Brain Fog, Memory Loss, and Alzheimer’s Risk During Menopause with Dr. Lisa Mosconi

23:50Dr. Mary Claire Haver:This episode of Unpaused is brought to you by Alloy Health. We talk a lot about hormones affecting mood and energy, but they also play a major role in your skin. Collagen, hydration, elasticity. And in midlife, when hormone levels start to shift, your skin changes too. I first heard about Alloy through a close friend who is a dermatologist. She shared how few products truly address hormonal skin changes. Once I understood that Alloy's approach is rooted in hormone science and physiology, I decided to try it myself. It changed the way I think about how skin care is at this stage of life. Alloy's M4 line includes the M4 face cream, M4 face serum, and M4 eye cream.

24:37Dr. Mary Claire Haver:These are prescription strength formulas made with estriol, the gold standard hormone your body stops producing naturally, and they are backed by clinical research. Women are seeking smoother-looking skin, improved firmness, and a brighter, more even tone. If your skin is changing, your skin care should change too. With Alloy, you consult with a doctor and receive expert guidance and have your treatment delivered right to your door. Head to myalloy.com and use code MCH20. That's MCH20 to get$20 off your first order. Perimenopause is not early menopause. It is its own distinct biological phase.

25:22Dr. Mary Claire Haver:And it has been largely ignored. My new book, The New Perimenopause, is about the 7 to 10 years before your period stopped. A transition that is anything but gentle. Hormones fluctuate wildly. And for many women, this is when the anxiety, brain fog, sleep disruption, weight changes, mood shifts, joint pain, and that unsettling feeling of, I don't feel like myself anymore, begin. Long before anyone says the word menopause. Perimenopause often starts quietly. It shows up in the brain first, then the body, then everywhere else. And too often, women are told, nothing is wrong. I wrote the new perimenopause because you deserve answers before things spiral.

26:09Dr. Mary Claire Haver:You deserve care before burnout. And you deserve a clear roadmap for a transition that medicine has ignored for far too long. The new perimenopause is now available for pre-order everywhere books are sold. Learn more and pre-order your copy at thepawselife.com. Many of you know I've spent my career pushing for better medical standards for women. MidiHealth is on that same mission, delivering the kind of care women have always deserved. For too long, women have been told to just deal with perimenopause and menopause symptoms. Your labs are normal. This is just a part of aging. Eat less. Work out more.

26:49Dr. Mary Claire Haver:That approach failed us, and it's exactly why both my work and Midi's exist. Midlife and menopause aren't the beginning of the end. They're a critical window of opportunity. But education is only half the battle. Women need access to clinicians who actually understand the science of female aging. That's the gap MIDI was built to close. MIDI is focused on health span, not just lifespan. That means looking at your metabolic health, bone density, cardiovascular risk, and cognitive function. It's the kind of proactive, evidence-based care I've always believed women deserve. And it's exactly what MIDI delivers.

27:30Dr. Mary Claire Haver:And here's what matters most. Women in all 50 states can access this care, covered by insurance, with clinicians trained in the latest menopause and longevity science. Because your zip code should never determine your access to quality menopause care. Book your virtual visit today at joinmidi.com. That's joinmidi.com.

27:59Dr. Mary Claire Haver:now we need to talk about something that went viral when robbie testified at the fda oh god yes she talked about in her studies um that we see you know and now help me walk me through this so that the basic listener can understand the brain will start utilizing some of its own white matter for fuel in menopause because glucose metabolism is impaired. So meaning it will turn around and grab whatever it can for energy. The brain will protect itself. And white matter is kind of the insulation. So that's fatty material that lines our neurons. And that got twisted into the brain eats itself somehow, which went viral, of course, on social media.

28:42Can you kind of explain what that is? Yes. One of the many functions of estrogen is that when it binds to estrogen receptors, that activates the glycolithic pathway, which means the brain starts burning glucose to make energy. The brain is always burning glucose to make energy. The brain runs on glucose for women until menopause. And that is wonderful because neurons need a lot of energy to just function correctly. What happens when estrogen declines or fluctuates is that the estrogen receptors are not activated the same way. And that has a negative feedback effect on the way that the brain uses or not uses glucose to make energy.

