7 Ways to Protect Your Brain Health as You Age
It's important for everyone to keep up with healthy habits as you get older. Taking care of your physical and mental well-being can help keep your body and joints functioning for longer, maintain bone health and muscle strength, reduce frailty, and even lessen the risk of certain health conditions, like type 2 diabetes and heart disease. A little TLC can also protect your brain health—which, it turns out, is especially important for women.
While women are at lower risk than men for many conditions like heart disease and lung cancer, they actually experience much higher rates of dementia, including Alzheimer's disease (AD). 'At this point, about two thirds of the people who have Alzheimer's disease are women,' Jessica Caldwell, PhD, director of the Women's Alzheimer's Movement Prevention and Research Center at the Cleveland Clinic Lou Ruvo Center for Brain Health, tells SELF. On top of that, research suggests that women with AD also tend to decline faster than men.
Research into sex-related differences in the development of Alzheimer's is relatively new. But 'there's a growing consensus and understanding that for females, the risks associated with developing late-onset cognitive decline are certainly unique and different from their male counterparts,' Michael Rosenbloom, MD, a board-certified neurologist at the UW Medicine Memory and Brain Wellness Center and director of clinical trials at the UW Alzheimer's Disease Research Center, tells SELF.
We spoke to experts to learn the factors that put women at greater risk for Alzheimer's—and, most importantly, what you can start doing today to keep your brain healthy.
Initially, doctors thought women were diagnosed with Alzheimer's more often simply because they lived longer on average than men—and perhaps were also more likely to see a doctor for their symptoms, Dr. Rosenbloom says. 'But now we know it's more than that, and that it's probably some combination of biological factors and cultural or social factors,' Elizabeth Bevins, MD, PhD, a neurologist at UC San Diego Health who focuses on memory disorders and neurodegenerative disease, tells SELF. 'We still don't fully understand it.'
One big factor seems to be the fluctuations in estrogen that occur with perimenopause and menopause. While we often think of estrogen as simply a sex hormone, 'the fact is that estrogen is active throughout our body, as well as in our brain,' Dr. Caldwell says. Estrogen supports the health and longevity of brain cells, Dr. Caldwell says, as well as the development of new neural pathways—which is how we learn new things. There's also evidence that estrogen influences key neurotransmitters like serotonin and dopamine (which help regulate things like mood, motivation, and body functions), as well as improves connectivity between brain regions, Dr. Rosenbloom adds. And estrogen seems to be especially active in an area called the hippocampus, Dr. Caldwell says—the part of your brain most involved in memory.
When women start menopause, their bodies and brains have to calibrate to the sharp drop in estrogen, Dr. Caldwell explains. 'For some women, that appears to be quite hard on memory.' Many people experience lapses in memory, brain fog, or trouble finding words, Dr. Rosenbloom says. Plus, the decline in estrogen can lead to issues like depression and insomnia, which can also impact your cognition, Dr. Bevins adds.
Some research suggests that women who start menopause earlier and/or start menstruating later are at higher risk for Alzheimer's—presumably because they have less estrogen exposure over their lifetime, Dr. Caldwell says. 'But the literature isn't entirely consistent, so we've got to do some more work.' It's also unclear if hormone therapy (HT) is helpful, Dr. Bevins says. Some research suggests HT lowers the risk of AD, while other research shows the opposite. Other studies have found HT only lowers your AD risk when it's started earlier in menopause and taken without progestin, Dr. Bevins says. 'So it's very complicated.'
Other biological and genetic differences might play a role too. For instance, one of the main disease drivers in Alzheimer's is something called neurofibrillary tangles—when strands of a protein, called tau, accumulate inside brain cells, Dr. Rosenbloom explains. 'There have been some studies that have found that women may have higher levels of tau in the brain, and that tau may spread more readily in a female brain.' And while Alzheimer's isn't entirely genetic, carrying a gene called APOE4 is linked to a higher likelihood of developing the disease—and the effect seems to be much stronger in women than men, Dr. Rosenbloom says.
Then there are social factors. Getting less education earlier in life is a risk factor for AD, since learning is thought to build up the brain's resilience against cognitive decline in older age, Dr. Bevins explains. 'And historically, women have not had the same access to higher education as men,' or career opportunities. So the current aging population of women may have less of that protective effect.
Meanwhile, many middle-aged women today are expected to do so much—act as the primary caretaker, work full-time, take care of aging parents—that they have less time to do things for themselves that can help reduce their risk of Alzheimer's, like working out and engaging in cognitively stimulating activities, Dr. Caldwell explains. (Research shows that women are, on average, less physically active than men.)
The good news is, there's a ton you can do to reduce your risk of Alzheimer's (and dementia in general), starting now. A 2024 review of dementia research published in The Lancet estimates that about 45% of dementia cases are preventable. Your brain is malleable throughout your life, Dr. Bevins explains, meaning your current lifestyle habits can improve your brain health down the road. 'It's never too soon to start thinking about this,' Dr. Bevins says. 'The earlier the better.' So let's get into it.
