Healthy body, healthy mind – It’s a no-brainer
by Tina Stibbe
It probably doesn’t come as a big surprise, that our overall medical health is closely linked to our brain health – after all, our body is a well-orchestrated entity. Consequentially, problems that manifest in the brain do not necessarily have their root cause in the same place. A wholesome approach to brain-health, that translates to overall medical health seems to be the best advice we can give. Nevertheless, there are certain aspects of our medical wellbeing that are worth directing special attention to – especially because there are distinct differences between men and women when it comes to brain and overall medical health, that you may not be aware of.
Cardiovascular risk also means brain health risk
Most risk factors for brain disease, in particular dementia and cognitive decline, are closely associated with cardiovascular risk factors. Arguably the most important one of them being hypertension, especially in midlife. While the brain itself is involved in the regulation of blood pressure, it is also one of the first organs to get damaged from long-term elevation of blood pressure (systolic BP above > 140 mmHg and/or diastolic BP >90 mmHg). Hypertension affects the brain by altering the structure of cerebral blood vessels and affecting the mechanisms that ensure an adequate blood supply, which is crucial to maintain the brain’s high metabolic demands. Undiagnosed and untreated hypertension can lead to serious brain diseases such as vascular dementia, Alzheimer’s disease and most of all stroke, which is the 3rd most common cause of death in developed countries. Moreover, hypertension not only worsens the outcome of a stroke, but it increases the risk of dying from it by 84%. Interestingly, it has been reported that 60% of deaths from stroke occur in women rather than men.
Professor Cassandra Szoeke, Director of the Healthy Ageing Program at the University of Melbourne in Australia and an international scientific advisor for the Women’s Brain Project, explains that the nature of vascular diseases differs between men and women in general. Men are more prone to develop macrovascular diseases, i.e., they have blockages of large vessels, which in turn lead to heart attacks that are more often fatal – to date, most treatments focus on this kind of cardiovascular complications to decrease mortality, such as bypass surgery. Women, on the other hand, tend to have more microvascular diseases, i.e., circulatory problems affecting smaller blood vessels, leading to a higher risk of stroke, particularly after menopause. Thereby, they end up being impacted to a greater extent when it comes to cognition, daily functioning, quality of life and mental health. Prof. Szoke continues to highlight that the most common type of dementia, which is mixed dementia, is closely linked to microvascular disease, which makes women much more susceptible to it.
Metabolic and inflammatory disorders quickly catch up with the brain as well
Diabetes has been identified to increase the risk of Alzheimer’s disease and vascular dementia substantially. Patients with type 2 diabetes have poorer executive functions and show cognitive decline more often later in life. Notably, this risk is higher in men with type 2 diabetes compared to women with the same condition.
Often connected to diabetes, obesity has been shown to lead to differences in brain structure and brain inflammation, that are associated with cognitive impairment as well. Eating more “comfort food” might possibly make you feel at ease in that particular moment but making this a recurring habit will most likely cause more harm than good in the long run.
Another parameter that should be monitored for brain and overall medical health is the blood lipid profile, meaning total cholesterol and the lipoproteins transporting it. Prof. Szoeke outlines that, as with cardiovascular disease, men and women are affected differently when it comes to inflammatory disease linked to these molecules. While for men management of the well-known “bad” cholesterol LDL (low density lipoprotein) and total cholesterol levels play a crucial role for medical health. In women, the amount of “good” cholesterol HDL (high density lipoprotein) is much more important to maintain healthy.
Dr. Florencia Iulita, a senior neuroscientist at the Memory Unit of the Sant Pau Hospital in Barcelona and member of the executive committee at the Women’s Brain Project, stresses that control of cardiovascular risk factors through diet, exercise and regular health check-ups can have a positive impact on brain health. In fact, a recent clinical trial including diet interventions, exercise, cognitive training and risk factor monitoring, called the FINGER-study, actually showed that this multifactorial approach can prevent cognitive decline in older adults. She adds that growing evidence suggests that men and women may manifest different risk factor profiles and it is crucial to study these differences to develop optimized preventative and diagnostic strategies for both.
Public health campaigns are focusing much more on vascular risk factors of men, that are well known, however the implications of vascular disease in women are far less popularised in the community. Although guidelines to maintain good health exist, women continue to show high rates of unhealthy behaviour such as low physical activity, obesity and insufficient intake of fruit and vegetables. Thereby, women continuously develop medical conditions such as microvascular disease and dementia – which have limited treatment options but are very much preventable by modifying certain risk factors.
Small changes can go a long way when it comes to tending to your medical health
If there is anything one should take home from this, it is that most of the risk factors for brain diseases are modifiable and prevention is always better than cure. Also, gender does play an important role, so, never forget your regular check-ups and increase your chances for a long, healthy life with the best your brain can be! Make routine appointments with your doctors and simply commit to doing little things regularly, like blood work and vital signs. In this context, small changes can go a long way, as you will be able to notice concerns early on and have a chance to counteract a trend that otherwise may stay unnoticed and cause tremendous damage in the long run.
The importance of this is reflected by the Cleveland Clinic establishing Medical Health and controlling your risk as one of the 6 pillars for brain health. Learn more about the others in our blog post series. We added one more important point and make it our goal to advocate for these rather simple rules to live a healthy brain lifestyle. If you want to learn more, you can take part in our Be Brain Powerful Switzerland Campaign and take a 30-day challenge to learn about how you can modify your risk for cognitive decline.