White text on purple background: 10 Questions Every Woman Should Ask Her Doctor About Brain Health

Every 65 seconds another brain develops Alzheimer’s disease. Two out of three of them belong to women and we don’t know why.

We do know that most women don’t talk to their doctors about their brain health, unaware that their future may depend on it. The following are 10 questions Women’s Alzheimer’s Movement at Cleveland Clinic recommends you ask your doctor to get started.

20s, 30s and 40s

1.
What lifestyle habits will protect my brain health throughout life? Ask about diet and exercise, and discuss any vitamins, supplements and hormones you are taking — including birth control or hormone therapy.

2.
I’m pregnant. What cognitive changes should I expect as a result of pregnancy? Pregnancy causes hormonal changes, including after you’ve given birth and during and after breastfeeding. Take notes about any signs of postpartum depression, and review them with your doctor. Preeclampsia is also a risk factor for cognitive decline and should be treated promptly.

40s and 50s

3.
I am considering a hysterectomy. Is there an Alzheimer’s disease link? Early studies show a correlation between a hysterectomy (removal of the uterus) and an oophorectomy (removal of the ovaries) and the risk of Alzheimer’s disease. However, other factors come into play, including age and whether you’ve gone through menopause. Ask about all your options to make an informed decision.

4.
I have a family history of Alzheimer’s disease. Is there anything I can do to protect myself? Having Alzheimer’s disease in the family doesn’t mean you’ll get it, but it’s good for your doctor to know as you review your overall health and plan of care. The best evidence is for the mediterranean diet.

5.
I think I am entering perimenopause. What should I expect? The start of menopause includes hormonal transitions that may create memory changes. Talk to your doctor if you are depressed, moody or having a hard time focusing. Ask about hormone replacement therapy and any associated cognitive effects.

6.
Do I need a brain scan and/or a baseline cognitive test? Your doctor may want a cognitive baseline if you are experiencing memory loss that concerns you.

7.
I have heard that hormone replacement therapy (HRT) may be linked to an increased risk for Alzheimer’s disease and cancer. What do I do? Whether your doctor is recommending HRT or you’re already on HRT, ask about any effects on brain health. Scientific studies indicate that HRT initiated early in menopausal transition can reduce risk of Alzheimer’s disease, whereas initiation later in life (65 and older) is of no benefit nor harm. The type of progestin used in HRT can be harmful. Review your symptoms, risk factors and preferences and make a decision that is best for you.

8.
I am going through cancer treatment. How will this affect my brain health? Some cancer treatments and chemotherapies that suppress estrogen production may affect brain health. Many women experience “brain fog” and “chemo brain,” which are not the same as Alzheimer’s disease. However, because estrogen loss may affect your long-term risk, ask for a plan tailored just for you.

 

60s and Beyond

9.
Should I see a neurologist or geriatrician? If you are experiencing forgetfulness, trouble with language, memory loss or other symptoms that concern you, ask to see a geriatrician or neurologist. It doesn’t mean you have Alzheimer’s disease, but a specialist can help.

10.
I’m worried I may have Alzheimer’s disease. How can I know for sure? Ask for testing to be sure. This usually involves a cognitive test and sometimes imaging. Ask if you are eligible to participate in a clinical trial, and if you are, sign up right away. It may help you — and might help scientists find the key to wiping out Alzheimer’s disease once and for all.