Physical inactivity is a known risk factor for dementia. In fact, the evidence shows that the number one thing you can do for your brain is move your body on the regular. 'If you have time for nothing else, exercise is where to start,' Dr. Caldwell says.
Studies show that doing moderate-intensity aerobic exercise and resistance training regularly causes physical and chemical changes in the brain that support memory and overall brain health—like protecting the volume of the hippocampus, per Dr. Rosenbloom, and supporting the growth of new brain cells and neural pathways, per Dr. Caldwell. And in people with AD, aerobic exercise has been shown to increase brain function by reducing the accumulation of tau proteins and amyloid plaques (a sign of dementia).
Experts generally recommend people aim for about 150 minutes of moderate-intensity aerobic activity and two 20- to 45-minute strength training sessions a week, according to Dr. Caldwell. If you're healthy and your doctor signs off on you exercising for longer or more intensely (like high-intensity interval training), go for it, Dr. Caldwell adds.
Good nutrition and gut health are crucial for brain health, Dr. Caldwell says. The general guidance is to focus on whole plant foods and minimally processed foods. The best examples are the Mediterranean or MIND diets, Dr. Caldwell says, which are both rich in foods like veggies, fruits, whole grains, beans, and fish.
A 2023 study in Neurology found that people who followed either diet were less likely to show signs of dementia in their brain tissue after death. (Green leafy vegetables in particular were found to be beneficial.) And a recent review of 40 studies found that the MIND diet—which emphasizes foods like berries, leafy greens, and nuts while minimizing red meat, sweets, cheese, and butter—is linked to better cognition and lower dementia risk. Meanwhile, a study on almost 11,000 people found that a diet high in ultra-processed foods is linked to cognitive decline. While there's more to learn, ultra-processed foods are 'probably bad for the brain,' Dr. Rosenbloom says.
Smoking and heavy drinking are strongly linked with Alzheimer's, according to the Lancet report. 'I don't think the average woman realizes that just one drink a day qualifies as moderate drinking,' Dr. Caldwell says. 'If you drink more than seven drinks a week, you're a heavy drinker, and you're putting yourself at risk for dementia.' So don't smoke, and cap your alcohol consumption at less than seven drinks a week.
Stress isn't known to be a direct risk factor for dementia, like heavy drinking. 'But we know that people who are stressed fare less well in the short term and the long term when it comes to brain health more generally,' Dr. Caldwell says. And chronic stress especially strains your brain's memory system.
Dr. Caldwell recommends exercise and mindfulness meditation as two evidence-based practices for giving your brain a break from the cascade of negative effects that occur when you're stressed. (You can start with just five minutes a day, she notes.) And prioritize whatever stress-reducing activities work for you—whether that's a spiritual practice, spending time with friends, or simply being in nature.
Keeping your brain stimulated in middle age can help build up that cognitive resiliency that protects your brain from Alzheimer's. One study found that playing games and engaging in social activities in midlife (and later life) is linked to a lower risk of developing mild cognitive impairment. An analysis of 19 studies showed a link between engaging in stimulating cognitive leisure activities (like reading, writing, and playing music) and a lower risk of cognitive impairment and dementia.
'The key is it needs to be a challenge or a learning experience,' Dr. Caldwell says. 'You can be mentally busy, but you might just be on autopilot.' That could look like learning a new instrument or language, taking on a new role at work, or joining a nonfiction book club that involves intellectually interesting conversations, Dr. Caldwell says.
Skimping on sleep is bad for your brain. While you sleep, a part of your brain called the glymphatic system filters waste out of the brain, Dr. Rosenbloom explains—including the amyloid plaques that play a role in Alzheimer's. Scientists think that not getting enough sleep could lead to a buildup of amyloid plaque, raising your risk of Alzheimer's. 'So getting a good night's sleep, seven to nine hours, is highly recommended,' Dr. Rosenbloom says.
Among older people, social isolation is linked to as much as a 50% higher risk of dementia, according to research. 'So staying socially active is something that we really recommend,' Dr. Rosenbloom says. And prioritizing social connections now sets you up for a more robust social life down the road.
Spending quality time with friends and loved ones has the dual benefit of providing mental stimulation and a mood boost, Dr. Rosenbloom says. 'When you socialize, a lot of times that overlaps with cognitive activity,' like playing games and having interesting conversations. Plus, social connection can help prevent depression, Dr. Rosenbloom points out—another risk factor for dementia.
While all of these tips are pretty basic healthy habits, 'that doesn't mean they're easy,' Dr. Bevins says. Often, the biggest challenge is just finding the time to put yourself first, Dr. Caldwell adds. 'But it's okay to prioritize your own health.'
Related:
What to Expect From Alzheimer's Treatment, According to Experts
Meet the New Drugs That Can Slow Down Early Alzheimer's
I'm a Neurologist. Here's the One Thing I Do Every Day for My Long-Term Brain Health
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