Louisa is a clinician and neuroscientist dedicated to preventing Alzheimer’s disease, which affects 60 million people worldwide (70% women) and is projected to triple by 2050. She argues that 95% of Alzheimer’s cases are preventable through lifestyle changes, yet once diagnosed, it is irreversible—like end-stage cancer. Her mission is deeply personal, driven by watching her grandmother die of cancer after hiding her symptoms and being failed by a system that neglects women’s health.
Alzheimer’s Disease: What It Is and Why It Starts Decades Before Symptoms
Alzheimer’s is a form of dementia that begins silently in your 30s, though symptoms typically don’t appear until the late 60s or 70s. It is not a natural part of aging.
The brain fully matures by age 25–30; after that, without proper care, cognitive decline begins. The brain has ~87 billion neurons with 5,000–50,000 connections per cell, consuming 20% of daily calories.
Two hallmark proteins define Alzheimer’s pathology:
Amyloid beta: A naturally occurring antimicrobial peptide that becomes problematic when it accumulates due to poor sleep and other lifestyle factors.
Tau protein: Stabilizes microtubules in neurons; under stress (especially estrogen loss), it hyperphosphorylates, forming tangles that collapse neural transport systems.
The disease attacks the brain both inside and outside cells simultaneously—amyloid builds up in cerebrospinal fluid while tau tangles form inside neurons.
Cognitive Reserve: Why Some 60-Year-Olds Are Razor Sharp and Others Aren’t
Cognitive reserve is the brain’s buffer against damage—the more connections you build through learning, novelty, and challenge, the more resilient you are.
Two people can have the same amount of amyloid plaque; one retains full cognition while the other declines, purely based on reserve.
Reserve is built through exercise, reading, handwriting, social engagement, and novel experiences—not passive scrolling.
Exercise: The Single Most Powerful Tool for Brain Health
Resistance training (strength training) at 80% of one-rep max is the highest-return exercise for brain health. The SMART trial showed it preserved and even enhanced cognitive function in people with mild cognitive impairment.
Heavy lifting releases myokines—signaling molecules from muscle that cross the blood-brain barrier and:
Stimulate BDNF (brain-derived neurotrophic factor), which grows new neurons in the hippocampus (the memory center first destroyed in Alzheimer’s).
Release irisin, which helps BDNF express itself.
Release IL-6, which acts as an anti-inflammatory in the brain (and has anti-cancer effects).
Leg strength is especially critical: A 10-year twin study found the twin with greater leg power had larger gray matter volume and better cognitive function despite identical genetics.
The one exercise she’d pick for life: The deadlift, because it engages nearly every muscle group and demands maximum neural drive.
Aerobic exercise also matters—30 minutes daily downregulates 13 types of cancers via natural killer cell activation.
Zone 5 training (90–95% max heart rate) is more beneficial for women than zone 2, especially given time constraints in midlife. Women get less return from zone 2 than men.
VO2 max is the strongest predictor of all-cause mortality. It declines starting at age 35. The Norwegian 4x4 protocol (4 minutes at 90–95% HR, 4 minutes rest, repeat 4 times) is the gold standard for improvement.
The Heart-Brain Connection: Remodeling Your Heart at Any Age
Dr. Ben Levine’s landmark study showed that 4 hours of structured exercise per week for two years reversed heart aging by 20 years in sedentary 50-year-old men—turning their hearts into those of 30-year-olds.
The protocol included:
One session of high-intensity (90% max HR) — the 4x4
One long aerobic session (60 minutes, e.g., hiking, cycling)
One moderate session (30 minutes, talk test)
One resistance training session
Critical window: This remodeling only works if started before age 65. After that, the heart becomes too stiff to reverse.
The brain is the most vascular-rich organ. The left ventricle supplies blood to the brain first—cardiovascular health is brain health.
Hypertension kills brain capillaries (one-cell-thick vessels), breaking down the blood-brain barrier (“leaky brain”). The SPRINT trial established 120/80 as the gold standard; aggressive BP management preserved gray matter.
