The Ageless Brain: How to Sharpen and Protect Your Mind for a Lifetime

by Dale E. Bredesen, Robert Petkoff (narrator), Macmillan Audio (publisher)

From the bestselling author of The End of Alzheimer’s , Dr. Dale Bredesen, comes a revolutionary new approach to preventing the onset of neurodegenerative disease and creating sustained brain health.

In recent decades, advances in medicine have changed the way we think about our health. Chronic diseases like obesity, heart disease, and diabetes can be prevented or reversed. Cancer treatment has become targeted and personalized. Gene editing will allow us to eradicate many inherited disorders. But there is one class of conditions that continues to elude researchers and cause tremendous neurodegenerative disease.

More than six million Americans live with Alzheimer’s disease; by 2050, this number is projected to reach thirteen million. An additional one in ten people over the age of sixty-five have dementia, while 22 percent of older adults live with some form of cognitive impairment. And it isn’t just the elderly who are afflicted; diagnosis rates are rising in younger adults, with women at a higher risk than men. For many—especially those with a genetic predisposition—this fate has seemed inevitable. Until now.

Dr. Dale Bredesen is a pioneer in the field of neurodegenerative research. Lauded for his integrative protocol, he has, in clinical studies, reversed the symptoms of Alzheimer’s and dementia. He shared this information in his bestselling book, The End of Alzheimer’s. But Dr. Bredesen doesn’t want to only treat the symptoms of this devastating illness. He wants to prevent it from developing in the first place.

In The Ageless Brain, Dr. Bredesen will share the latest, cutting-edge science on neurodegeneration, including how misunderstandings of the disease have hindered our efforts to treat it, as well as a preventative program that listeners of all ages can put into practice to optimize their cognitive health now and sustain it for years to come. This is an audiobook for everyone who cares about their ability to stay sharp and independent for a lifetime, for those who have witnessed family members decline, and for the many listeners who are beginning to experience moments of brain fog or fatigue in middle age, and are concerned about what the future may hold.

Just as bestselling authors like Dr. Peter Attia and Dr. Michael Greger have offered essential guidance for maintaining overall health and longevity, Dr. Bredesen has written the only book you need to retain your vibrant mind—and thrive for a lifetime.

A Macmillan Audio production from Flatiron Books.

PLEASE When you purchase this title, the accompanying PDF will be available in your Audible Library along with the audio.

Genres: Health, Nonfiction, Self Help, Science, Neuroscience, Audiobook, Medicine

Audible Audio

Published March 25, 2025

About the author

Dale Bredesen, M.D., is internationally recognized as an expert in the mechanisms of neurodegenerative diseases such as Alzheimer’s disease. He graduated from Caltech, then earned his M.D. from Duke University Medical Center in Durham, North Carolina. He served as chief resident in neurology at the University of California, San Francisco (UCSF) before joining Nobel laureate Stanley Prusiner’s laboratory at UCSF as an NIH postdoctoral fellow. He held faculty positions at UCSF, UCLA, and the University of California, San Diego. Dr. Bredesen directed the Program on Aging at the Burnham Institute before coming to the Buck Institute in 1998 as its founding president and CEO. He is the chief medical officer of MPI Cognition.

Reviews

[Ginger Hudock · Rating 5 out of 5]

As a health professional (nutritionist) I have read about Dr. Bredesen's research on Alzheimer's disease and the possibility of reversing it. This book explains the known factors that contribute to neurogentive diseases such as poor diet, diabetes, heart disease, obesity, toxins and stress. The chapter on diet explains his recommended nutritional protocol which is a plant heavy, mildly ketogenic diet. I have seen this type of diet improve many health conditions in my nutrition practice. Chapters are also included on exercise, detoxification, brain training, and the importance of a healthy gut.
This would be an excellent reference for those interested in a preventative approach to their health. People who have already been diagnosed with cognitive decline may learn some things from this book, but would likely need a health coach to fully implement the recommendations included. As someone who hopes to live to a healthy aged 100, I agree with Dr. Bredesden's assertion that "we should not wait for cognitive decline before we do something about it". This book is a worthy addition to the general literature on a critical topic to health in America.
I received an advanced copy from the publisher via NetGalley.

[Taylor TenBrock · Rating 2 out of 5]

I think this book could have been conveyed in half the number of pages and still get the same point across. I enjoyed the discussion of various molecular biology processes that go into brain health but not much about this approach seems too novel to me. In summary: eliminate sugar, low-carb mildly ketogenic diet, track health for metabolic syndrome, move your body with emphasis of HIIT and strength training, avoid infections, sleep 8-10 with focus on adequate REM, avoid alcohol. I did find it interesting that he recommended screening for cognitive decline at the age of mid-30s. Overall, somewhat good reminders with some added suggestions but it didn’t excite me too much.

