What Does Menopause Do to Your Brain? A Neuroscientist on the New Research

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Welcome to Wellness Simplified.
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I'm Kelly Nichols, and this show is for busy people who care deeply about their health, but are drowning in conflicting advice and don't know where to focus.
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Every episode, we simplify one area of health.
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One habit, one simple experiment, one clear next step that will actually fit into your life.
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Together, let's optimize our health.
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One simple step at a time.
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Hop flashes, broken sleep, losing your words mid-sentence.
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And somewhere in the back of your mind, I quite worry that menopause is doing something to your brain that you can't undo.
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So today you'll hear what's actually happening in your brain through menopause, including a brand new study that found no change in gray matter through this period, which might may surprise you.
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Why brain fog can feel so real even when cognitive tests pick up little to no change, and what the evidence actually shows and doesn't show about HRT and dementia.
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We also zoom out to the bigger picture.
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Why your brain might actually be at the most its most flexible in midlife, when forgetting a name is worth a chat with your GP, and when it's just a busy brain under pressure.
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And a clever trick for rehearsing how you want to feel before a big moment like a presentation.
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Plus, the one place to start for long-term brain health.
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My guest in today's episode of Wellness Simplified is Dr.
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Sarah Mackay, Oxford-trained neuroscientist and author of the woman's brain book, who has spent years rewriting the story we tell about women's brains.
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So let's get into it.
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Dr.
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Sarah Mackay, thank you so much for joining us.
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I really, really appreciate your time.
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Oh, thank you for the invitation.
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I always like chatting.
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Yeah, I'm I have a real interest in this.
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I mean, I have for always, but then my mum had um Alzheimer's.
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So I kind of uh you know witnessed firsthand the decline of the of the brain and it just deepened that interest.
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So thank you.
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Um you're welcome.
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Before we jump in, I just love to get to know the the guest a little bit.
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So could you share like how do you start your day or how did you start your day this morning?
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How do you set yourself, set that the time?
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Oh, um, well, today I have my alarm set for 5am because Wednesdays are the days I usually teach, do online, run my online courses and do podcasts, things like that.
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So that was that was today.
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Um, and the course I am running at the moment, there is a zoom, we have a Zoom call scheduled for 6am Sydney time and 6 p.m.
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Sydney time.
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Um, because my co-director or my the the woman I'm teaching my course with is in Dublin and Ireland.
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So we had to have a time that suited both of us 12 hours apart.
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So I got up at 5am today and I'm very happy to do that rather than have a late night call.
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Yeah.
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Um so yeah, set the alarm.
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The dog, as soon as the alarm went off, the dog started like sniffing around like little dogs do.
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And um then it was quite funny because I got up and threw on some clothes, and then my husband started talking to the dog, and then he thought it was a 6 a.m.
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alarm that had gone off, not a 5 a.m.
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And then suddenly he went, It's only 5 a.m.
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What am I doing?
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What am I doing?
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And I said, Yeah, I've told you last night.
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And he's like, Oh, so then I first and then the the the very next thing I do is I go and make a really strong cup of coffee.
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And then I um and and in this instance today, I then logged on, just checked that we were all set for our teaching for the day.
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Um, and then pretty much the Zoom call started about 10 to 6 when Mary logged on from over in Dublin, and we just made sure we were all ready to go.
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And then we taught our course for an hour and a half, and then I took the dog for a walk in Manley Dam, which you would know because it's not far from where you live too.
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Um, and came back and had breakfast after that.
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I saw some people I know I ran into some neighbours in the oval.
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So had a chat.
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Yeah, so it's been I've already lived a day and it's only 11am.
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It seems like it.
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Awesome.
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But no, that's good.
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I'm happy.
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It's a good thing.
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Beautiful.
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Beautiful.
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Um, and just one other question to to start.
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Like, I loved your TED talk and you had that kind of you know, N of One experiment sort of idea with the napping.
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I was curious to know, like, what's the most recent N of one experiment you've run on your health or and particularly your brain health?
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Oh, so I got and not not sponsored.
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This is not a sponsored post.
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I got a brick for my phone.
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Oh, I love them.
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Yeah, have you got one?
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You know what they are?
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Yeah, yeah, yeah.
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Yeah, because I had tried the whole um old-fashioned, let's plug my phone into the wall when I'm at home.
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So one charges and two acts like an old-fashioned phone.
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But then I was miss I missed a couple of text messages.
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And at one point, one of my boys of teenage sons was at the gym down the bottom of the hill.
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I live at the top of the hill, and he had a puncher and he sent me so many messages and I'd missed them all because I was in another room.
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Yeah.
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So that was, I was like, this isn't gonna work.
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So I got a brick, and I totally believe in the idea of behavioral nudges and whatever the opposite of a nudge is.
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And for those who don't know, it is this it is like literally a way of turning off apps on your phone, but it's a physical device, and I have mine on my fridge in the kitchen, and so I can turn off all my social media and have my app just function like a phone.
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I my my phone just function like an old-fashioned phone.
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Um and to access them again, I literally have to tap the phone onto the brick which I have in my fridge, which is great because so I can go to bed at night and turn everything off, and then in the morning I can't use my apps unless I get up, walk downstairs, go into the kitchen.
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So it adds a lot of friction into the and helps kind of break that mindlessness of so yeah, I have been quite evangelical about that.
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And the other N of one hack is about two weeks ago I found out that I'm my my diet is very low in calcium.
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So all the midlife ladies, yeah, I had sore knees, we all do, had an x-ray.
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It was like you have very mild osteopenia.
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And I'm like, but what about all the things I do?
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And then I looked at my diet, and it turned out I was eating about 25% of my recommended daily intake of calcium.
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Wow.
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Do you know how much we need at our age?
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How much?
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The equivalent of one liter of milk a day.
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One liter.
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Jesus.
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My youngest son would be sorted, but me on the other day.
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1300 milligrams is what you need over the age of 50.
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And 1300 milligrams is how much calcium is in one liter of milk.
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So most of us are probably doing all of the things, but we're not actually eating the calcium.
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So that's my other end of one.
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I've been drinking lots of milk.
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Sweet.
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And this is just I can drink milk.
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I'm I like it.
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I'm happy with it.
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I just so yeah, there's two N of One experiments that I'm working on in the world.
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I love it, I love it.
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I also love the brick.
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Um, yeah, I feel like it's made a big difference.
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I have my work time, like the apps, and then you know, if you get that kind of temptation to whatever it check LinkedIn, Instagram, whatever, it just you can't, and then it's done without and I love it how you go, you go to do it and it's brick, and then it says back to living.
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Yes, exactly.
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And it's like it's not sanctimonious, it's just like really, it's a really lovely phrase, I think.
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And it's like, yes, that's what we should be doing.
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Yeah.
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So I'm a big fan of it as well.
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Yeah.
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On a funny note, I um we had a big uh mold remediation in our house, and I've actually lost the brick.
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So I literally can't change it, even if I wanted to.
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Oh gosh.
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Which is actually quite a good thing.
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Um, anyway, let's jump in.
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Maybe we can start big picture.
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Um, I'm keen to just understand like how what's actually happening in the brain as we age, and how much of the kind of loss of brain power, memory, and so forth is just inevitable versus what what people can actually do about it with lifestyle changes and so forth.
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I don't think it's inevitable that our brains are on the decline.
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I think that there's a story that it's been told.
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I think this the current story is our brains aren't fully developed until age 25.
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And then once you hit age 26, you know, it's this inevitable decline, or maybe you get a few years in your 20s when people don't talk either about having an underdeveloped prefrontal cortex, or, you know, if you're a woman, either, you know, depression, anxiety, PMS baby brain, brain fog, dementia, risk reduction, etc.
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So, um, and in fact, I mean, not that I should be shouting out other people, um, Norman Swan, who Aussies will be very familiar with, has just published a book in the last couple of weeks called The Brain Cliff, which is where a lot of the literature and a lot of the people working in the space are kind of going now.
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And so he's right kind of on the, he's got his finger on the on the button that this idea that our brains are inevitably on the decline as they change across age, um, it has become a story that we've almost absorbed as inevitable.
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Yeah.
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And it makes and it and it almost comes a story of deficit and decline and things going wrong.
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And once you reach certain ages and stages, life feels like it should turn a little bit into a dementia risk reduction project.
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Most people don't think that, but certainly because I talk about this all the time, this is this is how I feel.
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Um, so yeah, brains change as we age, but a lot of what that change is is adapting and responding to the kind of the bodies in which our brains are part of and the world in which we move about, and brains continually receive information and adapt and respond and kind of try and often do their very, very best, despite the conditions within which they are living or, you know, kind of responding to.
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Um, and I think, you know, I'm 51, so I'm really interested in, and there's always been a bit of a gap in the kind of the literature in terms of life development in midlife.
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You know, we we know a lot about childhood development, adolescent development, um, and we've talked a lot about aging.
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We're sort of now starting to look a little bit more closely at reproductive transitions in women's lives, which is interesting because we've got, you know, pregnancy and we've got kind of, I suppose, menopause, perimenopause, menopause.
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But just the idea of midlife as a developmental stage, I think, is really interesting.
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It hasn't always been um studied.
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There is some psychosocial literature on that.
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Um, and I think that there's a far more positive story to be told than what is currently going around.
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Midlife brains are incredibly flexible and adaptable.
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And midlife brains may actually be at the stage of their greatest flexibility and adaptability.
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That's interesting.
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Um yeah, so there's some and it's really interesting because often research is and research questions are driven by the people doing the research and asking the questions.
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And as we get different kinds of people kind of coming and going out of, you know, neuroscience, we're starting to get different people asking questions that are relevant to feel relevant to to themselves more.
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Uh so there's this midlife kind of research narrow is looking at individual trajectories across the lifespan, not this inevitability of decline.
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There's a very loud noise in the background here.
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I don't know whether that's you or me.
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I can't hear anything.
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Oh gosh, sorry about that.
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It might be someone playing really loud music upstairs.
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Um there's this measure of cognitive flexibility, which I'm really fascinated in.
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And it's and we're and there's some early, early kind of research in literature showing that midlife, kind of around, you know, late 40s, early 50s, is when cognitive flexibility peaks.
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And cognitive flexibility, it's easier to kind of think about what that is not.
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So the opposite of that is a brain that's kind of very rigid or um stuck in its way.
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So we might think about young people in particular, whilst they can be very passionate, you know, passionate university activists or whatever, but it they can be very black and white.
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Yeah.
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And it's either this or that.
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There's not a lot of shades of grey and nuance.
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They haven't kind of built or developed the life skills and experiences to kind of sit back and be able to pivot and see shades of grey.
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It's, you know, the pattern recognition, the wisdom, the years of experience that you kind of build up over a lifetime.
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And then similarly, later in life, you know, largely driven, well, driven by a couple of kind of factors, driven by the fact that once you do kind of reach your sort of your 70s, 80s, and 90s, we do start to see biological aging really kind of kicking in.
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And one of the knock-on effects of that can be more rigidity.
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And that can make a person psychologically rigid and that they're less wanting to get out and explore the world.
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They're not kind of in that building-growing phase of life, you know, they're kind of more in the knuckling down, kind of settling down, not wanting to do things life.
