Book Review: “Keep Sharp: Build a Better Brain at Any Age” by Dr. Sanjay Gupta

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Keep Sharp: Build a Better Brain at Any Age, By Sanjay Gupta, Simon & Schuster. 318 pp. $28

In his new book, “Keep Sharp: Build a Better Brain at Any Age,” Sanjay Gupta starts with bad news. About 47 million Americans have some evidence of preclinical Alzheimer’s disease, which means their brains show signs of adverse changes, but symptoms have not yet developed. By 2060, one new case of dementia will be diagnosed every four seconds.

Yet Gupta, who is CNN’s chief medical correspondent and a practicing neurosurgeon in Atlanta, is quick to tell readers that fear of dementia should not be the reason to read the book, which was published collaboratively with AARP. Instead, he writes, “it should be the knowledge that you can build a better brain at any age.”

“Keep Sharp” is largely a self-help book, but Gupta devotes the first 100 pages or so to the science of the brain (“what makes you you,” as he aptly puts it) and dementia.

At the outset, he takes care to distinguish between dementia, which is a broad condition of functional impairment from cognitive decline, and the specific form of dementia known as Alzheimer’s disease, which accounts for more than half the cases of dementia.

Gupta explores a number of explanations for “ways the brain begins to break.” Genetics are a possible factor, as are blood flow abnormalities in the brain, neurotoxins and metabolic disorders. As for the “amyloid cascade hypothesis” for Alzheimer’s disease, which dates back to 1907, when Aloysius Alzheimer first identified “senile plaques” in a woman’s brain during an autopsy, Gupta writes that scientists increasingly believe that the plaques aren’t the cause of Alzheimer’s disease but a consequence of it.

Gupta does some interesting myth busting. For instance, he assures us that dementia is not necessarily an inevitable consequence of old age, that older people can in fact learn new things, and that doing the daily crossword puzzle is fine but flexes only a portion of your brain.

The book’s main thrust is prevention. Put simply, Gupta writes, “clean living can slash your risk of developing a serious mind-destroying disorder, including Alzheimer’s disease, even if you carry genetic risk factors.” Because dementia takes root decades before it is diagnosed, the earlier you start your prevention regimen, the better. To that end, Gupta lays out a 12-week “sharp brain” program, consisting of exercise, healthful eating, a bedtime routine, sound sleep, relaxation, intentional socializing, yoga, even a gratitude journal. Similar advice has been dispensed in numerous other books, and packaging it as a 12-week program sounds attractive. Yet while all of Gupta’s recommendations are good general tips, the jury is still out on whether doing any of this will actually sharpen your brain, much less stave off dementia.

Gupta presents himself as a model, and as such he’s asking a lot of his readers. Somehow, he finds time every day to exercise for an hour and to meditate. He avoids red meat, seldom snacks and has dabbled in fasting, which has been shown in animal models to boost memory.

Still, the book’s exhortations are difficult to ignore. After reading Part 2 (“How Not to Lose Your Mind”), this reader, for one, headed straight to the bathroom and threw out all the Benadryl in the medicine cabinet, brushed and flossed, Googled “turmeric recipes,” ordered a bottle of L-serine, then scaled a couple of San Francisco hills.

Gupta’s ghostwriter is Kristin Loberg, an experienced hand at collaborating on health books, particularly those of the self-help variety. The writing is largely lucid and succinct, but repetitive in places. The reader is reminded multiple times that the seeds of dementia are planted decades before symptoms appear. Read that frightening fact once, and you’re put on notice. By the fifth time it feels like unnecessary bludgeoning.

Snappy acronyms are a time-honored tradition in the self-help genre. But Gupta’s S.H.A.R.P. dietary protocol is just plain silly. The connections between a letter and its action item are less than obvious – the “A” stands for “Add more Omega-3’s” to your diet. (For the record, a number of recent studies have cast doubt on the benefits of omega-3s.) Then there’s “P,” for “Plan meals ahead.” Your grandmother could have told you this.

The most recent scientific study cited in the book is from late 2019, well before the coronavirus pandemic hit. While the most recent dementia studies might be too new to include, it’s a shame the book doesn’t note the widespread concern over the lasting neurological effects on those who have gotten sick from the coronavirus. Of those who have recovered from covid-19, roughly 1 in 3 have had lingering neurological problems, according to Stat, a publication covering health news. Gupta has reported at length on covid-19 for CNN, but no mention of the pandemic appears in the book. That’s too bad because this signal event is unlikely to vanish from anyone’s memory, short-term or otherwise.

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Hafner is a journalist who frequently writes about health care. She hosts the weekly podcast “Our Mothers Ourselves.”