504: How to Stay Sharp and Prevent Cognitive Decline in Retirement with Dr. Ross Andel

[INTRODUCTION]

Casey Weade: Is retirement bad for your brain? Today, we have a discussion around the hidden dangers in the form of increased risk of cognitive problems in dementia, and most of all, what you can do to mitigate these dangers. Hey, this is Casey Weed. Welcome to the podcast. I'm excited to bring you a great conversation today on the non-financial side of retirement with Dr. Ross Andel, a gerontologist and professor at the Edson College of Nursing and Health Innovation and he is also the PhD Program Director at ASU, Arizona State University. His research revolves around the examination of risk factors for accelerated cognitive decline and impairment, including research on work, retirement, and cognitive aging.

In 2023, he was elected a lifetime fellow of the American Association for the Advancement of Science for his achievements in the study of risk factors for age-related cognitive decline, for Alzheimer's disease, and other types of dementia. I was initially introduced to Ross and his research through his TED Talk titled “Is Retirement Bad for Your Brain?” His discussion explored how retirement may hold hidden dangers in the form of increased risk of cognitive problems or dementia, and how you can mitigate these dangers while still enjoying the positive aspects of this life chapter. Today, I'm excited to take Dr. Andel’s discussion a step further as we delve into his cutting-edge research on the cognitive implications of retirement and what you need to know to help keep your mind sharp regardless of your age.

[INTERVIEW]

Casey Weade: Dr. Andel, welcome to the show.

Ross Andel: Thank you very much. Thank you for having me.

Casey Weade: I'm excited to have you here because this is a conversation that I've wanted to have for a while. I just don't feel like I've found the right person. I feel like I found the right person to have this conversation now. It's been one that's brought to me by the audience. We have even team members here that have said, "We have to find somebody to talk about this because my parents are going through this, my grandparents are going through this.” This is something that impacts, it seems today, virtually all of us.

Ross Andel: Yeah, absolutely. I mean, there's no question. As we live longer, the chances of cognitive problems increase tremendously. And certainly, there are ways that we can help ourselves.

Casey Weade: Yeah. Well, before we get into some of your research and some brass tacks and applications, I think there's just, in general, at least for me, there's some confusion in this realm. You have Alzheimer's, you have dementia, you have cognitive decline. And my grandmother when she was experiencing this towards the end of her life, last couple of years, I remember walking out of the hospital at one point talking to one of the nurses and I said, "Something seems off. Is she suffering from Alzheimer's?” And they said, "No, it's dementia.” And I'm like, "Well, what's the difference?” So, what's the difference between? Can you just kind of help us delineate between these three elements of brain aging?

Ross Andel: Absolutely. No problem at all. Unfortunately, we only have an hour, and we probably need more than that just to try to cut through everything. But I can give you a nutshell. So, dementia in general is this syndrome that is most best characterized by neurodegeneration meaning we have millions and millions of neurons in the brain and they generate here and there just kind of normally. It's part of normal aging. But in dementia, they start to degenerate at really, really high numbers. Sometimes the neurons that degenerate are the ones that are in specific areas of the brain like the hippocampus, which is super important for us to store information and then retrieve it. It's kind of like the brain clerk that kind of operates, put things in, takes things out.

Well, if the hippocampus is not working very well, the disease that person is set to have is Alzheimer's disease, but there could be changes in the brain due to vascular changes, and then it's vascular dementia. And in that case, the neurodegeneration happens in pretty much any type, any area of the brain. And the symptoms might not really mimic perfectly Alzheimer's disease. The decline doesn't mimic Alzheimer's disease, much more unsteady. And they're like dozens of types of dementia, I would say. There's Lewy body dementia where the degeneration in the brain is in a different part of the brain.

So, in general, just to kind of not to take us into the rabbit hole here, there's this big class of syndromes that fall under the general umbrella of dementia. Among those, the most common is Alzheimer's disease. About 70% of cases of dementia are Alzheimer's disease, but then you have 30% that are other types of dementia. And I named Lewy body dementia. There's frontal lobe dementia. There's Parkinson's disease that's also a type of dementia that actually doesn't affect cognitive skills at all. It just affects motor skills at least early on. So, again, you have this large group, all characterized by neurodegeneration but the site of the degeneration is what ultimately determines the symptoms.

