Understanding Cognitive Health in Midlife

Are you finding it harder to focus, struggling with short-term memory, or feeling mentally sluggish? For many women in midlife, these cognitive shifts—commonly referred to as "brain fog"— while very common are also unsettling. This topic is close to my heart. With dementia on both sides of my family, I’ve made it a priority to understand these changes and explore ways we can be proactive in supporting our cognitive health and prevention strategies.

The good news is that while these midlife cognitive shifts are common, they are usually temporary. They are often tied to hormonal shifts, related lifestyle factors and the sheer mental load that comes with this stage of life. 

Why Does Brain Fog Happen?  

1. Hormonal Shifts: 

During perimenopause, fluctuating estrogen levels impact neurotransmitters like serotonin and dopamine, which play key roles in mood, memory, and focus.  

2. Sleep Disruptions  

Insomnia or disrupted sleep is common in midlife, whether due to night sweats, frequent waking or racing thoughts. Deep, restorative sleep is essential for cognitive health, and a lack of it is a primary underlying cause of brain fog.

3. The Mental Load:

Midlife often brings an increased mental load - balancing work, family, and caregiving. At the same time, decreasing estrogen levels diminish our capacity to multitask, focus and retain details, making these responsibilities feel even more overwhelming.

4. Natural Aging  

While aging itself doesn’t directly cause brain fog, it does slow down certain processes, amplifying the effects of hormonal and lifestyle changes.

How to Support your Cognitive Health

1. Prioritize Restorative Sleep:

• Create soothing evening rituals, such as making a cup of herbal tea, taking a warm bath, or getting cozy with a good book.
• Keep your bedtime consistent, aiming for at least 8 hours of sleep each night.
• Limit alcohol as it can disrupt your sleep cycle. 

2. Eat to Nourish Your Brain:

• Add omega-3-rich foods like salmon and walnuts to your diet.
• Include antioxidant rich options like berries and dark chocolate.
• Prioritize hydration throughout the day, as even mild dehydration can worsen brain fog.

3. Move Regularly:

• Exercise improves blood flow to the brain and lifts your mood. Ideally incorporating movement in the form of something you love to do - whether that’s walking in the forest, playing pickleball, strength training or dancing in your kitchen.

4. Evaluate and Reduce Stress:

• Practice saying ‘no’ to commitments that are not in alignment with your values
• Spend time in nature
• Incorporate mindfulness techniques like deep breathing or meditation, even for a few minutes a day can help to regulate your nervous system and reduce mental clutter. 

5. Engage Your Mind: 

• Challenge yourself to learn something new - an instrument, a language or a craft.
• Incorporate play into your routine with puzzles, crosswords or Scrabble (a personal favourite!)
• Stay socially connected; good conversations stimulate our brains.

When to Seek Support:

Cognitive changes associated with the midlife hormonal transition typically improve by about 5 years post-menopause. If these changes are persistent, or significantly impact your daily life, let’s check in. It is important to rule out other possible causes.