00:00I want to talk about rejuvenation, but tell us about this new chapter that you're embarking on
00:04right now. It's a pleasure to be back. The new chapter is basically just formalizing a lot of
00:11effort that Mount Sinai and other healthcare systems have put into advancing women's health.
00:17I am a neurodegenerative disease specialist. I want to understand the causes, drivers of dementia
00:23in order to prevent it. And we've known for a really long time that women are at much higher
00:28risk of developing Alzheimer's disease than men. But the root causes of that have not been
00:34understood. And so this new center, the Rowan Center for Women's Health, is taking a holistic
00:40approach to understanding risk factors in women and aging trajectories.
00:47Hey, Tim and I are looking at each other and I'm like, oh, great, you guys, another win for you
00:52all. And he says, well, women live longer. Is that why we are more at risk because we live longer?
00:57Are there certain things in terms of our composition, our makeup that make us women
01:02more susceptible? And it's not just about that. We live longer. Sorry, Tim.
01:05It's really interesting. We are more resilient. We do live longer, but correcting for that extra
01:12lifespan does not actually explain the increased risk. No, there are biological risk factors or
01:18fundamental differences between women's biology and men's biology. And with the new tools at our disposal,
01:24we want to tap into understanding those pathways of vulnerability.
01:31How do you separate what actually works and what's been tested, what's been proven in a clinical
01:36setting with a randomized controlled trial versus people who come to you and say, hey,
01:42I saw this. This is supposed to be to reverse aging. This is supposed to help me neurologically.
01:50It's what I've seen. It's what I'm seeing on social media. How do you separate the hype from
01:53what works? Oh, you need to do rigorous clinical trials. There's a lot of really exciting science
02:00emerging, including from the I can school of medicine. The next chapter is to use the same
02:06methodologies, methodologies that we've used for things like aspirin, drugs for cholesterol,
02:12the same rigorous randomized clinical trial design in order to test the anti-aging therapeutics.
02:20And we are undertaking a really exciting clinical trial at Mount Sinai that will test combination
02:26treatments to slow down the aging process. So this is really the next chapter for extending health
02:32spend. Yeah, it's really fast. I am kind of obsessed. It's funny. We've done a lot of report. I think
02:37even in the time story, they just talk about a lot of wealthy individuals who are obsessed and pouring
02:41money into it. I want to go back to something you said about the pathways to vulnerability for women.
02:47What are those pathways in particular? And there's so much out there on social media. You have to be
02:52very careful, but things where they say, here's how you can maybe fend off dementia or what you should
02:58be doing. And I don't know whether it's exercise, keeping the mind busy, just these different things that
03:04they talk about. I'll give a very concrete example based on work that my lab is doing. We are really
03:12focused on understanding how blood vessels age, we think is a fundamental component of aging of every
03:17organ system, including the brain. And we've uncovered really striking differences between the trajectory of
03:25vascular aging in women and men. And one of the really big differences in our lifespan is this middle age
03:35where women undergo menopause. What's surprising to me, and this is the beauty of data-driven
03:41studies, is that it's not all hormonal. There's this drastic shift and the physiology of women really
03:49changes. And I can't help but think that that biology that shifts is part of the risk for conditions
03:58later in life, such as Alzheimer's disease. So, you know, we go back to it. I can't remember if we've
04:03spoken with you about this before, but I know in this segment, we often bring it up, especially when
04:08it comes to women in menopause, the study when it comes to hormones and how that's been rethought
04:14because there were flaws or the outcome maybe wasn't true. And that we're now learning that women
04:22should maybe be taking hormones as they're going into menopause or before it. So what you're thinking
04:29around that, of course, every case is individual. I understand that in terms of healthcare and
04:33treatment, but is that part of something that can help women in this process, especially when it comes
04:39to our neurological aging? Yes. We think that there may be benefit to some individuals being
04:45on hormone replacement therapy. The question is for how long and how much of an effect is it going
04:51to have on Alzheimer's per se? And I think those studies are ongoing, but our data so far suggests that
04:59there may be an effect, but it wouldn't solve the Alzheimer's problem to put it that way. So just going
05:06on hormone replacement therapy in of itself without understanding more of the biology and having
05:12other interventions is not going to stop women from having the higher risk of Alzheimer's disease.
05:19Dr. Lahey, we have about a minute left and I'm just curious for women or men who their wives,
05:24their sisters, their daughters, whatever, might be listening or friends. So what is your advice
05:32to women based on what you know and what you're looking into?
05:37I would say that for women, they should have the conversation about hormone replacement therapy
05:41because outside of Alzheimer's disease, it can have other benefits and it may also benefit Alzheimer's.
05:46I would say exercise, exercise, exercise, work on sleep, do sleep studies to make sure you don't have
05:53sleep apnea, healthy diet, including the Mediterranean diet. All of these are basically
06:00as though we're taking drugs. They have real impact on the biology is what we have discovered.
06:06So taking lifestyle measures seriously can truly diminish one's risk.
06:12Just very briefly, the hormone replacement therapy, what age should women start having
06:16discussions with their doctor about it?
06:18Dr. Lahey, right around menopause. I would not wait long because I think what we do
06:22know for sure is that if you wait too long post-menopause, you may lose the benefit and only have
06:27the risk.
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