How to take care of brain health

Barcelona40% of dementia cases could be prevented or delayed with good prevention from an early age. This is stated by David Pérez Martínez, a neurologist with extensive professional experience focused on the study of cognitive decline and Alzheimer's, who assures that it is never too late (or too early) to start taking care of our brain. The neurologist recently published the book Cuida tu salud cerebral" (Alienta Editorial), a guide with which he aims to offer a practical approach that brings readers closer to the importance of having information at hand to adopt preventive measures. Prevention that we must carry out throughout our lives, which is why, in the book, he proposes a personal action plan suitable for all audiences. He states, emphatically, that the challenge, beyond having information and knowledge, is deciding to act. As Pérez explains, "for ten or fifteen years we have known that diseases like Alzheimer's do not begin when the symptoms start, but rather much earlier, probably fifteen or twenty years earlier. Therefore, if we intervene early with preventive measures, we could try to slow down the course of these types of diseases or delay their onset".

According to Pérez, it is important to strengthen brain health to compensate for aging. He acknowledges that there is still a lack of information to determine how cognitive decline processes originate, but it is clear that it is important to offer a multidimensional and continuous approach to its prevention from birth until old age. In this regard, he points out that the educational level plays a fundamental role and that poor education in childhood and adolescence has been associated with less cognitive reserve development, hence the importance of intellectual stimulation and early learning. For their part, in middle age, between thirty and sixty years old, it is essential to take care of aspects such as arterial hypertension, obesity, excessive alcohol consumption, or hearing loss, factors that can trigger long-term cognitive decline. In older ages, aspects such as social isolation, depression, sedentary lifestyle, diabetes, smoking, and exposure to environmental pollution influence.

The neurologist points out that "these interventions work at any time of life, even in childhood. There is data showing how children who have fewer psychological traumas, who have better nutrition, or who have a higher educational level, thirty, forty, or fifty years later have a lower incidence of dementias." And this can be extrapolated to all stages of life, because it is known that "even those who have symptoms, those who already have a diagnosis of Alzheimer's disease, if they are able to do physical exercise, cognitive stimulation, control vascular risk factors, or improve sleep, have a much better prognosis than those who do not. Therefore, it is never too late or too early to try to carry out these types of interventions," he reflects.

Risk factors

It is estimated that more than 55 million people live with dementia, a figure that could triple by 2050. Precisely for this reason, the neurologist advocates making information accessible to everyone so that we can all consciously adopt preventive measures. Investing in prevention can significantly avoid or delay the onset of neurodegenerative diseases such as Alzheimer's, and this requires moving, with progressive steps, towards a new lifestyle that includes regular physical exercise, a balanced diet, cognitive stimulation, good rest, as well as maintaining good social relationships. The specialist explains that "we need to adopt a brain-healthy lifestyle, but knowing that it cannot be radically changed from one day to the next. We must analyze what we are doing right and what we are doing wrong. And with this whole approach, which I include in my book as a guide, try to plan short-term challenges. We know that small changes have a significant impact, therefore, we must start with small gestures that accumulate and have a beneficial long-term effect. In the same way that we save to have a financially healthy retirement, we must make preventive interventions to have a cognitively healthy retirement." He states, positively, that we now have a window of opportunity to try to prevent dementias in thirty years.

In this regard, Pérez, who is the director of the Neurology Service at La Luz University Hospital, insists that physical exercise has beneficial effects on the nervous system, due to its ability to generate new neurons. He points out that the more quantity and intensity of exercise, the greater the cognitive benefits, and emphasizes that it is useful for both healthy individuals and those who already have deterioration. In the same vein, he insists on the importance of sleep and good rest for rejuvenating the brain and highlights how relevant social relationships and enjoying mental well-being are. He also warns, however, about the negative impact that stress, anxiety, and depression have on brain health. In this context, he talks about the dangers of what he calls cognitive sedentary lifestyle, "which is closely related to the emergence of social networks and new technologies, which facilitate our access to many interactions and information of all kinds, but which do not provide us with great value because we do not pay attention to them. These are interventions that generate little neuronal plasticity, and it is also likely that in the long term they will not generate adequate stimulation, as reading, discussion, criticism, games... do."

The prevalence of dementia in Spain is between 7% and 10% in people over 65 years of age, and of these, between 60% and 70% are cases of Alzheimer's. As the neurologist recalls, to this day there is still no treatment beyond alleviating symptoms, but he highlights that intervention is possible "at any stage of the disease. Because we always have interventions that will improve the quality of life of the patient and, especially, the caregiver. Because we must not forget that this disease is not a disease of one patient, it is a disease of the family nucleus".

Pérez Martínez speaks of this disease as a silent pandemic, and recommends being attentive to risk factors and warning signs that may indicate something is wrong, aware of the importance of making a good diagnosis. Regarding the symptoms, he highlights some related to memory, such as repeating questions or forgetting important appointments, others related to executive functions, such as difficulty carrying out complex daily tasks or planning activities, as well as alterations in orientation and language, in addition to loss of interest in pleasurable activities, social isolation and mood swings. For all these reasons, he recalls that it is essential to consult a doctor when some of these signs are detected, either combined or worsening over time, because "if we wait for the patient to have progressed, the effectiveness of the treatment will be much lower." He concludes by recalling a worrying fact: a study shows that the average time it takes European patients from when they have symptoms until they go to their primary care physician is more than fifteen months. Too much time and too many missed opportunities to act.