Ernestine: The first thing that I tell all of my people: Age is nothing but a number, and that you can get fit. Jay: That's the voice of a well-muscled 87-year old. Ernestine Shepherd is here to demolish stereotypes about aging and to bear witness that having a healthy fit body, pumps up your chances for a healthy fit brain. Allison: Welcome to Defy Dementia, a podcast for anyone who has a brain. It's all about living in ways that keep your brain healthy and reduce your risk of dementia. Jay: Because dementia is not predestined by your genes. Genetics can play a role, but there are other risk factors like lack of exercise or poor sleep. Scientists think that these risk factors account for about 40% of dementia cases worldwide, dementia cases that could be prevented or delayed. Allison: And on today's show, exercise. It's one of the best ways to boost your brain health. Jay: I'm Jay Ingram. I'm a science author and broadcaster. I've been writing about and talking about dementia for nearly a quarter-century. Allison: And I'm Allison Sekuler, president and chief scientist for the Baycrest Academy for Research and Education, and the Center for Aging and Brain Health Innovation. Jay: Join us as we defy dementia. Allison: Because you're never too young or too old to take care of your brain. It's well established that exercise and physical activity are good for the body, but it might surprise you to know that they're also good for your brain, and I mean really good for your brain. Whether you're young or old, exercise can reduce your risk of dementia or delay its progression if there's already a diagnosis. Jay: We've got the very latest expert information on this for you. But first, let's hear from someone whose life experience in this area is unique. Allison: Ernestine Shepherd is a grandmother who lives in Baltimore, Maryland. She loves to sing in her church choir. She just turned 87 years old. And how do I put this? She is in much better shape than me, Jay, and most people. She made headlines in 2010 and 2011 when Guinness World Records named her the world's oldest competitive female bodybuilder. And Ernestine doesn't compete anymore. She's a trainer now. But if you Google her, you'll see a recent picture of her and you'll understand why she has earned the nickname, Granny Six-Pack. Welcome to Defy Dementia, Ernestine. Ernestine: Thank you. Thank you. How are you? Allison: I'm great, and it's so great to see you. I know you have said your dream is to meet Oprah. My dream is to meet you, and I'm so excited to have you here. Jay: And I'm getting caught up in this dream. So I will call you, Ernestine, not Granny Six-Pack. But we would like to know the story of how you got inspired to get into physical training seriously late in life. Ernestine: Late in life, after my sister had died from a brain aneurysm, I had promised her that I would really start becoming a bodybuilder and helping as many people as I can to live a healthy, happy, positive, confident lifestyle by first prayer, eating healthy, getting out, walking, and lifting weights. And this and that is what I have been doing all of these years from the age of 71 on up. Allison: That's amazing. So how did you and your sister end up getting into weightlifting of all things? And how did you end up in the Guinness Book of World Records? Ernestine: How I got into weightlifting was that she and I had gone to purchase bathing suits, and we put them on and we didn't look so good in them. So she said, "We've got to do something about this." And then the instructor told us we should start lifting weights, which we did, but I didn't lift as good as Velvet did. But then finally, Velvet, when she found out that she had the brain aneurysm and that she died right then and there. Well, I had to make that promise as I said to you, that I would continue what we started. So I didn't do it immediately. But then finally one day I went past a church and they were having a revival service. I went in there and all of a sudden, and I told you I love to sing, and it was a particular song that I love to sing. It was called, Here I Am Lord. That brought so much joy, and that made me think of the promise that I had made to Velvet. So I went back to my church, I prayed, and I got busy. I started training with a person by the name of Yohnnie Shambourger. He was the former Mr. Universe. And I trusted him and I worked out with him for approximately, I'd say, six months. And then we had our first show. And when we did the show, believe it or not, I came in first place and some of the other people who were in the show were much younger than me. They were in their 40s. And I came in first place, and then Yohnnie got a call from Rome, Guinness Book of World Records, and said they thought I was the oldest female competitive bodybuilder in the world, and they would like for me to come to Rome if it were so. They found out that it was true. And guess what? We went to Rome. I arrived in Rome on March the 16th, my sister Velvet's birthday. Allison: It's amazing how inspired you were by your sister and how she sort of spurred you onto action. And you don't know this, but you spurred me onto action. I have for many years been showing your picture whenever I give lectures on healthy aging, and how to break the stereotype of aging, and how it's possible to do things when you're older. So I show everyone the picture of you. There's a picture of you when you were 80 as a champion bodybuilder, and your story was so inspiring that you inspired me to