192: Dr. Perlmutter: How to Protect Your Brain From Alzheimer's & Cognitive Decline

192: Dr. Perlmutter: How to Protect Your Brain From Alzheimer's & Cognitive Decline

August 20, 2026 · 1h 9m

About this episode

Dr. David Perlmutter discusses the influence of metabolic health on Alzheimer's risk and the role of microglia in brain health.

What if your risk of Alzheimer's isn't predetermined by your genes—but influenced by the metabolic health of your brain? My guest, Dr. David Perlmutter , is a board-certified neurologist, six-time New York Times bestselling author, and one of the world's leading voices on brain health and neurodegenerative disease. His latest work reveals a fascinating shift in how we understand Alzheimer's and Parkinson's: the role of the brain's own immune cells. At the center of our conversation are microglia —specialized immune cells that can either protect your neurons or contribute to inflammation and neurodegeneration. Dr. Perlmutter explains why their function is closely connected to metabolic health, and how insulin resistance, obesity, poor sleep, gut dysfunction, chronic inflammation, and environmental toxins may influence the way your brain ages. We also challenge the idea that carrying APOE4 means Alzheimer's is inevitable and examine research showing how lifestyle interventions can influence cognitive function—even later in life. In this episode, you'll learn: • How microglia can shift from "brain defenders" to drivers of neuroinflammation • Why metabolic health and insulin…

People in this episode

Host: Darshan Shah

Guest: Dr. David Perlmutter

Mentioned in this episode

Organizations: New York Times

Books & works: Alzheimer's, Parkinson's

More episodes of Extend Podcast with Darshan Shah, MD

Explore listener stats, chart rankings, contacts and more on the Extend Podcast with Darshan Shah, MD podcast page.