Casey Weade: So, then is cognitive decline even above this? Is it cognitive decline then dementia, and then Alzheimer's is a dementia?

Ross Andel: Yeah. So, looking at it sort of from this vertical perspective does get a little difficult, but I can just, again, give you a little scoop. So, as we get older, some of our cognitive abilities do decline. There's also wisdom that tends to be just really not only stable, but it can even increase, say after the age of 60. But let's say speed of processing, these fluid skills, they do go down. There's just no way around it. It's just part of normal aging. Just like if we try to sprint somewhere when we're at 65, we'll be slower than when we were 25. It's kind of a very similar thing. So, it's not kind of across the board, but in general, we see that there is cognitive decline. There's nothing to worry about as far as normal cognitive decline.

But then people start worrying about say misplacing things or forgetting too much. And maybe they are starting to experience some mild cognitive problems. And that tends to lead to potentially that decline that I just described that is actually underlined by neurodegeneration. And that's when people start to decline faster and things kind of go in the wrong direction at that point. Can we do something about it? Sometimes yes, sometimes not. We all have our genetic predisposition that we're born with or parents have given us a certain level of risk for all kinds of diseases including Alzheimer's disease.

Some potentially 50% of the risk of Alzheimer's disease or any other types of dementia is it's 50% genes, 50% environment. So, there's something we can do, but not always. But with that said, we're here to fight through it all the way to the end and do our best as we age. And that's kind of where my research lies and the 50% that we can modify.

Casey Weade: There was something that stood out to me that I heard you say in there, and it's something that I've heard before, but I don't want to gloss over it. That was that you can have cognitive decline, even dementia, and still see wisdom increase. How do you delineate between these two things?

Ross Andel: So, yeah, not an easy one. So, let me back up just a little bit. So, we have cognitive decline. It's just like physical decline. Decline in any other system, any other body system, there's some decline. And that decline tends to be most pronounced in areas that are described by these fluid abilities like speed of processing that it takes us maybe a little longer to make a decision. If you came to a laboratory to get tested and there was a test of sort of a processing speed, which can be tested very well, you will see that processing speed will start to decline but then let's say there's a test of vocabulary that you might not see much of a decline there.

So, the verbal skills can be well preserved with a normal brain very long. And again, there are not that many tests of wisdom but in a normal aging brain, wisdom can be preserved until very, very old age and it's the normal aging brain. When dementia comes in, then the changes start to occur in all areas of cognitive function. All domains of cognition end up being affected. In Alzheimer's disease, in particular, it's initially sort of the memory, tip-of-the-tongue phenomenon. Again, it's slowing that's exaggerated, that the speed of processing slows down to a point where it's very obvious even during normal everyday life.

There are some changes to visual-spatial skills. That's where it's sometimes difficult for people to find their way back home even from places that are familiar to them that presents a certain danger, but it's, again, specific to Alzheimer's disease. A different type of dementia might be affected differently. So, once this really abnormal neurodegeneration sets in, the changes in cognition kind of accelerate and they're much, much more universal.

Casey Weade: Yeah. You mentioned misplacing things and, I mean, I can tell you probably once a day I'll misplace something and have, "Where is it? I don't know where I put the keys or where's my computer?” I think we all seem to suffer from certain aspects that could be misconstrued as cognitive decline and then we go, "Well, can we self-diagnose in some way?” I know I talked to my parents and different clients and loved ones, and it seems to me what I observe is those that really are experiencing cognitive decline tend to, it seems like there's just kind of an ignorance of it or it is just they have no idea that it's actually happening.

And then those that I don't think are actually experiencing cognitive decline tend to think they're experiencing cognitive decline. So, when we're going through this, can we self-diagnose in some way and say, “Nope, I'm still doing really good. I should still have my car keys”? Do we have the ability to actually make those decisions on our own? Or do we need to seek assessment or help? And how many people actually seek assessment when they're going through cognitive decline?

Ross Andel: Yeah. Those are great questions for sure. I mean, as older adults do need a certain level of resilience to absorb the information that's around them, including what we were talking about, and say, "Okay. If I am 75 years old or 65 years old and I forgot my keys somewhere,” it doesn't mean that I have dementia. I can tell you my son's coming back in town with us for a little bit, and self-diagnosis. I can probably diagnose him with some type of dementia because he does forget things here and there but he looks at it differently. At a young age, you look at the same event differently than when you're older.

