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The cognitive edge podcast is designed to help you gain an advantage in all things thinking, learning and understanding. This podcast is brought to you by Strat Futures Pty Limited, the developer of the cognitive readiness and resilience. It is an evidence-backed digital platform for leaders to enhance cognitive performance. We deliver actionable cognitive fitness enhancements based on user needs, including focus techniques, productivity tools, critical thinking and decision frameworks and biological optimisation. Supported by practical training, data-driven insights, and a peer community, we empower users to build resilience, make better decisions, and thrive cognitively in a digital world.
Miah Hammond-Errey (00:03)
Welcome to the Cognitive Edge. I'm your host, Dr. Miah Hammond-Errey. I'm the CEO of Strat Futures and an adjunct associate professor at Deakin University. In this podcast, we focus on anything that helps you think, learn, and understand to help you improve and gain a cognitive edge. Follow and join us on this journey.
Dr Miah Hammond-Errey (00:27)
My guest today is Dr. Caroline Gurvich. Caroline is the Deputy Director of the Her Center Australia at Monash University and Head of the Cognition and Hormones Group. She is an Associate Professor at Monash University where she leads research in the neuropsychology of women's mental health. She's also a highly experienced clinical neuropsychologist with over 20 years experience in public and private health systems. She's a fellow of the APS College of Clinical Neuropsychologists
and share of the Victorian section. I am so excited for this chat. Carolyn, thanks for coming.
Caroline Gurvich (01:01)
Thank you, Miah, for having me.
Dr Miah Hammond-Errey (01:04)
I'm recording today from the lands of the Gadigal people. I pay my respects to elders past, present and emerging and acknowledge their continuing connection to land, sea and community. So this is the first episode of a new podcast, which I've started to reach out to experts for their insights into aspects of cognitive performance. Here at Strat Futures, we've developed the cognitive readiness and resilience platform.
We provide data-driven, individualized cognitive enhancement protocols for leaders making high stakes decisions. And so lots of the questions from today have actually come from our customers. We define cognitive as thinking, learning, and understanding. And Carolyn, how does that match with your definition? And what do you see as most important when we're thinking about cognition?
Caroline Gurvich (01:47)
think that's a nice definition of cognition. is everything that we do that allows us to process the world, to think, to learn new information, to integrate new information with what we already know. It's all of those processes. It also involves emotions as well. So there's a lot of overlap between how we think and how we feel and that interacts. that cognition.
social cognition, our social awareness, our emotional cognition. So I think cognition is a really broad umbrella term that does reflect all of our thinking processes, our learning processes, and our ability to communicate and to feel and to integrate all of that information.
Dr Miah Hammond-Errey (02:35)
It can be so difficult in such a data focused world when we start to think about how to integrate ideas of emotion into cognition. So I want to get to that later. But first, what do you think are the foundational building blocks of good cognitive health?
Caroline Gurvich (02:50)
There's lots, some of them are related to our lifestyle, really broad healthy lifestyle factors. And then some are more specifically related to cognition and more practical elements that are more in the moment type elements. So if we think about good cognitive health and our lifestyle, it's all the healthy lifestyle things, which are exactly the same things for brain health as they are for heart health. So it's making sure you have enough sleep, making sure you're eating a healthy.
diet with not lots of processed food, like a Mediterranean diet or something like that. It's making sure you don't drink large amounts of alcohol, you're not smoking, you're looking after your blood pressure and making sure you exercise. Exercise is a big one and then doing what you need to do to minimize the amount of stress that you have in day-to-day life. Like a little bit of stress is good and I'm sure a lot of people you work with probably have high amounts of stress but it's managing that stress in
an appropriate way. So there's lots of lifestyle things we can do to make sure we can optimize our cognition and think as clearly as we can and process information as well as we can. And then there's the practical in the moment type thing. So that's really comes down to making sure you're focused on what you need to be focused on, that your mind is not elsewhere, that you're present and you're focusing on the task at hand.
you're taking in the information that you need to take in, you're giving your brain and mind time to process that information and react and make appropriate decisions. So I think this is also where that emotional component can come in. And we want to make sure that we're aware that we're making decisions that are not always emotionally driven, but they're instead driven by thought through processes, by the front part of our brain, the frontal lobes, which is where
our judgment and decision making kind of sits and we want to make sure that we're making decisions that are in line with our broader goals and our thought through decisions, not emotional decisions that are reactive and that we might potentially later regret.
