrious career. But one day, he captured that central dogma by saying, "The worst thing about growing old is listening to my neurons commit suicide by diving into the ventricular lake." That struck me and it's in my book. And then fast-forward to about two thousand and three, four, I was asked to review a grant from a philanthropy where I serve on the medical scientific advisory board, and this grant was asking for funding to study physical exercise, specifically walking, an aerobic exercise, in an at-risk group of sedentary aging adults. So I did a little background reading, and I thought, "Wow, maybe this has some legs." And the idea popped into my mind to build health clubs, health facilities for aging Americans, with the emphasis on what I call the fifteen or twenty muscles inside your brain. People understand exercising muscles makes them stronger. And so I wrote a business plan, and I showed it to a couple folks that I respected and trusted, and they both said,"Well pretty good. How are you gonna get money to build bricks and mortar in Florida or Arizona, wherever you wanna put these places? Why don't you develop the program and provide it to existing channels, senior centers and the like?" So that was the big pivot, and we did that, and I'm, you know, really pleased that I was able to attract some smart people, nutritionists, physical exercise experts, a geropsychologist, and the like, to now we have two years of curriculum in the program, And it's a l-live instructor-led program that encompasses the six pillars of Brain. So someone can start, let's a week for an hour for two years and get new information and build their cognitive reserve using neuroplasticity

Mike: 7:47

Paul, is the program a classroom education or is it physical exercise?

Paul Bendheim: 7:54

Well, it's fairly structured. Starts off with a couple minutes of relaxation, meditation, so people are getting rid of some of the stress they come with so they can learn. And then the first section is what we call a cognitive movement activity, thinking and moving at the same time. The best example, is dancing. You have to think and move at the same time. And so that gets people warmed up, and then the next section is the actual physical exercise part with about fifteen minutes of aerobics with some weight, strength bearing, some flexibility and balance thrown in. That's followed by the formal cognitive exercise where we teach techniques to improve your memory, process new information more quickly. And then that's followed by the mini-lecture on one of the six pillars. So maybe on Monday you're gonna learn some more about healthy sleep habits, and then the next week you're gonna learn about the difference between omega-3s and omega-6 fatty acids. So we have these six pillars, and they're all covered in rotation, and the lessons build on one another. And we've organized the curriculum in quarter blocks, twelve-week blocks, and that way new people can join at the beginning of a quarter. The first week is a review and a catch-up. And it's, you know, gratifying, People like doing it, and I think the key is, Mike, the socialization aspect. A number of people that come to these classes have lost their spouse, friends have moved, and the socialization aspect is enormous. And the further I get into this, the more I realize that may be the single most important aspect. If someone comes to me, "Well, Doc, I don't do any of those six. Where do I start?" I think I still would answer, "Start moving." Any movement is better than no movement, and it'll affect your attitude, it'll affect your brain's health, it'll affect your heart's health. And especially if you do it outside, you'll meet other people, so you get the socialization aspect. And people that move and start moving for the first time or more, they start thinking about the fuel they put into their body, and so they'll start thinking about eating a more healthy diet. And people that exercise sleep better, and that's another one of the six pillars, and that's a clear risk factor. Poor sleep hygiene, poor sleep is a big risk factor for Alzheimer's disease. So it's gratifying now that a, a number of big authorities, including WHO and AARP and others recommend these multimodal lifestyle programs to preserve and enhance brain health

Mike: 10:36

Paul how do you start or give advice to someone who is living a sedentary type of a lifestyle?

Paul Bendheim: 10:44

Yeah

Mike: 10:45

Six or eight hours of television every day

Paul Bendheim: 10:47

Yeah. So again, I think the easiest way to start is by starting a very mild exercise program. Get up off the couch and go outside and take a five or ten-minute walk. And if you haven't been exercising, you may feel that your breathing is a bit labored. So you continue that very mild exercise for a number of weeks until you feel like,"Huh, I'm feeling a little bit stronger when I walk." Then add five minutes. The goal is to build to about thirty minutes, five times a week. And you don't have to be marathon running. You have to be moving, and preferably with a friend, a spouse, so that you're having a conversation. And when you start, you're gonna find that you have to take an extra breath or two to complete a sentence. But as you progress, that's gonna reduce the need. And you don't have to measure your heart rate. You're doing good things for your body

Mike: 11:48

Good. Let's take a short break here and listen to an Alzheimer's tip from Dr. Craig Curtis

Dr. Craig Curtis: 11:54

Amyloid is the spark, and tau is the fire. We have this spark barking for 20 years without symptoms. Once the spark causes the fire, the breakdown of tau inside the cell, we start to see symptoms. We are actively researching ways to stop tau as well. Is it possible to regrow new brain cells to replace the ones the tower was killed? That's a hot topic. Scientists for the most part, do not believe that we can regenerate any brain cells. There have been a few research papers published in the last four or five years that hint that there might be some brain cell regeneration specifically in a part of the brain called the hippocampus. Which ironically is where Alzheimer's disease starts, but it's really hard to prove that in humans.