[SaraFair · Rating 5 out of 5]

A family predisposition for dementia is a scary thought. Caring for a loved one can create a fear of seeing the same condition elsewhere in the future of the family. In The Ageless Brain, author Dale E. Bredesen explains the science behind preventing and stopping this group of cognitive disorders. He begins with quite a few pages of anecdotes describing those approaching and passing the age of 100, yet having brains that are still as sharp as they were many years ago. The stories are so hopeful, as well as the stories of patients that have started a new protocol to try and avoid the mental pain of their ancestors. There is a lot of science here but its well explained and brought down to earth so it’s understandable. Bredesen gives ways to measure cognitive decline in our body before we actually notice it and pointers to work toward lowering the reasons for that decline. This information should be read by everyone.

[Micaelly Cabral · Rating 3 out of 5]

This book is a solid read, however it had too many issues for me to give it above 3 stars. I also happened to read this right after reading Outlive by Peter Attaia, which I recommend well above this one and the concepts are the same.

As a neuroscientist myself who studies Alzheimer's disease, some concepts in this book really bothered me. The author starts by claiming he has found a method / program to reverse the damage caused by Alzheimer's disease and criticizes other physicians for not using his "proven method". The issue with this is: if only ONE doctor found this method to be effective - many others have probably tried and found it to be ineffective, which is why it's not a hot topic and also why it's probably not true. Additionally, the loss of memory itself is not a process that can be undone. Once you lose a particular memory, it is entirely gone. A memory is quite literally a pattern of neural connections that activate your neurons in a particular way in reference to each other, so that when you remember any particular thing that same pattern activates again and changes it slightly to add connections that allow you to perceive that memory as something that happened in the past or information that you already knew without altering your present day reality. In other words, a memory is formed based on the pattern of connections of your neurons of when that memory occurred, combining your senses and your emotions at that time. With that in mind, dementia causes memory loss by a multitude of factors including by killing off neurons and breaking those connections. Once that pattern is broken you can't restore that particular memory.

So the author claims that with his treatment method he can REVERSE dementia, which is not true because the very nature of what a memory is would not allow that. Now, several of the things mentioned in the book have been linked to decrease the development and progression of dementia in many instances. So it is good advice to take care of diet, exercise, sleep, etc.

All in all, this book isn't bad per say but the author is very biased towards his own personal research. Again, if you want to read this one, I would recommend Outlive instead - same concepts but better grasp on current and relevant scientific findings. Outlive has also been reviewed by many scientists specialized in specific areas of research mentioned in the book.


EDIT: Do not read Outlive by Peter Attia as he has been found to share over 1700 emails with Epstein including deeply disturbing messages.

[Laura · Rating 5 out of 5]

In The Ageless Brain, Dr. Dale Bredesen explains a new paradigm concerning how the healthcare system can more effectively detect and treat Alzheimer's disease and improve overall age-related cognitive outcomes. He describes how many environmental and lifestyle factors can contribute to cognitive decline and how early detection and action can result in longer, healthier lifespans. The Ageless Brain challenges the conventional knowledge of dementia and Alzheimer's and is a worthwhile read for anyone interested in living a long, healthy life.

[Weston Gardner · Rating 5 out of 5]

Absorbing and instructive. Dr. Bredesen has done it again. This is a great book for anyone who wants to protect their brain or anyone who cares about how the brain works!

[Jung]

In "The Ageless Brain", Dr. Dale Bredesen presents a compelling argument that challenges the widely accepted belief that cognitive decline is an unavoidable part of aging. Through personal case studies, clinical research, and evidence-based strategies, he offers a roadmap for not only preventing mental deterioration but potentially reversing early signs of cognitive impairment. Bredesen's central thesis is rooted in a simple but radical premise: aging doesn’t have to mean losing your mental clarity, and with the right interventions, you can retain sharpness well into your later years.

Bredesen introduces this concept by describing common instances of forgetfulness — misplacing keys, losing track of conversations, forgetting why you walked into a room. Many brush off these moments as typical signs of aging, but he cautions that these small lapses might be early signs of more serious issues like Alzheimer’s. He shares the story of Nina, a woman in her forties who began experiencing forgetfulness and later scored below average on a standard cognitive assessment. Despite her relatively young age, her symptoms, combined with a family history of Alzheimer's, suggested an alarming early onset of cognitive decline. However, through the strategies Bredesen outlines in the book, cases like Nina’s can often be stabilized or improved.

