The #1 Habit Women Should Start to Lower Dementia Risk, According to a Neurologist

Reviewed by Dietitian Katey Davidson, M.Sc.FN, RD, CPT

Key Points

• Menopause influences brain health in women, increasing brain fog and decreasing other abilities.

• A neurologist and menopause researcher recommends exercise to improve cognitive function.

• She also recommends the Mediterranean diet, learning new things and socializing.

If you’re a menopausal woman, you’re probably well-acquainted with brain fog. And while the topic may have been brushed aside by friends, family and even medical professionals as just an inevitable part of aging, scientists are discovering that there’s more to it than that.

In a recent episode of Next Question with Katie Couric, Couric interviews Rhonda Voskuhl, M.D., professor of neurology at UCLA and founding neurologist of UCLA’s Comprehensive Menopause Program, about brain health during menopause.

Voskuhl explains that women’s bodies and brains are loaded with estrogen receptors, because in a woman’s body, estrogen is a good thing for skin, bones, heart and brain. But when estrogen takes a sudden nosedive—typically when a woman is in her early 50s—Voskuhl states that certain regions of the brain actually shrink. This is when you get what is commonly referred to as brain fog, or what Voskuhl refers to as cognitive domain–specific problems.

“[That includes] working memory, verbal memory, processing speed and train of thought,” says Voskuhl.

Voskuhl explains that when the brain is no longer receiving estrogen, it can trigger a kind of domino effect. “The cells in that memory area are not getting supported [by estrogen], and in turn, they’re not supporting those nerve cells that are making connections,” she explains. 

Some women take estrogen supplements for menopausal symptoms, like hot flashes, and that’s OK if it’s been recommended by your health care provider. But, Voskuhl explains, the type of estrogen prescribed for hot flashes is unlikely to help with brain fog, because different regions of the brain deal with temperature regulation (the hypothalamus) versus cognitive regulation (hippocampus and frontal cortex)—and this requires different types of estrogen.

“The problem is, we’re still talking about estradiol from 30 years ago,” says Voskuhl. “We need to have estrogens that will target brain health, [that] you can tolerate [and that] don’t have as much deleterious effect on clotting and breast and so forth.”

And while Voskuhl and her team are researching this topic and working on developing safe, brain-health estrogens, it could be years before they’re FDA-approved for the masses. She also notes that even if you don’t—or can’t—take estrogen, eventually, the hot flashes will go away on their own. The brain fog, however, ensues.

When challenged by Couric to discuss options for women who cannot take estrogen, Voskuhl offers one remedy in particular. “The best thing I think you can do is exercise,” says Voskuhl, who explains that exercise positively influences the three main types of cognitive-loss dementia: Alzheimer’s disease, vascular dementia and a mix of both. Voskuhl also notes an interesting fact that two-thirds of Alzheimer’s cases are in women.

“When you think about those three [types of dementia], it’s really important to exercise, because you can have an effect on your cardiovascular system,” says Voskuhl.

This effect on the cardiovascular system includes a lower risk of atherosclerosis, a major risk factor for heart disease and stroke. In simple terms, if your blood vessels aren’t clogged, more blood will get to the brain. Voskuhl considers this an indirect effect of exercise on the brain.

“A direct effect, though, on the brain that’s really cool with exercise is the brain [and muscles] make a factor—brain-derived neurotrophic factor—which is … protective for the brain,” says Voskuhl. “And so physical exercise can help the brain both indirectly through its effect on reducing cardiovascular issues, and directly through this factor for the brain. That’s really cool. So we need physical exercise.”

Brain-derived neurotrophic factor—BDNF—is an essential brain protein necessary for healthy cognition. There is evidence that exercise-induced BDNF may help your frontal cortex perform better.

Voskuhl explains that the type of physical exercise she’s referring to is cardiovascular exercise that gets your heart rate up—including cycling, brisk walking, jogging and swimming—and strength training. “Three times a week—30 minutes for cardiovascular—get your heart rate up,” says Voskuhl. “The other 30 minutes is weight lifting. And that’s good for bone [health].”

But physical exercise isn’t the only type of exercise Voskuhl recommends. She also recommends cognitive exercise—but not just any brain games. Voskuhl says to go for activities that challenge verbal memory, processing speed and concentration. And try learning new things, which also challenges the brain.

Of course, diet also plays an important role in brain health, and Voskuhl recommends a low-fat Mediterranean diet. The MIND diet, a fusion of the Mediterranean diet and the DASH diet, has been shown to support brain health by lowering inflammation and providing the brain and blood vessels with antioxidants, fiber and other nutrients that support their health. These diets are also lower in saturated fat and sodium, which are linked with poorer heart and brain health.

In the end, Voskuhl encourages menopausal women to not give up, but rather, take action. Exercise, eat well, try new things and be sure to engage with friends and family, Voskuhl advises. Making those changes can feel overwhelming, but it’s possible to take small steps to improve your health. Start with one cardio workout each week, like a walk with some jogging thrown in or a bike ride around your neighborhood. Consider taking a class at a community center to stimulate your brain, or making a new Mediterranean diet recipe each week.

Need a delicious place to start? We have some fun options for you.

Read the original article on EatingWell