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So they're not experiencing as many different things every day.
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And so they do get much more stuck in their ways.
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And certainly, and you may or may not, depending on what kind of path your mother took through Alzheimer's, we might we start to see people get very sort of um rigid in their thinking and inflexible again.
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Yep, definitely.
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Perhaps being driven by different processes.
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Yet the peak of flexibility, the opposite of both of those ends of the lifespan, is midlife.
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And if we think about, you know, we've got we've got years of wisdom and experience.
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You might if you've been in like, say, the same professional discipline or not, you know, you kind of just know straight away.
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Like you, you, you pattern recognition and your ability to just your your instinct is really finely tuned because you've got so much experience.
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So you kind of know things straight away almost.
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You can kind of see into the future in a way.
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That's pattern recognition, essentially.
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Because you've you've you've you've just you know done a lot of stuff, right?
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Yeah.
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But you haven't lost the ability to be flexible, and you've grown out of the inability to be flexible.
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So it's a really great time, and yet I feel like so many of the conversations are about the things that go wrong.
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Totally.
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And if only the conversations are only about symptom management of menopause, say, or you know, avoiding anxiety and depression, how to manage stressful lives, which are all valid, reasonable things to come have conversations about, and/or dementia risk reduction, then that's all a conversation ever is.
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And it makes it feel as if this is the the inevitable path.
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There's no alternative trajectory.
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And that's not what the evidence shows.
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The evidence shows so many, so many strengths and upsides.
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So what's the what do you think is the well, first of all, I just want to recognize, and I see this in all of your work that I've read or or watched, is it's like you're helping people tell a different story about how their brain is functioning, whether it's in motherhood or teenage years or menopause, because we get into these stigmas that this is the way what's happening to your brain, and then people act from there, I imagine, right?
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Yeah, we pathologize female bodies and brains from puberty.
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And um, that's and partly that's driven by my own personal experiences, but then it's hard to separate out my personal experiences from my attitudes and having a strong sense of agency.
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And I have had a lot of blessings and you know, wonderful things come my way in life, but also I've gone looking for them and I've also put a lot of practices in place to kind of build the resilience into the system as well.
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But I'm also aware of the positives and the upsides and the strengths and how powerful narratives can be, whether they be social media or or you know, social or even within our own minds, in terms of determining health outcomes.
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So um, yeah, it's it's very important for me that we also tell those stories.
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It's an also an and story, not an or.
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Yeah.
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So a couple of follow-ups on that.
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Um, I mean, one that I'm really interested in is I'm fascinated by how people can change like beliefs that are that they're really stuck in.
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Like let's say it's a it's a belief that like a deep fear about aging or the brain or whatever.
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What's happening in the brain when like what could you explain from the brain perspective about how people can actually change those kind of neural pathways that are that are locked in?
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Beliefs are actually some of the hardest things to change.
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That from a neuroscience perspective, they're really it's a they're they're quite a difficult problem because it's hard to operationalise what a belief is because it becomes knowledge that you don't question as being a fact.
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You absorb it almost implicitly, and it's often within a belief system, and it's often been and it's often something that we've learned socially.
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So it's not like you've learned about it as, you know, what is the capital of you know each country in Europe, or here's how to do calculus, or even, you know, let's sort of study some historical facts.
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Or, you know, you you don't ever remember learning an idea because it wasn't a fact, more it was like a message.
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It was almost kind of like, you know, you can't see this, you know, you can't see the soup that you swim in type thing.
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So beliefs are actually quite hard to change.
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And it's beliefs aren't usually in an individual idea that we've absorbed, and usually it's we've absorbed it socially, so we don't question it.
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We kind of um understand it rather than learn it.
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Um and it's often embedded in a much more it's embedded in a much broader system.
00:18:03.519 --> 00:18:08.640
Um and it is hard to simply get someone to change a belief by telling them a fact.
00:18:08.799 --> 00:18:20.480
Some people can be very easily influenced, largely maybe by their training or perhaps other experiences they've had, when you can present a fact to them, you can say, hey, aging isn't inevitable.
00:18:20.720 --> 00:18:25.119
I mean, aging is inevitable, but brain decline isn't inevitable for everyone.
00:18:25.359 --> 00:18:30.400
And then they can easily switch their ideas around that or their beliefs.
00:18:30.880 --> 00:18:37.519
Others may be far, far more resistant, and and that will because their belief is embedded within their life experiences.
00:18:37.759 --> 00:18:46.079
So it is a very hard, it is actually when we're talking about behaviour change, beliefs are kind of the hardest thing to change.
00:18:46.319 --> 00:18:53.920
There are other kind of more pragmatic, like ha like habits, for example, are the biggest bang for the buck in terms of behaviour change outcomes.
00:18:54.640 --> 00:19:10.160
So um I kind of try to think about not telling people what they think isn't tr isn't real or but to understand, like they may have a belief that's developed and it's perfectly logical that that's what they think.
00:19:10.400 --> 00:19:16.880
I just kind of give tell them other stories which you know also and stories rather than either or.
00:19:17.039 --> 00:19:21.359
I kind of think myth busting can sometimes have uh the opposite effect.
00:19:21.519 --> 00:19:31.920
I mean, we know, say, we we see this with something like say vaccine hesitancy or people who don't want to take a vaccine, but telling them that a vaccine is safe and giving them facts about that doesn't bugger all.
00:19:32.160 --> 00:19:32.240
Yeah.
00:19:32.720 --> 00:19:34.319
It might sh change some people.
00:19:34.480 --> 00:19:44.960
What we've got to do is kind of repeat uh messaging that is empathic and is embedded within a broader kind of sort of a system.
00:19:45.279 --> 00:19:45.519
Yeah.
00:19:46.799 --> 00:19:53.279
Yeah, because if you tell them like the myth busting, then they just grab onto their existing belief, right?
00:19:53.519 --> 00:19:56.000
Yeah, and it challenges your sense of identity often.
00:19:56.880 --> 00:19:58.880
Um and particularly if you've grown up.
00:19:59.039 --> 00:20:01.440
Like and you know, you can think about religious belief, right?
00:20:01.519 --> 00:20:05.440
Lots of you know, you kind of if you grew up in a religious I grew up in a religious family.
00:20:05.599 --> 00:20:29.359
Um I didn't everything that I was taught and through, you know, every Sunday going to church and going through, you know, religious schools, it wasn't until I went to university and I wasn't surrounded by religion all of the time, I kind of stepped back and looked at it from the outside in and thought, oh gosh, like that's an idea that some people have that other people don't.
00:20:29.519 --> 00:20:35.839
It never occurred to me that it was an idea some people had that other people didn't, because I'd never been exposed to anything different.
00:20:36.240 --> 00:20:54.960
Um, if someone had have come to me when I was a very holy teenager going to youth group, was really into all of that sort of stuff and challenged me, I wouldn't have been interested in being challenged because I this was the ecosystem in which I was living and I was fine.
00:20:55.039 --> 00:21:04.000
I mean, it wasn't to me in any way harmful, but um sometimes it just takes repeated exposure to other ideas over time.
00:21:04.720 --> 00:21:08.400
When you sort of learn a new kind of ecosystem or landscape.
00:21:08.559 --> 00:21:15.519
So from a brain perspective, it's very we don't we wouldn't really kind of go on and go, well, here's a belief wide and in this way, let's pluck it out.
00:21:15.680 --> 00:21:18.480
They're actually quite hard, a hard ask.
00:21:18.799 --> 00:21:19.039
Yeah.
00:21:19.200 --> 00:21:19.519
Okay.
00:21:20.000 --> 00:21:32.799
Um, and with that like midlife uh flexibility and of thinking and so forth, what are some things that people can do to optimize that and also to make it last as long as possible?
00:21:32.960 --> 00:21:37.680
So hopefully in their 70s and their 80s and so forth, they don't fall into that rigidity.
00:21:37.920 --> 00:21:43.279
Yeah, well, I always think about the brain in terms of this model I have where I we kind of map it out.
00:21:43.359 --> 00:21:49.359
We don't really need to know too much about what's going on inside the brain in terms of networks and sort of systems and neurotransmitters.
00:21:49.440 --> 00:21:50.480
That's all kind of by the by.
00:21:50.640 --> 00:21:52.160
That's interesting, but not necessary.
00:21:52.319 --> 00:21:55.599
I always think about what information is the brain receiving and what is it doing with it?
00:21:55.680 --> 00:21:59.839
So it's receiving information from our body, you know, kind of from our from I always call it the bottom up.
00:22:00.160 --> 00:22:00.240
Up.
00:22:00.319 --> 00:22:06.240
So we look at the brain in the middle, what's happening from the bottom-up body, what's happening in terms of information coming in from the outside world.
00:22:06.319 --> 00:22:10.160
And that doesn't make its way in by magic, like through what we see and what we hear.
00:22:10.319 --> 00:22:13.759
And if it's close enough, we might touch it or taste it or smell it or whatever.
00:22:13.839 --> 00:22:15.920
And we've also, you know, know we know what ways up and down.
00:22:16.000 --> 00:22:17.599
We've got the sense of gravity, right?
00:22:17.759 --> 00:22:20.720
Um, the rising and setting of the sun, that's all coming in through our senses.
00:22:20.799 --> 00:22:22.880
So that's the outside world making its way in.
00:22:23.039 --> 00:22:33.680
And then we've also, because we're humans, we've got like what I call top-downs, we've got minds, we've got, you know, our thoughts, our feelings, our memories, our expectations, you know, what happened in the past and that predicts what we do next.
00:22:33.839 --> 00:22:54.880
And so I always think there's not really kind of like this list, it's more like kind of a system in which a brain is embedded to ensure that when we do face inevitable challenges or stresses or life transitions, because things just happen, that the brain is being given its kind the best opportunity to kind of carry on as best it can.
00:22:54.960 --> 00:22:58.799
And so, what can we do to take care of our biological body?
00:22:58.960 --> 00:23:00.319
So we're taking care of our brain.
00:23:00.400 --> 00:23:02.079
And honestly, there's nothing new under the sun here.
00:23:02.160 --> 00:23:25.599
It's you know, the basics, sleep, you know, sleep, exercise, um, you know, food, um, you know, uh, and then also like kind of more, I would think about kind of falling under kind of medical health care things like, you know, are you taking care of, you know, your cardiovascular health, your metabolic health, your hormonal health, um, you know, is your iron low?
00:23:25.759 --> 00:23:26.720
Do you need more calcium?
00:23:26.799 --> 00:23:28.480
You know, there's just little things like that.
00:23:28.640 --> 00:23:31.119
That's all biological bottom-up body stuff.
00:23:31.359 --> 00:23:37.680
And then from the outside in, you know, as I said, you know, beliefs form because we live in cultures.
00:23:37.759 --> 00:23:37.920
Yes.
00:23:38.079 --> 00:23:44.240
And we don't necessarily remember learning facts, but we implicitly understand our uh, you know, how we make our way through the world.
00:23:44.400 --> 00:23:46.160
So, you know, kind of what we see in here.
00:23:46.400 --> 00:23:56.960
So the people we're interacting with, um, you know, the the how how much access do you have to the natural world and where we live on the northern beaches of Sydney, you know, it's basically a blue zone.
