The brain is a vital part of a high quality of life. It is essential in our ability to move, feel, learn, think, communicate with others and make decisions that affect every aspect of our lives. 

While it is no secret that the brain changes (not always for the better) as we age, it is important to differentiate between “normal” and changes to brain health and what may be signs for concern. 

Below, we cover a question we've heard asked often: what's the difference between menopause brain and cognitive decline, and give you 6 key steps towards protecting your brain - whether you're 20 or 80.  

What is Menopause Brain?

The onset of menopause for women most certainly adds a whole other layer to the ageing process -  hot flushes, night sweats, mood swings... but also something a little scarier: an unwelcome change in cognitive function.

The emotional rollercoaster of this period of transition is hard enough, but throw in the complexity of your brain not getting up to speed? That’s a battle. And to make matters worse, it can be difficult to tell apart menopause brain and more serious cognitive disorders like dementia, heightening the worry and stress for lots of women during menopause. 

Commonly termed “menopause brain”,  menopausal women often report experiencing problems with memory, recall, reasoning and daily brain fog that not only clouds thinking, but can also severely affect mood balance. This, together with the array of age-related diseases that start to come forth, can take its toll mentally and physically, stripping women of self-worth, motivation and the daily drive to get things done.

But let's be clear on one thing: there absolutely is a difference between age-related cognitive decline and menopause-related cognitive changes.

While the former is often the result of neuroinflammation that results in permanent cell and tissue damage or death, the latter is likely caused by the effects of fluctuating hormone levels of the brain – and more importantly, is temporary and does not increase the risk of dementia or Alzheimer’s disease.

Estrogen and progesterone, which are hormones produced by the ovaries, keep our brain healthy. They bind to receptors in our brain to enable sharp thinking and enhance memory. However, during menopause, the levels of both these hormones fluctuate and eventually decrease, contributing to cognitive difficulties such as brain fog.

Furthermore, we know that on a cellular level, estrogen supports the biochemical pathways that that use insulin to generate energy from glucose. When estrogen levels drop in midlife, this can result in changes in how neurons in the brain use glucose, leading to an overall reduction in brain energy and affecting attention and memory.

However, a study done by Dr Lisa Mosconi in 2021 found that the brain cleverly compensated for this by increasing cerebral blood flow and increase ATP metabolism to help speed the brain back up post-menopause! Pretty amazing, hey?

Although hormone fluctuations play a big part in cognitive changes during menopause, we also need to consider the prevalence of other unique challenges that may be going on physiologically and psychologically during this period. For example, some studies have established a link between the disrupted sleep from night sweats and the presence of brain fog.

What is Age-Related Cognitive Decline? 

When it comes to age-related cognitive decline, an increasing body of evidence suggests that decreased cellular health is a key factor, together with an increase in oxidative damage and low-grade inflammatory processes in the body.

If our cells are unhealthy, which can be the result of developmental factors, stress, nutrition, heavy metals and various environmental, our mitochondria (the powerhouses in our cells) are unable to do their crucial work in keeping the brain functioning optimally. Following that, in time we’ll start to see a cascade of reactions that ultimately diminish our memory capacity and cognitive function.

While some cognitive decline is a normal part of ageing, dementia and serious cognitive disorders like Alzheimer's disease are not. 

Dementia is the result of damage to brain cells in different parts of the brain. For example, in Alzheimer's disease, amyloid plaques form in and around brain cells , disrupting cell function and the ability of neurons to communicate. These neurons eventually die and brain regions start to shrink.

7 Ways to Protect Your Brain As You Age

1. A diet rich in plants and omega-3 and -6 fatty acids

A number of dietary and lifestyle factors have been associated with decreasing the risk of age-related dementia and cognitive decline, including eating lots of fruits and vegetables, reducing the levels of cholesterol and saturated fats as well as reducing the excessive intake of alcohol.

Epidemiologic studies have revealed that individuals who consume large amounts of fruits and vegetables may reduce the risks associated with age-related diseases Supplementation with fruit and vegetable extracts high in antioxidants (e.g. blueberry or spinach extracts) may also decrease the enhanced vulnerability to oxidative stress that occurs with ageing and improve motor and cognitive behaviour.

In particular, a study suggests that the Mediterranean diet is especially supportive of women’s brain health as it is high in fresh fruits, vegetables, whole grains and healthy fats, as well as rich in foods that contain phytoestrogens. The study found that those on a Mediterranean diet had fewer beta-amyloid deposits in their brains – the protein that causes Alzheimer’s.

A diet rich in polyunsaturated fatty acids such as omega-3 and omega-6 are also essential in maintaining cognitive health as you age. These can be found in fish, nuts and eggs.

A Note on Antioxidants: Why Emphasis on Antioxidant-Rich Foods is Outdated Thinking

While many suggest that eating a diet containing antioxidant-rich foods is crucial to health and in particular, cellular health, it’s not quite that simple.