When a 65-year-old forgets the keys the way he does, he says, "Ah, okay. I'll just come back.” The 65 would say, “Is there anything going on with my brain?” even though you may have been doing this the entire time. So, that's kind of where that resilience to this information that's coming in comes in. I mean, be realistic. Can you carry a conversation? Are you independent in your daily activities? Of course, you might forget a few things here and there, but how much is it affecting your life? I think once it does start to affect one's life, that's when again we need to kind of step in and get that diagnosis and kind of move.

Casey Weade: When you say step in, is it possible that…? I don't know what happens during this period of time. Does the person actually recognize that it's affecting their lives? Or is it usually someone else that says, "You need to go get an assessment”?

Ross Andel: Early on, yes. People do have that recognition. It usually occurs around moderate stage of dementia where anosognosia sets in, meaning people just don't even realize that they have these problems. But early on we're all different but, yeah, hang on. It's a really tough one as well, but people do have a tendency to, at least some, or people around that person can kind of realize, "Okay, you know what, it's time for us to at least take action.” And sometimes it happens where the offspring take away keys for the car. They say, "Okay. Dad, you know what? I know you say you feel fine. We're starting to get worried. You don't want to get assessed but you should not be driving.” So, you're right that to some point, look, I don't know if it's in some cases a denial or if it's lack of self-awareness.

Casey Weade: Or it's just fear of the diagnosis itself that keeps us from seeking it. And I think about the other things we get assessed for regularly as we age. Just as men, we're going to get prostate exams once a year and we know we should do that. When it comes to cognitive decline, is it important that we catch it early? The earlier we catch it, do we have the ability to mitigate it or manage it better? And if so, then why isn't it standard practice that we have an annual checkup in this area?

Ross Andel: Believe it or not, we're still not far enough into being able to, A, understand dementia and, B, be able to treat it where these assessments are absolutely crucial, but we are definitely getting there, particularly recent developments in the ability to diagnose early signs of dementia through blood profile. Those seem to be game-changers. There's also new medication that may work better than just postponing the decline right now. There are these cholinesterase inhibitors that can allow these neurotransmitters that are important for transmitting information in the brain to stay in the brain a little bit longer.

Even though they're being depleted through the disease, they do stay in the brain a little bit longer through the medication that's given to patients. So, for example, Aricept, but it's unfortunately just a temporary like a Band-Aid on the disease. It's not really treating the underlying neurodegeneration, but it does slow the symptoms for some maybe two to three years. So, hopefully, as we progress and as we start to understand the disease a little bit better, there's this really strong amyloid hypothesis around which a lot of the new medication is being developed. So, hopefully, we're right and this new medication starts to show more than just the promise.

So, yeah, there's more and more reasons to get assessed. Another reason is just safety. If someone's declining, maybe they do need someone to be around them a little bit more. One issue is driving, another one is getting lost. Those are very important. I live in Arizona. I mean, the temperatures here during the summer can be life-threatening. So, you don't want, say, your grandpa to get lost, your grandma to get lost on their way if they go for a walk. Maybe you want to go with them if you suspect that something's going on. So, being assessed at that point might be very important.

Casey Weade: Well, there's one aspect of this, which is these cases of dementia and cognitive decline in younger age individuals even in their forties or fifties which just seems starkly different than those that are in their eighties or nineties, which makes -- it's always felt like, well, aren't we all going to have cognitive decline because isn't this all a factor of just us no longer having the same level of cellular regeneration that we once have? And really we're trying to cure aging. In order to cure dementia or Alzheimer's or really I should say cognitive decline, it sounds like, we would have to cure aging. Is that a correct assessment?

Ross Andel: Yeah, you're right. I mean, we can do that, obviously. We all age. Our bodies change naturally. It's just a normal phenomenon. You did mention early diagnosis in the forties or fifties. Those are usually cases where there's some type of a strong genetic predisposition. It's very rare. It's just extremely rare. But these gene-driven cases do occur. In general, really, we all know that we have to pay taxes and we die. Those are just kind of the two certainties of life. So, our bodies just decline and so does the brain. It's part of our body, so it does decline. There are ways how we can mitigate some of the changes that occur naturally. And frankly, we are actually getting pretty good at it.