00:23:57.039 --> 00:23:57.200
Yeah.
00:23:57.359 --> 00:24:01.599
You know, we're we're like the healthiest, wealthiest place almost on the planet, right?
00:24:02.000 --> 00:24:06.799
I and I'm not just financially wealthy, but you know, like we have it so good here.
00:24:07.279 --> 00:24:11.599
Um, we're so connected to blue zones and green zones.
00:24:11.759 --> 00:24:14.319
It's just we're we're so wealthy in that respect.
00:24:15.039 --> 00:24:19.519
Um, so you know, how can you look at, you know, external stresses coming in?
00:24:19.680 --> 00:24:23.759
How can you um find ways to manage manage that?
00:24:24.160 --> 00:24:26.480
Um, what are your social relationships like?
00:24:26.640 --> 00:24:28.160
What is your built environment like?
00:24:28.319 --> 00:24:29.680
What is your workplace like?
00:24:29.839 --> 00:24:34.640
Those are outside in things that we can help manage, you know, how our brain reacts and responds.
00:24:34.799 --> 00:24:42.319
And then finally, top down, which is hardest, because you know, this is where we just talked about beliefs, but these are, you know, kind of our thoughts and our feelings and our memories.
00:24:42.400 --> 00:24:55.440
And essentially the brain is sitting in the middle of all of this, receiving all of this information and kind of, and it's been gathering information for for a lifetime and going, taking on board all of this and figuring out what to do next.
00:24:55.519 --> 00:25:08.160
And so we want our brains to be biologically healthy, like we want a biologically healthy and well brain, the same way we want a biologically healthy and well heart and cardiovascular system and and muscles and bones, etc.
00:25:08.720 --> 00:25:11.119
But we also want a healthy and well mind.
00:25:11.680 --> 00:25:17.920
And then we want, you know, as as much autonomy as we have over our the ecosystem in which we live.
00:25:18.000 --> 00:25:21.200
We want a healthy and well world in which our brain lives.
00:25:21.359 --> 00:25:32.400
So it's kind of doing the best we can to kind of, I hate to use the word optimise, but to see we can kind of make a few little kind of small steps of improvement.
00:25:32.640 --> 00:25:33.200
Mm-hmm.
00:25:33.839 --> 00:25:38.799
So I mean, there's the healthy lifestyle, the the culture, the environment, and so forth.
00:25:38.880 --> 00:25:44.480
And with the top down, like what are what are the specific things that you'd recommend for people in that regard?
00:25:44.720 --> 00:25:47.759
Is it just minding your thoughts and yeah?
00:25:47.839 --> 00:25:52.960
I so I mean some people, you know, think to spend too much time thinking about themselves.
00:25:53.119 --> 00:25:53.279
Yes.
00:25:54.559 --> 00:25:58.400
So like, you know, like we've got this really precious resource, which is our attention.
00:25:58.799 --> 00:26:02.640
And our attention is what information we filter in and what we filter out.
00:26:02.880 --> 00:26:08.400
And that's it can be incredibly powerful and incredibly gratifying or incredibly, you know, damaging.
00:26:08.559 --> 00:26:18.400
We've got like different networks in the brain, some which, you know, uh are very much focused on processing information that's coming in from the outside world and making meaning of that.
00:26:18.480 --> 00:26:28.319
And then we've also got networks in the brain which are very much involved with kind of you know, rolling over ideas in our minds, eye, imagination, thinking about the past, thinking about the future.
00:26:28.559 --> 00:26:34.960
Um, you know, people who practice mindfulness are very much about paying attention to what is happening in the now.
00:26:35.359 --> 00:26:40.400
Um, but maybe, you know, your default mode network, I quite like having a little wander around the world in my mind.
00:26:40.559 --> 00:26:44.240
You know, I've never found it to be a very bleak, dark place.
00:26:44.480 --> 00:26:47.279
Um, it's quite I quite enjoy my own imagination.
00:26:47.599 --> 00:27:00.000
Um, but yeah, so it's understanding how our brains are constructing thoughts and emotions based on what's happening in our body and then the outside world and then making meaning of that.
00:27:00.480 --> 00:27:09.440
Um, and but I I I kind of feel a little bit like if you're in a have a thought or an emotion that you're not wanting, you know, you want to shift.
00:27:09.599 --> 00:27:11.920
Using your mind to control your mind is the hardest thing.
00:27:12.079 --> 00:27:14.720
Like some people have have got great cognitive control.
00:27:15.119 --> 00:27:17.519
Other people are useless at that, and that's fine.
00:27:17.599 --> 00:27:22.400
It's understanding that that's not the only way in to change, you know, yourself.
00:27:22.720 --> 00:27:31.759
If you're feeling a bit flat, like talking yourself out of feeling flat, like who wants to spend time talking at themselves in their own mind, right?
00:27:32.079 --> 00:27:38.799
Maybe like changing, you know, something physiologically, that's why people go and jump in cold water or jump in the ocean, right?
00:27:38.880 --> 00:27:42.400
Yeah, you're completely changing all of the sensory input that's coming in.
00:27:42.480 --> 00:27:42.640
Yeah.
00:27:42.799 --> 00:27:49.680
So your attention is shifted from your inside your mind to just what's happening in your body as you're on the sea.
00:27:49.920 --> 00:27:50.240
Yeah.
00:27:50.480 --> 00:27:52.480
So there's lots of ways in.
00:27:53.119 --> 00:28:02.720
Um, it's kind of figuring out which are the ones that we want to be working on or improving if we feel like there's a need for improvement.
00:28:02.880 --> 00:28:03.119
Yeah.
00:28:03.279 --> 00:28:06.960
Um, the brain isn't really kind of prioritizing necessarily one over the other.
00:28:07.039 --> 00:28:12.640
It's just all kind of coming in, and the brain's going, okay, well, I last time I encountered this situation, it was pretty cool.
00:28:12.720 --> 00:28:13.519
I might do that next.
00:28:13.599 --> 00:28:14.799
So I look forward to that.
00:28:14.960 --> 00:28:17.039
I might be motivated, I might imagine it.
00:28:17.440 --> 00:28:21.440
Other times you might encounter something that really sucks, so you really kind of don't want to do it again.
00:28:21.599 --> 00:28:28.160
So, you know, you you want to avoid that or not or not, you know, feel motivated or have a negative thought or feeling about it.
00:28:28.400 --> 00:28:35.920
So our our poor old brain's often just sort of in the middle trying to do its very best in the situation in which it it is in.
00:28:36.240 --> 00:28:38.079
And we do have the capacity.
00:28:38.160 --> 00:28:45.599
And if you're asking the question right, what can I do to ensure that my brain is given the best chance?
00:28:45.759 --> 00:28:49.279
We're in a very fortunate position if we're able to ask that question.
00:28:49.359 --> 00:28:49.680
Yeah.
00:28:49.920 --> 00:28:58.319
Um, and you know, even our attitudes towards, you know, health, aging influence those outcomes.
00:28:59.839 --> 00:29:01.200
Yeah, yeah, absolutely.
00:29:01.440 --> 00:29:05.200
Because I think the fear, uh surely, like I I okay, I'm curious about this.
00:29:05.279 --> 00:29:07.839
Like, what does fear and stress do to the brain?
00:29:10.000 --> 00:29:16.000
It's not really what they do to the brain, they're the brain reacting and responding to the situations and circumstances that that we're in.
00:29:16.079 --> 00:29:19.039
I mean, the brain isn't separate like to the fear.
00:29:19.200 --> 00:29:19.599
Yeah, yeah.
00:29:19.759 --> 00:29:28.480
Um, you know, so you could feel feel, and I hate the word stress because it gets you, it's like this one word that gets used to describe lots of things.
00:29:28.640 --> 00:29:38.319
So, you know, we could in in neuroscience we talk about what is the stress or is the thing that is making you feel threatened or scared.
00:29:38.559 --> 00:29:43.440
It could be a spider crawling up the wall, but could be something in your imagination that's not even real, right?
00:29:43.599 --> 00:29:50.079
Um, it could be an ongoing kind of low-level threat, you know, like there's lots of sharks out there in the ocean at the moment.
00:29:50.160 --> 00:30:00.240
I kind of feel a little nervous whenever I go down to the sea, so I don't have to go in, so I avoid them, you know, or it could be something kind of, you know, you'll you're worried about your child because they've got depression or something.
00:30:00.640 --> 00:30:02.240
So there's a stress ore.
00:30:02.559 --> 00:30:09.680
And then but but in any individual stress ore will have a different effect in lots of different people.
00:30:09.839 --> 00:30:17.759
So some people react, you know, to a stressor and they see it as a threat, some people might see that as a challenge, some people might see it as an opportunity.
00:30:18.640 --> 00:30:21.759
So we've all got very different kinds of perceptions.
00:30:21.839 --> 00:30:25.039
So we've got this information coming in that we're then making meaning of.
00:30:25.279 --> 00:30:39.920
Then we've got our stress response systems, and there are multiple kind of pathways in which your brain and your body adapt and react and respond to enable you to kind of mobilize to respond appropriately.
00:30:40.400 --> 00:30:46.240
So, say there's a cuntsman kind of crawling up the wall, and I hate them and I like scream my head off or whatever.
00:30:46.319 --> 00:30:54.319
So, you know, my heart rate's going up, you know, I'm breathing, I'm like, oh, and I'm kind of like semi stuck while I'm waiting to see where it's going to go next.
00:30:54.400 --> 00:30:56.799
Will I decide am I gonna run or am I gonna go and fight?
00:30:56.880 --> 00:30:59.920
Or am I how am I gonna kind of react and respond?
00:31:00.079 --> 00:31:03.359
So we've got like kind of our short-term stress response systems.
00:31:03.519 --> 00:31:14.960
That's very different to the kind of you know, responses that your brain and your body are deploying, you know, in advance of, you know, HSC exams are coming up next year for my youngest son.
00:31:15.039 --> 00:31:17.759
It's already kind of niggling away in the back of his mind.
00:31:18.079 --> 00:31:21.680
That's kind of low-level kind of chronic stress.
00:31:22.079 --> 00:31:23.920
So, what is that doing to us?
00:31:24.079 --> 00:31:27.279
Well, the reactions in the short term are well, they're important.
00:31:27.359 --> 00:31:34.400
They enable us to react and respond and mobilize and you know, like our heart rate and our blood pressure rise so we can react and respond.
00:31:34.480 --> 00:31:37.359
You know, glucose is metabolized so we can react and respond.
00:31:37.519 --> 00:31:41.119
What we want is to be able to kind of come back to a healthy baseline.
00:31:41.440 --> 00:31:46.079
Um, so we're not kind of always staying activated, but we also want to activate sometimes.
00:31:46.240 --> 00:31:49.599
We need a little bit of fish on to get us up and moving in the morning.
00:31:49.839 --> 00:31:50.799
Get up and study, yeah.
00:31:51.279 --> 00:31:58.880
Yeah, so it's not like what happens to our brain when it is stressed, rather, it's understanding what stress varies, and there's many stress response systems.
00:31:58.960 --> 00:32:02.480
We call it an orchestrated neurosymphony of stress.
00:32:02.720 --> 00:32:09.519
There are many systems which are essentially the brain reacting and adapting and responding to the circumstances.
