An estimated 7.2 million Americans age 65 and older are currently living with Alzheimer's dementia. The part that should alarm every woman listening is this: almost two thirds of them are women. In this episode, Dr. Mary Claire Haver sits down with neurophysiologist and Alzheimer's researcher Dr. Louisa Nicola to unpack what's really happening to women's brains during perimenopause and menopause and what we can do about it. Louisa Nicola is a neurophysiologist, human performance coach, and founder of Neuro Athletics, a consulting firm that works with elite athletes and high-level professionals to optimize brain health and performance. A former world class triathlete, she transitioned into neuroscience and earned her Master of Medicine in neurophysiology from the University of Sydney. Dr. Nicola is currently pursuing her doctorate studying the effects of resistance exercise on brain health. She focuses on optimizing brain function and longevity, particularly in women, through sleep, nutrition, and exercise interventions. Dr. Nicola reveals how Alzheimer's disease doesn't suddenly appear at 70 but starts quietly in our thirties and forties, building up over a 30-year progression. She explains what's happening in the brain as amyloid beta proteins and tau tangles accumulate, why the hippocampus is the first area to go, and the critical role that sleep plays in clearing these proteins through the glymphatic system. The conversation explores why women are more predisposed to tau protein accumulation than men and how estrogen, progesterone, and prolactin inhibit the enzyme that causes tau proteins to become hyperphosphorylated and toxic. Dr. Nicola explains the connection between declining estrogen during perimenopause and increased Alzheimer's risk, including how estrogen helps mediate glucose metabolism in the brain, supports synaptic connections, and why the loss of this hormonal scaffolding leaves women vulnerable to cognitive decline. Guest Links: * Louisa Nicola (Instagram) https://www.instagram.com/louisanicola_/ * Louisa Nicola (Facebook) https://www.facebook.com/louisanicola/ * Louisa Nicola, MMed, PhD(c) (LinkedIn) https://www.linkedin.com/in/louisanicola/ * Louisa Nicola (YouTube) https://www.youtube.com/c/LouisaNicola * Louisa Nicola (X) https://x.com/louisanicola_?lang=en * Neuro Athletics https://www.neuroathletics.com.au/ * The Neuro Experience Podcast (Apple Podcasts) https://podcasts.apple.com/us/podcast/the-neuro-experience/id1274468842 * The Brain Code https://go.neuroathletics.com.au/sales-page-1312 Recommended Books: * “Joyspan,” by Dr. Kerry Burnight https://drkerryburnight.com/joyspan For full show notes, please visit: https://bit.ly/unPAUSEDDrLouisaNicola 00:00:00 — Why 70% of Alzheimer’s cases are women (and why genetics is rare) 00:00:56 — The real fear: cognitive decline in midlife + what we can control 00:03:00 — Louisa’s path: elite triathlete → math teacher → neuroscience/PhD 00:05:01 — What a neurophysiologist does (EEGs, seizures, brain function) 00:05:49 — Mild Cognitive Impairment (MCI): the “pre-dementia” stage explained 00:06:46 — “Betty at 52”: early-onset Alzheimer’s and the wake-up call 00:15:04 — Brain fog vs dementia: what’s normal, what’s not, when to worry 00:17:55 — Alzheimer’s starts decades earlier: what’s happening in your 30s–40s 00:20:03 — Amyloid isn’t just “bad”: protection, sleep, and the clearance system 00:21:03 — Tau, hormones, and why women may be more vulnerable during menopause 00:29:45 — The perimenopausal brain + the “window of opportunity” for HRT (APOE4) 00:33:45 — “Candy neurons,” hot flashes, neurotransmitters, and brain chemistry shifts 00:39:03 — Sleep: the 2AM wake-up, progesterone/GABA, temperature hacks, and melatonin 00:49:32 — Wearables + HRV: alcohol’s impact and the breathwork that moves the needle 00:54:39 — Exercise as brain medicine: VO₂ max, Zone 2, “Zone 5,” lactate, and strength training 00:01:07:17 — Nutrition + supplements: MIND/Mediterranean patterns, omega index, DHA/EPA, creatine 00:01:13:19 — The 3 biggest brain-protection moves (testing, lipids, exercise, sleep, food) + social connection Never miss an episode—sign up for The ’Pause Life Newsletter: https://thepauselife.com/pages/newsletter Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The ’Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.