What does it mean to have good health?
According to the World Health Organization (WHO), health is "a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity".
WHO statistics, though, reveal that diseases and conditions affecting the brain are the leading cause of disability and the second leading cause of death globally. Stroke and dementia are two of the most common contributors for neurological disorders leading to disability. Parkinson's disease, in part due to an increasingly large ageing population, is the fastest growing neurological disorder.
Interestingly, while many of us make the effort to undergo regular health screenings for conditions affecting our body organs and their ability to function, as well as cancer, we often overlook checking the most important organ of all – our brain.
The human brain is a complex organ about which much is still being learnt, despite the leaps and bounds made in modern medicine over the years. Given the crucial role it plays in all aspects of our daily lives – including our ability to think, feel emotion and remember things – having a functional brain, and ensuring it remains healthy throughout the course of our lives, is paramount for sustained good health.
Understanding our brain's cognitive function
Cognitive function, or the ability to think clearly, learn and remember, is an important aspect of our ability to perform daily tasks.
Cognitive health is just one dimension of our brain's health. Other aspects of brain health include motor function (the control of movement and balance), emotional regulation, and tactile function (the ability to feel and respond to stimuli such as pain, temperature and pressure).
A wide range of factors can adversely affect the health of our brain. These include genetics, ageing, injuries such as stroke, trauma to the brain from an accident, mental health disorders such as clinical depression and generalised anxiety disorder, substance use such as smoking and alcohol, and diseases such as Parkinson's disease and/or related dementias.
Understanding cognitive impairment
It is natural to expect some gradual cognitive decline with age, such as occasionally forgetting names or words, misplacing things, and finding it more difficult to learn something new. It's just part and parcel of ageing.
Mild cognitive impairment (MCI), on the other hand, is a condition in which a person faces more frequent difficulties with their memory or thinking than a healthy person their age would be expected to have. This decline is noticeable by the individual and those who regularly interact with them, but the changes are not yet severe enough to interfere with normal daily activities.
MCI can happen at any age and is not just a problem of the older population. The Centers for Disease Control and Prevention reports that 1 in 9 Americans 45 years and older have reported problems with cognition. In Singapore, each year the National Neuroscience Institute diagnoses more than 100 patients younger than 65 years with MCI and the diagnosis is often made late. The number of younger people with MCI may increase as cognitive decline is one of the symptoms associated with long COVID. Living in polluted areas too has been associated with MCI.
Although it is not a dementia, someone diagnosed with MCI has a higher risk of developing dementia. Early diagnosis of MCI is important for early intervention and prevention.
MCI may also be caused by a health condition or even medication, and can be reversible or treatable. Some of the possible causes include:
- Health conditions including heart disease, lipid disorders, hypertension, diabetes mellitus, metabolic syndrome and obesity
- Mental health issues including depression and anxiety
- Poorly-managed stress
- Sleep disorders and obstructive sleep apnoea
- Structural brain problems including stroke, traumatic brain injury and tumours
- Vitamin deficiencies and other nutritional disorders
- Thyroid, kidney or liver disorders
- Visual or hearing difficulties
- Substance abuse, including alcohol and illegal drugs
- Medication side effects such as anticholinergic medications used to treat urinary conditions, medications for depression and other mental health conditions
How to 'test' your brain
Early detection is vital for slowing down and preventing many future health issues. Our brain's health is no exception.
Age is a common cause of cognitive impairment, but it isn't the only cause. Although seniors are at higher risk of cognitive decline and thus more regularly screened during wellness check-ups, anyone of any age can receive cognitive testing.
The Mini Mental State Examination (MMSE) is the most common screening tool for cognitive impairment and dementia. It consists of 11 questions that test areas of cognitive function, such as orientation, registration, attention, calculation, recall and language.
Similarly, the Abbreviated Mental Test (AMT) is a 10-point assessment commonly used in hospitals to assess for delirium and other mental impairment in patients.
Parkway Shenton, through partnership with Neurowyzr, now offers brain health screening and monitoring with Neurowyzr's proprietary Digital Brain Function Scan (DBFS).
A medical-grade tool, the DBFS comprises a series of neuroscience games that can be completed in 15 – 20 minutes. This test focuses on evaluating the brain's working memory, long-term memory, attention, and executive function. It can be done online using a mobile phone, tablet, laptop or desktop computer, thus offering greater convenience for individuals who choose to complete the assessment from the comfort of home.
The results of the DBFS are available soon after completion and can be subsequently discussed with your doctor. This enables primary care physicians to better diagnose brain diseases early, including structural problems such as stroke, tumours, traumatic brain injury, as well as functional brain disorders including neurodegenerative disease such as Alzheimer's disease, Parkinson's disease and other dementias. With the recent COVID-19 pandemic, the heightened interest in the long-term effects of a COVID-19 infection on the brain can also be monitored with this test.
Tips for a healthy brain
While it's not possible to prevent all causes of cognitive decline, making small investments early can have a profound difference on our future.
For a start, consider adopting some dietary and lifestyle changes, such as:
- Exercising regularly, and reducing sedentary time
- Eating a healthy diet
- Scheduling regular health screenings
- Managing any health risks such as high blood pressure, diabetes or pre-diabetes, and lipid disorders
- Seeking help for substance use or addiction to smoking, alcohol and/or recreational drugs
- Managing stress
- Adopting healthy sleep habits
- Challenging your brain (because, like muscle strength, you can lose cognitive ability if you fail to use it)
- Nurturing social contacts
Good brain health is more than just the absence of disease. It's about optimising the function of your brain so that with the natural process of growing older, the risk of age-related cognitive decline and brain disease is lowered while general health and well-being is improved.
Naturally, the earlier you start, the better.
Keen to book an appointment for regular health screenings or find out more about the Digital Brain Function Scan?