Dr Miah Hammond-Errey (05:00)
How can people in those moments get a sense of where their emotion is coming into play? I mean, I often ask people to do a bit of a body scan and say, like, what's a sign that you're under heavy cognitive load, for example, or you're under physical load and people say, my heart rate increases or I feel sweaty or nervous. What are some of the diagnostic features,
Caroline Gurvich (05:13)
mmm
Mm-hmm.
Dr Miah Hammond-Errey (05:25)
that emotion coming into play in your cognitive processes.
Caroline Gurvich (05:30)
Yeah, well, there can be lots of different emotions that can ⁓ contribute to our decision making. And so some of them that you're referring to, so those, you know, heart beating quickly, sweaty palms, those kinds of stress signals. So sometimes we can have a bit of stress and that's not necessarily a bad thing, but it's just being aware and allowing ourselves as much time as we can in the moment.
to reflect on the information at hand and reflect on the decision that you're making. So it's not totally reactive. It has to have some conscious thought through component and just checking in with yourself on how you're feeling. If you can try and name emotions that you might be feeling, whether that stress, whether it's anger or whether you're irritable or whether you're sad or, you know, just trying to put a label on how you're feeling and reflect on that.
and then think about whatever decision you have to make, cognitive decision you have to make, and trying to take the time to make the decision that you would like to make. I mean, there's not always time to consider whether those decisions reflect on your values or your work values or those kinds of things. But it's just ensuring that it's not a really quick, reactive, emotionally driven decision that it's more thought through.
Dr Miah Hammond-Errey (06:49)
Yeah, it's great advice because I think even under significant pressure, there is almost always the time to take a single deep breath and center yourself and work out, know, where am I coming from at the moment? Like, is it a bit of healthy adrenaline? Is it a bit of external stress? Or am I actually being, you know, impulsive because I'm carrying some emotional stress from somewhere else? And when we practice doing it, it does help get
Caroline Gurvich (07:03)
Hmm.
Exactly.
Dr Miah Hammond-Errey (07:18)
quicker at understanding, like identifying where we're feeling and like what we're feeling and how it's impacting us. But it can be a little bit uncomfortable at first.
Caroline Gurvich (07:27)
It can, but that breath work that you're talking about, it's hugely powerful just to take some deep breaths and just time and space between the decision and the information as much as you can have. But it can be as simple as a few deep breaths just to allow you to process and reflect on your decision before you make it ⁓ can have an impact.
Dr Miah Hammond-Errey (07:48)
I'm going to come to some tips in a little bit, but I want to get straight into the relationship between cognition and hormones? And if it's possible, maybe start kind of broadly and then narrowing down to like women and specific age groups if that's possible.
Caroline Gurvich (08:03)
Yeah, sure. So when we're talking about hormones in this context, most of my research relates to our sex hormones, and we're talking about estrogen and progesterone, testosterone. And when we think of these sex hormones, often we think about these hormones as regulating our reproductive functions, which they do. But
Over the last couple of decades, we've actually learnt that these sex hormones do a whole lot more than regulate our reproductive function. So the sex hormones, estrogen, progesterone, testosterone, they cross the blood brain barrier and they have actions inside our brain, which means that they have the potential to affect the way that we think and the way that we feel. And the receptors in our brain that respond to these neuro steroids or these hormones are
in the front part of our brain and also in a part of our brain called the temporal lobe, specifically in the amygdala and the hippocampus. So these are brain areas that are really crucial for regulating our emotions and regulating our decision-making in the front part of our brain, regulating our memory in the hippocampus. So these parts of our brains can respond to changes in hormone levels. And we also know that these hormones
interact with other chemicals in our brain. We call them neurotransmitters. So people might have heard of dopamine or serotonin and these are neurotransmitter systems or chemical systems in our brain that are really important for things like motivation and drive and decision making and regulating our mood. So there's a few pieces of information we've got from animal studies really that have provided us with that scientific understanding of
how the hormones work in our brain and why they might impact how we think and how we feel. So most of my research is on women and hormones and cognition. So for females, there are certain life phases where we have quite significant fluctuations in our sex hormones. So from puberty onwards, there's a menstrual cycle and the menstrual cycle is associated with cyclical changes in our estrogen and progesterone levels. And then
Some people have pregnancy and postnatal period. ⁓ periods of females life are associated with quite significant hormone changes, lots of hormones, not just estrogen, progesterone. But they're also associated both adolescents and pregnancy, they're huge life changes as well. So there's lots of other factors that come into play. And then the other area that I've become really interested in is menopause. So midlife for a lot of women, often around the age of
Dr Miah Hammond-Errey (10:37)
You
Caroline Gurvich (10:47)
51, it's menopause itself is one day in someone's life, which is defined as 12 months after someone's final menstrual period. But the menopause transition is referred to as perimenopause and that can go for four to 10 years. And during that time, there's quite rapid fluctuations and an overall decline in estrogen and progesterone. And then we have other changes in other hormones in the post-menopausal years.