One of the major points Bredesen emphasizes is the need to abandon the passive attitude that many people adopt toward brain health. He argues that the earlier people begin proactive efforts, the better the results. Cognitive decline, though increasingly common, is not a natural or inevitable part of aging. Instead, it is often the result of a confluence of factors — including poor diet, chronic inflammation, lack of exercise, toxin exposure, stress, and inadequate sleep — that, over time, chip away at mental acuity. Bredesen's message is empowering: individuals have far more control over their cognitive future than they might think.

A foundational step in this process is testing. Bredesen recommends a wide range of assessments, including cognitive tests like the MoCA (Montreal Cognitive Assessment) and SLUMS, along with blood tests for biomarkers associated with neurodegeneration. These include glucose metabolism, GFAP (which measures brain inflammation), and homocysteine, among others. Such tests don’t directly assess brain function in a visible way but provide critical insight into systemic factors that influence cognitive health. By identifying imbalances early, individuals can make the necessary changes before noticeable decline occurs. Bredesen even notes that many of these tests are surprisingly affordable, especially when weighed against the long-term costs of cognitive illness.

Diet plays a pivotal role in brain health, and Bredesen offers specific dietary recommendations aimed at supporting mental clarity. He advocates for a mildly ketogenic, plant-forward eating plan that is rich in fiber, phytonutrients, healthy fats, and low in sugar and simple carbs. Cruciferous vegetables, low-mercury fish, nuts, and berries are all encouraged, while grains, dairy, and ultra-processed foods should be minimized or avoided. He also stresses the importance of timing meals to optimize sleep and metabolic processes, suggesting that eating within three hours of bedtime be avoided. Importantly, he doesn’t present these changes as all-or-nothing. Progress is encouraged through gradual shifts in eating habits, not perfection.

In tandem with diet, exercise is another cornerstone of the program. Regular aerobic activity, strength training, and even high-intensity interval workouts are all recommended to support both physical and cognitive function. Bredesen adds depth to this by introducing less commonly discussed techniques, like blood flow restriction training and exercise with oxygen therapy, which have shown promise in enhancing brain resilience. He acknowledges that time is a barrier for many, but also challenges readers to reevaluate how they prioritize their health. More than just a way to burn calories, exercise enhances sleep quality, reduces inflammation, and improves mood — all of which contribute to a more robust brain.

Sleep, too, is a non-negotiable component of cognitive vitality. While the conventional wisdom around aiming for 7 to 8 hours per night still holds, Bredesen provides more nuanced guidelines: the brain needs at least an hour of deep sleep and 1.5 hours of REM sleep per night for optimal restoration. Poor sleep isn’t just an annoyance — it’s a red flag for cognitive decline. He recommends simple sleep hygiene practices, like limiting screen use before bed and maintaining a consistent sleep schedule. Getting sleep right is just as important as diet and exercise, and improvements in this area often yield quick and noticeable benefits.

Beyond physical health, Bredesen dives into the psychological and social dimensions of brain wellness. He introduces the concept of neuroplasticity — the brain’s ability to rewire itself — and suggests that continual learning and novel experiences are vital to maintaining mental agility. To that end, he proposes a regimen of cognitive challenges: small daily activities, like puzzles or exploring new environments; medium monthly tasks, like learning new recipes or reading different genres; and large annual goals, such as learning a new language. These tasks aren’t just hobbies — they’re exercises designed to stimulate different brain regions and maintain cognitive flexibility.

Social interaction, often overlooked in discussions of brain health, receives significant attention in Bredesen’s framework. Engaging with others forces the brain to process a multitude of stimuli — facial expressions, emotional cues, verbal and nonverbal communication — all of which foster neurological agility. Interestingly, he even points out that interactions with strangers offer particular benefits because they involve more cognitive processing than familiar conversations. Bredesen argues that being open to new viewpoints and maintaining diverse social connections protects against cognitive rigidity and may even help prevent memory distortion and ideological bias — phenomena often observed in later-stage dementia patients.

One of the strengths of "The Ageless Brain" is its holistic approach. Rather than offering a single miracle cure or magic supplement, Bredesen outlines a multifaceted program grounded in systems thinking. He encourages readers to treat the brain not as an isolated organ, but as a part of a complex, dynamic system influenced by lifestyle, environment, biology, and psychology. His emphasis on personal agency and early intervention runs throughout the book, reinforcing the idea that cognitive decline is not a mystery or a foregone conclusion, but rather a condition with identifiable causes and actionable solutions.

The book closes on an optimistic note. Though cognitive decline may seem like a distant or inevitable problem, the truth is that it can start much earlier than we think — often in our twenties or thirties. Yet with consistent effort, people of all ages can take meaningful steps to safeguard their brains. This might include making better food choices, prioritizing sleep, scheduling workouts, stimulating the mind through challenges, or simply spending more time talking with loved ones. The path to a sharper mind doesn’t require dramatic change overnight, just sustained attention and intention.