Large epidemiological studies are suggesting that the incidence of dementia is at least stable, if not declining. There are still more cases. The prevalence is still high because more and more people live into high age. So, the life expectancy that's been increasing very steadily over time also carries along with it the great likelihood of dementia. Say, someone we know survives until 95 but would've died at 85, say, 20, 30 years ago if they were born earlier. Now, they might be developing dementia at that older age, whereas before that, maybe a cardiovascular problem would kill them or it would develop cancer much earlier. So, we're getting much better at living these healthier lives that allow us to maintain our physical abilities longer, and it seems to translate to our cognitive abilities as well.

Casey Weade: In conducting the study that began in 2001, the Path Through Life project, have you found that the results have matched your expectations, or have there been some surprises?

Ross Andel: So, this is a very unique sample. I'm more of a guest with this study. This study is run in Australia under Dr. Kaarin Anstey, who was originally at the Australian National University. Now, she's at the University of New South Wales. It's a sample of, you know, many of these people were government workers who actually showed a tremendous amount of stability in their cognitive ability. So, maybe that was one surprise, how steady they were in terms of their cognitive function. And that was mostly post-retirement. The retirement age for government workers in Australia, at least in Canberra, in the capital, is around 55. And many of them were very involved.

Volunteering is huge in Australia, so maybe that's one of the lessons that we can carry from Australia to the United States, that these people would retire but they would automatically transition into whatever they were volunteering in because they would volunteer even while they were working. I was actually trying to look at volunteering along with retirement, but I just did not have any variability. Everybody was volunteering. So, how do you compare those who are volunteering to those who are not volunteering when everyone's volunteering? So, they really take that volunteering very seriously. So, their transition into retirement might be somewhat easier because they have these activities that are well above and beyond their occupation.

Casey Weade: Well, there's something that stands out to me in this study, and I think it ties into what you just said there that, hopefully, maybe you can help me reconcile. The study showed that post-retirement cognitive decline was almost three times steeper in white compared to black individuals and twice as much in men compared to women, most substantial for white men, most minimal for black women. And I look at the race piece there and you also have this chart in here. You said the big risk factors are diabetes, smoking, obesity. These are some that stood out to me. Alcohol.

And when we look at the black community as a whole, there are higher rates of, say, diabetes or smoking or obesity largely that are due, in my novice level of knowledge, that has to do with their access to quality healthcare, quality food in some of those lower-income communities. So, how can you explain that those individuals are experiencing cognitive decline at a significantly lower rate than individuals that we would expect on average to have more access to quality food and healthcare, and lower rates of diabetes, lower rates of smoking, and obesity?

Ross Andel: Yeah. Very good. So, let me back up just a little bit. So, the original study that was part of the TED Talk that I gave, I think it's in 2019, was the Australian study, the PATH through Life study. This one was published last year using a sample called REGARDS, which is based in Alabama but covers the entire United States. So, this is a US-based sample, this new study that you're referencing. So, this one, you're right, there were some really interesting differences between black and white retirees. And now why? Okay. So, for one part, overall, the cognitive level of the white retirees was a little bit higher. So, this can be attributed to the higher initial cognitive functioning.

If you work, if you're at a higher level, you have more room to go down, obviously, on these cognitive testing. We're using tests that have ceiling effect then the floor effect. So, some of it is sort of psychometric that they decline, but that can only explain a small portion. So, why could that be that retirement is just not as important, that doesn't have the same sort of potentially negative effect? Also, we not only looked at retirement, but we also looked at what type of jobs the participants were retiring from.

And someone who was retiring from a really engaging complex occupation where you're working, making decisions, you have a lot of control as to what you do, those seem to experience faster decline than those who are in occupations where they were kind of less engaged. Their occupations were more complex, telling you that maybe the individual is not as engaged in that occupation. So, retiring from that complex occupation might carry its own risk. And this is kind of where we can target our message to people who are retiring as to if you have that occupation that's, A, taking up a lot of your time and carries a lot of your identity, you have to be particularly careful to replace it with something else to do relatively quickly after retirement.

If you’re actually thinking about retiring and you’re retiring from an occupation where you’re really involved, you’re working long hours, you’re making those decisions, it is fulfilling. It is maybe more part of your identity than someone whose occupation is at a lower level where they don’t have to make decisions. They’re just kind of listening to orders and completing tasks as they’re told. They (a) may be more ready to retire as to having things that are more fulfilling to them than their occupation, and (b), they might have more time to focus on those hobbies and volunteering activities and other things.

