The menopause is linked to changes in the brain similar to those seen in Alzheimer’s, according to a large UK study.

The loss of grey matter in areas involved with memory and emotion might partly explain why women are generally at greater risk of dementia than men, researchers speculate.

The findings come from nearly 125,000 women, of whom 11,000 had MRI brain scans.

In the study, published in the journal Psychological Medicine, hormone replacement therapy (HRT) use did not appear to prevent the grey matter loss.

Prof Barbara Sahakian, senior author and from Cambridge University, said: “The brain regions where we saw these differences are ones that tend to be affected by Alzheimer’s disease.

“Menopause could make these women vulnerable further down the line. While not the whole story, it may help explain why we see almost twice as many cases of dementia in women than in men.”

The brain changes occurred in:

• an area which has a major role in learning and memory – the hippocampus
• a region essential for forming memories and spatial navigation – the entorhinal cortex
• a part which helps with attention and regulating emotions – the anterior cingulate cortex

White matter and grey matter are both essential parts of the brain and spinal cord.

Grey matter consists of neuronal cell bodies and their dendrites – short protrusions that communicate with neurons nearby.

White matter consists of long axons of neurons that transmit impulses to more distant regions of the brain and spinal cord.

According to guidelines for the NHS, HRT can be considered for menopausal symptoms such as sleep problems and hot flushes.

There is limited understanding of the effects of menopause and HRT use on the brain, memory and mood, say the researchers.

The study found women on HRT were more likely to suffer poor mental health. But many of those already had poorer mental health before being prescribed the medication.

Co-researcher Dr Christelle Langley said it was important to recognise the variety of struggles that can come with menopause.

“We all need to be more sensitive to not only the physical, but also the mental health of women during menopause.

“There should be no embarrassment in letting others know what you’re going through and asking for help.”

Prof Channa Jayasena, an expert in hormones and from Imperial College London, said: “The effect of HRT on brain health in menopause continues to be a topic of debate, and old clinical trials like the Women’s Health Initiative have failed to answer this question. Either way, this is an important complication that millions of women experience in the UK, so deserves close attention in the future.”

Michelle Dyson from the Alzheimer’s Society said women account for around two-thirds of people living with Alzheimer’s disease in the UK.

“And while we still don’t fully understand why they are more susceptible than men, it is thought that hormones may play a role,” she said.

“This large study adds to evidence showing how menopause impacts the brain, including physical changes such as loss of brain volume.

“But without long-term participant tracking, to check if they later develop dementia, we cannot be sure that these brain changes associated with menopause also increase dementia risk.”

She said getting regular exercise, not smoking and limiting alcohol intake can help cut the risk of dementia.

Wellbeing has become such a priceless (or in many cases pricey) endeavour that we can’t seem to get enough of it.

Last year, we were mainlining magnesium, consuming creatine – a muscle boosting supplement that became mainstream, and we turned to AI chatbots for help with anything from a personalised training regime to a daily meal plan.

And, that’s against a backdrop of more than a million people paying privately for weight loss drugs, in some cases completely transforming their relationship with food and exercise.

What is the multi-trillion pound industry focussing on in 2026? Several experts give us their thoughts on what’s on the wellbeing agenda.

If 2025 was about smashing targets at the gym, tracking runs to the second and lifting heavier and heavier weights, then this year is all about recovery.

Jak Phillips, a growth director from global fitness brand Les Mills, says it’s no longer about no pain no gain, something that “fitness has built on for years”.

“Technology has made us so much smarter now,” he says. “It’s no longer about training ourselves into the ground.”

He says smartwatches have revolutionised our understanding of what it means to be fit.

By tracking our movement and our heart rate they tell us when to have rest days, warn us if we have trained too hard and highlight days when our fitness levels are “peaking”.

“Now we have more data and understanding of our wellbeing – we can give ourselves a break.”

Factor in rest days, reframe them as a way of staying fit, rather than “taking time off”, he says.

And with that, a relatively new acronym will begin to seep into our consciousness, Mr Phillips predicts. This year will be about JOMO instead of FOMO.

“So many of us can relate to FOMO – the Fear Of Missing Out – but what if we stop trying to keep across everything?

“Why don’t we experience JOMO – the Joy Of Missing Out?”

