Dr. David Perlmutter has listed the five lifestyle choices he would never make after spending his career analyzing thousands of brains and Alzheimer’s scans.
The neurologist and author, who lost his own father to the disease, shared his warnings during a recent appearance on the Diary of a CEO podcast. Perlmutter, who describes himself as a “pioneering researcher,” has built his career around the argument that Alzheimer’s is “significantly preventable” despite widespread public belief that genetics alone determine fate. He emphasized that women face roughly double the risk of developing the condition compared to men.
“Alzheimer’s is the third leading cause of death in the US,” he claimed during the interview.
“The destiny of your brain is really based upon how you are choosing to live you life today,” Perlmutter said on the podcast. He has long promoted the framing that “genetics load the gun, lifestyle pulls the trigger.”
Topping his list of harmful habits is remaining sedentary. Perlmutter called the lack of physical movement a “huge” problem for cognitive function and ranked it as the single most damaging behavior for brain health.
“Exercise and movement is a multi-tool for the brain. It targets the function of insulin. It targets inflammation. It targets mitochondrial function. It targets blood flow. These are all hugely important mechanisms in keeping the brain healthy,” he explained on the podcast.
Social isolation claimed the second spot on his ranking. Perlmutter tied human connection directly to neurochemistry, explaining that relationships trigger oxytocin release in the brain. He described this hormone’s role in regulating microglial cells, the brain’s immune cells.
“When we connect to people and when we develop a relationship, our bodies, our brains, increase the output of a chemical called oxytocin. It’s called the love hormone,” he said during the interview. “And this oxytocin stimulates our good brain immune cells, these microglial cells, and helps keep them in their supportive, loving, nurturing role as opposed to letting them drift to becoming what I call the evil twin, increasing inflammation, increasing the destruction of our synapses.”
Non-restorative sleep ranked third among his concerns. Perlmutter stressed that quality sleep allows memory consolidation and REM cycles, plus activates what he termed the brain’s waste removal system.
“It allows activation of the glymphatic system that allows us to take out the garbage basically, which new research indicates happens when we move as well,” he noted on the podcast.
Poor diet, particularly sugar consumption, took the fourth position. Perlmutter urged that people “should do our best to avoid sugar” as part of Alzheimer’s prevention.
His final warning targeted a generational attitude rather than a specific behavior. Perlmutter cautioned that younger people should not count on future medical breakthroughs to shield them from dementia, but should instead take preventive action through their own daily choices now.