The Sedentary Crisis and a Simple Fix
We are becoming increasingly sedentary—even people who exercise 30–60 minutes daily but sit for 10+ hours have elevated cardiovascular disease risk because prolonged sitting shuts down lipoprotein lipase, an enzyme essential for metabolizing fat and glucose.
10 air squats every hour can compensate for a sedentary lifestyle by restoring glucose regulation and outweighing the benefits of a 30-minute power walk.
Sleep: The Glymphatic System and Why You Can’t “Catch Up”
During deep sleep, the glymphatic system activates—glial cells shrink, allowing cerebrospinal fluid to wash out amyloid beta. This is the brain’s self-cleaning mechanism.
One night of sleep deprivation increases amyloid beta risk by 4–5%, and this compounds over time. It is not reversible by “banking” sleep on weekends.
In perimenopause and menopause, hot flashes and night sweats fragment sleep, preventing deep sleep and causing amyloid accumulation.
Sleep optimization strategies:
Core body temperature must drop ~2°F to fall asleep (cool room, feet outside sheets, temperature-controlled mattress).
Glycine supplementation aids temperature regulation and has longevity benefits.
GABA helps with racing thoughts at bedtime.
Ashwagandha and rhodiola are adaptogens that stabilize cortisol.
Dim lights at 8 PM, use red light bulbs, avoid blue light, stop emails/hard conversations—mimic the sun’s natural rhythm.
The Menopause-Alzheimer’s Link: Estrogen, Ketones, and Brain Energy
Being a woman is itself a risk factor for Alzheimer’s, independent of lifespan. The decline in estrogen during perimenopause (starting ~age 30, accelerating at 42–45) drives this risk.
Estrogen decline causes a 30% reduction in brain glucose metabolism—the brain enters an energetic crisis, leading to brain fog, hot flashes, and myelin breakdown.
The brain compensates by breaking down myelin sheaths; astrocytes convert this into ketone bodies as an alternative fuel source.
Ketogenic diet recommendation: Women in perimenopause should consider a ketogenic or ketone-rich diet to provide the brain with alternative fuel during this metabolic crisis.
Hormone replacement therapy (HRT):
Reduces Alzheimer’s risk by up to 30%, primarily by improving sleep (reducing hot flashes) and supporting muscle protein synthesis and bone density.
The Women’s Health Initiative scared women away from HRT with breast cancer fears, dropping usage from 40% to 4%. Louisa believes this was a mistake and will personally use HRT (patch form).
Estrogen is anabolic to muscle—replacing it helps address multiple Alzheimer’s risk factors simultaneously.
Vaginal estrogen cream applied to the face may be the best skincare available (estrogen receptors exist in skin).
Genetics: APOE4 and What You Can Control
Only ~3% of Alzheimer’s cases are driven by deterministic genetic mutations (presenilin 1, presenilin 2, amyloid precursor protein).
APOE4 is the strongest genetic risk factor:
One copy: 2–3x risk (6x for women)
Two copies: 10x risk (15x for women)
Chris Hemsworth discovered he has two copies and has aggressively modified his lifestyle.
Having APOE4 is not a foregone conclusion—lifestyle can override genetic risk. It’s a simple blood test.
Supplements That Actually Work for the Brain
Omega-3 fatty acids:
60% of the brain is fat; 70% of that is DHA (from omega-3s).
Improve cell membrane fluidity, synaptic transmission, and have anti-inflammatory effects comparable to NSAIDs.
Most effective for mild cognitive impairment, APOE4 carriers, and Alzheimer’s patients.
Warning: 95% of popular omega-3 supplements in the US exceed safe oxidation levels (rancid). Buy NSF-certified, store in the fridge, treat like olive oil.
Vitamin D:
Receptors are abundant in the hippocampus. Deficiency increases all-cause dementia risk by 40%.
Levels around 60 ng/dL may lower Alzheimer’s risk by ~80%. Centenarian women who preserved cognition had high vitamin D.
Creatine:
The most widely studied supplement on the market. Naturally produced (2–3g/day) but insufficient; supplementation is necessary.
