Please welcome Elizabeth Mills, PhD, a member of the ADDF's Aging and Alzheimer's Prevention program. She critically evaluates the scientific evidence regarding prospective therapies to promote brain health and/or prevent Alzheimer's disease, and contributes to CognitiveVitality.org.
Dr. Mills came to the ADDF from the University of Michigan, where she served as the grant writing manager for a clinical laboratory specializing in neuroautoimmune diseases. She also completed a Postdoctoral fellowship at the University of Michigan, where she worked to uncover genes that could promote retina regeneration. She earned her doctorate in neuroscience at Johns Hopkins University School of Medicine, where she studied the role of glial cells in the optic nerve, and their contribution to neurodegeneration in glaucoma. She obtained her bachelor's degree in biology from the College of the Holy Cross. Dr. Mills has a strong passion for community outreach, and has served as program presenter with the Michigan Great Lakes Chapter of the Alzheimer's Association to promote dementia awareness.
Cognitive Vitality: https://www.alzdiscovery.org/cognitive-vitality
Hanh Brown: [00:00:00] Today, my guest is Elizabeth Mills. She is a member of the ADDF aging and Alzheimer’s prevention program. ADDF is Alzheimer’s drug discovery foundation. She critically evaluates the scientific evidence regarding prospective therapies to promote brain health and, or prevent Alzheimer’s disease. And she also contributes to the cognitive vitality.org.
[00:01:39] Dr. Mills came to the ADDF from the university of Michigan, where she served as a grant writing manager for clinical laboratory specializing in neuro auto immune diseases. She also completed a post-doctoral fellowship at the university of Michigan, or she worked to uncover genes that could promote retina regeneration.
[00:02:02] She earned her doctorate in neuroscience at John Hopkins university school of medicine. Dr. Mills has a strong passion for community outreach and has served as a program presenter with the Michigan great lakes chapter of Alzheimer’s association to promote dementia awareness. So please tell us about your journey, how you got to studying dementia and now studying about the drugs for the prevention of dementia.
[00:02:29] So how did you get to this place?
Elizabeth Mills: [00:02:30] you get to this place? So I did my graduate work in neuroscience and basic research. And then I was doing mostly work in the eye, looking at retinal degeneration, glaucoma, and then my post-doc, I decided I wanted to go more translational, more working with patients and, you know, just something that had more direct impact.
[00:02:51] And so I did a small post-doc in a lab that was multiple sclerosis lab, where they were working on clinical trials for drugs. I kind of really got to see that aspect of it. And I really liked that more having a direct impact and something, I thought about a lot when reading the papers and working on that was how nice it was to be able to kind of shape the science.
[00:03:14] And so I really liked the idea of being in a position of. The role of the funder or the people that set the guidelines of this is how we should be doing science. And this is what we need in the field. And so that really attracted me to working for a funding organization. And then while I was in my time at Michigan, I was a volunteer with the Alzheimer’s association.
[00:03:36] And so I did a lot of outreach and one of the big messages is the importance of awareness. Empowerment about learning about your brain and brain health and prevention. And that got me really excited because right now we don’t have any drugs for Alzheimer’s, but there are steps you can take for prevention.
[00:03:56] And so to me, the be in a position where we’re actively working on promoting that idea. What can you do to protect your brain and what can you do now as well as also helping to maybe have a drug someday? Cause they saw that you’re such a need was really attractive for me in terms of what, how can I make an impact with my training in the field?
[00:04:18] So that’s how I ended up working.
Hanh Brown: [00:04:20] That’s right. There are steps you can take for the prevention of dementia. And now you’re promoting the idea of what. You can do to protect your brain, to have a brain healthy lifestyle. I have my own journey in caring for my mom who is in the later stages of dementia, no proper training, just life experience and all the lessons that come with that until there’s a cure, we have to bring awareness, empowerment, education, and promote healthy living.
[00:04:50] So this will minimize your chance of getting dementia. So you want to take all these extra precautions as early in life as possible, and it is never too early.
Elizabeth Mills: [00:05:00] Is that right? He can ever start to caring about protecting your brain.