So, if you’re in that high complex occupation, sort of the more managerial type of occupation, you probably want to be more careful as to how you plan out your retirement. Just don’t think of it as a long vacation or don’t think of it that the first three months of your retirement needs to be spent resting. You want to have a plan that involves– it doesn’t have to be overwhelming work, but you want to have each day filled with something meaningful to do.

Casey Weade: Yeah, and sometimes argument’s been made. Well, you want to go ahead and spend those first few months just exploring and relaxing and just getting comfortable. Wake up when you want to wake up, go to sleep when you want to go to sleep.

Ross Andel: Exactly.

Casey Weade: This is a really good reason to have a plan prior to make sure that that cognitive engine doesn’t slow down and kind of hit a wall as soon as you step into retirement.

Ross Andel: Yeah. I try to name it The Retirement Trap in the TED Talk where basically, the feeling like, well, look, I deserve a long vacation. I just retired. Well, it’s a little bit of a trap because it’s hard to get out of that. Once you lose sort of the rhythm, you lose the routine, it tends to be a little hard to regain. So, you can still have your time off, but you want to have time when you are engaged in something meaningful, like sort of the Friday afternoon feeling where you worked for the whole week. And now, you feel like, yes, okay, I’m just going to relax, but you’re only relaxed, say, for a weekend or a long weekend. Or let’s say that you have a two-week vacation because you work so hard up until now. But after those two weeks, you go back and you again have routine and you keep yourself going with something that makes sense to you, that has purpose for you. That’s kind of important.

So, sometimes that retirement becomes sort of this extended vacation time with no real plan as to what to do afterwards. I mean, you can have a rough plan. Like, all right, let’s say that after all this, I’m going to start building wooden airplanes or something. I’ll find something then. It’ll be okay. Well, sometimes it is, sometimes it’s not.

Casey Weade: Well, what I hear you saying there is an object in motions tends to stay in motion. And so, there’s also something I find a little contradictory in the statistics. So, according to Alzheimer’s Disease International (ADI), dementia cases are projected to nearly double in the US by 2060. The lifetime risk of developing dementia after 55, about 42%, but Americans are working longer. So, the percentage of Americans age 65 and older in the workplace has nearly doubled since the late 80s, 19% are currently working in 2023, and so, that’s probably over 20% are still working after the age of 65 today.

And the Bureau of Labor Statistics projects that the number of people 75 and older in the labor force will continue to grow significantly. So, we’ve seen a lot more individuals that are working into these later years doubling after age 65 since the 80s. So, we’ve gone, say, 30 or 40 years, and now more and more people are actually working beyond this age. So, if Alzheimer’s numbers are projected to continue to increase while we continue to work longer, retirement can’t be the real problem here.

Ross Andel: Yeah, it’s a complicated question. Again, the number of cases of Alzheimer’s disease increasing is so closely tied to increasing life expectancy that you might have someone who used to work would retire at 62. Now, they might retire at 67. But 20 years ago, they may have lived to 78. Now, they might be able to– like their average life expectancy might be 85. So, they’re much higher life expectancy. They’re working longer, but they’re also living much longer. So, both those extend so you end up with the tail end that’s sort of much bigger where we have older adults who are at a particular risk of Alzheimer’s disease much later on. With that said, is it retirement that that’s the main risk? I agree with you, I don’t think so. It’s the mental retirement.

So, the idea that once your plan for retirement is to take it easy, our brain will respond to that. If you say, okay, we’re just going to relax and not do much, all right, then why waste body resources on the brain when you’re saying you might not be using it that much? Let’s put the body resources somewhere else. So, it’s an important sort of part of the thinking.

Casey Weade: Does the other side of the coin here tell us that retirement can actually be an opportunity to improve our mental capacity, our mental health, our cognitive development, can we improve these things by stepping into retirement? And I look at those individuals that have maybe retired from a profession that was a little mundane. They didn’t enjoy it, they didn’t have passion around it, they weren’t that engaged. Now, they have a new phase of life where they can find something they are more passionate about, that they are more engaged in, where they can actually see an increase in their cognitive abilities.

