What Works for the Heart will Work for the Brain

The potential human and monetary costs are indeed sobering: One million Canadians are expected to have some form of dementia within 30 years, according to the recent Rising Tide report, commissioned by the Alzheimer Society of Canada. The annual cost of treatment is projected to increase 10 times in the next generation to $153 billion a year.

But there is good news: by focusing on prevention, we can now do for brain disease what we have already done for heart disease.

With Alzheimer’s disease, the major cause of dementia, the emerging view is that abnormal brain changes actually begin many years or even decades before the symptoms start to show. The same may be true of stroke and Parkinson’s disease. To more effectively address age-related brain disease, we can learn from how we have approached heart disease. On average, by the time the middle-aged or older person has suffered a heart attack, coronary artery disease has been in place for several years. To avoid heart disease when we are older, we focus on prevention when we are younger. This involves eating healthily, exercising regularly, and minimizing risk factors such as smoking, elevated cholesterol, high blood pressure, diabetes and obesity.

In the medical field, we figured out a few decades ago that maintaining good cardiac fitness throughout the lifespan was the way to avoid heart disease. The results of that approach speak for themselves. We are much better now at early detecting of the subtle changes that may predict a heart attack. We have identified modifiable risk factors and developed scientifically proven techniques for keeping our hearts healthy and for treating damaged hearts so that the disability doesn’t progress.

A “blood pressure” cuff for the brain
We don’t focus on end-stage heart disease in 83-year-olds to improve the population’s cardiovascular fitness. We take a lifelong perspective on prevention. We must do the same for brain health. Certainly, we should continue to intervene in advanced brain failure to optimize the well-being of those already affected by Alzheimer’s disease and related conditions, but at the same time we must focus more attention and resources on maintaining brain health and fitness throughout our lives.

Early detection of the changes that give rise to brain failure is key, as is the need for better information about risk factors. I like to use the analogy that for detecting an emerging cognitive problem we need the equivalent of a blood pressure cuff, EKG or treadmill stress test for the brain.

“ We don’t focus on end-stage heart disease in 83-year-olds to improve the population’s cardiovascular fitness. We take a lifelong perspective on prevention. We must do the same for brain health.”

Maintaining cognitive health may involve engaging in specific physical and brain exercises, selecting foods that are proven through sound research to be good for our brains, and minimizing known risk factors for brain failure.

This emerging “brain fitness” approach is already leading to dramatic growth in a new commercial market opportunity — fueled by the Baby Boomers’ demand for strategies to keep their minds sharp longer in the lifespan, as well as the huge cost burden of treating brain failure in a rapidly aging population. The growing market in “brain fitness” includes tools for cognitive assessment (in the doctor’s office), novel techniques to strengthen memory and other functions in healthy seniors and rehabilitate cognitive deficits associated with disorders such as stroke and mild cognitive impairment, as well as solutions for the consumer to delay the onset of dementia.

Canada can take a lead role in developing scientifically sound and effective brain fitness approaches. One example of that potential is the Centre for Brain Fitness at Baycrest in Toronto, which is financially supported by the Ontario government and private philanthropy. Within 18 months of establishing the Centre, a new company was formed by Baycrest in partnership with MaRS. Cogniciti will market research-driven and clinically effective brain fitness products for the clinic, the workplace and the home.

This kind of public-private initiative with a commercial, real-world application in brain health is essential if we are to successfully tackle what otherwise could be an unmanageable public health burden.

Let us together, across Canada, strengthen our collective efforts to ensure that today’s Boomers, who are tomorrow’s seniors, will remain fully-engaged, autonomous and vitally productive members of society through our efforts in promoting healthy brain aging.