Interesting research is now being conducted on menopause, Alzheimer’s and mental health labeled ‘The Menopause Affect’. We now better understand what happens during menopause and why some women start menopause earlier or later than others. In all honesty, with a huge hole in the medical research regarding women’s health issues, menopause (symptoms, treatment and education) has been severely lacking up until this point. While women’s health issues haven’t received the time and attention as compared to men’s health issues, the good news is, a change is definitely underway.
We do know that menopause does not cause Alzheimer’s but menopause seems to present us with an incredibly important window of time in the fight. Since women predominantly represent the vast majority of Alzheimer’s cases, research is indicating that the ages of 40-60 could be the critical time for prevention.
In contrast to the brains of women in their 40s and 50s, brains of males in the same age group are not found to have aged significantly, and fewer have beta-amyloid plaques. One explanation is that testosterone, like estrogen, is neuroprotective—and levels of testosterone never drop as steeply or abruptly in andropause as estrogen's does in menopause. This difference might help explain why fewer men get the disease. Estrogen depletion at this time in a woman’s life changes the entire ecology of a woman’s body. It is easy to see how a complex array of factors might give rise to Alzheimer's and why taking control of and managing prevention with a healthy lifestyle is key.
In a 2016 study, 500 healthy post-menopausal women were separated into 3 different groups
1) women who had optimal metabolic health
2) women who had borderline high blood pressure issues/conditions
3) women who had borderline metabolic health issues/conditions
The research found that one group scored significantly lower on verbal memory tests; the women with borderline unhealthy metabolic health. Although they were still within a “normal range” their blood glucose levels were nearing the threshold of prediabetes. These findings highlight the significance and importance of a healthy lifestyle during menopause.
The importance of a healthy lifestyle, mind & body:
What determines your metabolic health? After a meal, insulin helps glucose enter the cells for use as energy. In someone with prediabetes or someone with a comprised metabolic health system, cells in the body start to resist insulin. When brain cells become resistant to insulin, they absorb glucose but fail to respond to it. This resistance coupled with the menopausal slowdown in glucose metabolism, can contribute to neurodegeneration. For many women in this transitional phase, prediabetes is a prelude to type 2 diabetes, which almost doubles Alzheimer's risk. More than 80 percent of Alzheimer's patients are insulin-resistant.
Sleep also plays a huge role in regulating your metabolism including regulating your insulin sensitivity. During a normal night’s sleep, glial cells flush out beta-amyloid and tau proteins. Sleep deprivation disrupts this process, causing the proteins to build up and form plaques, which lead to fragmented sleep, impairing glucose metabolism and accelerating the neurodegenerative processes.
Estrogen has a healthy effect on the cardiovascular system including raising “good HDL cholesterol and decreasing bad LDL cholesterol being vigilant at this time is key. Because of the decrease in estrogen during menopause, being aware of and carefully planning a training and nutrition program to regulate cholesterol is important.
Stress can also be the tipping point during menopause. A study found that stressors lasting a month or more for women in their 40-50’s led to a higher risk for Alzheimer’s. Another study found that depression nearly doubles the dementia risk. Incorporating physical training, meditation and relation
Prevention and what you can do
The gene APOE4 is the gene they are currently researching as the “Alzheimer’s gene”. This menopause hypothesis looks to explore how a decline in estrogen levels can make the brain vulnerable to future damage and why pre/peri/post menopause is such a pivotal time in a woman’s life to be committed to a healthy lifestyle.
What can you do?
It is important to note that researchers believe that carriers of this gene APOE4, do not have an Alzheimer’s sentence.
A significant number of Alzheimer’s patients also suffer from diabetes, obesity, poor diet and other risk factors that are preventable according to a 2017 report in the Lancet. The message being, you can’t change your chromosomal sex or age or your gene variant but you can change your metabolic health and thus your risk level.
Prevention is essential. The research recommendations include:
- a plant centered diet that is low in sugar and in trans fats
- physical exercise that is challenging and dynamic
- stress reduction
- nightly seven hours or more of beta and tau-cleaning sleep
I personally work with a lot of women in this age demographic and in addition to the above recommendations I would specifically add in:
1) Meditation: a well-researched management system for stress
2) Cold showers/training: research shows the cold training will boost your immunity and improve overall health
3) Intermittent fasting: I work with a lot of women (ranging in age from 20-80+) who I coach on how to incorporate intermittent fasting (or IF) into their lifestyle. An overwhelming amount of research suggests that fasting improves and in most cases reverses insulin resistance.
Pincott, Jena. “Menopause Predisposes a fifth of women to Alzheimer's.”Scientific American May 2020 Issue