#236 ‒ Neurodegenerative disease: pathology, screening, and prevention | Kellyann Niotis, M.D.

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Kellyann Niotis is a neurologist specializing in risk reduction strategies for the prevention or slowing of neurodegenerative disorders. In this episode, Kellyann provides an overview of the various diseases associated with neurodegeneration, including, but not limited to, Alzheimer’s disease, Lewy body dementia, and Parkinson’s disease. She goes in-depth on Parkinson’s disease, explaining its pathology, role in movement capacity, very early warning signs, and the role of anxiety and sleep. Similarly, she provides an in-depth discussion of Alzheimer’s disease, including the latest in screening, genetics, and tools/strategies for prevention. She ties the discussion together by explaining the differences and commonalities among the various diseases of neurodegeneration and the potential causative triggers, and she highlights the importance of early screening, cognitive testing, and taking the proper steps to lowering the risk of disease.

We discuss:
0:00:00 - Intro
0:00:08 - Kellyann’s background, training, and interest in the brain
0:03:33 - A primer on neurodegeneration: different types, prevalences, interventions, and more
0:14:44 - Overview of Parkinson’s disease and neuromuscular disorders including ALS
0:16:26 - Parkinson’s disease: early signs, diagnosis, genetics, causative triggers, and more
0:31:12 - Interventions to delay or avoid Parkinson’s disease, and the role of sleep and anxiety
0:40:26 - The challenge of standardizing early interventions for Parkinson’s disease without a clear biomarker
0:49:22 - Alzheimer’s disease: pathophysiology and the role of the amyloid and tau proteins
0:53:16 - Can PET scans be informative for diagnosing Alzheimer’s disease?
0:59:28 - Tau accumulation in the brain, tau scans, serum biomarkers, and possible early detection of Alzheimer’s disease pathology
1:06:43 - Cognitive testing explained
1:18:55 - The challenge of identifying the stage of the disease and why drugs have not shown efficacy
1:22:23 - The association between hearing loss and dementia
1:26:39 - The relationship between oral health and neurodegenerative diseases
1:29:58 - Genetic risk for Alzheimer’s disease
1:39:17 - What one’s mitochondrial haplotype can reveal about their risk of neurodegenerative disease
1:43:23 - The positive impact of exercise on brain health
1:46:34 - High blood pressure as a risk factor
1:51:22 - Why women are disproportionately affected by Alzheimer’s disease
1:54:14 - Final takeaways: the future of understanding neurodegenerative disease and further reducing risk


The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 45 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).

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