00:32:11.599 --> 00:32:18.240
Um and just back to the question in regards to uh changes and so forth with age.
00:32:18.319 --> 00:32:20.240
Uh, what about specifically memory?
00:32:20.319 --> 00:32:22.160
Because that's one that you know you hear a lot.
00:32:22.240 --> 00:32:29.119
Oh, I feel like I'm forgetting things now and I'm forgetting names and I'm so what's hap, what's happening and how can we improve that or or help them?
00:32:29.440 --> 00:32:29.680
Yeah.
00:32:29.839 --> 00:32:53.440
And I don't think that that's necessarily um, you know, there's this again, we've got like these subjective experiences that the different people have at different points in life, which may or may not be a cause for concern depending on what the problem is, how much it's interfering, and what else is going on in your life.
00:32:53.839 --> 00:33:19.440
So, you know, if say my mum, who's in her late 70s, tells me the same story three times in a day and doesn't remember that she told me that before, that's a different type of memory loss than um my 17-year-old going into a chemistry exam and forgetting, you know, which had a balance of redox reaction, right?
00:33:19.759 --> 00:33:22.559
They're both forgetting things that you know.
00:33:23.279 --> 00:33:44.319
So we've got lots of different ways in which we remember and we forget and different kinds of things that we worry about at different kinds of ages and stages, particularly say women in midlife, often worry that when we forget words or it takes kind of longer for a word to kind of surface into our kind of consciousness that that's like the first sign of Alzheimer's or dementia.
00:33:44.400 --> 00:33:45.920
We get really, really worried about that.
00:33:47.279 --> 00:33:54.000
But that can happen to men too, and it can happen to different people at different ages and stages.
00:33:54.240 --> 00:34:05.839
Sometimes it's the the context within which it is happening which makes us worry more or more, you know, how much do we need to worry about that?
00:34:06.079 --> 00:34:15.519
So um it's always contextual and it's always a little bit hard to say someone forgot a word, therefore we need to worry, or therefore we don't.
00:34:15.760 --> 00:34:22.320
There's there's different contexts within which forgetting something is more or less of a concern.
00:34:22.639 --> 00:34:37.840
If forgetting things starts to interfere with people's life and they don't notice, but other people around them do, that's sometimes more of a cause of concern than someone themselves noticing it, but no one else.
00:34:38.000 --> 00:34:38.559
Right.
00:34:38.800 --> 00:34:41.519
And often we will notice things.
00:34:42.000 --> 00:34:49.840
Say you're having a conversation and you're trying to remember someone's name or the name of a street or band or whatever.
00:34:50.239 --> 00:34:57.760
Often it feels way worse because you're in a conversation with someone and there's all of this kind of social, like, oh my god, oh my god, they're gonna notice I forgot.
00:34:57.840 --> 00:34:58.800
What are they gonna think about me?
00:34:58.960 --> 00:34:59.599
Oh, I can't.
00:34:59.679 --> 00:35:04.559
And so then you get all stressed, and then like you almost kind of make it even harder to remember the thing.
00:35:05.840 --> 00:35:15.280
Um, you can just sort of just you go the band, oh you know, that band from the 90s that we always used to listen to, um, and they sang that song that sounded like Oasis, but it wasn't.
00:35:15.360 --> 00:35:21.039
Well, I don't know, you just say say something like that, and then you kind of carry on, and then the name will kind of kind of bubble to the surface.
00:35:21.280 --> 00:35:27.519
Often it's the social situation or the context within which which which we forget something that can make it feel way worse.
00:35:27.679 --> 00:35:27.840
Yeah.
00:35:27.920 --> 00:35:39.360
Oh, I could forget a name of a band, one of my teenage sons forgets the name of a band, he doesn't automatically default to worry about whether he's got menopause or dementia.
00:35:39.760 --> 00:35:41.679
He's just like, oh, I just forgot, right?
00:35:41.840 --> 00:35:42.239
Yeah.
00:35:42.800 --> 00:35:54.159
But if my mum forgets the name of a of a of a band or forgets that she's asked me the name of that band three times in one day, then that's a bit of a different situation, right?
00:35:54.480 --> 00:35:58.719
So there's the context within which that is that it's happening and how much impact it's having.
00:35:58.800 --> 00:36:05.119
And often it's other people noticing when someone is starting to go through those early stages of dementia and Alzheimer's disease.
00:36:05.280 --> 00:36:09.440
Sometimes, but not always, other people start noticing before that other person.
00:36:10.320 --> 00:36:15.280
Um, I'm not sure whether that was your experience, but um, that's often a bit of a tell.
00:36:15.840 --> 00:36:17.360
Um, yeah.
00:36:17.679 --> 00:36:20.000
So how much do we need to worry about it?
00:36:20.239 --> 00:36:24.480
Probably depends on context and like go off to go to your GP and have a conversation, right?
00:36:24.639 --> 00:36:38.800
They've got really great screening tools that you'd you can do in your GP office that will determine how much you and a screen is like breast screen or you know, Vicos mirror screens, but we don't seem to do them as much anymore now that we've got the vaccine.
00:36:38.960 --> 00:36:48.559
Um, you know, a screening test is just something that we can kind of do quickly and easily to a lot of people in a population and then decide do we need to send you on for more investigations.
00:36:48.800 --> 00:36:49.119
Yeah.
00:36:49.360 --> 00:36:51.920
So you can do that in a in a in your GP.
00:36:52.000 --> 00:36:58.000
And if they think we need to worry about this kind of memory loss, we'll refer you on to a memory clinic or someone else.
00:36:58.320 --> 00:37:01.360
And more often than not, there's not a cause for concern.
00:37:02.480 --> 00:37:09.599
And just in general, like people wanting to keep their brain healthy for as long as possible and functioning at the highest level.
00:37:09.760 --> 00:37:11.679
You talked about like lifestyle factors.
00:37:11.920 --> 00:37:14.960
There's also, I don't know if I I'm sure you get them as well.
00:37:15.119 --> 00:37:21.360
Like, there's such a plethora of like advanced training, longevity programs, devices, supplements.
00:37:21.519 --> 00:37:21.599
Yeah.
00:37:21.840 --> 00:37:26.639
How much of that is just marketing and what are you like actually genuinely excited about?
00:37:27.039 --> 00:37:31.440
There's all of this with the protocol, protocols.
00:37:32.239 --> 00:37:42.639
The protocols that the bros do, the protocols and the optimization, which is very much about, you know, and a lot of that's like peak performers just wanting to like make a few more millions, I reckon.
00:37:43.199 --> 00:37:46.320
Um, it's not about like kind of population level interventions.
00:37:46.400 --> 00:38:08.159
And the vast majority of people still need the population level interventions, which are the basics, which are like kind of, you know, access to good education, um, you know, managing their cardiovascular risk, not smoking, not drinking too much, helping with their depression, getting their hearing tested, um, you know, making sure they haven't got, you know, haven't got high blood pressure diabetes or high cholesterol, whatever.
00:38:08.320 --> 00:38:15.679
It's just the kind of the basics and managing that with good diet, with exercise, with sleep, you know, with social support networks around them.
00:38:16.000 --> 00:38:20.000
All of those basics are where we would see the biggest bang for your buck.
00:38:20.079 --> 00:38:20.320
Yeah.
00:38:20.480 --> 00:38:24.320
Um, taking the supplements and tweaking this and monitoring that.
00:38:24.719 --> 00:38:39.920
I personally feel like we can become a lot of people are so over-optimised and so protocolled, and they're tracking every kind of, you know, like step and sleep and cycle day and you know, calorie that there's that they almost become inflexible.
00:38:40.000 --> 00:38:41.760
And what we want is flexibility in a system.
00:38:41.840 --> 00:38:46.480
We want systems that can adapt and respond and kind of give when necessary, yeah.
00:38:46.639 --> 00:38:50.000
Not that are so tightly optimized that they're brittle.
00:38:50.079 --> 00:38:50.159
Yeah.
00:38:50.320 --> 00:38:52.960
That when one thing changes, everything collapses.
00:38:53.119 --> 00:38:56.239
Yeah, I can't do my seventh step morning routine, so I'm stuck.
00:38:56.480 --> 00:38:58.159
No, that's kind of ridiculous it's kind of ridiculous.
00:38:58.239 --> 00:39:04.559
And it's usually the guys, the guys, the childless guys, um, or the husbands that are that are doing that kind of thing.
00:39:04.800 --> 00:39:11.760
Um, whereas it's the the vast majority of people just need to be doing the basics.
00:39:11.840 --> 00:39:26.079
And there's so many people that that aren't not through any fault of their own, aren't or can't or don't understand the importance of, you know, just good diet, nutrition, you know, sleep, not smoking, you know, still.
00:39:26.320 --> 00:39:26.639
Yeah.
00:39:27.199 --> 00:39:40.320
So, you know, I think it's like scientifically interesting to tweak um all of this stuff, but um a lot of it I think almost encourages navel gazing as well.
00:39:40.480 --> 00:39:48.800
It becomes quite like it's they become very self-absorbed and they're not necessarily don't seem like they're having a lot of fun along the way.
00:39:50.239 --> 00:39:51.440
Think about Brian Johnson.
00:39:51.519 --> 00:39:55.360
I'm like, is that like is he having a good time?
00:39:55.679 --> 00:40:05.840
He said something once about how he would have to come he had to come to Australia to meet his um partner's uh parents and so worried about the cost on his age.
00:40:05.920 --> 00:40:06.880
I'm like seriously.
00:40:07.360 --> 00:40:07.920
Yeah, I know.
00:40:08.000 --> 00:40:09.039
There's not a lot of joy.
00:40:09.119 --> 00:40:12.480
His his joy span is quite narrow.
00:40:12.960 --> 00:40:14.800
That should be a whole measurement, right?
00:40:14.880 --> 00:40:16.159
Like joy span.
00:40:16.320 --> 00:40:16.960
And that's fine.
00:40:17.039 --> 00:40:29.280
Like he can do he can do he can do what he likes, but um and and they all can really, but I I'm not necessarily sure whether it's gonna help as many other people apart from himself as he thinks.
00:40:30.239 --> 00:40:30.480
Cool.
00:40:30.639 --> 00:40:32.079
Let's switch skids a little bit.
00:40:32.159 --> 00:40:35.599
Um, I love learning new things, and I imagine lots of the listeners do too.
00:40:35.679 --> 00:40:39.280
So I'm just keen to hear about your thoughts.
00:40:39.360 --> 00:40:45.440
I I read somewhere from you about how visualization can be used for mastering like new skills and so forth.
00:40:45.519 --> 00:40:45.599
Yeah.
00:40:45.920 --> 00:40:47.679
If you could tell us a little bit about that.
00:40:48.000 --> 00:41:05.360
Yeah, I mean, most people when they think about visualization, they'll think about, say, an Olympic athlete, you know, the a gymnast in particular, because you'd see them like before they do the vault or the floor, you can see them kind of doing it in their mind's eye, and they're kind of moving their body and they're kind of doing that mental rehearsal rehearsal and visualization.
00:41:05.519 --> 00:41:09.440
So as we we've got so much evidence that it's really powerful and useful.
