00:00:12 Simon Gaisford
Welcome to Life Sciences at University College London, The Big Questions.
00:00:17 Simon Gaisford
I'm your host Simon Gaisford, Professor of Pharmaceutics at UCL School of Pharmacy.
00:00:23 Simon Gaisford
With me today in the studio is my colleague Professor Tara Keck.
00:00:27 Simon Gaisford
Tara is a neuroscientist whose particular research interests focus on neuroplasticity, which means how does our brain change and respond to various factors such as ageing or stress, social interactions and things like that.
00:00:42 Simon Gaisford
So I'm very pleased to welcome Tara to the studio today, and I'm hoping that by the end of our conversation, she'll give us some top tips that allow us to keep our brains in full working order.
00:00:52 Simon Gaisford
So Tara, welcome.
00:00:54 Tara Keck
Thank you for having me, Simon.
00:00:55 Simon Gaisford
You're very welcome. It's very nice you're here.
00:00:57 Simon Gaisford
So first question is an easy starter for 10.
00:01:00 Simon Gaisford
What is neuroplasticity and why do you find it so interesting?
00:01:04 Tara Keck
Yeah, so as you alluded to, neuroplasticity is how our brains change in response to our experiences.
00:01:10 Tara Keck
And so that could be forming new memories.
00:01:12 Tara Keck
It could be learning a new skill like playing the piano or learning French.
00:01:17 Tara Keck
And it basically happens throughout our lives and it's how we encode what's happened around us and allows us to sort of think about how we interact with the world.
00:01:26 Simon Gaisford
Is it a survival mechanism?
00:01:29 Tara Keck
In many ways, yeah.
00:01:30 Tara Keck
So we need to, I think the most extreme form of neuroplasticity that people will be familiar with is sort of what we consider fear learning or reverse learning.
00:01:38 Tara Keck
So, for example, if anyone's ever had food poisoning,
00:01:42 Tara Keck
I'm never going to that restaurant again.
00:01:45 Tara Keck
Exactly, yeah.
00:01:45 Tara Keck
I had food poisoning when I was 14.
00:01:48 Tara Keck
I ate something called fettuccine Alfredo, which is popular in the US.
00:01:51 Tara Keck
I got very sick and I have not even looked at it since.
00:01:54 Tara Keck
It's just, you know, and so I think that when something has the potential to be poisonous or kill you, your brain learns really fast that you need to not do that again because you need to survive.
00:02:03 Simon Gaisford
Yeah, that's a survive.
00:02:04 Simon Gaisford
Or I suppose a famous example which we've all done is your mum saying, don't touch the oven because it's hot and then you just put your hands straight on it.
00:02:12 Tara Keck
It’s very fast learning.
00:02:13 Tara Keck
But then it can also be positive things, right?
00:02:14 Tara Keck
So if we're thinking about from sort of a long-term human perspective, if there's certain places that we always know that there's good food when we think about hunters and gatherers, things like that, then that's something that we want to encode in our spatial memory so that we can keep going back there because we know we'll be able to have a positive experience by finding more food or berries or fruit or whatever it is that was in that space.
00:02:33 Simon Gaisford
Yeah, so that's like...
00:02:36 Simon Gaisford
That's like positive reinforcement, something that you want to keep doing.
00:02:39 Simon Gaisford
And also we can have negative reinforcements.
00:02:42 Simon Gaisford
So I get that as a sort of, as a reward and defence mechanism.
00:02:47 Tara Keck
That's right.
00:02:48 Simon Gaisford
What else, some of your research interests include things like social interactions, you know, why it's important to have friends and not lock yourself away in your own home.
00:02:58 Simon Gaisford
How does that impact your brain?
00:03:01 Tara Keck
I think that when we think about aging, there are certain factors that keep our brains healthy.
00:03:07 Tara Keck
And they tend to go throughout our lifespans.
00:03:10 Tara Keck
Very often when we think about aging, we start thinking about it when we're 60, 70, 80.
00:03:14 Tara Keck
Right around the time we start retiring.
00:03:17 Simon Gaisford
Yeah, exactly.
00:03:18 Tara Keck
Yes.
00:03:18 Simon Gaisford
And I am thinking about retirement.
00:03:20 Tara Keck
Yeah, and so I think that when that's the case, we really want to start thinking about aging early.
00:03:24 Tara Keck
So we know that there are risk factors for brain health sort of in our long-term aging span throughout our lifespans.
00:03:30 Tara Keck
And so these have been well described.
00:03:32 Tara Keck
And there's certain ones that, you know, there's a number of things or the ones that I focus on that are sort of key.
00:03:38 Tara Keck
that are sort of the two things we have really good evidence for is making sure we're cardiovascularly healthy and then having enough social interaction.
00:03:46 Tara Keck
And so we know about these, so people have done cohort studies.
00:03:50 Tara Keck
And so what a cohort study is that a group of scientists will take a large group of people, thousands usually, and they'll follow them over time.
00:03:57 Tara Keck
And they'll ask them a bunch of questions
00:03:59 Tara Keck
What are the activities that you're doing?
00:04:01 Tara Keck
How do you feel about things?
00:04:02 Tara Keck
Ask them mental health questions, how hopeful they are, things along those lines.
00:04:05 Tara Keck
They'll also, in many of them, some of the bigger ones, they'll take sort of biological samples, so they'll do a brain scan or take blood and do some tests, things along those lines.
00:04:13 Tara Keck
We have a lot of those.
00:04:14 Tara Keck
There's some in the UK that have been going for decades.
00:04:16 Tara Keck
There's one in the US that's now, I think, over 100 years old.
00:04:19 Tara Keck
So they're studying the great.
00:04:20 Simon Gaisford
I bet there's no grandchildren there at the start.
00:04:22 Tara Keck
The grandchildren and the great grandchildren of people.
00:04:25 Tara Keck
And so we can start to actually really say like, okay, well, what are the social factors that lead to healthy longevity?
00:04:30 Tara Keck
And then what are the sort of biological factors?
00:04:32 Simon Gaisford
Okay, that is super interesting, isn't it?
00:04:35 Simon Gaisford
Yeah.
00:04:35 Simon Gaisford
Okay, so we might need to unpick some of these things as we go on then.
00:04:40 Simon Gaisford
So firstly,
00:04:42 Simon Gaisford
How does the brain form memories or reshape itself so that you have a memory?
00:04:50 Simon Gaisford
Don't touch that oven.
00:04:51 Simon Gaisford
Don't go back to that restaurant.
00:04:53 Tara Keck
Yeah, so we have good ideas.
00:04:55 Tara Keck
And what we generally think is happening is that in our brains, our brain cells are connected to each other.
00:05:00 Tara Keck
So a brain cell in general, in many parts of the brain, it has sort of the main cell part, but then it has a tree that grows out of it.
00:05:07 Tara Keck
And that's where all the inputs to it come.
00:05:09 Tara Keck
And then it has sort of another cord that comes out of the bottom that is where it sends information to the next neuron.
00:05:16 Tara Keck
And so all of these neurons are connected to one another.
00:05:18 Tara Keck
And it's those connections that change.
00:05:20 Tara Keck
So basically, these trees can grow out little branches.
00:05:23 Tara Keck
And this is a lot of what we've studied over my career.
00:05:26 Tara Keck
And connect to new partners.
00:05:29 Tara Keck
And it's through those partners that we actually then have memories.
00:05:32 Simon Gaisford
And those connections get stronger as something is positively reinforced to us.
00:05:39 Simon Gaisford
Or negatively.
00:05:42 Simon Gaisford
As something is repeated.
00:05:43 Simon Gaisford
So the more time something happens, the stronger that particular connection becomes.
00:05:46 Tara Keck
That's right.
00:05:47 Tara Keck
Yeah.
00:05:47 Tara Keck
So I think that a lot of the activity that we have, the way that our brain communicates is through electrical activity.
00:05:54 Tara Keck
And so there'd be more electrical activity, the more important a particular connection is.
00:05:59 Tara Keck
And so if you're learning something that's positive, actually learning positive things takes a lot more repetition than negative things.
00:06:06 Tara Keck
Just because of the sort of difference in if something is dangerous, you need to learn right away.
00:06:12 Tara Keck
You can't do it the second time.
00:06:13 Tara Keck
Whereas if something's good, you maybe want to be a little bit more reserved and take more time to figure out that it's really good.
00:06:18 Tara Keck
So that's why you sort of have this practice element.
00:06:20 Tara Keck
And anyone who's tried to learn a language or an instrument or anything else, skiing in adulthood, any of these things are really hard, right?
00:06:28 Tara Keck
And so you have to do them over and over and you get better at them.
00:06:30 Tara Keck
And so yeah, that strengthens these connections which are called synapses.
00:06:34 Simon Gaisford
Yeah, because they often say children, for instance, if they grow up in a house where there's more than one language being spoken, it's completely bilingual.
00:06:40 Simon Gaisford
Also, children tend to be better off learning a second language before say six or seven, don't they?
00:06:45 Simon Gaisford
Presumably because their brains at that point are like sponges.
00:06:48 Tara Keck
Yeah, so our brains have four different brain regions.
00:06:52 Tara Keck
So our brain has a region that sort of calculates all of our vision and our hearing and then our language.
00:06:58 Tara Keck
And obviously there's sort of other brain regions that integrate those, right?
00:07:01 Tara Keck
Because basically if you think about watching a movie that's dubbed, right?
00:07:05 Tara Keck
And they're talking in a language and their mouth movement doesn't match the hearing thing in here, right?
00:07:09 Tara Keck
So your brain goes crazy when that happens.
00:07:11 Tara Keck
So you do look at the integration, but there's sort of these ways that your brain just processes each of these different sensory inputs.
00:07:20 Tara Keck
And so what we know is that each of those sensory areas have what is called a sensitive or critical period.
00:07:26 Tara Keck
So we've known this since about the 60s.
00:07:28 Tara Keck
And so what that means is that there's periods during which your brain is still developing when you're young.
00:07:33 Tara Keck
And so we know, for example, with hearing.
00:07:36 Tara Keck
If a child is born hearing with either partially deaf or fully deaf, then if you actually get cochlear implants before they're a year or two, they actually have more or less completely normal hearing.
00:07:45 Tara Keck
The brain can actually adapt to it.
00:07:47 Tara Keck
But if you get it in a bit later, then actually it's much more impaired.
00:07:50 Tara Keck
And so for languages, it's the same thing.
00:07:52 Tara Keck
Our language critical period is longer.
00:07:54 Tara Keck
So you have until maybe 10 to 12 where you can learn a first language natively and you can learn numerous languages.
00:08:02 Tara Keck
And then if you start learning after that, it's going to go into basically a second language region in your brain and it's never going to quite be, you can be incredibly proficient, you can be fluent, but it's very hard to be quite native.
00:08:16 Simon Gaisford
Yeah.
00:08:16 Simon Gaisford
I think what you might have done there is answer some questions about why I did so badly at GCSE French.
00:08:20 Tara Keck
I think that's not, you're not alone in that.
00:08:24 Simon Gaisford
That's true.
00:08:25 Simon Gaisford
Well, everyone else in my school did badly in GCSE French as well.
00:08:27 Simon Gaisford
Yeah.
00:08:28 Simon Gaisford
Okay, that's so that's super interesting.
00:08:30 Simon Gaisford
So
00:08:31 Simon Gaisford
The plasticity of a brain, when I read that neuroplasticity, my brain went to plasticine and I just imagined something that's very soft and fluid, easily moulded.
00:08:41 Simon Gaisford
Is that how we should read neuroplasticity?
00:08:44 Simon Gaisford
You know, your brain is something that can very rapidly change or, where am I heading here?
00:08:52 Simon Gaisford
If you've learnt some things, you made some connections,
00:08:57 Simon Gaisford
Are they then rigid for the rest of your life or can they change?
00:09:00 Tara Keck
Yeah, so if we think about it from a scientific point of view, it's much easier to determine somebody's learned something than somebody's forgotten it.
00:09:08 Tara Keck
Because when have you forgotten it?
00:09:09 Tara Keck
It sounds like a philosophical question, but it's actually a really hard thing to pin down.
00:09:14 Tara Keck
So we have a pretty good understanding of learning.
00:09:17 Tara Keck
So yes, the brain is moldable and we have these new synapses that form and you can then say, yes, I've learned this.
00:09:24 Tara Keck
When you've forgotten something, and this is, we work a lot in mental health and we work with people in traumatic memories.
00:09:29 Tara Keck
And it's a question of like, well, when is something really gone or is it gone enough that you can then, go back to normal life?
00:09:35 Tara Keck
It's a really tricky question.
00:09:36 Tara Keck
But in general,memories are there and they can be re-invoked by, we have this in our own life.
00:09:44 Tara Keck
You see something and smells, smell, smell is really, really, really prominent, right?
00:09:48 Tara Keck
And so this is where we have these interactions between different parts of our brain.
00:09:52 Tara Keck
And so when you have something that triggers this, you can remember something that happened when you were, you know, 12 and you haven't thought about for, you know, 35 years.
00:10:00 Tara Keck
But that being said, it's still there.
00:10:02 Tara Keck
But if you had been asked about the memory, you might not have been able to pull it up.
00:10:06 Simon Gaisford
That’s exactly what I was going to say.
00:10:07 Simon Gaisford
If someone asked you, do you remember
00:10:08 Simon Gaisford
what your mum's, let's say your mum made something that you really enjoyed eating as a child and you'd forgotten that.
00:10:13 Simon Gaisford
And then you asked, do you ever remember that?
00:10:15 Simon Gaisford
You say no, but you smell it instantly, it retriggers.
00:10:18 Simon Gaisford
Yeah, that's kind of interesting, isn't it?
00:10:20 Simon Gaisford
Okay, what happens then, and I'm wondering slightly off topic here, what happens in adulthood, for instance, then, if someone has some sort of brain trauma?
00:10:31 Simon Gaisford
So let's say they had a car accident and part of their brain was completely damaged.
00:10:37 Simon Gaisford
Each part of the brain is doing a different function, does that mean that function is completely lost?
00:10:41 Simon Gaisford
Can other parts of the brain take over?
00:10:44 Simon Gaisford
Is that also neuroplasticity?
00:10:47 Tara Keck
I mean, yeah, so there are examples of other parts of the brain taking over.
00:10:50 Tara Keck
There's sort of the... one of the main figures initially of neuroplasticity is a guy called Mercenich who's in California.
00:10:58 Tara Keck
And he's done a lot of experiments where, you know, there is sort of a loss of one sense or that you have sort of some sort of brain trauma and other parts can take over.
00:11:08 Tara Keck
So that can happen.
00:11:09 Tara Keck
It depends a bit on the injury and a bit on, you know, how old you are.
00:11:12 Tara Keck
The older you get, the less.
00:11:14 Simon Gaisford
The worse it's getting.
00:11:15 Tara Keck
Kind of.
00:11:15 Tara Keck
And that doesn't mean that your brain isn't plastic throughout your life.
00:11:18 Tara Keck
Of course it is, right?
00:11:19 Tara Keck
Like you meet new people.
00:11:21 Simon Gaisford
Yeah.
00:11:21 Tara Keck
You go to new places.
00:11:23 Tara Keck
So I think people do have the misconception that once you reach a certain age, your brain is fixed.
00:11:30 Simon Gaisford
It's all downhill.
