Neuroscientist Roberta Diaz Brinton, Ph.D., first became concerned about Alzheimer’s disease thirty years ago after realizing how severely it was affecting women in particular. Think about the following stats: Women make up nearly two-thirds of individuals with the brain disorder; startlingly, one in five of us could receive a diagnosis by the time we are 65; and by 2050, as many as 9 million women could develop the condition. The situation is even worse for African Americans, who have a two to three times greater risk of developing Alzheimer’s than non-Hispanic whites.
But when Brinton, the director of the Center for Innovation in Brain Science at the University of Arizona, went looking for answers (and whose work has long been supported by the Women’s Alzheimer’s Movement), she discovered that the current response to these statistics was, at best, unsatisfactory and, at worst, infuriating.
She said that she kept hearing that it was because women live longer than men. But the difference in our lifespan is only about 4.5 years. That doesn’t explain why our lifetime risk is two times higher.
It also doesn’t explain why some other difficulties with brain health affect women far more than men: Women are roughly twice as likely to experience depression than males are, twice as likely to acquire certain types of brain tumours, and three times more likely to experience headaches. We’re also considerably more likely to get a stroke and acquire an autoimmune condition like multiple sclerosis that damages the brain.
Participate in the discussion on brain health by watching the You & Your Brain web series, which was presented by Prevention, HealthyWomen, and the Women’s Alzheimer’s Movement.
Therefore, Brinton and a number of her international colleagues began concentrating on what may be happening in women’s brains specifically—other than aging and bad genes—to cause such greater rates of brain disease.
The solution became obvious. The average age of an Alzheimer’s diagnosis is between 72 and 75, according to Brinton. “We know that Alzheimer’s disease can take up to 20 years to develop prior to a diagnosis.” “It doesn’t take a math genius to figure out that the average age of menopause, which is 51, is reached when you remove 20 from the average age of an Alzheimer’s diagnosis.”
Since Brinton’s lightbulb moment, more study has produced convincing evidence that women’s brains are more susceptible to certain diseases than men’s. Every chronic disease is impacted by sex differences in our biologies, such as distinct chromosomes and hormones, according to Jill Goldstein, M.D., a professor of psychiatry and medicine at Harvard Medical School and the executive director of the Innovation Center on Sex Differences in Medicine. “Our gender also has expectations in terms of things like social roles and norms. If we pay attention to the significance of these distinctions, I am more encouraged than ever that we can have an impact on how we prevent and treat disease.
The good news is that scientists now know more than ever about how and why sex differences in the brain lead to disease vulnerability and what you can do to address it. According to Brinton, “the aging brain is dynamic—not it’s this linear decrease that most of us fear.” Additionally, you can strengthen your own brain by understanding the changes that the female brain goes through that may be linked to sickness.
What is the effects of estrogen on the brain?
Puberty, pregnancy, and perimenopause are the three major stages that have the most impact on how the female brain develops and changes. In addition, even though we often associate sex hormones with reproduction, Lisa Mosconi, Ph.D., director of the Women’s Brain Initiative (another WAM-funded project), and author of The XX Brain, explains that these hormones actually perform a variety of other functions that have nothing to do with reproduction and everything to do with how the brain uses energy.
Estrogen is the primary energy-production regulator for the female brain, maintaining the health and activity of brain cells as well as promoting activity in the parts of the brain involved in memory, attention, and planning. According to Mosconi, “We know that estrogen promotes the development of new connections between brain cells, which increases the brain’s resilience and adaptability.” It also acts as a neuroprotective hormone, protecting brain cells from damage.
Though testosterone levels in men rise after puberty, they remain comparatively constant until andropause, when they start to fall. (That might occur at any time, in a man’s 40s through 80s, or never.)
Contrarily, women have numerous peaks and troughs in estrogen levels as a result of their monthly cycles and pregnancy, as well as a sharp decline in the years before to menopause. The extent of this drop in estrogen around menopause “becomes a lot clearer if you regard estrogen as fuel for the brain rather than merely for making babies,” claims Mosconi.
According to Mosconi, changing hormones in the female brain hasten the aging process by weakening our neurons and making our brains more susceptible to disease and aging. For instance, Mosconi discovered 30% lower levels of brain energy when she examined brain scans of perimenopausal and postmenopausal women. It’s interesting to note that men of the same age exhibited little to no brain changes.
The brain uses a lot of glucose, which is its main fuel, in both men and women, according to Brinton. However, estrogen controls up to 25% of this glucose metabolism in women.
Every chronic disease is influenced by sex differences in our biologies.
According to Brinton, any disorder that impairs the brain’s capacity to absorb glucose from the blood vessels or turn that glucose into energy will have an effect on brain function. This explains why, as estrogen levels fall during perimenopause, women frequently experience cognitive deterioration (brain fog and memory lapses, anyone?). When your brain’s glucose metabolism slows down due to low estrogen levels, something even more serious begins to occur: your brain triggers a starving reaction.
The good news, according to Brinton, is that your brain begins drawing peripheral fat from your thighs and abdomen to provide you with this extra fuel source. The brain will actually begin to “eat” its own white matter for energy in the long run since it doesn’t like not getting enough glucose. (White matter contributes crucial connectivity, linking diverse brain regions into networks that carry out varied functions.)
According to Mosconi, this recently discovered diversity of estrogen’s protective effects on the brain may provide insight into why male and female brains age differently. Men between the ages of 40 and 60 typically have strong levels of brain energy, whereas menopause causes a noticeable reduction in brain energy in women.To be clear, not all females who have Alzheimer’s plaques will eventually develop dementia. We are attempting to comprehend this risk better.