Standard 5g dose saturates muscles, leaving nothing for the brain. A pilot study on Alzheimer’s patients used 20g/day and found preserved cognitive function, more energy, and increased exercise capacity.
Protects against concussions, stroke, and sleep deprivation. Can reverse negative effects of sleeping only 4–6 hours.
Anti-cancer effects: A 2025 study of 25,000+ adults found higher dietary creatine intake associated with 5–18% lower cancer risk, strongest in adults over 50.
No kidney risk for healthy individuals—creatinine elevation is normal with high muscle mass or exercise. Ask for cystatin C for accurate kidney assessment.
Look for Creapure (German gold standard, gritty texture) and NSF certification. Avoid powdered/icing sugar versions with additives.
Being studied across the female lifespan: perimenopause, pregnancy, menopause, and dementia.
Training the Brain: Simple Drills for Cognitive Reserve
Hand-eye coordination drills (tennis ball + eye patch): 5 minutes a day trains the visual cortex, processing speed, reaction time, and executive functions. Adding an eye patch removes 50% of vision, forcing the brain to work under stress. Standing on one leg engages the cerebellum and spatial awareness.
Stroop test cards (saying the color of the word, not the word itself) measure processing speed and executive function—the brain processes visual information 15x faster than text.
The Anterior Midcingulate Cortex (AMCC): The “Willpower Muscle”
The AMCC is a brain region that grows when you do hard, challenging things and shrinks when you avoid difficulty.
It is larger in super agers (80–90-year-olds with the fitness and cognition of 50–60-year-olds), athletes, and people who push through discomfort.
It atrophies in sedentary people and those with obesity—but begins growing the moment they start challenging interventions.
Scientists now view it as the seat of the will to live—its size predicts survival after major health setbacks or surgery.
Growth only occurs through resistance: if you love ice baths, your AMCC doesn’t change; if you hate them but force yourself, it grows.
This explains why New Year’s resolutions fail by February—without a growing AMCC, there’s no neurobiological foundation for sustained willpower. It’s not a character flaw; it’s brain state.
Louisa connects this to Theodore Roosevelt’s transformation after personal tragedy—two years of extreme hardship in the Badlands literally rewired his brain, forging the resilience that defined his presidency.
Why Women Are Disproportionately Affected—and Why Louisa Is Angry
Women represent 70% of Alzheimer’s cases and 80% of autoimmune diseases, largely because they are underrepresented in research, downplay symptoms, and are socialized to put themselves second.
Louisa’s grandmother (her namesake) died of ovarian/pancreatic cancer after hiding her symptoms and never asking for help. She was 18, watching the doctor say “there’s nothing you can do.”
Only 4% of women take HRT due to fear. Women’s risk of heart events and Alzheimer’s increases at menopause—yet the medical system has failed to act.
Louisa moved from Australia to New York to be surrounded by the world’s best neurosurgeons. Her obsession has cost her family time, health, and proximity to loved ones—but she wouldn’t have it any other way.
She believes women have been lied to, and that free education through social media is the best hope for change—not government, not pharmaceutical companies.
What to Do If Diagnosed with Alzheimer’s
Louisa would aggressively exercise, adopt a ketogenic diet (to provide ketone bodies as alternative brain fuel during glucose metabolism failure), take high-dose omega-3s, and maximize social engagement and cognitive stimulation.
She would throw tennis balls against a wall—anything to preserve neural connections for as long as possible.
The Bigger Picture: Prevention Is Possible, but the Window Closes
Midlife is the window of opportunity for brain health. After 65, the heart loses plasticity; after Alzheimer’s diagnosis, there is no reversal.
The disease is preventable but not curable. The tragedy is that society spends billions on Mars missions while neglecting a disease that destroys identity, memory, and personhood.
Louisa’s definition of success: being able to control your brain states—knowing how to switch on (focus, drive, norepinephrine) and switch off (recovery, parasympathetic) at will.
Her final reflection: if she could turn down her obsession, she might be happier—but she’d also be less herself. The trade-off is uncertain, but the mission is non-negotiable.