And so this is a time that a lot of women experience changes in their mood and changes in their cognition. Women often refer to it as brain fog in terms of their cognitive changes and the hormone changes we think play a large role in this, but there can be other factors that contribute to the cognitive mood symptoms. So for some women, they can experience other menopause symptoms like hot flushes, nights where it's poor sleep and
those factors might contribute to some of the cognitive changes as well as the hormone changes or instead of the hormone changes. And the other factor that I think is also really important is that menopause and midlife can be a really stressful time for women in our modern world where we're juggling, women are juggling a lot at these years of their life. So they're often super busy, super stretched and stressed.
And so there's just a lot going on. So that's another factor to consider. So I think while we think hormones play a really significant role, there can be lots of other factors that might be contributing to some of the symptoms that women experience. Not every woman experiences symptoms at all during the menopause transition, but about two thirds report this kind of brain fog and about a third of women experience some sort of mood changes like irritability, menopausal depression. So...
it is really important that we learn more about these symptoms and try to help women to ensure that they can thrive and do their best and get through this time as well.
Dr Miah Hammond-Errey (12:46)
I understand from the research that men do not have the number of transitions through like from a hormonal perspective in the same way that women do, is the most similar experience for them in terms of understanding so like that cascade of shift puberty?
Caroline Gurvich (12:53)
Hmm.
Yes, yes, that would be the...
Dr Miah Hammond-Errey (13:04)
and
then they're relatively consistent until they start to decline in testosterone later on.
Caroline Gurvich (13:10)
Yeah, correct. So there's a very gradual decline in testosterone. As there is in females, the decline in testosterone is also gradual. It's not abrupt as the changes for estrogen progesterone are around menopause.
Dr Miah Hammond-Errey (13:23)
So for men trying to understand what the kind of hormonal shifts of a woman's life are, what can they think back to I mean, I'm trying to, you know, get people to understand what might feel similar. in your partner's, in your friends' and family's lives, like these are huge shifts. And there's something that's starting to be talked about a lot. But I wondered if there's ways that, men can think back to an experience that might be a little bit similar for them.
Caroline Gurvich (13:35)
Yeah.
Mmm.
Yeah, I think asking adult male females to reflect back on what was going on at puberty, I think it's really hard to think back about the influence of hormones because it's impossible also to tease that apart from just adolescence and that transition phase of your life and all the social changes and everything else that happens.
In terms of the cognitive symptoms, the way women describe that brain fog experience, I would say it's probably akin to being really stressed and sleep deprived and thinking of those moments where you're feeling quite like you've got a short fuse, you're irritable, you're easily triggered, you're having trouble kind of decisions and thinking through things clearly.
some of those symptoms are what women describe in response to their hormonal shifts and menopause. So I guess everyone has been through those things at some point in their life. So forgetfulness, that tip of the tongue phenomena where you can't find the right word, a little bit of trouble making decisions at different times, those kind of brain foggy symptoms
are not unique to menopause, but they do increase and they are more common at menopause. So I think everyone can relate to experiencing the symptoms at some point in their life. And often it's the same kinds of symptoms to sleep deprivation that people might experience. I think if you can think of a time in your life where you felt really busy and stretched and sleep deprived and that you just had a general kind of fogginess, that
tends to be the kind of description that women describe happening to them across those menopause transition years, but it's not always in the context of sleep deprivation. It can happen in the context of hormone changes.
Dr Miah Hammond-Errey (15:43)
I know we've spoken previously about the connection between perception and data. And I wondered if there was any research in relation to women and going through ⁓ that phase of feeling like those decisions don't come easily, but still performing objectively. And I wondered where that line is and kind of connected to that is like, how do we measure these things?
Caroline Gurvich (15:49)
Mmm.
Yes, I'm really glad you brought that up. And I do always like to talk about the objective data because it is very different to this subjective experience in the context of menopause. So the subjective experience is one generally of brain fogging about two thirds of women to differing degrees of severity. For some people, it's quite subtle. For other people, it really has a huge impact on their day to day life.
