Your Stressful Life Is Increasing Your Alzheimer's Risk — Especially If You're a Woman With a Maternal History
Chronic stress impacts the same areas of the brain that Alzheimer's impacts.
Of all the factors that contribute to Alzheimer’s risk, chronic stress is the one most consistently underestimated, most often set aside, and in my experience, the most frequently ignored altogether.
Once you understand what’s really happening to you because of chronic stress, you’re much more likely to recognize it, notice it more often, and reduce it.
The stress response was designed to save your life. When you perceive a threat — whether physical, emotional, or chemical — your brain activates the fight or flight system, flooding your body with stress hormones that:
• Sharpen your focus
• Increase your heart rate
• Prepare you to run, fight, or hide
Your digestive system shuts down. Your reproductive system shuts down. All available energy goes toward responding to the threat.
This is a brilliant system. It works exactly as it should — when the threat is short-term.
The problem is that the stress you’re most likely living with today is not short-term. It’s relentless. Financial pressure, caregiving responsibilities, work demands, family dynamics, health fears, and the low-grade anxiety that comes from simply watching the world — these don’t resolve in minutes the way a near-accident on the highway does. They stay.
And your body responds to that sustained perception of threat the same way it responds to any other.
Chronic stress is like living with one foot on the gas pedal and one foot on the brake at the same time, flooding your body with stress hormones.
When the stress response stays on, there is no time for repair. The systems responsible for your health cannot do their jobs when your body believes it is constantly under threat.
What makes this particularly relevant to Alzheimer’s is that chronically high cortisol, a stress hormone, negatively impacts the same areas of the brain that Alzheimer’s impacts. Over time it can cause the prefrontal cortex — the region responsible for memory, learning, planning, attention, and decision-making — to begin to shrink.
It affects the hippocampus, which is central to memory and emotional regulation and is also the area most affected early in Alzheimer’s disease. And it increases the size of the amygdala, which amplifies fear and anxiety.
Chronic stress also depletes BDNF — the brain’s growth factor — which is necessary for the birth and nourishment of new brain cells throughout your life. It depletes serotonin and dopamine. And it drives inflammation — the kind that can compromise the blood-brain barrier and accelerate the very processes we’re trying to prevent.
None of this causes Alzheimer’s in isolation. But chronic stress is a strong upstream contributor — and for many people, it may be where the metabolic unraveling begins.
Why women are more vulnerable
Estrogen, which is neuroprotective in many ways, also amplifies the stress response in the short term. As estrogen declines during perimenopause and menopause, the regulation of that stress response becomes less stable, and the brain becomes more vulnerable to its effects.
Women also have a more reactive stress response system overall, which means cortisol is released more readily and in greater amounts in response to perceived threats.
Women also tend to ruminate more — to replay, rehearse, and worry.
Interestingly, you can turn on the stress response just by thinking about a current problem or one you anticipate in the future. Which means the stress is not always coming from outside circumstances — it’s being generated internally, by thought.
If you have a maternal history of Alzheimer’s, there’s an additional layer. Seeing your mother or grandmother decline with Alzheimer’s is itself a chronic stressor. The worry, the grief, the anticipatory fear — these are real stressors with real physiological effects.
And there’s a cruel irony in the fact that caring for someone with Alzheimer’s, which is one of the most emotionally and physically demanding things you can do, is also one of the most significant chronic stress exposures a brain can undergo.
Women are the primary caregivers for spouses and parents with Alzheimer’s. They are also, by a significant margin, the ones who develop the disease themselves. Two-thirds of all Alzheimer’s diagnoses are women.
The daughters who care for their mothers are often walking the same road their mothers walked — carrying the same stress, experiencing the same sleeplessness, putting themselves last in the same way, and ultimately facing the same risk.
That cycle is worth interrupting. The stress you are living with right now is relevant to the brain you will have in the future. Managing it is not a luxury or a self-indulgence. It is part of your Alzheimer’s prevention strategy.
In the rest of this email, I share specific, practical strategies for turning off the stress response — including one I use before going to sleep every night that also improves my ability to fall asleep.