00:41:09.599 --> 00:41:13.119
You can use it to like practice a musical instrument, to practice like dance moves.
00:41:13.199 --> 00:41:18.320
I do musical theatre, so you know we we can lie in bed at night and practice our dance moves in our mind.
00:41:18.400 --> 00:41:22.719
We don't just have to be looking at ourselves in the mirror going, what am I doing?
00:41:23.440 --> 00:41:26.320
Um, so it's a great add-on extra.
00:41:26.400 --> 00:41:40.400
It doesn't always necessarily it doesn't replace like practicing the actual thing, but it's a really great kind of adjunct, and that's because um very similar brain networks are kind of involved with the process of imagining yourself doing a thing as doing the thing itself.
00:41:40.559 --> 00:41:44.719
It can't replace doing the thing, but imagining doing the thing can be quite useful.
00:41:44.960 --> 00:41:52.239
People have got more or less kind of capacity or ability to be able to imagine things that aren't there.
00:41:52.400 --> 00:41:56.719
Um, I've got quite a very strong imagination and visual kind of sense.
00:41:56.880 --> 00:42:01.519
I can kind of um see things quite clearly in my mind.
00:42:01.840 --> 00:42:04.480
So that's quite easy for me to kind of do.
00:42:04.800 --> 00:42:07.360
Um, other people much more fight would find it much harder.
00:42:07.440 --> 00:42:10.639
So sometimes we'll use the word now imagine instead of visualize.
00:42:10.800 --> 00:42:19.199
Um just on that, because I'm very curious about that, because I've naturally been much more about like absorbed information differently than visual.
00:42:19.360 --> 00:42:25.519
Um, so can you train yourself to be like a better, better at visualization, or does it not mat matter?
00:42:25.599 --> 00:42:28.000
It's just I don't really think it it matters.
00:42:28.079 --> 00:42:31.440
It's more about like, does the imagining?
00:42:31.840 --> 00:42:39.920
This is why we might use the word imagine instead of visualize, um, imagining yourself doing a thing help with the outcome.
00:42:40.239 --> 00:42:55.039
And I'm not sure of the literature, it may or may not exist that people who are visual have have more or less might have better outcomes than people who aren't so visual, who like have visual kind of hyper fantasia versus like apantasia.
00:42:55.199 --> 00:43:01.440
Kind of some people are very good at kind of imagining scenarios and other people aren't as good at that.
00:43:02.000 --> 00:43:12.159
Um, and then I th so I think like the tendency would be the more imaginative you are and the more you can control that imagination to rehearse a situation, the better the outcome.
00:43:12.719 --> 00:43:17.280
But that's not necessarily always the case because it depends on the practical skill.
00:43:17.519 --> 00:43:29.360
I think one underrecognized situation where where lots of people could use it and they don't, because they don't understand how emotions are constructed, is that you can use it to rehearse emotions in advance of a situation.
00:43:29.920 --> 00:43:32.400
Everyone who works in theatre knows this.
00:43:32.639 --> 00:43:44.239
You can, you know, train yourself to use to feel the emotions that you are acting out, and you know, you feel them, and so they're in your body, and you know, they'll be displayed and expressed for other people to kind of see.
00:43:44.719 --> 00:43:48.559
Um and and that's because you practice them so many times in advance.
00:43:48.639 --> 00:43:51.199
So you can do that in any kind of situation.
00:43:51.440 --> 00:43:58.159
And I I I taught this from someone who worked in theatre who helped me prepare for my TED talk, which was like a million years ago now.
00:43:58.239 --> 00:43:59.760
I think it was like in 2013 or 2014.
00:44:00.239 --> 00:44:01.440
It was so long ago.
00:44:01.519 --> 00:44:04.559
Um, I've almost forgotten how long you do another one.
00:44:04.960 --> 00:44:06.159
Oh, can't be bothered.
00:44:06.719 --> 00:44:16.320
Um But she she what I wanted to do was not feel so ner so scared that I was nervous that I couldn't do the talk.
00:44:16.400 --> 00:44:17.599
And she was like, Well, that's easy.
00:44:17.679 --> 00:44:19.039
We can practice how you want to feel as well.
00:44:19.199 --> 00:44:22.239
So we'll rehearse the talk, but we can rehearse your emotions too.
00:44:22.480 --> 00:44:27.360
And essentially what that does, it's like learning anything, it becomes sort of semi-automated.
00:44:27.440 --> 00:44:37.039
So when you're in the situation or the context, the emotions that you've rehearsed also roll out, which is great because then you don't have to worry about containing them and controlling them.
00:44:37.280 --> 00:44:52.079
And you're not using cognitive capacity, you're not adding to your cognitive load by also managing your emotions because you practice what ones you're gonna so they will roll out, the talk will roll out, and then that frees frees you up to react and to respond in the moment.
00:44:52.800 --> 00:45:09.280
So, you know, you can react and respond to you know the audience or um to an unexpected situation that may arise because you've got the emotions rehearsed and practiced, you've got the talk rehearsed and practiced, the dance moves rehearsed and practiced, whatever.
00:45:09.440 --> 00:45:16.239
There's so many cool ways in which, like, you know, um neuroscience and our understandings of this and theatre come together.
00:45:16.320 --> 00:45:19.039
And because I do a bit of musical theatre, I think about this quite a lot.
00:45:19.599 --> 00:45:31.760
Um, there's so much about where attention goes and um, you know, what's happening in our bodies and our and our breath and you know, our and interacting with other people.
00:45:32.480 --> 00:45:36.559
Um neuroscience and theater could learn a lot from each other.
00:45:36.639 --> 00:45:38.880
It's really I find that really fascinating.
00:45:39.199 --> 00:45:49.280
Is that yeah, I mean, I love that I I um used to do a lot of dance performances and I stopped for 10 years and I just recently did one and I was so busy at the time I barely had time to practice.
00:45:49.360 --> 00:45:53.840
And I had read this about visualization, and so I visualized the hell out of that thing every night.
00:45:53.920 --> 00:45:56.320
And I think it absolutely made a big difference.
00:45:56.400 --> 00:45:59.199
But I love what you're saying about emotions because you can apply that to anything.
00:45:59.280 --> 00:46:06.719
Like even you have to have like, I don't know, a stressful conversation with your boss or whatever, like imagining it so you can be present in the moment is so powerful.
00:46:06.960 --> 00:46:11.440
Yeah, and imagine what emotions you are going to feel, not oh, what will I do when I get upset?
00:46:11.760 --> 00:46:12.000
Yeah, yeah.
00:46:12.159 --> 00:46:18.800
It's like go in and practice the conversation in advance in your mind and practice the emotion that you will feel.
00:46:19.760 --> 00:46:27.840
Because your construct uh your emotions are constructed based on the context of your body and the context that you're in, and also your mind.
00:46:28.559 --> 00:46:32.079
And so you can rehearse that too.
00:46:32.400 --> 00:46:34.800
You you have a lot of agency over that.
00:46:35.199 --> 00:46:43.519
Um, it's not like uh you're not, you know, um writing this like emotional roller coaster that you're not in charge of.
00:46:44.239 --> 00:46:45.840
So you can train it up too.
00:46:46.239 --> 00:47:06.719
And did you go get into musical theater specifically, kind of uh seeing the linkage, the usage, or was it a passion and then I think I was one of those kids who was always too shy and scared, and the confident girls at school were the ones that did that, and I was quite shy and not very confident, and I always wanted to, but I was like, who am I?
00:47:06.960 --> 00:47:18.719
Like I you know, um, and it and only well, one I started doing doing more and more public speaking um and started to understand how that was actually a performance.
00:47:19.280 --> 00:47:38.719
Um when I first started doing a lot of keynote speaking and public speaking, I found it really hard to reconcile being on stage and putting on a performance and then coming off and then like I I didn't realize that I it was a performance and it was okay to kind of shift between various versions of yourself.
00:47:39.119 --> 00:47:58.800
Initially I felt like that was quite um not deceptive, but I found it quite confused my sense of identity, and I actually started feeling I started feeling quite panicky and stressed and anxious, not about being on stage, but about afterwards interacting with people when I wasn't on stage.
00:47:58.880 --> 00:48:03.440
I just found it very confusing time in terms of my identity.
00:48:03.519 --> 00:48:05.760
And then randomly I was talking to a psychiatrist about it.
00:48:05.840 --> 00:48:19.039
I wasn't seeing a psychiatrist, he just happened to be at a conference I was at, and I was sort of chatting to him about that, and he told me how he called it this particular phenomenon, and I cannot for the life of me remember it was a phenomenon that was named after some old style English actor.
00:48:19.199 --> 00:48:21.840
I keep meaning to look it up, maybe AI might now know.
00:48:22.000 --> 00:48:22.320
Yes.
00:48:22.480 --> 00:48:34.159
Um, and he said, just watch yourself go between he said it's okay, you don't need to just watch, just stand back and observe these different kinds of people that you are.
00:48:34.480 --> 00:48:38.960
And I was like, Oh, I don't need it's not a I don't need to have a war within myself.
00:48:39.360 --> 00:48:41.599
And as soon as he said that, I was like, oh, I can.
00:48:41.840 --> 00:48:42.400
It's okay.
00:48:42.480 --> 00:48:44.079
It's okay to do these things.
00:48:44.239 --> 00:48:47.199
And then um the musical theatre came about.
00:48:47.679 --> 00:48:55.519
Um, so my local pri then my our primary school where I am in Laby Heights, Labbey Heights Public School for the win.
00:48:55.599 --> 00:49:05.679
Um, 10 years ago, um, some of the parents, so my boys were kind of like years three, four, two, three, something like that at that point, decided to put on musical to raise funds for the PNC.
00:49:06.239 --> 00:49:09.760
And a couple of the people had done like theatre, loads of theatre stuff.
00:49:10.000 --> 00:49:15.280
Turned out quite a few people were like quite talented, and they put on a thing of Greece.
00:49:15.519 --> 00:49:22.159
Um, and I was out of the country, so I couldn't be involved, but I just so wanted to be involved.
00:49:22.480 --> 00:49:24.559
And so I have been involved ever since.
00:49:24.639 --> 00:49:35.840
We've put on four different musicals over the years, um, and it's mostly just you know, now all of our kids have grown up and gone off to university, but we still get on stage.
00:49:36.159 --> 00:49:36.800
Love it, don't you?
00:49:37.119 --> 00:49:39.199
And it is the best time.
00:49:39.440 --> 00:49:47.519
It takes up about six months every two years, and then for the other 18 months, everyone is very sad that we're no longer like rock stars on stage.
00:49:47.599 --> 00:49:48.079
Yeah, yeah, yeah.
00:49:48.239 --> 00:49:48.559
Oh my god.
00:49:48.960 --> 00:49:49.840
Show girls or whatever.
00:49:49.920 --> 00:49:50.719
Yeah, totally.
00:49:50.800 --> 00:49:51.199
I love it.
00:49:51.440 --> 00:49:55.440
So that's how I got into that, and then with the and that's helped my public speaking.
00:49:55.599 --> 00:49:56.239
Yeah, of course.
00:49:56.559 --> 00:49:59.599
Um, because people just want to have a good time.
00:49:59.760 --> 00:50:00.079
Yeah.