Most of the objective neuropsychological data, so that's when we take someone and we sit in a room and we do cognitive testing and we test someone's ability to remember pieces of information, to attend, to juggle information in their working memory. Most of that data suggests that even in women who are experiencing quite significant day-to-day brain fog, their objective neuropsychological performance in a quiet structured room is within normal limits. It doesn't change.
So people's ability, cognitive ability generally doesn't drop. There is an association. So for women who experience greater degrees of brain fog, their learning efficiency is ⁓ lower. So there is a broad association, but that is quite subtle. But that is seen in the data. So more brain fog, the one area of cognition that seems to drop a little bit is how efficiently people can learn. But overall, it's still within normal limits.
and people are still able to perform cognitively. I think there's a few factors that are really important in terms of that perception. think one is just acknowledging that even though there's not an objective change, it's still a very valid and real experience for women. So we don't want to invalidate their data experiences. It's real, it exists, but it's happening at a subjective.
level, it's people's experiences. And the flip side of that is people should know that their cognitive ability isn't changing. They're still able to do all of the tasks that they used to be able to do, but they might feel like at a day-to-day level that they're struggling more. So it's just about getting the right supports in place, the right understandings in place to ensure that women can continue to do what they need to do or they want to do in the workplace or in day-to-day life.
So they don't exactly align that subjective experience and the objective cognitive data. And that's in lots of areas of neuropsychology that there's a mismatch between that subjective experience and the objective neuropsychological performance. They're not always reflecting the same thing.
Dr Miah Hammond-Errey (18:51)
It's really interesting because in so many ways we think that our self-perception or our confidence actually is directly correlated to our performance. So it's quite a fascinating interplay. I think it's super important, as you say, not to discount people's personal subjective experience because if you feel like you're struggling, it's actually really important to get the supports you need to lessen that, those difficulties or, you know, but also on the...
Caroline Gurvich (18:59)
Yeah.
Dr Miah Hammond-Errey (19:18)
flip side to have confidence that you're actually still really capable, even though you might feel like you're not.
Caroline Gurvich (19:22)
Yes.
Yes, yes, exactly. So they're both really important, subjective and objective, both super important to measure, to acknowledge and to manage, but they're not always closely associated.
Dr Miah Hammond-Errey (19:39)
When we think about cognitive performance, sleep is absolutely critical. What are the impacts of hormones and hormonal changes on sleep?
Caroline Gurvich (19:49)
Yes, so in the context of menopause, there is a change in sleep and there is a hormonal component to that sleep change. So many women experience vasomotor symptoms, it's called, so they're hot flushes and they're night sweats. So that can be one driving factor of sleep disturbance. So waking up in a hot sweat can disturb someone's sleep and then they don't have a good night's sleep. And there's other...
hormonal mechanisms that can directly dysregulate sleep, like links between changes in estrogen and our body's ability to regulate melatonin. So there are other hormonal mechanisms that can dysregulate sleep in women across the menopause transition when our estrogen levels are fluctuating and declining. ⁓ So it is quite common for people to experience changes in their sleep during the menopause transition years.
that can then have flow and effects to mood and to cognition. And I think anyone at any life phase knows that poor sleep can make you feel like rubbish and make it hard to perform at your best. And you were just talking before about postpartum years. think that's any mother who has experienced that degree of sleep deprivation, you know what it feels like. It's not great.
So sleep is super important during any phase of life in terms of making sure we can optimize our cognition. And there's lots of supports again, out there to improve your sleep. So it's not that people just have to put up with it and accept it. It's about recognizing actually my sleep's not great at the moment and going to speak to someone so you can do things to optimize your sleep. And then hopefully that has beneficial flow and effects to.
your cognition in the short term, but also in the long term, just for like our brain health, sleep is really important.
Dr Miah Hammond-Errey (21:48)
So you touched on a bunch of things. I'm going to go to one of them. I understand Hercenter has done some research into the effect of estrogen on cognition and brain function broadly. I would like to understand the findings, but also what does that mean for women post menopause in terms of brain function?
Caroline Gurvich (22:07)
⁓ So our understanding at the moment is that during menopause transition, there are many women who experience a subjective cognitive symptoms, which we often call brain fog. So these are they walking into a room and forgetting why that tip of the tongue for words, learning inefficiencies, foggy decision making, those kind of brain foggy symptoms. So we know that that happens and it seems to happen.
during the perimenopause, so in those transition years, it seems to be less prominent in postmenopause, we think, but it's more common in those perimenopausal transition years. And then our understanding of objectively when we assess people is that there's a subtle decline in learning efficiency, but still within the normal limit. So it's only quite subtle that people's ⁓ ability to learn is slightly less efficient, but it's...