29:30And when estrogen is very low after menopause, but even prior, what happens is that the brain starts glitching because it can't get all the energy that it needs from glucose. And because the brain is an exceptionally intelligent organ, of course, doesn't just sit there and decide that we're all going to develop dementia. It switches tracks. So it says, OK, if I can't burn glucose for energy because the mechanisms are not working, I'm going to go hybrid. I'm going to start burning other sources of energy. And first, it switches to amino acids. It's an easy switch, right, chemically. But the problem is that the brain also needs amino acids to make neurotransmitters.

30:14So that could backfire. So then the brain says, well, no, no, no, no, no. I need the amino acids for a number of different functionalities. So I'm going to start burning fat. And that is called beta oxidation. And in the entire body, when you go into a state of very low glucose, the body starts burning fat, which is one of the principles of diet.

30:36Dr. Mary Claire Haver:There you go. The same thing can happen in the brain. So the brain starts burning fat to produce ATP. What happens then? Well, the brain is a very fatty organ. There's a lot of fat, good fat, that, like you said, insulates neurons. So actually, when you look at MRI scans, you leave a little bit of gray around the brain. That is the gray matter. But everything else is white, right? That's white matter, which means fat and other things. So what is the easiest accessible source of fat to burn? The white matter. And so the brain, at least in animal models, starts utilizing a little bit of this white matter as a source of energy.

31:21In rodents, very specific Alzheimer's models, that long term turns into the world that triggered the brain eats itself, which is called catabolism. Anabolism, when you're building tissue, catabolism, you're breaking it down. It does sound unpleasant. Yeah.

31:44Dr. Mary Claire Haver:It was kind of scary, you know, where the brain eats itself, but I knew it is not an autoimmune disorder. It is not an autoimmune reaction. It is not phagocytosis. It's an adaptive response. It's remodeling. It's more like energy preservation in that case. I would say that in rodents, it backfires if it doesn't stop after a certain amount of time. And if it just doesn't stop, it will lead to white matter degradation and their neuronal loss. But this is in rodents. We need to consider that female rats tend to die quite soon after the end of the reproductive life. So reproductive senescence for animals is a little bit like the end of the line, right?

32:36So their lifespan matches their reproductive span.

32:39Dr. Mary Claire Haver:Right. Most mammals don't have a protracted menopause like humans. Exactly. There are a few, but we're really the... Yes. So women live at least another 20 percent of their lives. So there's not a great menopause model other than taking out ovaries. We don't have a perimenopause model. You know, you don't. So, you know, if there are some female rats that live quite long, some specific strains, and then Robbie uses them to look at the natural menopausal transition. But still, still, it does not really replicate brain aging in humans. And that's why translation of research is so important. That's why Robbie reached out to me and we've been working together ever since because she can probe the mechanisms doing experiments, which we will never be able to do on women.

33:25But we can apply those findings to see if similar mechanisms or patterns are present in women.

33:34Dr. Mary Claire Haver:Okay. Very often they do, but sometimes they do not. That we have shown by following women over time, and this is actually not published yet, but it's hopefully soon. We have shown evidence for adaptation as part of menopause. So definitely there are changes. Now I can say changes because we also have published and we're doing longitudinal studies where we're following women over time. And we do see that the metabolic changes are progressive in some brain regions, not all brain regions. We do find that the gray matter is reduced in some regions and not others. But we also find evidence of compensation.

34:13Some parts of the brain ramp up their metabolic activity as other brain regions decline. So overall, cognitive performance is preserved. And I think this is very, very important to say because I know that our work has perhaps not been fully understood. And the notion is that if you have these things, then you have a disease or a pathology. Whereas we're always saying, no, no, no. What we are trying to do is really understand how the brain, women's brains respond to a very significant transition, not just from a reproductive perspective, but also from a neurological perspective, and how that could reflect an inflection point for Alzheimer's risk for some women.

35:03Menopause does not cause Alzheimer's. What we're understanding more and more is that it kind of unmasks a vulnerability or multiple vulnerabilities, right? It's when some women develop anxiety or depression is when some women have more severe symptoms of multiple sclerosis. That's when the risk for stroke increases. There's like a cellular aging accelerator. I guess if you have an underlying vulnerability, that becomes more evident. And it's important to study that because then we can offset the risk, which is really what we're trying to do.