00:11:31 Tara Keck
Yeah, it's not.
00:11:32 Tara Keck
You can continue to learn throughout your life, especially if you sort of are making an effort to.
00:11:36 Tara Keck
It's just not going to be as easy as when you were ten.
00:11:39 Tara Keck
So I think that in terms of this type of thing, like yeah, you can have entire brain regions take over and you can see this for people who are, for example, blind.
00:11:47 Tara Keck
The part of their brain that's involved in vision isn't just doing nothing, doing other things because it's not been it's not been used for the purpose it originally was.
00:11:54 Simon Gaisford
Yeah, I mean, we might touch on this towards the end, but I mean, I know quite a few people that do crosswords or Sudoku, and what they'll say is, I'm doing these to keep my brain active.
00:12:04 Simon Gaisford
It's encouraging them.
00:12:06 Simon Gaisford
Is there truth in that?
00:12:08 Tara Keck
No.
00:12:09 Tara Keck
Sorry.
00:12:10 Tara Keck
I should.
00:12:12 Tara Keck
I'll expand.
00:12:13 Simon Gaisford
Yeah, you can't leave everyone hanging on the note.
00:12:15 Tara Keck
This is what I get asked the most often is like, what if I do Sudoku?
00:12:18 Tara Keck
And the thing is, if you want to keep your brain healthy, people either want to do Sudoku, they want to eat fish, or they want to eat blueberries.
00:12:27 Tara Keck
Yeah, exactly.
00:12:28 Tara Keck
People are very excited about Omega-3s.
00:12:30 Tara Keck
And that's not to say that, you know, eating healthy isn't a good thing, or that doing Sudoku isn't necessarily a good thing.
00:12:35 Tara Keck
But there isn't some sort of magic bullet that's going to like keep your brain plastic.
00:12:40 Tara Keck
It's that straightforward.
00:12:42 Tara Keck
And it's part of the issue is that doing a Sudoku the first time, you know, fine.
00:12:46 Tara Keck
It's actually kind of hard.
00:12:47 Tara Keck
But once you get good at it, you're not challenging your brain anymore, right?
00:12:50 Tara Keck
So it's just you know exactly, you know, I look for the numbers and I set it up this way.
00:12:54 Tara Keck
And it's the same thing with crosswords, right?
00:12:56 Tara Keck
And so I think that once you've become good at something where it becomes automatic, you're not challenging your brain in the same way.
00:13:01 Tara Keck
So what you need to sort of continually be doing is challenging your brain in hard ways.
00:13:05 Tara Keck
So if you're thinking this is hard and I'm thinking hard and that's really where you're keeping your brain sort of active and healthy.
00:13:12 Simon Gaisford
I remember reading a letter in the Times many years ago about a professor at Cambridge University and he did the Times cryptic crossword every day which I find insanely difficult.
00:13:24 Simon Gaisford
But it got to a point where he was so good at that he would put an egg on to boil every morning, start the crossword and he would time how long the egg was in the in the saucepan by how long it took him to do the crossword.
00:13:38 Tara Keck
Yeah.
00:13:39 Simon Gaisford
And it said he did not like his eggs hard boiled.
00:13:42 Tara Keck
Wow.
00:13:42 Tara Keck
I mean, that is, those crosswords are really hard if you aren't used to it.
00:13:46 Simon Gaisford
Yeah, but once you know, it's just, you're just rattling.
00:13:48 Simon Gaisford
I see that.
00:13:49 Tara Keck
That's right.
00:13:50 Tara Keck
And I think that's it is that most things that we do are skills.
00:13:54 Tara Keck
And as we get good at them, they become no longer sort of that you actively have to do this.
00:13:59 Tara Keck
And we have this with everything we've learned, right?
00:14:01 Tara Keck
Like anything that you're starting out with the first few times you do it, it's really hard.
00:14:04 Tara Keck
And then you get better at it.
00:14:05 Tara Keck
And then it's no longer a challenge to do.
00:14:07 Tara Keck
And that's nice.
00:14:08 Tara Keck
And you automatically do all these things in your life that at one point in your life were very hard for you.
00:14:13 Tara Keck
And so once you're into the automatic phase, it's no longer sort of the challenging thing that it once was.
00:14:18 Simon Gaisford
That's a very interesting point.
00:14:19 Simon Gaisford
So when I get to the station in the morning, I have a choice of coming down from the platform on the escalator or the stairs.
00:14:25 Simon Gaisford
And I've always chosen the stairs on the grounds that
00:14:27 Simon Gaisford
I'm having to use my brain to coordinate where my feet are going to go down the stairs as opposed to just standing still on the escalator.
00:14:33 Simon Gaisford
And I've naively thought this is a good thing because it's keeping my brain in tip-top shape.
00:14:37 Simon Gaisford
We're probably going to come back to some tips at the end here about what people can or can't do.
00:14:42 Simon Gaisford
Sudoku, clearly not.
00:14:44 Tara Keck
I'm not saying don't do Sudoku, but it's probably once you get good at it, it's.
00:14:47 Simon Gaisford
Probably not helping as much as you hope.
00:14:50 Simon Gaisford
I'm not saying use the escalator, not the stairs, because there's an exercise element to that stuff, but it's not necessarily helping my brain keep in tip-top shape.
00:15:00 Tara Keck
I mean, yeah, I think that we see the same thing that I think there was a study that came out maybe five years ago that was talking about the association between having good balance and developing Alzheimer's disease.
00:15:11 Tara Keck
There was an inverse association.
00:15:13 Tara Keck
So if you had worse balance, then you were more likely to get Alzheimer's.
00:15:17 Tara Keck
And I think that this is often a common problem with science is that people were then were like, I'll practice my balance.
00:15:23 Tara Keck
And it's like, actually, it's not the balance that is the cause of Alzheimer's disease.
00:15:29 Tara Keck
It's that you have, what happens is that, and actually the biggest preventable risk factor for dementia and Alzheimer's disease is hearing loss.
00:15:38 Tara Keck
And so we don't exactly know why, but I guess I can say one thing is you should protect your hearing and don't put your earbuds too loud.
00:15:45 Tara Keck
Because it is a huge thing, but there's a lot of things that, and we can sort of think about this more broadly, that a lot of these problems are complex, right?
00:15:52 Tara Keck
So if you lose hearing loss, we don't know if it's that,
00:15:56 Tara Keck
It could be that you have some sort of cardiovascular change and that affects your brain.
00:16:01 Tara Keck
And it also affects your ears.
00:16:02 Tara Keck
And so your balance is also done in circular canals in your ears.
00:16:06 Tara Keck
So you would have this reduction of blood flow to your brain, which is really what's involved in the Alzheimer's.
00:16:12 Tara Keck
And you'd also have a reduction of blood flow to balance and hearing.
00:16:16 Tara Keck
And so as a result, you'd see them happening very often together.
00:16:19 Tara Keck
But the issue is the cardiovascular issue.
00:16:21 Tara Keck
It's not that the balance loss or the hearing loss is necessarily causing the Alzheimer's.
00:16:25 Tara Keck
But there could also be causal elements because as you start to lose your hearing, and this happens to many people as they age, what happens first is that in a conversation like this,many people are fine.
00:16:38 Tara Keck
There's something called hidden hearing loss, and they look at this a lot at the Ear Institute at UCL, which is in the Faculty of Brain Sciences.
00:16:45 Tara Keck
And what it is that you're great in a quiet environment, but you go out to a pub or a restaurant where there's a bit of background noise, and then you can't actually discern what the person's saying to you from what's going on in the background.
00:16:57 Tara Keck
And so it becomes frustrating.
00:16:59 Tara Keck
And anyone who's been in a really loud bar club and tried to talk to their friends, even when you're young, you know the annoyance of this.
00:17:04 Tara Keck
And so if that was every social interaction you had, you'd stop going out, right?
00:17:08 Tara Keck
And so it could have this knock-on effect that it's changing your social engagement.
00:17:12 Tara Keck
And so that's also then having effects.
00:17:14 Tara Keck
So it's hard to actually separate them out.
00:17:18 Tara Keck
But just because, you know, we're thinking about one thing causing the other, it's a lot of these things are often just multifactorial.
00:17:25 Simon Gaisford
So I do a lot of work with the Down syndrome community
00:17:27 Simon Gaisford
And one of the things I've been learning in interacting with people with Down syndrome is their risk of developing Alzheimer's is insanely high.
00:17:38 Simon Gaisford
Two very scary statistics.
00:17:39 Simon Gaisford
By the time a child with Down syndrome has reached their 40s, they have a 65% chance of developing Alzheimer's.
00:17:45 Simon Gaisford
And by the time they get into their 70s, that rises to a 100%.
00:17:49 Simon Gaisford
And when I tell people this, I have to repeat that number, a 100% chance of developing Alzheimer's.
00:17:56 Simon Gaisford
And another interesting thing about children with Down syndrome is they have very poor gut function.
00:18:01 Simon Gaisford
And so where I've been involved is in trying to improve their gut function because I feel like that in the long term is going to improve their propensity to go and develop Alzheimer's.
00:18:11 Simon Gaisford
Now I've always thought of that is in terms of faecal matter in the gut, pushing against the gut wall, leaky gut syndrome, stuff going across into blood that we don't want.
00:18:21 Simon Gaisford
I hadn't thought until you mentioned it just then that there's also an element of reduced blood flow.
00:18:26 Simon Gaisford
So where someone's gut's not working properly, the body then diverts blood to the gut because it's effectively an immune system response.
00:18:35 Simon Gaisford
And that means peripherally you've got less blood flow.
00:18:37 Simon Gaisford
So I suppose that and in combination with poor cardiovascular health, they may also be factors.
00:18:44 Simon Gaisford
Like we say, it's multifactorial, but they could all be factors that might lead into and other neurological conditions.
00:18:51 Simon Gaisford
I think anyone that knows anyone that's got Parkinson's disease
00:18:56 Simon Gaisford
80% of people that go on to develop Parkinson's in the 10 to 20 years prior to developing obvious motor symptoms, they have constipation.
00:19:04 Simon Gaisford
So this thing about blood flow is kind of interesting, isn't it?
00:19:07 Tara Keck
Yeah, I think it's really emerged, like I think that there are certain scientists who have been sort of saying this for a while, but it's really become sort of a mainstream point of view that a lot of this is a blood flow issue.
00:19:20 Tara Keck
So I mean, it really does seem like if you were going to do one thing to age in a good way, it's not just for your brain, but for your whole body.
00:19:26 Tara Keck
It's stay cardiovascularly fit.
00:19:29 Simon Gaisford
Let's talk about cardiovascular health then.
00:19:30 Simon Gaisford
So how would, because I wonder if a member of the public might not make that link between cardiovascular health.
00:19:37 Simon Gaisford
I mean, I think they might worry, I don't want to die of a heart attack, for instance.
00:19:43 Simon Gaisford
the link between cardiovascular health and neurodegeneration.
00:19:47 Simon Gaisford
And also, unless I've got my stats wrong, men are way more likely to have a heart attack than women, I think.
00:19:58 Simon Gaisford
Does that mean that men have a higher risk of developing Alzheimer's, for instance, than women?
00:20:03 Tara Keck
I think that the stats say, and we should check this before we put it in the podcast, I think that the stats say that women are more likely to develop Alzheimer's.
00:20:11 Tara Keck
And there's a number of factors for that.
00:20:13 Tara Keck
But one of them is just that women live longer.
00:20:15 Tara Keck
And so the longer you...
00:20:16 Simon Gaisford
Yeah.
00:20:16 Tara Keck
So I remember UCL has a Neuroscience Day where there's people from across all of UCL, clinicians, basic scientists talk about neuroscience.
00:20:26 Tara Keck
And one of the clinicians was giving a talk about Alzheimer's and he stood up and said, well, all of you in this room are more likely to develop Alzheimer's than average.
00:20:35 Tara Keck
And we were all like, okay.
00:20:38 Tara Keck
That's true, that's true, yeah.
00:20:40 Tara Keck
But the point that he was making was that that's because given sort of education and health and other stats that were sort of associated with this demographic, that you're less likely to die of a heart attack, therefore you're likely to live longer, which means you're more likely to develop some form of dementia.
00:20:57 Tara Keck
So I think that it is, there is an element of living longer
00:21:01 Tara Keck
And I think that, it's not necessarily clear.
00:21:03 Tara Keck
There's the very specific version of vascular dementia, which given its name, vascular is referring to blood vessels.
00:21:10 Tara Keck
And so in that sense, we knew that there were elements of Alzheimer's, but it seems that there's more indication that this might be playing a bigger role than we originally thought.
00:21:18 Tara Keck
There's a lot of interesting work going on about that at UCL as well, both in the Dementia Research Institute and then other individuals.
00:21:25 Tara Keck
David Atwell, for example, does a lot of work in this area.
00:21:27 Simon Gaisford
What other factors are important if someone wants to try and maintain good brain health.
00:21:33 Tara Keck
I think the second one that we have really good evidence for from these long-term studies that I was talking about is social.
00:21:38 Tara Keck
And so basically making sure that you have social engagement.
00:21:44 Tara Keck
And so when we think about something like loneliness, we started doing loneliness studies in the late teens, so 18, 19, and then COVID happened and it became very popular.
00:21:54 Tara Keck
So we did a whole bunch of loneliness studies then.
00:21:57 Tara Keck
But I think that, so everyone understands sort of the concept of loneliness, but loneliness is subjective.
00:22:03 Tara Keck
So it's basically having fewer social relationships than you'd like.
00:22:06 Tara Keck
So for some people, you could have three to five friends and you're like, that's more than enough. I don't have space for more.
00:22:11 Simon Gaisford
I'm in that category.
00:22:12 Tara Keck
I am too.
00:22:13 Tara Keck
Yeah.
00:22:14 Tara Keck
And then there's other people who, you know, are like, you know, those social people and they have like 25 friends and they somehow keep up with all of them.
00:22:19 Tara Keck
Yeah.
00:22:20 Tara Keck
And those are great.
00:22:20 Tara Keck
I mean, I really, I have friends like that.
00:22:22 Tara Keck
I love that they are like that.
00:22:24 Tara Keck
I would be exhausted.
00:22:25 Tara Keck
But yeah, but I think that's is that, in the situation where they had three to five friends, they would feel lonely.
00:22:30 Tara Keck
And so it's really an individual thing per person.
00:22:33 Tara Keck
And that makes it a little bit hard to track, right?
00:22:35 Tara Keck
Because there's lots of reasons that you could have be feeling loneliness.
00:22:40 Tara Keck
And so when they do interventions for loneliness, it's a little bit tricky because it's a little bit dependent on the person.
00:22:48 Tara Keck
And so when we're thinking about loneliness, I think there's
00:22:52 Tara Keck
There's the discussion that it's a risk factor for many diseases, including dementia and aging-related diseases.
00:23:00 Tara Keck
But I think that one of the challenges we've seen in loneliness is that loneliness in itself isn't necessarily bad, right?
00:23:07 Tara Keck
So if you're feeling acute loneliness, I like to think of it as something like hunger, right?
00:23:11 Tara Keck
So if you're hungry, it's your stomach being like, go get some food, right?
00:23:14 Tara Keck
And it's the same thing with loneliness.
00:23:16 Tara Keck
If you're feeling lonely acutely because you've moved somewhere new or your closest friend moved to a different city or country, you’re not seeing them as often, that's just a normal reaction.