Dr Miah Hammond-Errey (23:05)
in the transition
years or also in postmenopause. Sorry.
Caroline Gurvich (23:08)
So we think it's in the transition
years. There hasn't been heaps of great research that's really tracked women well from pre-menopausal sort of reproductive years through those transition years and into post-menopause. Of the few studies that are out there, it's possible and looks like our cognition bounces back, that subtle change in learning efficiency, but I would say it's inconclusive in terms of what happens.
in the post-menopausal years. I would say we still don't have a really good grasp, but the brain foggy type symptoms do seem to resolve. Most people report that that kind of peaks in perimenopause and then lessens in the post-menopausal years. But the objective stuff, it's...
most likely also resolve. the scientific idea is that our brains adapt to having lower levels of estrogen. So estrogen is neuroprotective, it does lots of good things in the brain and then the levels fluctuate, the levels drop and then our brains adapt. So they get used to a new level of lower levels of estrogen in the post-menopausal years.
Dr Miah Hammond-Errey (24:17)
So does that mean then that it's quite possible that it's actually the fluctuation that is what's difficult for us to cope with and once it stabilizes we kind of adapt?
Caroline Gurvich (24:26)
Most likely that's some of the theory, particularly with mood that is thought to be a reaction to the fluctuations. With cognition, we're not 100 % sure if it's the fluctuations in those earlier perimenopausal years or the overall gradual decline that we're not getting the same levels of estrogen that are doing the same good things in our brain that are then having the flow and effects. So it could be both adapting to...
fluctuating levels as well as adapting to lower levels that are contributing to the cognitive symptoms.
Dr Miah Hammond-Errey (24:59)
Okay, I'm going to do a hard pivot. How can we measure cognitive load?
Caroline Gurvich (25:03)
Yeah, so one measure that we use clinically is by assessing someone's working memory. So that is how much can someone juggle and mentally manipulate at one point in time. So that's a measure of in the moment cognitive load. And we do that in lots of different ways, but sometimes we just do things like reading out numbers to people and asking them to mentally manipulate things or mentally manipulate pieces of information and you see how much information.
can someone mentally manipulate? And working memory is very much something we're using in the moment. It's not about how much can you ⁓ keep loading into your brain. It's a temporary storage of information that we mentally manipulate. Cognitive load in a broader sense, like how much information can you keep taking on and keep working with, it's really quite challenging to measure cognitive load broadly.
I've got a PhD student at the moment who is designing a measure of cognitive load in the parenting years and having a look because, know, with young children or children of any age, you're doing a lot and there comes a cognitive load with that. And we actually think that that's a beneficial thing. We're using different parts of our brain, our executive functions, our planning, our organising.
that's all part of our cognitive load. So having some degree of cognitive load is really important. It builds our cognitive resilience and our brain power basically. And that's a protective factor for helping us not get dementia later in life. having some degree of cognitive load is a good thing, but there's a tipping point where if you're juggling too much, you're at your capacity and you can't keep taking in ⁓ and juggling pieces of information.
So it's trying to kind of get the right balance. That's not quite what your question was in terms of, I know I'm coming back to what you're asking about measuring it.
Dr Miah Hammond-Errey (27:01)
I mean, that's super interesting because
we are thinking about developing cognitive resilience to say state information threats, information warfare. I mean, trying to understand at what point, like where are these thresholds for being able to cognitively withstand a certain level of external, you know, high level volume information coming at you that is designed to
Caroline Gurvich (27:11)
Mmm.
Hmm.
Dr Miah Hammond-Errey (27:27)
disrupt your thinking. So interested in both, like how do we actually measure cognitive load? The end the moment stuff is, I think, from what I've seen, more developed and mature in terms of how we assess it. ⁓ You know, as we start to think about, AI generated information flooding out our, information ecosystem, we're seeing the impact of that. Which brings me to another question. Have you seen any interesting research on how
Caroline Gurvich (27:39)
Yes.
Dr Miah Hammond-Errey (27:56)
technology ecosystems might impact our cognition. When you started to think about things like cognitive processes, like perception and attention, ⁓ emotion, decision-making, memory, trust, those, I mean, we start to think about the digital research showing that our attention is changing. But I wondered if you'd seen it on memory, perception.
Caroline Gurvich (28:06)
Mmm.
Yes.