Ross Andel: Yeah, absolutely. So, you’re absolutely right. This is an opportunity as long as people approach it the right way. If you don’t fall into the trap of taking it too easy and actually find a meaning, this could be a second career, this could be an opportunity to engage in something you always wanted to engage in. It is really an opportunity and the opportunity is larger because of the better preserved, in general, the physical health that we tend to maintain much more than we used to. People are healthier today at the same age than they used to be. So, taking advantage of that with something meaningful to do is super important. That really is the front and center of retiring successfully.

Casey Weade: You’ve analyzed a lot of culprits here. You’ve analyzed from cholesterol to physical health, smoking, alcohol, social isolation, air pollution. Are there some of these factors that we should prioritize over others? Are there some that really stand out that we should be paying the most close attention to? And maybe that differs based on our age or place we find ourselves in life.

Ross Andel: The cardiometabolic health is really, really important. And it’s just basic stuff, being able to exercise regularly and eat properly, keeping weights kind of in control shouldn’t be too low or too high. Just being able to do that is very important, for sure, to really kind of extend life tremendously. Sometimes, we underestimate the importance of maintaining proper cardiometabolic health. As long as we have control over it, obviously, again, just like with the brain, we’re given our genetic disposition, which carries– we have some strength and we have some weaknesses. But working with what we have and trying to maintain cardiometabolic health can go a really long way in helping us retire successfully and enjoy our life as long as possible.

Casey Weade: Are there certain supplements or vitamins that we should be considering, maybe even putting in the water, so to speak? That being in, we hear about– for this very reason, for the last several years, I’ve taken NAD+ and CoQ10, I mean, what are your thoughts around those things or anything specific areas of nutrition supplements that you say, “Hey, put this in the water, this is going to be the one thing everybody should be doing to protect themselves outside of the obvious of diet and exercise”?

Ross Andel: Yeah. That’s a great point. Where do we go with this? So, let me just start by saying I do not believe that there’s a magic pill that we could take once a day and be okay, which is not what you’re asking me anyway, obviously. Yeah, but do these things help? Potentially, you do have to be kind of judicial. I don’t think these are controlled by the FDA, so you need to find a supplement that’s properly tested and true to its name. If that’s okay, I can mention that I’m part of developing a supplement that’s specific for brain function.

Casey Weade: Interesting.

Ross Andel: Yeah. So, it’s basically, just like many of these supplements, it’s based on fruits, vegetables, anti-inflammatory compounds like turmeric and so on that targets the brain specifically, that targets brain function specifically. It’s called Axolt, A-X-O-L-T. So, one of several that maybe are– actually, this one is, I think, the only one that’s specific to the brain, but there are many of these supplements that people can take. Is it bad to take them? Absolutely not. Is it the only thing you should be doing? Well, you might be thinking, okay, if I take this supplement, then maybe I don’t have to go for that long walk. It doesn’t work that way, but it certainly helps. Plus, it commits the person to living healthy.

If you commit yourself, yes, I’m going to have this supplement once a day, so maybe Axolt will help me with brain function. And now, if I combine it with other things I’ll do, I’ll be okay. It’s sort of the taking the supplement might be a motivation to really stay healthy. It should not be a motivation to avoid doing other healthy things, but it can be another sort of boost in living the right way. So, it kind of pushes you in the right direction. So, absolutely.

Casey Weade: How much is sleep a factor? I mean, it used to be– I mean, I was a big Tony Robbins fan, so early on, I believed I’ll sleep when I’m dead. And it seems like that sleep research has come a long way and we know that that’s not the case today. But I still also hear that as we age, we need less sleep. Is that the case? Or how does sleep kind of interweave here with cognitive decline?

Ross Andel: Okay, well, that’s– I’m really glad you brought that up. Sleep is so important and as we get older sometimes, it’s harder to get that deep regenerative sleep. So, we kind of have to pay more attention to what’s called sleep hygiene. Going to bed at the right time, getting up at the right time, maybe taking a nap in the afternoon, but making sure that it’s not too long, making sure that, however you work in terms of your eating habits, that those are consistent. Some people don’t sleep well if they snack late at night. And you might still want to have that snack, but maybe you shouldn’t, so that your sleep is okay, but it’s that regenerative sleep. Sleep health is just so important. It really is one of the pillars of healthy aging. No question about that.