35:45Dr. Mary Claire Haver:We can intervene earlier, see who's at risk, and provide hope. Let's talk about the statistics that a lot of women aren't familiar with. And I'm not fear-mongering here. I think it's important that our listeners, especially younger listeners who are like, is this, you know, oh my God, I don't want to get older. This sounds terrible. But I think if you know, then you can prepare yourself and you're not so blindsided when you start having symptoms. So women are twice as likely as men to be diagnosed with an anxiety disorder or depression. And so when I looked at the data on SSRI prescription use, so that's a marker for how many women have depression or anxiety because these are the medications we use to treat.

36:28Dr. Mary Claire Haver:We have about a 10 % use before perimenopause. And then we double that. Now, part of that is because a lot of practitioners are not comfortable prescribing hormone therapy and will default to giving a patient an SSRI to treat a hot flash and to treat visomotor symptoms. But we do see a doubling. So we go from 10 % to 20 % after age 40, and then we go to 25 % at age 65. And then women are twice as likely to develop Alzheimer's, three times more likely to develop an autoimmune disorder, including those that attack the brain. And multiple sclerosis. Including multiple sclerosis. Four times more likely to suffer from migraines or headaches.

37:08Dr. Mary Claire Haver:Yes. And then more likely to actually be killed by a stroke after menopause, and that's a ratio that's two to one or even higher. No one taught me this, you know, when I was in training in medical school. Me neither. So this is all kind of new information. Yeah, I looked it up when I was writing the XX brain. I pulled these stats from your book. Yes, I figured. This is all research that we had to do kind of from scratch by pulling information from different fields to really, I think it's important to have a big picture. You know, like a high level understanding of what your risks may be and how to protect yourself against those risks.

37:52And I think it's really important to know that prevention is on the table. Yeah. And we have a lot of power to make the right choices and protect our bodies and brains. I think because we can't see our brains, we really don't have some kind of direct line of access to our brains. they feel so foreign, almost like I can't touch them. They can't read. They don't quite, it doesn't quite belong to you, your brain, until you have symptoms, right? Then you realize, oh my God, I do have a brain. How can I take care of my brain? But I think it's becoming more and more commonplace to pay attention to mental health, at least, and brain health.

38:31And there are many things that we can do.

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39:55Dr. Mary Claire Haver:Over half of postmenopausal women report significant sleep disruption and hot flashes are one of the leading causes. In fact, more than half experience sleep disorders during this stage of life. And it's not just about falling asleep. It's about staying asleep when night sweats, temperature swings, and neck or back discomfort keep interrupting those deeper sleep cycles. That's where Coop Sleep Goods come in. Their Cool Plus pillow is made to help dissipate excess heat during hot flashes with cooling gel-infused memory foam. 50 % more breathability, and a cool-to-the-touch cover that feels crisp and refreshing.

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42:22Dr. Mary Claire Haver:what i'm seeing in my patients in clinic and and definitely when people you know sharing their stories on social media is the cognitive and the mental health yeah changes that are really acutely happening where we build a life for ourself right we build a family we build a job we build this wonderful beautiful life that is messy and complicated and you know all the things you You know, that all the jobs and the hats we wear as women. Yes. And we've got it. We've got it managed. We have good days. We have bad days. But, you know, we are in control of our lives. Yeah. Until we're not. And then we're not.

42:58Dr. Mary Claire Haver:And the common theme in this we're not seems to be perimenopause. Yes. There's an inflection point. I love the way you describe it. So walk our listeners through, in general, what is happening to our brains. Before menopause, you know, perimenopause, and then postmenopause. from a brain perspective. It's a really good question. And I think we need to do more research to really be conclusive and talk about old women. As far as I know, we are still one of the very few teams that are looking into it at this point in time. And we are learning more and more. That's shocking to me. It's not that shocking.