No, most of the research I have seen is on attention and predominantly visual attention as well. It's that visual stimulation, the capacity to look at visual information. Our attention span for that seems to be getting reduced as we're getting more and more used to short bursts of visual stimulation. People seem to be able to attend to longer periods for sort of auditory content.
But I haven't seen any research on how that is changing more broadly our cognition. And I think it will come and I don't know what it's going to look like. It's slightly scary. think this whole new world of AI integrating with our own, our cognitive changes, it might come with that.
Dr Miah Hammond-Errey (29:07)
Yeah, I mean, from my perspective, and you know, listeners of the technology and security podcasts will be across my great fear of neurotechnologies and the way that they can influence your thinking, not just, track it, both are equally as scary.
Caroline Gurvich (29:18)
Mm-hmm.
Dr Miah Hammond-Errey (29:21)
what are your top tips to keep strong cognitive performance as we're aging?
Caroline Gurvich (29:26)
So the two key things are lifestyle and practical strategies. So the lifestyle things that are really important for...
optimizing our cognition in the short term, but also long term to ensure we have healthy cognitive aging, healthy brain aging, making sure that we have good sleep and seeking help if you don't, because there is help out there, making sure that we think about what we're eating and consuming and drinking. having a diet that is not full of highly processed foods, having something that looks a bit like a Mediterranean diet, making sure we're not drinking too much alcohol.
making sure that we're not smoking, that we're looking after our heart health, our blood pressure, ⁓ our cholesterol, all of those things. So checking in with your GP to make sure you're looking after your heart health because it's heart health, brain health, it's all the same thing in terms of dementia prevention. There was also interestingly a Lancet Commission paper on dementia prevention and it had 14 modifiable lifestyle factors that we can
think about that have got nice evidence base now to reduce our dementia risk. So it includes things like making sure that you attend to any hearing loss, that you manage any hearing loss, that any vision loss. So just really looking after yourself as best you can is really important. And the other one is exercise. Exercise is really important. Short-term cognition, boosting sort of blood flow to the brain and being able to think in the short term, but also
in terms of longevity and brain health and reducing your risk of cognitive decline later in life. Exercise is really important and the World Health Organization guidelines are 150 minutes of moderate intensity exercise a week as well as two resistance trainings. So it's actually quite a lot to incorporate that much exercise into a week, but it's super important and there's short term and long term benefits on mood and cognition for.
exercising. And I think once people can embed exercise into their routine, they will feel the benefits. And that should hopefully be enough to keep them going and keep exercise going. some of the really practical strategies that people can do like in the moment, but to create good cognitive habits, ⁓ trying to do one thing at a time, trying to focus on the task at hand.
trying to sort of brain dump so you're not carrying around heaps of pieces of information that aren't that relevant to your task at hand. So if you, you know, I don't know, you need to buy milk and a birthday present and not just keep, you know, writing that down so you don't have to hold that in your head because it's really not important to your work life or your day-to-day life. So just trying to get rid of all the little pieces of information that are floating around your head, write them down or put them into your diary that you're going to do that task.
on another day, another time, so you don't have to think about it. And that gives you a bit more head space and a bit more working memory capacity to really focus on the task at hand and attend to that task and process that information. Getting rid of any kind of distractions wherever you can. So I don't know in your world if that is possible, wherever you can, trying to sort of minimize distractions so you can just focus on the information you need to focus on.
Dr Miah Hammond-Errey (32:47)
Excellent. I recently heard Dr. Matthew Walker talk about new research on sleep banking to minimize the negative impacts of anticipatory low sleep. So he advocates for a focus on quality, quantity, regularity and timing of sleep. ⁓ If we're leading up to high stress environments, are there ways we can
anticipatorily prepare. So if we know something's coming, can we cognitively prepare? So I'm thinking of things like pass or fail exams, know, high stakes selection courses, deployments, or really challenging work environments. risk associated with low sleep?
What can we do cognitively before a big event?
Caroline Gurvich (33:28)
the same kind of preparation. So thinking through what the task ahead might look like, what different scenarios, how they might play out. So we've got some preparation for the different options and different decisions that we might have to make. So having some thought through processes. So again, in the moment, the different scenarios have already played out in your mind and then I mean, there's
other potentials that might not have, but you might have thought through different options and have some different plans in place. And if you've done that ahead of time, then they're thought through plans. They're not emotionally driven decisions. They're thought through decisions. So if you have some cognitive preparation, some preparation for different decisions that you might have to make, preparation for different scenarios, I guess, you know, a bit like preparing for an exam, like the more practice you do, the more prepared you are, the more familiar you
you are with the content of that that prepares your brain cognitively. And then just, you know, making sure you can be in the best position to make decisions on the spot. So trying to get rid of any stress, preparing yourself. So if you're doing breathing exercises or something like that on the spot, you've already practiced those. So your body knows how to respond when you're, when you're breathing and it has the right relaxant effects on you or the right ability to, you know,
clear your mind or recognise your emotions.
