Brain health: the paramount investment

Achieving optimum brain health for everyone is the single best investment a society can make, but worldwide, countries are falling short

Our brains are the site of all our experiences and the agents of all our actions. Our brains will determine the future of humankind.

Without a healthy brain, quality of life wanes and actions falter. New threats have arisen with unexpected fury, thanks to the pandemic, the war in Ukraine and ferocious floods, fires and temperature extremes. The World Health Organization has noted a 25% increase in anxiety and depression as a result of the disasters arising from climate change.

The problems are interconnected. The urgent use of scarce resources to beat Covid-19 resulted in the neglect of other diseases and delays in attaining the Sustainable Development Goals. The war in Ukraine threatens more famine in Africa and has generated an energy crisis that is delaying tackling climate instability and fuelling inflation.

On the other hand, these changes have dramatised how interdependent and complex the world has become. These problems are examples showing that we need holistic approaches. Our ability to cope with such complexities determines our future – as individuals and as societies. 

And the key to this is brain health. 

This in turn represents a complex system. Already in the 19th century, Rudolf Virchow, a German doctor, pathologist, anthropologist, politician and successful social activist, stated, “Medicine is a social science and politics is nothing more than medicine on a large scale.” Many reasons suggest that the “medicine … on a large scale” for the 21st century is brain health.

Optimal well-being

Brain health is a state of optimal cognitive, mental and social well-being in a healthy, safe environment. To achieve this, we have to engage the best that we are capable of with our individual and collective brains, since our brains are our future.

Homo sapiens became the dominant species largely through the brisk growth of intellectual capacities. Understanding the evolution of life and of homo sapiens and the role we play as a species in maintaining a healthy planet earth and the health of the people means understanding that we have to take responsibility especially for maintaining brain health. The importance of these aspects grows exponentially as we increase our living standards at the cost of using our habitats’ resources, with dramatic effects on climate and far-reaching consequences on our way of life.

The pandemic has taught us how closely intertwined cognitive performance and learning are to mental health and social interactions. The knowledge-based economy and the relentless digitalisation of our world require ongoing learning.

Crises come with silver linings

The pandemic has expanded communications and opened new possibilities for learning. Education has to be comprehensive and lifelong, given the accelerated pace of change. It must encompass cognitive, mental and social dimensions and develop a critical sense to be able to separate facts from falsehoods and spin, and truth from pernicious ideologies.

Brain health matters to all – to live, to be productive and to tackle the growing global problems. Consequently, all need to be involved: individuals, families, communities, governments and society as a whole.

If we think not only what is best for ourselves but also for everybody, and if we understand that we have to take more responsibility as citizens and as scientists, then we will begin to understand that investing in brain health is paramount. Brain health is the basis for curiosity, for learning, for education and for understanding complexity and finding solutions.

The best single investment for oneself is having a healthy brain, a rich emotional life, and enjoyable and productive relationships. Similarly, the best single investment for society is to achieve brain health for everyone to the degree that it is possible. An immediate benefit accrues from healthy brains being more productive and more capable of introducing innovations. Behaviours that foster brain health also delay, prevent or mitigate chronic diseases, especially stroke and dementia, which account for 62% of disability-adjusted life years among diseases of the nervous system. These have become the leading causes of DALYs globally. Stroke and dementia are preventable by 80% and 40% respectively.

Although prevention is infinitely a better investment than acute care, most countries devote less than 1% of their healthcare budget to prevention. Moreover, prevention is usually advocated for units too large and diverse for effective implementation. Even countries with universal healthcare systems such as Canada are too diverse for a one-size-fits-all solution. New approaches could include:

• Preventing stroke, heart disease and dementia together by promoting brain health and focusing on units small enough to have a sense of community;
• Understanding that education is the best vaccination against these diseases;
•  Realising that simple measures such as engaging in exercise, maintaining healthy nutrition, controlling blood pressure, and avoiding being overweight, smoking and consuming excess alcohol are very effective;
• Working through existing government, community and non-governmental organisations for implementation and qualifying existing healthcare professionals with micro-credentialling for different aspects of prevention; and
• Changing the message from fear to hope. Instead of warnings about future catastrophes, foster brain health now, for immediate and long-term benefits. Brain health is essential throughout everyone’s lifespan. It is key to health, productivity and well-being. Science has a major role and responsibility in this.
  

Brain health can provide the focus, inspiration and promise that if we commit to the 17 Sustainable Development Goals and improve partnership for the SDGs we will have better brains for understanding what needs to be done for individual well-being and for a better world.