The Brain-Hormone Connection — Dementia Prevention in Midlife with Dr. Ashanthi Gajaweera
Send us Fan Mail Beyond the Thyroid - Episode 59: The Brain-Hormone Connection — Dementia Prevention in Midlife with Dr. Ashanthi Gajaweera Most women in midlife have been told that brain fog, memory lapses, and cognitive changes are just part of getting older. Most doctors aren’t telling them that midlife is also the most important window they have to prevent dementia -- and that 45% of cases are preventable. In this episode, Dr. Dana Gibbs sits down with Dr. Ashanthi Gajaweera, a board-certified neurologist, Menopause Society Certified Practitioner, MIT-trained engineer, and founder of Healthspan Neurology PC. Dr. Gajaweera spent over 25 years seeing patients with neurodegenerative disease before building one of the only neurologist-led practices in the country dedicated entirely to cognitive longevity and dementia prevention. Her program, Mind Over Menopause, is specifically designed for women navigating the perimenopausal transition. In this episode you’ll learn: Why 45% of dementia cases worldwide are preventable, according to the 2024 Lancet Commission -- and why most physicians still don’t know this Why family history is not a life sentence: only 2% of dementia cases are deterministically inherited Why the prevention window opens 20 to 30 years before the first symptom, and why that window shifts earlier for women What amyloid and tau actually are -- and why they represent the end of the Alzheimer’s process, not the beginning The ABCs of dementia risk: ancestry and genetics, biomarkers including volumetric brain imaging and ApoB, and cognitive testing across 12 domains Why neurophobia has created a care gap that is costing midlife women their brain health What the evidence actually shows about estrogen and cognitive decline, why the WHI study used the wrong compound, and what micronized bioidentical progesterone does in the brain Why ApoB is a better marker than LDL for brain blood flow -- and why most patients have never had it checked Where thyroid function fits in the list of modifiable dementia risk factors -- and why it matters more in women That you can grow new neurons into your 90s, and what that means for what is still possible 📑 Join the The Thyroid Clarity Checkup Priority List! 📁 Get My Free Lab Ordering Guide for Thyroid Health 🎯 Get The Free Food Tracker! 🩺 Interested in a Discovery Call with Dr. Dana? Click here! 📺 Watch on YouTube Connect with Dr. Gajaweera Website: healthspanneurology.com Instagram / YouTube Email: drg@healthspanneuro.com Programs: Cognitive Longevity Program (men and women) and Mind Over Menopause (women in perimenopause) — both found at healthspanneurology.com Episode Highlights 00:00 Midlife Brain Fog Warning 00:43 Meet Dr. Gajaweera 02:07 Why Dementia Prevention 04:38 Engineer Mindset in Neurology 09:20 45 Percent Preventable Risks 15:15 Genetics Versus Lifestyle 16:06 The 20-Year Prevention Window 21:24 Amyloid and Tau Explained 24:39 What Doctors Miss 27:47 Neurophobia and the Menopause Care Gap 33:37 HRT and Dementia Prevention 35:50 Why Neurologists Should Own Hormone Safety 37:00 Estrogen Evidence and the WHI 37:54 Progesterone Questions 41:16 Beyond Hormones -- What Else Is in the Window 42:16 The ABCs of Dementia Risk 48:25 ApoB and Brain Blood Flow 51:14 Thyroid and Dementia Risk 54:32 Key Takeaways and Hope 55:55 Mind Over Menopause Program 58:32 Wrap Up and Disclaimers Let's connect! 🔔 Facebook - Consultants In Metabolism Instagram - @danagibbsms LinkedIn - Dana Gibbs MD Tiktok - @dana.gibbs.md ✉️ Email Dr. Gibbs at drgibbs@DanaGibbsMD.com or visit https://www.danagibbsmd.com/ for more information. Thank you so much for listening! Tune in on the next episode. The medical information provided in this episode is intended for informational purposes only and should not be construed as medical advice. Always consult a qualified healthcare provider regarding any medical questions or concerns.
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