go to the gym and to start weightlifting, learning to powerlift, learning Olympic lifts. So I'm wondering right now, what is your workout routine these days? What do you do these days? You're not competing anymore, I don't think, but what are you still doing? Ernestine: I'm not competing, but what I do, I go to the gym on Mondays. On Mondays, I work my chest and my biceps. And after I do that, I leave and go out and I walk after that class. But in between that, before I do my training, I'm training others. Then on Wednesday, I work my shoulders and my triceps. And then again, I get out and I walk. And after that, I train my class. The third day is on a Friday. I work back, then I do my legs. And that's how I divide up my workouts. I'm getting all my body parts in. And then again, as I mentioned, I train classes. I train them Monday, Wednesday, and Friday. Then we get out and we walk. You would say, "Well, how in the world can you do all of that?" But it's done because that is the joy of living a healthy, happy, positive, confident lifestyle. Allison: When you're walking, how many steps do you think you're walking each day? Ernestine: Well, each day I walk at least five to 10 miles each day, and it is a joy to do that. Jay: So you mentioned chest and biceps, shoulders and triceps, but your brain is an important body part too. Ernestine: Oh yes. Jay: How do you think your physical exercise has benefited your brain? Ernestine: Well, first of all, I would like to tell you this. After my husband died, I ended up with anxiety and depression. I found out that when I would go out and walk, all of that disappeared. When I lift weights, all of that disappears. But if I were to sit in the house and do absolutely nothing, don't you know that those two things would bother me? And I have an improved mood by doing all of this. And then to see that there others out there with the same thing that I have and to know that I'm helping them, that really is a wonderful blessing for me. Jay: What would you say, Ernestine, to people, and I think there are a lot of people like this, who think they're too old to start exercising. Ernestine: The first thing that I tell all of my people, age is nothing but a number and that you can get fit. Allison: I'm wondering people who are listening, who maybe are disabled or living with dementia, and they're thinking maybe exercise is not okay for them because they can't get out and walk 15,000 steps a day. What sort of message would you have for the people who are living with disabilities, living with dementia about exercising? Ernestine: Well, I would use that dementia the same way that I use being depressed. When they first start working out, it's a slow thing. It'll put you in a better mood because when you find that you can move your body and you know what you're doing, immediately you're in a better mood most likely. And then you get reduced risk of falls because you've got to think about everything that you're doing. Allison: You talked about reduced risk of falls, and one of the things I think that people don't necessarily understand is they think cardio, cardio, cardio. But what I love about you is you think weightlifting, weightlifting, weightlifting, and you do some cardio as well, obviously. But you mentioned the strength, and I just wonder if you can comment on whether you think people should be weightlifting or just walking. I mean, what's the advantage of the weightlifting part of it? Ernestine: Well, actually I think it should be both. I really do. When you are lifting weights, it's giving you the strength that you need to lift those weights. And then plus, it helps you to improve your memory because lifting and you have to think about what you're doing- Allison: Yep. Ernestine: ... because if I say, "Come on, we're going to do biceps," you've got to learn what those biceps are, and that'll improve your memory to know what a bicep is, what a tricep is, what legs are. All of that is so important. So yes, lifting weights will help with dementia. It really improves your memory. It really does. Allison: Thank you so much for joining us. Jay: Yes, thanks a lot, Ernestine. Ernestine: It's been a pleasure. It really has. Allison: Ernestine Shepherd is a trainer and bodybuilder. She lives in Baltimore, Maryland. Jay: Our next guest has been listening to Ernestine. Dr. Jennifer Heisz is director of the NeuroFitLab at McMaster University in Hamilton, Ontario. She's also an adjunct scientist at Baycrest Academy's Rotman Research Institute, and she is a pioneer in the study of how exercise impacts mental health and the risk of dementia. Jennifer is the author of Move The Body, Heal The Mind, a book that documents her journey from sedentary academic to accomplished triathlete, and it has some tips on getting fit. Welcome to Defy Dementia, Jennifer. What struck you about Ernestine Shepherd's interview? Jennifer: What an amazing woman. I think her vitality came across in just the way she spoke, her enthusiasm for exercise, her joy for exercise. I think one thing that really struck me was she had this bigger purpose for why she was exercising. It was her sister, and it was this commitment that she had made to her sister that kept motivating her consistently day in and day out. And we know that when it comes to exercising for brain health, consistency is key. Another thing that struck me about her interview was how scheduled she was. She had it all planned out: Monday, Wednesday, Friday. She knew exactly what she was doing, when she was