The #1 Predictor of Dementia (Not Genetics) — How to Stimulate Your Mind & Prevent Alzheimer’s with Dr. Tommy Wood
The Ready State Podcast
Kelly Starrett & Juliet Starrett
4.9 • 623 Ratings
🗓️ 5 March 2026
⏱️ 79 minutes
🧾️ Download transcript
Summary
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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.
Key Highlights:(00:00) – Brain Health & Cognitive Longevity Intro
(00:35) – Brain Evolution & Survival Mechanisms
(02:53) – Diabetes & Alzheimer’s Disease Link
(07:31) – Genetic Risk & Dementia Family History
(11:32) – Expanding Brain Capacity & Headroom
(15:08) – Cognitive Reserve & Brain Resilience
(19:55) – Preventing Age-Related Cognitive Decline
(23:00) – Exercise Data for Brain Health
(26:16) – Best Exercises for Cognitive Function
(35:11) – Amyloid Plaques & Alzheimer’s Pathology
(38:00) – Amyloid-Targeting Drugs & Treatments
(40:31) – Subjective Cognitive Decline Measures
(45:04) – Testing & Measuring Brain Performance
(49:58) – Menopause & Female Brain Health
(56:10) – Aging Brain, Wisdom & Intelligence
(1:05:00) – Cognitive Processing Speed & Aging
(1:07:07) – Benefits of Boredom for the Brain
(1:12:17) – Book Recommendations for Mental Growth
Connect with Dr. Tommy WoodWebsite | Substack | Instagram
Pre-Order The Stimulated Mind for tons of extra perks!
Transcript
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| 0:00.0 | The classical idea of Alzheimer's disease is that we accumulate these proteins in the brain, |
| 0:04.8 | amyloid plaques and tau tangles. And as they accumulate, they damage the neurons and other things, |
| 0:09.9 | they create inflammation and other stuff. Because of that, neurons die and we start to lose function. |
| 0:14.1 | It's almost like the brain says, we're dying. That was Dr. Tommy Wood, this week's guest. |
| 0:20.2 | Tommy is an associate professor of pediatrics and neuroscience at the University of Washington |
| 0:24.7 | School of Medicine, where his lab focuses on brain health across the lifespan, including |
| 0:29.5 | in babies-borne preterm, adults who experience brain trauma, and the confluence of factors that |
| 0:34.9 | affect long-term cognitive function and the risk of dementia. |
| 0:38.5 | This conversation is really important. |
| 0:41.8 | Yeah, I mean, I would say in our group of sort of aging humans that we are in, people who are |
| 0:48.8 | starting to be able to look forward in time and they see their own parents aging, one of the |
| 0:53.4 | biggest concerns is how to retain our cognitive function as long as possible. |
| 0:58.7 | And we can just say global function, right? |
| 1:01.8 | But the brain leads. |
| 1:03.8 | And I'll tell you, what's great about Tommy, as we've had on the, you should listen to our other podcast with him. |
| 1:09.6 | But, you know know with a lens of |
| 1:11.7 | performance and action like this isn't just pure science you know change these |
| 1:17.7 | particles in your brain like it's actually what can you do how should we think about |
| 1:24.2 | this in terms of even demystifying some of the fear mongering that we have |
| 1:29.9 | and really realizing we have a ton of control around how our brains go along and age with us. |
| 1:36.1 | Yeah, I mean, this idea of getting dementia is that it is inevitable, even if we have a family |
| 1:40.7 | history of it, is not the case. And there are so many things we can do now. |
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