Warren: 12:43

With over 20 years of experience studying brain health, Dr. Curtis's goal is to educate the village's community on how to live a longer, healthier life. To learn more, visit his website, craig curtis md.com, or call 3 5 2 5 0 0 5 2 5 2 to attend a free seminar.

Mike: 12:59

Thank you, Dr. Curtis. I'm back with Paul , and we're talking about how you can exercise your brain, that's the way I'm gonna put it,

Paul Bendheim: 13:08

Yeah.

Mike: 13:09

to

Paul Bendheim: 13:09

Use it or lose it, Mike. I'm sorry to interrupt you, but that's use it or lose it

Mike: 13:13

Great. How do you deal with people who tell you something like, "I feel my memory is slipping. What should I do?".

Paul Bendheim: 13:19

That's the most common complaint in a memory disorders clinic or a dementia Alzheimer's clinic, ' cause it's usually, not always, but most commonly the first presenting symptom of somebody who has dementia or a mild stage before they're actually demented. That's called mild cognitive impairment. But remember, your brain, like every organ in your body, suffers wear and tear as you age. So some memory impairment, some more frequent forgetfulness is not abnormal. If… Mike, if you forget tomorrow morning where you put your car keys, that is not diagnostic of Alzheimer's disease. That's normal age-related forgetfulness. So the key is, if you're not doing things that protect your memory, protect your brain, you need to start. And again, we go through the same protocol. Start moving, start sleeping better, get your hearing and vision checked. Both of those now are recognized as risk factors for Alzheimer's disease. Socialize. All the things that may be reduced in your life after you've retired, after you've moved away, at Brain Savers, we introduce the concept of the World Brain Gym. What is that? You know, our classes, our sessions are two hours a week. You can't do everything in two hours that you should be doing. How do you exercise for a hundred and fifty minutes when there's only a hundred and twenty minutes, and that's only twelve to fifteen minutes of each class? So the World Brain Gym in The Villages are all the wonderful opportunities to participate in all sorts of programs, classes, socializing, whether it's on the golf course or in one of the common restaurants. So that's the World Brain Gym, and every community of any size is teeming with activities that are fun and are brain strengthening

Mike: 15:23

I participate in several improv clubs here in The Villages. The first 15 minutes of every session having people work in either small groups or in a large circle and we end every session in a group exercise, and everyone loves it.

Paul Bendheim: 15:42

Yeah

Mike: 15:43

It is very energizing. It's a stimulus for people's brains

Paul Bendheim: 15:48

Yeah

Mike: 15:49

exercise passing a whoosh around the room, and then he'll say, "Okay, we're gonna do the same thing faster."

Paul Bendheim: 15:55

We have variations of that in our Brain Savers curriculum. In fact, if let's say you and I were in a class together, and we have a ball, and we toss that ball back and forth, but as we're tossing it, we have to start naming vegetables or fruits going through the alphabet. And so that's another thinking and moving activity. You know, there's no magic bullet, Mike, for protecting your brain. It's really using it and using your body in a whole variety of fun and engaging activities. And when it comes specifically to your brain, if you're a fluent Spanish speaker, you're not gonna do a whole lot of good for your brain by going to a Spanish class that you could basically do when you're asleep. You need to challenge your brain, but again, just like physical activity, you wanna challenge it modestly and build upon that, and that is a tremendous builder of what is known now as cognitive reserve. You strengthen your brain.

Mike: 16:55

Now, your book is titled The Brain Training Revolution. Why did you come up with that title?

Paul Bendheim: 17:01

When I wrote the book, it was at the cusp of this major shift in the paradigm of the aging brain. And so it was a revolution, the multimodal lifestyle program has revolutionized what we can do to be proactive in protecting our brain. And it's training. Just like you train to be physically capable, you need to train your brain to maintain it and actually enhance it.

Mike: 17:28

If someone's been diagnosed with an early case of Alzheimer's can Brain really help them?