Hanh Brown: [00:05:06] So let’s talk about the steps to take in lowering your chance of getting dementia.
Elizabeth Mills: [00:05:11] So there’s a briny of different guidelines that have come out from different organizations, such as the world health organization, medical organizations, and ARP, and they all kind of converge around similar themes. One of the main takeaways is that. A healthy heart is kind of the gateway to a healthy brain.
[00:05:34] So people are familiar with the recommendations of the American heart association. And some of these will be very familiar because a lot of them are the same and there’s a very strong connection between vascular health and protecting your brain. And so these include things like having a healthy well balanced diet.
[00:05:54] So having a lot of fruits and vegetables, whole grains, Less processed food. There’s no one diet that is definitely, you know, this is the best for your brain. It really depends. Everyone’s different, but kind of overall having well-balanced diet is very important. You’re getting physical activity. Having exercise is very important, as well as weight management.
[00:06:18] That same vein is managing other chronic diseases because things like heart disease and diabetes, these also are big risk factors for increasing your chance for getting dementia. And so having those all controlled can reduce your risk later on. And not smoking, not drinking heavily. And also some things that are maybe a little bit different in terms of brain stimulation are being social, which is difficult these times, but there’s still ways that we can connect with one another.
[00:06:53] Whether it’s. Having a phone call I’m involved in variety of volunteer groups. We have weekly zoom meetings. I’m a big fan of writing letters and mailing packages to people, you know, letting them know you care. There’s a great way to just try to keep contact with each other, obviously in different times, being engaged in the community and having those ties is very important as well.
[00:07:16] Doing things to stimulate your brain. So trying to learn something new and doing brain puzzles or, you know, whatever kind of you like if you liked doing the crossword puzzle or you just want to take up, try learning a musical instrument, anything that you can do to stimulate your brain there’s no, this is it.
[00:07:35] It’s just whatever works for you and makes you happy. And another thing, which is also very difficult right now is managing your stress levels. Cause stress and anxiety can also lead to processes that can accelerate cognitive decline. So trying to manage stress, whether that’s just taking time for yourself, meditating, listening to relaxing music, reading, finding what you need to do to manage stress levels.
[00:08:03] So these are things that we can all do. This is the general consensus from a variety of organizations that these are kind of the best steps that we have right now to help.
Hanh Brown: [00:08:15] So that’s great. So what I hear from you is that engagement to keep your mind sharp, proper diet exercise. Manage your stress level, sleep and sleep and sleep because of lack of sleep can really hurt your brain.
Elizabeth Mills: [00:08:30] Thanks. I’m glad you brought that up. Sleep is extremely important to know that a lot of times, you know, as people get older, they can have trouble sleeping and sleep can be more fragmented. And that is a real challenge because we know that there’s processes that take place in your brain during sleep that are really important for maintaining.
[00:08:51] Healthy brain function. And if there was processes, don’t take place, then it can lead to cognitive impairment. We all know if you just can’t sleep one night the next day, your brain isn’t working as well. And so if you imagine over time, that kind of compounds. So trying to figure out how to get a good sleep schedule and supporting sleep is very important.
Hanh Brown: [00:09:13] Whole heartedly believe that in a mid day, you should take a nap because sleep is central to. Health and your wellbeing, but it’s people get older, the quality of their sleep. Can you tear? Right. So we shouldn’t feel guilty. First thing that we’re lazy for taking a nap?
Elizabeth Mills: [00:09:31] Oh, absolutely. I think naps to me.
[00:09:33] Very great. As long as they’re not too close to, when you actually want to go to sleep at night and midday, nap is very restorative helping recharge and reset, and also that will help with your stress levels as well. So overall, particularly if you just had a meal, you know, can help with digestion and promoting sleep.
[00:09:50] And also, I would say trying to do things in a routine manner can really help your body maintain its rhythms, which can sometimes get off and it helping maintain proper rhythms also is good for general functioning of your body and your brain.
Hanh Brown: [00:10:06] Yes. I think you’re spot on one thing personally, that I have tried in addition to all the items that you mentioned is the spiritual development.
