Speaker 1: Why is it so hard to get real answers about
Speaker 1: your health? If you've been told that everything looks fine,
Speaker 1: but you know that something is off, we're not imagining it.
Speaker 1: That's why I created Vitality three sixty to help you
Speaker 1: better understand what's going on inside your body so that
Speaker 1: you can take the targeted action needed. With a functional
Speaker 1: health approach plus testing, we go beyond the guesswork to
Speaker 1: uncover the root causes of your symptoms. I've teamed up
Speaker 1: with Doctyesmina, an incredible integrative GP and together we will
Speaker 1: help you decode your body's signals and answer questions like
Speaker 1: why am I always exhausted? What's really causing my stubborn weight?
Speaker 1: Am I inflamed? Insulin resistant? Or maybe missing key nutrients?
Speaker 1: Because when you understand your body better, you can transform
Speaker 1: your health. Visit v three sixty dot health or check
Speaker 1: out the show notes for more. This is healthy Heir
Speaker 1: with Amelia Phillips and welcome to one of my mini
Speaker 1: motivation episodes. These are shorter, targeted episodes we tackle one
Speaker 1: specific question or challenge head on. Well. Today we are
Speaker 1: bringing in neuroscientists doctor Sarah Mackay to discuss the very
Speaker 1: real and practical strategies that can lower our risk of
Speaker 1: dementia by a whopping forty five percent. So if you
Speaker 1: have a family history of neurological disorders such as dementia, Alzheimer's, MS, Parkinson's,
Speaker 1: or you simply are just wanting to lower your own risk,
Speaker 1: today's episode is for you. Doctor Sarah is the author
Speaker 1: of three neuroscience books on brain health, including her latest book,
Speaker 1: Brain Health for Dummies, published earlier this year. She was
Speaker 1: also recently on the Mel Robins podcast and she's got
Speaker 1: a fabulous Instagram page which I'll pop a link in
Speaker 1: the show notes too, because it's all about helping our
Speaker 1: female brains thrive. So here is what doctor Sarah had
Speaker 1: to say about reducing our risk of dementia In Australia. Dementia,
Speaker 1: which also includes Alzheimer's, has recently overtaken heart disease as
Speaker 1: the number one killer of Australians. Researchers believe that this
Speaker 1: is due to three main reasons. So firstly, we're living longer,
Speaker 1: so that's a good thing. Secondly, we are now better
Speaker 1: at preventing and managing heart disease, which is also a
Speaker 1: good thing. And thirdly, we now have better diagnosis and
Speaker 1: awareness of dementia, which is also a good thing, but
Speaker 1: still we do want to avoid dementia ideally, So doctor
Speaker 1: Sarah kicking off, what actually is dementia, it's in a
Speaker 1: very broad general sense.
Speaker 2: We often talk about nowadays Alzheimer's disease and related dementia's.
Speaker 1: Like neurodegenerative disease.
Speaker 2: Dementitsia's kind of the umbrella term which describes these sort
Speaker 2: of symptoms that you would get, you know, when you're
Speaker 2: hopefully when you're much much older, about which Alzheimer's disease
Speaker 2: is one of the main causes one of the kind
Speaker 2: of diseases that causes symptoms of dementia. So you could
Speaker 2: also develop dementia. If you had Parkinson's disease, you could
Speaker 2: have front to temporal dementia like what Bruce Willis has right,
Speaker 2: perhaps some type of dimention cause by alcoholism.
Speaker 1: So dementia's kind of actually dimess going on and neurons
Speaker 1: not firing or shrinking.
Speaker 2: Again, it bends on which of the diseases we're looking at.
Speaker 2: If we were looking at Alzheimer's disease in a brain
Speaker 2: that had clinically diagnosed Alzheimer's disease, that brain would be
Speaker 2: much it would be very, very shrunken. We would see
Speaker 2: a lot of death in the neurons. A lot of
Speaker 2: the neurons that were still kind of living would be
Speaker 2: would be kind of filled with all of these kind
Speaker 2: of tangles of proteins, so you know, then the connections
Speaker 2: between neurons would be lost. So the whole brain is
Speaker 2: kind of really starting meted by well, starting to literally degenerate.