00:23:24 Tara Keck
And it's encouraging you to go out and make some new friends.
00:23:26 Tara Keck
So it's sort of a protective mechanism.
00:23:29 Tara Keck
It's chronic loneliness that's really the problem.
00:23:30 Tara Keck
So that means that we have to measure, you know, we need to use these longitudinal studies where people are measured over time to say like, okay, well actually are you lonely repeatedly or was it just sort of a flash in time where you know something had happened and.
00:23:44 Simon Gaisford
You're a victim of circumstance.
00:23:46 Simon Gaisford
Should someone, do you think there's a case then for intervention if
00:23:49 Simon Gaisford
If someone is chronically lonely, I didn't even know how that would work.
00:23:53 Simon Gaisford
If someone's chronically lonely, I suppose.
00:23:55 Simon Gaisford
Because you could be chronically lonely, it doesn't mean that you're confined indoors and no one's seeing you, does it?
00:24:00 Simon Gaisford
You go out, but you're not interacting with people.
00:24:02 Tara Keck
That's right.
00:24:03 Tara Keck
So I think that it's, if you're chronically indoors and not interacting with people,
00:24:08 Tara Keck
sort of, we think about that as social isolation, which also has its own set of risk factors, also not a great thing, and also something that we need to worry about sort of from a population point of view.
00:24:17 Tara Keck
But loneliness is a little bit trickier to task because someone could be going out, interacting all the time and still feeling lonely.
00:24:23 Tara Keck
We especially see this, it happens a lot in, you're most likely to be lonely when you're quite young and quite old.
00:24:29 Tara Keck
So up until about 20, and then again when you're in your 60s.
00:24:34 Tara Keck
I mean, there are interventions.
00:24:36 Tara Keck
And so there's been a lot of work in trying to understand how.
00:24:39 Tara Keck
And so I think the first key thing, and so we've done some loneliness studies in populations.
00:24:43 Tara Keck
And what we always try and start off with is like identifying loneliness levels, which are pretty consistent globally.
00:24:49 Tara Keck
Like we've done this in, I did a study in six countries in Eastern Europe and Central Asia.
00:24:54 Tara Keck
They more or less match what we see in Europe, what we see in Southeast Asia, loneliness levels among cohort, certain groups of people who are older are pretty consistent.
00:25:05 Tara Keck
What's not always the same is the reasons that people are lonely.
00:25:08 Tara Keck
And so what we found is, and this was not, I mean, what we see across the board is that you would think something like someone's lonely because, you know, their spouse died.
00:25:18 Tara Keck
And if you're 70 and you lose a spouse, I mean, you can't start again.
00:25:21 Tara Keck
It's yeah, it's I'm sure devastating, but actually that's not that associated with loneliness.
00:25:27 Tara Keck
What we see is that it's when people don't feel like they have sort of lots of sort of connections and day-to-day.
00:25:33 Tara Keck
So it's the day-to-day stuff that matters.
00:25:34 Tara Keck
And so what we saw in our study was that it was very much, is there someone if you need help getting groceries that you can call?
00:25:42 Tara Keck
And so that's pretty simple because it doesn't need to be a spouse that you've had for 50 years, but you're not replacing someone's spouse.
00:25:48 Tara Keck
But you could actually, you know, and so in some of the countries that we did this in, they've set up these sort of friend programs with younger people and, you know, someone drops out of your milk and it actually does make people feel connected to the community, but then also addresses needs that they have.
00:26:02 Tara Keck
And so I think that when we're thinking about interventions, they need to be very specific.
00:26:07 Tara Keck
The second intervention that has been very consistent to work, which is a lot of people have trouble with loneliness when they get older because they have what is in essence social anxiety.
00:26:20 Tara Keck
So they're nervous about going out and meeting people.
00:26:23 Tara Keck
And at first, this sounds a little bit like silly, just, but I think that when you retire in particular, what we see is that when people retire, very often they've left work, where you have constant social interactions, whether you want to or not, and then what happens in a lot of communities is people might move, right?
00:26:42 Tara Keck
So they move to be closer to their children and by sort of more potential, more important proxy, their grandchildren.
00:26:49 Tara Keck
And so they have these communities that they've lived in, but then they go into a new community.
00:26:53 Tara Keck
And the reality is that most of us don't make new friends from scratch.
00:26:57 Tara Keck
Like in most people, it's their nightmare to walk into a room with a bunch of people they don't know and just start chatting, right?
00:27:03 Tara Keck
Like that's like really hard for most people.
00:27:05 Simon Gaisford
Definitely, I'm in that category.
00:27:10 Tara Keck
What we see with loneliness is that like what you're actually asking people to do is that in you go to school, you make friends because you're forced to be at school together.
00:27:18 Tara Keck
Then you go to university, same thing.
00:27:20 Tara Keck
Everyone's there to make friends.
00:27:21 Tara Keck
You then get your job and then let's say you have kids, you're friends with your kids’ friends’ parents.
00:27:28 Tara Keck
You meet new people all the time through these things where it's very natural and you don't have to walk up to someone and say, let's be friends.
00:27:34 Tara Keck
And so I think that what we see is that often people try and come up with these social events that are like parties and they are incredibly ineffective.
00:27:43 Tara Keck
People are socially nervous about going.
00:27:44 Tara Keck
So what I think is really effective is having activities with purpose.
00:27:48 Tara Keck
And so we've done a bunch of our studies based off of, in Eastern Europe and Central Asia, they have a lot of older people because they have a low birth rate, but then a lot of their younger people have also moved to Western Europe and so they have a migration thing that has shifted the populations.
00:28:06 Tara Keck
And so in a lot of these countries, they have these healthy aging centres.
00:28:10 Tara Keck
And so these are day centres where older people can go and do a bunch of social activities.
00:28:15 Tara Keck
And there's all sorts of activities there.
00:28:17 Tara Keck
They have exercise classes.
00:28:20 Tara Keck
They have computer classes so they can basically learn to use Zoom.
00:28:25 Tara Keck
They have art classes.
00:28:26 Tara Keck
There's a ping pong league.
00:28:28 Tara Keck
And I've been to visit these and I was brought into the ping pong league and I absolutely got beat very badly by this 98-year-old guy who was amazing at ping pong.
00:28:38 Tara Keck
And yeah, so everyone there are super active, they're super energetic, they're super social and like it's just actually amazing to visit them.
00:28:45 Tara Keck
It's really joyful to be there.
00:28:48 Tara Keck
But what we see in these places is that there's this increase in both sort of life satisfaction, but then also physical activity.
00:28:55 Tara Keck
And so when people have these reasons to engage with other people, it's much easier to talk to each other, right?
00:29:03 Tara Keck
So, oh, we're our thing together.
00:29:04 Tara Keck
Oh, we're doing ping pong together.
00:29:06 Tara Keck
And so I think that does make it much easier.
00:29:08 Tara Keck
And so you actually have these better social outcomes.
00:29:11 Simon Gaisford
Yeah.
00:29:12 Simon Gaisford
Because even if we went around the UK and we looked at, we were stereotyping, older people, we might say they're down the bowls club, aren't they?
00:29:21 Simon Gaisford
My local golf club, for instance, has quite a lot of older people.
00:29:24 Simon Gaisford
And so maybe in a way, when we look at society and we think we don't notice necessarily that these things are in place, but actually that's because historically, before people started to work out why these things were important, they did it anyway because it just felt right, didn't it?
00:29:39 Simon Gaisford
So I suppose, so these things are really important, aren't they, in society for keeping people healthy?
00:29:46 Tara Keck
Definitely.
00:29:46 Tara Keck
And I think that it's also just a good place where you can identify like if there's a bunch of people who you're socially accountable to, if something happens, then, well, there's a bunch of people who are sort of messaging to make sure you're all right.
00:30:00 Tara Keck
And I think that there's those elements as well.
00:30:02 Tara Keck
So I think there's sort of this element of belonging, which is natural for all people.
00:30:05 Tara Keck
And then I think having this community infrastructure and sort of support in place is really beneficial for people's long-term health.
00:30:12 Simon Gaisford
So you mentioned COVID because I imagine that a lot of these issues came to the fore during COVID.
00:30:16 Tara Keck
Yeah.
00:30:17 Simon Gaisford
So I completely understand how social interactions, going out and hanging out with people is important.
00:30:24 Simon Gaisford
Can someone achieve the same outcome just with social media?
00:30:28 Simon Gaisford
So if they're only interacting through their screen at home, they're not actually physically going out, would they get the same benefit?
00:30:34 Tara Keck
We don't know yet.
00:30:35 Tara Keck
I don't think the answer is… It's not certain that it won't be able to be done through interaction.
00:30:41 Tara Keck
So I think that there's different forms of social media, right?
00:30:43 Tara Keck
There's what?
00:30:44 Simon Gaisford
Doom scrolling, yeah.
00:30:46 Simon Gaisford
That's probably not helping.
00:30:47 Tara Keck
That's probably not helping social interaction, yeah.
00:30:50 Tara Keck
But I think that if you, know, if we talk to our students, what they consider WhatsApp social media.
00:30:56 Tara Keck
So that's just messaging people.
00:30:58 Simon Gaisford
Yeah.
00:30:58 Simon Gaisford
So I don't consider that social media.
00:31:00 Tara Keck
So I think it just depends on what you're calling social media.
00:31:03 Tara Keck
So when you're talking about direct messaging between people that you, I'm going to say no and use that loosely because you don't need to have met people in person.
00:31:11 Tara Keck
I think that's a wonderful thing about the internet is that, you know, we can talk a lot about what's good and bad about the internet, but you can meet people who are not necessarily from your small area and you have common interests and you can, you know, and.
00:31:22 Simon Gaisford
That's the theme, isn't it?
00:31:23 Simon Gaisford
Common interest.
00:31:24 Simon Gaisford
That's why you choose to hang out with someone.
00:31:26 Tara Keck
That's right.
00:31:27 Tara Keck
And so I think that it's not out of the question that, especially for people who are younger and have grown up with this.
00:31:33 Tara Keck
I mean, I didn't grow up with social media.
00:31:35 Tara Keck
It sort of hit me in mid-adulthood, we’ll call it.
00:31:38 Tara Keck
And so for me, like the idea that I would only engage with someone over like messaging feels, it's probably not going to work for me.
00:31:46 Tara Keck
For younger people, it's working.
00:31:47 Tara Keck
I mean, I think we do see that there's an increase in loneliness levels in younger people.
00:31:51 Tara Keck
I don't think that we have sufficient evidence to blame that on social media, but I think that there is some, there's maybe enough sort of correlation to start to think about should we take pause here and.
00:32:04 Simon Gaisford
Yeah, because a number of countries have banned social media for youngsters.
00:32:08 Simon Gaisford
Australia much recently for under 16s, I think.
00:32:11 Tara Keck
That's right.
00:32:11 Tara Keck
And so I think that, yeah, I mean, there's the data on social media and its effect on young people's mental health is.. it's really mixed.
00:32:23 Tara Keck
And so, I think that it's really hard to make any concrete conclusions yet on the whole.
00:32:31 Tara Keck
But I guess what I would say is that I'm personally not on social media.
00:32:36 Tara Keck
So that's my choice and how I think it affects my brain.
00:32:39 Tara Keck
So that's, I guess when people ask my opinion, my opinion is it doesn't work for me.
00:32:44 Tara Keck
And so if you're on social media and it makes you feel bad, like
00:32:47 Tara Keck
I don't know, then maybe it's not great, right?
00:32:49 Tara Keck
So maybe try and limit your time or limit it to the activities that do make you feel better.
00:32:53 Tara Keck
But I think that, I think it's going to affect different people in different ways, right?
00:32:56 Tara Keck
We all have different.
00:32:58 Simon Gaisford
Yeah, there's not going to be a one-size-fits-all solution, is there?
00:33:01 Tara Keck
No, I don't think so.
00:33:02 Tara Keck
And so I think it is, there's lots of things that some people are, you know, fine, it's no problem and others that it's just, you know, too much.
00:33:09 Tara Keck
And social media might be one of those, might be one of those.
00:33:12 Simon Gaisford
Yeah, and it's exactly like we just said about some people are
00:33:16 Simon Gaisford
Some people have to be in a room with loads of other people to actually function.
00:33:20 Simon Gaisford
Other people, and I'm putting myself in this category, can be social for a bit and then I have to leave and recharge in a quiet environment.
00:33:28 Tara Keck
Yeah, and that's fine.
00:33:29 Simon Gaisford
And neither group of that is right or wrong, it's just how you are as a person, isn't it?
00:33:33 Simon Gaisford
And I'm sure that social media is the same.
00:33:35 Simon Gaisford
Some people need that constant interaction.
00:33:38 Simon Gaisford
I personally know some younger people, should we say, where they will put images of themselves on Instagram or something like that.
00:33:46 Simon Gaisford
And if they haven't got 600 likes by the end of the day, they actually start to fret about that.
00:33:51 Simon Gaisford
That is disturbing.
00:33:53 Tara Keck
Yeah, So I think it's very much based on your relationship and what you need.
00:33:56 Tara Keck
And that's true with all social things, right?
00:33:57 Tara Keck
And I think that we, it's hard because like when you're young, there's all these pressures, even in, you know, throughout your life, there's social pressures.
00:34:04 Tara Keck
And I think it is really about like identifying like what's good for you and what works for you and doing more of that and trying to reduce the amount that's making you feel bad.
00:34:11 Simon Gaisford
Yeah,
00:34:14 Simon Gaisford
So some of these policies, we go back to the Australians and the, no social media for under 16s and stuff.
00:34:20 Simon Gaisford
You've worked with the United Nations.
00:34:22 Simon Gaisford
How does working with organisations like that, does it help governments to put in place policies that they feel can help people?
00:34:30 Simon Gaisford
I suppose I'm heading here, did the Australian government make that decision completely independently and thought it was a good idea?
00:34:37 Simon Gaisford
Does the United Nations, does it advise on healthy ageing, social media and getting out more?
00:34:46 Tara Keck
So I think that for something like the United Nations, what they're doing in countries that they're working in is working with governments, working with people so that everything is co-produced for what is right for that group of people.
00:34:57 Tara Keck
So they're there as enablers.
00:34:59 Simon Gaisford
Not dictators.
00:35:01 Tara Keck
Absolutely not.
00:35:02 Tara Keck
I mean, that doesn't work.
00:35:04 Tara Keck
And so in a lot of the work that we've done together with the UN, it's always co-produced with the population, right?
00:35:10 Tara Keck
And it's more, here's some information that I have or some expertise I have that might be helpful.
00:35:16 Tara Keck
How is it that I give that information to you and then support you in adapting it so that it works for your group?
00:35:21 Tara Keck
And so I think that that's very much the role that the UN is playing.
00:35:24 Tara Keck
So for something like social media, I mean, I'm not sure if they've weighed in on that.
00:35:28 Tara Keck
I'm going to guess not.
00:35:30 Tara Keck
But I think that there are things that we all need to be worried about with social media and things that it has pluses and minuses like all things.
00:35:38 Tara Keck
I guess I'm not sure if the United Nations has advised on social media to the government, but I think that they often do help look at policies and bring in experts and things along those lines.
00:35:50 Tara Keck
Governments obviously are doing that largely on their own as well.
00:35:53 Tara Keck
So I think that there are particular areas and countries.
