Jessica Caldwell, PhD is the director of the Women’s Alzheimer’s Movement Prevention and Research Center. She spoke with us about the results of our survey with Parade and how women can care for their brains.

Read the Q&A with Dr. Caldwell below.

WAM: While awareness seems to be growing, almost half of women in this country are still unaware that they are at higher risk than men for developing Alzheimer’s disease. Could you clarify the current understanding of how gender impacts risk and progression of the disease?
Dr. Caldwell: We still do not fully understand why this disease, which is the most common type of dementia, is especially bad for women. Some of this disparity may be explained by women’s longer lifespan, losing estrogen at menopause, greater brain effects of conditions like diabetes, and increased impact of genetic risks. Differences in social and lifestyle risks, such as higher rates of depression, lower rates of exercise, and greater impact of social isolation may also play a role.

In addition, severity of the disease or quickness of decline is also greater in women compared to men. This is likely due to a combination of women being diagnosed later than men and women activating brain-based compensatory strategies. Both of these are hot topics in current research.

WAM: Another concerning statistic was that only 15% of women said they discussed ways to optimize their brain health with doctors. How—and at what point in the lifespan—should women and doctors start that conversation?
Dr. Caldwell: It is never too early to have this conversation. We know that changes in the brain associated with Alzheimer’s disease occur decades before the onset of symptoms. The sooner we are able to implement a healthy lifestyle, the more likely we are to reduce our risk.

This conversation should be started in primary care because many healthy behaviors that doctors are already recommending, like diet and exercise, are directly relevant to brain health as well as body health. The sooner women can hear about that connection, the sooner they can make changes.

WAM: A significant portion of respondents under 50 reported experiencing memory/brain health issues but being afraid to seek help. What would you recommend for individuals in this situation, and why is it important to address these concerns promptly?
Dr. Caldwell: Memory changes are not always caused by Alzheimer’s or another neurodegenerative disease. Medications, stress, menopause, and poor sleep are all factors that can impact cognition, and are also all things that can be changed. If people do not seek help, they may be losing out on a chance at the relief of improving their memory by fixing the underlying problem.

We also know that new disease-modifying therapies for Alzheimer’s are only effective earlier in the disease state, further underscoring the importance of receiving a diagnosis as soon as possible.

WAM: Young people seem especially concerned about brain health, with 1 in 10 young people saying they think about developing a brain health issue daily. Is that good or bad news? (Good in that they are thinking about it earlier, bad in that they are anxious?)
Dr. Caldwell: I think it’s both. We know that young people are at a very low risk for this disease, but given the role of lifestyle, it is encouraging that they are thinking about their brain health early on, when they can implement lifestyle modifications to most effectively reduce their risk for developing it later in life.

At the same time, we know that stress is a risk factor for Alzheimer’s disease, especially in women. Research shows that women are better at activating a stress response, which can be good when they need to act quickly or fight off illness. However, women also are less able to dampen a chronic stress response, for example when work or caring for others becomes taxing. If thinking about a brain healthy issue becomes a daily concern, it may be more helpful to speak with a doctor for perspective and/or a therapist for reframing or coping with risk.

WAM: The survey revealed that older adults (aged 65+) were more likely to take vitamins and supplements for brain health. Are there specific vitamins or supplements that have been shown to benefit brain health or potentially reduce Alzheimer’s disease risk?
Dr. Caldwell: Data from scientific studies on supplements is murky at best. Most studies that looked at whether supplements can significantly improve memory and thinking or reduce risk for dementia have failed. A better strategy? Eating a balanced, Mediterranean-style diet that includes a wide variety of fruits and vegetables, whole grains, and healthy fats (fish, avocados, nuts/seed, yogurt).