Dr Miah Hammond-Errey (34:55)
What is the link between visualising positive outcomes and that cognitive preparation? Like actually thinking about, thinking through the options, but then also imagining those successful options and visualizing how you get there.
Caroline Gurvich (35:10)
So I think in terms of the emotional component, if you're visualized and you've planned ahead and you've got some clarity in what different decisions might look like, that can help. You can also think about factors that might hinder your process of decision making. preparing for any obstacles that might appear. again, it's just about preparing.
Visualizing can give you confidence in making different decisions if you have thought through and you can picture what the different outcomes might look like. It can give you confidence to make different decisions if you've thought through and you can picture the different outcomes.
Dr Miah Hammond-Errey (35:52)
Thank you. ⁓ I understand some of your research has been on eye tracking and cognition. Can you explain what it tells about cognitive performance and fatigue and how you actually measure it?
Caroline Gurvich (36:03)
Yes, so I love using eye tracking as a research tool. It's a little bit like you move a window into the brain. So when we're using eye tracking, what we're measuring is people's response to different information we put on a screen. So it could be really simple. Sometimes we just have a green cross and we ask someone just look at the green cross when it moves and we just look at how quickly they can look towards that. It's called a saccade, is a rapid shift of gaze and a pro saccade looking towards something. Or we might say to someone,
The green cross is going to move when it moves. Don't look at it. Instead, look at the opposite direction or the mirror location. That's called an anti saccade. So looking away from the ⁓ image that appears or the stimulus. So when you do a pro saccade, it's engaged as a pretty short circuit in the brain. Just to, it's almost like a reflex. It's not quite, but almost like a reflex. When you do an anti saccade though, it engages lots of other areas of the brain. So you have to inhibit.
the automatic response of looking towards something. So sometimes people make errors and they keep accidentally looking towards a target even though we've told them not to. So we can measure how often someone makes inhibitory errors. And then they have to, if we've asked them to look in the opposite direction, mirror location, then they have to use their working memory, their spatial working memory to calculate, okay, that target is whatever degrees from the center. So I need to look in the opposite direction, the same number of degrees in the opposite way.
And so then we can get a measure of how accurate someone's spatial working memory is. Sometimes we'll show something on a screen and then it disappears and we'll say, look to where you're remembered seeing something. So we can look at different visual memory circuitry. And then sometimes we do other broad things with our visual system. Like we might show people scenes from movies and ask them to just look at the movie and answer questions or things like that. And then we can see where do people get their visual cues from? What are they looking at?
Different types of people can look at very different things in different social environments or visual environments. And so it's really interesting to get that granular level of detail of what information people are looking at. Because if you don't look at something, you don't necessarily pick up that information. So we use eye tracking for lots of different areas of research. And it gives us lots of information. So from that, we've learned with people with lots of different psychiatric conditions.
for example, people with schizophrenia, make a lot of those inhibitory control errors. They really struggle to inhibit, to not look at something when you've told them not to look at something. And that translates to lots of things in data life that people really struggle to not do something, not do automatic responses, to have that level of inhibitory control. ⁓ And so there's other areas of research that we've used eye tracking for. We've looked at how
autistic people take social information from their environment compared to neurotypical people and the aspects of the environment. Yeah, so it was a PhD student and she was looking at adults who were neurotypical or adults who were autistic and having look at scenes from common TV shows and just there were differences in what they looked, what they focused on visually. So autistic adults tended to focus on more
Dr Miah Hammond-Errey (38:58)
What are the differences there? That must be really interesting.
Caroline Gurvich (39:19)
less social aspects of the scene, so more objects in the scene, and neurotypical people tended to focus more on faces and expressions and looking between people in the scene or anticipating where someone in the scene might be walking to or anticipating social aspects of the scene. So it was quite interesting to see how people picked up different aspects of their visual environment.
Dr Miah Hammond-Errey (39:44)
What are some of the of cognition and hormones that you wish were better understood?
Caroline Gurvich (39:50)
I think at a really broad level, it would just be great for the general population to have an understanding that hormones can influence cognition. So this isn't a science lab kind of research level, just in the general population, because I think a lot of people aren't aware that hormone changes might influence their mood, might influence their cognition. And so for some people, they'll go on a hormonal contraceptive pill and then it might impact their mood adversely.
