Alzheimer’s Breakthrough with Dr. Josh Helman, MD
Aug 6, 2026 · 1 hr 8 min · 12 segments
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Josh HelmanHost
So along those lines, though, when we're talking about the brain, it is super complex.

And I love the fact that you talk about humility because, sure, we can understand it.

But you also described how when you were initially studying histology slides of patients or people's brains, you were like, how in the world can we learn everything about someone's someone's brain or or function just from a slide that you look under a microscope
yeah absolutely and i think this is kind of really driven by still this is still makes a huge part of what what is done in neurology and in neuroscience and you know i do some of this stuff in my lab too don't get me wrong like it we do get important information from this but Most of you historically, most of neuroscience was describing what you saw on a dead slice of brain under the microscope.
And the majority of neurology was just describing what was wrong with the patient using fancy words.
Those two things together actually tell you very, very little about the brain of that person, what it was and what it did before life, if we're looking at their brain under a slide.
And still, we struggle with this idea of... connecting pathology, proteins that accumulate in the brain, changes in blood vessels, changes in other cells in the brain to the thing that actually we care about, which is that person and how they think and feel and interact and engage with the world.
But I think we're missing some information in terms of, you know, well, let's also take in more, more about who they are as a person, how they eat, how they move, how they engage in the world and what their environment was now or is now and what it was when they were growing up.
Because actually, once we start to piece all those things together, I think we get a much better idea of what it is that's really contributing a significant chunk to people's brain health today and then long term into the future.

And that's what I love about your background is you have both a medical degree and a PhD in neurosciences.
Really, I think the answer is no, the way that most people would think about it.
There are some individuals who, through some combination of genetics and other things, may have a very high likelihood of experiencing significant decline in dementia.
We don't understand all dementias yet, which then means that we can't fully intervene either to prevent or treat them.
But when you look even at historical data, going back into the mid 20th century, when they first started to look at people and measure their cognitive function regularly over time in the same individual, the majority of adults seem to maintain function into their late 70s or 80s.

So along those lines, though, when we're talking about the brain, it is super complex.

And I love the fact that you talk about humility because, sure, we can understand it.

But you also described how when you were initially studying histology slides of patients or people's brains, you were like, how in the world can we learn everything about someone's someone's brain or or function just from a slide that you look under a microscope
yeah absolutely and i think this is kind of really driven by still this is still makes a huge part of what what is done in neurology and in neuroscience and you know i do some of this stuff in my lab too don't get me wrong like it we do get important information from this but Most of you historically, most of neuroscience was describing what you saw on a dead slice of brain under the microscope.
And the majority of neurology was just describing what was wrong with the patient using fancy words.
Those two things together actually tell you very, very little about the brain of that person, what it was and what it did before life, if we're looking at their brain under a slide.
And still, we struggle with this idea of... connecting pathology, proteins that accumulate in the brain, changes in blood vessels, changes in other cells in the brain to the thing that actually we care about, which is that person and how they think and feel and interact and engage with the world.
But I think we're missing some information in terms of, you know, well, let's also take in more, more about who they are as a person, how they eat, how they move, how they engage in the world and what their environment was now or is now and what it was when they were growing up.
Because actually, once we start to piece all those things together, I think we get a much better idea of what it is that's really contributing a significant chunk to people's brain health today and then long term into the future.

And that's what I love about your background is you have both a medical degree and a PhD in neurosciences.
Really, I think the answer is no, the way that most people would think about it.
There are some individuals who, through some combination of genetics and other things, may have a very high likelihood of experiencing significant decline in dementia.
We don't understand all dementias yet, which then means that we can't fully intervene either to prevent or treat them.
But when you look even at historical data, going back into the mid 20th century, when they first started to look at people and measure their cognitive function regularly over time in the same individual, the majority of adults seem to maintain function into their late 70s or 80s.
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