00:35:55 Simon Gaisford
Right, a couple of things to wrap up then.
00:35:56 Simon Gaisford
So the future, at least as you see it for your own research, where are you heading research wise?
00:36:03 Tara Keck
So we have a couple of projects I'm really excited about, but I think that sort of the overarching bits is, we've been very focused on mental health and mental health intervention.
00:36:12 Tara Keck
So a huge risk factor for aging well and aging with dignity is addressing any mental health issues in youth and middle age.
00:36:21 Tara Keck
So if those go untreated and unmanaged, then we really, that's not gonna go well for aging.
00:36:28 Tara Keck
And so we've been doing a lot of projects related to this where we work in partnership with the UN and with governments and groups in the countries that we're working in to try and help develop mental health interventions that can be deployed sort of with medium-sized training.
00:36:48 Tara Keck
So we can train people for a month or two and then be able to actually provide mental health care.
00:36:52 Tara Keck
Because what we see is that the mental health crisis is global.
00:36:55 Tara Keck
It's increasing dramatically.
00:36:57 Tara Keck
There was a new paper in the Lancet I think today or this week talking about how actually it's, you know, especially in young people, it's increasing dramatically.
00:37:05 Tara Keck
And we just don't have anywhere close to enough mental health professionals.
00:37:09 Tara Keck
And so especially in low resource settings like rural areas in certain countries or countries that are lower in the socioeconomic, then you'd end up with just very, very few people to be able to support.
00:37:22 Tara Keck
So we're trying to look at this and figure out ways that we can create and build sort of infrastructure and foundations for people who can actually start to support people as they need it, without them needing to get four-year degrees.
00:37:36 Tara Keck
And of course, being able to go to a psychiatrist or a psychologist is a great option, but it's a privilege that is only available to a small number of people in the world.
00:37:45 Tara Keck
And so a lot of what we've been doing is looking at how do we work in partnership with communities to build community infrastructure, to have these types of supports in place that allow us to make all of these things that are good for your brain, so exercise, social interaction, taking care of your mental health easy, and make them sort of habitual.
00:38:06 Simon Gaisford
Okay.
00:38:07 Simon Gaisford
In terms of other research areas that you find interesting, I think you mentioned GLP-1, the class of GLP-1 drugs.
00:38:18 Simon Gaisford
Is that something that's interesting to you because of their effect on the most people think those drugs are interacting with your gut, but I believe there's also growing evidence they're interacting with your brain.
00:38:28 Tara Keck
Yeah, so I think the GLP-1s, which is basically Ozempic, for those of us who don't call them GLP-1s.
00:38:35 Tara Keck
So Ozempic, which is like, I mean, it's such a fascinating drug, right?
00:38:38 Tara Keck
Like it has been enormously effective.
00:38:41 Tara Keck
Everyone is talking about this.
00:38:42 Tara Keck
It's very popular.
00:38:43 Tara Keck
And yeah, so the way it works is it's thought to be a combination of things.
00:38:46 Tara Keck
So it does interact with your gut.
00:38:49 Tara Keck
It, I think, changes your insulin release as well and sort of smooths it out, which is what it started as.
00:38:54 Tara Keck
It started as a diabetes drug.
00:38:56 Tara Keck
But it also seems to have an effect on your brain.
00:38:58 Tara Keck
And what it's doing is sort of taking away the reward associated with eating.
00:39:01 Tara Keck
So it sort of makes you not quite as hungry all the time is the sort of effect that you feel.
00:39:08 Tara Keck
And we actually have a lot of people working on this in Life Sciences at the Centre for Cardiovascular Metabolic Neuroscience, in particular, Stefan Trapp and Dan Brierley in my department are very excited about this.
00:39:17 Tara Keck
They're in my building and I'm constantly asking them questions.
00:39:19 Tara Keck
So yeah, I think these are really exciting.
00:39:21 Tara Keck
But actually what I think is fascinating about this is that this drug has been so effective.
00:39:26 Tara Keck
It's really one of the better drugs we've had.
00:39:28 Tara Keck
Well, you can speak to this as the School of Pharmacy person, but
00:39:34 Tara Keck
But what we're seeing now is it's been a while that people have had them.
00:39:37 Tara Keck
You get to 18 months and everything flatlines.
00:39:40 Tara Keck
So you stop losing weight.
00:39:41 Tara Keck
And if you go off the drugs, your weight goes back to where it was more or less before you started taking it.
00:39:47 Tara Keck
So what I think is interesting about this is that this is really kind of one of the best options for drugs that we've seen and it's still not enough.
00:39:56 Tara Keck
And I think we have the new Alzheimer's drugs that came out in the last couple of months as well.
00:40:00 Tara Keck
And of course, those are great.
00:40:02 Tara Keck
It's a huge breakthrough.
00:40:04 Tara Keck
They are going to be beneficial.
00:40:06 Tara Keck
But if you take a drug, it's not going to, if you've gone through cognitive decline, and as we talked about, your synapses is changing.
00:40:11 Tara Keck
All your synapses have changed.
00:40:12 Tara Keck
It's not coming back to where it was before, right?
00:40:15 Tara Keck
So I think it's really driving home this idea that
00:40:18 Tara Keck
Medicine is an amazing tool.
00:40:20 Tara Keck
We are so lucky to have all of this, but we need to be thinking about sort of the societal element of it as well, right?
00:40:27 Tara Keck
So we need to be building things in communities that help people do healthy behaviours like exercise, like eating well, not smoking, socialising, all of these things that we know are important.
00:40:39 Tara Keck
We need to be, making that the default and making that easy.
00:40:44 Tara Keck
And it's not right now.
00:40:46 Tara Keck
And I think that, the drugs alone, everyone hopes that, oh, well, don't worry, it'll be fine.
00:40:52 Tara Keck
And you know, by the time I get to that age, I'll take the pill and it'll take care of me.
00:40:55 Tara Keck
And I think that's, I don't think scientists think that's the case, but I do worry that that's, you know, the hope of the general public.
00:41:02 Tara Keck
And so I think we really do need to think about this at a population level and encourage this type of thing.
00:41:06 Simon Gaisford
Yeah, it's a bit misguided, isn't it?
00:41:07 Simon Gaisford
I think the general public does view that as we'll just medicate our way out of the problem.
00:41:11 Simon Gaisford
And I think you're absolutely right that some of the newer drugs are a really good adjunct to other things such as healthy living.
00:41:21 Simon Gaisford
They are not a substitute for healthy living.
00:41:23 Tara Keck
They aren't and I think that where something like Ozempic can be really valuable is like if you're using that to take off weight and then that allows you to exercise more easily and then you can sort of slowly change your lifestyle, then it’s a wonderful tool.
00:41:34 Simon Gaisford
Then it's a win-win.
00:41:37 Simon Gaisford
I just finished reading The Magic Pill by Johann Hari.
00:41:41 Simon Gaisford
It's a really good book.
00:41:42 Simon Gaisford
That is all about, it's a very personal story by him actually of his journey for weight loss using Ozempic.
00:41:49 Simon Gaisford
And he then goes through, he goes and talks to various scientists and clinicians, Nova Nordisk.
00:41:56 Simon Gaisford
And he does touch on, you know, on a very personal level, some issues with drugs like that.
00:42:02 Simon Gaisford
And one that I was going to mention before we finish is it appears at least, and I've also been to talk to Stefan and Dan around the corner from your office.
00:42:11 Simon Gaisford
Yeah, and they were very clear that drugs like this, they're not just acting on your gut, they're also acting on the reward centre of your brain.
00:42:17 Simon Gaisford
We touched on this right at the start, but you know, positive reinforcement of something, eating in particular, you know, it's a reward.
00:42:24 Simon Gaisford
It's a reward system in your brain.
00:42:26 Simon Gaisford
And Ozempic seems to be dialing that reward.
00:42:29 Tara Keck
That's right.
00:42:30 Simon Gaisford
And so it does, it does then lead to some other interesting questions, and he does touch upon them in the book actually, about whether these GLP-1 drugs could be used with patients that are addicted to something else.
00:42:45 Simon Gaisford
That could be alcohol, it could be illicit drugs as well.
00:42:48 Simon Gaisford
It's not just food.
00:42:49 Simon Gaisford
I mean, it's a very, very dangerous route to go down and start putting overeating in the same category as being addicted to heroin, for instance.
00:42:58 Simon Gaisford
But nonetheless, the principle is it could be that they have other applications, not just for diet.
00:43:06 Tara Keck
Yeah, I think that's probably the case.
00:43:07 Tara Keck
And what we see with a lot of drugs in neuro is that I think that often they're originally developed for something else.
00:43:14 Tara Keck
And then we find out that, I mean, that there's a lot of that in drug discovery.
00:43:18 Tara Keck
So I think that I wouldn't be surprised if they end up being, you know, I think there's already some things they've seen in other organs where they're quite active at sort of reversing things.
00:43:27 Tara Keck
And so I think that they seem to be, it seems to be this kind of wonder drug and I do hope that some of it can be sustained.
00:43:34 Simon Gaisford
Yeah, absolutely.
00:43:35 Simon Gaisford
Okay, excellent.
00:43:36 Simon Gaisford
I think what we'll do is we'll finish because I did promise the listeners, I did promise that we would give them some top, when I say we, you'd give them some top tips of things they might do to try and keep their brain in a tip-top condition for as long as possible.
00:43:50 Tara Keck
Yes, so I think that the thing I would say is that you should exercise with your friends.
00:43:55 Simon Gaisford
Okay.
00:43:56 Tara Keck
I think that by doing that, you're sort of hitting two of your major risk factors all at once.
00:44:02 Tara Keck
So you've got both your socialisation and your cardiovascular?
00:44:05 Simon Gaisford
Yeah, that's a two for one whammy.
00:44:08 Tara Keck
I think you also get the advantage that if you're going to meet your friends, you're more likely to show up.
00:44:13 Simon Gaisford
Yeah, I know this myself.
00:44:17 Simon Gaisford
Sometimes I think I go to the gym before I come to work and it's just me.
00:44:21 Simon Gaisford
And so I quite frequently don't.
00:44:22 Tara Keck
Yes.
00:44:23 Tara Keck
No, and absolutely.
00:44:24 Tara Keck
This is 100% what I do in my life.
00:44:25 Tara Keck
My friends are at my gym.
00:44:26 Tara Keck
I will name them.
00:44:29 Tara Keck
So it's Christina, Daniela, Patty, Luke, and Drew.
00:44:33 Tara Keck
And we, you know, for me, there are many mornings when I get up and like you, I do not want to go to the gym because at least for me, running is not fun.
00:44:42 Tara Keck
I know people love it.
00:44:43 Tara Keck
I have run my whole life, but it's not fun.
00:44:46 Tara Keck
But I think of it as, okay, well, one, this person's waiting for me.
00:44:50 Tara Keck
And then I think of it as like, well, I'll just show up and socialise and talk to them.
00:44:53 Tara Keck
And so I'm meeting my friend and then I'm there in workout clothes and then the workout class starts.
00:44:57 Tara Keck
So of course I go in and then I've worked out.
00:44:58 Tara Keck
So I think that's really the key thing is that you want to think about these factors that are important for your health and really find ways to make them sort of automatic and easy to do.
00:45:09 Simon Gaisford
Yeah, and most gyms do run classes, don't they?
00:45:12 Simon Gaisford
And so you can go with like-minded people and you can make friends that way.
00:45:14 Simon Gaisford
I've seen that at my own gym, so that's very good.
00:45:17 Simon Gaisford
Diet, should people worry about diet?
00:45:20 Simon Gaisford
I'm presuming you're not advocating a diet that causes cardiovascular disease.
00:45:25 Tara Keck
That's right.
00:45:25 Tara Keck
I mean, I think you need to be sensible about your diet and eat…
00:45:30 Tara Keck
I think I'll take a word from Michael Pollan, who's written about this, like, eat real food, not too much.
00:45:37 Simon Gaisford
Absolutely.
00:45:38 Tara Keck
I mean, that's it.
00:45:39 Tara Keck
Like, and so I think that, you know, I would say from my point of view, like, one, if you're working out enough, then you can't eat that much bad food.
00:45:48 Tara Keck
Well, I guess it depends on how old you are.
00:45:49 Tara Keck
Once you reach a certain age, you can no longer eat really terrible food and continue to work out. Like, they are no longer compatible.
00:45:55 Simon Gaisford
Yeah, that's right, that's right.
00:45:57 Tara Keck
Maybe if you're 25, but
00:45:59 Tara Keck
But so I think that, I think it's something to pay attention to, but I don't think it's something worth fretting over.
00:46:03 Tara Keck
Like, as long as you're eating healthy food and, you aren't eating too much, then if you've, if you're still exercising and doing all of that, then I think that worrying about the details.
00:46:12 Tara Keck
I think people get worked up about the details. And that can cause paralysis.
00:46:17 Simon Gaisford
Absolutely.
00:46:17 Simon Gaisford
There's so much information out there and everyone seems to have a different opinion.
00:46:22 Simon Gaisford
I've just finished reading, other than The Magic Pill,
00:46:19 Simon Gaisford
Ultra-Processed People by our own UCL colleague, Chris van Tulleken.
00:46:29 Simon Gaisford
And that's also, that's kind of interesting.
00:46:31 Simon Gaisford
That makes you, it doesn't say don't eat things.
00:46:34 Simon Gaisford
It just makes me, anyway, stop and look at the food label before I start eating something.
00:46:39 Tara Keck
I think that's right. And I think that like, you know, I eat ice cream.
00:46:42 Tara Keck
I like ice cream.
00:46:43 Simon Gaisford
There’s a chapter in that book about ice cream.
00:46:45 Tara Keck
Yeah.
00:46:45 Tara Keck
And the thing is, it's like, okay, well, if there's certain things you like that aren't great for you, that's fine.
00:46:51 Tara Keck
Just if you actually aren't really, yeah, I think everything in moderation.
00:46:53 Tara Keck
But also if you aren't enjoying something in particular, then maybe cut that out.
00:46:55 Simon Gaisford
Yeah, absolutely.
00:46:56 Tara Keck
It's not that hard to take a quick look.
00:46:38 Tara Keck
And so I think that's it is, everything in moderation is probably.
00:47:02 Simon Gaisford
Yeah, and I imagine that a lot of people have eaten something comfort eating.
00:47:06 Simon Gaisford
So you go and buy a ready meal and eat something because it's comfort eating.
00:47:09 Simon Gaisford
And afterwards you feel awful.
00:47:00 Tara Keck
Yeah.
00:47:00 Simon Gaisford
And you feel awful because it's not nutritious.
00:47:12 Simon Gaisford
So yeah, that's quite so.
00:47:15 Simon Gaisford
We have at least recommended to our listeners a few books they should be reading.
00:47:17 Tara Keck
Yes, that's true.
00:47:17 Tara Keck
Yes.
00:47:18 Simon Gaisford
Well, that is absolutely excellent.
00:47:19 Simon Gaisford
Thank you, Tara.
00:47:20 Simon Gaisford
That was super interesting.
00:47:21 Simon Gaisford
I've learned loads of stuff.
00:47:23 Simon Gaisford
All right, excellent.
00:47:27 Tara Keck
Thank you very much for having me.
00:47:28 Simon Gaisford
You're welcome.
00:47:28 Simon Gaisford
Thank you.
