Last month we explored how to prevent Alzheimer’s and cognitive decline. This month, Dr. Talerico dives deeper into detection — specifically, what a standard neurological evaluation misses and why that gap matters.
Just as we get a colonoscopy at 50 to screen for colorectal cancer, Dr. Dale Bredesen recommends getting a “cognoscopy” at 45. Most people experiencing cognitive decline don’t seek help because they’ve been told nothing can be done — or they’ve watched loved ones go through standard medical protocols with little result. But the earlier the causes of cognitive decline are identified and corrected, the better the chance of avoiding Alzheimer’s and even mild cognitive impairment.
A typical neurological workup includes a brain MRI, CBC, CMP, thyroid panel, and B12. But according to Dr. Talerico, a truly comprehensive cognoscopy should also evaluate:
- Genetics — Beyond ApoE4, dozens of other genes can raise Alzheimer’s risk.
- Inflammatory markers — Chronic inflammation underlies Alzheimer’s, cardiovascular disease, cancer, and accelerated aging. Key markers include hs-CRP, albumin/globulin ratio, omega-6 to omega-3 ratio, IL-6, and TNF alpha.
- Viral or bacterial infections — These can be directly implicated in Alzheimer’s disease.
- Homocysteine levels — A marker of both inflammation and suboptimal nutrition.
- Toxic exposure — Mercury, copper, and zinc levels all matter for brain health.
- Fasting insulin — A critical marker for insulin resistance, diabetes, and Alzheimer’s risk.
- Microbiome status — Gut health is central to brain health and is best assessed through a stool test or a Wheat Zoomer/Leaky Gut test.
- Body Mass Index (BMI) — A BMI under 30 is considered optimal for brain health.
- Hormonal status — Vitamin D, thyroid, estrogen, progesterone, testosterone, cortisol, pregnenolone, and DHEA all play a role in cognitive function and are worth evaluating.
Together, these markers can reveal which synapse-destroying processes may be at work — long before memory loss becomes noticeable.