Louisa Nicola: Australian-born neurophysiologist and brain health clinician-academic based in New York whose doctoral work focuses on women and Alzheimer's disease. She advises elite performers and works alongside leading neurosurgeons.
What this episode covers
Louisa Nicola argues that Alzheimer's is largely a lifestyle disease that silently starts in midlife (the 30s) but only shows symptoms decades later. She walks through the biology of cognitive reserve, amyloid beta, tau tangles, and the glymphatic system, and lays out the prevention levers: heavy resistance training, zone-five cardio, blood pressure control, deep sleep, omega-3s, vitamin D, and high-dose creatine. A major thread is why women are disproportionately affected, the role of declining estrogen in perimenopause, and the contested case for hormone replacement therapy. The conversation closes on the anterior midcingulate cortex (the 'willpower muscle'), the brain-rot risk of AI and scrolling, and Louisa's personal motivation rooted in losing her grandmother.
Recommended on this episode
Flow
Mihaly Csikszentmihalyi
“The book that changed my mind on that was Flow by Mihaly Csikszentmihalyi, which actually speaks about the flow state.”— Louisa Nicola
Big reveals from this episode
- Claims 95% of current Alzheimer's cases could have been prevented because it is a disease of lifestyle, not genetics.
- Says cardiovascular disease/dementia is the number one killer of women in the UK and number one cause of death in Australia.
- Cites Dr. Ben Levine's study where four hours of exercise a week for two years remodeled 50-year-old hearts to be 20 years younger.
- Reveals the amyloid 'cascade' theory was wrong; amyloid is actually a protective antimicrobial peptide and amyloid-clearing IV drugs caused microhemorrhages and some deaths.
- First pilot study put Alzheimer's patients on 20g of creatine a day; they preserved cognition, had more energy, and exercised more.
- Biological age testing came back at 22.
- Becomes emotional revealing her grandmother Louisa, whom she's named after, died of cancer after hiding her symptoms, the origin of her obsession.
- Goes 'political,' criticizing the flip-flop on vaccine messaging from Secretary Kennedy and the erosion of public trust.
Worth remembering
- 60 million people worldwide have Alzheimer's, 70% of them women.
- The brain is 87 billion neurons and uses 20% of your daily calories.
- One night of sleep deprivation raises your amyloid beta risk by about 4-5%.
- One copy of the APOE4 gene roughly sixfolds a woman's Alzheimer's risk; two copies raises it about 15-fold.
- Doing 10 air squats every hour can offset a sedentary lifestyle, even if you exercise daily but sit 10+ hours.
- During perimenopause, falling estrogen causes about a 30% reduction in brain glucose metabolism, contributing to brain fog.
- Around 95% of popular US omega-3 supplements tested exceeded normal oxidation levels; store fish oil in the fridge like olive oil.
- Vitamin D deficiency can raise all-cause dementia risk by 40%, while high levels (~60 ng/dL) may lower Alzheimer's risk by ~80%.
- Cystatin C is a better kidney-function marker than creatinine for people taking creatine or with high muscle mass.
- The anterior midcingulate cortex (the 'willpower muscle') only grows when you force yourself to do things you hate, and predicts survival after major setbacks.