43:37You know, menopause is now on people's minds, But it was not until recently. What happens is this, that hormones are starting to change. And the pattern of hormones is starting to change. And what we have learned and we're learning more about is that the brain is in part a neuroendocrine system. is a hormonal organ that responds to the action of sex hormones from the ovaries, which are predominantly estradiol and progesterone. And at the same time, the brain uses hormones to communicate back with the ovaries. And these hormones are called gonadotropine. So they're usually FSH and LH that we focus on most.

44:24So as long as estrogen and progesterone are flowing up and FSH and LH are flowing back down, the brain has a very clear plan with the ovaries. When the ovaries start glitching and they're running out of follicles and their sex ovarian hormones start to fluctuate, the brain gets confused. The reason being, so actually this is a very important thing that I was hoping we would talk about that when I talk about estrogen being neuroprotective, I'm really talking about estrogen, the endogenous hormone.

45:03Dr. Mary Claire Haver:Estradiol, coming from the ovary. The endogenous hormone that the ovaries make because of this feedback loop. I'm not talking about estrogen therapy. Right. But a lot of people make the assumption. They're the same. Yes, especially now that people use this term of bioidentical hormones, it's even more confusing because you're thinking, well, if the estrogen I make is neuroprotective and I can take the same estrogen from a patch or a pill, then that estrogen also needs to be neuroprotective. It's assumed to be neuroprotective. Not so easy. We would wish, right? That would be fantastic. But the point is that estrogen alone doesn't quite matter.

45:47Can we talk about the biology of estrogen? Yes. Okay, good. The way that estrogen works, and let's just look at the brain, is that estrogen is able to cross the blood-brain barrier by plastic diffusion and also potentially transport-mediated channels that are being investigated now. And then it goes in the cell and looks for estrogen receptors. Estrogen will bind to an estrogen receptor. It's like a key that needs to open a lock. Actually, it's like a key that needs to get jammed inside a lock. And together, they go inside the nucleus of the cell. They look for DNA and they bind to a specific part of DNA that's called the ERE, estrogen receptor element, that is in the promoter part of the DNA.

46:39So it directly triggers transcription, which means protein synthesis and cell function. So hormones alone, if you don't have the receptor and if the system is not responsive, the hormones alone don't do anything. Don't do anything.

46:56Dr. Mary Claire Haver:They have to bind to something. Yes. They need to bind to the receptor and the binding needs to be functional. It needs to be able to get to the DNA, speak to the DNA and tell the DNA what to do. The things that can happen is either we're telling the DNA to make more of certain things or we're telling the DNA to make less of certain things. So what can estrogen with the receptor do? Well, for instance, can make more BDNF, brain-derived neurotrophic factor. And that is a good thing. That's wonderful. It's a protein that really supports a synaptic plasticity and growth. It keeps your neurons healthy, which is why we say that estrogen is neuroprotective.

47:40By activating these pathways, it supports brain protection. Things that we want to make less of, for instance, pro-inflammatory cytokines. We say that estrogen is anti-inflammatory, reduces oxidative stress because it goes through the DNA and say, stop making TNF-alpha, stop making interleukin-6, right? So it turns off the inflammatory response. So that's why estrogen is so important for brain health. And we are now able to measure that using brain scans, which, again, is the first time ever.

48:16Dr. Mary Claire Haver:And your research, one of the things that fascinated me was you were the first or your team to document that across the transition, we actually upregulate the estrogen receptor. Do it to look at it? Yes. Yes. Okay. So for those of you who are listening on our YouTube, we will have the images for you to see. And we'll get the images and they'll be linked in the show notes as well. Great. So back to 2019, we had been studying menopause for a bit. And the assumption was that the differences that we were seeing between women at different menopausal stages, but also at that point over time, were directly caused or associated with changes in estrogen function.

49:03But that needs to be proven, right? So I went to my radiochemistry department and I said, I need a tracer to use with brain imaging to look at estrogen in the brain. 2019. Right. And they said to me, well, we don't have it.