Speaker 2: We're getting tissue degeneration, getting all the immune cells to
Speaker 2: go in and kind of eat up the generating tassoe.
Speaker 2: So that's what you would see in the case of
Speaker 2: someone with extreme Alzheimer's disease. But you know, that process
Speaker 2: can you know, take ten, twenty, even thirty years. So
Speaker 2: sometimes the very very first signs of Alzheimer's disease are
Speaker 2: these these classic things that people have heard about, like,
Speaker 2: you know, kind of forgetfulness, getting lost is a really
Speaker 2: big one. Losing your sense of smell, having memories from
Speaker 2: your past but not being able to kind of remember
Speaker 2: what happened.
Speaker 1: You know, I get all those now, I know.
Speaker 2: But it's also the inability to imagine the future.
Speaker 1: Oh oh, that's an interesting.
Speaker 2: Yeah, so we've got there. There's quite a tight correlation
Speaker 2: between your autobiographical memories of your autobiographical past and your
Speaker 2: ability to imagine the future. Very similar brain networks are involved.
Speaker 2: So often people don't have the ability to kind of
Speaker 2: just set in daydream. So there's a whole lot of
Speaker 2: different symptoms, and you get personality change. You can often
Speaker 2: get like kind of depression, you can get you know, aggression.
Speaker 2: There's a whole host of symptoms under that. We typically
Speaker 2: think it's about memory loss or forgetting your kids' names
Speaker 2: or whatever, or it's people say, oh, I can't you know,
Speaker 2: I always losing my glasses. I'm always losing my keys.
Speaker 2: Someone with Alzheimer's disease would find their glasses, but then
Speaker 2: they wouldn't know what to do with them.
Speaker 1: Got it? But remember and you really know, like when
Speaker 1: I'm thinking about those of us that have aging parents,
Speaker 1: you know, and we all, oh, you know, mum, you
Speaker 1: can't remember where you parked your car. That's not necessarily
Speaker 1: a massive red flag, but I think most of us
Speaker 1: can sense what happens.
Speaker 2: It starts to happen regularly every day, and it's interfering
Speaker 2: with people's you know, daily life.
Speaker 1: That's fine.
Speaker 2: I mean you go off to the doctor or you
Speaker 2: take them. Sometimes they don't want to go because sometimes
Speaker 2: they mightn't even notice that there's a problem. Often they
Speaker 2: don't necessarily know that that there's issues.
Speaker 1: As people on the outside. Yeah.
Speaker 2: Yeah, And there's some really interesting gendered research on that,
Speaker 2: particularly in like very traditional structured families that often the
Speaker 2: gerry intoligist friend of mine told me that she will
Speaker 2: see elderly gentle and coming and much further along in
Speaker 2: their kind of disease process because they've got like say,
Speaker 2: a really traditional wife who's cocked cleaned, cox olivers meals,
Speaker 2: doesn't wash.
Speaker 1: It's an amazing network whereund.
Speaker 2: She gets Alzheimer's disease, he's not getting in his breakfast,
Speaker 2: so he brings her in at a much earlier stage
Speaker 2: of the disease, and particularly those traditional structured families, which
Speaker 2: feeds into what you were saying there about when we're
Speaker 2: looking at these statistics, we're looking you know, different people
Speaker 2: are going to be diagnosed at different kind of points
Speaker 2: in their life span, Like so that woman might have
Speaker 2: been diagnosed far younger than the man, even though they
Speaker 2: both started showing symptoms at the same age, because it's
Speaker 2: the family structure that's determined that. We were also getting
Speaker 2: just some good news about Alzheimer's and dementia. We've got
Speaker 2: lots more old people, so there's more old people alive
Speaker 2: that are developing it. But your individual risk, or we
Speaker 2: might call the incidents, particularly in healthy, wealthy countries, is
Speaker 2: actually declining. So my generation and your generation have a
Speaker 2: much lower risk of developing Alzheimer's disease in our mother's
Speaker 2: generation and our grandmother's generation.
Speaker 1: But then why is it now overtaking heart disease.