Paul Bendheim: 17:34

Our program is designed to be a risk reduction, a prevention program. We never promote it as a treatment of any sort. But there's increasing literature that if you make your lifestyle healthier, you may slow the progression of cognitive impairment. Even the normal wear and tear that we all suffer from as we age can be minimized, reduced. But let me back up. So when you say diagnosed, I'm assuming you mean somebody who's gone to a qualified physician and had a very adequate and complete workup because there are mimics of Alzheimer's disease that are treatable and reversible. And even though they're a relatively small percentage of the total cases, n-no one wants to miss one of those

Mike: 18:26

I understand there are some vitamin deficiencies that

Paul Bendheim: 18:28

Well, there are,

Mike: 18:29

symptoms

Paul Bendheim: 18:29

yeah. Yeah, even occasionally a, a benign tumor pressing on the brain. There are a number… Some thyroid conditions can mimic. And the biggest one that should never be missed is depression. Chronic depression is a very active stressor to the brain, and people with long-standing depression can be almost indistinguishable from somebody with Alzheimer's disease, and it's treatable.- There's a lot of stress in stress can lead to depression. And there you have it.

Mike: 19:43

So if someone walks into a room and doesn't remember why they walked into the room is that an early Alzheimer's symptom?

Paul Bendheim: 19:50

Did you talk to my wife before this? Mike,

Mike: 19:53

Yeah, she

Paul Bendheim: 19:53

On our front door, she has car keys, sunglasses, cell phone. She knows I'm gonna leave the house without one of those or more than one of those three. So the answer is emphatically no. You know, you're distracted. You know, maybe you turned on the stove to heat up some soup, and then you remember that you're-- or you think you remember that you left your cell phone in, in the bedroom. But you wanna make sure the soup is not gonna over boil. By the time you get up to go, you can't remember why you left to go to the room, but it'll come back. So that's, yeah. Don't worry about that. That's, again, normal age-related forgetfulness.

Mike: 20:30

So there are a number of drugs on the market now aimed at Alzheimer's disease, and how effective do you think they really are?

Paul Bendheim: 20:38

Well, so there's two monoclonal antibodies approved by the FDA for for MCI, mild cognitive impairment or early mild stage dementia. And they wouldn't be approved by the FDA if they didn't show some efficacy. And I know 'cause I led a team with a, a drug candidate for Alzheimer's disease to the FDA. I know how professional , they are and how concerned they are with patient safety. That's their first concern. Is this proposed treatment safe for people to take? Only after that's established do they look at if it-- is it effective for the disease, in this case, Alzheimer's. And so both of these monoclonal antibodies were approved. They have limited efficacy. They don't cure people but they definitely slow progression. They're very expensive, and they're b-they're both associated with some adverse effects that can be serious. It's such an active research area. Every major and some minor pharmaceutical companies, biotech companies, because we're in an epidemic now of Alzheimer's. With ten thousand boomers turning sixty-five every day and advancing age being the biggest risk factor for dementia and specifically for Alzheimer's disease, the number of Americans, currently about seven million, is going to double in the next twenty, twenty-five years if we don't find a way to either delay the onset or prevent it. And that's where I'm proud of all the research that people have done to demonstrate that lifestyle, which really doesn't have any side effects, exercising, eating well, sleeping well is now front and center in this crusade against age-related cognitive impairment, age-related brain deterioration and dementia, specifically Alzheimer's disease. And I would mention the second most common cause of dementia is what we call vascular dementia, in which there are multiple small strokes, and those add up to dementia. And often both conditions, Alzheimer's and vascular dementia coexist. And so a healthy lifestyle, we've known this from the Framingham study, if you do physical exercise, eat better, m-manage your high blood pressure if you have it and diabetes, you reduce your risk of cardiovascular disease, which includes stroke

Mike: 23:05

Drugs on the market now that are aimed at removing both amyloid and tau from the, brain. Do you think those are going to provide any avenue for cure for Alzheimer's in the near term?

Paul Bendheim: 23:17

I don't think in the very near term, but there's a lot of excitement about using combination therapies, much like chemotherapy evolved for various cancers. And I'm a believer that the answer eventually… I don't know if we're gonna cure the disease with that approach, but I think we can come close to stopping its progression. If you relieve the brain of its burden of these toxic proteins, amyloid and certain forms of tau, you should reduce the progression of the neuropathology, the death of brain cells.

Mike: 23:52

Now, will exercise that a senior does cause more brain cells to grow?