Ultimately, "The Ageless Brain" is more than just a guide to mental fitness; it's a call to reimagine how we approach aging itself. Bredesen argues that our brains are capable of far more than we give them credit for, and with the right inputs, we can enjoy a life that is not only longer, but richer, more connected, and mentally vibrant. His message is clear and hopeful: take care of your brain now, and it will take care of you for decades to come.

[Allan Reyes · Rating 3 out of 5]

This was an informative book with important and useful information on how to take care of our brains. In summary:

1. Eat a healthy diet consisting of mostly plant-based foods, and fasting for 12 hours or more between dinner and breakfast.
2. Exercise. Both aerobic and strength workouts.
3. Reduce stress. Or at least, release stress daily.
4. Sleep well (7-8 hours), with at least 1.5 hrs of REM and at least 1 hour of deep sleep.
5. Actively use your brain by learning new things, challenging yourself, and maintaining social connections.

I'm giving it three stars for two reasons.

First, the book is longer than it needs to be though (which I understand it has to be in order to be sold as one). It could've been a series of blog posts, and convey the same information.

And second, it sometimes contradicts itself. For example, the author says to avoid eating tuna because of its high concentration of mercury. But, then, when talking about vitamin D, he says good sources include tuna. The same happens with dairy. He says we should avoid dairy, and yet mentions yogurt multiple times as a source of different kinds of vitamins, and probiotics. It's confusing, and removes some credibility as to what should be avoided or not.

[Books · Rating 2 out of 5]

Rea_5-10% decent. A lot of fluff and sporadic case studies. Not much substance. It doesn’t bring anything to the old advice: exercise, eat well, sleep well, follow common sense and don’t do anything crazy. Take supplements here and there and hope for the best. Dementia is still incurable in my book and the percentage that is “preventable” isn’t clear or well defined in research so far.

[Jwt Jan50 · Rating 5 out of 5]

This is actually 10* out of 5. Yes, there are style issues. Yes, some of it you're going to have to research. But, you should read this book. You should take notes. You should make the effort to change your habits. Even if you only get 85% or 50%, you'll still be better off. The alternatives are not good.

[Beth Bryant · Rating 4 out of 5]

The tremendously important message of this book gets a full 5 stars! Regardless of what we usually hear, there are doctors who are helping people reverse cognitive decline! For anyone who has either experienced cognitive decline or watched a loved one go through it, that is really good news. And not only is that possible, it is possible to prevent cognitive decline through many of the same approaches that Dr. Bredesen has documented in his earlier books about how to survive Alzheimer’s. One of my best friends is living proof that his protocol can lead to a reversal of early Alzheimer’s. He talks about Sally in his chapter about sleep.

The earlier we get started on prevention, the greater our chances are of never experiencing cognitive decline, even when we have a genetic vulnerability to it.

I had to give the book four stars though, because I think the editor only gets three stars. The content is so important, but the book was longer and more repetitive than it needed to be. If you want to learn about Dr. Bredesen, and the success his patients have had, I suggest you read one of his earlier books first. Or start with his website. https://www.apollohealthco.com

[Natalie · Rating 3 out of 5]

3.5/5⭐️

[Stories&Sarah · Rating 4 out of 5]

Great books with lots of actionable information for maintaining brain health. I like that the author kept the book engaging with lots of stories.

[Bryan · Rating 3 out of 5]

Overall I was waiting to be blew away by some medical research or insights that I would not have easily accessed given most latest information in doctors and research was mazed into layers upon layers of papers and things waiting approval. But that moment came and went, as the author only offered little insights into cutting edge discoveries that were finally delivered in moments when I was barely able to pay attention anymore.

The over arching theme of the book was more about how to live a healthy life and that in turn actually leads to key factors in brain health. So it was useful read. And I also did not find the author was trying to defend themselves or their method from the general medical public that has been trying to distance themselves from his unproven claims. I didn't find major upsell of any unproven claims here. But at the same time, I didn't find anything mind blowing either. A good doctor, and an easy read, and live healthy and start now before the brain deteriorates, was the main take away.

[Justin Tapp · Rating 3 out of 5]

The Ageless Brain by Dale E. Bredesen, M.D.

I received an advanced copy of The Ageless Brain from Flatiron Books via Netgalley with the expectation, but not the requirement, that I write a review. (I’m a little late to publish it because I had a newborn in the meantime.) Some of the content may not have been complete (I noted a few tables missing at the end). My opinions are my own.

I previously reviewed Bredesen’s The First Survivors of Alzheimer’s and have listened to many podcast interviews from 2020-2024 with Bredesen and others whom he has trained or similar practitioners in the field such as the two Dr. Sherzais, David Perlmutter, Ben Bikman, and Valter Longo as well as the complete audio recordings from Perlmutter’s Alzheimer’s: The Science of Prevention, where Bredesen is one in about 30 neurologists, nutritionists, and psychologists who focus on brain health and Alzheimer’s who were featured.