FOMO was first recognised by the Oxford Dictionary back in 2004, where we compare our lives to others, and put pressure on ourselves to keep up in a world that’s often been created by our sparkling, shiny socials.

Now, more than 20 years later, a counter movement is growing to reduce the anxiety that often comes with worrying about what others are doing and trying not to spread ourselves too thinly.

It’s not just as simple as saying no to things, Mr Phillips says, it’s about learning to be more comfortable in ourselves and not needing external validation for how we choose to live our lives – whether that’s the frequency of our workouts or how often we socialise.

“It’s about understanding what’s right for you, and not feeling guilt or shame for prioritising yourself,” he says.

“Boosting, that’s the key word here,” Rachel Chatterton, a product director at Holland Barrett explains.

“Our customers are super interested in anything that gives them a boost – and this year will be about boosting their brain power.”

Nootropics, supplements which purportedly enhance cognition which are sometimes referred to as “smart drugs”, have been around for decades, but it’s only in the past few years that their appeal has really taken off.

These should not be confused with regulated pharmaceutical drugs which can help with conditions like ADHD, narcolepsy and Alzheimer’s disease and should only be taken with a diagnosed medical condition.

By 2030, the likes of lion’s mane, ashwagandha and L-theanine could be commanding an $11bn (£8bn) size slice of the wellbeing market.

There may only be a number of small studies that suggest these supplements can improve cognition, enhance memory and reduce stress but Ms Chatterton says the market, especially among Gen Z, is booming.

“They are so much more interested in health than any other generation and I think that’s driving a quite significant movement in terms of preventative health.

“They are really thinking about how they can look after their brain at every life stage.”

And many of us might start “supplement stacking through the day,” she suggests. “Not necessarily swapping any in or out, but mixing magnesium with lion’s mane, for example.”

But boosting our brains does not end there, millions of us are downloading brain training apps to improve our processing speed, memory and to try to protect the 86 billion neurons we have stored in our heads – and as a way, we are told, of staying mentally resilient in the age of artificial intelligence.

Lifestyle GP, Dr Alex Maxwell, is not convinced by the purported power of nootropics and brain training.

“You’re going to get much more bang for your buck by increasing the amount you sleep, that’s a great brain protector, managing your cardiovascular and metabolic health through exercise – they are the kind of things that will help and are proven to help.”

Nootropics have limited evidence they work on the general healthy population, he says, and taking a bit of a lion’s mane, for example, is not going to get to the root cause of why someone is not getting enough sleep or help them feel less stressed in the long term.

So how can we cope with the stresses that this year will inevitably throw at us? If there’s one nerve you want to touch in 2026 – it’s the vagus nerve.

As we begin to understand the vital role our nervous system plays in our ability to manage to stress, there is a growing body of evidence that the vagus nerve might hold the key.

TV doctor, GP Zoe Williams believes that by hacking into the nerve – known as the body’s super highway – we can calm down more quickly in stressful situations and build up a level of stress resilience.

“Whether it’s a work deadline or comparing yourself to somebody on social media or having an argument with your partner or missing the bus, they’re all little doses of stress our body wasn’t designed for,” she explains.

She recommends several simple techniques which can help us activate it, to kick start our parasympathetic nervous system and put the brakes on the “fight or flight” situation many of us might find ourselves in on a daily basis.

Techniques which can help activate the vagus nerve:

• Being aware of our breathing, Dr Williams recommends the “physiological sigh” which consists of two sharp intakes of breath followed by one long exhale
• Cold water therapy – splashing cold water on your face can help lower your heart rate, and stimulate the vagus nerve
• If you want to spend a few hundred pounds you could invest in a vagus nerve stimulator, small devices which are worn round the neck or clipped on the ear which gently vibrate

Dr Maxwell says “back to basics” is his key wellness theme – eat well, sleep and move – those three things are key to being healthy.

He warns simplicity can sometimes be best, as some people are taking monitoring their daily lives to the extreme with life logging. You can now log your entire day using a new wearable AI device that constantly records audio. It lets you know who you have met, what you chatted about, summarises the exchange and basically gives you a rundown of the rich tapestry of your day.

What’s not to love?

Dr Maxwell shakes his head as I give him this example.