Welcome to Life Sciences at University College London, The Big Questions.
00:00:17 Simon Gaisford
I'm your host Simon Gaisford, Professor of Pharmaceutics at UCL School of Pharmacy.
00:00:23 Simon Gaisford
With me today in the studio is my colleague Professor Tara Keck.
00:00:27 Simon Gaisford
Tara is a neuroscientist whose particular research interests focus on neuroplasticity, which means how does our brain change and respond to various factors such as ageing or stress, social interactions and things like that.
00:00:42 Simon Gaisford
So I'm very pleased to welcome Tara to the studio today, and I'm hoping that by the end of our conversation, she'll give us some top tips that allow us to keep our brains in full working order.
00:00:52 Simon Gaisford
So Tara, welcome.
00:00:54 Tara Keck
Thank you for having me, Simon.
00:00:55 Simon Gaisford
You're very welcome. It's very nice you're here.
00:00:57 Simon Gaisford
So first question is an easy starter for 10.
00:01:00 Simon Gaisford
What is neuroplasticity and why do you find it so interesting?
00:01:04 Tara Keck
Yeah, so as you alluded to, neuroplasticity is how our brains change in response to our experiences.
00:01:10 Tara Keck
And so that could be forming new memories.
00:01:12 Tara Keck
It could be learning a new skill like playing the piano or learning French.
00:01:17 Tara Keck
And it basically happens throughout our lives and it's how we encode what's happened around us and allows us to sort of think about how we interact with the world.
00:01:26 Simon Gaisford
Is it a survival mechanism?
00:01:29 Tara Keck
In many ways, yeah.
00:01:30 Tara Keck
So we need to, I think the most extreme form of neuroplasticity that people will be familiar with is sort of what we consider fear learning or reverse learning.
00:01:38 Tara Keck
So, for example, if anyone's ever had food poisoning,
00:01:42 Tara Keck
I'm never going to that restaurant again.
00:01:45 Tara Keck
Exactly, yeah.
00:01:45 Tara Keck
I had food poisoning when I was 14.
00:01:48 Tara Keck
I ate something called fettuccine Alfredo, which is popular in the US.
00:01:51 Tara Keck
I got very sick and I have not even looked at it since.
00:01:54 Tara Keck
It's just, you know, and so I think that when something has the potential to be poisonous or kill you, your brain learns really fast that you need to not do that again because you need to survive.
00:02:03 Simon Gaisford
Yeah, that's a survive.
00:02:04 Simon Gaisford
Or I suppose a famous example which we've all done is your mum saying, don't touch the oven because it's hot and then you just put your hands straight on it.
00:02:12 Tara Keck
It’s very fast learning.
00:02:13 Tara Keck
But then it can also be positive things, right?
00:02:14 Tara Keck
So if we're thinking about from sort of a long-term human perspective, if there's certain places that we always know that there's good food when we think about hunters and gatherers, things like that, then that's something that we want to encode in our spatial memory so that we can keep going back there because we know we'll be able to have a positive experience by finding more food or berries or fruit or whatever it is that was in that space.
00:02:33 Simon Gaisford
Yeah, so that's like...
00:02:36 Simon Gaisford
That's like positive reinforcement, something that you want to keep doing.
00:02:39 Simon Gaisford
And also we can have negative reinforcements.
00:02:42 Simon Gaisford
So I get that as a sort of, as a reward and defence mechanism.
00:02:47 Tara Keck
That's right.
00:02:48 Simon Gaisford
What else, some of your research interests include things like social interactions, you know, why it's important to have friends and not lock yourself away in your own home.
00:02:58 Simon Gaisford
How does that impact your brain?
00:03:01 Tara Keck
I think that when we think about aging, there are certain factors that keep our brains healthy.
00:03:07 Tara Keck
And they tend to go throughout our lifespans.
00:03:10 Tara Keck
Very often when we think about aging, we start thinking about it when we're 60, 70, 80.
00:03:14 Tara Keck
Right around the time we start retiring.
00:03:17 Simon Gaisford
Yeah, exactly.
00:03:18 Tara Keck
Yes.
00:03:18 Simon Gaisford
And I am thinking about retirement.
00:03:20 Tara Keck
Yeah, and so I think that when that's the case, we really want to start thinking about aging early.
00:03:24 Tara Keck
So we know that there are risk factors for brain health sort of in our long-term aging span throughout our lifespans.
00:03:30 Tara Keck
And so these have been well described.
00:03:32 Tara Keck
And there's certain ones that, you know, there's a number of things or the ones that I focus on that are sort of key.
00:03:38 Tara Keck
that are sort of the two things we have really good evidence for is making sure we're cardiovascularly healthy and then having enough social interaction.
00:03:46 Tara Keck
And so we know about these, so people have done cohort studies.
00:03:50 Tara Keck
And so what a cohort study is that a group of scientists will take a large group of people, thousands usually, and they'll follow them over time.
00:03:57 Tara Keck
And they'll ask them a bunch of questions
00:03:59 Tara Keck
What are the activities that you're doing?
00:04:01 Tara Keck
How do you feel about things?
00:04:02 Tara Keck
Ask them mental health questions, how hopeful they are, things along those lines.
00:04:05 Tara Keck
They'll also, in many of them, some of the bigger ones, they'll take sort of biological samples, so they'll do a brain scan or take blood and do some tests, things along those lines.
00:04:13 Tara Keck
We have a lot of those.
00:04:14 Tara Keck
There's some in the UK that have been going for decades.
00:04:16 Tara Keck
There's one in the US that's now, I think, over 100 years old.
00:04:19 Tara Keck
So they're studying the great.
00:04:20 Simon Gaisford
I bet there's no grandchildren there at the start.
00:04:22 Tara Keck
The grandchildren and the great grandchildren of people.
00:04:25 Tara Keck
And so we can start to actually really say like, okay, well, what are the social factors that lead to healthy longevity?
00:04:30 Tara Keck
And then what are the sort of biological factors?
00:04:32 Simon Gaisford
Okay, that is super interesting, isn't it?
00:04:35 Simon Gaisford
Yeah.
00:04:35 Simon Gaisford
Okay, so we might need to unpick some of these things as we go on then.
00:04:40 Simon Gaisford
So firstly,
00:04:42 Simon Gaisford
How does the brain form memories or reshape itself so that you have a memory?
00:04:50 Simon Gaisford
Don't touch that oven.
00:04:51 Simon Gaisford
Don't go back to that restaurant.
00:04:53 Tara Keck
Yeah, so we have good ideas.
00:04:55 Tara Keck
And what we generally think is happening is that in our brains, our brain cells are connected to each other.
00:05:00 Tara Keck
So a brain cell in general, in many parts of the brain, it has sort of the main cell part, but then it has a tree that grows out of it.
00:05:07 Tara Keck
And that's where all the inputs to it come.
00:05:09 Tara Keck
And then it has sort of another cord that comes out of the bottom that is where it sends information to the next neuron.
00:05:16 Tara Keck
And so all of these neurons are connected to one another.
00:05:18 Tara Keck
And it's those connections that change.
00:05:20 Tara Keck
So basically, these trees can grow out little branches.
00:05:23 Tara Keck
And this is a lot of what we've studied over my career.
00:05:26 Tara Keck
And connect to new partners.
00:05:29 Tara Keck
And it's through those partners that we actually then have memories.
00:05:32 Simon Gaisford
And those connections get stronger as something is positively reinforced to us.
00:05:39 Simon Gaisford
Or negatively.
00:05:42 Simon Gaisford
As something is repeated.
00:05:43 Simon Gaisford
So the more time something happens, the stronger that particular connection becomes.
00:05:46 Tara Keck
That's right.
00:05:47 Tara Keck
Yeah.
00:05:47 Tara Keck
So I think that a lot of the activity that we have, the way that our brain communicates is through electrical activity.
00:05:54 Tara Keck
And so there'd be more electrical activity, the more important a particular connection is.
00:05:59 Tara Keck
And so if you're learning something that's positive, actually learning positive things takes a lot more repetition than negative things.
00:06:06 Tara Keck
Just because of the sort of difference in if something is dangerous, you need to learn right away.
00:06:12 Tara Keck
You can't do it the second time.
00:06:13 Tara Keck
Whereas if something's good, you maybe want to be a little bit more reserved and take more time to figure out that it's really good.
00:06:18 Tara Keck
So that's why you sort of have this practice element.
00:06:20 Tara Keck
And anyone who's tried to learn a language or an instrument or anything else, skiing in adulthood, any of these things are really hard, right?
00:06:28 Tara Keck
And so you have to do them over and over and you get better at them.
00:06:30 Tara Keck
And so yeah, that strengthens these connections which are called synapses.
00:06:34 Simon Gaisford
Yeah, because they often say children, for instance, if they grow up in a house where there's more than one language being spoken, it's completely bilingual.
00:06:40 Simon Gaisford
Also, children tend to be better off learning a second language before say six or seven, don't they?
00:06:45 Simon Gaisford
Presumably because their brains at that point are like sponges.
00:06:48 Tara Keck
Yeah, so our brains have four different brain regions.
00:06:52 Tara Keck
So our brain has a region that sort of calculates all of our vision and our hearing and then our language.
00:06:58 Tara Keck
And obviously there's sort of other brain regions that integrate those, right?
00:07:01 Tara Keck
Because basically if you think about watching a movie that's dubbed, right?
00:07:05 Tara Keck
And they're talking in a language and their mouth movement doesn't match the hearing thing in here, right?
00:07:09 Tara Keck
So your brain goes crazy when that happens.
00:07:11 Tara Keck
So you do look at the integration, but there's sort of these ways that your brain just processes each of these different sensory inputs.
00:07:20 Tara Keck
And so what we know is that each of those sensory areas have what is called a sensitive or critical period.
00:07:26 Tara Keck
So we've known this since about the 60s.
00:07:28 Tara Keck
And so what that means is that there's periods during which your brain is still developing when you're young.
00:07:33 Tara Keck
And so we know, for example, with hearing.
00:07:36 Tara Keck
If a child is born hearing with either partially deaf or fully deaf, then if you actually get cochlear implants before they're a year or two, they actually have more or less completely normal hearing.
00:07:45 Tara Keck
The brain can actually adapt to it.
00:07:47 Tara Keck
But if you get it in a bit later, then actually it's much more impaired.
00:07:50 Tara Keck
And so for languages, it's the same thing.
00:07:52 Tara Keck
Our language critical period is longer.
00:07:54 Tara Keck
So you have until maybe 10 to 12 where you can learn a first language natively and you can learn numerous languages.
00:08:02 Tara Keck
And then if you start learning after that, it's going to go into basically a second language region in your brain and it's never going to quite be, you can be incredibly proficient, you can be fluent, but it's very hard to be quite native.
00:08:16 Simon Gaisford
Yeah.
00:08:16 Simon Gaisford
I think what you might have done there is answer some questions about why I did so badly at GCSE French.
00:08:20 Tara Keck
I think that's not, you're not alone in that.
00:08:24 Simon Gaisford
That's true.
00:08:25 Simon Gaisford
Well, everyone else in my school did badly in GCSE French as well.
00:08:27 Simon Gaisford
Yeah.
00:08:28 Simon Gaisford
Okay, that's so that's super interesting.
00:08:30 Simon Gaisford
So
00:08:31 Simon Gaisford
The plasticity of a brain, when I read that neuroplasticity, my brain went to plasticine and I just imagined something that's very soft and fluid, easily moulded.
00:08:41 Simon Gaisford
Is that how we should read neuroplasticity?
00:08:44 Simon Gaisford
You know, your brain is something that can very rapidly change or, where am I heading here?
00:08:52 Simon Gaisford
If you've learnt some things, you made some connections,
00:08:57 Simon Gaisford
Are they then rigid for the rest of your life or can they change?
00:09:00 Tara Keck
Yeah, so if we think about it from a scientific point of view, it's much easier to determine somebody's learned something than somebody's forgotten it.
00:09:08 Tara Keck
Because when have you forgotten it?
00:09:09 Tara Keck
It sounds like a philosophical question, but it's actually a really hard thing to pin down.
00:09:14 Tara Keck
So we have a pretty good understanding of learning.
00:09:17 Tara Keck
So yes, the brain is moldable and we have these new synapses that form and you can then say, yes, I've learned this.
00:09:24 Tara Keck
When you've forgotten something, and this is, we work a lot in mental health and we work with people in traumatic memories.
00:09:29 Tara Keck
And it's a question of like, well, when is something really gone or is it gone enough that you can then, go back to normal life?
00:09:35 Tara Keck
It's a really tricky question.
00:09:36 Tara Keck
But in general,memories are there and they can be re-invoked by, we have this in our own life.
00:09:44 Tara Keck
You see something and smells, smell, smell is really, really, really prominent, right?
00:09:48 Tara Keck
And so this is where we have these interactions between different parts of our brain.
00:09:52 Tara Keck
And so when you have something that triggers this, you can remember something that happened when you were, you know, 12 and you haven't thought about for, you know, 35 years.
00:10:00 Tara Keck
But that being said, it's still there.
00:10:02 Tara Keck
But if you had been asked about the memory, you might not have been able to pull it up.
00:10:06 Simon Gaisford
That’s exactly what I was going to say.
00:10:07 Simon Gaisford
If someone asked you, do you remember
00:10:08 Simon Gaisford
what your mum's, let's say your mum made something that you really enjoyed eating as a child and you'd forgotten that.
00:10:13 Simon Gaisford
And then you asked, do you ever remember that?
00:10:15 Simon Gaisford
You say no, but you smell it instantly, it retriggers.
00:10:18 Simon Gaisford
Yeah, that's kind of interesting, isn't it?
00:10:20 Simon Gaisford
Okay, what happens then, and I'm wondering slightly off topic here, what happens in adulthood, for instance, then, if someone has some sort of brain trauma?
00:10:31 Simon Gaisford
So let's say they had a car accident and part of their brain was completely damaged.
00:10:37 Simon Gaisford
Each part of the brain is doing a different function, does that mean that function is completely lost?
00:10:41 Simon Gaisford
Can other parts of the brain take over?
00:10:44 Simon Gaisford
Is that also neuroplasticity?
00:10:47 Tara Keck
I mean, yeah, so there are examples of other parts of the brain taking over.
00:10:50 Tara Keck
There's sort of the... one of the main figures initially of neuroplasticity is a guy called Mercenich who's in California.
00:10:58 Tara Keck
And he's done a lot of experiments where, you know, there is sort of a loss of one sense or that you have sort of some sort of brain trauma and other parts can take over.
00:11:08 Tara Keck
So that can happen.
00:11:09 Tara Keck
It depends a bit on the injury and a bit on, you know, how old you are.
00:11:12 Tara Keck
The older you get, the less.
00:11:14 Simon Gaisford
The worse it's getting.
00:11:15 Tara Keck
Kind of.
00:11:15 Tara Keck
And that doesn't mean that your brain isn't plastic throughout your life.
00:11:18 Tara Keck
Of course it is, right?
00:11:19 Tara Keck
Like you meet new people.
00:11:21 Simon Gaisford
Yeah.
00:11:21 Tara Keck
You go to new places.
00:11:23 Tara Keck
So I think people do have the misconception that once you reach a certain age, your brain is fixed.
00:11:30 Simon Gaisford
It's all downhill.
