MY MUM HAD ALZHEIMER’S – THIS IS WHAT I’M DOING TO REDUCE MY RISK

I care both personally and professionally about Alzheimer’s, because my whip-smart mum Ella Muir died, word by lost word, of the disease at the age of 89 in 2015. Her illness has been the driving force behind my subsequent investigation into the latest science and attempts to avoid the same fate.

For children of Alzheimer’s patients, and those who carry copies of the APOE4 genetic variant that can put us at risk of the disease, there is some surprisingly good news: we can take action now to reduce our chances.

Every time I read about a new Big Pharma “cure” I’m both hopeful and incensed, because most drugs are about slowing the disease, not preventing it. In reports published this month on the drug Lecanemab, which helps clear amyloid plaques clogging the brain, the study leader Professor Christopher van Dyck of Yale University admitted: “You will get worse over time, but it will take longer to get there.” That’s just not good enough.

Because there is so much more we can do in terms of early lifestyle changes and hormone replacement to lower the risk of Alzheimer’s – prevention is better than slow decline.

Read Next: 11 low-effort ways to boost your happiness hormones, according to experts

This is not just a health issue – it’s a feminist issue. Two thirds of Alzheimer’s patients are female and research shows that women with early menopause are 35 per more likely to get Alzheimer’s and dementia. (And drugs like Lecanemab are more effective in men than women, but that’s not in the headlines.)

Women need to be thinking ahead before they can’t think at all.

The impact on women

The big hitter in this story is hormones, and we should be shouting that from the rooftops. Women begin to lose the hormones progesterone and estrogen in menopause, years before men lose testosterone. When estrogen declines, amyloid plaques accumulate between the nerve cells of the brain, along with tau tangles. Tau tangles, also known as neurofibrillary tangles, are abnormal clumps of a protein called tau that accumulate inside neurons. Both amyloid plaques and tau tangles can be hallmarks of Alzheimer’s.

Replacing missing hormones around menopause has been proven to be hugely protective against late-onset Alzheimer’s.

American neuroscientist Professor Lisa Mosconi wrote The Menopause Brain and said: “By using brain imaging, we demonstrated that  the ebb in estrogen causes the loss of a key neuroprotective element in the female brain, with an aggressively higher vulnerability to brain aging and Alzheimer’s disease.”

Here’s the mechanism: the longer your exposure to estrogen, the healthier for your brain – hence the neurological danger zone of surgical or early menopause, when you’re left high and dry for years – unless you take hormone replacement therapy (HRT).

I also read a study that had me dancing round the room back in 2021 by neuroscientist Professor Roberta Diaz Brinton at the University of Arizona. Her research compared almost 400,000 women in a health insurance database over 10 years, and found that those on HRT were 58 per cent less likely to develop Alzheimer’s and neurodegenerative diseases. The greatest reduction was in women who took HRT for six years or longer, with a 79 per cent lower risk.

Professor Brinton believes that the earlier hormones are started, the better for the brain, which starts to change when women are in perimenopause in their forties. When I met her, she told me: “Hot flashes are actually a sign of something occurring in the brain. The loss of oestrogen during menopause is enough to shift the brain’s glucose metabolism by 20 to 25 per cent, which activates a starvation response, causing the brain to look for supplementary fuel. The brain can use its own white matter [its communication network] as fuel, leading to the potential development of Alzheimer’s.”

So many women could massively lower their risk by keeping estrogen, progesterone and testosterone topped up with natural, body-identical HRT, available on the NHS.

I will be on HRT for life

I’m one of them, and I’ll be staying on HRT for life – I know already that it’s made a profound improvement in my memory and cognition, both temporarily affected by menopause. The perimenopausal and menopausal memory loss or ‘brain fog’ – reported by 73 per cent of midlife women in a Fawcett Society poll – is improved by HRT in most women, and severe brain fog could be a warning light for the future.

