The Ageless Brain by Dale E. Bredesen, M.D.

I received an advanced copy of The Ageless Brain from Flatiron Books via Netgalley with the expectation, but not the requirement, that I write a review. (I’m a little late to publish it because I had a newborn in the meantime.) Some of the content may not have been complete (I noted a few tables missing at the end). My opinions are my own.

I previously reviewed Bredesen’s The First Survivors of Alzheimer’s and have listened to many podcast interviews from 2020-2024 with Bredesen and others whom he has trained or similar practitioners in the field such as the two Dr. Sherzais, David Perlmutter, Ben Bikman, and Valter Longo as well as the complete audio recordings from Perlmutter’s Alzheimer’s: The Science of Prevention, where Bredesen is one in about 30 neurologists, nutritionists, and psychologists who focus on brain health and Alzheimer’s who were featured.

I’m the ideal audience for the book, a 45 year old who is active and health-conscious with a genetic predisposition and family history, at a crossroads of deciding what commitment I need or want to delay cognitive decline as long as possible. I am an APOE 3/4 watching my mother struggle in the relatively early days of Alzheimer’s while her older brother is in an advanced memory care facility. However, I’m also skeptical, allergic to phrases like “reversing Alzheimer’s” or telling people that Alzheimer’s is “completely preventable,” as Bredesen does in at least one podcast. There are 443 citations of scientific articles and studies in the citations (about 25% of the book), suggesting he certainly is aware of his critics who say he’s not doing medicine or scientific work anymore.

The premise of the book is Bredesen’s personal quest to get to age 100 or more with perfect cognition. Inspired by his dad, He writes as though he would feel like a failure if he cannot achieve that goal and that he feels a certain responsibility for seeing similar results in those patients he is treating. The Ageless Brain presents the latest science behind nutrition, fasting, insulin resistance, sleep, brain training, brain plasticity, exercise, and mitigating exposure to various toxins (and mycotoxins). It is similar to the second half of Survivors where Bredesen lays out the latest science that is behind his PreCODE and ReCODE protocols.

The author also writes about the latest research that may pay dividends in the decades to come. He has an optimism about continued research, technology, cleaning the environment, etc. which I now find naive given the billions in cuts in federal funding to universities for research of all types by HHS this year, including funds and canceling grants to those labs responsible for some of the research cited in the book, not to mention cuts at the EPA and deregulation that will encourage more polluting and less clean water.

Anyone looking for a quick read or lists of tests and diets won’t find it in Bredesen’s books, you have to read the whole narrative, make notes, and piece it together for yourself. I did that in time for my annual physical and included my notes in the tests. For a simple example to assist you, here’s a list I compiled from tests Bredesen recommends in various places in the book:

Annually:
fasting glucose
hemoglobin A1C
fasting insulin
Apo B (Apolipoprotein B-100)
hs-CRP High sensitivity C-reactive protein
homocysteine test


Every five years after age 35 he recommends these, which his employer Apollo Health offers as BrainScan:
GFAP - (glial fibrillary acidic protein)
p-tau 217 (or p-tau 181 instead)
NfL neurofilament light chain

For everyone with the APOE4 allele he recommends these along with a MoCA (or similar) cognitive exam every five years, unless symptoms begin to develop sooner.

(The final chapter of the book also adds a skin test that can be used to determine risk of several other chronic diseases.)

Bredesen also mentions the progress of some of his patients that he’s studied, whose stories were included in Survivors, as well as his lament over specific individuals whom he was unable to help.

I find his books paradoxical because Bredsen tells the reader upfront that his protocols are difficult. But he challenges the reader with (paraphrase) “How bad do you want to live?” He doubles down that those in Gen Z “will never even have cause to worry…we now know how to prevent cognitive decline and dementia in virtually everyone” (loc. 83), but this belies the fact that the steps to preventing your Alzheimer’s may be quite complicated and hard to unlock and that you’d better start soon – “there’s been a 373% increase in diagnoses for those between 30 and 44.”

The good: You’ll learn a lot about the latest in health and nutrition science related to dementia and chronic disease.

The bad: You’ll often be left with more questions than answers. How do I test for what toxins in my body, much less how to cleanse from them? Of all of these foods and supplements, how do I determine which is most beneficial for me, particularly if I’m already showing signs? The answer as far as what I’ve found is basically that you can pay his company Apollo Health for monthly updates, they’ll process your bloodwork and send you adjustments to your supplements based on their algorithm. To his credit, this book does not advertise those services.

Bredesen writes that Alzheimer’s is purely preventable without large caveats that there are certain things that may be beyond your control that make it very difficult. Whatever you’ve done in the decades before you read this book may show up to haunt you, including what your parents fed you and exposed you to as a child.