00:11:31 Tara Keck
Yeah, it's not.
00:11:32 Tara Keck
You can continue to learn throughout your life, especially if you sort of are making an effort to.
00:11:36 Tara Keck
It's just not going to be as easy as when you were ten.
00:11:39 Tara Keck
So I think that in terms of this type of thing, like yeah, you can have entire brain regions take over and you can see this for people who are, for example, blind.
00:11:47 Tara Keck
The part of their brain that's involved in vision isn't just doing nothing, doing other things because it's not been it's not been used for the purpose it originally was.
00:11:54 Simon Gaisford
Yeah, I mean, we might touch on this towards the end, but I mean, I know quite a few people that do crosswords or Sudoku, and what they'll say is, I'm doing these to keep my brain active.
00:12:04 Simon Gaisford
It's encouraging them.
00:12:06 Simon Gaisford
Is there truth in that?
00:12:08 Tara Keck
No.
00:12:09 Tara Keck
Sorry.
00:12:10 Tara Keck
I should.
00:12:12 Tara Keck
I'll expand.
00:12:13 Simon Gaisford
Yeah, you can't leave everyone hanging on the note.
00:12:15 Tara Keck
This is what I get asked the most often is like, what if I do Sudoku?
00:12:18 Tara Keck
And the thing is, if you want to keep your brain healthy, people either want to do Sudoku, they want to eat fish, or they want to eat blueberries.
00:12:27 Tara Keck
Yeah, exactly.
00:12:28 Tara Keck
People are very excited about Omega-3s.
00:12:30 Tara Keck
And that's not to say that, you know, eating healthy isn't a good thing, or that doing Sudoku isn't necessarily a good thing.
00:12:35 Tara Keck
But there isn't some sort of magic bullet that's going to like keep your brain plastic.
00:12:40 Tara Keck
It's that straightforward.
00:12:42 Tara Keck
And it's part of the issue is that doing a Sudoku the first time, you know, fine.
00:12:46 Tara Keck
It's actually kind of hard.
00:12:47 Tara Keck
But once you get good at it, you're not challenging your brain anymore, right?
00:12:50 Tara Keck
So it's just you know exactly, you know, I look for the numbers and I set it up this way.
00:12:54 Tara Keck
And it's the same thing with crosswords, right?
00:12:56 Tara Keck
And so I think that once you've become good at something where it becomes automatic, you're not challenging your brain in the same way.
00:13:01 Tara Keck
So what you need to sort of continually be doing is challenging your brain in hard ways.
00:13:05 Tara Keck
So if you're thinking this is hard and I'm thinking hard and that's really where you're keeping your brain sort of active and healthy.
00:13:12 Simon Gaisford
I remember reading a letter in the Times many years ago about a professor at Cambridge University and he did the Times cryptic crossword every day which I find insanely difficult.
00:13:24 Simon Gaisford
But it got to a point where he was so good at that he would put an egg on to boil every morning, start the crossword and he would time how long the egg was in the in the saucepan by how long it took him to do the crossword.
00:13:38 Tara Keck
Yeah.
00:13:39 Simon Gaisford
And it said he did not like his eggs hard boiled.
00:13:42 Tara Keck
Wow.
00:13:42 Tara Keck
I mean, that is, those crosswords are really hard if you aren't used to it.
00:13:46 Simon Gaisford
Yeah, but once you know, it's just, you're just rattling.
00:13:48 Simon Gaisford
I see that.
00:13:49 Tara Keck
That's right.
00:13:50 Tara Keck
And I think that's it is that most things that we do are skills.
00:13:54 Tara Keck
And as we get good at them, they become no longer sort of that you actively have to do this.
00:13:59 Tara Keck
And we have this with everything we've learned, right?
00:14:01 Tara Keck
Like anything that you're starting out with the first few times you do it, it's really hard.
00:14:04 Tara Keck
And then you get better at it.
00:14:05 Tara Keck
And then it's no longer a challenge to do.
00:14:07 Tara Keck
And that's nice.
00:14:08 Tara Keck
And you automatically do all these things in your life that at one point in your life were very hard for you.
00:14:13 Tara Keck
And so once you're into the automatic phase, it's no longer sort of the challenging thing that it once was.
00:14:18 Simon Gaisford
That's a very interesting point.
00:14:19 Simon Gaisford
So when I get to the station in the morning, I have a choice of coming down from the platform on the escalator or the stairs.
00:14:25 Simon Gaisford
And I've always chosen the stairs on the grounds that
00:14:27 Simon Gaisford
I'm having to use my brain to coordinate where my feet are going to go down the stairs as opposed to just standing still on the escalator.
00:14:33 Simon Gaisford
And I've naively thought this is a good thing because it's keeping my brain in tip-top shape.
00:14:37 Simon Gaisford
We're probably going to come back to some tips at the end here about what people can or can't do.
00:14:42 Simon Gaisford
Sudoku, clearly not.
00:14:44 Tara Keck
I'm not saying don't do Sudoku, but it's probably once you get good at it, it's.
00:14:47 Simon Gaisford
Probably not helping as much as you hope.
00:14:50 Simon Gaisford
I'm not saying use the escalator, not the stairs, because there's an exercise element to that stuff, but it's not necessarily helping my brain keep in tip-top shape.
00:15:00 Tara Keck
I mean, yeah, I think that we see the same thing that I think there was a study that came out maybe five years ago that was talking about the association between having good balance and developing Alzheimer's disease.
00:15:11 Tara Keck
There was an inverse association.
00:15:13 Tara Keck
So if you had worse balance, then you were more likely to get Alzheimer's.
00:15:17 Tara Keck
And I think that this is often a common problem with science is that people were then were like, I'll practice my balance.
00:15:23 Tara Keck
And it's like, actually, it's not the balance that is the cause of Alzheimer's disease.
00:15:29 Tara Keck
It's that you have, what happens is that, and actually the biggest preventable risk factor for dementia and Alzheimer's disease is hearing loss.
00:15:38 Tara Keck
And so we don't exactly know why, but I guess I can say one thing is you should protect your hearing and don't put your earbuds too loud.
00:15:45 Tara Keck
Because it is a huge thing, but there's a lot of things that, and we can sort of think about this more broadly, that a lot of these problems are complex, right?
00:15:52 Tara Keck
So if you lose hearing loss, we don't know if it's that,
00:15:56 Tara Keck
It could be that you have some sort of cardiovascular change and that affects your brain.
00:16:01 Tara Keck
And it also affects your ears.
00:16:02 Tara Keck
And so your balance is also done in circular canals in your ears.
00:16:06 Tara Keck
So you would have this reduction of blood flow to your brain, which is really what's involved in the Alzheimer's.
00:16:12 Tara Keck
And you'd also have a reduction of blood flow to balance and hearing.
00:16:16 Tara Keck
And so as a result, you'd see them happening very often together.
00:16:19 Tara Keck
But the issue is the cardiovascular issue.
00:16:21 Tara Keck
It's not that the balance loss or the hearing loss is necessarily causing the Alzheimer's.
00:16:25 Tara Keck
But there could also be causal elements because as you start to lose your hearing, and this happens to many people as they age, what happens first is that in a conversation like this,many people are fine.
00:16:38 Tara Keck
There's something called hidden hearing loss, and they look at this a lot at the Ear Institute at UCL, which is in the Faculty of Brain Sciences.
00:16:45 Tara Keck
And what it is that you're great in a quiet environment, but you go out to a pub or a restaurant where there's a bit of background noise, and then you can't actually discern what the person's saying to you from what's going on in the background.
00:16:57 Tara Keck
And so it becomes frustrating.
00:16:59 Tara Keck
And anyone who's been in a really loud bar club and tried to talk to their friends, even when you're young, you know the annoyance of this.
00:17:04 Tara Keck
And so if that was every social interaction you had, you'd stop going out, right?
00:17:08 Tara Keck
And so it could have this knock-on effect that it's changing your social engagement.
00:17:12 Tara Keck
And so that's also then having effects.
00:17:14 Tara Keck
So it's hard to actually separate them out.
00:17:18 Tara Keck
But just because, you know, we're thinking about one thing causing the other, it's a lot of these things are often just multifactorial.
00:17:25 Simon Gaisford
So I do a lot of work with the Down syndrome community
00:17:27 Simon Gaisford
And one of the things I've been learning in interacting with people with Down syndrome is their risk of developing Alzheimer's is insanely high.
00:17:38 Simon Gaisford
Two very scary statistics.
00:17:39 Simon Gaisford
By the time a child with Down syndrome has reached their 40s, they have a 65% chance of developing Alzheimer's.
00:17:45 Simon Gaisford
And by the time they get into their 70s, that rises to a 100%.
00:17:49 Simon Gaisford
And when I tell people this, I have to repeat that number, a 100% chance of developing Alzheimer's.
00:17:56 Simon Gaisford
And another interesting thing about children with Down syndrome is they have very poor gut function.
00:18:01 Simon Gaisford
And so where I've been involved is in trying to improve their gut function because I feel like that in the long term is going to improve their propensity to go and develop Alzheimer's.
00:18:11 Simon Gaisford
Now I've always thought of that is in terms of faecal matter in the gut, pushing against the gut wall, leaky gut syndrome, stuff going across into blood that we don't want.
00:18:21 Simon Gaisford
I hadn't thought until you mentioned it just then that there's also an element of reduced blood flow.
00:18:26 Simon Gaisford
So where someone's gut's not working properly, the body then diverts blood to the gut because it's effectively an immune system response.
00:18:35 Simon Gaisford
And that means peripherally you've got less blood flow.
00:18:37 Simon Gaisford
So I suppose that and in combination with poor cardiovascular health, they may also be factors.
00:18:44 Simon Gaisford
Like we say, it's multifactorial, but they could all be factors that might lead into and other neurological conditions.
00:18:51 Simon Gaisford
I think anyone that knows anyone that's got Parkinson's disease
00:18:56 Simon Gaisford
80% of people that go on to develop Parkinson's in the 10 to 20 years prior to developing obvious motor symptoms, they have constipation.
00:19:04 Simon Gaisford
So this thing about blood flow is kind of interesting, isn't it?
00:19:07 Tara Keck
Yeah, I think it's really emerged, like I think that there are certain scientists who have been sort of saying this for a while, but it's really become sort of a mainstream point of view that a lot of this is a blood flow issue.
00:19:20 Tara Keck
So I mean, it really does seem like if you were going to do one thing to age in a good way, it's not just for your brain, but for your whole body.
00:19:26 Tara Keck
It's stay cardiovascularly fit.
00:19:29 Simon Gaisford
Let's talk about cardiovascular health then.
00:19:30 Simon Gaisford
So how would, because I wonder if a member of the public might not make that link between cardiovascular health.
00:19:37 Simon Gaisford
I mean, I think they might worry, I don't want to die of a heart attack, for instance.
00:19:43 Simon Gaisford
the link between cardiovascular health and neurodegeneration.
00:19:47 Simon Gaisford
And also, unless I've got my stats wrong, men are way more likely to have a heart attack than women, I think.
00:19:58 Simon Gaisford
Does that mean that men have a higher risk of developing Alzheimer's, for instance, than women?
00:20:03 Tara Keck
I think that the stats say, and we should check this before we put it in the podcast, I think that the stats say that women are more likely to develop Alzheimer's.
00:20:11 Tara Keck
And there's a number of factors for that.
00:20:13 Tara Keck
But one of them is just that women live longer.
00:20:15 Tara Keck
And so the longer you...
00:20:16 Simon Gaisford
Yeah.
00:20:16 Tara Keck
So I remember UCL has a Neuroscience Day where there's people from across all of UCL, clinicians, basic scientists talk about neuroscience.
00:20:26 Tara Keck
And one of the clinicians was giving a talk about Alzheimer's and he stood up and said, well, all of you in this room are more likely to develop Alzheimer's than average.
00:20:35 Tara Keck
And we were all like, okay.
00:20:38 Tara Keck
That's true, that's true, yeah.
00:20:40 Tara Keck
But the point that he was making was that that's because given sort of education and health and other stats that were sort of associated with this demographic, that you're less likely to die of a heart attack, therefore you're likely to live longer, which means you're more likely to develop some form of dementia.
00:20:57 Tara Keck
So I think that it is, there is an element of living longer
00:21:01 Tara Keck
And I think that, it's not necessarily clear.
00:21:03 Tara Keck
There's the very specific version of vascular dementia, which given its name, vascular is referring to blood vessels.
00:21:10 Tara Keck
And so in that sense, we knew that there were elements of Alzheimer's, but it seems that there's more indication that this might be playing a bigger role than we originally thought.
00:21:18 Tara Keck
There's a lot of interesting work going on about that at UCL as well, both in the Dementia Research Institute and then other individuals.
00:21:25 Tara Keck
David Atwell, for example, does a lot of work in this area.
00:21:27 Simon Gaisford
What other factors are important if someone wants to try and maintain good brain health.
00:21:33 Tara Keck
I think the second one that we have really good evidence for from these long-term studies that I was talking about is social.
00:21:38 Tara Keck
And so basically making sure that you have social engagement.
00:21:44 Tara Keck
And so when we think about something like loneliness, we started doing loneliness studies in the late teens, so 18, 19, and then COVID happened and it became very popular.
00:21:54 Tara Keck
So we did a whole bunch of loneliness studies then.
00:21:57 Tara Keck
But I think that, so everyone understands sort of the concept of loneliness, but loneliness is subjective.
00:22:03 Tara Keck
So it's basically having fewer social relationships than you'd like.
00:22:06 Tara Keck
So for some people, you could have three to five friends and you're like, that's more than enough. I don't have space for more.
00:22:11 Simon Gaisford
I'm in that category.
00:22:12 Tara Keck
I am too.
00:22:13 Tara Keck
Yeah.
00:22:14 Tara Keck
And then there's other people who, you know, are like, you know, those social people and they have like 25 friends and they somehow keep up with all of them.
00:22:19 Tara Keck
Yeah.
00:22:20 Tara Keck
And those are great.
00:22:20 Tara Keck
I mean, I really, I have friends like that.
00:22:22 Tara Keck
I love that they are like that.
00:22:24 Tara Keck
I would be exhausted.
00:22:25 Tara Keck
But yeah, but I think that's is that, in the situation where they had three to five friends, they would feel lonely.
00:22:30 Tara Keck
And so it's really an individual thing per person.
00:22:33 Tara Keck
And that makes it a little bit hard to track, right?
00:22:35 Tara Keck
Because there's lots of reasons that you could have be feeling loneliness.
00:22:40 Tara Keck
And so when they do interventions for loneliness, it's a little bit tricky because it's a little bit dependent on the person.
00:22:48 Tara Keck
And so when we're thinking about loneliness, I think there's
00:22:52 Tara Keck
There's the discussion that it's a risk factor for many diseases, including dementia and aging-related diseases.
00:23:00 Tara Keck
But I think that one of the challenges we've seen in loneliness is that loneliness in itself isn't necessarily bad, right?
00:23:07 Tara Keck
So if you're feeling acute loneliness, I like to think of it as something like hunger, right?
00:23:11 Tara Keck
So if you're hungry, it's your stomach being like, go get some food, right?
00:23:14 Tara Keck
And it's the same thing with loneliness.
00:23:16 Tara Keck
If you're feeling lonely acutely because you've moved somewhere new or your closest friend moved to a different city or country, you’re not seeing them as often, that's just a normal reaction.
