I’ve just returned from the US, where I saw a batch of my close American girlfriends, who are mostly my age.

I was heartsick to learn that of the two dear friends who’d had surgical facelifts, one was still in pain a few years later (a one in a million chance, her doctor told her – not very comforting when you are that one in the statistic), and the other’s face was still numb after more than a year.

The surgeries had been well done. Both looked lovely and not artificially pulled, but they had come at a terrible price.

Now, don’t get me wrong. I’m as vain as the next woman. I like to look good. But the lengths to which my friends had gone got me thinking about women and ageing, and why women ‘of a certain age’ (which apparently refers to ‘menopausal or post-menopausal women’), according to The Urban Dictionary, tend to be extraordinarily apologetic about their advancing years.

What has got mostly overlooked in the #metoo movement, with its emphasis on liberating young women from the tyranny of sexism, is the greatest pressure of all on the female sex – the overwhelming pressure to be younger, particularly once you hit 50.

This has only intensified now that the media has been portraying menopause essentially as a sickness that has to be cured with HRT, particularly because not doing so may cause a woman to go gaga.

So what exactly is ageing exceptionally well? Again, the emphasis is in the wrong place. The important place to look first is not the face or body, but the brain.

The fact is that 43 percent of us are at risk of developing Alzheimer’s disease – with a disproportionate of that percentage women, not because they don’t take HRT, but because they tend to live longer, but not especially healthily.

Enter Dr. Robert Friedland, a leading US neurologist, who has identified four factors that impact how well you age that have nothing to do with a bad toss of the genetic coin.

In fact, he doesn’t believe in genetic testing for the double APOE4 genes, since only 1 percent of people with that genetic profile will ever develop Alzheimer’s.

In his new book Unaging (Cambridge University Press, 2022), he said something revelatory: “Significant cognitive impairment with or without dementia is not normal at any age.”

All the major causes, he maintains, are within our control.

Two of the biggest risk factors are, not surprisingly, the number of prescription drugs you are taking and the amount of toxic food you are consuming.

When you review population studies, as one study did, you discover that anywhere from 30-90 percent of the elderly take five or more drugs at the same time. Many drugs, particularly the anticholinergic drugs, used to treat everything from asthma to depression, are known to have harmful effects on the brain.

And then there is the problem of food. It's been a few years since I’ve been back in the US, but when I went to stock up on food at a grocery store a few weeks ago, I was shocked. Every single packet of food – even the so-called health food section – was chock full of sugar, artificial flavors and chemicals, not to mention genetically modified ingredients. Every last one.

Small wonder that three-quarters of Americans are considered overweight or obese.

Although GM foods are prohibited in the UK (at the moment), Britain is hardly any better, holding the title of fattest nation in Europe, with some 65 per cent of the population overweight or obese.

Another risk factor for poor ageing, says Friedland, is a faulty gut microbiome, since low-grade inflammation there can cause inflammation in the brain, too. Yet another reason to feed your gut with high fiber organic whole foods.

Being sedentary and not exercising also makes the difference between staying sharp and losing it, says Friedland. As does a good detox.

And finally, there is the importance of giving your brain constant challenges.

We met friends for lunch recently and listened as the couple, 10 years younger than us, but who’d retired early, were talking already about preparing for old age – how they would move their bedroom downstairs so they won’t have to walk up the single flight of stairs in their house.

They had their hobbies, but no big challenges anymore – nothing to bound out of bed for in the morning.

I thought about Anat Baniel, originator of the Anat Baniel Method®, who told us recently that she had her dad practice her neuromovement exercises, which create new neural connections, while he continued to pursue his lifelong interest of making new things.

He ended up creating a prizewinning invention at the age of . . . 100.

I’d add just one more thing to Friedland’s list – a closeknit community, which protects us from everything, from heart disease to dementia, a major reason why I teach people to heal in Power of Eight® groups.

I will never look like I did in my 20s, no matter what I do to myself. But when I gaze in the mirror, I see something better: the joy and satisfaction, after the wrong turns and missteps of youth, of the path I have forged for myself, the family I’ve created, the purpose I wake up for. It’s etched all over my face.

May you look in the mirror and also celebrate the life you have led. And discover that the fountain of youth resides inside your head.