I’m the ideal audience for the book, a 45 year old who is active and health-conscious with a genetic predisposition and family history, at a crossroads of deciding what commitment I need or want to delay cognitive decline as long as possible. I am an APOE 3/4 watching my mother struggle in the relatively early days of Alzheimer’s while her older brother is in an advanced memory care facility. However, I’m also skeptical, allergic to phrases like “reversing Alzheimer’s” or telling people that Alzheimer’s is “completely preventable,” as Bredesen does in at least one podcast. There are 443 citations of scientific articles and studies in the citations (about 25% of the book), suggesting he certainly is aware of his critics who say he’s not doing medicine or scientific work anymore.

The premise of the book is Bredesen’s personal quest to get to age 100 or more with perfect cognition. Inspired by his dad, He writes as though he would feel like a failure if he cannot achieve that goal and that he feels a certain responsibility for seeing similar results in those patients he is treating. The Ageless Brain presents the latest science behind nutrition, fasting, insulin resistance, sleep, brain training, brain plasticity, exercise, and mitigating exposure to various toxins (and mycotoxins). It is similar to the second half of Survivors where Bredesen lays out the latest science that is behind his PreCODE and ReCODE protocols.

The author also writes about the latest research that may pay dividends in the decades to come. He has an optimism about continued research, technology, cleaning the environment, etc. which I now find naive given the billions in cuts in federal funding to universities for research of all types by HHS this year, including funds and canceling grants to those labs responsible for some of the research cited in the book, not to mention cuts at the EPA and deregulation that will encourage more polluting and less clean water.

Anyone looking for a quick read or lists of tests and diets won’t find it in Bredesen’s books, you have to read the whole narrative, make notes, and piece it together for yourself. I did that in time for my annual physical and included my notes in the tests. For a simple example to assist you, here’s a list I compiled from tests Bredesen recommends in various places in the book:

Annually:
fasting glucose
hemoglobin A1C
fasting insulin
Apo B (Apolipoprotein B-100)
hs-CRP High sensitivity C-reactive protein
homocysteine test


Every five years after age 35 he recommends these, which his employer Apollo Health offers as BrainScan:
GFAP - (glial fibrillary acidic protein)
p-tau 217 (or p-tau 181 instead)
NfL neurofilament light chain

For everyone with the APOE4 allele he recommends these along with a MoCA (or similar) cognitive exam every five years, unless symptoms begin to develop sooner.

(The final chapter of the book also adds a skin test that can be used to determine risk of several other chronic diseases.)

Bredesen also mentions the progress of some of his patients that he’s studied, whose stories were included in Survivors, as well as his lament over specific individuals whom he was unable to help.

I find his books paradoxical because Bredsen tells the reader upfront that his protocols are difficult. But he challenges the reader with (paraphrase) “How bad do you want to live?” He doubles down that those in Gen Z “will never even have cause to worry…we now know how to prevent cognitive decline and dementia in virtually everyone” (loc. 83), but this belies the fact that the steps to preventing your Alzheimer’s may be quite complicated and hard to unlock and that you’d better start soon – “there’s been a 373% increase in diagnoses for those between 30 and 44.”

The good: You’ll learn a lot about the latest in health and nutrition science related to dementia and chronic disease.

The bad: You’ll often be left with more questions than answers. How do I test for what toxins in my body, much less how to cleanse from them? Of all of these foods and supplements, how do I determine which is most beneficial for me, particularly if I’m already showing signs? The answer as far as what I’ve found is basically that you can pay his company Apollo Health for monthly updates, they’ll process your bloodwork and send you adjustments to your supplements based on their algorithm. To his credit, this book does not advertise those services.

Bredesen writes that Alzheimer’s is purely preventable without large caveats that there are certain things that may be beyond your control that make it very difficult. Whatever you’ve done in the decades before you read this book may show up to haunt you, including what your parents fed you and exposed you to as a child.

He writes that even those with advanced Alzheimer’s have seen improvement in their symptoms by following his prescribed protocols. However, reading the r/Alzheimers forum on Reddit and observing first hand those with mild cognitive impairment (MCI), and reading the testimonies he presents in his Survivors of Alzheimer’s, it’s not the average joe who is able to see true “reversal.” It’s only highly-motivated people who are in good (largely excellent) physical shape, have not had many emotional traumas (or have had good therapy to overcome it), were fortunate enough to avoid cancer and chronic disease, have excellent support from close family and friends, and –crucially– are highly-motivated to do the research and experiment with different combinations of activities and supplements. Also, they’d better still be able to do physical activities like weightlifting and other strenuous exercises.

