Key ideas from Peter Attia

• Alzheimer's disease affects women at twice the rate of men, with women showing brain pathology decades before symptoms appear - 'Alzheimer's is not a disease of old age, it's a disease of midlife with symptoms that start in old age' - Lisa
• Women with APOE4 heterozygous genotype have 4x increased dementia risk versus non-carriers; homozygous women face 12-15x higher risk, about twice men's risk levels
• New brain estrogen receptor imaging reveals density remains high until age 65, contradicting animal models that predicted rapid decline after menopause
• Observational studies show 32% reduced Alzheimer's risk for women starting estrogen-only therapy within 10 years of menopause, 23% reduction for combined therapy
• The CARE Initiative represents a $50 million, 3-year research program targeting a 50% reduction in women's Alzheimer's risk by 2050
• Brain estrogen receptors increase during perimenopause as the brain compensates for declining hormone levels, suggesting extended therapeutic windows
• Women develop Alzheimer's lesions earlier than men but mask symptoms longer due to higher verbal memory reserves, leading to delayed diagnosis despite advanced pathology
• Mendelian randomization studies show that for every 37 mg/dL reduction in LDL cholesterol, there's a 50-55% risk reduction in cardiovascular disease - Lane