00:23:24 Tara Keck
And it's encouraging you to go out and make some new friends.
00:23:26 Tara Keck
So it's sort of a protective mechanism.
00:23:29 Tara Keck
It's chronic loneliness that's really the problem.
00:23:30 Tara Keck
So that means that we have to measure, you know, we need to use these longitudinal studies where people are measured over time to say like, okay, well actually are you lonely repeatedly or was it just sort of a flash in time where you know something had happened and.
00:23:44 Simon Gaisford
You're a victim of circumstance.
00:23:46 Simon Gaisford
Should someone, do you think there's a case then for intervention if
00:23:49 Simon Gaisford
If someone is chronically lonely, I didn't even know how that would work.
00:23:53 Simon Gaisford
If someone's chronically lonely, I suppose.
00:23:55 Simon Gaisford
Because you could be chronically lonely, it doesn't mean that you're confined indoors and no one's seeing you, does it?
00:24:00 Simon Gaisford
You go out, but you're not interacting with people.
00:24:02 Tara Keck
That's right.
00:24:03 Tara Keck
So I think that it's, if you're chronically indoors and not interacting with people,
00:24:08 Tara Keck
sort of, we think about that as social isolation, which also has its own set of risk factors, also not a great thing, and also something that we need to worry about sort of from a population point of view.
00:24:17 Tara Keck
But loneliness is a little bit trickier to task because someone could be going out, interacting all the time and still feeling lonely.
00:24:23 Tara Keck
We especially see this, it happens a lot in, you're most likely to be lonely when you're quite young and quite old.
00:24:29 Tara Keck
So up until about 20, and then again when you're in your 60s.
00:24:34 Tara Keck
I mean, there are interventions.
00:24:36 Tara Keck
And so there's been a lot of work in trying to understand how.
00:24:39 Tara Keck
And so I think the first key thing, and so we've done some loneliness studies in populations.
00:24:43 Tara Keck
And what we always try and start off with is like identifying loneliness levels, which are pretty consistent globally.
00:24:49 Tara Keck
Like we've done this in, I did a study in six countries in Eastern Europe and Central Asia.
00:24:54 Tara Keck
They more or less match what we see in Europe, what we see in Southeast Asia, loneliness levels among cohort, certain groups of people who are older are pretty consistent.
00:25:05 Tara Keck
What's not always the same is the reasons that people are lonely.
00:25:08 Tara Keck
And so what we found is, and this was not, I mean, what we see across the board is that you would think something like someone's lonely because, you know, their spouse died.
00:25:18 Tara Keck
And if you're 70 and you lose a spouse, I mean, you can't start again.
00:25:21 Tara Keck
It's yeah, it's I'm sure devastating, but actually that's not that associated with loneliness.
00:25:27 Tara Keck
What we see is that it's when people don't feel like they have sort of lots of sort of connections and day-to-day.
00:25:33 Tara Keck
So it's the day-to-day stuff that matters.
00:25:34 Tara Keck
And so what we saw in our study was that it was very much, is there someone if you need help getting groceries that you can call?
00:25:42 Tara Keck
And so that's pretty simple because it doesn't need to be a spouse that you've had for 50 years, but you're not replacing someone's spouse.
00:25:48 Tara Keck
But you could actually, you know, and so in some of the countries that we did this in, they've set up these sort of friend programs with younger people and, you know, someone drops out of your milk and it actually does make people feel connected to the community, but then also addresses needs that they have.
00:26:02 Tara Keck
And so I think that when we're thinking about interventions, they need to be very specific.
00:26:07 Tara Keck
The second intervention that has been very consistent to work, which is a lot of people have trouble with loneliness when they get older because they have what is in essence social anxiety.
00:26:20 Tara Keck
So they're nervous about going out and meeting people.
00:26:23 Tara Keck
And at first, this sounds a little bit like silly, just, but I think that when you retire in particular, what we see is that when people retire, very often they've left work, where you have constant social interactions, whether you want to or not, and then what happens in a lot of communities is people might move, right?
00:26:42 Tara Keck
So they move to be closer to their children and by sort of more potential, more important proxy, their grandchildren.
00:26:49 Tara Keck
And so they have these communities that they've lived in, but then they go into a new community.
00:26:53 Tara Keck
And the reality is that most of us don't make new friends from scratch.
00:26:57 Tara Keck
Like in most people, it's their nightmare to walk into a room with a bunch of people they don't know and just start chatting, right?
00:27:03 Tara Keck
Like that's like really hard for most people.
00:27:05 Simon Gaisford
Definitely, I'm in that category.
00:27:10 Tara Keck
What we see with loneliness is that like what you're actually asking people to do is that in you go to school, you make friends because you're forced to be at school together.
00:27:18 Tara Keck
Then you go to university, same thing.
00:27:20 Tara Keck
Everyone's there to make friends.
00:27:21 Tara Keck
You then get your job and then let's say you have kids, you're friends with your kids’ friends’ parents.
00:27:28 Tara Keck
You meet new people all the time through these things where it's very natural and you don't have to walk up to someone and say, let's be friends.
00:27:34 Tara Keck
And so I think that what we see is that often people try and come up with these social events that are like parties and they are incredibly ineffective.
00:27:43 Tara Keck
People are socially nervous about going.
00:27:44 Tara Keck
So what I think is really effective is having activities with purpose.
00:27:48 Tara Keck
And so we've done a bunch of our studies based off of, in Eastern Europe and Central Asia, they have a lot of older people because they have a low birth rate, but then a lot of their younger people have also moved to Western Europe and so they have a migration thing that has shifted the populations.
00:28:06 Tara Keck
And so in a lot of these countries, they have these healthy aging centres.
00:28:10 Tara Keck
And so these are day centres where older people can go and do a bunch of social activities.
00:28:15 Tara Keck
And there's all sorts of activities there.
00:28:17 Tara Keck
They have exercise classes.
00:28:20 Tara Keck
They have computer classes so they can basically learn to use Zoom.
00:28:25 Tara Keck
They have art classes.
00:28:26 Tara Keck
There's a ping pong league.
00:28:28 Tara Keck
And I've been to visit these and I was brought into the ping pong league and I absolutely got beat very badly by this 98-year-old guy who was amazing at ping pong.
00:28:38 Tara Keck
And yeah, so everyone there are super active, they're super energetic, they're super social and like it's just actually amazing to visit them.
00:28:45 Tara Keck
It's really joyful to be there.
00:28:48 Tara Keck
But what we see in these places is that there's this increase in both sort of life satisfaction, but then also physical activity.
00:28:55 Tara Keck
And so when people have these reasons to engage with other people, it's much easier to talk to each other, right?
00:29:03 Tara Keck
So, oh, we're our thing together.
00:29:04 Tara Keck
Oh, we're doing ping pong together.
00:29:06 Tara Keck
And so I think that does make it much easier.
00:29:08 Tara Keck
And so you actually have these better social outcomes.
00:29:11 Simon Gaisford
Yeah.
00:29:12 Simon Gaisford
Because even if we went around the UK and we looked at, we were stereotyping, older people, we might say they're down the bowls club, aren't they?
00:29:21 Simon Gaisford
My local golf club, for instance, has quite a lot of older people.
00:29:24 Simon Gaisford
And so maybe in a way, when we look at society and we think we don't notice necessarily that these things are in place, but actually that's because historically, before people started to work out why these things were important, they did it anyway because it just felt right, didn't it?
00:29:39 Simon Gaisford
So I suppose, so these things are really important, aren't they, in society for keeping people healthy?
00:29:46 Tara Keck
Definitely.
00:29:46 Tara Keck
And I think that it's also just a good place where you can identify like if there's a bunch of people who you're socially accountable to, if something happens, then, well, there's a bunch of people who are sort of messaging to make sure you're all right.
00:30:00 Tara Keck
And I think that there's those elements as well.
00:30:02 Tara Keck
So I think there's sort of this element of belonging, which is natural for all people.
00:30:05 Tara Keck
And then I think having this community infrastructure and sort of support in place is really beneficial for people's long-term health.
00:30:12 Simon Gaisford
So you mentioned COVID because I imagine that a lot of these issues came to the fore during COVID.
00:30:16 Tara Keck
Yeah.
00:30:17 Simon Gaisford
So I completely understand how social interactions, going out and hanging out with people is important.
00:30:24 Simon Gaisford
Can someone achieve the same outcome just with social media?
00:30:28 Simon Gaisford
So if they're only interacting through their screen at home, they're not actually physically going out, would they get the same benefit?
00:30:34 Tara Keck
We don't know yet.
00:30:35 Tara Keck
I don't think the answer is… It's not certain that it won't be able to be done through interaction.
00:30:41 Tara Keck
So I think that there's different forms of social media, right?
00:30:43 Tara Keck
There's what?
00:30:44 Simon Gaisford
Doom scrolling, yeah.
00:30:46 Simon Gaisford
That's probably not helping.
00:30:47 Tara Keck
That's probably not helping social interaction, yeah.
00:30:50 Tara Keck
But I think that if you, know, if we talk to our students, what they consider WhatsApp social media.
00:30:56 Tara Keck
So that's just messaging people.
00:30:58 Simon Gaisford
Yeah.
00:30:58 Simon Gaisford
So I don't consider that social media.
00:31:00 Tara Keck
So I think it just depends on what you're calling social media.
00:31:03 Tara Keck
So when you're talking about direct messaging between people that you, I'm going to say no and use that loosely because you don't need to have met people in person.
00:31:11 Tara Keck
I think that's a wonderful thing about the internet is that, you know, we can talk a lot about what's good and bad about the internet, but you can meet people who are not necessarily from your small area and you have common interests and you can, you know, and.
00:31:22 Simon Gaisford
That's the theme, isn't it?
00:31:23 Simon Gaisford
Common interest.
00:31:24 Simon Gaisford
That's why you choose to hang out with someone.
00:31:26 Tara Keck
That's right.
00:31:27 Tara Keck
And so I think that it's not out of the question that, especially for people who are younger and have grown up with this.
00:31:33 Tara Keck
I mean, I didn't grow up with social media.
00:31:35 Tara Keck
It sort of hit me in mid-adulthood, we’ll call it.
00:31:38 Tara Keck
And so for me, like the idea that I would only engage with someone over like messaging feels, it's probably not going to work for me.
00:31:46 Tara Keck
For younger people, it's working.
00:31:47 Tara Keck
I mean, I think we do see that there's an increase in loneliness levels in younger people.
00:31:51 Tara Keck
I don't think that we have sufficient evidence to blame that on social media, but I think that there is some, there's maybe enough sort of correlation to start to think about should we take pause here and.
00:32:04 Simon Gaisford
Yeah, because a number of countries have banned social media for youngsters.
00:32:08 Simon Gaisford
Australia much recently for under 16s, I think.
00:32:11 Tara Keck
That's right.
00:32:11 Tara Keck
And so I think that, yeah, I mean, there's the data on social media and its effect on young people's mental health is.. it's really mixed.
00:32:23 Tara Keck
And so, I think that it's really hard to make any concrete conclusions yet on the whole.
00:32:31 Tara Keck
But I guess what I would say is that I'm personally not on social media.
00:32:36 Tara Keck
So that's my choice and how I think it affects my brain.
00:32:39 Tara Keck
So that's, I guess when people ask my opinion, my opinion is it doesn't work for me.
00:32:44 Tara Keck
And so if you're on social media and it makes you feel bad, like
00:32:47 Tara Keck
I don't know, then maybe it's not great, right?
00:32:49 Tara Keck
So maybe try and limit your time or limit it to the activities that do make you feel better.
00:32:53 Tara Keck
But I think that, I think it's going to affect different people in different ways, right?
00:32:56 Tara Keck
We all have different.
00:32:58 Simon Gaisford
Yeah, there's not going to be a one-size-fits-all solution, is there?
00:33:01 Tara Keck
No, I don't think so.
00:33:02 Tara Keck
And so I think it is, there's lots of things that some people are, you know, fine, it's no problem and others that it's just, you know, too much.
00:33:09 Tara Keck
And social media might be one of those, might be one of those.
00:33:12 Simon Gaisford
Yeah, and it's exactly like we just said about some people are
00:33:16 Simon Gaisford
Some people have to be in a room with loads of other people to actually function.
00:33:20 Simon Gaisford
Other people, and I'm putting myself in this category, can be social for a bit and then I have to leave and recharge in a quiet environment.
00:33:28 Tara Keck
Yeah, and that's fine.
00:33:29 Simon Gaisford
And neither group of that is right or wrong, it's just how you are as a person, isn't it?
00:33:33 Simon Gaisford
And I'm sure that social media is the same.
00:33:35 Simon Gaisford
Some people need that constant interaction.
00:33:38 Simon Gaisford
I personally know some younger people, should we say, where they will put images of themselves on Instagram or something like that.
00:33:46 Simon Gaisford
And if they haven't got 600 likes by the end of the day, they actually start to fret about that.
00:33:51 Simon Gaisford
That is disturbing.
00:33:53 Tara Keck
Yeah, So I think it's very much based on your relationship and what you need.
00:33:56 Tara Keck
And that's true with all social things, right?
00:33:57 Tara Keck
And I think that we, it's hard because like when you're young, there's all these pressures, even in, you know, throughout your life, there's social pressures.
00:34:04 Tara Keck
And I think it is really about like identifying like what's good for you and what works for you and doing more of that and trying to reduce the amount that's making you feel bad.
00:34:11 Simon Gaisford
Yeah,
00:34:14 Simon Gaisford
So some of these policies, we go back to the Australians and the, no social media for under 16s and stuff.
00:34:20 Simon Gaisford
You've worked with the United Nations.
00:34:22 Simon Gaisford
How does working with organisations like that, does it help governments to put in place policies that they feel can help people?
00:34:30 Simon Gaisford
I suppose I'm heading here, did the Australian government make that decision completely independently and thought it was a good idea?
00:34:37 Simon Gaisford
Does the United Nations, does it advise on healthy ageing, social media and getting out more?
00:34:46 Tara Keck
So I think that for something like the United Nations, what they're doing in countries that they're working in is working with governments, working with people so that everything is co-produced for what is right for that group of people.
00:34:57 Tara Keck
So they're there as enablers.
00:34:59 Simon Gaisford
Not dictators.
00:35:01 Tara Keck
Absolutely not.
00:35:02 Tara Keck
I mean, that doesn't work.
00:35:04 Tara Keck
And so in a lot of the work that we've done together with the UN, it's always co-produced with the population, right?
00:35:10 Tara Keck
And it's more, here's some information that I have or some expertise I have that might be helpful.
00:35:16 Tara Keck
How is it that I give that information to you and then support you in adapting it so that it works for your group?
00:35:21 Tara Keck
And so I think that that's very much the role that the UN is playing.
00:35:24 Tara Keck
So for something like social media, I mean, I'm not sure if they've weighed in on that.
00:35:28 Tara Keck
I'm going to guess not.
00:35:30 Tara Keck
But I think that there are things that we all need to be worried about with social media and things that it has pluses and minuses like all things.
00:35:38 Tara Keck
I guess I'm not sure if the United Nations has advised on social media to the government, but I think that they often do help look at policies and bring in experts and things along those lines.
00:35:50 Tara Keck
Governments obviously are doing that largely on their own as well.
00:35:53 Tara Keck
So I think that there are particular areas and countries.