It also helps if you can afford to sell your house and move away from any toxins or pollutants. (Good luck to people in places like New Delhi and Manila.) Bredsen writes that he knows this will not be a reality for everyone, but every little bit helps. “I’m not convinced that most people are ever in a position to completely eradicate the most common sources of biotoxic exposure. We can, however, be more thoughtful…” (loc. 3613).

Another problem I have with several of these practitioners is they write like getting a continuous glucose monitor (GCM) is relatively cheap or easy. Ask anyone with Type 1 diabetes about the difficulty of getting insurance to cover the components every time their monitor has a mandatory update– it’s a monopoly/scam that doesn’t appear to go away anytime soon.

In all, I have to give this book three stars. As you can see from many of the reviews of Bredesen’s book, people are looking for a playbook of “exactly how” instead of “why.” It provided a lot of useful information for me, but I also don’t like the glib way that Bredesen can admit following the protocols require intense dedication and enormous sacrifices while saying “but anyone can do it.” I agree with folks like the Drs. Sharzai who see Alzheimer’s through a public health lens– there are a lot of vulnerable populations at a disadvantage for implementing such radical changes to save their brains that go unlooked.

[Jorge DeFlon · Rating 5 out of 5]

Another interesting book about how to stay healthy for as long as possible. This time with a special emphasis on brain health. Easy to read, although in some sections it uses medical terms most of us aren't familiar with. Still, it's considered worth reading for anyone interested in their own health, that of their loved ones, or society in general.

[David · Rating 5 out of 5]

This is a very hopeful, and I would argue must-read book on brain health. Many families have been told that if one of their members suffers from Alzheimer's there is little that can be done. Dr. Bredesen emphatically states throughout the book that this is not the case. In fact, he argues that in many cases the damage done by Alzheimer's, dementia and Parkinson's disease can be reversed. I was very surprised and encouraged by the arguments he makes through the book and the cases he discusses.

"The Ageless Brain" is not fluff by a longshot. I had been expecting more of a self-help book (which this is) but it is closer to a medical paper, at least for non-doctors. I found that I could only read at most, two chapters a day. This is not a complaint; I appreciate the thoroughness. But it is a dense book and I doubt anyone could read it in one sitting, even at 300 pages long.

The "answers" are somewhat what you might expect: good sleep, good diet, exercise. But even here Bredesen goes into great detail as to how each of these factors can affect brain health. Beyond that there is a rather dizzying discussion of toxins, microbes, peptides, hormones, etc. that may come into play when it comes to preventing dementia and like illnesses. But, as the author states, you don't have to do everything at once. It is a great book in its depth, but also in the hope that it can give so many families. I hope that a lot of people read it.

[Deanna · Rating 2 out of 5]

I was excited about this book and looking forward to reading it. Then I started reading it. Yawn.

There is no new information here. It is the same info that we get from heath magazines: exercise, don’t eat junk food, don’t smoke or drink, take a class, solve puzzles, get good sleep. Problematically, unlike heath magazines, this book blinds you with science. The text is a stumbling block of acronyms, parentheses, and unpronounceable words. For example, from the first chapter we get: p-tau 217, SCI, MCI, MoCA, ADLs, panspermia hypotheses, antagonistic pleiotropy, and “metabolic activators that included L-serine, nicotinamide riboside, N-acetyl-L-cysteine, and L-carnitine tartrate.”

I believe there is useful information sandwiched somewhere within these mind-numbing sentences but I am unwilling to mine for it. It feels like more of an attempt to impress the reader with the author’s knowledge than a genuine attempt to reach the average reader who wants to preserve their mental functioning. I made it to chapter three and gave up due to the very real possibility that the book was actually killing my brain cells. If your brain is ready to plow through this, you don’t need the book.

[Barb Hildebrandt · Rating 5 out of 5]

Very informative. Enjoyed medical information in layman's terms.

[Alexandria · Rating 2 out of 5]

Just do everything right and your mind will live forever.
of course, exercise, good diet, sleep, will all help, always good to get pumped and motivated to make healthy changes, but then it diverts into highly specific things and some up and coming possible things, include specific testing, proteins, etc etc etc .... and you lost me. who is going to be able to do all that extra stuff? I even found myself thinking of looking more into some of the proteins, but let's be real, it's still being studied and there wasn't any studies to back it up except in rats..... ridiculous.
I do really enjoy health books and was getting worried about my mind, but this wasn't very helpful, too much inaccessible (and not fully studied) information.
I listened to the audiobook, so I also was not able and did not verify any of the citations (if those were included)

[Porsha · Rating 5 out of 5]

This is five stars because I learned so much, however if you are not rich, a lot of this is not applicable. I will start doing what I can afford to do though.