00:50:00.320 --> 00:50:08.639
It doesn't matter whether it's an audience of grumpy high school principals, and as a collective noun, high school principals are a massive big grump.
00:50:09.280 --> 00:50:14.960
Um they're probably the hardest crowd to crack, but everyone else in an audience just wants to have a good time.
00:50:15.119 --> 00:50:15.280
Yeah.
00:50:15.440 --> 00:50:22.320
They just want to be entertained and to learn something new and to have a bit of fun, and that's all a musical theatre audience wants as well.
00:50:22.480 --> 00:50:22.639
Yeah.
00:50:22.719 --> 00:50:22.960
Yeah.
00:50:23.119 --> 00:50:28.719
So I've just learned that the power of like kind of performance and engagement.
00:50:28.880 --> 00:50:33.920
And if you've learned, you know, your stuff and you're up there having fun, then they will too.
00:50:34.000 --> 00:50:34.960
And that's all that matters.
00:50:35.199 --> 00:50:35.920
Yeah, I love it.
00:50:36.079 --> 00:50:37.039
Love it so much.
00:50:37.280 --> 00:50:40.639
Um, okay, let's f turn the focus now to women.
00:50:40.719 --> 00:50:51.760
Um and I'm really, and obviously this is one of your areas of expertise, because I'd love to hear like what's actually happening um in a woman's brain during that kind of perimenopause and menopause period.
00:50:52.079 --> 00:50:53.920
Yeah, so there's a there's a couple of things.
00:50:54.079 --> 00:51:00.480
One is what, you know, in our brain, that kind of brain ovarian body conversation drives the onset of menopause.
00:51:00.559 --> 00:51:02.159
How does the brain react and respond?
00:51:02.320 --> 00:51:09.119
And then what symptoms do we experience and what do we know, you know, in terms of what's happening to the symptoms in the moment in our long-term health?
00:51:09.280 --> 00:51:13.519
So there's quite a bit, and I know we've we've not got all day, I could talk about this all day.
00:51:13.760 --> 00:51:16.239
So the brain reacts and responds to everything that is happening.
00:51:16.320 --> 00:51:18.079
That's all the brains do, react and respond.
00:51:18.159 --> 00:51:29.840
They don't really, you know, prioritize, but as our ovarian, you know, hormones sort of start to the cycles start to dial down, the brain's reacting and responding to those roller coastering hormones.
00:51:30.079 --> 00:51:44.320
So the one part of our neurobiology that we do understand absolutely definitely happens is that the hypothalamus, which is responsible for lots of kind of basic physiological functions, there are neurons in that that are regulated by estrogen that help us detect and manage body temperature.
00:51:44.559 --> 00:51:55.199
And the reason body temperature and our brains and hormones have anything to do with each other is that our fertility and our body temperature are really tightly entwined, and we need very, very good thermoregulatory control to be fertile.
00:51:55.599 --> 00:52:00.800
Once we start kind of going through our reproductive senescence, we're no longer fertile.
00:52:00.960 --> 00:52:05.039
There's not really any kind of like, you know, evolutionary adaptive need.
00:52:06.000 --> 00:52:08.400
We've reproduced, Mother Nature really doesn't mind anymore.
00:52:08.480 --> 00:52:09.039
What happens?
00:52:09.519 --> 00:52:15.199
Um, and so you know, we don't need that tight control of our thermoregulation anymore.
00:52:15.360 --> 00:52:23.760
And so we understand that the kind of the neurons and the brain that respond to body, small changes in body temperature can get like just like massively overreact.
00:52:23.920 --> 00:52:32.719
It's just like they're just like dialed up and there's a small shift in body temperature, and the neurons in the brain go, oh my god, it's hot, and here we need to cool her down as quick as possible.
00:52:32.800 --> 00:52:34.960
And they kind of go on to alarm, alarm, alarm.
00:52:35.119 --> 00:52:39.599
And so we've got like physiological responses like sweating and flushing, which cool us down.
00:52:39.679 --> 00:52:41.360
So that rapid heat dissipation.
00:52:41.599 --> 00:52:44.159
Your body might not need it, but your brain thinks it does.
00:52:44.639 --> 00:52:47.840
Um, and then the behavioural ways to cool ourselves down.
00:52:48.079 --> 00:52:52.320
So, um, which are fine if you're awake, you can open a door or take clothes off.
00:52:52.400 --> 00:53:02.960
But if you're asleep and you've got lots of bed covers on you, then you're not behaving to cool yourself down, and your brain is trying so hard because it thinks you're overheating that it eventually wakes you up.
00:53:03.119 --> 00:53:18.239
And then so once you go from into the sleep disruption, then there's so many other dominoes that that start to fall, which may be kind of a secondary consequence of these changes in thermoregulation.
00:53:18.960 --> 00:53:30.559
What's like a primary result of changing hormones on the brain, and what is secondary to thermoregulation and then sleep is debatable, and it might differ for different women.
00:53:30.880 --> 00:53:39.760
Um, we know that hormones are responsible because if we put hormones back in with HRT, we reset the thermostat and the vasomotor symptoms are largely managed in most women.
00:53:39.920 --> 00:53:41.760
Not all women all the time, but most.
00:53:42.079 --> 00:53:50.960
Um so how does the brain kind of people often want to then hear, oh, well, what happens is your brain gets shrunken across menopause, and that's why I'm forgetful.
00:53:51.199 --> 00:53:53.679
I feel like that's the story people want to hear.
00:53:53.920 --> 00:53:57.360
I don't know why they want to hear that their brain is damaged, but it is not.
00:53:57.519 --> 00:54:02.639
And last, just last week, we have been waiting for many years for what a longitudinal study.
00:54:02.800 --> 00:54:13.360
So I don't want to just look at a group of women pre-menopausal, perimenopausal, and post-menopausal and average them out and go, well, this is like what an average brain of this group of women looks like.
00:54:13.440 --> 00:54:14.559
Because my brain is an average.
00:54:14.639 --> 00:54:16.079
I don't want to be an average.
00:54:16.320 --> 00:54:17.440
Yeah, thank you very much.
00:54:17.760 --> 00:54:19.119
So thank you very much.
00:54:19.280 --> 00:54:21.440
You can all be average, mine is not.
00:54:21.599 --> 00:54:35.199
What we want is we want to look at a large group of women and we want to kind of follow them across an age or life stage that's a longitudinal study, and then look at all of the different trajectories because not everyone is like ruined.
00:54:35.519 --> 00:54:39.519
Lots of people's brains just like carry on, you know, improving.
00:54:39.679 --> 00:54:46.079
Some people's brains are stable, some people's cognition does start to alter, some people styles down and jumps back up, right?
00:54:46.239 --> 00:54:50.000
So we want to understand all of these different individual trajectories and what drives them.
00:54:50.159 --> 00:54:50.239
Yeah.
00:54:50.400 --> 00:55:00.239
So just a couple of weeks ago, uh, this longitudinal study that was published, and it was looking at grey matter, and gray matter is kind of like if you looked at the outside of a brain, it's all of a wrinkly kind of covering of the brain.
00:55:00.320 --> 00:55:05.280
And it looked what happens across puberty, what happens across pregnancy, and what happens across menopause.
00:55:05.599 --> 00:55:12.639
Puberty and pregnancy are very similar in that regions of the grey matter get slightly thinner, which sounds like degeneration.
00:55:12.880 --> 00:55:15.760
It's not shrinkage, it's like streamlining.
00:55:15.840 --> 00:55:29.840
It's getting kind of leaner and meaner, it's getting kind of better at doing what it does, and mapping and tracking alongside the changes, the reduction in grey matter volume in teenagers, brains and pregnancy is the emergence of new skills.
00:55:30.159 --> 00:55:40.400
It's kind of like, you know, we see new, new kind of abilities and strengths kind of emerge or enhance as we see that shrinkage, which is kind of interesting.
00:55:40.559 --> 00:55:42.960
You you would might think it's the opposite, but it's not.
00:55:43.199 --> 00:55:53.840
Menopause, then everyone's like, well, it's probably, is it gonna well if puberty and pregnancy show shrinkage, but they're adaptive benefits, what are we gonna see at menopause?
00:55:54.320 --> 00:55:55.760
They found no change.
00:55:56.480 --> 00:55:56.639
Really?
00:56:00.400 --> 00:56:03.199
It's not accelerating degeneration.
00:56:03.679 --> 00:56:32.000
If anything, it seemed to pause it, which was super interesting because what you do see, like if you look across the entire lifespan, you do see gray matter kind of, we see these big changes, big adaptive changes in response to puberty and pregnancy, which are driven by hormones, in terms of gray matter getting kind of narrower, but also across the entire lifespan, the men included, brains do, brain gray matter also gets slightly thinner, which just reflects aging.
00:56:32.239 --> 00:56:36.079
But what they saw during perimenopause was actually that stopped.
00:56:36.400 --> 00:56:44.239
It didn't like in some studies, not the longitudinal studies, but some other studies have actually shown the gray matter getting slightly thicker.
00:56:44.719 --> 00:56:53.920
So those stories of degeneration and decline and dysfunction aren't playing out in terms of what that menopause kind of structural change is showing us.
00:56:54.079 --> 00:56:57.920
So that's sort of that's kind of a very brand new and interesting finding.
00:56:58.159 --> 00:56:58.960
That's crazy.
00:56:59.039 --> 00:57:02.320
Like that's totally counter to what we're told, right?
00:57:03.039 --> 00:57:08.719
Well, because people who are telling you things aren't telling you based on science stories about neuroscience.
00:57:08.880 --> 00:57:11.280
They're just speaking, they're just speaking words.
00:57:11.440 --> 00:57:11.599
Yeah.
00:57:11.920 --> 00:57:16.239
They're not describing the science, they're not describing what we've seen in the studies.
00:57:16.639 --> 00:57:17.280
Yeah.
00:57:17.760 --> 00:57:20.079
So there's there's that, right.
00:57:20.239 --> 00:57:26.000
And then there's other, then then then there's more like the symptoms that we might experience.
00:57:26.159 --> 00:57:31.599
So these could be mood symptoms like anxiety and depression, which we do see increases of.
00:57:31.760 --> 00:57:35.519
What causes what causes that is an interesting question.
00:57:35.679 --> 00:57:43.519
And then another might be brain fog, and what that is, even, and what causes that, and therefore what we can do about it, is also an interesting question.
00:57:43.840 --> 00:57:47.920
So I'll do the brain fog because the mood stuff's again.
00:57:48.239 --> 00:57:48.719
We'll do it.
00:57:49.199 --> 00:57:50.400
We've probably only got time to do one.
00:57:50.559 --> 00:57:56.400
Brain fog is interesting because brain fog is a word that we use to describe, I feel like my brain isn't kind of working right.
00:57:56.639 --> 00:58:01.599
I'm feeling a bit forgetful, I can't pay attention, my brain isn't, I don't feel like myself.
00:58:02.000 --> 00:58:07.599
But women going through pregnancy and early motherhood also report the exact same subjective experiences.
00:58:07.760 --> 00:58:19.840
But so do people maybe who are going through chemotherapy or maybe you've got depression, um, you might report brain fog or um sleep deprivation, you might report brain fog.
