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The answer lives in this podcast The Diary Of A CEO with Steven Bartlett · Steven Bartlett

Published August 17, 2026 · Editorial summary by Listenly based on the real audio episode · Topics: SMART trial · ApoE4 gene · Apolipoprotein E gene

Is Alzheimer's disease really the leading cause of death for women — and how does it ultimately kill patients?

Dementia is the number one killer of women in the UK, and the leading cause of death for both men and women in Australia. Alzheimer's disease does not kill patients directly — instead, the brain progressively loses the ability to send signals for the most basic bodily functions, leaving patients at fatal risk from asphyxiation, the inability to swallow, or falls caused by lost balance.

Once diagnosed, there is no cure and no way to reverse the damage already done. That irreversibility is what makes the preceding two-decade window so critical: the disease begins accumulating pathology roughly 20 years before any symptoms appear, which means the real opportunity to intervene sits firmly in the prevention phase — not after a diagnosis has been received.

Key risk factor explained in the episode The ApoE4 gene (Apolipoprotein E gene) is one of the strongest known genetic risk factors for Alzheimer's disease. Carrying one copy raises risk 2–3× for men and up to 6× for women. Carrying two copies raises risk 10× for men and 15× for women. Critically, it is not a foregone conclusion — genetic risk does not equal genetic destiny, and lifestyle factors during that 20-year prevention window can still meaningfully shift the outcome.

The episode also highlights that the stakes of inaction are measurable at a population level. When one in two women will develop dementia in their lifetime, understanding exactly what the disease does to the body — not just to memory — reframes it from an abstract cognitive decline into a concrete physical threat. Explore the full conversation on Listenly to hear the discussion in its full context.

"Having strong legs is by far the most important tool in your toolbox for the prevention of Alzheimer's disease."

— Steven Bartlett, The Diary Of A CEO with Steven Bartlett

See also

What role does a ketogenic diet play in managing Alzheimer's disease and why does the brain lose the ability to use glucose?

During Alzheimer's disease, the brain undergoes a metabolic crisis where it loses the ability to use glucose as its primary fuel source. A ketogenic diet offers an alternative energy pathway that may help manage symptoms and slow progression.

How does high blood pressure damage the brain and what blood pressure level should be maintained to protect cognitive function?

The brain is the most vascular-rich organ in the body, and hypertension — elevated blood pressure above 135 systolic — starts to kill off the capillaries, progressively impairing cognitive function over time.

What did Dr. Ben Levine's landmark study show about reversing the aging of the heart through exercise?

Dr. Ben Levine, a sports cardiologist, took a group of sedentary males with an average age of around 50 and subjected them to approximately four hours of exercise per week over two years — reversing heart aging by 20 years.

Listen to the episode on Listenly