Speaker 2: Because we're better at treating heart disease, so people aren't
Speaker 2: dying of that, they're living into their nineties, and so
Speaker 2: they're more likely to get dementia in their nineties. But
Speaker 2: we're going to be less likely to get it because
Speaker 2: we're living healthier up until that point. Ok So someone
Speaker 2: who was born in nineteen hundred, like you look at
Speaker 2: a woman born in nineteen hundred, she might have left
Speaker 2: school at twelve. I was still at university when I
Speaker 2: was twenty five, So we've got the number of years
Speaker 2: of education you have as an incredibly important protective factor.
Speaker 2: She may have smoked, drunk, had a really stressful life
Speaker 2: and not had very intellectually challenging kind of stimulating life,
Speaker 2: never done any exercise, had diabetes that was perhaps untreated,
Speaker 2: you know, been very metabolically unwell, and so she's much
Speaker 2: more likely to develop Alzheimer's disease than say I am.
Speaker 2: But we've got more old people alive. So we've got
Speaker 2: this prevalence problem and healthy wealthy countries, but the incidents
Speaker 2: in healthy wealthy countries is going down. We've got less
Speaker 2: people flowing in, but an sort of lower socioeconomic countries,
Speaker 2: incidence is increasing and the prevalence is increasing. Yeah, so
Speaker 2: we've got to be careful when we talk about statistics,
Speaker 2: how we make meaning of that in terms of individual risks.
Speaker 1: Yeah. Well, I've also got some good news for you
Speaker 1: around the prevention and delay of dementia. So an updated
Speaker 1: Lancet Commission from twenty twenty four now identifies fourteen modifiable
Speaker 1: risk factors. It used to be twelve apparently, but now
Speaker 1: it's fourteen. So these are modifiable, so we can impact
Speaker 1: them or change them. That together, if we modify and
Speaker 1: manage them well, can prevent or delay up to forty
Speaker 1: five percent of dementia cases, which is crazyally.
Speaker 2: Yeah, I think globally is really important to realize there,
Speaker 2: like across the planet.
Speaker 1: Yeah, okay, and a lot.
Speaker 2: Of that burden of risk has carried and you know
Speaker 2: the load.
Speaker 1: Right. Let me list out these fourteen modifiable risk factors,
Speaker 1: and for a listener sitting here, you can say which
Speaker 1: of these you think the levers you're pulling pretty well
Speaker 1: and which you might want to be able to focus
Speaker 1: on and put them into categories. So the first one
Speaker 1: is early life and environment, so that covers low education,
Speaker 1: so to your point earlier, if someone's uneducated or going
Speaker 1: to university till they're twenty five, So low education and
Speaker 1: air pollution that's in that category.
Speaker 2: And air pollution is a really tough one for an
Speaker 2: individual to change. Yeah, it's modifiable, but perhaps not modifiable
Speaker 2: for a person.
Speaker 1: Yes, exactly. So. Then the second bucket is lifestyle and behavior.
Speaker 1: So we've got risk factors physical inactivity, smoking, and excessive
Speaker 1: alcohol intake. So the next bucket is brain and sensory health,
Speaker 1: so untreated vision loss, traumatic brain injury, which you could
Speaker 1: also argue is not modifiable, but at least if you're
Speaker 1: wearing a helmet or not, you know, don't climb a ladder. Yeah, yeah,
Speaker 1: don't write a hood play. Yeah. And the third one
Speaker 1: in that brain and sensory health is hearing loss, and
Speaker 1: that's the new one. There's two new ones.
Speaker 2: Loss and hearing loss, hearing life. Yeah, hearing is seven percent. Yeah,
Speaker 2: this is globally, which is enormous.
Speaker 1: By the way. Fun fact, if you own a pair
Speaker 1: of Apple air pods, they now come with an in
Speaker 1: built standardized hearing tests, do they Yes, I did it
Speaker 1: on myself the other day. Yeah. My left is worse
Speaker 1: than my right here. So that was the bucket of
Speaker 1: brain and sensory health. So then the last two buckets
Speaker 1: cardio metabolic health. So that's high blood pressure, type two,
Speaker 1: diabetes and obesity. Okay, so you want to avoid those.