doing, where she was doing it. And having these details figured out ahead of time is really important. Research shows that this helps take the guessing game out of it. It reduces the willpower we need to get exercising, and it helps us to stick with it over the long term. Allison: And you know I've been a huge Ernestine fan girl for a very long time. She clearly thinks that the exercise that she's doing is keeping her brain fit as well. And I'm wondering if you can talk a little bit about what the science actually says about the relationship between exercise and dementia risk. Jennifer: So exercise is one of the greatest modifiable risk factors against dementia. People who exercise earlier in life are less likely to develop dementia later in life. Those who have mild cognitive impairment, for example, can revert back to normal. And that reversion rate is more likely if they're regularly exercising. And for individuals who have a diagnosis of dementia, a regular consistent exercise program can help reduce the rate at which they decline. So keeping them healthier for longer so that they can engage with life. Allison: And you run a lab that's really focused right on the role of exercise in aging and dementia. Have there been any major findings that have come out of your lab at the NeuroFitLab that speak to this? Jennifer: So one of my favorite findings is related to sort of this counterpoint between genetic risk and physical activity. Now, when we think of dementia, we often think of it as sort of this biological disease that we have no control over. But the research we did in my lab really tests that. So we compared physical inactivity to genetic risk for dementia, and we found that physical inactivity can actually completely negate a healthy set of genes. And so you can't change your genes, but you can change your lifestyle. And this is so important, I think a very empowering message for people that just the simple act of moving the body can do a lot to protect your brain as you get older. There are so many amazing things that exercise does for the body and the brain. And we often think of the benefits of exercise for the body, for the heart, and really what's good for the heart is also good for the brain. Exercise increases brain blood flow, it also reduces blood pressure, which helps reduce dementia risk. Exercise also helps to reduce, when we contract our muscles, it reduces these things called myokines. Now, that's a pretty fancy word, but essentially it just means these chemical messengers that move from the muscles through the bloodstream across the blood brain barrier to the brain, and they report to this brain region called the hippocampus, which is critical for memory and is also devastated by Alzheimer's disease. And so when these chemical messengers get there, what they do is something really incredible. They promote the growth of brand new brain cells within that brain region, and that happens throughout the lifespan. And so they promote these growth of brand new brain cells, they improve memory, they fortify the structure there to protect the brain against dementia. Allison: So exercise is literally growing your brain. Jennifer: Exercise is growing your brain. Jay: I'd like to just go back quickly to the consistency in scheduling that struck you about Ernestine. And you said that it's possible if somebody has mild cognitive impairment that that can be lessened or even maybe moved in the other direction by exercise. But is it important that you already have been exercising to really get the benefits? Is it possible to cause your risk of dementia, say, to decline just by starting exercise at a late life? Jennifer: Yes. So it's never too late to start. This is the amazing result from research. In our lab, we've recruited sedentary older adults from the community, and within three months they see benefits to their memory from a regular exercise program. Just really amazing. And the reason why this works is because when we contract our muscles during exercise, they release these myokines which move through the blood to the brain and can stimulate a ton of growth within the brain that helps support memory and other cognitive functions. Allison: And one question I've always had is to what extent do you have to keep exercising to maintain those gains? Once you start and you get the gains back, do you have to now keep doing it forever? Or is there something that's more long-lasting? Jennifer: I think it's a forever thing. So unfortunately you have to do it, and this is the hard part. Allison: Well, fortunately. If it brings you joy, that's fortunately, right? Jennifer: Well, and so there's the trick is that we have to figure out what brings us joy in the way we move. And for some people like Ernestine, it's lifting weight. She loves that. It brings her a lot of joy. She loves walking as well, and she does that consistently. For other people, it's dancing. For other people, it's playing a sport. And so whichever way moves you to move more, that's the thing that you should be doing because that's what you'll be doing consistently for the rest of your life. Allison: And just following on that discussion, Jen, in terms of doing something that brings you joy, and it could be one thing or another, and Ernestine talked about, yes, it's mostly the weightlifting that brings her the joy, but she also does walking. And some people, as you know, may not be as able to lift those weights. Are all exercises equal? Jennifer: This is a great question. And originally