Longitudinal evidence for preserved cognition

Tommy cites the Seattle Longitudinal Study showing many people maintain cognitive function into their 70s and 80s.

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What if the biggest predictor of dementia isn’t your genes — but your metabolic health?

In this episode, neuroscientist and performance coach Dr. Tommy Wood reveals why blood sugar regulation and blood pressure are more powerful predictors of Alzheimer’s disease and cognitive decline than amyloid plaques or even genetics like ApoE4.

For decades, Alzheimer’s has been framed as either a genetic lottery or the inevitable buildup of amyloid in the brain. But emerging research shows that metabolic dysfunction, insulin resistance, and vascular health may play a far greater role in determining long-term brain outcomes.

Instead of focusing on fear, this conversation delivers a practical blueprint for building cognitive reserve and “cognitive headroom” — the brain’s ability to stay resilient, adaptable, and high-performing as you age.

You’ll learn why crossword puzzles aren’t enough, how high-intensity exercise and resistance training stimulate brain-derived neurotrophic factors (BDNF), why lactate may act like “Miracle-Gro” for your neurons, and how to interpret early warning signs like subjective brain fog.

What You'll Learn in This Episode

Why Alzheimer’s isn’t just about amyloid plaques
The powerful link between blood sugar and cognitive decline
How genetics (like ApoE4) increase risk — but don’t seal your fate
What “cognitive headroom” means and how to build it
Why high-intensity exercise may act as Miracle-Gro for the brain
The surprising role of resistance training in brain health
What subjective brain fog might be telling you
How menopause affects cognition — and what’s reversible
Why boredom and focus matter more than we think
The kinds of skills you should keep practicing as you age

For women navigating perimenopause and menopause, Dr. Wood explains what cognitive changes are hormonally driven, what’s reversible, and how to protect long-term brain health.

Whether your goal is preventing Alzheimer’s disease, improving focus and processing speed, or becoming a cognitive “superager,” this episode provides evidence-based strategies to help you build a brain that is robust, metabolically healthy, and built to last.