“Sounds positively petrifying,” he says. “Tech should be your servant, not your master.

“Do the research and check what evidence is behind these new trends,” he recommends.

“Wellbeing should be a personal choice, and what works for one person might not necessarily work for you.”

Content warning: this article includes details about the impact of conflict on children in war zones and descriptions of injuries that some readers may find distressing.

The first thing was that Abdelrahman’s dad was killed. The family home was struck by an Israeli air strike. The boy’s mum, Asma al-Nashash, 29, remembers that “they brought him out in pieces”.

Then on 16 July 2024 an air strike hit the school in Nuseirat, central Gaza. Eleven-year-old Abdelrahman was seriously wounded. Doctors had to amputate his leg.

His mental state began to deteriorate. “He started pulling his hair and hitting himself hard,” Asma recalls. “He became like someone who has depression, seeing his friends playing and running around… and he’s sitting alone.”

When I meet Abdelrahman at a hospital in Jordan in May 2025, he is withdrawn and wary. Dozens of children have been evacuated to the Kingdom from Gaza for medical treatment.

“We will return to Gaza,” he tells me. “We will die there.”

Abdelrahman is one of thousands of traumatised children I’ve met in my nearly four decades of reporting on conflicts. Certain faces are embedded in my memory.

Some as though I had only met them yesterday. They reflect the depth of terror inflicted on children in our time.

The first was on a hilltop in Eritrea in the mid-1980s. Adonai Mikael was a child victim of an Ethiopian napalm strike, crying in agony as the wind blew dust on to his wounds. The cries, the expression of pure agony in his eyes sent me fleeing from the tent where he was being treated.

In Belfast a few years later, I remember a boy following the coffin of his father, blown up by the IRA. Never before had I seen such a distance in anyone’s eyes.

In Sierra Leone during the civil war, there was the girl whose hands were hacked off by a drunken militiaman; from Soweto there is the image of a child helping her mother mop the blood of a murder victim on their doorstep; and in Rwanda the boy who broke down when I asked him why the other children called him “Grenade” – a moment of insensitivity I will always regret.

He had been wounded by an explosion that killed his parents.

Figures underscore the sheer scale of the crisis. In 2024, 520 million children were living in conflict zones – one in every five children worldwide – according to an analysis by the Peace Research Institute Oslo, which pieced together conflict records with population data to arrive at the estimate.

Prof Theresa Betancourt, author of Shadows into Light, a book about former child soldiers, calls this “the largest humanitarian disaster since World War Two”.

She warns trauma has an impact that lasts long into the future. “[It can affect] the developing architecture of the brain in young children, with lifelong consequences for learning, behaviour, and both physical and mental health.”

But given how much time has been spent researching the impact of war on children’s minds, what can help?

This is a question that has never been more relevant following this period of multiple global conflicts that have affected millions of children: from those Sudanese children who, in October, saw their mothers and sisters raped by militiamen in el-Fasher, Darfur; the youngsters abducted from Israel by Hamas on 7 October, 2023, many having witnessed the slaughter of family and neighbours; the children of Bucha in Ukraine whose parents were among the people massacred by Russian troops in February 2022; and the hundreds of thousands of children like Abdelrahman who have endured more than two years of war in Gaza.

I should declare a personal interest. I suffered from post traumatic stress disorder – PTSD both as a child in a broken home, and later as an adult, witnessing war and genocide. Though different from experiencing war as a child, I know the symptoms all too well: the extreme anxiety, hypervigilance – being constantly on guard against threats – flashbacks, nightmares, and depression. The symptoms were severe enough to require several hospitalisations.

Personal experience has made me intensely curious about how children respond and are treated.

“The evidence is quite solid across different studies that the exposure to war and displacement is associated with a higher risk of mental health problems,” says Michael Pluess, a professor of psychology at the University of Surrey.

He has carried out long-term research into the children of Syrian war refugees, and cautions against making assumptions. “It’s important to recognise that children differ in how they respond.”

A variety of factors can influence the outcome. How long was the child exposed to the traumatic events? Were they physically wounded? Did they lose an important person in their life, or see them killed or injured? Did they have physical security and emotional support in the aftermath?