there were guidelines around certain thresholds that people had to meet like 150 minutes per week. It turns out when it comes to brain health, you can get by with much less. And the research is showing that some movement, any movement is better than no movement. So just getting up off the couch and moving around the room, down the driveway around the block is better than just sitting there. So there is research showing that prolonged sitting can really do detrimental to the brain health because it increases blood pressure, which can eventually lead to small vessel disease and create conditions that could cause dementia, including vascular dementia as well as Alzheimer's disease. And just breaking up sedentary time can actually help counteract that risk, increase blood flow, and increase the vital nutrients that the brain needs to thrive. Allison: Like when your watch tells you every half an hour, "Stand up," time to stand up or something like that? Jennifer: Yeah. Jay: What do you do? Jennifer: So the research suggests every 30 minutes you should stand up and do a two-minute movement break. It doesn't have to be a vigorous run or jog, just moving around the room, going to get a glass of water. This is what I do. I have a timer, 25 minutes. I do intensive work for 25 minutes, and then I walk around the room, I do a stretching break. And you can notice that you can have focus longer throughout the day. And that's the blood flow infusing, especially the prefrontal cortex that helps us focus and think creatively. Jay: This is really great for us to hear because we're urging people who listen to the podcast to engage themselves mentally and try something new. It might be a puzzle, it might be music lessons. Now we're going to have to add, "But whatever you do, only do it for 25 minutes and take a five-minute break." Jennifer: Or do something that involves movement, right? Allison: Yeah. Jennifer: Try something new that involves movement. And so I think back to your point about what can people do that maybe have mobility limitations or haven't been moving much lately. So if walking is a possibility, there are tremendous benefits that people can get from walking, and this could be walking even with an assisted device. Also, really cool research related to the resistance training piece is around hand grip exercise. So people who may be confined to a wheelchair or have mobility limitations may not be able to get up and walk around. But a hand grip has been shown to reduce blood pressure, which helps to reduce dementia risk and increase brain blood flow, just simply squeezing this hand grip. And I think that's a really fascinating intro into exercise that can be done by anybody. Allison: One of the things we've heard in some of the other discussions around other risk factors is that doing the same thing over and over in one particular way isn't necessarily the best way to get the most benefits. And is that true also in exercise? If you just are walking at a consistent rate all the time and doing the same sort of path and so on, is that going to give you maximal benefits? Or are there ways that you can sort of tweak your routine a little bit that can improve the benefits? Jennifer: Yeah, exactly. So what happens when we start exercising is that the body adapts. So we think of exercise as this positive stressor. It's a physical stressor that in low doses actually causes the body to adapt to that new stress so that it can grow fitter and stronger. But the body grows fitter and stronger. And now, if you keep the intensity or duration of your exercise the same, you're not getting that good stress benefit. And so you have to pick up the pace. And so for people who are regular walkers, one great way that they can pick up the pace is through interval walking. And interval walking is simply you go out for your regular walk and intermittently you're picking up the pace. Now, you want to pick it up to the point where it's difficult to have a conversation. And this is called the talk test. So you go out for your walk, you can have a conversation with your walking partner or even yourself. Allison: So it could be a social activity too. There you go. Jennifer: It could be a social activity. And you want to pick up the pace to the point where you can say maybe a few words, but you can't get in a full sentence. And this is a good indication that you're above your lactate threshold. And new research is showing that lactate, we used to think of it as this villain. It used to be associated with the burnings- Allison: Burns. Jennifer: ... of the muscles, but it turns out it's the hero. And so lactate moves from the muscles, it's one of those myokines, moves from the muscles to the brain and stimulates brain-derived neurotrophic factor, which is like this miracle growth factor that supports the growth, function, and survival of brand new brain cells within the hippocampus. And the hippocampus is a key center for memory. It's also the one that's targeted by Alzheimer's disease. And so exercising has this fortifying effect right on the hippocampus. Allison: I think I smell a new marvel movie coming up like Captain Lactate. Jennifer: The Hero. Jay: Lacto Man. Jen, these are fantastic pieces of guidance and advice, but I suspect a lot of people for whom this is news may have a bit of inertia facing them. They'd like to get going, but they don't really know how. Other than listening to good advice, have you experienced that and have you found ways that you can get people to start