00:35:55 Simon Gaisford
Right, a couple of things to wrap up then.
00:35:56 Simon Gaisford
So the future, at least as you see it for your own research, where are you heading research wise?
00:36:03 Tara Keck
So we have a couple of projects I'm really excited about, but I think that sort of the overarching bits is, we've been very focused on mental health and mental health intervention.
00:36:12 Tara Keck
So a huge risk factor for aging well and aging with dignity is addressing any mental health issues in youth and middle age.
00:36:21 Tara Keck
So if those go untreated and unmanaged, then we really, that's not gonna go well for aging.
00:36:28 Tara Keck
And so we've been doing a lot of projects related to this where we work in partnership with the UN and with governments and groups in the countries that we're working in to try and help develop mental health interventions that can be deployed sort of with medium-sized training.
00:36:48 Tara Keck
So we can train people for a month or two and then be able to actually provide mental health care.
00:36:52 Tara Keck
Because what we see is that the mental health crisis is global.
00:36:55 Tara Keck
It's increasing dramatically.
00:36:57 Tara Keck
There was a new paper in the Lancet I think today or this week talking about how actually it's, you know, especially in young people, it's increasing dramatically.
00:37:05 Tara Keck
And we just don't have anywhere close to enough mental health professionals.
00:37:09 Tara Keck
And so especially in low resource settings like rural areas in certain countries or countries that are lower in the socioeconomic, then you'd end up with just very, very few people to be able to support.
00:37:22 Tara Keck
So we're trying to look at this and figure out ways that we can create and build sort of infrastructure and foundations for people who can actually start to support people as they need it, without them needing to get four-year degrees.
00:37:36 Tara Keck
And of course, being able to go to a psychiatrist or a psychologist is a great option, but it's a privilege that is only available to a small number of people in the world.
00:37:45 Tara Keck
And so a lot of what we've been doing is looking at how do we work in partnership with communities to build community infrastructure, to have these types of supports in place that allow us to make all of these things that are good for your brain, so exercise, social interaction, taking care of your mental health easy, and make them sort of habitual.
00:38:06 Simon Gaisford
Okay.
00:38:07 Simon Gaisford
In terms of other research areas that you find interesting, I think you mentioned GLP-1, the class of GLP-1 drugs.
00:38:18 Simon Gaisford
Is that something that's interesting to you because of their effect on the most people think those drugs are interacting with your gut, but I believe there's also growing evidence they're interacting with your brain.
00:38:28 Tara Keck
Yeah, so I think the GLP-1s, which is basically Ozempic, for those of us who don't call them GLP-1s.
00:38:35 Tara Keck
So Ozempic, which is like, I mean, it's such a fascinating drug, right?
00:38:38 Tara Keck
Like it has been enormously effective.
00:38:41 Tara Keck
Everyone is talking about this.
00:38:42 Tara Keck
It's very popular.
00:38:43 Tara Keck
And yeah, so the way it works is it's thought to be a combination of things.
00:38:46 Tara Keck
So it does interact with your gut.
00:38:49 Tara Keck
It, I think, changes your insulin release as well and sort of smooths it out, which is what it started as.
00:38:54 Tara Keck
It started as a diabetes drug.
00:38:56 Tara Keck
But it also seems to have an effect on your brain.
00:38:58 Tara Keck
And what it's doing is sort of taking away the reward associated with eating.
00:39:01 Tara Keck
So it sort of makes you not quite as hungry all the time is the sort of effect that you feel.
00:39:08 Tara Keck
And we actually have a lot of people working on this in Life Sciences at the Centre for Cardiovascular Metabolic Neuroscience, in particular, Stefan Trapp and Dan Brierley in my department are very excited about this.
00:39:17 Tara Keck
They're in my building and I'm constantly asking them questions.
00:39:19 Tara Keck
So yeah, I think these are really exciting.
00:39:21 Tara Keck
But actually what I think is fascinating about this is that this drug has been so effective.
00:39:26 Tara Keck
It's really one of the better drugs we've had.
00:39:28 Tara Keck
Well, you can speak to this as the School of Pharmacy person, but
00:39:34 Tara Keck
But what we're seeing now is it's been a while that people have had them.
00:39:37 Tara Keck
You get to 18 months and everything flatlines.
00:39:40 Tara Keck
So you stop losing weight.
00:39:41 Tara Keck
And if you go off the drugs, your weight goes back to where it was more or less before you started taking it.
00:39:47 Tara Keck
So what I think is interesting about this is that this is really kind of one of the best options for drugs that we've seen and it's still not enough.
00:39:56 Tara Keck
And I think we have the new Alzheimer's drugs that came out in the last couple of months as well.
00:40:00 Tara Keck
And of course, those are great.
00:40:02 Tara Keck
It's a huge breakthrough.
00:40:04 Tara Keck
They are going to be beneficial.
00:40:06 Tara Keck
But if you take a drug, it's not going to, if you've gone through cognitive decline, and as we talked about, your synapses is changing.
00:40:11 Tara Keck
All your synapses have changed.
00:40:12 Tara Keck
It's not coming back to where it was before, right?
00:40:15 Tara Keck
So I think it's really driving home this idea that
00:40:18 Tara Keck
Medicine is an amazing tool.
00:40:20 Tara Keck
We are so lucky to have all of this, but we need to be thinking about sort of the societal element of it as well, right?
00:40:27 Tara Keck
So we need to be building things in communities that help people do healthy behaviours like exercise, like eating well, not smoking, socialising, all of these things that we know are important.
00:40:39 Tara Keck
We need to be, making that the default and making that easy.
00:40:44 Tara Keck
And it's not right now.
00:40:46 Tara Keck
And I think that, the drugs alone, everyone hopes that, oh, well, don't worry, it'll be fine.
00:40:52 Tara Keck
And you know, by the time I get to that age, I'll take the pill and it'll take care of me.
00:40:55 Tara Keck
And I think that's, I don't think scientists think that's the case, but I do worry that that's, you know, the hope of the general public.
00:41:02 Tara Keck
And so I think we really do need to think about this at a population level and encourage this type of thing.
00:41:06 Simon Gaisford
Yeah, it's a bit misguided, isn't it?
00:41:07 Simon Gaisford
I think the general public does view that as we'll just medicate our way out of the problem.
00:41:11 Simon Gaisford
And I think you're absolutely right that some of the newer drugs are a really good adjunct to other things such as healthy living.
00:41:21 Simon Gaisford
They are not a substitute for healthy living.
00:41:23 Tara Keck
They aren't and I think that where something like Ozempic can be really valuable is like if you're using that to take off weight and then that allows you to exercise more easily and then you can sort of slowly change your lifestyle, then it’s a wonderful tool.
00:41:34 Simon Gaisford
Then it's a win-win.
00:41:37 Simon Gaisford
I just finished reading The Magic Pill by Johann Hari.
00:41:41 Simon Gaisford
It's a really good book.
00:41:42 Simon Gaisford
That is all about, it's a very personal story by him actually of his journey for weight loss using Ozempic.
00:41:49 Simon Gaisford
And he then goes through, he goes and talks to various scientists and clinicians, Nova Nordisk.
00:41:56 Simon Gaisford
And he does touch on, you know, on a very personal level, some issues with drugs like that.
00:42:02 Simon Gaisford
And one that I was going to mention before we finish is it appears at least, and I've also been to talk to Stefan and Dan around the corner from your office.
00:42:11 Simon Gaisford
Yeah, and they were very clear that drugs like this, they're not just acting on your gut, they're also acting on the reward centre of your brain.
00:42:17 Simon Gaisford
We touched on this right at the start, but you know, positive reinforcement of something, eating in particular, you know, it's a reward.
00:42:24 Simon Gaisford
It's a reward system in your brain.
00:42:26 Simon Gaisford
And Ozempic seems to be dialing that reward.
00:42:29 Tara Keck
That's right.
00:42:30 Simon Gaisford
And so it does, it does then lead to some other interesting questions, and he does touch upon them in the book actually, about whether these GLP-1 drugs could be used with patients that are addicted to something else.
00:42:45 Simon Gaisford
That could be alcohol, it could be illicit drugs as well.
00:42:48 Simon Gaisford
It's not just food.
00:42:49 Simon Gaisford
I mean, it's a very, very dangerous route to go down and start putting overeating in the same category as being addicted to heroin, for instance.
00:42:58 Simon Gaisford
But nonetheless, the principle is it could be that they have other applications, not just for diet.
00:43:06 Tara Keck
Yeah, I think that's probably the case.
00:43:07 Tara Keck
And what we see with a lot of drugs in neuro is that I think that often they're originally developed for something else.
00:43:14 Tara Keck
And then we find out that, I mean, that there's a lot of that in drug discovery.
00:43:18 Tara Keck
So I think that I wouldn't be surprised if they end up being, you know, I think there's already some things they've seen in other organs where they're quite active at sort of reversing things.
00:43:27 Tara Keck
And so I think that they seem to be, it seems to be this kind of wonder drug and I do hope that some of it can be sustained.
00:43:34 Simon Gaisford
Yeah, absolutely.
00:43:35 Simon Gaisford
Okay, excellent.
00:43:36 Simon Gaisford
I think what we'll do is we'll finish because I did promise the listeners, I did promise that we would give them some top, when I say we, you'd give them some top tips of things they might do to try and keep their brain in a tip-top condition for as long as possible.
00:43:50 Tara Keck
Yes, so I think that the thing I would say is that you should exercise with your friends.
00:43:55 Simon Gaisford
Okay.
00:43:56 Tara Keck
I think that by doing that, you're sort of hitting two of your major risk factors all at once.
00:44:02 Tara Keck
So you've got both your socialisation and your cardiovascular?
00:44:05 Simon Gaisford
Yeah, that's a two for one whammy.
00:44:08 Tara Keck
I think you also get the advantage that if you're going to meet your friends, you're more likely to show up.
00:44:13 Simon Gaisford
Yeah, I know this myself.
00:44:17 Simon Gaisford
Sometimes I think I go to the gym before I come to work and it's just me.
00:44:21 Simon Gaisford
And so I quite frequently don't.
00:44:22 Tara Keck
Yes.
00:44:23 Tara Keck
No, and absolutely.
00:44:24 Tara Keck
This is 100% what I do in my life.
00:44:25 Tara Keck
My friends are at my gym.
00:44:26 Tara Keck
I will name them.
00:44:29 Tara Keck
So it's Christina, Daniela, Patty, Luke, and Drew.
00:44:33 Tara Keck
And we, you know, for me, there are many mornings when I get up and like you, I do not want to go to the gym because at least for me, running is not fun.
00:44:42 Tara Keck
I know people love it.
00:44:43 Tara Keck
I have run my whole life, but it's not fun.
00:44:46 Tara Keck
But I think of it as, okay, well, one, this person's waiting for me.
00:44:50 Tara Keck
And then I think of it as like, well, I'll just show up and socialise and talk to them.
00:44:53 Tara Keck
And so I'm meeting my friend and then I'm there in workout clothes and then the workout class starts.
00:44:57 Tara Keck
So of course I go in and then I've worked out.
00:44:58 Tara Keck
So I think that's really the key thing is that you want to think about these factors that are important for your health and really find ways to make them sort of automatic and easy to do.
00:45:09 Simon Gaisford
Yeah, and most gyms do run classes, don't they?
00:45:12 Simon Gaisford
And so you can go with like-minded people and you can make friends that way.
00:45:14 Simon Gaisford
I've seen that at my own gym, so that's very good.
00:45:17 Simon Gaisford
Diet, should people worry about diet?
00:45:20 Simon Gaisford
I'm presuming you're not advocating a diet that causes cardiovascular disease.
00:45:25 Tara Keck
That's right.
00:45:25 Tara Keck
I mean, I think you need to be sensible about your diet and eat…
00:45:30 Tara Keck
I think I'll take a word from Michael Pollan, who's written about this, like, eat real food, not too much.
00:45:37 Simon Gaisford
Absolutely.
00:45:38 Tara Keck
I mean, that's it.
00:45:39 Tara Keck
Like, and so I think that, you know, I would say from my point of view, like, one, if you're working out enough, then you can't eat that much bad food.
00:45:48 Tara Keck
Well, I guess it depends on how old you are.
00:45:49 Tara Keck
Once you reach a certain age, you can no longer eat really terrible food and continue to work out. Like, they are no longer compatible.
00:45:55 Simon Gaisford
Yeah, that's right, that's right.
00:45:57 Tara Keck
Maybe if you're 25, but
00:45:59 Tara Keck
But so I think that, I think it's something to pay attention to, but I don't think it's something worth fretting over.
00:46:03 Tara Keck
Like, as long as you're eating healthy food and, you aren't eating too much, then if you've, if you're still exercising and doing all of that, then I think that worrying about the details.
00:46:12 Tara Keck
I think people get worked up about the details. And that can cause paralysis.
00:46:17 Simon Gaisford
Absolutely.
00:46:17 Simon Gaisford
There's so much information out there and everyone seems to have a different opinion.
00:46:22 Simon Gaisford
I've just finished reading, other than The Magic Pill,
00:46:19 Simon Gaisford
Ultra-Processed People by our own UCL colleague, Chris van Tulleken.
00:46:29 Simon Gaisford
And that's also, that's kind of interesting.
00:46:31 Simon Gaisford
That makes you, it doesn't say don't eat things.
00:46:34 Simon Gaisford
It just makes me, anyway, stop and look at the food label before I start eating something.
00:46:39 Tara Keck
I think that's right. And I think that like, you know, I eat ice cream.
00:46:42 Tara Keck
I like ice cream.
00:46:43 Simon Gaisford
There’s a chapter in that book about ice cream.
00:46:45 Tara Keck
Yeah.
00:46:45 Tara Keck
And the thing is, it's like, okay, well, if there's certain things you like that aren't great for you, that's fine.
00:46:51 Tara Keck
Just if you actually aren't really, yeah, I think everything in moderation.
00:46:53 Tara Keck
But also if you aren't enjoying something in particular, then maybe cut that out.
00:46:55 Simon Gaisford
Yeah, absolutely.
00:46:56 Tara Keck
It's not that hard to take a quick look.
00:46:38 Tara Keck
And so I think that's it is, everything in moderation is probably.
00:47:02 Simon Gaisford
Yeah, and I imagine that a lot of people have eaten something comfort eating.
00:47:06 Simon Gaisford
So you go and buy a ready meal and eat something because it's comfort eating.
00:47:09 Simon Gaisford
And afterwards you feel awful.
00:47:00 Tara Keck
Yeah.
00:47:00 Simon Gaisford
And you feel awful because it's not nutritious.
00:47:12 Simon Gaisford
So yeah, that's quite so.
00:47:15 Simon Gaisford
We have at least recommended to our listeners a few books they should be reading.
00:47:17 Tara Keck
Yes, that's true.
00:47:17 Tara Keck
Yes.
00:47:18 Simon Gaisford
Well, that is absolutely excellent.
00:47:19 Simon Gaisford
Thank you, Tara.
00:47:20 Simon Gaisford
That was super interesting.
00:47:21 Simon Gaisford
I've learned loads of stuff.
00:47:23 Simon Gaisford
All right, excellent.
00:47:27 Tara Keck
Thank you very much for having me.
00:47:28 Simon Gaisford
You're welcome.
00:47:28 Simon Gaisford
Thank you.
