Janet, 66. Came to me for memory concerns. But the symptom that worried me most had nothing to do with memory. "I can't smell anything anymore. My husband says dinner is burning and I have no idea." Most people write off smell loss. Allergies. Aging. COVID. But research published recently found that immune cells in the brain actively destroy smell-related nerve fibers in Alzheimer's disease. This damage begins before memory symptoms appear. Your olfactory system is the only sense that connects directly to the brain without passing through a relay station. It's the brain's most exposed nerve pathway. And it's often the first to show damage. What Janet's smell loss told me: Her brain's immune system was already activated. Microglia (the brain's cleanup crew) were attacking nerve fibers that detect odor. This same process eventually spreads to regions involved in memory and thinking. Smell loss didn't cause her Alzheimer's. But it was the canary in the coal mine. I ordered blood-based biomarkers. P-tau217 was elevated. We started an aggressive prevention protocol immediately. What this means for you: If you've gradually lost your sense of smell and it's not explained by allergies, sinus issues, or a recent infection, mention it to your doctor. It could be nothing. But it could be the earliest signal your brain is giving you. And the earlier we catch it, the more we can do. 📌 Follow Reza Hosseini Ghomi, MD, MSE for the warning signs most doctors overlook 💬 Have you noticed changes in your sense of smell? It's worth paying attention to. Citation: Meyer C., Early locus coeruleus noradrenergic axon loss drives olfactory dysfunction in Alzheimer’s disease, Nature Communications, 2025.

Richard, 67. Retired firefighter. He told me his memory was fine. His wife Linda had a different version. "He asks me the same question three times in an hour. He forgot our granddaughter's birthday party last month. He left the gas stove on overnight twice." Richard: "She exaggerates." This is the most common scene in my clinic. The patient says they're fine. The spouse is quietly terrified. And the spouse is almost always right. Why patients can't see their own decline: It's called anosognosia. Impaired self-awareness. And it's not denial. It's a neurological symptom. The same brain regions that are declining are the ones responsible for recognizing that something is wrong. The patient isn't lying. They genuinely believe they're fine. Their internal monitoring system is broken. This is why I always, always talk to the care partner separately. If I only listened to the patient, I would miss the diagnosis half the time. What I've learned from hundreds of these conversations: 1. The spouse noticed 1-3 years before the first appointment ↳ They waited because they hoped it was stress or aging ↳ They waited because the patient refused to come in ↳ They waited because they were scared of the answer 2. The first symptom is rarely overt memory ↳ It's personality change, lost initiative, poor judgment ↳ The spouse says "he's just not himself" before they say "he's forgetful" 3. The patient needs to be heard, not corrected ↳ Arguing with someone about their cognitive decline doesn't work ↳ I validate their experience and gently introduce the testing ↳ The data speaks for itself What happened with Richard: His testing showed moderate impairment in multiple domains. His MRI showed significant hippocampal atrophy. When I showed him the results, he got quiet. "I guess Linda was right." He wasn't angry. He was relieved. He'd been noticing things he couldn't explain and was scared to say it out loud. If someone you love seems different: Trust your instincts. You know them better than any doctor does.

When everything feels heavy, LEAN IN. Open up. Be raw. Cry, hurt, vent. Do that as much and as long as you want to. Do it until doing that becomes boring. And then...do something else. Write. Or paint or draw or act or sing. Build, invent, create, or dance. Speak, organize, teach, or lead. Do something about the heavy things in the world or about any area where you feel like adding something good. Just do SOMETHING. Do art. Do work. Do love. It doesn't matter what you call it. Just contribute in some way. In your way. This is how we move through the heaviness of life. It's how we make a difference on the outside and it's how we heal on the inside. Lean in. Then bring what you've got. And hey....thank you in advance for doing it. We need you. Have a beautiful week! I love you all, Jocelyn

The things outside of you are not as powerful as your mind believes. They do not ultimately control you. This doesn't mean they aren't influential. It means they don't have the final say in who you are, what you experience, or what you choose to do next. This is something I'm constantly reminding people (and myself.) But that's only part one. Part two is equally as important if not more important to understand. It's that you are much much much MORE powerful than your mind believes. You have so many options. So much control. So much more power than you realize. In any situation you have choices. In any circumstance you have power. You should be walking around feeling very excited about what's possible. Full of ideas about what you want to create in your life next. Lit up with desire about the life ahead of you. If your not feeling this way on the regular, your mind is just not seeing the truth. Mine forgets the truth too at times. And unfortunately this is the norm. Most people have it backwards. They think their life has to be great to believe it's possible to have a great life. So don't feel bad ...just decide to do something about it. Decide today to flip the script. If you need help..I'm here. Have a beautiful week! I love you all, Jocelyn