What Every Woman MUST KNOW to PREVENT Alzheimer’s | Neuroscientist Lisa Mosconi X Rich Roll Podcast

Added: Mar 11, 2024

In this podcast episode, Dr. Lisa Mosconi, a renowned neuroscientist, discusses her research on menopause and its impact on the brain. Her interest in neuroscience began at a young age, and she pursued a career in the field, eventually obtaining a PhD in neuroscience from the University of Florence. She later moved to the United States to work at NYU Medicine on early detection of Alzheimer's disease.

Key takeaways


Menopause is a neurologically active phase that impacts the brain, leading to symptoms like hot flashes, memory lapses, and mood changes.


Gender bias in healthcare has led to a lack of understanding of sex differences in health outcomes, highlighting the need for personalized and effective healthcare for women.


Women going through menopause show signs of trouble in the brain, such as increased amyloid plaque deposits and reductions in brain glucose metabolism, which can indicate a higher risk of Alzheimer's disease.


A Mediterranean-style diet rich in antioxidants can support brain health during menopause. Supplements can also be useful, but should not replace a healthy diet.


Sleep is crucial for brain health, as it allows the brain to flush out toxins and waste products, emphasizing the importance of managing sleep quality during menopause.

Menopause and Brain Changes

Dr. Mosconi's research focuses on the impact of menopause on the brain. She found that there was a lack of brain imaging studies on menopause, prompting her to conduct her own research. Her studies revealed that women's brains age differently from men's brains, with hormonal fluctuations during menopause affecting brain health. Women's brains are regulated by estrogen, while men's brains are more modulated by testosterone levels. Menopause is a neuroendocrine transition state that affects the brain as well as the ovaries.

Menopause as a Neurological Transition

Menopause is not just a phase that affects the ovaries; it is a neurologically active phase that impacts the brain. Women going through menopause may experience symptoms such as hot flashes, night sweats, depression, anxiety, insomnia, brain fog, memory lapses, and panic attacks. These symptoms are neurological and can be attributed to the changes in the brain during menopause. Menopause is a process, not an on-off switch, and its onset and experience can vary widely among women.

Gender Bias in Healthcare

Dr. Mosconi discusses the concept of "bikini medicine," where women's health is often reduced to reproductive organs and not considered holistically. Gender bias in healthcare has led to a lack of understanding of sex differences in health outcomes. Women are more likely to experience certain brain conditions, autoimmune disorders, headaches, migraines, and strokes compared to men. Recognizing these differences is crucial for personalized and effective healthcare.

Impact of Menopause on Brain Health

Dr. Mosconi's research found that women going through menopause show signs of trouble in the brain, such as increased amyloid plaque deposits and reductions in brain glucose metabolism. These changes are localized in brain regions affected in Alzheimer's disease patients. Women with a family history or genetic risk factors for Alzheimer's disease are at a higher risk of developing the condition. Early detection of these brain changes can help in interventions to prevent or delay the onset of Alzheimer's disease.

Genetic Predisposition and Alzheimer's Disease

Dr. Mosconi explains that genetic mutations can cause Alzheimer's disease, with mutations in genes such as APP, PSEN1, and PSEN2 leading to early-onset Alzheimer's. However, these mutations are rare and only account for about 2-3% of all Alzheimer's cases. The majority of Alzheimer's cases are sporadic or late-onset, with lifestyle and medical conditions playing a significant role in the development of the disease.

Dr. Mosconi discusses the APOE gene, specifically the Epsilon 4 allele, which is associated with a higher risk of Alzheimer's disease. However, having the APOE4 allele does not guarantee that a person will develop Alzheimer's, and lifestyle factors can still play a significant role in reducing the risk of the disease.

Menopause and Brain Health

Dr. Mosconi highlights the three stages in a woman's life that involve significant brain changes: puberty, pregnancy, and perimenopause. She explains that during menopause, the brain undergoes a remodeling process that can lead to changes in cognitive function and brain metabolism. Women going through menopause may experience symptoms such as brain fog, memory issues, and mood changes, which are often overlooked in medical practice.

Brain Scans and Menopause

Dr. Mosconi presents brain scans showing the changes in brain glucose metabolism before and after menopause. The scans reveal a decrease in brain activity post-menopause, indicating a shift in brain energy levels. Some women may experience a rebound in brain activity after menopause, while others may continue to decline. These changes in brain metabolism can impact cognitive function and overall brain health.

Differential Experiences in Menopause

Dr. Mosconi discusses the variability in women's experiences during menopause, with some women experiencing more severe symptoms than others. Factors such as the type of menopause (spontaneous vs. surgical), age at menopause onset, and overall health can influence the severity of menopausal symptoms and their impact on brain health. Women who undergo surgical menopause, such as through a hysterectomy, may have a higher risk of developing Alzheimer's disease and other dementias.

Prevention and Treatment

Dr. Mosconi emphasizes the importance of Alzheimer's prevention strategies for women going through menopause, especially those at higher risk due to genetic factors or surgical menopause. Lifestyle factors such as diet, exercise, and cognitive stimulation can play a significant role in maintaining brain health and reducing the risk of cognitive decline. Regular brain scans and monitoring can help track changes in brain metabolism and identify potential risk factors for Alzheimer's disease.