49:20Dr. Mary Claire Haver:And I said, hmm, that doesn't sound so good to me. So you had no way to study estrogen in the brain because there was no tracer available. There was no tracer. So a tracer is something you use in radiology. Explain what a tracer is. A tracer, in our case, we do positron emission tomography or PET imaging, which is that kind of technique. You know, when you look at the brain and some parts are red, blue, green. So that's positron emission tomography. Just like here. Yeah. And what we do is that in this case, we take estradiol and we just attach a fluorine-18 molecule to the estradiol. Fluorine-18 is a radioactive isotope.

49:58It's a very, very low dose radioactivity. But what is so special about it is that that becomes a tracer or a ligand. And you just inject it in the bloodstream and it behaves exactly like estrogen. So it's lipid soluble. So it gets right through inside the brain and then it looks for the estrogen receptors and it binds to the estrogen receptors. But we have this teeny tiny little thing attached to it that emits gamma rays, which means it shoots out light. You light up on the scan. You light up, yes.

50:32Dr. Mary Claire Haver:It's like a GPS. Or very similar to when we do thyroid studies. Lots of women have had a tracer that picks up thyroid hormone and they're looking for activity for different autoimmune thyroid diseases. Yes. We use it for all sorts of things, for breast cancer. We use it for heart. But there was nothing available for estrogen. There was nothing. No. This tracer was available. This is called fluoroestradiol. And we have been using this tracer for breast cancer for a very long time. But that's from the neck down. It's really hard to get stuff in the brain unless the brain accepts whatever tracers.

51:10Dr. Mary Claire Haver:The brain protects itself. There's a blood-brain barrier, and it's very protective. Yes, which is great, right, for us as humans. Not so great if you're trying to see what's happening. But this tracer actually crosses, and it binds especially to that structure in red. Okay, so walk everybody through the images. Yes. So these are three brain scans of three different women. One is premenopausal, one is perimenopausal in the middle, and the last one is postmenopausal, early postmenopausal 52. And what we're looking at is the way that the estrogen tracer binds to estrogen receptors in the brain. What's important to know is that estrogen receptors are everywhere in the brain, but they're more abundant in some regions than others.

51:59So we are looking for the hot spots in a way. What we were looking for based on animal studies was a reduction in estrogen receptors because, like we were saying before, the brains of female rodents are not well suited to outlive menopause. And so what happens is that soon after the end of the reproductive spin, the brain stops making estrogen receptors. and you can see the down regulation. It really just, they disappear. You expected this to happen in humans.

52:33Dr. Mary Claire Haver:Like when women go through menopause, they'll just stop making estrogen receptors. But what did you find? The opposite. So what we found, and I drove my students insane. I was like, you've done it wrong. They're like, no, I haven't. I was like, go back. I just cannot believe it. And we just kept enrolling participants because it was like, maybe it's just... A fluke. Yes, some kind of abnormalities. But it really holds. And now we have hundreds of women in the study and we still see this. So pre-menopause, we're looking at women who are at the peak of ovulation. So we have a lot of estradiol, endogenous estradiol in the brain.

53:10So all the estrogen receptors are taken. So you don't see any binding, basically. Everything is kind of bluish, greenish. But then at the perimenopausal stage, when estrogen is actually, this is late period, so the estrogen is kind of down. we start seeing the red blob in the middle of the brain that is the pituitary gland is that part of the brain that is actually talking to the ovaries and sending down the fsh and lh saying i need more estrogen and what we found was in more estrogen receptor density there are more estrogen receptors rather than less, which was expected in Perry. But there are even more after menopause, up to age 65.

53:56And people thought it was crazy when I said, we're going to go all the way to 65 because I wanted to map the curve. Right? And they thought, it's too late. It's too late. So for 15 years, the brain is trying.

54:08Dr. Mary Claire Haver:The brain is trying. This is how I read it. This is the brain's attempt to compensate for the fact that estrogen is very low. So usually hormones and receptors work in balance. When you have a physiological level of hormone, you only need these many receptors. If you have a lot of hormone, then you need fewer receptors, which is a conservative, right? It takes energy to make the receptors. So it's good to kind of like sit back and relax. But if the hormones go down, that is an upregulation that is likely an attempt to just grab every little bit of estrogen that's present in the circulation. It's also, in a way, a bit of a distress signal.

54:51Because what's happening in the pituitary, you can see it, is that the FSH and LH levels are increasing. So it's the brain telling the ovaries, I still want it. I'm still here. That is amazing.