[00:10:15] I believe your inner self helps you to have that core, which helps with your stress, your food choices, exercise, and of course sleep. Those are all very critical components, but I want to point out the importance of the spiritual component, which I believe will help with the other elements you are spot on.
[00:10:36] So you mentioned there’s an overwhelming information about super foods and supplements that can prevent dementia. Are these claims accurate and I guess, how are they misleading and why?
Elizabeth Mills: [00:10:47] So absolutely. So that you hear so many stories that come out. You supplant or the blueberries, it will cure everything.
[00:10:54] And the problem is, is that there is an element of truth there based on scientific studies generally, but they can be very misleading if you don’t have a scientific background to understand, because studies can be done in a variety of different ways. And so there’s very different between if you have a study that shows that if we put this compound in a laboratory animal, that it shows an positive effect on their function, versus we have this long-term clinical trial showing that eating berries every day, prevents dementia.
[00:11:29] So those are very different levels of evidence. And so one case you wouldn’t put a lot of weight on it. When the other case you would say that’s very strong amount of evidence, but from the general article, they usually don’t provide that information. So there are resources available that want to let people know about that.
[00:11:47] Distill that information down. So is the ARP global council on brain health? Where they provide a very useful information about what they recommend is a whole bunch of scientists and clinicians and people from variety of different fields have weighed in on best practices. And many of the things I’ve already mentioned, the world health organization has information and us against Alzheimer’s also has a brain powerful campaign.
[00:12:17] Where they provide a lot of practical advice and have seminars and webinars about information to protect your brain. I want him to focus on something that I’m involved in my organization, which is called cognitive vitality.org. And we have several neuroscientists on staff. And part of our job is to go through all of these different articles on various compounds.
[00:12:42] Supplements foods that you hear that they may claim is about for brain health. And we try to distill that down in a way that other people can understand. And we do it based on this evidence that I mentioned. So if we see that there was a compound that was just only studied in animals, will that showed a positive benefit?
[00:13:05] We will read it based on evidence. Potential benefit and safety, which I’ll get you later, but safety is extremely important aspect of it. So that shows that there is potential for benefit, but the evidence is extremely low. So you might be wary about taking something with such little evidence. Whereas, if we have something saying green tea, which there’s thousands of, years of evidence where people have been taking it, then we can say that there’s a lot more evidence to support that that that’s important is the clinical trial.
[00:13:37] But in many cases that’s not available. There hasn’t been tested. So, you know, we basically try to rate and so you can see it, but has a lot of evidence and a potential benefit and it’s safe. Then that may be something that you might consider. We do not recommend anything. It’s just providing information in a way that you can understand.
[00:13:56] We also have some blog posts that also kind of touch on some of the recent articles that come out to try to understand what they mean for your brain health. Sure, our free resource, so people can understand what they’re seeing in these claims. And when getting back to safety, assuming that you may say, well, there’s some potential benefit, but there’s not that much evidence.
[00:14:19] What’s the harm in taking it. And actually there could be a lot of harm. And taking things that particularly if we have very little evidence about them, because the way a drug or a supplement will work in a person may be very different from how it works in an animal or in cells, in a laboratory. And so you don’t want to have some type of adverse reaction.
[00:14:42] Another important aspect is think about is that, you know, as people get older and start taking a lot of critical medications, say blood pressure medication or cholesterol medication, and these drugs can interact with other things. So you may be taking a supplement that on its own could be safe for a healthy person.
[00:15:02] But now if you’re also taking some other medication, you could have an interaction between that supplement and that medication. So that could be very dangerous. We provide some information about interactions that are known, but in some cases, interactions are not known. So that’s why it’s extremely important.
[00:15:22] Considering any supplements to always talk to your. Medical provider about any supplements you’re taking or considering taking. So they can have a discussion of whether it may interact with any of the medications that you need to take. Some people have some type of nutritional deficiencies. And so we know that vitamin D or vitamin B deficiencies can impair function.
[00:15:47] And so if someone. Maybe the brain’s not working as well. And they go to the doctor and learn that it’s because these nutritional deficiencies, in which case it may be necessary for them to take the supplements. And some of these have shown that they can have important benefits, but that doesn’t mean that if you don’t have the deficiencies, that you should take them, there are certain things that show that in people with deficiencies.