The impact of the stress gap
Men’s and women’s brains react to stress in different ways, according to Cynthia Munro, Ph.D., an associate professor of psychiatry and behavioural sciences at Johns Hopkins University.
According to Jessica Caldwell, Ph.D., a neuro-psychologist specializing in sex-based brain research and the director of the Women’s Alzheimer’s Movement Prevention Center at Cleveland Clinic, other studies have suggested that men may be biologically better able than women to adapt their brain responses to chronic stress.
Men’s brains “seem to be able to adjust to the stressor in a way that allows them to function at a new set point in the face of prolonged stress,” according to Caldwell. “Women’s brains don’t do this, and it’s particularly awful for the hippocampus, which is important for memory, when stress is persistent and our bodies are signalling our brains that we’re constantly in fight-or-flight mode,” says the author.
According to Caldwell, this is because the hippocampal region of the brain has an abundance of glucocorticoid receptors, which make it highly susceptible to stress.This would further derange the brain’s response to stress and could worsen any cognitive issues you may already be dealing with.
We tend to suffer some types of pressures more than males do, at every age, so this is a major issue for women in particular, according to Caldwell. “Women are in the work/life/caring-for-children-and-elders/juggling-everything years from our mid-30s to our mid-40s, and that just so happens to be when perimenopause is pushing estrogen levels down as well.” A perfect storm that affects women but not males may stop the growth of new brain cells and even kill brain cells in the hippocampus.
Women in their 40s who reported greater stressors performed worse on a memory test than those who reported fewer stressors, according to Munro. We are aware that stress is unavoidable, she argues. But the research shows that we must practice maintaining our composure in the face of it.
Proven techniques for brain protection
According to Brinton, there is a paradigm change taking place in the way neuroscientists and medical professionals see the health of women’s brains. We need to take action to improve our brain health now rather than waiting until we are older and cognitively compromised to cure symptoms. In fact, according to recent population-based research, if people changed their lifestyles in significant ways, they may avoid roughly a third of all Alzheimer’s cases. Here are some things you can do in your 40s, 50s, and beyond to strengthen your brain. The best aspect is that you can start at any time.
Don’t disregard mental lapses.
According to Brinton, forgetfulness and brain fog may seem like typical symptoms of perimenopause, but they are actually crucial indicators that your brain is experiencing hormone changes. “These are indicators that there is a window of opportunity to put risk-reduction measures in place.”
You might be an excellent candidate for hormone replacement therapy, for instance (HRT). According to Brinton’s research, hormone therapy can lower the chance of Alzheimer’s development in women who are being treated for menopausal symptoms. “HRT is of no value when used after menopause, when the brain’s estrogen response mechanism has already been destroyed.”
Chow down the brain-healthy way.
According to Mosconi, the Mediterranean diet, which is high in fruits, vegetables, fish, nuts, legumes, and whole grains, is the way to go if you’re searching for a diet that has been proven to be good for the health of your brain. According to her research, 50-year-old women who followed this diet had brains that appeared five years younger than similar-aged women who ate a standard Western diet. Phytoestrogens, which function in the body somewhat like estrogen, are abundant in plant-based meals.
She adds that getting adequate fibre is crucial. According to Mosconi, “Fiber affects levels of sex hormone binding globulin [SHBG], which significantly affects estrogen.” Because fibre stabilizes blood sugar levels and enables glucose to reach the brain, fibrous vegetables are an excellent method to give your brain the glucose it needs. The vegetables with the highest levels of glucose and fibre are red beets, turnips, rutabagas, carrots, parsnips, and scallions.
Move your body.
Everyone can benefit from exercise as one of the best preventive measures against Alzheimer’s disease, however women seem to need it more than men do: When compared to women who are sedentary, physical activity is linked to a 30% reduction in Alzheimer’s risk in females under the age of 65, and a 20% risk reduction in females aged 65 to 70.
Not a big gym person? Brinton claims: Just make an effort to move more during the day. She utilizes the cheap stair stepper next to her desk for a short while every hour. Go for it, suggests Brinton, if you enjoy working out at a higher level of intensity. But bear in mind that even brief bursts of lower-intensity exercise spread throughout the day will raise your heart rate and improve blood supply to your brain, helping to maintain its health.
Rest your body and mind.
Brinton refers to sleep as the great brain elixir, yet studies reveal that women have more difficulty getting and staying asleep than males do. She claims that as you age, you need to provide more time for repair and healing, which takes place while you sleep.
So, heed the wise counsel you’ve previously received: Avoid daytime naps, limit your use of screens at night, develop a soothing sleep ritual, and spend time in natural light to control your circadian cycle. In addition, Brinton advises seeking professional assistance if you have difficulties falling asleep or don’t feel rested when you wake up.
Lighten your mental load.
The idea of “cognitive load,” or the amount of mental acrobatics that women engage in everyday to keep all the balls in the air, and its effects on our brains are just now being studied by female neuroscientists. It turns out that undertaking the majority of the household’s planning tasks—reserving doctor’s appointments, organising family vacations, and so forth—can result in cognitive issues in later life.
It’s beneficial to have some mental load, but when it becomes too much, says Caldwell, “you’ve got a potentially chronic stressor that’s extremely awful for your brain.” Tell the truth about what you can handle and what becomes too much. After that, cross some items off your list. What would you advise a friend who was carrying your amount of load, asks Caldwell?
You should pay attention to the health of your brain after all. Taking care of your brain is essential if you want to take care of yourself, as Brinton puts it: “The neuronal circuitry in your brain makes up who you are.” The most effective way to care for oneself is to safeguard your brain. So, while Brinton and her team look for solutions for everyone, take care of yourself.