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An estimated 7.2 million Americans age 65 and older are currently living with Alzheimer's dementia. The part that should alarm every woman listening is this: almost two thirds of them are women.

In this episode, Dr. Mary Claire Haver sits down with neurophysiologist and Alzheimer's researcher Dr. Louisa Nicola to unpack what's really happening to women's brains during perimenopause and menopause and what we can do about it. Louisa Nicola is a neurophysiologist, human performance coach, and founder of Neuro Athletics, a consulting firm that works with elite athletes and high-level professionals to optimize brain health and performance. A former world class triathlete, she transitioned into neuroscience and earned her Master of Medicine in neurophysiology from the University of Sydney. Dr. Nicola is currently pursuing her doctorate studying the effects of resistance exercise on brain health. She focuses on optimizing brain function and longevity, particularly in women, through sleep, nutrition, and exercise interventions.

Dr. Nicola reveals how Alzheimer's disease doesn't suddenly appear at 70 but starts quietly in our thirties and forties, building up over a 30-year progression. She explains what's happening in the brain as amyloid beta proteins and tau tangles accumulate, why the hippocampus is the first area to go, and the critical role that sleep plays in clearing these proteins through the glymphatic system. The conversation explores why women are more predisposed to tau protein accumulation than men and how estrogen, progesterone, and prolactin inhibit the enzyme that causes tau proteins to become hyperphosphorylated and toxic. Dr. Nicola explains the connection between declining estrogen during perimenopause and increased Alzheimer's risk, including how estrogen helps mediate glucose metabolism in the brain, supports synaptic connections, and why the loss of this hormonal scaffolding leaves women vulnerable to cognitive decline.

Guest links:

Louisa Nicola (Instagram)

Louisa Nicola (Facebook)

Louisa Nicola, MMed, PhD(c) (LinkedIn)

Louisa Nicola (YouTube)

Louisa Nicola (X)

Neuro Athletics

The Neuro Experience Podcast (Apple Podcasts)

The Brain Code

Books

“Joyspan,” by Dr. Kerry Burnight

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