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Alzheimer’s in Women: Forgetful or Something More Serious?

04/06/2023 | 7 min. read

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As we age, it’s natural to become more forgetful. The stress of juggling work, family, and other responsibilities can make anyone feel scatterbrained at times. And for women going through the menopausal transition, who often experience brain fog and concentration difficulties, it can be especially noticeable.

I remember as a teenager getting a good laugh at my mom’s expense as she frantically searched the house for her glasses—only to realize she had not one but two pairs pushed up into her hair. Now who’s eating crow? Me and my 40-year-old self, who relies on strategically placed sticky notes and alarm reminders on my phone to keep track of work and family schedules and commitments!

It is also natural to be concerned about forgetfulness and to wonder if what you are experiencing is normal or something more serious, such as early signs of Alzheimer’s disease. Alzheimer's is scary! The drugs approved for its treatment may temporarily reduce symptoms, but there is no cure for this progressive disease. Furthermore, two-thirds of the 6.5 million Americans living with Alzheimer's are women.

I don’t want to minimize the impact of this devastating disease, but I want to remind you that most people with Alzheimer's are in their late 70s or older. The memory problems that younger women, especially those under age 65, experience usually have other causes that can be treated.

Early Signs of Alzheimer’s in Females

Before we get into common treatable causes of forgetfulness, let’s review the early signs of Alzheimer’s disease:

  • Short-term memory loss, e.g., forgetting recent information or repeating the same questions

  • Challenges with planning, keeping track of bills, following directions, etc.

  • Difficulty with daily tasks such as driving to a familiar location

  • Losing track of dates and the passage of time

  • Problems with vision, balance, reading, and judging distance

  • Reduced ability to find words or follow a conversation, which may result in social withdrawal

  • Putting things in unusual places and being unable to retrace steps to find them

  • Changes in judgment, decision-making, and personal grooming

  • Mood and personality changes, including increased anxiety, depression, fearfulness, suspiciousness, and confusion

Evaluation and Treatment Are Essential

Alzheimer’s symptoms, which may be subtle at first, eventually become so pronounced that they disrupt daily life. It can be distressing to acknowledge such changes in yourself or a loved one, but you can’t bury your head in the sand. It’s important to consult a healthcare provider for evaluation and assessment of cognitive function.

These symptoms could be a sign of another disorder that affects memory and cognitive function such as mild cognitive impairment (MCI). MCI may be caused by neurodegenerative changes that worsen over time. However, many people with MCI never get worse—and some get better!

Even if it is Alzheimer's, isn’t it better to know so you or your loved one can get started on available treatments and prepare for inevitable changes?

“Normal” Forgetfulness

That said, most of the memory challenges that younger women experience have other causes that can be treated with natural therapies and lifestyle changes. Typical symptoms of run-of-the-mill cognitive problems include:

  • Forgetting names, appointments, etc., but remembering them later

  • Losing your train of thought or the thread of conversations, books, or movies

  • Having trouble finding the right word (tip-of-the-tongue phenomenon)

  • Making occasional errors on work or household tasks

  • Temporarily forgetting the day of the week

  • Misplacing things but being able to retrace your steps to find them

  • Experiencing depression or anxiety

Reversible Causes of Memory Loss

Although these mental lapses may not be terribly disruptive, they are annoying and disconcerting. Potential causes include:

  • Hormonal changes: Estrogen is highly protective of the brain, and fluctuations during the menopausal transition can do a number on memory and mood. Low thyroid (hypothyroidism), which is most common in older women, is also associated with changes in cognitive function.

  • Depression and anxiety: Poor concentration, social withdrawal, mood swings, ruminating thoughts, etc., are signs of treatable psychiatric disorders.

  • Chronic stress: Dealing with chronic stress may lead to elevations in cortisol, a stress hormone that adversely affects the brain and is associated with an increased risk of dementia.

  • Lack of sleep: Poor sleep can make you feel foggy the next day, but it also has long-term ill effects on brain health. During sleep, your brain consolidates memories and clears out toxins. Studies reveal that getting fewer than five hours a night doubles the risk of developing dementia.