[Jill · Rating 5 out of 5]

Everyone with a brain should read this book! It has necessary life giving information about living a healthy life for adults of ALL ages, not just those in their latter years. Do your older self a favor and learn about the things Dr. Bredesen talks about in this book!

[Jonica Pagnucco · Rating 5 out of 5]

Some good updates since “The End of Alzheimer’s” was published. Will be tweaking my work ups and supplement recommendations a bit further. Great resource.

[Gretchen · Rating 5 out of 5]

I believe this is a ‘must read’ for anyone who may have loved ones who are having cognitive issues.
I read it in 2 days and took pages of notes.

[Peter McCluskey · Rating 4 out of 5]

As expected, The Ageless Brain repeats a good deal of information from Bredesen's prior groundbreaking books about Alzheimer's. Maybe 10% of the book seemed like ideas that I hadn't seen elsewhere.

This time, he's focused a bit more on cognitive decline in people who are young enough to not be at much risk yet for full-fledged Alzheimer's. But that doesn't create much of a difference in his advice for brain health.

It continues the trend of his books being increasingly about improving general health, rather than avoiding a specific disease. More than his prior books, it prioritizes lifestyle improvements over detecting problems.

I see a good deal of variation in the quality of his advice, but nearly all of it is worth trying if your risk seems high.

Exercise has a great risk / reward ratio, and is backed by RCTs.

Bredesen has gotten pretty ambitious about pushing exercise (recommending more of it than does exercise nut Peter Attia!). I exercise more, and more regularly, than do most people, but I'm not going to manage to do as much as Bredesen suggests as long as my mind continues to function well above average levels.

Other suggestions are more poorly supported:

media sources that tell people how to think and encourage them to believe that people who are not exactly like them are wrong (or even "evil") are robbing their consumers of the cognitive challenge of adjusting their ideas and expectations of others over time. That may be why highly partisan people (on any part of the political spectrum) are more likely to suffer from faulty memories, struggle with perception of reality, and difficulty distinguishing fact from fiction. [16]

I expect there's some sort of correlation there, but I don't see a serious attempt to figure out how the causality works here. Avoiding partisanship seems like advice that has a great risk / reward ratio, but I'm unclear on whether preventing cognitive decline is an important part of why we should adopt it.

The book has a frustrating chapter on why the mainstream medical establishment hasn't adopted Bredesen's approach. It's about half right. I wish he'd written less on this topic.

At least one third of the problem is that there's almost no way to fund impressive studies of treatments that aren't protected by patents. There's at least a book worth of additional problems that could be written about what's wrong with the medical establishment, but Bredesen doesn't seem like the right person to write that book.

Note that the establishment hasn't completely ignored Bredesen's ideas: Back when Bredesen's first book was published, the Alzheimer's Association website said that Alzheimer's "cannot be prevented, cured or even slowed." Now it says:

evidence is strong that people can reduce their risk by making key lifestyle changes, including participating in regular activity and maintaining good heart health. Based on this research, the Alzheimer's Association offers 10 Healthy Habits for Your Brain — a collection of tips that can reduce the risk of cognitive decline.

That's a watered-down version of Bredesen's message, presumably aiming at people who are only conscientious enough to follow a small fraction of Bredesen's advice.

Most people should read Bredesen's The End of Alzheimer's first, and only read both if you're at significant risk of cognitive decline.

[Paul · Rating 5 out of 5]

For many years, a diagnosis of Alzheimer’s Disease or other types of dementia has been a death sentence (go home and enjoy the time you have left; there is nothing that medical science can do). The author of this book strongly disagrees with that assertion.

In this book are many examples of people who have been able to slow, or stop, the progression of mental decline. How did they do it? Here are some recommendations. Greatly decrease, or eliminate, your consumption of sugar. Greatly increase your consumption of fresh fruits and vegetables (organic, if possible). Get a good night’s sleep every night (at least 7 hours). Start exercising; strength training and High Intensity Interval Training are preferred. The best kind of exercise is that which you will do consistently, without even thinking about it. Your preferred exercise could be jogging, swimming, pickleball or golf. Strengthen your mental muscle by, for instance, learning a new language or learning how to play a musical instrument. There are many free online college courses on a myriad of subjects; try one and see if you like it.

Important Note: Do not wait until symptoms of mental decline appear before adopting any of these recommendations. Start them today, and maybe keep the symptoms away, permanently. There are many other possible causes of mental decline, including toxins in the air, lead water pipes, volatile organic compounds (VOC), pesticides and microplastics (which seem to be everywhere). The book contains a long list of things to check at your next blood test, and supplements to take to slow the onset of symptoms. Don’t try to do all of them; pick a few at a time, then add to it.

