Episode 55: TGen Talks Live (part i)

DECEMBER TGen Talks Live (part I)

Karie Dozer [00:00:04] I'm Karie Dozer and this is TGen Talks. When you think about TGen, you probably think about cures for diseases, rare childhood disorders, or research into COVID 19 and other global pandemics. But you might not realize that TGen scientists are also working to unravel the mystery of how and why we age, how our minds and bodies change as we get older. What you're about to hear is the first of a two-part series about precision aging with two experts in the field, Dr. Nicholas Schork and Dr. Matt Huentelman. The entire conversation was captured on video in front of a live studio audience. And following the conversation, the researchers took audience questions. You can watch the conversation in its entirety at TGen’s website TGen.org.

You are both TGen researchers who are experts in the field of aging. You [Dr. Schork] more in the physical sense and you [Dr. Huentelman] more in the brain or mental sense. Let's start with you, Nick. Your area of research involves our physical selves, how our bodies age over time. Most of us listening, watching, taking part today. Our physical selves peaked years ago. Is there an age at which our physical selves are at their best?

Dr. Schork [00:01:17] Well, unfortunately, there's no consensus on this. Some people think that aging starts at conception. Other people think it starts at birth. Other people after puberty. Other people. Midlife. I think where I come from, aging unfortunately starts at conception because there are processes that are kicked off and in start that actually start to accumulate damage to the body. So we need to basically take care of ourselves throughout our entire lives.

Karie Dozer [00:01:45] That's pretty discouraging. Nobody's thinking about aging at conception or in their teens or probably in their twenties either.

Dr. Schork [00:01:50] That's true.

Karie Dozer [00:01:51] So what are we supposed to do about it?

Dr. Schork [00:01:53] Well, there's some obvious things to do. I mean, keep fit to eat right to all these sorts of things. But as you maybe encounter signs of disease, you definitely should take care of them. You know, there's no question.

Karie Dozer [00:02:06] Is our human body, as it exists today, designed to live 80 or 90 years, because on average, men in the United States live 77 years and women live 81 years. Are we set up for this at this point in time?

Dr. Schork [00:02:18] Again, no consensus, but there is a belief that there is a maximum to the human lifespan. It's around 120 years. And so a lot of efforts and sort of research I do and certainly, Matt, are really to extend the health span of people rather than the lifespan. So give people as many healthy years as possible if in fact there's an upper limit to human lifespan.

Karie Dozer [00:02:40] Matt You study the human brain and how it ages over time. Is there an age at which our human brain is at its best?

Dr. Huentelman [00:02:48] It's a great question. And the answer is somewhat complicated because it really depends on what brain function you're talking about. So it's really interesting because things like a certain type of memory might peak in the twenties, but for other things like vocabulary, we know that that peaks much later in life. But there's another twist to it as well. And that is we can all beat the odds. So in our studies of large groups of people as they age normally, we can see people who still perform on these cognitive tests, these memory tests, as if they were many decades younger. So that's kind of the fun side of this as well, is that you can beat the odds.

Karie Dozer [00:03:37] Everyone listening or watching probably has one person in mind. It's somebody at work, it's somebody at their gym. It's somebody they encounter on a fairly regular basis who never, ever, ever seems to get older. You want to know what she's taking? You want to know what he's eating? What do they do at home? Why are they not getting any older? Is that their genetic makeup or is that most likely a combination of their lifestyle, their diet, their where they live, their environment? What is it? How much is chance and how much is not?

Dr. Schork [00:04:09] So clearly there's a genetic component to aging, but it doesn't actually explain a lot. So you could predict someone's life span from birth, but the error bars on those predictions are pretty big. So you've got to take those sorts of predictions with a grain of salt. And that's because hopefully this will come out more in full as we talk. Things you can do to sustain a healthy life. And of course, that's what people are after, trying to figure out just what it is that we can do to combat the bad genes we might have.

