Rethinking Cognitive Decline: Stimulus, Exercise, and the Aging Brain | Dr. Tommy Wood, MD, PhD | The Metabolic Link Ep. 90
The Metabolic Link
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Decreased glucose uptake in the brain is often considered a hallmark of Alzheimer's disease. But Dr. Tommy Wood asks whether part of that metabolic signature may reflect how little cognitive demand we place on the brain.
He sits down with Dr. Dominic D'Agostino for a nuanced conversation on metabolic health and cognitive function.. Dr. Wood is a neuroscientist, neonatal brain injury researcher, and author of The Stimulated Mind.
This episode follows the metabolic thread through every stage of brain health. Pre-diabetes and type 2 diabetes as predictors of cognitive decline. Neurovascular coupling as the reason heart disease risk factors double as brain disease risk factors. Lactate crossing the blood-brain barrier to drive BDNF production where it actually matters. Creatine as a brain energy distributor that most people still only associate with muscle. Dr. Wood lays out his Three S Model — Stimulus, Supply, Support — and makes the case that cognitive demand drives glucose uptake into the brain the same way muscular contraction drives it into skeletal muscle.
Questions Answered in This Episode:
- Does the brain respond to energy demand the same way skeletal muscle does?
- What role does creatine play in brain energy distribution, and what do the clinical trials show?
- Can heavy resistance training produce the same brain-relevant lactate response as HIIT?
- How should exercise be dosed after a concussion or traumatic brain injury?
- Is cognitive decline in your 50s, 60s, and 70s actually inevitable, or is that a statistical artifact?
- Why are pre-diabetes and metabolic syndrome among the strongest predictors of dementia?
The mechanistic throughline here is demand-driven metabolism. Dr. Wood makes the case that the same principles governing glucose uptake in skeletal muscle apply to the brain — and the conversation gets into what that means for how we interpret FDG-PET data, design lifestyle interventions, and think about neurodegeneration itself.
Find more at DrTommyWood.com
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