And it’s hard to maintain cardiometabolic health if you’re not sleeping well. It’s hard to maintain normal cognition if your sleep is impacted. It is very individual, obviously. Some people maybe need a little bit more sleep than others. Seven to eight hours a day seems to be sort of the gold standard if we can achieve it.

Casey Weade: Is that the same for our whole life? Because we’ve heard, well, it goes down over time. You only need five or six when you get older. Is it always seven to eight?

Ross Andel: Well, for adults, it appears that way that adults– so look, if you’re older, if you still sleep the same amount of time, you will probably have less of that healthier regenerative sleep during those seven to eight hours, but being horizontal for those seven to eight hours will still give you a better chance to regenerate at night. So, I really don’t know if, as you might see from my CV, I have been part of several studies on sleep and seven to eight hours seems to be part of, this is the standard even for older adults that they would need less sleep than seven hours is not evidence based necessarily.

Casey Weade: That’s good to hear. I know what to say next time my dad tells me he needs less sleep because he is older. So, you’ve given us three reasons for brain aging and you’ve touched on each of these. It’s natural. It’s just genetically driven by aging. Number two, there’s random influences, accidents, don’t play football. And the third one is largely due to decisions that we make. And we’ve talked about some different decisions you can make. I’m curious, so for you, you’ve researched this for so long, you’ve spent so much time in this, what are some of your routines that you have put in place for yourself and your own lifestyle to ensure you have the best brain health as well?

Ross Andel: Okay. Fair question. So, I’m addicted to exercise since I was a kid. So, that’s to my advantage that I enjoy exercising. I think that really helps. So, I try to get out every day. I walk my dogs twice a day, so I get my 10,000 steps a day. That’s kind of the big one. So, the physical engagement, being engaged physically every day, that’s something that I crave in a way. So, it’s kind of like my go-to if someone likes chocolate, I like to exercise. So, it relaxes me, although I like chocolate as well, just to be clear. I can do that as well. So, that is important. I do try to pay attention to my routine, my daily routine, so that I go to bed at the same time, get up at the same time. If I don’t sleep well, I try to use meditation to relax myself and stay in bed and at least, get some rest. So, yeah, that daily routine, that’s important.

And then kind of maintaining that daily purpose, you get up and you have a plan as to what you want to accomplish that day. I think that’s important. That might be more important sort of for mental health, but I think it translates to physical and cognitive health as well to do that. So, then eating healthy, I do enjoy that Axolt supplement to maintain brain health. Let’s see. Is there anything I’m forgetting?

I also try not to overthink things though. Like, let’s say that I have to get up at three in the morning for whatever reason, I have a flight to catch, well, it’s not the end of the world. I’m not going to sleep 10 hours the next night. I’ll just go back to my regular routine next day, or I feel like I deserve ice cream at 8PM, well, okay, I might have that. Not every day, but, like, not overthinking, just still live a normal life. Not to restrict yourself too much by thinking about aging.

Casey Weade: So, I hear you say it’s discipline, a sleep routine, daily exercise, and supplementation and diet and just having a plan that’s based around your unique purpose and what drives you. We’ve talked about a lot of things that we can do as individuals to maintain our own brain health, and yet, there’s a lot of individuals out there that have loved ones that are experiencing this. And this is a tough thing I’ve seen in my own family. How do you approach this conversation when you see a loved one experiencing some of these things and showing some of these early signs of cognitive impairment?

Ross Andel: Yeah, it is difficult. Obviously, you don’t want to overreact, but you also want to be helpful. These conversations are very hard by their nature. So, I think we all can just need to do our best. I mean, having the health of our loved ones in mind is obviously the best approach. Going to a memory clinic to get assessed for potential cognitive problems, there’s no shame in that. But I do understand that some older adults, some loved ones will resist it. So, navigating that is difficult. I really don’t have much more to say about that. We have to persist, we have to try to do our best. It’s a difficult conversation to have, but it’s necessary in some cases.

Casey Weade: Well, and as well, we need to take care of ourselves during these period of times if we’re caring for someone that’s going through this. And we’ve got a question from Jerry, thanks for your question. I know Jerry pretty well and I know what he’s been through over the last decade or so. He says this, he said, “As a caregiver for my spouse with dementia for the past 10 years and now moving into an Alzheimer’s facility, what can I do to help myself during this decline? And we’ve been married for 40 years and I think there’s different elements of that, but it is– how do we care for ourselves when we’re trying to care for a loved one that’s going through this?”