Diet and Brain Health

Dr. Mosconi advocates for a Mediterranean-style diet with a focus on plant-based foods, particularly dark leafy greens, fruits, nuts, and seeds. These foods are rich in antioxidants, which help combat oxidative stress in the brain. Antioxidants are essential for brain health as the brain is highly metabolically active and susceptible to damage from free radicals. Consuming a variety of antioxidant-rich foods can support brain function and energy levels.

Supplementation and Nutrient Deficiencies

While supplementation can be beneficial for individuals with specific nutrient deficiencies, Dr. Mosconi emphasizes that supplements should not replace a healthy diet. It is essential to prioritize nutrient-dense foods over relying solely on supplements. Common deficiencies in menopausal women may include calcium and Vitamin D for bone health. However, more research is needed to understand the connection between nutrient deficiencies and Alzheimer's disease in menopausal women.

Microbiome and Hormonal Health

The gut microbiome plays a crucial role in hormone regulation and overall health. Fiber-rich plant foods support the estrobolome, a community of bacteria involved in estrogen metabolism. Consuming a diverse range of plant-based foods, especially those high in oligosaccharides, can promote hormonal balance and support gut-brain communication. The microbiome influences various bodily functions, including cravings and mood, highlighting the interconnectedness of the gut and brain.

Exercise and Brain Health

Dr. Mosconi highlights the benefits of moderate-intensity exercise for women in menopause, citing studies that show a reduction in the risk of cardiovascular conditions, diabetes, and obesity. She explains that moderate-intensity exercise is more sustainable for women in this age group compared to high-intensity workouts. Consistency in exercise is key for brain health, as quick fixes do not work due to the brain's stability.

Hormone Replacement Therapy

The discussion shifts to the controversial topic of hormone replacement therapy. Dr. Mosconi explains that estrogen plays a crucial role in women's brain health and that hormone replacement therapy can have both positive and negative effects depending on timing and the type of hormones used. She emphasizes the importance of starting HRT during menopause and using bioidentical hormones to reduce the risk of Alzheimer's disease.

Phytoestrogens and Brain Health

Dr. Mosconi introduces phytoestrogens, a plant-derived form of estrogen that is designed to target the brain's estrogen receptors while minimizing effects on reproductive tissues. She discusses ongoing research on phytoestrogens and their potential benefits for brain health in menopausal women.

Other Pharmacological Interventions

In addition to hormone replacement therapy, Dr. Mosconi mentions antidepressants as a potential option for managing menopausal symptoms, particularly hot flashes. She also discusses the role of testosterone in addressing low libido and supplements as complementary approaches to support brain health during menopause.

The Importance of Sleep

Dr. Mosconi emphasizes that sleep is crucial for brain health as it allows the brain to take care of itself by flushing out toxins and waste products during deep sleep. This process, known as the glymphatic system, is like a dishwasher for the brain, helping to remove harmful substances like Alzheimer's plaques. She highlights the negative effects of fragmented sleep, which can lead to an increased risk of cognitive decline and other health issues.

Sleep and Menopause

Dr. Mosconi also addresses the impact of menopause on sleep, noting that many women experience disrupted sleep during this time. Hormonal changes during menopause can affect sleep quality, leading to issues like insomnia and frequent awakenings. She stresses the importance of managing stress, avoiding stimulants like caffeine and alcohol, and staying physically active to improve sleep during menopause.

Testing and Cognitive Evaluation

To get a clearer picture of their health and brain function, Dr. Mosconi recommends undergoing blood work to assess metabolic markers, thyroid function, iron levels, and B12 levels. She also suggests cognitive evaluation tests to measure memory, attention, language, executive function, and processing speed. These tests provide a baseline for future comparisons and can help identify any cognitive changes over time.

Brain Scans and Alzheimer's Prevention

Dr. Mosconi discusses the brain scans conducted at her Alzheimer's prevention program in New York City, which include MRI scans to assess brain volume, damage, and connectivity. They also measure blood flow and ATP production in the brain, as well as screen for Alzheimer's plaques. These scans provide valuable insights into brain health and can help detect early signs of cognitive decline or other brain-related issues.

Media Hygiene and Trustworthy Sources

The conversation shifts to the importance of media hygiene and sourcing reliable information, especially in the age of social media and misinformation. Dr. Mosconi acknowledges the challenges of navigating the vast amount of health information available online and emphasizes the need to verify sources and fact-check information before accepting it as true. She highlights the role of peer-reviewed scientific publications as trustworthy sources of information and encourages individuals to seek out credible sources for health-related news.

Challenges of Science Communication

Dr. Mosconi reflects on the challenges of science communication, noting that scientists and doctors often lack the time and resources to engage with the public and address misinformation effectively. She emphasizes the importance of effective science communication in bridging the gap between research and public understanding, highlighting the need for scientists to share their knowledge in accessible ways.


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