55:08Dr. Mary Claire Haver:And then after age 65-ish, we see this signal attenuate. We haven't yet. We're doing it now. As of now, I think we're the only team doing this. Amazing. As far as I know, we are the only team with an active IND with the permission from the FDA to use this tracer for the brain. I'm hoping that more and more people will start doing it. And at the same time, I'm directly sponsoring developmental new brain tracers for estrogen. Because this is good enough for the pituitary, which is very interesting. But we want to be able to measure more and to get more information out of the brain scans. And the other thing we're doing now is that we're looking at hormone therapy and what kind of effect it has on these.

55:53Receptors. But this was stunning when we found it. And you know the response that we got, and people just don't believe it. Do not believe it. Repeat the study, yeah.

56:03Dr. Mary Claire Haver:Or don't waste money. I was told, do not waste money.

56:09Dr. Mary Claire Haver:Now it's time for the MidiPause. I'm Dr. Mary Claire Haver, host of the podcast Unpaused, bringing you a word from MidiHealth. Let's talk about something that I think about a lot, and something I know many of you lie awake worrying about. Dementia. Here's what I want you to know. The choices you make today directly affect your brain health tomorrow. And you have more power than you think. As a 57-year-old woman, I am taking small steps daily to protect my brain, like staying active, eating well, and managing my stress. These are things I find work for me, but they may not be right for everyone.

56:48Dr. Mary Claire Haver:Every woman deserves the conversation, and that's why MidiHealth is dedicated to changing the way menopause is treated with a personalized approach to each woman's specific needs. I personally lift weights two to three times a week. Resistance training is important because having more muscle is directly linked to better cognition and brain health. Strong body, strong mind. It's all connected. In my workouts, I try to do at least 150 minutes of cardio per week. Zone two training usually at a moderate pace where you can still hold a conversation. Your heart, lungs, and brain all benefit. I also eat to fight inflammation, whole grains, healthy fats, lean protein, colorful fruits and vegetables, and prioritize protein, at least 30 grams per meal.

57:35Dr. Mary Claire Haver:And arguably, most importantly, I protect my sleep and manage my stress daily. Sleep is when brain clears waste and consolidates memory, and chronic stress speeds up brain aging. By getting quality sleep and setting boundaries, you're putting your health first and getting ahead of any dementia symptoms. It may not be right for everyone, but every woman deserves the conversation. Women who start hormone therapy early in menopause have shown lower rates of dementia, stronger bones, and lower heart disease risk. You deserve a conversation. If you want a clinician in your corner who understands what your body and brain need right now, that's exactly what MIDI is built for.

58:18Dr. Mary Claire Haver:Go to joinmidi.com, J-O-I-N-M-I-D-I.com, and connect with one of their clinicians today.

58:31Dr. Mary Claire Haver:So what are you most excited about right now? I am super excited that I started working with Dr. Regina Dugan, who is the former director of DARPA. DARPA is the Advanced Research Program Agency for Defense, which is basically the research arm of the U.S. military. In other words, she's the first woman to ever run DARPA, and she is brilliant, and she is a powerhouse. She's magnificent. And she launched Welcome Leap, which is an independent subsidiary of the Welcome Trust, which is based in London, one of the world's largest philanthropic organizations. So Welcome Leap takes after DARPA, which means that they sponsor high risk, high reward, three years research programs.

59:23Dr. Mary Claire Haver:And this is not NIH. This is not NIH. Independent. It's independent of NIH, fully independent. And so this is where you got the$50 million. Yes. So they asked me to serve as program director, which is a huge honor. And I was able to design my own program of research. They gave me a$50 million budget, which I was like, oh, my God, is this Christmas? It's got to be Christmas. And what I really love about this is that they didn't just give me that money to do the work. They sponsor global international coalitions of scientists who then all work together to address a question that none of us can realistically hope to answer alone.

1:00:11So they really promote collaboration between scientists, whereas usually we're very reluctant.