Speaker 1: And then the final bucket is mental and social well being,
Speaker 1: which is depression and social isolation. And sorry, the other
Speaker 1: one in the cardio metabolic the new one I forgot
Speaker 1: to mention is high LDL cholesterol. So they're the two
Speaker 1: new additions, the hearing loss and the high LDL cholesterol,
Speaker 1: which I.
Speaker 2: Think are an enormous way.
Speaker 1: Yes.
Speaker 2: Yeah. I often talk about like those old fashioned scales,
Speaker 2: if you imagine the weights like each of those risk factors,
Speaker 2: like maybe you're at UNI until you were thirty, but
Speaker 2: you smoke. Yeah, you've kind of got weights on either
Speaker 2: side of the risk.
Speaker 1: Just to make it clear for my listeners, I'll pop
Speaker 1: those fourteen risk factors in the show notes and maybe
Speaker 1: you can just sit and read them and just reflect.
Speaker 1: There's probably a lot you can tick and go, yeah,
Speaker 1: I'm cooking with gas on those, But then there's a
Speaker 1: couple of way, like you really want to focus on those.
Speaker 1: Why is it so hard to get real answers about
Speaker 1: your health If you've been told that everything looks fine,
Speaker 1: but you know that something is off, we're not imagining it.
Speaker 1: That's why I created Vitality three point sixty to help
Speaker 1: you better understand what's going on inside your body so
Speaker 1: that you can take the targeted action needed. With a
Speaker 1: functional health approach plus testing, we go beyond the guesswork
Speaker 1: to uncover the root causes of your symptoms. I've teamed
Speaker 1: up with Dottysmina, an incredible integrative GP, and together we
Speaker 1: will help you decode your body's signals and answer questions
Speaker 1: like why am I always exhausted? What's really causing my
Speaker 1: stubborn weight, am I inflamed, insulin resistant, or maybe missing
Speaker 1: key nutrients. Because when you understand your body better, you
Speaker 1: can transform your health. Visit V three sixty dot health
Speaker 1: or check out the show notes for more. But I
Speaker 1: wanted to ask you, as you know, for a woman
Speaker 1: in midlife, of these fourteen risk factors, do you think
Speaker 1: there are any we need to particularly pay close attention
Speaker 1: to if we want to lower our risk of dementia? Like,
Speaker 1: is there a couple there that you just go, oh
Speaker 1: my gosh, you really want to manage? Yeah?
Speaker 2: Look, I really think the hearing loss is completely underrecognized
Speaker 2: because it's not very sixy Yes, so it doesn't there's
Speaker 2: not these like glossy, charismatic hearing loss influences. I mean
Speaker 2: they probably are, but they're not reaching like midlife women
Speaker 2: because we're only being told if you take hormone therapy,
Speaker 2: job done. So.
Speaker 1: I even felt funny doing the hearing tests on myself
Speaker 1: the other day. I was like, I hope no one's
Speaker 1: watching that. I don't want to tell anyone that I'm
Speaker 1: taking a hearing test. It makes me sound really old.
Speaker 2: Yeah, there's there's a lot of stigma around that, and
Speaker 2: it could just be you know you went to too
Speaker 2: many concerts when you were young. Well, you know your
Speaker 2: work in construction. You know, there's and what happens when
Speaker 2: you aren't hearing, You're losing you know, that sense of
Speaker 2: connection and communication and interaction with the world around you.
Speaker 2: So you kind of withdraw into yourself. So you're reducing
Speaker 2: all of the sensory stimulation. Plus there's the added cognitive
Speaker 2: load of like trying to hear people and trying to
Speaker 2: pay attention to conversations. So there's kind of a few
Speaker 2: different sort of pathways which and which that.
Speaker 1: And also it's a bit of an easy fix if
Speaker 1: you think about it, if you have been diagnosed with
Speaker 1: hearing loss. There's so many options of aids.
Speaker 2: Aren't what they used to be. Like, everyone's got them
Speaker 2: hopped up to the you know, their phones, and some
Speaker 2: people even have just them on the end of the glasses.
Speaker 2: There's lots of really great interventions there, and I think
Speaker 2: it's very underrecognized and we need some really beautiful people
Speaker 2: to talk about that on Instagram. Well we're doing that
Speaker 2: right now.
