Episode 02: Dementia Isn't Inevitable: What You Can Do in Midlife

Episode Summary In this episode, host Dr. Traci DeSplinter sits down with neurologist and preventive brain health expert Dr. Ashanthi Gajaweera to explore what women can do in midlife to reduce their risk of dementia and protect long-term brain health. They discuss why dementia is not simply an inevitable part of aging, how changes in the brain can begin decades before symptoms appear, and why midlife may be a critical window for prevention. From sleep and movement to metabolic health, hormone changes, genetics, and medication use, this conversation offers practical ways to take a more proactive approach to brain health. Takeaways Dementia Prevention: Nearly half of dementia cases may be preventable by addressing modifiable risk factors early. The Midlife Brain: Brain changes associated with dementia can begin decades before symptoms appear. Menopause & Brain Health: Menopause brings significant physiologic and structural changes to the brain and may represent an important opportunity to optimize brain health. Sleep & Brain Clearance: Deep sleep supports the brain's glymphatic system, which clear waste products from the brain. APOE4 & Genetics: Having an APOE4 gene variant increases dementia risk but is not deterministic. Whole-Body Health: Factors affecting overall health also influence brain health. Timestamps 01:20 – Meet Dr. Ashanthi Gajaweera and preventive neurology. 03:13 – What exactly is dementia? 05:46 – Different types of dementia and overlapping causes. 06:34 – When do changes in the brain actually begin? 09:04 – Why dementia-related changes can begin decades before symptoms. 10:32 – How common is dementia? 12:00 – Why dementia disproportionately affects women. 12:42 – Menopause and the changing brain. 15:53 – Menopause as a window of neuroplasticity and opportunity. 17:42 – The 14 modifiable risk factors for dementia. 20:20 – Why dementia prevention requires more than checking boxes. 25:00 – Sleep and the brain's glymphatic system. 29:02 – How waste clearance may relate to dementia. 31:05 – Medications and potential dementia risk. 33:05 – Statins, cholesterol, and dementia risk. 38:51 – Understanding APOE4 and genetic dementia risk. 49:17 – The problem with healthcare silos and the need for whole-person prevention. 52:38 – Dr. Ashanthi's simple message for midlife women. 54:22 – Where to find Dr. Ashanthi and learn more about her work. Resources & Community Refined Women’s Health Learn more about our practice and how we help women navigate midlife with a proactive, personalized approach to their health. ⁠www.refinedwomenshealth.com⁠ Instagram: ⁠https://www.instagram.com/tracidesplintermd⁠ Facebook: ⁠https://www.facebook.com/TraciDeSplinterMD⁠ TikTok: ⁠https://www.tiktok.com/@tracidesplintermd⁠ Threads: ⁠https://www.threads.com/@tracidesplintermd... Follow Dr. Ashanthi Gajaweera Learn more about preventive neurology, brain health, dementia prevention, and strategies for protecting your health span. Website:⁠www.healthspanneurology.com⁠ Instagram: @drashanti  ⁠https://www.instagram.com/drashanthi/⁠ YouTube: @dr.ashanti  ⁠   / @drashanthi   Facebook: @dr.ashanti ⁠https://www.facebook.com/ashanthi.gajaweera⁠ LinkedIn: ⁠https://www.linkedin.com/in/drashanthi/⁠ Follow Midlife Refined Facebook: ⁠https://www.facebook.com/profile.php?id=61... Instagram: ⁠https://www.instagram.com/midlife_refined/⁠ Support Midlife Refined Enjoying Midlife Refined? Subscribe to the podcast, share this episode with a woman in your life, and leave us a review. New episodes every Wednesday. Medical Disclaimer Midlife Refined is provided for educational and informational purposes only and is not intended to constitute personal medical advice, diagnosis, or treatment. The information discussed on this podcast should not be used as a substitute for individualized care from a qualified healthcare professional. Always consult your healthcare provider regarding your personal health, symptoms, medications, and treatment decisions.