00:58:20.159 --> 00:58:27.519
And actually, the latest survey of women across the lifespan done by Jean Hales asked, Are you worried about your memory and attention?
00:58:27.679 --> 00:58:34.079
And the largest proportion was 60% of an age group were girls aged 18 to 30 who were most worried.
00:58:34.239 --> 00:58:39.760
So we've got these subjective words we use to describe, I feel like my memory and attention aren't working.
00:58:40.480 --> 00:58:48.079
But I feel like we use them at different ages and stages, sometimes using different words like baby brain, maybe in pregnancy.
00:58:48.159 --> 00:58:51.360
Yeah, brain fog, maybe perimenopause.
00:58:51.760 --> 00:58:54.880
I don't know what the girls aged 18 to 30 are saying.
00:58:55.280 --> 00:58:56.480
They're just worried.
00:58:56.639 --> 00:58:56.880
Yeah.
00:58:57.199 --> 00:59:00.719
Older women are, women at 16 over weren't worried at all.
00:59:01.360 --> 00:59:02.480
Go figure.
00:59:03.199 --> 00:59:06.639
So we've got the subjective experience.
00:59:06.880 --> 00:59:09.199
And then what we want to do is measure that.
00:59:09.280 --> 00:59:10.480
Like go, well, what is this?
00:59:10.639 --> 00:59:11.599
Can we can we measure it?
00:59:11.679 --> 00:59:14.480
And so we can go in and do all of these kinds of cognitive tests.
00:59:14.800 --> 00:59:20.639
And mostly when we do a lot of cognitive tests on most women, we don't pick up any change whatsoever.
00:59:20.800 --> 00:59:26.480
So women might be saying they feel like there's a problem with their brain, but we're going in and going, well, there's not.
00:59:26.559 --> 00:59:28.800
And that doesn't mean you're making it up.
00:59:29.199 --> 00:59:32.480
It's more that, well, we're not picking up deficit or decline.
00:59:34.000 --> 00:59:35.119
Which is interesting.
00:59:35.280 --> 00:59:42.960
If we do pick up something, and some women, some of the time, if we do pick up anything, it's it's often verbal recall issues.
00:59:43.119 --> 00:59:54.960
So that's like here's a list of I well, I'll read out 20 words to you, re read, you know, repeat as many back to me as you can remember, and then 10 minutes later I'll ask ask you again, and then tomorrow I'll ask you again.
00:59:55.199 --> 00:59:58.239
So verbal recall is how many of those can you remember?
00:59:58.400 --> 01:00:05.679
Um, and if we pick up anything during perimenopause, often there's a little bit of a a gap there, but it's nothing pathological.
01:00:05.840 --> 01:00:07.840
It's not like a cause for concern.
01:00:07.920 --> 01:00:10.159
You might just be remembering a word or two less.
01:00:10.400 --> 01:00:12.320
So that's an interesting finding.
01:00:12.400 --> 01:00:16.880
And then what what we tend to see is that sort of changes and then it kind of bounces back.
01:00:17.119 --> 01:00:19.360
Um women kind of seem to react and respond.
01:00:19.519 --> 01:00:20.960
So what's that due to?
01:00:21.119 --> 01:00:21.519
Yeah.
01:00:21.760 --> 01:00:28.800
What is the subjective, even if we set aside the objective measures when we're not picking anything up, what's the subjective feeling due to?
01:00:28.960 --> 01:00:33.280
Is it a direct consequence of the lack of sleep that's caused by the vasomotor symptoms?
01:00:33.519 --> 01:00:45.280
Is it going hand in hand perhaps with depression and or anxiety, which may be a consequence of the lack of sleep or a consequence of a really dialed up nervous system that's been busy trying to cool you down?
01:00:45.599 --> 01:00:58.239
Um is it due to cognitive load, which is the ability, you know, how many competing things are there that your brain is trying to juggle and manage and respond, react and respond to?
01:00:58.320 --> 01:00:58.480
Yeah.
01:00:58.719 --> 01:01:10.320
Cognitive load is probably what the young girls are managing because their issue is probably, you know, working memory issues caused by trying to ignore their phone.
01:01:10.960 --> 01:01:13.519
Like so much of their attention is being sucked up by their phone.
01:01:13.679 --> 01:01:18.079
It's like the mobile phone is has got the same salience as a newborn baby.
01:01:18.159 --> 01:01:18.320
Yeah.
01:01:18.480 --> 01:01:30.000
And so when your attention is focused in on your newborn baby, um, you can't how much information you're taking in and filtering out is determined by the baby in your arms.
01:01:30.239 --> 01:01:30.880
Yeah, totally.
01:01:31.039 --> 01:01:34.719
Um, it's not that the brain isn't working, it's just got competing demands.
01:01:34.880 --> 01:01:37.119
So is it some competing demand thing?
01:01:37.360 --> 01:01:41.039
Is it due to changes in brain metabolism?
01:01:41.199 --> 01:01:54.400
There's one idea in here that as brains are going through this kind of reproductive transition, that um in some women some of the time, and I will always say some women some of the time, because some women don't even notice anything, they get through menopause fine.
01:01:54.639 --> 01:02:03.679
Some women, some of the time, um, it may be that their brain metabolism isn't quite um it's you know, it's some in some way altered.
01:02:03.760 --> 01:02:13.039
It's a bit like almost fatigued, um, and it kind of needs to kind of, you know, find new ways to sort of utilize glucose, etc.
01:02:13.280 --> 01:02:15.840
So that's where a lot of the creatine stories have come from.
01:02:16.000 --> 01:02:16.159
Yeah.
01:02:16.400 --> 01:02:22.719
Um, a lot of women are using creatine as a way of kind of bypassing, you know, give give giving quick release energy stores to the brain.
01:02:22.800 --> 01:02:26.480
Um, there's a clinical trial going on in Sydney at the moment to take a look at that.
01:02:26.719 --> 01:02:34.239
Um, so there's a whole ton of things going on when it comes to it's not an easy, we don't have this really clear, nice narrative yet.
01:02:35.280 --> 01:02:38.639
Um does hormone replacement therapy help?
01:02:38.880 --> 01:02:41.360
The randomized control trials say no.
01:02:42.000 --> 01:02:42.559
Really?
01:02:42.960 --> 01:02:47.280
The subjective experiences anecdotally a woman will say yes.
01:02:47.760 --> 01:02:50.320
That's why we do, you know, clinical trials.
01:02:50.480 --> 01:03:01.840
If you blind people as to whether they are um being treated with hormones or not, and there's lots of, you know, there's there's this there's not lots of studies, but there are studies out there that have looked at that.
01:03:01.920 --> 01:03:08.239
Um they find that it doesn't make a difference, which is kind of interesting and doesn't feel intuitive.
01:03:08.800 --> 01:03:11.599
So brain fog is a bit of a conundrum.
01:03:12.719 --> 01:03:24.000
But I mean, I think the one of the really important things that you're saying is don't like there's actually your brain is not declining from uh from what the what the research shows.
01:03:24.079 --> 01:03:30.239
There's lots of gray matter's structure is not speeding up its loss.
01:03:30.400 --> 01:03:32.320
In fact, it's stopping.
01:03:32.880 --> 01:03:45.920
Um and we don't always necessarily see something in the brain getting bigger or smaller, like grey matter getting thinner or fatter, doesn't necessarily play out in the way that we intuitively expect.
01:03:46.000 --> 01:03:48.960
You think less is worse, more is better.
01:03:49.440 --> 01:03:51.760
But sometimes less can be better.
01:03:52.480 --> 01:03:56.800
Because brains don't really always react and respond the way we we necessarily predict.
01:03:57.119 --> 01:04:03.760
So is menopause a time in which brain aging speeds up or slows down?
01:04:04.880 --> 01:04:07.760
It's definitely an inflection point.
01:04:08.079 --> 01:04:17.840
Yeah, our brains definitely react and respond, and it's probably a really good time to sort of start thinking about what we can do to support it for the next phase of life.
01:04:18.400 --> 01:04:22.000
Um, and there's many ways in which we can support our brains.
01:04:22.239 --> 01:04:29.920
I suppose the big question currently is is menopause bringing you closer to dementia.
01:04:30.079 --> 01:04:35.360
Well, I mean, you're getting older, so it's like saying, does puberty bring you closer to adulthood and further from childhood?
01:04:35.519 --> 01:04:36.000
Well, yes.
01:04:36.079 --> 01:04:38.559
It's this inevitable reproductive transition.
01:04:38.719 --> 01:04:42.000
It's very hard to separate it out from aging because it happens as you get older.
01:04:42.159 --> 01:04:44.480
The older you are, the more likely you've gone through menopause.
01:04:44.639 --> 01:04:49.440
So it's very, very hard and it takes and it's a longer process, so it's really hard to tease that out.
01:04:49.840 --> 01:04:53.840
Um, I don't necessarily know whether that's the right question.
01:04:54.159 --> 01:05:00.960
I think the more important question is if we're using hormone replacement therapy, is that increasing or decreasing risk for dementia?
01:05:01.280 --> 01:05:03.360
Because menopause is going to happen anyway.
01:05:03.519 --> 01:05:04.719
It's like puberty.
01:05:05.119 --> 01:05:06.239
You can't stop it.
01:05:07.599 --> 01:05:18.400
So if we're treating the symptoms of menopause in the now with hormone replacement therapy, we're treating treating vasomotor symptoms, is that preventing dementia risk later in life?
01:05:18.639 --> 01:05:23.440
And right now, the the data is not clear enough to say one way or another.
01:05:24.159 --> 01:05:29.599
Lots of people are saying yes, which is not based on the data.
01:05:29.920 --> 01:05:32.000
That's based on them wanting it to be true.
01:05:32.559 --> 01:05:40.880
I don't think we need to make up reasons for women to take hormone replacement therapy because the reasons for treating symptoms should be compelling enough.
01:05:40.960 --> 01:05:53.440
We don't need to make stuff make stories up about brain health later in life as a way of validating the use of hormone replacement therapy now or the age in which you start using it.
01:05:53.679 --> 01:05:57.039
Um does it increase the risk of dementia?
01:05:57.119 --> 01:05:59.760
I mean, we've got some studies that say uh it slightly increases risk.
01:06:00.559 --> 01:06:05.440
Other studies saying it slightly decreases risk, and other studies saying it's kind of net neutral.
01:06:06.079 --> 01:06:15.519
So I always think about dementia risk as being like a set of scales, like those old-fashioned scales, and something that increases your risk, you know, kind of tips the scales down.
01:06:15.760 --> 01:06:20.400
Something that pr is a preventative or reduces your risk is a weight that goes on the other side.
01:06:20.480 --> 01:06:21.760
It kind of balances things out.
01:06:21.840 --> 01:06:27.119
And obviously you want as many protective factors and as fewer risk factors as possible.
01:06:28.320 --> 01:06:34.719
And with hormone replacement therapy, one, we don't know how big and heavy that weight is, and two, we don't know which side it goes on.
01:06:36.000 --> 01:06:45.920
And that's what people should be in the world who aren't saying this should be saying, because that's the that's based on the current state of the research.
