112. Why Women Make Up 75% of Dementia Cases: A Brain Health Coach on Prevention in Midlife

Most women don't think about their brains until something catastrophic happens. A stroke. A diagnosis. A parent who no longer recognizes them. But your brain is quietly sending signals long before that, and in perimenopause, those signals get louder.In this episode, Victoria talks with Christine Despres, a registered nurse with more than 30 years in healthcare and a certified dementia practitioner who spent much of her career working in hospice and dementia care. That work, combined with losing her mother at 57 and learning she carries the APOE4 gene, is what pulled her toward brain health as the starting point for her coaching practice.Christine and Victoria talk through what is actually happening to the brain during perimenopause, including research suggesting women can lose up to 30 percent of brain function during this transition, and why symptoms like brain fog, word-finding trouble, and forgetfulness are common but not something to dismiss as normal aging. They walk through the four lifestyle areas the Alzheimer's Association and the US POINTER study identified as having the greatest impact on cognitive decline: exercise, the MIND diet, cognitive engagement, and knowing your numbers.The conversation also covers genetic testing for Alzheimer's risk, where alcohol fits into a brain-healthy lifestyle, why hormone therapy and brain health is such a contested topic online, and why willpower is not the answer for lasting change. Christine's core message is a practical one: brain health does not require a complicated program. It requires small, consistent shifts that fit into a life you already have.What You'll LearnWhy women account for roughly 75 percent of memory care residents, and what that statistic actually reflectsThe four lifestyle factors the US POINTER study found move the needle most for cognitive decline: exercise, nutrition, cognitive engagement, and knowing your numbersWhat the MIND diet is, how it differs from the Mediterranean and DASH diets, and what a 2025 study found about its impact on cognitive declineWhy brain fog and forgetfulness in perimenopause are signals worth listening to rather than symptoms to push throughWhat genetic testing for the APOE4 gene and P-Tau involve, and how to think about whether testing is right for youWhere alcohol fits into a brain-healthy lifestyle, and how to think about risk versus reward instead of an all-or-nothing ruleWhy hormone therapy and cognitive health is such a divided conversation online, and what the evidence currently supportsHow cognitive engagement works, including specific ways to build novelty into a life that is already fullWhy willpower is not a reliable strategy for long-term change, and what to focus on insteadTimestamps00:00 Introduction to Christine Despres and her path from dementia and hospice nursing to brain health coaching05:10 Why 75 percent of memory care residents are women12:13 What brain fog and forgetfulness actually signal in perimenopause13:24 The US POINTER study and the four habits that move the needle most for cognitive decline16:39 Where alcohol fits into brain health, and the concept of joy span21:18 The difference between telling someone what to do and coaching them toward lasting change25:37 How to build cognitive engagement into a life that already feels full31:22 The MIND diet explained: what to eat, what to limit, and why consistency matters more than perfection35:38 Genetic testing for Alzheimer's risk, including the APOE4 gene and P-Tau testing38:27 Hormone therapy and brain health: why the research feels contradictory and how to navigate it43:01 Christine's closing thoughts on shifting from willpower to identity-based habitsGuest BioChristine Despres is a registered nurse with more than 30 years of experience in healthcare and the founder of The Wellness Navigator. She is a board-certified health and wellness coach and a certified dementia practitioner. Christine spent much of her nursing career working in dementia and hospice care, including 15 years as director of nursing at a skilled nursing facility. After losing her mother at 57 and learning she carries the APOE4 gene, which raises Alzheimer's risk, Christine shifted her focus toward helping midlife women protect and strengthen brain function through lifestyle change.Resources MentionedUS POINTER study, Alzheimer's AssociationDr. Lisa Mosconi's research on the perimenopausal brainThe MIND dietBrainHQ (cognitive training platform used in the POINTER study)Recode program, Dr. Heather Sandison and Dr. BresnanAmen University brain coaching programDr. Kerry