Speaker 1: Yeah. And you know, I kept my hearing results because
Speaker 1: I thought I'm going to retest this every year. Yeah,
Speaker 1: to track and see if I'm seeing a hearing loss decline,
Speaker 1: because I'm curious to know if it's healthy now, where's
Speaker 1: it going to be in five years? Yeah?
Speaker 2: And another thing I think because it talks about education there,
Speaker 2: and obviously once you've aged fifty, you can't go back
Speaker 2: and readlive your life again, right, But the idea of
Speaker 2: like staying intellectually and cognitively stimulated and engaged with the
Speaker 2: world is incredibly important. And we know that people who
Speaker 2: you know, kind of maintain those cognitive test schools, they
Speaker 2: maintain they're kind of their verbal recall, their kind of
Speaker 2: mental maths ability. They're good vocab, you know, they're good
Speaker 2: at the word as they are. The people that kind
Speaker 2: of keep on doing these things, they don't sort of stop.
Speaker 2: They're still reading, you know, the literary fiction, the Book
Speaker 2: of Prize when they are still engaged and reasonably intellectually
Speaker 2: and cognitively challenging work. They haven't kind of stopped doing that.
Speaker 1: Where I'm confused with that. I'd love your thoughts on
Speaker 1: doing those cognitive actstivities like Sudoku, word all, etc. Versus
Speaker 1: having purpose, Like if someone's sitting here and they do
Speaker 1: all those things, and maybe they're learning a language or whatever.
Speaker 1: Compared to someone who sits on a board or who
Speaker 1: is part of a not for profit or who is
Speaker 1: doing something that has a large sense of purpose in
Speaker 1: their life. Would you say it doesn't really matter, like
Speaker 1: if you're just spending your day reading some articles in
Speaker 1: the paper, doing your cognitive you know, word all and sudoku,
Speaker 1: or do you feel like it needs to be attached
Speaker 1: to something that has a big purpose and meaning to you.
Speaker 2: I mean lots of people get a lot of purpose
Speaker 2: and meaning out of a crossword or word or business like.
Speaker 2: It can be a bit of a social aspecture. I
Speaker 2: think it's about the cognitive friction and kind of challenging
Speaker 2: your intellect and finding ways to continue.
Speaker 1: To do that.
Speaker 2: But you do have to be careful that you know,
Speaker 2: you don't overburden yourself that you kind of burn yourself out.
Speaker 2: But it's about that bit of friction. Yeah, it's a
Speaker 2: little bit like exercising.
Speaker 1: You need a bit of a challenge.
Speaker 2: Just go and left to two kilo wait every single
Speaker 2: day for ten years and not keep on increasing the load.
Speaker 2: It's about having a bit of challenge and if that challenge,
Speaker 2: I mean my mum wouldn't go and sit on a board,
Speaker 2: but you know she might do you know, a cross words.
Speaker 1: We are very competitive in my word or chat right,
Speaker 1: and my mum's always the first one of the day,
Speaker 1: and yesterday she got it in three and so my
Speaker 1: competitive side was like, I've got to get it in
Speaker 1: cred goes as.
Speaker 2: Well because it's kind of social and that kind of
Speaker 2: keeps the motivation. And it's not just doing each other.
Speaker 2: And it's just not just doing word or just doing
Speaker 2: sudocal just and I mean, stay away from online brain
Speaker 2: training if you've got a disk job and you're better
Speaker 2: off to go.
Speaker 1: For a rum.
Speaker 2: But it's about continuing that intellectual and cognitive challenge and
Speaker 2: stimulation throughout the lifespan, not just thinking, well, I leave
Speaker 2: school when I was fifteen, I can't really do much
Speaker 2: else about it.
Speaker 1: If you were listening to this episode today and you
Speaker 1: have a family history of these neuro degenerative diseases such
Speaker 1: as dementia, Parkinson's, Alzheimer's, and you really want to do
Speaker 1: everything you can personally to delay or prevent it, what
Speaker 1: would you do in this situation?
Speaker 2: I would you would do all of the things you've
Speaker 2: got to kind of make sure that you've not just
Speaker 2: think of my grand got Alzheimer's disease when she was eighty.