And they might not make that link that mood changes could be related to the pill because who would have thought that the pill would affect mood. So I think just having a broad appreciation for people to know that mood changes might affect mood and might affect thinking skills would be really great. I'm really interested in why.
there are cognitive changes during menopause. We do have some scientific rationale, but really understanding that a whole lot more, I think, is really important. And I think probably as important is the fact that we don't really know what some of the brain changes and neuroendocrine changes of menopause, how they might be associated with ⁓ later life, cognitive changes, brain changes. We know the...
women, females are more likely to develop Alzheimer's disease. So just being female increases your risk of Alzheimer's. So learning more about is there a connection between some of those menopause brain changes and Alzheimer's disease risk, I think that's a really important area of research that we need to get better at understanding. just hasn't hasn't been done well yet.
Dr Miah Hammond-Errey (41:29)
What's on the horizon in your field? What's coming up that we should think about?
Caroline Gurvich (41:34)
So in the hormones and cognition space, think a few things. One is better managing the cognitive symptoms so women don't experience them during menopause or if they do, they can be managed. At the moment, we have a very poor understanding of which hormones, if any, might treat or help cognitive symptoms. That research just hasn't been done. So that is something that needs to be on the horizon. And then better understanding.
the long-term implications, if any, of brain fog during menopause. So I think that's something that also needs to be better understood about the neuroendocrine changes of menopause and how that might play a role in later life, brain health and cognitive aging.
Dr Miah Hammond-Errey (42:17)
there any biomarkers or you know blood tests or even just kind of physiological changes that women can keep an eye on as they move through that critical decade of 35 to 45 ⁓ and then of course into perimenopause and menopause?
Caroline Gurvich (42:33)
That's another area that I think needs more research. And there are research groups that are trying to develop those markers, but no, they don't exist at the moment.
Dr Miah Hammond-Errey (42:42)
on days when we aren't feeling great, what are some of the things we can do to temporarily perform really well?
Caroline Gurvich (42:51)
So I think self-care is really important where you can. So if your audience are kind of working in environment where they can't go and take a walk or a shower or meditated, that kind of self-care not an option in the moment. Just being aware and being kind in the moment. So it might just be acknowledging that you're experiencing a stressful situation, that you're not thinking as well as you might.
have at other times. And if you can give yourself just a bit of space to acknowledge, to know that it's a really normal experience to not always be at your best. And sometimes you might not be performing your best, but just being kind and saying, you know, that's okay. And taking some breaths and then trying to ⁓ develop a better mindset just in that moment can be helpful, but it can be challenging as well when you're...
not feeling great to try and implement some of those things. So wherever possible to build self-care into other times in your life so you can build your resilience is important.
Dr Miah Hammond-Errey (43:56)
what are three things that everyone can do after this to improve their cognitive health?
Caroline Gurvich (44:02)
So my top three would be lifestyle related. So they would be ⁓ good sleep, exercise, either good diet or minimizing managing stress levels. So you can sort of optimize good stress but not have distress all the time. So that would kind of be my take homes.
Dr Miah Hammond-Errey (44:21)
They are excellent and it's such a reminder that cognitive and physical health and performance are really interrelated. And so many of the suggestions about improving both actually help the other. What have you been reading, listening to or watching lately that might be of interest to the audience?
Caroline Gurvich (44:37)
So my kind of go-to podcasts, one's called Navigating Neuropsychology. So it's very much about neuropsychology. And then I love Andrew Huberman's podcast as well. So I like those kind of sciency, neurosciency based podcasts. So that's my listening. Reading, I love reading and I read every single day and highly recommend.
reading to everyone. think it's such a nice switch off.
Dr Miah Hammond-Errey (45:08)
And my final question is, is there anything I didn't ask you that would have been great to cover?
Caroline Gurvich (45:12)
I feel like we've done a good cover of everything. don't
we're always doing research and always looking for people who are interested in research to at least visit our website. So Her Centre Australia website.
Probably the best thing I'd like to plug for anyone to get involved in research is to check out our website.
Dr Miah Hammond-Errey (45:28)
excellent. The link will be in the show notes. Thank you so much for joining me today, Carolyn. It's been a real pleasure learning from you and I can't wait to share the episode.
Caroline Gurvich (45:31)
Thank you.
Thank you very much for having me, I appreciate it.
Miah Hammond-Errey (45:42)
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