Experts address the global burden of brain diseases

Think Brain Health - a policy, clinical and research challenge, a virtual meeting featuring expert speakers in the field of neurodegenerative diseases, addressed current and future opportunities to help everyone achieve good brain health.

Brain health is a choice that we make in life and … dementia and related disorders are not an inevitable consequence of ageing."

Dr Alastair NoyceChair and Reader in Neurology and Neuroepidemiology, Queen Mary University of London

The global burden of brain diseases, such as Alzheimer's disease and Parkinson's disease, is increasing as people live longer. Worldwide, dementia (mostly Alzheimer's disease) affects about 50 million people and Parkinson's disease affects more than 6 million.

Left uncontrolled, brain diseases will impose an ever-growing socioeconomic and individual burden. However, many cases of dementia can be avoided or delayed. Therefore, maintaining brain health can help to reduce this enormous burden and provide large financial savings to overstretched healthcare systems.

Think Brain Health is calling for increased focus on acting early to reduce the risk of brain disease before symptoms appear.

Simple lifestyle changes, such as improving patters of nutrition and increasing levels of physical activity and social engagement, can lower risk of dementia, the most feared illness in people over the age of 50.

Dr Naaheed Mukadam (UCL, London) showed that in the UK alone, a combination of preventing diabetes, reducing hypertension, supporting smoking cessation and correcting hearing loss could save the UK around £1.86 billion per year and reduce the prevalence of dementia by 8.5%.

Accurately assessing an individual's risk of brain disease through an understanding of the interplay between modifiable environmental and molecular/genetic factors will help clinicians optimize long-term care. Overall, developing brain health services based on principles of individualized risk scores will help people live better as well as longer through early action to promote wellness and delay or prevent symptoms of brain disease.

As Dr Charles Alessi, Public Health England lead for preventable dementia highlighted, although "longevity is extremely important … what we've really got to look to is productive healthy aging rather than morbidity, with people being as active and contributing to society [as much] as possible." Primary care professionals can play a key role in promoting health across the lifespan that is independent of "medicine by body part."

Professor Philip Scheltens (University Medical Centers, Amsterdam), co-chair, stated that "making sure that the brain is healthier than it was before is of evident importance for clinical practice for the future."

Early recognition of brain health risk requires awareness in the "silent period" before symptoms appear, as described by Professor Craig Ritchie (Edinburgh, Scotland), Director of Brain Health Scotland, currently the UK's most forward-looking brain health service.

To allow better "listening" in this silent period, it is essential to have proven systems to identify lifestyle and biological risk factors for dementia, as well as "understanding when the brain is working well," as described by Professor Wiesje van der Flier (University Medical Centers, Amsterdam).

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