[00:16:12] Taking supplements is beneficial, but there’s no evidence that is beneficial if you don’t have them. And again, I said there could be side effects associated with that. So it’s always important to discuss this with your doctor and to also know we have on here also some drugs and medications that people take on may not know that some of their medications could have cognitive side effects and so that they should alert their doctor.
[00:16:40] Oh, I started taking this medication and maybe it’s not this onset of cognitive decline. Maybe it’s just, their brain is reacting to whatever medication they’re taking. And so it’s important to have that discussion with your doctor to see maybe can you change the medication or the dose or something to help keep your cognitive faculties and tax to help keep your cognitive faculties intact.
[00:17:03] Make sure that you work closely with your doctor on any medication taken. It sounds like you have several metrics in assessing proper supplements.
Hanh Brown: [00:17:00] What are those metrics ? Please summarize them ?
Elizabeth Mills: [00:17:14] Once we have our level of evidence to say that that has to do with whether it’s been only studying in cells in a laboratory, whether it’s been studied in thousands of people over a long period of time in clinical trials.
[00:17:29] How much evidence do we have to know that this does something beneficial or harmful, and then there’s also potential benefit. So what are those studies say? Do all of those studies show, it has the benefit do only some of them show it has a benefit or to any of them show it has harm. And then we also have safety, which has to do with, as it’s shown to be saved in these different models.
[00:17:52] Is there any potential interactions that you need to worry about? Our particular populations of people. Sensitive in a certain way. So we try to incorporate all that in an easily accessible form.
Hanh Brown: [00:18:04] So ensure that your medical provider, your doctor is very integral to you taking any medication to ensure that it’s not in conflict or have a reaction from your prescribed medicine.
Elizabeth Mills: [00:18:17] supplements should be considered medication, just like anything else it’s prescribed by the doctor.
[00:18:22] And so you’d always have those conversations, whether you want to take something or not, because. It may say that it’s safe based on the available evidence, but that doesn’t necessarily mean it’s safe for you. It just means in a broad scale, this is what the science says, but your particular case may be different and your doctor could know that general advice can’t know what’s best for you.
Hanh Brown: [00:18:45] You’re absolutely right. Your history of medication and your current prescription is potential interaction could be very harmful. It’s essential to capture all that. So share with us the polypharmacy in how certain the medication or the combination can impact the brain function.
Elizabeth Mills: [00:19:03] So in addition to you may be taking a supplement on top of a particular medication, many people as they get older and take increasing amounts of different medications.
[00:19:14] And sometimes those can interact with one another. So it’s extremely important to let all of your doctors know all other medications that you may be taking. Sometimes pharmacists can detect these interactions, but they may not. And so sometimes taking two different medications together while on their own.
[00:19:32] They’re fine. When they come together, they could have side effects, including cognitive side effects. And so that’s really something to be aware of. If you keep taking additional medications, if you want to add a new one, watch for anything, how did you feel differently? Is your brain working differently and make sure to report that to your doctor?
[00:19:52] Okay, as you notice anything
Hanh Brown: [00:19:53] that makes sense as far as the best method for prevention, that on a large scale prevention studies that involve lifestyle measures, cognitive engagement, exercise, and diet. How has that overlap with the heart and brain and how do we do a better job with the cardiovascular health?
Elizabeth Mills: [00:20:11] Actually the American heart association had a big goal starting in 2010 for 2020 to try to reduce heart disease and really trying to gain awareness for that. And I think that’s still similar to an ongoing struggle. People really. There are getting more awareness about how to protect your heart, but we can always do better on these different metrics.
[00:20:34] So there have been large-scale studies such as the finger study, and there’s also the pointer study from the Alzheimer’s association and they’re really addressed it. How well do these lifestyle interventions? Work to help prevent dementia. And the data is very saying that it does have a clinically meaningful effect that people that follow these interventions.