moving? Jennifer: Yeah. It's actually a built-in brain thing, and it's a relic of our evolutionary past. This idea that the brain is actually wired to conserve energy, and any voluntary exercise or voluntary form of movement, the brain sees as an extravagant expense, and it tries to talk you out of doing it. And so I think understanding that that inertia will be there and respecting it, but knowing that it can be overcome. So simple things we can do to overcome that inertia. Ernestine talked about it in her podcast. She talked about scheduling. She has a very clear schedule about what she's doing, when she's doing, why. And this helps to take the thinking out of the moment, and that helps to reduce the willpower you need in the moment, saves it up for getting over that inertia. Another great tip is having a workout buddy. She talked about her sister. Initially when her sister was alive, they did it together. And then after her sister passed, that became her motivation. So having this partner, that social outlet, that's an important part. Doing things you enjoy doing, and then knowing that as soon as you start moving, the body will work with you. It's just getting over that initial hump. So once you start moving, and I've found this in my workouts, sometimes I'm just sitting on the couch, I'm like, "I'm too tired. I don't have any energy." But the funny thing is, once I start moving, I feel more energized and maybe I convinced myself, "Well, I'll just do 10 minutes today rather than the 30 I was supposed to do." But I would start out on my 10 minutes, and because I felt so good, I'd end up doing the 30 anyways. And so it's this virtuous cycle, it reinforces itself. Another really fun trick that is supported by science, it comes back to this energy theory, is actually if you swish a sugary drink in your mouth, it can actually help get you over that initial inertia. As you start working out, it feels less effortful. And the trick is you don't actually have to swallow it. You could just swish it around and spit it out. And the presence of sugar in the mouth is enough to convince the energy-conservative or lazy brain that resources are plenty and it's easier to move. I think just keeping in mind that every step counts and trying to move a little bit more every day. And it doesn't have to be a one hour at the gym, you don't have to be an Olympic weightlifter, you don't have to run a marathon to get the benefits of exercise, every step counts. Some is better than none. And I think having that as your mantra and knowing that if you move a little bit more today, you're going to be able to engage more with life later. And for a lot of people, that's a gift. It's a gift that exercise gives, and I think we just need to keep reminding people that that is a really special gift that it does give. Jay: Jennifer, this has been fantastic. So much good, healthy, really great advice for people listening to this. And actually, I'm glad in one way that the interview is coming to an end because I need to get up and move. I've been sitting here for too long. But thank you very much. It's been absolutely fantastic having you join us on Defy Dementia. Jennifer: Thank you so much for having me. Jay: Dr. Jennifer Heisz is an associate professor in the department of Kinesiology and director of the NeuroFitLab at McMaster University. She's also an adjunct scientist in Baycrest Academy's Rotman Research Institute. She is also the author of Move the Body, Heal the Mind, published by Mariner Books. Allison: So amazing conversations, Jay. What did you think? Jay: Both Ernestine and Jen said something the same in that consistency, but, as Ernestine did with her sister, having some kind of inspiration helps. And I think those two are so closely linked because in a way to do exercise for its ultimate benefit, you really have to do it. You can't just decide, "Maybe this afternoon if it's sunny." And that's where the inspiration comes in. And so I think those two help alleviate the inertia that people might feel. What did you think? Allison: I think inspiration and also passion. You need to do what really floats your boat. I mean, so for Ernestine, weightlifting is so critical for her, but she also does walk. For other people, walking or running might be more important. And so you really need to do what's going to keep you going, because if you're not sort of inherently interested in doing it, you're going to be less likely to continue it. To find out more about reducing the risk of dementia, please visit us at defydementia.org and check out other episodes of the podcast as well as our videos and infographics. Jay: Our podcast production team is Rosanne Aleong, Monique Cheng, Sylvain Dubroqua. Our Chase producer is Ben Schaub. Production is by PodText. Music is by Steve Dodd and cover art by Amanda Forbis and Wendy Tilby. Allison: And a big nod to the Public Health Agency of Canada who funded this podcast. Thank you very much. Please note that the views expressed here do not necessarily represent the views of the Public Health Agency of Canada. Jay: Your support is greatly appreciated. Speaking of physical activity, just mash down that subscribe button on Spotify, Apple Podcasts, Google Podcasts, or wherever you get your podcast. I'm Jay Ingram. Allison: And I'm Allison Sekuler. You don't want to miss our next episode of Defy Dementia. We'll be talking about everybody's favourite topic, food, how a diet of truly delicious brain healthy food can decrease your risk of dementia or slow it down.