He writes that even those with advanced Alzheimer’s have seen improvement in their symptoms by following his prescribed protocols. However, reading the r/Alzheimers forum on Reddit and observing first hand those with mild cognitive impairment (MCI), and reading the testimonies he presents in his Survivors of Alzheimer’s, it’s not the average joe who is able to see true “reversal.” It’s only highly-motivated people who are in good (largely excellent) physical shape, have not had many emotional traumas (or have had good therapy to overcome it), were fortunate enough to avoid cancer and chronic disease, have excellent support from close family and friends, and –crucially– are highly-motivated to do the research and experiment with different combinations of activities and supplements. Also, they’d better still be able to do physical activities like weightlifting and other strenuous exercises.

It also helps if you can afford to sell your house and move away from any toxins or pollutants. (Good luck to people in places like New Delhi and Manila.) Bredsen writes that he knows this will not be a reality for everyone, but every little bit helps. “I’m not convinced that most people are ever in a position to completely eradicate the most common sources of biotoxic exposure. We can, however, be more thoughtful…” (loc. 3613).

Another problem I have with several of these practitioners is they write like getting a continuous glucose monitor (GCM) is relatively cheap or easy. Ask anyone with Type 1 diabetes about the difficulty of getting insurance to cover the components every time their monitor has a mandatory update– it’s a monopoly/scam that doesn’t appear to go away anytime soon.

In all, I have to give this book three stars. As you can see from many of the reviews of Bredesen’s book, people are looking for a playbook of “exactly how” instead of “why.” It provided a lot of useful information for me, but I also don’t like the glib way that Bredesen can admit following the protocols require intense dedication and enormous sacrifices while saying “but anyone can do it.” I agree with folks like the Drs. Sharzai who see Alzheimer’s through a public health lens– there are a lot of vulnerable populations at a disadvantage for implementing such radical changes to save their brains that go unlooked.

This is a pretty neat book to read. It is full of information and research to an approach to living a healthy life to help our brains thrive. I like that he uses studies and scientific information through the book. I think it is a good message for anyone of any age to read since keeping our brains healthy is important through all of our life! It covers all kinds of things like food, exercise & so much more. I felt the book was easy to read and easy to understand.

Dr. Dale Bredesen's "The Ageless Brain" was filled with an incredible amount of information, depth, and was very helpful! The book and research entails Dr. Bredesen's approach to living fully and as healthy as one can, to achieve a brain capacity of 100 years old. He bases his entire book on a rigorous amount of scientific information and studies, and I appreciated the detailed explanation of the various factors that contribute to cognitive decline. The book contains various methods of testing and protocols for treatment interventions that can help anyone in trying to improve their cognition and maintain brain health. Everything from diet and exercise to advanced testing and interventions is contained in this book. I found this to be quite thorough, and I appreciated it being rooted in science and quality testing. The book's foundational message, that a proactive process towards brain health and caring for this most important organ in your body, is both achievable and exciting to read! This book will fill you with hope that even if you have a possible genetic predisposition, there are steps you can take to protect cognitive future.
I highly recommend this book to all. The principles and guidelines would be helpful for anyone at any age, and empowers you to control those variables that you can actively control. Thank you for NetGalley and FlatIron books for the advanced review copy. All opinions are my own.

As someone with a family history of Alzheimer's, both in my own lineage and my husband's, Dale Bredesen's "The Ageless Brain" was both fascinating and deeply helpful. It's clear that Bredesen's approach is rooted in rigorous science, and I appreciated the detailed explanation of the various factors that contribute to cognitive decline. While the book outlines a comprehensive protocol—covering everything from diet and exercise to advanced testing and interventions—I found it a bit overwhelming at times. The sheer volume of information and the potential financial commitment for some of the recommended tests might be a barrier for many. However, the book's core message, that proactive brain health is achievable, is incredibly empowering. I found the anecdotes particularly inspiring, and they gave me hope that even with a genetic predisposition, there are steps I can take to protect my cognitive future. While I might not implement every aspect of Bredesen's program, the book has given me a much clearer understanding of what I can do, and that's invaluable. For anyone concerned about neurodegenerative diseases, especially those with a family history, this book is a worthwhile, though demanding, read.

There is a lot of ground covered here...probably would need to go back and review sections. Lots of science and studies referenced. Much of it were things I've heard before but lots of new information. The whole spectrum seems like it would be difficult to execute but seems there is a lot of basis linking this to brain health!

Very informative and well researched book on preserving cognitive function throughout your life! I found the writing easy to understand (even with lots of biological and medical terms included). The author includes a ton of practical steps to take, backed by his research, to give yourself the best brain function for the majority of your life. It was interesting to hear how a lot of cognitive decline can happen pretty early in life and years before any “symptoms” may appear.