In a sample of 2,976 children from Bosnia-Herzegovina – all of whom had been exposed to war and were aged between nine and 14 – high levels of post-traumatic symptoms and grief symptoms were reported.

But there is the potential for long-term health damage – heart disease, autoimmune problems – linked to “toxic stress”, where the body is flooded with hormones like cortisol and catecholamines, which produce adrenaline.

There is also a developing field of research into epigenetics, which asks whether the experience of trauma by one generation can show up in later generations through changes in the way our genes behave.

Are we more susceptible to, say, poor mental health, addictions or other health problems if our families have a history of trauma – and how much has this to do with genetics versus our family setups and everyday lives?

Epigenetics is a tentative and debated area of scientific research with much still to be learned.

“I think there is some evidence that there is a sort of intergenerational transmission of trauma,” says Prof Pluess. “Some of that or much of that will happen through social practice rather than biological practice, but there’s some evidence to suggest that there are some epigenetic factors as well.”

Prof Metin Başoğlu, director of the Istanbul Centre for Behavioural Sciences, is sceptical. However, he says it is possible that certain temperament traits (for example, predispositions that are transmitted genetically across generations) might make some people more vulnerable to traumatic events.

During research for a book on my own PTSD, I remember a conversation with one of Britain’s most eminent experts in the field, Prof Simon Wessely, former president of the Royal College of Psychiatrists.

I wondered whether my own family history – great-grandparents born during the Irish famine, a grandmother who was traumatised by her war experiences in the 1920s – could have made me more genetically predisposed to PTSD?

“There is simply no way of knowing, without studying a representative sample group from the same area, with ancestors born in the same place and subjected to the same conditions,” he told me. “I can’t do it on one person…

“What I think is much easier to understand – and, I think, is also the most powerful – is the influence of our background. And it’s absolutely impossible for you to have grown up in the household that you did, with the interests that you have, for that not to have the same effect on you.”

There is broader consensus that trauma is a family crisis. It isn’t only a question of what a child witnesses or survives – there is also the impact on adults.

“Not only do children in war zones face the death of caregivers and traumatic separations,” says Prof Betancourt, “but caregivers experiencing their own trauma and distress may not be fully available to help protect and guide their children through the horrors of war.”

Prof Pluess’s research among Syrian refugees supports this. Among the 80% of children found to be vulnerable to more than one psychological disorder, family circumstances were critical.

Around 1,600 families took part in a study, published in 2022, of Syrian refugees in Lebanon. Prof Pluess says that children’s living conditions (such as access to safe housing, food, and schooling) were found to be “about 10 times more predictive of their mental health”.

Children who adapted more healthily may have “had a social environment that was very protective, maybe the parents were able to shield them, maybe they had close friendships, relationships, maybe they have access to school, all those external things that sort of buffer the negative impact of war exposure.”

The roots of this knowledge in Britain go back to WW2 and the experience of children who lived through the Blitz – the eight months of German air attacks between September 1940 and May 1941.

Prof Edgar Jones, of King’s College London, points to a study of 212 children treated at Great Ormond Street Hospital for Children during the war. When researchers went back to the children in 1949 – four years after the conflict ended – they found only 21% had recovered. The role of parents – both positive and negative – emerged as an important finding.

“The severity of a child’s reaction to bombing was judged to be influenced by their parents’ response to the trauma either to accentuate or calm their anxiety,” says Prof Jones.

In my own experience, therapy and medication helped, but also the ongoing support of family and friends. Without the power of caring relationships I don’t believe I could have emerged from the darkness.

I was also encouraged to confront my avoidance of anything that might remind me of the trauma. For example, I went through a long period of avoiding travel to the continent of Africa, fearing that simply being there would trigger reminders of the Rwandan genocide. But my therapist gradually encouraged me to face the fear. It took several years but I did return, and continue to visit places there that are dear to my heart.

Prof Başoğlu pioneered the use of what is called CFBT – Control Focused Behavioural Treatment – among survivors of the 1999 Turkish earthquake, which killed about 18,000 people.

The idea is to encourage the individual to take control of their fear of the event recurring. In the case of children who were constantly clinging to their parents, this was attempted by encouraging them to get used to sleeping alone.

“Once they overcome their fear, all the traumatic stress reactions that are associated with fear also improve,” Prof Başoğlu says.

