Lessons from how the world has tackled the pandemic could be applied to the rising challenge stemming from the increased incidence of brain disease
We are our brains. Brains mediate all human actions and experience, holding the key to health, wealth and well-being.
IN SEARCH OF AN OVERARCHING DEFINITION
Brain health has no agreed definition. Typically it is cast as the absence of disease, perpetrating the perception that mental and social well-being can be understood separately from the brain.
An overarching definition has been proposed recently based on the World Health Organization’s definition of health: a state of complete physical, mental and social well-being through the continuous development and exercise of the brain. ‘Continuous development’ recognises that our brains are in constant evolution, each action or interaction creating millions of new connections unendingly reshaping itself. To develop the brain requires exercising it cognitively, mentally and socially in optimal balance.
If someone develops a chronic condition, their ability to look after themselves depends on the brain – likewise the capacity to look after others. There is no health without brain health. The brain itself is under threat. Globally, diseases of the nervous system inflict the largest number of disability adjusted life years, known as DALYs, which constitute a combined index of premature mortality and years lived with disability. Among brain diseases, stroke and dementia account for 62% of DALYS and 87% of deaths. Although the absolute numbers are rising, the number of cases per thousand is declining in G7 countries. We need to find out urgently what contributes to this decline and help apply the lessons worldwide. The pandemic has set a good example of how academia, governments, the private sector and the public can come together to tackle a global health problem.
Although the ageing population poses the most immediate challenge, to promote brain health we need to take a life cycle approach, since healthy brain promotion begins even before birth. In 2016 G7 leaders called for “interdisciplinary research efforts” on “fundamental aspects of brain functions”. This involves not only understanding what can go awry, but also studying the highest attributes of human life, such as the creation and enjoyment of beauty, a moral sense, and the infinite capacity to discover and to create.
Progress in the ongoing technical, digital and artificial intelligence revolution depends on innovations and constant adaptation, both mediated through the brain. Wealth needs to be understood broadly, not merely as material abundance but also in terms of human capital, cultural wealth and the creation of environments that make living worthwhile. The world population is ageing. This makes it particularly important that younger generations have all the advantages of brain health. They will represent a relatively smaller proportion of the population and will be expected to do more to sustain and advance the well-being of
The study of happiness and well-being is gaining respectability, but remains largely disconnected from our increasing understanding of the brain. The pandemic has exposed the close connections among isolation, solitude and mental, social and brain health. Those need to be understood together. The pandemic has also intensified the relationships of people forced to live together in close quarters and isolated from those beyond. The need to reach out has greatly accelerated the development and use of internet connectivity and created new virtual communities. These could provide new venues to foster brain healthy relationships.
The G7 has promoted brain health at different meetings to different degrees. Brain health in the proposed broad definition could become the unifying, synergistic priority that could drive health, wealth and well-being in the post-pandemic world. The most immediate task is to find out how to postpone, mitigate or prevent stroke and dementia and educate everyone how to decrease the chances of falling victims to them.
All human experience and activities occur through the brain. Hence its health is paramount. The G7 could adopt brain health as a unifying, motivating and actionable key to health, wealth and well-being. As we can see from the synergistic efforts in the fight against the current pandemic, an immediate and promising area is to learn why and how the number of cases per thousand of stroke and dementia is decreasing in G7 countries and applying the lessons globally.