1:00:18Dr. Mary Claire Haver:Because you're fighting for the same research dollars. We're fighting for the same, yes, the same part of money. It's terrible. And in this case, instead, we now have, I'm trying to find the slide I want to show you, we now have 17 sites with over 70 leading scientists from all over the world. And what is the question you're trying to answer? Well, the question is, can we realistically have the risk of Alzheimer's disease for women by the year 2050, in the next 25 years? And how do we do that? We have estimated, we have done all sorts of calculations and projections, but we have estimated that if we're able to do all the work that I designed, all the work that I said we needed to do in the next three years, potentially, then we can expect to reduce the risk of Alzheimer's disease for an estimated 330 million women all over the world.

1:01:17and given current conversion rates to Alzheimer's, hopefully prevent 55 million new Alzheimer's cases among women by the year 2050. What we're doing specifically is that we are looking at menopause and hormonal aging throughout a woman's life. We're looking at pregnancy. We're looking at puberty. We're looking at birth control. We're looking at all the female-specific risk factors that are mainly neuroendocrine-based, but also everything else that impacts a woman's life, everything we have talked about today. And we're going to try and firmly position at least some of these factors as predictors of Alzheimer's risk in women using brain scans and biological markers.

1:02:00And then we're going to test whether hormone therapy can offset the risk of Alzheimer's by using a modern biomarker-based approach, which is what I think is missing in the field right now. And then we're going to use all the knowledge to develop sort of like online risk calculators for women. We have them for breast cancer.

1:02:22Dr. Mary Claire Haver:We have them for cardiovascular disease. We have them for osteoporosis. Exactly. We don't have them for Alzheimer's, especially for women. And we are targeting an easy-to-use tool that can be implemented in Epic and become point-of-care for women. I must show you this slide. We have now data through CARE. So we have all the scientists that I mentioned. And CARE stands for? CARE stands for cutting Alzheimer's risk through endocrinology. Wow. So when I made this slide, we had 67 leading scientists. We now have 70 investigators from all over the world. These are all the data that we have access to from all over the planet.

1:03:04Six continents, all major continents except Antarctica. and we're going to leverage data from 100 million women estimated if all the data sets come through, which makes CARE, this program of research, the largest ever global examination of women's health and Alzheimer's risk ever attempted. Amazing. Congratulations.

1:03:28Dr. Mary Claire Haver:Thank you. I am so happy. I think your new position is less stressful than... Surprisingly enough, it is. You're doing the work you're born to do now. You know, like without the... This episode was sponsored by MidiHealth, the first virtual clinic created for women by women for the treatment of menopause. Don't let anyone tell you menopause is something you have to suffer through alone. Midi can help. Visit joinmidi.com to learn more. What, you know, our listeners don't understand is the way that research has been set up historically is very difficult and so many hoops to jump through and that you basically were given the gift of a lifetime for a researcher.

1:04:11Dr. Mary Claire Haver:Yes. You know, build your program. Here's the money. Let us know how it works out, you know. And really, you know, with all the pushback and all the all the things that people have said to me ever, ever since I started being a scientist, just hearing I believe that you know what you're doing you know it's like oh yeah we do know what we're doing well congratulations thank you and I'm so glad you came so glad to hear it was lovely all the papers coming so it's going to be amazing as a reminder to our audience you can follow Dr. Moscone on Instagram at Dr. underscore Moscone her book The Menopause Brain is available now through her website at lisamoscone.com.

1:04:58Dr. Mary Claire Haver:You can find full episodes of Unpaused on YouTube at Dr. Mary Claire. I'd love to hear from you about this topic and anything else that's on your mind. You can follow me on Instagram at Dr. Mary Claire and get honest and accurate information on health, fitness, and navigating midlife at thepawselife.com. My upcoming book, The New Perimenopause, is available for pre-order on Amazon. If you're loving this podcast, I have an important request. Please take a moment to follow Unpaused on your favorite podcast app. Following and listening is what pushes this information to more women who need it. So if this podcast has helped you feel seen, understood, or supported, hit follow right now so you never miss an episode.

1:05:44Dr. Mary Claire Haver:Thank you for being here with me. Let's keep going. Unpaused. Unpaused is presented by Odyssey in conjunction with Pod People. I'm your host, Dr. Mary Claire Haber. The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.