The Ageless Brain: How to Sharpen and Protect Your Mind for a Lifetime by Dale E. Bredesen

I've already spent decades doing what I can to take care of my health and much of the more assessable things that Dr. Bredesen recommends for brain (and body) health are things I've already been doing. The emphasis on a Mediterranean type diet (vegetables, fruits, whole grains, fish), elimination of processed foods and sugary drinks, and the use of certain supplements on a daily basis are things that I've already incorporated in my lifestyle for many years. Exercise that includes brisk long walks, indoor biking, strength training and other activities are a regular part of my daily habits. I have a doctor who is very willing to be a partner in running regular tests that we go over and discuss so I can better plan my supplementation of things that I can't get from my diet. I have life long sleep apnea related problems that are not easily treated by more conventional means and have a coordinated treatment plan with the help of several doctors to allow me the best sleep situation my body will allow. I've been aware that my attempt to do the best for my body is a forever type of thing, it's not as if I will reach a certain spot in my personal health care program when I'm "there" where I can stop putting in the effort and discernment necessary to keep me aiming for my best health. So I enjoy reading books such as this one, knowing that I might not be able to or even want to do everything mentioned in my attempt for better health.

In the case of the steps Dr Bredesen mentions in this book, at some point a person will need the help of professionals and a hefty financial outlay for variety of tests that can let the patient and the doctor see where a person is when it comes to certain functions of the body. This baseline will be a guide for what comes next, what to do next, and what changes need to be made to lead to a better cognitive future. Along with these tests, the doctor's exercise regimen can eventually include adding oxygen therapy to some exercises. There is a lot to take in here, a person can start where ever they are and make improvements, and in my case, I take what I can do and want to do, knowing that following Dr. Bredesen's complete program may not be for me. This is a book that is probably better read more than once, there is a lot to absorb here, and I always do more research on what I learn to be sure certain steps would be right for me.

Of course, the younger you can start in the effort to prevent the decline of cognitive functions, the better, but Dr Bredesen says that even later in life you can find out where you stand when it comes to cognitive decline, with the hopes of slowing down, stopping, and maybe reversing some of the effects of cognitive decline. There comes a point where the things that Dr Bredesen mentions can not be something I can do on my own, there will be the financial outlay of ongoing testing to see where one stands and how one is progressing with changes made to help one be healthier. It's all very interesting and can be overwhelming. I know taking care of our health is never all or nothing, we can always make improvements in the way we treat our body and this book gives you very accessible steps to improving health. From there you can decide just how far you want to go to making use of all the tools that Dr Bredesen shows us in this book.

Thank you to Flatiron Books and NetGalley for the gifted copy of this ARC.

Neurologist Dale Bredesen MD is known for his work with Alzheimer’s patients. In The Ageless Brain, he expands upon his previous work, discussing ways to measure and improve cognitive health. His promise is that if we start protecting our cognitive health early enough, we can avoid neurodegenerative conditions such as Alzheimer's disease, ALS, Lewy body disease, and Parkinson's disease.

I appreciated Bredesen’s discussion of the simple things we can do to improve our health, such as eating a nutrient-dense, mildly ketogenic diet; maintaining insulin sensitivity and balancing blood sugar; exercising; getting enough quality sleep; and learning new skills. The anecdotes he shared were inspiring and suggest how implementing his program might look for different people.

The text is too technical for most laypeople in a few sections, but I think most of the book will be understandable for the target audience. The tests that Bredesen recommends are generally not covered by insurance and will be prohibitively expensive for many people. Trying to diagnose and treat chronic infections, heavy metals, and toxins may also be prohibitively expensive. I hope that these tests and treatments will eventually become more widely accessible.

The back matter includes acknowledgments, notes, and an index.

I was provided an ARC through NetGalley. I volunteered to provide an honest review. The ARC did not include any of the tables, which I would have liked to be able to review.

A family predisposition for dementia is a scary thought. Caring for a loved one can create a fear of seeing the same condition elsewhere in the future of the family. In The Ageless Brain, author Dale E. Bredesen explains the science behind preventing and stopping this group of cognitive disorders. He begins with quite a few pages of anecdotes describing those approaching and passing the age of 100, yet having brains that are still as sharp as they were many years ago. The stories are so hopeful, as well as the stories of patients that have started a new protocol to try and avoid the mental pain of their ancestors. There is a lot of science here but its well explained and brought down to earth so it’s understandable. Bredesen gives ways to measure cognitive decline in our body before we actually notice it and pointers to work toward lowering the reasons for that decline. This information should be read by everyone.

As a health professional (nutritionist) I have read about Dr. Bredesen's research on Alzheimer's disease and the possibility of reversing it. This book explains the known factors that contribute to neurogentive diseases such as poor diet, diabetes, heart disease, obesity, toxins and stress. The chapter on diet explains his recommended nutritional protocol which is a plant heavy, mildly ketogenic diet. I have seen this type of diet improve many health conditions in my nutrition practice. Chapters are also included on exercise, detoxification, brain training, and the importance of a healthy gut.
This would be an excellent reference for those interested in a preventative approach to their health. People who have already been diagnosed with cognitive decline may learn some things from this book, but would likely need a health coach to fully implement the recommendations included. As someone who hopes to live to a healthy aged 100, I agree with Dr. Bredesden's assertion that "we should not wait for cognitive decline before we do something about it". This book is a worthy addition to the general literature on a critical topic to health in America.
I received an advanced copy from the publisher via NetGalley.