Speaker 2: It's about understanding, perhaps also the difference between do you
Speaker 2: have a particular gene which increases your rists?
Speaker 1: A po E four four is a test for.
Speaker 2: But typically in Australia we're just not going to randomly test.
Speaker 2: I mean, you can probably pay one of these longevity
Speaker 2: clinics now to test at four.
Speaker 1: You can ice screen does.
Speaker 2: If you have like got a shitload of money.
Speaker 1: Yes, I think it's somewhere between three to five hundred.
Speaker 2: Vast majority of people aren't paying for that.
Speaker 1: So what happens if you get so you say you
Speaker 1: take this test to see if you have a po
Speaker 1: E four and it's it's not even you've got like
Speaker 1: one a lievel or two earlier.
Speaker 2: Yeah yeah, yeah, and I think it was Chris Hemsworth
Speaker 2: did this time. Yeah yeah, and show you're still going
Speaker 2: to be doing exactly the same thing types of things
Speaker 2: is what you would do if you hadn't got it ten.
Speaker 1: And if you have, they're the one, you know, the
Speaker 1: one or the two alleles which you know increases your
Speaker 1: risk by x percent. Doesn't mean you're going to get dementia.
Speaker 1: And if you come back with not carrying the genes
Speaker 1: doesn't mean you're not going.
Speaker 2: To be you know, like, is it gonna you know,
Speaker 2: tip the scales in your favor the odds in your
Speaker 2: favor or not in your favorites. And like instance disease
Speaker 2: where if you've got like, you know, this particular gene
Speaker 2: for Huntington's disease, you will get Huntington's.
Speaker 1: Yeah, or like bracker even like the evidence around bracker
Speaker 1: for breast cancer is stronger. So if you're you know,
Speaker 1: if you've got lots of money and you're interested in longevity,
Speaker 1: sure go and take your test. You're going to do it.
Speaker 1: You're gonna have to take them.
Speaker 2: You're still going to have to do all the same things.
Speaker 2: And there might be down the track there might be
Speaker 2: more interventions. So when it's still super early days where
Speaker 2: people are like, you know, will taking the g LP ones,
Speaker 2: is that gonna like reduce people's risks who have the
Speaker 2: genes versus don't have the genes, And it perhaps looks
Speaker 2: and because the apoe gene is coding for a protein
Speaker 2: which is involved with kind of lipid transport, so it's
Speaker 2: not just outzhider disease risks. All of that kind of
Speaker 2: cardiovascular metabolic health is all kind of mixed up in there.
Speaker 1: So it's really those fourteen So you're still.
Speaker 2: Going to have to do the same things. That might
Speaker 2: be more motivating for you, but some people might not
Speaker 2: find that motivating. I think we also need to be
Speaker 2: quite careful and thoughtful about when we do genetic testing.
Speaker 2: Is that you understand one the insurance implications. Are you
Speaker 2: going to then have to declare it if you're like
Speaker 2: changing private health insurance providers? What does that implication? Does
Speaker 2: that mean for family members who may or may not
Speaker 2: want to get tested? If you know you've got a
Speaker 2: particular gene, does that mean your mum or your dad
Speaker 2: or your kids are going to have it? And what
Speaker 2: implications does that have for their kind of informed consent
Speaker 2: about knowing about that. So I think it's kind of
Speaker 2: easy to throw caution to the wind and go and
Speaker 2: get tested for all of the things. But is that
Speaker 2: going to change, you know, a treatment plan or an outcome.
Speaker 2: In time, I think we probably will get to the
Speaker 2: point where we will have much more precision, individualized medicine
Speaker 2: for these people. But right now, You're still going to
Speaker 2: have to get your ass to the gym, You're still
Speaker 2: going to have to manage to sleep, You're still going
Speaker 2: to have to get your colored stroll checked.
Speaker 1: Okay. So here's another scenario for you. You are carrying
Speaker 1: an extra twenty kilos of weight, and you have done
Speaker 1: for a long time, and you've got close family members
Speaker 1: that have had dementia, and you've tried to lose weight before,
Speaker 1: and it's quite stubborn. Would you go on a GLP one.