Israeli psychologists working with children released from Hamas captivity after the 7 October attacks also stress the importance of re-establishing a sense of control.

In a paper for the Child and Adolescent Psychiatry and Mental Health journal, a team of Israeli specialists wrote that this was achieved “by providing survivors with information and space to express their concerns while ensuring that their needs and voices are heard”.

But successful interventions depend greatly on creating a stable environment where the fear of being killed or maimed is not an ever-present reality.

“What they also need is that their parents are well, that they live in a safe place, that they have access to education, that they have a routine, that they have some predictability,” says Prof Pluess.

This is rarely certain in areas ravaged by war. Ceasefires break down. Front lines become frozen. The displaced are stuck in camps.

Still, those words about a safe place bring to mind my friend Beata and the difference stability made to her life.

She was 15 years old when the Rwandan genocide – the worst mass slaughter since the Nazi Holocaust – erupted in 1994. Up to 800,000 people, mostly members of the Tutsi minority, were massacred over a period of 100 days.

As a reporter I travelled on the convoy that evacuated dozens of orphaned children – Beata Umubyeyi Mairesse among them – through roadblocks manned by the murderous Interahamwe militia. It was a terrifying experience, but especially for the children whose families had been killed.

From roadblock to roadblock, we did not know if the machete-wielding gangs would attack.

Years later when she was researching her experiences (later published in a book, The Convoy), Beata got in touch. I remember being struck by her composure and openness. She is married with two children, lives in France and is now a successful writer.

“The first thing that helped me was exile to France, leaving the scene of the genocide. I found myself safe, in a peaceful place, with shelter, a foster family who took care of all my material needs, and the opportunity to see a psychologist. I went back to school in September, and that helped me too.”

Beata was joined by her mother who also survived. Her father had died before the slaughter.

Composed as she was, there were lingering terrors. She panicked one night when classical music was played on the radio – similar to music played on Rwandan radio the night the genocide began. Fireworks or the sound of hunters shooting sent her hiding under a desk in class “because I thought war had broken out in France”.

I wondered if she makes a conscious effort to protect her children from the traumatic inheritance of genocide.

“There are things that are difficult to tell your children, how we were dehumanised, how I was almost raped. The term ‘unspeakable’ makes sense when passing on stories to children. We are afraid of contaminating them with our trauma.”

But for Beata, nuance is vital. “Their only image of Rwanda should not be the genocide. I told them stories from my childhood and every time I went there I brought them back fruit so that they could also discover a country full of flavour.”

Although she lives a full and happy life, Beata still suffers from anxiety and takes anti-depressants to deal with insomnia. I also use medication, and like Beata I do not see it as a burden or a stigma.

Rather I count myself fortunate to be able to access care and medicine.

Creating a safe community is also seen as critical by many experts.

“They’re not just victims of mental health,” says Prof Pluess. “They’re little people with interests and that’s why they need to go to school, they need to have opportunities to play together – and that might be as important as dealing with the mental health problems that they’re facing.”

Psychologists working in Gaza are well aware of these needs. Davide Musardo, who volunteered with Medecins Sans Frontieres, has written of trying to provide therapy against the background of drones and explosions.

“In Gaza, one survives but the exposure to trauma is constant. Everything is missing, even the idea of a future. For people, the greatest anguish is not of today — the bombs, the fighting, and the mourning — but of the aftermath. There is little confidence about peace and reconstruction, and the children I saw in the hospital showed clear signs of regression.”

It is possible, in devastated Gaza, that the current ceasefire will become a permanent peace, allowing rebuilding, and the restoration of family life and schooling. Possible but by no means certain. In Sudan there are attempts to re-start talks about peace but little optimism for their outcome. The war in Ukraine, and many other wars grind on every day.

Trauma is as old as war itself. Politicians, journalists, and experts looking to the aftermath of a conflict often ask, “What will happen when the killing stops?” But somewhere else the killing will continue. That is the relentless tragedy of children caught in wars they did not start, over which they have no control. For all the knowledge gained about treating trauma, humanity is far from dealing with its root cause – war itself.

Additional reporting by Harriet Whitehead

Top picture credit: EPA/Shutterstock

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