For some people, the information in this book will be common knowledge. For others, this book will be a revelation. Any information that can slow the spread of Alzheimer’s Disease through society without expensive drugs or surgery is highly recommended. This is highly recommended.

[Lorena · Rating 4 out of 5]

Neurologist Dale Bredesen MD is known for his work with Alzheimer’s patients. In The Ageless Brain, he expands upon his previous work, discussing ways to measure and improve cognitive health. His promise is that if we start protecting our cognitive health early enough, we can avoid neurodegenerative conditions such as Alzheimer's disease, ALS, Lewy body disease, and Parkinson's disease.

I appreciated Bredesen’s discussion of the simple things we can do to improve our health, such as eating a nutrient-dense, mildly ketogenic diet; maintaining insulin sensitivity and balancing blood sugar; exercising; getting enough quality sleep; and learning new skills. The anecdotes he shared were inspiring and suggest how implementing his program might look for different people.

The text is too technical for most laypeople in a few sections, but I think most of the book will be understandable for the target audience. The tests that Bredesen recommends are generally not covered by insurance and will be prohibitively expensive for many people. Trying to diagnose and treat chronic infections, heavy metals, and toxins may also be prohibitively expensive. I hope that these tests and treatments will eventually become more widely accessible.

The back matter includes acknowledgments, notes, and an index.

I was provided an ARC through NetGalley. I volunteered to provide an honest review. The ARC did not include any of the tables, which I would have liked to be able to review.

[Kim · Rating 5 out of 5]

Dr. Dale Bredesen's "The Ageless Brain" was filled with an incredible amount of information, depth, and was very helpful! The book and research entails Dr. Bredesen's approach to living fully and as healthy as one can, to achieve a brain capacity of 100 years old. He bases his entire book on a rigorous amount of scientific information and studies, and I appreciated the detailed explanation of the various factors that contribute to cognitive decline. The book contains various methods of testing and protocols for treatment interventions that can help anyone in trying to improve their cognition and maintain brain health. Everything from diet and exercise to advanced testing and interventions is contained in this book. I found this to be quite thorough, and I appreciated it being rooted in science and quality testing. The book's foundational message, that a proactive process towards brain health and caring for this most important organ in your body, is both achievable and exciting to read! This book will fill you with hope that even if you have a possible genetic predisposition, there are steps you can take to protect cognitive future.
I highly recommend this book to all. The principles and guidelines would be helpful for anyone at any age, and empowers you to control those variables that you can actively control. Thank you for NetGalley and FlatIron books for the advanced review copy. All opinions are my own.

[HollyWHITE · Rating 5 out of 5]

Keeping My Mind Sharp — Lessons from Grandma

I just finished reading *The Ageless Brain*, and it really struck a chord with me. I’ve always wanted to keep my mind sharp for as long as I live, because even a little brain fog feels unbearable to me. This book gave me practical insights, but it also opened up something I didn’t expect—it helped me see my grandma in a new light.
She’s 73 now, and while reading, I started wondering if she had an “ageless brain.” To my surprise, she absolutely does. Her memory is so vivid, and the stories she shared with me were filled with detail and emotion.
She told me about her childhood, when she lost both her father and her eldest sister to starvation. She recalled the tragedy of losing her first son to drowning, and how helpless she felt when no one nearby could swim well enough to save him. She shared how, while pregnant with her second son, she was chased by government officials, and how she was almost arrested for daring to reveal the unfair things they did.
Listening to her, I realized her sharp mind isn’t just about memory—it’s about resilience. She has carried pain, loss, and hardship, but she has never lost her clarity. That makes me admire her even more.
Reading the book gave me tools, but listening to my grandma gave me inspiration. If she can keep her mind this sharp after everything she has lived through, then I want to take care of mine with the same determination.

[Crystal King · Rating 4 out of 5]

As someone with a family history of Alzheimer's, both in my own lineage and my husband's, Dale Bredesen's "The Ageless Brain" was both fascinating and deeply helpful. It's clear that Bredesen's approach is rooted in rigorous science, and I appreciated the detailed explanation of the various factors that contribute to cognitive decline. While the book outlines a comprehensive protocol—covering everything from diet and exercise to advanced testing and interventions—I found it a bit overwhelming at times. The sheer volume of information and the potential financial commitment for some of the recommended tests might be a barrier for many. However, the book's core message, that proactive brain health is achievable, is incredibly empowering. I found the anecdotes particularly inspiring, and they gave me hope that even with a genetic predisposition, there are steps I can take to protect my cognitive future. While I might not implement every aspect of Bredesen's program, the book has given me a much clearer understanding of what I can do, and that's invaluable. For anyone concerned about neurodegenerative diseases, especially those with a family history, this book is a worthwhile, though demanding, read.