There’s also a growing body of research on the preventative effect of testosterone against Alzheimer’s in men – and recently on mice and that low testosterone in women with the APOE4 genetic variant negatively affects cognition.

Testosterone is a major female hormone too, and studies have shown that topping it up in later life helps memory in women – as well as often improving mood, bone, muscle, and of course, libido.

I’ll be eating sardines and spinach

As well as HRT, nutrition, sleep and exercise help too.

Professor Mosconi says that over years, the traditional Western diet of burgers, sugary drinks and ultra-processed food (UPFs) can cause brain atrophy. As the brain loses neurons, they’re replaced by fluid – signs of accelerated ageing and increased risk of dementia.

“There’s consensus in the scientific community that we might be able to prevent at least one in every three Alzheimer’s cases by addressing lifestyle factors, including diet,” said Professor Mosconi. In her book Brain Food, she advocates the Mediterranean diet – olive oil, vegetables, fruit, oily fish, fibre – to protect the brain. Vitamin D and Omega 3 supplements also help.

That research is bolstered by this 2025 study over 13 years on over 130,000 people in the UK Biobank database which showed those on anti-inflammatory diets like the Mediterranean one had about a quarter less risk of dementia. Of course, it’s not just food but lifestyle: what’s grim about all this is that people who live in the areas of highest poverty, with most stress and least access to good food and healthcare, have a higher risk.

Why are we still not getting this message out that bad food choices can rot your brain? If you’re a child of Alzheimer’s like me, you’ll suddenly find sardines and spinach enticing.

I run, walk my dog, and swim year-round

It turns out exercise is a no-brainer too. A Canadian study of more than 9,000 people showed high levels of physical activity reduced Alzheimer’s risk by an amazing 50 per cent. Other studies show older adults exercising at least three times a week (for a mere 15 minutes) had a 40 per cent lower risk.

Better still, weight training along with regular exercise is extra protective of the brain. I run, walk my dog, and swim year round.

Every hour you sleep is an hour of brain care too. In studies, people who only slept five hours a night doubled their Alzheimer’s risk, and those with six hours still increased their risk by 30 per cent. (It makes me think about Margaret Thatcher announcing she only slept four hours a night – before she got Alzheimer’s.) Sleep disruption by hot flushes in menopause increases dementia risk, so it’s worth considering HRT to banish that too.

There’s lots of research showing daily meditation improves regular brain function, but a study in Frontiers in Human Neuroscience looked at the effects of meditation over six months on patients with mild cognitive impairment or Alzheimer’s. There were structural and energy changes – literally, brains were lighting up again – but it didn’t seem to repair past damage.

The latest studies in The Lancet on GLP-1s – drugs like Mounjaro and Ozempic – show that users, particularly those with diabetes, have a significantly lower risk of dementia over 10 years. But it’s not clear whether there’s something specific about these drugs, or whether weight loss and better nutrition is making the difference.

I’ve also cut down on alcohol

The more you drink alcohol, the more your risk of damage, and even small amounts don’t seem to be safe, according to research using the UK Biobank. I’ve nearly given up alcohol myself, but I still have a Lucky Saint 0.5 per cent almost non-alcoholic lager, which tastes surprisingly convincing.

So there are many ways to take early, positive action. But it’s still always in the back of my mind that carrying one copy of the APOE4 genetic variant doubles or triples the risk of Alzheimer’s, and carrying two copies (one from each parent) can increase the risk eight times or more.

It’s really tough for those of us caring for parents with Alzheimer’s or dementia to look in the mirror and think: will that be me one day?

A couple of decades ago, before all this new research was done, we had very little hope. Now something useful appears on my Alzheimer’s Google alert almost every day, and it’s worth keeping track. It’s clear to me that an attack on all fronts is the best way forward: holistic and hormonal.

So those are some useful hacks for brain health. Live well and pay attention to your hormones is a simple piece of advice. But it could be mind-changing.

Follow my research at KateMuir.substack.com and my book How to Have a Magnificent Midlife Crisis

2025-08-11T05:51:51Z