Karie Dozer [00:04:39] And what about the lady at work who never seems to forget a thing and she must be going on 70? Isn't it time for her to retire? What about that person whose brain is eternally young?

Dr. Huentelman [00:04:48] It's. It's the same story. It's not all genetics. So we know very clearly it's a combination of both your lifestyle, your health, your medical factors and your genetics. It just turns out that genetics is one of the things that's a little bit easier to study than, you know, your environment, your lifestyle.

Karie Dozer [00:05:07] Is that because people aren't honest about their lifestyle?

Dr. Huentelman [00:05:09] Well, they're not honest. But also, you know, what did you have for breakfast last week on Monday, Karie? It's kind of hard to remember a lot of things that are daily choices that we make.

Karie Dozer [00:05:18] All right. Let's talk about the concept of blue zones, these places in the world where people tend to live longer as a group. What is a blue zone and why the heck do people tend to live to be 95 and actively nine? Yeah.

Dr. Schork [00:05:31] Well, the blue zones are just as you said, these are places throughout the world where for whatever reason, there tends to be a longer lifespans for people that, you know, have somehow found healthy lifestyles. Most of the research suggests that keeping physically active no surprise is one thing eating right is another. Having social support is incredibly crucial, and this has been hammered home time and time again in in research projects. I'm sure Matt would agree. So it's not just the environment, not just your genes, but your social life. That is important, too.

Karie Dozer [00:06:09] What about the brains of these people? You visited one of these blue zones, didn't you?

Dr, Huentelman [00:06:13] Yeah. I had the privilege to visit some centenarians in Okinawa, people who have lived over 100 years. And as Nick mentioned, it was really striking. These individuals were still very independent. But the beautiful thing was that their family was sort of right out their back door. So they lived in these familial communities with different generations who probably kept them really thinking and being much younger than they really were. It was really quite striking how different that is than sort of a typical household that we grew up in here in the U.S.

Karie Dozer [00:06:51] What's become typical in the United States is instant access to everything. Any food that you want, anything that you, anything that you want. You can basically order to be delivered to your home. We don't have to go anywhere anymore. Is that as you look at these blue zones, is that in direct contrast to the way these people are living?

Dr. Schork [00:07:12] I would say yes. You know, they have more limited access to food. So the Amalfi Coast in Italy is another blue zone. And the sorts of food that people have access to is much different. A lot of it is grown locally. It's kind of organic, so not as much processed food. So there is a pretty strong correlation between the amount of processed food one eats and their health and cognitive abilities later in life. So if these aren't in the orbit of the people who live in these blue zones, it's probably contributing to their health at some level.

Karie Dozer [00:07:47] They probably have to think about what they're going to eat and planet. So that's a mental process that many of us don't need to go through anymore.

Dr. Huentelman [00:07:54] And that's really important. Think of all the steps involved, even just in creating your weekly grocery list, right? You have to you have to have a craving for a certain food. You have to imagine that recipe. Maybe you have to write it out or find it, and then you have to plan on what you need to purchase. So it's actually a pretty interesting. Sort of cognitively challenging process to plan out something as simple as what am I going to eat this week? But I think Nick brought up something really important. And this is the aspect of these processed foods. And new research just came out this week that him and I were talking about by email, showing that, you know, a diet too reliant on these processed foods could actually be bad cognitively. And that was really surprising to us. But it was certainly a large study and fairly convincing that we need to make sure we're not relying too much on these super processed foods.

Karie Dozer [00:08:51] Matt, obviously studying the brain, you know a lot about Alzheimer's disease and deal with a lot of people whose family members have it or who have it themselves. I feel like most Americans are highly aware of Alzheimer's, what it means. And I would say that most people fear it. I think it's the number one thing. You probably get it from friends and neighbors, you know, how do I know that I'm not going to get Alzheimer's? Is that fear justified? Just based on the numbers?