There are many “antioxidant-rich” foods like green tea, turmeric and berries. While these foods contain many beneficial compounds, they are in fact unlikely to be very effective as antioxidants.

We'll cover more on this in a separate post, but for now, just remember this: the evidence shows that polyphenol-rich foods act as antioxidants in the digestive tract and not our cells, so they are most beneficial when consumed with meals, ideally meals that may be a significant source of free radicals (barbecued meats, bacon, etc).

2. Reduce Oxidative Damage

The brain is high in iron and fatty content, making the extremely sensitive to oxidative stress, and its susceptibility is further exacerbated by lowered antioxidant defence mechanisms.

As mentioned above, antioxidant-rich foods only work in the digestive tract. So if free radical damage is occurring in our cells, no amount of green tea or blueberries will be of help!

So how do we get antioxidant activity in our cells? Saunas, ice baths and intermittent fasting are a few ways to trigger this, as well as a special compound called sulforaphane, which is produced in our bodies when we ingest broccoli sprouts. What makes sulforaphane so extraordinary is its ability to activate Nrf2 in our bodies – a small protein that “switches on” the natural defence mechanisms within our cells! More specifically, it can activate more than 200 different genes, all of which contain the code for cellular defence.

When these protective genes are switched on, our cells are able to operate more efficiently, not only producing more energy (and in turn giving us more energy), but also effectively carrying out autophagy and mitophagy, clearing our toxins and waste products from cells to rejuvenate them.

Look for supplement that contains a high quality broccoli sprout concentrate.

3. Consider plant-derived nootropics

"Nootropics" was a termed coined in 1972 by the Romanian psychologist and chemist Cornelieu Giurgea, referring to a drug, nutrient or food that improves one or more aspects of brain function. 

Plant-derived nootropics are, as the name suggests, nootropics that are found naturally in plants which have now become well-known for their cognition enhancing properties. 

One example is Bacopa monnieri, or Brahmi, which is one of the most common herbal nootropics. Bacopa works by improving synaptic communication, resulting in improved memory, recall, attention span and cognitive performance. 

The nootropic effect of Alpinia galanga, commonly known as Galangal has also been well researched. More recently, a proprietary extract of A. galanga called enXtra™ has been shown in a clinical study to promote mental alertness and support clarity and concentration for up to five hours. 

Other common plant-derived nootropics are Ashwagandha, Gotu kola and Lion's mane. 

Ora's Bright Mind Complex contains both enXtra™ and a clinically-trialled extract of Brahmi called BacoMind™ to enhance mental alertness, cognitive performance and memory, together with Holy Basil and Yerba Maté which is traditionally used in Western Herbal Medicine to decrease mental fatigue.

4. Physical Activity – Get Moving!

Exercise not only contributes to overall health and fitness but also improves muscular control and co-ordination, as well as address some of the factors involved in impaired cognition by reducing the risk factors associated with heart and vascular disease. Moving the body is also essential for improving blood flow to the brain and may encourage the growth of new brain cells.

5. Manage Your Stress

Studies show that elevated levels of stress hormones – cortisol in particular – can speed up brain shrinkage, negatively impacting learning and memory. Studies have demonstrated that healthy elderly patients compared to young adults have higher levels of the body’s key stress hormone, cortisol, while having notable reductions in DHEA levels. This ratio imbalance was even more so evident in demented patients when compared to young controls, and significantly linked to both age and cognitive impairment.

The mindfulness-based practices such as meditation, yoga and Tai Chi promote a relaxation response in the body, switching off fight-or-flight mode, which can help with not just improved cognition, but a better quality of life overall.

Additionally, adaptogenic herbs such as Ashwagandha and Siberian ginseng help the body adapt to stress (hence the name) by regulating our metabolic processes, bringing us back to a state of homeostasis. 

6. Mental Activity – Use It or Lose It

Research indicates that intellectually stimulating activities such as crosswords, Sodoku, reading, board games and playing music help to build brain cells, keeping them protected. Maintaining the functionality of the brain by gathering knowledge and participating in creative exercises is just as important as memory exercises. Activating the brain this way is key in keeping our neural pathways intact.

7. Adequate Deep Sleep

It may be difficult to get a proper night’s rest, especially if you’re going through perimenopause and menopause with the disrupted circadian rhythm and night sweats that arise as a result of fluctuating hormones. But without deep sleep, the brain is unable to rest, restore and remove the toxins and impurities from our cells, which is exactly keeps us youthful – on a cellular level anyway – and our brains healthy.

Establishing a healthy sleep routine can dramatically improve your sleep – from ensuring you power down your screens 1-2 hours before bedtime to keeping your bedroom as dark as possible. Sleep-supporting herbs like lemon balm and chamomile are also great ways to calm the nervous system down, as well as natural sleep supplements.