Ross Andel: Yeah. That’s a great question. There’s a lot of research into caregiving. And the caregiver burden is real. At the same time, giving care can be so rewarding as well. You are really extending a good life for your loved one as long as possible. With that said, with dementia being the devastating disease that it is, once the patient with dementia progresses to the point where their behavior starts to change, they may become agitated too much or even combative. There’s another really difficult decision and it is to place that dementia patient into professional care.

And it sounds like Jerry did that, and to congratulate him for that, it’s a tough decision, but it is the decision that just has to be made for the welfare of both, for the welfare of the dementia patient, and for the welfare of the caregiver, because the care owner just cannot provide that same care at that point. Memory problems, okay, that can be dealt with. Behavioral problems that are part of dementia in many cases, that can get too difficult.

So, how can a caregiver take care of themselves? Again, my purpose just do your best to live every life to its fullest, knowing that you’ve done what you could while the disease didn’t progress to that point where professional care is necessary. So, yeah, just find things to do, volunteer, reengage with the family, with the rest of the family. Sometimes, you’re so preoccupied with caregiving that you forget about your offspring or other relatives. So, this maybe an opportunity to reengage.

Casey Weade: Yeah. I think that so many need to hear that Ross has just, remember to take care of yourself. That’s what they would want at the end of the day. And it’s so easy to forget that you need to take care of yourself along the way when you’re caring for a loved one. Yeah, when you think about retirement and along with all the research that you’ve done here in brain aging, how has your research shaped your own personal views of retirement?

Ross Andel: Yeah, well, so some of it is my research. I do think that it’s a difficult period of time. From the research that I’m doing, I see that it’s a difficult period of time. Some people handle it just fine. Others really struggle with that time. They struggle to really find that same level of routine to stay disciplined as they used to be, find something engaging and stimulating. I do enjoy my job quite a bit. I do hope that I could get to do it for a long time. So, even before I started doing this research, I was thinking, okay, I’ll just kind of keep working, see how that goes.

So, for me, I’m thinking maybe I’ll try to avoid retirement as long as possible for others. Retirement can be so fulfilling. It could be a great period of human life. It can be even more fulfilling than work. So, it is an opportunity. It is a great opportunity that’s in their higher horizon. It’s a brighter opportunity today than it used to be because we have advanced so much in terms of preserving our physical and cognitive health so that we can truly enjoy it. Financially, a person who’s secured financially, obviously, will probably enjoy their retirement better as well, but I don’t know how much. There are ways how to enjoy retirement regardless. So, yeah, it’s a great opportunity for me personally. Right now, at this point, I think I’m just going to keep kind of going what I’m doing as long as I can, as long as my health is okay. But yeah, I mean, I do see it an opportunity for others to really enjoy their life and enjoy new potentially wonderful chapter of their life.\

Casey Weade: Yeah. Well, you’re on the Retire with Purpose podcast, and so, it goes without saying, I know you want to work as long as you possibly can here. You love your work, you have real passion and purpose around it, but how would you define or describe retiring with purpose? What does retire with purpose mean to you?

Ross Andel: It would really mean having the plan, having a plan for what I will do. When we are engaged in a full-time occupation, the plan is going to give them to us. They’re benchmarks need to meet. We’re given certain roles and tasks and responsibilities that we accomplish. We take it as a given. When we retire, now it’s a little bit more up to us. So, can we really take charge of our life at that point and then just kind of fill our life with meaningful things? And it could really be anything. This is where it’s almost difficult to talk about because it’s really, there’s that one thing that everyone has for themselves. But what it is, it’s really hard to define. Someone might just really want to spend more time with their grandchildren. Great. Someone else might want to devote more of their time to a performing arts center. Wonderful. Someone else maybe always wanted to get more education. Now, maybe that’s an opportunity for that. It just varies. It just varies from person to person, and every one of us has the responsibility to sit down in peace and quiet and think about it. What it is that I want to do with the next chapter of my life?

Casey Weade: That’s beautiful. Well, Ross, thank you so much for joining us and I look forward to seeing where your research takes us and starting to implement some of these things for myself.

Ross Andel: Excellent. Thank you for having me.

Casey Weade: Thank you.

Ross Andel: Bye.

[END]