Dr. Huentelman [00:09:17] Yeah, it's a great question. So I think it's natural to fear it because it's so striking when it happens. And, you know, when you know someone with Alzheimer's disease, very few people would say would choose that. Right. So, yes, it makes total sense to be fearful, but the statistics don't necessarily support that. So this is not our destiny. Only a small fraction of us over the age of 65 end up with Alzheimer's disease. Yes. As you start to take slices of the population that are older and older, that risk increases, but it starts out as low as ten or 11%. So it is not really the pre destiny of us as we age. So I would never say the fear is not unfounded, but it's it certainly shouldn't dominate your thoughts about, well, this is what's going to happen as I get older.

Karie Dozer [00:10:10] What about genetic markers? Obviously, now you can screen for probability. Is that is that reliable data? Is it something that people should do if they have a concern?

Dr. Huentelman [00:10:21] This is really a personal decision. So we do a pretty good job of using genetics to estimate your risk for Alzheimer's disease. But the key word is risk. So it is not there is not a way for me to look into your future with exceptions of very rare forms of Alzheimer's disease. We can do that with very rare forms, but the most common form that we're all concerned about, we can't look into your future with absolute certainty. So some people feel empowered by that. They want to know if they have higher risk because they're going to do things, they're going to change, maybe their planning, their savings, they're going to change their wills. And some people will say, well, I can't do anything about it, so I don't want to know. So that's why I say it's a personal decision. But I also don't think it's not a slam dunk right now. So that's why I can't I wouldn't make a blanket recommendation that this is what you should do; that's why I think it's personal.

Karie Dozer [00:11:17] When someone is diagnosed with Alzheimer's and it's official, it is an official diagnosis. It's not a question. After a certain point in time, is there a physical ramification of it or is it purely a brain disease?

Dr. Schork  [00:11:29] No, there is physical manifestations. But just to the point and I'll share this story with you. So there is a gene, it's called the APOE gene, one gene that Matt has studied in his colleagues. And there's a change that some people have in that gene which causes them to have greater susceptibility to Alzheimer's. I carry that gene. My mother had Alzheimer's disease. So I have been paying attention to developments in how to prevent and treat Alzheimer's disease. So there's no question this this one particular gene change in the in the employee gene, if you have makes you more susceptible. But as we're talking about, that is not necessarily a guaranteed. So there's much that one can do. In fact, there's a there's a joke out there that I've used before, and that is as we age, we rely less on memory and more on memoranda. So I write things down. I take steps to make sure that I've got things coordinated and, you know, wish I had done more of this with my with my mother to sort of get her to kind of be more active in preparing her day and taking part to sort of get her more involved in thinking about things. Yeah.

Karie Dozer [00:12:42] So what about those physical ramifications, aside from not remembering a basic thing like how to drive or where you live or getting lost in your own neighborhood, what are those physical ramifications?

Dr. Schork [00:12:53] So it's interesting, with the APOE gene, there's probably not as many physical kind of correlations as there are with the more cognitive deficits, but there are other genetic factors which clearly contribute to both cognitive decline in age and kind of physical decline in age, and they affect certain processes. We won't go through the technical details, but sort of the way your cells are powered, there's a organelle called the mitochondria in your cells and those tend to wind down and contribute to aging. So there's known to be genetic factors that kind of complicate the powerhouse of your of your cell. And those contribute to both cognitive deficits as well as physical deficits.

Karie Dozer [00:13:32] What can the average person not having any knowledge of their genetic risk for Alzheimer's, what can that average person do to put themselves at ease and know that they're doing whatever they can to either prevent it or prevent the symptoms of it, because as we age, a lot of people experience different kinds of dementia. It doesn't have to be Alzheimer's. But what is it that we can do to our brains now and every day until we get to be 90? Hopefully to help keep that from happening.