01:06:46.559 --> 01:06:53.840
But lots of people are are talking about it if it's a big heavy weight that goes on the prevention side, and I don't think that that's fair or accurate.
01:06:54.000 --> 01:06:55.679
We don't need to say that.
01:06:56.400 --> 01:07:00.400
We've got plenty of other things that we can say with certainty.
01:07:00.800 --> 01:07:10.400
So maybe just to finish up, we can um just look quickly at like what are some of you mentioned earlier about habits being something that's easy, easier to look at.
01:07:10.559 --> 01:07:17.280
Um like what are some of the habits that a woman during this phase can do that are protective?
01:07:17.519 --> 01:07:22.639
Yeah, I don't I I would not use the word habits here because within neuroscience it's got a specific meaning.
01:07:22.800 --> 01:07:22.960
Okay.
01:07:23.280 --> 01:07:32.239
Um I would say lifestyle choices, bearing in mind not everyone has choices about which lifestyle things to implement.
01:07:32.400 --> 01:07:52.079
So we know, like an early, you know, the first kind of couple of decades of your life, the more education, the more intellectually engaged you are, the more you like train your brain to learn stuff, not like look at stupid reels on Instagram all day long, um, get off the screens and handwrite stuff and read books and learn things, the more reserve you'll build up in your brain.
01:07:52.239 --> 01:08:04.960
And we'd say the stronger signals for, you know, education, primary, secondary, tertiary education, but the more kind of intellectually stimulated we we maintain throughout our lifespan, the more kind of we use it, the less you will lose it.
01:08:05.039 --> 01:08:20.640
And we see it's not that you will stop the pathological, you know, it's not that you will prevent Alzheimer's disease pathology, rather you'll build up resilience so that your brain can function for longer despite of the pathology.
01:08:20.800 --> 01:08:25.199
Because right now, for something like Alzheimer's disease, we we can't prevent it.
01:08:25.520 --> 01:08:28.560
Um lots of people are trying lots of different things, but it's very hard.
01:08:28.640 --> 01:08:31.359
So all we can do is reduce our risk, which is very different.
01:08:31.520 --> 01:08:35.439
So try and tip the odds in your favor as much as possible, but nothing's guaranteed.
01:08:35.600 --> 01:08:43.119
So lots of intellectual stimulation, particularly, you know, academic, and you know, using your brain, not just sitting around doing nothing.
01:08:43.359 --> 01:08:52.560
Um midlife and then later life, making sure our sensory kind of neuron uh sorry, hearing and vision loss are managed.
01:08:53.039 --> 01:08:59.359
Um, an enormous burden globally of Alzheimer's disease and other dementias are caused by hearing loss at midlife.
01:08:59.600 --> 01:09:08.319
Because as soon as you can't hear, that increases the masses of cognitive load and it also reduces people's ability to kind of socialize and interact with the world.
01:09:08.399 --> 01:09:18.960
So they become very kind of insulated and isolated, which exacerbates the risk for Alzheimer's, because we also know that social connections are a very important part of that kind of equation.
01:09:19.199 --> 01:09:23.920
So being able to kind of maintain your ability to engage with the world is incredibly important.
01:09:24.079 --> 01:09:24.399
Yeah.
01:09:24.640 --> 01:09:54.880
Um, and then there's a whole lot of um things that we would kind of put under that kind of medical management, the things like your LDL cholesterol, um obesity or overweight, um, high blood pressure, diabetes, and managing that we do using, you know, with how we might need various medical interventions, and or we also need um things like you know, the exercise and um diet and and sleep and finding ways to reduce stress.
01:09:55.119 --> 01:09:58.479
Um what else is usually in there?
01:09:59.039 --> 01:10:02.000
Um I think I might have covered them all off.
01:10:02.159 --> 01:10:24.560
Oh, and then things like depression we know can increase risk, and I'm not we're not really sure whether it's the the kind of the secondary effects of someone with depression withdraws from the world or whether there's some sort of shared pathology whereby a depressed brain is you might be a a a consequence of poor kind of overall body brain health.
01:10:24.720 --> 01:10:38.640
It's hard to know what the chicken and egg is there, and then also like kind of preventing brain damage, whether that's falling off a ladder, you know, falling off your bike, um, drinking too much alcohol, um, air pollution.
01:10:38.880 --> 01:10:48.159
So ways in which we can kind of prevent like the brain being impacted by external like insults would be be a word in there.
01:10:48.479 --> 01:10:51.760
So I mean, none of that's particularly sexy or exciting.
01:10:52.159 --> 01:10:53.760
But easy enough to do, right?
01:10:53.920 --> 01:10:55.199
That's uh you don't need to.
01:10:55.520 --> 01:10:58.800
I don't know whether it's easy to do for everyone all of the time.
01:10:58.960 --> 01:11:01.600
It's simple, but some of those might be hard.
01:11:01.680 --> 01:11:09.359
You know, it can be it might be really hard for um, you know, it could be really hard for people to lose weight.
01:11:09.760 --> 01:11:13.760
You know, it could be very hard to eat healthier to reduce your blood pressure.
01:11:14.399 --> 01:11:17.600
Um it's easy to s tell someone to do that.
01:11:17.760 --> 01:11:26.880
It's hard for them to, you know, implement that and how much of that falls back on the individual, you know, you end up with dementia.
01:11:26.960 --> 01:11:36.239
And like there's so much discussion and it kind of makes me a bit sad that there's so many conversations about dementia risk reduction and you should do this and do that.
01:11:36.399 --> 01:11:39.760
And then what some people just get dementia in Alzheimer's anyway.
01:11:40.560 --> 01:11:44.880
Um, and that and are we increasing the stigma of that?
01:11:45.600 --> 01:11:49.920
Are we gonna be looking at these people now and go, well, look at you, you didn't do your sudoku, did you?
01:11:50.319 --> 01:11:54.479
It feels very stigmatizing and kind of mean almost.
01:11:55.520 --> 01:12:06.079
One, we don't want our lives to be a dementia risk reduction project because that's not a very interesting and fun way to live, even though having a healthy lifestyle is good for you.
01:12:06.239 --> 01:12:15.039
Um but two, I worry that it places so much onus on the individual as if every li illness is a lifestyle choice.
01:12:15.920 --> 01:12:23.520
Um, when you know we we are living within the ecosystems in which, you know, we're trying to do our best, most of us, to just get by.
01:12:23.760 --> 01:12:24.239
Yeah.
01:12:24.560 --> 01:12:28.640
Yeah, and increase stress all around us and the environment, absolutely.
01:12:29.199 --> 01:12:29.520
Yeah.
01:12:29.680 --> 01:12:29.920
Yeah.
01:12:30.159 --> 01:12:34.720
But I mean, there's it's great that what you've said, there are clear steps that people can say.
01:12:34.800 --> 01:12:37.600
And yes, they're simple, but not necessarily easy.
01:12:37.840 --> 01:12:40.960
Is there one that you would say maybe start here?
01:12:44.479 --> 01:13:00.479
Um, I think like going back to like thinking about the brain from the bottom up outside and top down, I always say that if you can get your sleep sorted, you're a really, you know, everything else is easy is is an easier step to take next.
01:13:00.720 --> 01:13:01.119
Totally.
01:13:01.279 --> 01:13:05.039
If you haven't got your sleep sorted, then everything else is that much harder.
01:13:05.199 --> 01:13:05.439
Yeah.
01:13:05.600 --> 01:13:13.199
Um, because we spend an awful um, you know, an awful lot of time over a 24-hour sort of cycle or day asleep.
01:13:13.359 --> 01:13:13.840
Yeah.
01:13:14.079 --> 01:13:19.439
Um, and we all know what it's like when we don't get enough and it's disrupted.
01:13:19.680 --> 01:13:30.960
So addressing that and as many, you know, using as many kind of tools that we have available, whether they are medical, whether they are hormonal, whether they are lifestyle, whether they are cognitive behavioral.
01:13:31.279 --> 01:13:35.039
We have so many resources available for people to use.
01:13:35.199 --> 01:13:39.199
And so that's um, I think the best place to start.
01:13:39.439 --> 01:13:40.319
Yeah, perfect.
01:13:40.479 --> 01:13:40.880
Awesome.
01:13:41.039 --> 01:13:41.600
Thank you.
01:13:41.760 --> 01:13:44.960
Um, and just to clo to close, like where can people find you?
01:13:45.119 --> 01:13:47.600
You've got books, apps, programs, all kinds of things.
01:13:47.920 --> 01:13:48.399
Oh, yeah.
01:13:48.560 --> 01:13:52.560
Um, I've been doing my courses for a really, really, really long time now.
01:13:52.880 --> 01:13:58.960
Um, so I'm not quite sure what's happening with them all in 2027.
01:13:59.439 --> 01:14:04.479
Um, they may or may not be rolling out in the same cadence that they have this year.
01:14:04.720 --> 01:14:08.079
Um, but I do have professional development training programs.
01:14:08.159 --> 01:14:18.399
Um, I've got an app for Women in Midlife, which is very much taking with zero, it's not hooked up to any like trackers or it's not about optimizing or counting or tracking anything.
01:14:18.479 --> 01:14:25.279
It's just about kind of teaching people, you know, the awareness of thinking about their brain from the bottom up outside in and top down.
01:14:25.439 --> 01:14:35.760
And then, you know, with a minute or two every day, what's like kind of one tiny little step you can take towards um, you know, a healthier brain, I suppose, in midlife.
01:14:35.920 --> 01:14:38.079
Um, and it's built for midlife women.
01:14:38.239 --> 01:14:40.800
Um, and then I've got um a few different books.
01:14:40.960 --> 01:14:43.600
I've got Brain Health for Dummies, I've got Women's Brain Book.
01:14:43.680 --> 01:14:51.199
You can just find out all of this if you come to my website, um, dressarahmakai.com, M C K A Y.
01:14:51.920 --> 01:14:52.479
Awesome.
01:14:52.640 --> 01:14:53.039
Perfect.
01:14:53.199 --> 01:14:54.800
We'll link it in the show notes.
01:14:54.880 --> 01:14:56.399
Um, and thank you so much for your time.
01:14:56.479 --> 01:14:57.199
That was really awesome.
01:14:57.439 --> 01:14:58.560
Yeah, no, you're very welcome.
01:14:58.800 --> 01:14:59.840
Now it's your turn.
01:15:00.000 --> 01:15:02.640
Take what you've learned today and put it into action.
01:15:02.800 --> 01:15:07.279
Try the habit, run the experiment, and actually track how you go.
01:15:07.760 --> 01:15:11.039
I'll be doing it right alongside you and sharing on socials.
01:15:11.119 --> 01:15:12.239
So come find me there.
01:15:12.399 --> 01:15:13.840
Links are in the show notes.
01:15:14.079 --> 01:15:17.439
Tell me what's working, what is it, and what questions are coming up.
01:15:17.600 --> 01:15:19.359
I genuinely want to know.
01:15:19.600 --> 01:15:23.840
And if today's episode helped, share it with someone who needs it.
01:15:24.000 --> 01:15:29.199
And if you haven't already, hit subscribe so we can keep optimizing our health together.
01:15:29.439 --> 01:15:31.359
One simple step at a time.
01:15:31.760 --> 01:15:34.159
Take care, and I'll see you next week.