Vasso’s Corner: Understanding brain health – A growing global priority

Vasso’s Corner: Understanding brain health – A growing global priority

Brain health is vital for overall well-being, affecting cognitive abilities, emotional balance, and daily functioning throughout life. The World Health Organization (WHO) defines it as the optimal brain function across cognition, sensory perception, social interactions, emotions, behaviour, and movement. This comprehensive view highlights its importance for individual well-being and societal progress, driving productivity, innovation, and future well-being.

The rising concern of neurological disorders

The increasing prevalence of neurological disorders, such as stroke, dementia, epilepsy, and migraines, suggests the urgent need to focus on brain health. According to the Global Burden of Disease (GBD) 2021 report, these conditions are major causes of disability and death, with rates expected to rise due to aging populations. This economic burden affects healthcare systems and productivity, and is particularly severe in low- and middle-income countries (LMICs), where limited resources amplify the stress and mental health challenges for families caring for loved ones with chronic conditions

The emergence of preventive neurology

To address these challenges, preventive neurology has become an important approach. This field focuses on identifying and managing risk factors before neurological diseases fully develop. Preventive neurology can be divided into three main strategies:

1.     Primary Prevention: This involves making lifestyle changes to reduce the risk of developing neurological disorders. Regular physical activity, a balanced diet, mental engagement, and sufficient sleep are key to lowering risk (Summarised in the figure), especially for those with genetic or environmental risk factors.

2.     Secondary Prevention: This strategy focuses on early detection through screening programs, biomarkers, and advanced imaging to spot early signs of neurological diseases. Detecting these signs early can delay symptoms and lessen the disease’s impact.

3.     Tertiary Prevention: For those already diagnosed with neurological conditions, the goal is effective disease management to prevent complications and improve quality of life. This includes medication, rehabilitation, and personalised lifestyle changes to manage symptoms and boost well-being.

Recognising early warning signs

A key part of preventive neurology is identifying the “prodromal phase,” where early symptoms of neurological diseases appear before a full diagnosis. For example, mild cognitive impairment (MCI) in Alzheimer’s can last years before dementia develops, allowing for early interventions to delay progression. Similarly, transient ischemic attacks signal a higher risk of stroke, with prompt treatment helping to prevent severe outcomes.

Challenges and opportunities in Low- and Middle-Income Countries (LMICs)

Implementing preventive neurology presents both challenges and opportunities. These regions often struggle with a higher burden of neurological disorders due to limited healthcare resources, lower education levels, and higher exposure to risk factors such as infections and poor nutrition. However, there are several promising approaches:

Challenges:

– Limited Resources: Many LMICs lack advanced diagnostic tools, specialised healthcare professionals, and essential medications.

– Lack of Awareness: There is often limited awareness about neurological conditions among the public and healthcare providers, leading to delays in diagnosis and treatment.

– Social and Cultural Factors: Mental health issues are frequently stigmatized, resulting in inadequate care and support.

Opportunities:

– Community-Based Interventions: Public health campaigns and educational programs can increase awareness about brain health and encourage early intervention.

– Technology: Telemedicine and mobile health technologies can help bridge gaps in healthcare access, especially in remote areas.

– International Support: Global partnerships can offer technical assistance, funding, and resources to improve brain health care in LMICs.

Success stories

There have been successful examples of preventive neurology in resource-limited settings. For instance, South Africa’s “Reach for Recovery” program uses community health workers to support stroke survivors, improving outcomes and reducing the burden on healthcare facilities. In India, the “Brain Health Initiative” focuses on raising awareness about dementia risk factors and promoting brain-healthy lifestyles among the elderly population.

The way forward

To ensure brain health remains a global priority, several steps need to be taken:

1.     Healthcare Policy Reform: Governments should prioritize brain health in their healthcare systems, making mental health services accessible and affordable for everyone.

2.     Education and Awareness: Public campaigns and educational programs are essential for promoting brain health and encouraging healthy lifestyles.

3.     Global Strategy Development: A global strategy for brain health should be developed to guide efforts in reducing neurological disorders, improving care access, and promoting research.

4.     International Collaboration: Organisations like the WHO and various neurology associations play a vital role in advocating for brain health, coordinating efforts, and mobilizing resources.

Aligning brain health with global goals

Brain health intersects with broader global goals:

– Good Health and Well-being (SDG 3): Promote preventive strategies to enhance brain health.

– No Poverty and Reduced Inequalities (SDG 1 and SDG 10): Address social factors affecting brain health.

– Gender Equality (SDG 5): Support research and care considering gender-specific issues.

– Quality Education (SDG 4): Integrate brain health into education to foster cognitive development.

– Sustainable Development (SDG 8 and SDG 9): Utilize brain health to drive economic growth and innovation.

– Climate Action (SDG 13) and Clean Water (SDG 6): Address environmental risks to brain health.

Overall: Brain health is crucial for quality of life and overall well-being. By prioritising prevention, early detection, and effective management, we can tackle the growing prevalence of neurological disorders and enhance global health. Through international collaboration and focused strategies, we can overcome challenges and ensure a healthier future for everyone. It’s time to make brain health a global priority

*Professor Vasso Apostolopoulos is a Distinguished Professor, at the School of Health and Biomedical Sciences, RMIT University and the Department of Neurology, Australian Institute of Migraine. Co author Professor Tissa Wijeratne is a Director, Department of Neurology, Western Health; Migraine Foundation Australia, Australia; School of Health and Biomedical Sciences, RMIT University; Department of Neurology, Australian Institute of Migraine.

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