Paul Bendheim: 23:59

The answer, surprisingly, is yes. That before, you know, I and a whole lot of others got into this field, again, the central dogma was that you were losing brain cells, there was nothing you can do about it. We now know there is some neurogenesis, some birth of new brain cells in the adult brain. And what's in-interesting, the number one area is the hippocampus is the seahorse. That's what the na-- the word means in Greek. It's the seahorse shaped structure in your temporal lobes. That's where memories are made. That's the first area that's often affected pathologically in Alzheimer's disease, and explains what we talked about earlier, why memory complaints are often the presenting symptom in somebody who's developing Alzheimer's disease. So that's where there's now evidence that you can grow new cells and there may be some new growth in the frontal lobes. And the other aspect of changing the, your brain's architecture is increasing the number of synapses. Those are the connections Each single brain cell connects with about ten thousand others, and amyloid interferes with those connections. And so that's what we see pathologically. And the denser your synaptic connections, the higher your threshold is for de-degeneration and a disease like Alzheimer's. So that's what we call cognitive reserve, and that is built by using your brain. So if you, let's say, start learning French tomorrow, as an example, Mike, you're gonna grow synapses in certain parts of your brain. My favorite example when I talk to groups is if you're right-handed, you brush your teeth with your right hand. Switch to your left hand, and you'll find that you're gonna bruise your gums for the first few days. But over time, you're gonna become more facile with your left hand, your non-dominant hand. And if we could do MRI studies, you'll see a growth of the network there in the motor cortex that controls the left hand. So that's changing the architecture of your brain. But that's in a very focal region. By doing a variety of brain stimulating activities, which we've touched on, you're gonna stimulate the growth of synapses throughout the brain. And learning a language is my favorite example because that really works your brain in multiple areas

Mike: 26:24

Does music play any part in your program?

Paul Bendheim: 26:27

Well, we don't actually incorporate music lessons, but we certainly encourage . There's literature now showing that music therapy is beneficial to the aging brain. I use it personally as a stress reliever. Listening to classical music for me for ten minutes calms me down. And so really a variety of whatever it is that makes you happy, whether it's classical music, looking at beautiful artwork, planning a trip to Italy, anything like that is brain strengthening. The key is, just like with exercise, you can't go for a walk today and say,"Well, I've protected my heart and my brain forever." You gotta build on that, and the continuing practice of brain healthy lifestyles is what's vitally important.

Mike: 27:17

Paul, are there any questions that I failed to ask you today that you'd like to put into the podcast today to tell people?

Paul Bendheim: 27:22

The critical thing is for everybody to become their own healthy brain quarterback. You have to decide how important making some changes in your lifestyle are if you know that they're gonna provide benefits for years. So th-that would be my suggestion. Look at your lifestyle. If you're not moving, start moving. If you're eating a highly processed diet, start adding fruits and vegetables, salads, and make transitions over time. And do this with friends and family. It's much easier. That's why I think our classes are so successful. There's a instructor, a coach there, and you have other people who will reinforce your beneficial ideas, and you'll exchange ideas with them.

Mike: 28:12

Paul, if someone wants to get more information about the Brain Savers program and maybe where it's taught in their locale how do they do that?

Paul Bendheim: 28:20

I think the easiest way is just to go to our website brainsavers.com and make an outreach. We're growing now, and more and more communities, whether it be at senior centers or YMCAs or Jewish community centers or the City of Dallas Parks and Rec Department now is giving our program in a number of their community centers , that cater to seniors. And so we're here to help everybody and anyone who wants to do something good for themselves and good for their community.

Mike: 28:54

Thanks for joining us today.

Paul Bendheim: 28:55

Oh, it's been a pleasure, Mike. Thank you for your good work in bringing this sort of information to the public.

Dolores: 29:00

Remember, our next episode will be released

next Friday at 9: 29:02

00 AM. Should you want to become a major supporter of the show or have questions, please contact us at mike@rothvoice.com. This is a shout-out for supporters Tweet Coleman, Ed Williams, Duane Roemmich, Paul Sorgen, and Dr. Craig Curtis at K2 in The Villages. We will be hearing more from Dr. Curtis with short Alzheimer's tips each week. If you know someone who should be on the show, contact us at mike@rothvoice.com. The way our show grows is with your help. Text your friends about this show if you enjoyed listening. Use the fan mail button on our homepage, villagesvitality.life, to leave comments. Be sure to include your name, email, and phone number. We thank everyone for listening. The content of the show is copyrighted by Roth Voice 2026. All rights reserved