[00:20:55] And one thing I will point out is that as I brought up before, it’s all about what’s best for you personally. One of the main takeaways from these studies is that a personalized plan is much more effective than a general plan. So I can say eat right and exercise, but it’s really. Talking to your doctor or feeling what’s best for you that in getting a specific plan, because not everyone has the same needs or capabilities, you know, in terms of some people have allergic to certain foods and can’t eat them.
[00:21:27] Some people, their mobility may be limited. So you have to just figure out exactly something that’s tailored to what you can do in terms of how do you get exercise? How can you increase your social network? What healthy foods can you incorporate to your diet? How can you make a shift? So I think in this case, it’s really promoting an individualized plan and what works best for you and talking to your doctor and nutritionist about how can you make this work and making it a priority and say, I want to develop a plan for my brain health.
[00:22:01] How can we make this happen? So major campaign. We’re also interested in that’s being spearheaded by us against Alzheimer’s is promoting conversations between patients and their doctors about how can I promote my brain health as steps that I can take. So the first step is just talking to your doctor about this is something you care about, how can you help me make this happen.
Hanh Brown: [00:22:25] So what I’m hearing is first and foremost, You have to commit to coming up with a plan and to do that, you got to say, Hey, I’m worth it. And I value my agent journey. You gotta be committed and consistent because there’s action items to follow that, which includes proper food choices, diet, exercise, mental stimulation, and so forth.
[00:22:49] Before coming up with this plan, you have to be aware of yourself because it’s a personalized plan. And to do that. You got to know where you are in life, your strengths. And what you have issues with that particular medication, what you like or dislike to do socially? Do you know what I mean? So everybody has their specifics in calibrating, their likes and dislikes.
Elizabeth Mills: [00:23:13]That’s what I’m hearing. Oh, you should take our running. If you hate running, don’t take up running, find out what you like to do and works best for you because ultimately the key to this is having something that you can stick with lifeline may change over time, but you want something. It’s not like a fan diet where you just going to throw it away next week.
[00:23:37] You want to find something that you like, that you can incorporate into your life. So think of it as a lifestyle.
Hanh Brown: [00:23:45] Yes, that is great. I’m wholeheartedly a believer. I’m in my mid fifties and I feel stronger, healthier now than I was when my kids were toddlers. I think it’s very important to be aware of where you are in life.
[00:23:58] You got to calibrate yourself and it’s not following what societal expectations of who you should be or what aging is for you. It’s a personal goal that you have and how you want to live your life. It takes commitment because I think everything you described, you have to have a brain healthy lifestyle first and foremost.
[00:24:18] Make healthy food choices, exercise have engagement with family, friends, and community. And also proper sleep and reducing your stress. All of which I think take a lot of commitment. And I also want to add, to do this successfully. You need to have a spiritual strength and know your core and know that you’re worth it.
[00:24:38] So do you have other comments or suggestions that you want to add ?
Elizabeth Mills: [00:24:40] I mean, I think that statement you just made about that you’re worth it, I think is really the most important takeaway message that you should protect your brain because you have so much important information that you learned. You have so much valuable things that you can contribute to the world as you go on through life and you want to protect that faculty.
[00:25:04] So I think being empowered because you are a powerful, wonderful person.
Hanh Brown: [00:25:09] I loved him. Absolutely. Hey, I really appreciate your time. I think everything that you’re saying is so important and it’s so good for people to know you can’t never do enough to bring awareness. I think all of us need to use our platform to educate and inspire others, to live a brain healthy lifestyle.
[00:25:27] This is something I believe everyone should know, even when you’re in your twenties or thirties and not wait until you’re later in life. So I think the more we empower people with this knowledge, we will see a decline in dementia. That’s what I hope.
[00:25:42] So what is the name of your website and how do people get ahold of you?
Elizabeth Mills: [00:25:47] Cognitive vitality.org. You can access it directly or through the Alzheimer’s drug discovery foundation website, and it’s a free resource available to everyone.
Hanh Brown: [00:26:00] I really appreciate your time to share with the listeners a step to take in reducing the chance of dementia. It is never too early to learn how to live a brain healthy lifestyle.
[00:26:11] I look forward to talking to you again.
Elizabeth Mills: [00:26:13] It sounds wonderful.