Speaker 2: We have absolutely no expertise in the space, so I
Speaker 2: couldn't comment one way or another.
Speaker 1: Okay, I mean.
Speaker 2: I'd have to be a medic who is an expert on.
Speaker 1: And also no one really knows because we don't know
Speaker 1: the long don't implications of you know, is the medication
Speaker 1: itself going to actually be helpful for preventing dementia or
Speaker 1: is there other factors?
Speaker 2: Say it's a checking moment. The little bit of data
Speaker 2: that I'm familiar with is it's probably reducing your risk.
Speaker 2: We don't know whether it's reducing your risk via some
Speaker 2: direct you know, is.
Speaker 1: Somehow mechanism, or that you've lost the weight and is
Speaker 1: it the knock on effix see are lots of sort
Speaker 1: of steps or.
Speaker 2: Dominos in between. I mean, the other question which we
Speaker 2: haven't really kind of touched on, is the idea about
Speaker 2: HRT for menopause symptoms and dementia, because that's a really
Speaker 2: big one, and that's not in that Lancet commission. That
Speaker 2: wasn't sex true, that wasn't well, they looked at it.
Speaker 2: It wasn't a heavy enough weight. There wasn't enough evidence
Speaker 2: to recommend for or against it. So people think, oh,
Speaker 2: women's health, it's been neglected. We're not studying it, we're
Speaker 2: not looking at it. They didn't look at it. That's
Speaker 2: why it's not only there. They looked at it. They
Speaker 2: reviewed the data. They said, right now, the data doesn't
Speaker 2: say that we should tell women to.
Speaker 1: Take it as a preventatives prevent and.
Speaker 2: It also doesn't say we should tell women not to
Speaker 2: take it, right because it's like some studies got, oh,
Speaker 2: I increase your rest depending on what kind of hit
Speaker 2: you're taking, what agency. Some of the studies say it
Speaker 2: decreases your risk. A lot of them are kind of
Speaker 2: net neutral, and they were kind of like, the data
Speaker 2: isn't there for us to put it in a recommendation.
Speaker 2: That doesn't mean that women were ignored. That means they
Speaker 2: looked at the data and we're not putting it in this.
Speaker 1: Well, look, we've got fourteen factors to focus on. Yeah,
Speaker 1: so that's enough. I'm going to sit down and study
Speaker 1: these and look at which ones I could probably improve on.
Speaker 1: I think you're probably doing okay.
Speaker 2: And I also think I just want to say, you know,
Speaker 2: you can do all of the right things. It's like
Speaker 2: you could never smoke a cigarette and ge lung cancer.
Speaker 2: Some people still get diagnosed with Alzheimer's disease or other
Speaker 2: diseases of brain aging. And I think we need to
Speaker 2: be very careful when we're talking so much about demitia
Speaker 2: rest that we don't stigmatize people that have problem mild
Speaker 2: cognitive decline, have family members with Alzheimer's or dementia. There's
Speaker 2: still people that we can love and care about and
Speaker 2: have value. And I don't think that our entireme mi
Speaker 2: life focus should be a dementia risk reduction project. We've
Speaker 2: got to have a bit of joy and I've got
Speaker 2: not just like a long health span and a lifespan,
Speaker 2: but you know, there's these ideas of a joy span,
Speaker 2: and I think that we kind of do run the
Speaker 2: risk of throwing a little bit of kind of ageism
Speaker 2: in there as well, assuming that like these last years
Speaker 2: of our lives are going to be terrible. Oh no,
Speaker 2: we need a bit of grace, I think for ourselves
Speaker 2: and for the other people out there that are going
Speaker 2: through stuff.
Speaker 1: I love that that is such.
Speaker 2: It's not it doesn't feel very I don't know, heartfelt
Speaker 2: to me to always be talking about avoid dementia at
Speaker 2: all costs, because it's the worst thing that can happen.
Speaker 2: It is a terrible thing. But let's give a bit
Speaker 2: of grace to the people who are.
Speaker 1: Going through that. Oh, doctor Sarah, such a beautiful note
Speaker 1: to end on. Thank you so much. You're welcome. Why
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Speaker 1: out the show notes for more