Dr. Huentelman [00:14:02] I get this question a lot, Karie, and I think…it's one of those that drives our current research as well. So what can you do? There's a long list of things that we know have scientific evidence to support brain health. The interesting thing for the audience is that most of those are also supportive of body health. So good for your body. Good for your brain. Things like eating well, eating a balanced diet, eating a healthy diet, getting the necessary sleep that you need each night. Some people at 7 hours, others it's nine. Find out what you need and don't skimp on your sleep. Exercise both strength training and aerobic exercise. And another big one is socialization. Get out there. Do things come to an event like this? Meet new people. Hear new things. That's just four on the list. Okay, the list gets really long. So I think what the problem is, that list gets too long. It gets daunting.

Karie Dozer [00:15:02] I don't have time for it. All right.

Dr. Huentelman [00:15:03] Some people say, well, I want to do all those every day because I want to I want to really help my brain. So I'm going to do all the things on the list. And that's just too difficult. There's not enough time. So one of the things that Nick and I are trying to do together is to understand how we can prioritize this list for an individual person. Yeah. So for you, if you only had an hour, what should you do? Should you focus on cooking the best food? Should you focus on exercise? Should you focus on socialization? We don't know that answer just yet. That's why our list is so long. So we want to find out a way to recommend prioritized things to each person individually. What should you do now that has the biggest bang for your buck, biggest bang for your investment of time?

Karie Dozer [00:15:49] Is there any truth to the idea or merit to the idea that what it is that you want to go do? I'll just say personally in our family, I would be the one to go to the gym, whereas our daughter would sit and do a crossword puzzle. If you give us one hour, right, she's going to get help. She's going to ask everybody in the family for answers. But this is how we do crossword puzzle. Yeah. So that those are the two things that feed us. Is there any merit to the idea that that might be what we're supposed to do based on our genetic makeup?

Dr. Schork [00:16:21] I think yes. And in fact, to echo what Matt said, there's there some truth to the fact that these kind of preventive strategies should be personalized. So I just told you that for me, I have this copy of this bad gene that predisposes me to Alzheimer's. Not many people have that. Certainly not many people in the room, probably. So I need to be on the lookout for, you know, things associated with cognitive decline. But that's not true of other people. Physically, I'm doing fine. My family, for whatever reason, seems to be blessed with good physical genes. So, you know, we're all kind of fit. They can handle stressors of one sort or another. So for me, it's more cognitive impairments and less on the physical side, but you can imagine the opposite for somebody else.

Karie Dozer [00:17:04] Might you be in the right line of work for somebody who has this genetic make-up?

Dr. Schork  [00:17:08] Well, you know, people typically choose professions that have something to do with, you know, their own.

Karie Dozer [00:17:14] But you had no idea when you joined this on the job.

Dr. Schork [00:17:17] Right.

Karie Dozer [00:17:18] We've all heard the phrase use it or lose it. I'm sure that there's truth to that mantra, both physically and mentally. How do we as we age, we probably fall into some comfortable patterns, right? We do things that might be easier. How do we as Americans who live in a country with access to everything, an abundance of everything, how do we continue to find things that challenge us? Because as we were talking about before we started this, we could watch Netflix all day, every day. We could we could entertain ourselves endlessly. How do we find the good work to do to keep our brains working?

Dr. Huentelman [00:17:55] Yeah, I think it's really important, but I don't know that I have the perfect answer. I think that's another one of these personalized things. But I do think it's important here that this is really critical, you know, the variety being the spice of life. That that's a saying because of its influence on our brain and body health. And so certainly that is very, very important. How we solve that for everybody is still a difficult question.

Karie Dozer [00:18:26] You can listen to the rest of this conversation on precision aging with Dr. Nicholas Schork and Dr. Matt Huentelman in January on TGen Talks. For more on TGen’s research, go to TGen dot org slash news. The Translational Genomics Research Institute, part of City of Hope, is an Arizona based nonprofit medical research institution dedicated to conducting groundbreaking research with life changing results. You can find more of these podcasts at TGen dot org slash TGen Talks, Apple and Spotify and most podcast platforms for TGen Talks I'm Kerry Dozer.