  • Poor diet: Highly processed foods with an excess of sugars and refined carbohydrates wreak havoc on blood sugar control and the gut microbiome—both of which influence brain function.

  • Nutrient deficiencies: Deficiencies in omega-3 fatty acids, vitamin B12, vitamin D, and iron have been linked with cognitive dysfunction.
  • Medication side effects: Several popular prescription and over-the-counter drugs have adverse effects on the brain. They include cholesterol-lowering statin drugs, antidepressants, sleeping pills, anti-anxiety medications, and anticholinergics (meds prescribed for urinary incontinence, allergies, Parkinson's, and other conditions).

Some of these conditions often occur together and may be related to one another. For example, the decrease in estrogen that ushers in the menopausal transition can cause hot flashes that keep you up at night, leading to poor sleep—and a poor night sleep leaves you exhausted and struggling to concentrate in the morning. Stress can also interfere with your sleep or affect your mood and lead to depression and concentration difficulties.

Prevention and Treatment

Fear not! Addressing these underlying causes will not only improve brain fog and memory lapses but also enhance overall brain health and reduce your risk of developing more serious problems in the future.

  • Have your hormones tested and balanced. Natural therapies and bioidentical hormone replacement, if indicated, can provide enormous benefits during the menopausal transition. Hypothyroidism may benefit from natural or synthetic thyroid replacement.
  • Reduce stress with adaptogenic herbs, meditation (kirtan kriya is an easy, cost-effective practice), nature therapy (spending time outdoors), physical activity, creative play, brain stimulation, and meaningful connections with others.
  • Improve your sleep by adopting sleep hygiene techniques. If snoring or sleep apnea is an issue, get treatment with C-PAP, an oral appliance, or mouth taping.
  • Eat a healthy diet based on whole, unprocessed foods. Low-glycemic carbohydrates encourage healthy blood sugar and insulin levels, and protein and healthy fats enhance hormone and neurotransmitter support. These foods also promote a healthy gut microbiome, which influences hormone clearance.
  • Consider intermittent fasting and short-term cleanses to encourage metabolic flexibility and fat burning (ketones) for increased mental clarity.
  • Exercise regularly. It’s one of the best things you can do to promote brain health. In one study, patients with dementia or MCI scored better on tests of cognitive function after engaging in six to 12 months of exercise, compared with sedentary controls. Studies reveal that regular physical activity also reduces the likelihood of developing Alzheimer's.
  • Stay busy. A 2022 study found that people who engaged in cognitive, physical, and/or social leisure-time activities were less likely to develop Alzheimer's and other forms of dementia. Reading, writing, games, puzzles, musical instruments, computers, painting, handicrafts, volunteering, socializing, group or religious activities, and a wide variety of sports—all were protective.
  • Take supportive supplements. Suggested supplements include omega-3 fatty acids, zinc, nootropics, mushrooms, choline, and antioxidants. I also recommend probiotics to support the gut microbiome and the gut-brain connection.
  • Talk to your doctor. If lifestyle changes and natural therapies don’t help, ask your doctor to rule out medication side effects and other potential disorders (depression, anxiety, hypothyroidism, etc.).

Recap

Feeling forgetful, unfocused, or spaced out happens to women of all ages from time to time. However, these symptoms are particularly common during the years leading up to menopause and beyond.

The good news is that in many cases, there is an underlying condition that, once identified, can be treated. Hormone balancing and a healthy lifestyle—including a nutritious diet, regular exercise, optimal sleep, and stress reduction—are powerful therapies not only for improving cognitive function but also for reducing the risk of developing dementia.

Please note that confusion, poor judgment, social withdrawal, an inability to complete familiar tasks, etc., are signs of dementia and should be brought to the attention of your healthcare provider.

Dr. Briana Sinatra

Meet Dr. Briana Sinatra

Dr. Briana Sinatra is a board-certified naturopathic doctor with a vibrant practice in the Pacific Northwest. There she focuses on women’s and family health, taking a holistic approach to healthcare by empowering women with the knowledge and tools they need to live their best life now and protect their future wellness by looking at how all the systems in the body work together and how diet, lifestyle, and environment all influence health.

More About Dr. Briana Sinatra