Is Brain Health the Next Healthcare Frontier?

A decade ago in Davos, I spoke on a panel with Dr. Aki Hintsa, an orthopedic and trauma surgeon who was coaching Formula One drivers on brain health and performance. He was also working with Dr. Tommy Wood, a neuroscientist whose new book on brain health, The Stimulated Mind, comes out this month. In the ten years since, brain health has migrated to the mainstream, jumping from the pages of academic journals like JAMA to major book releases and hugely popular podcasts.

The common definition of brain health has also changed. Previously, brain health conversations focused on cognitive decline, dementia, and Alzheimer’s. Now we see that brain health is a continuum that spans our whole life, from everyday mental wellbeing and cognitive performance to the long-term management of neurodegenerative disease. Perhaps the biggest change has been the compelling recent science that shows the most powerful tool we have to improve our brain health at every stage of life and mitigate cognitive decline is our daily habits. 

Plus, demand for breakthroughs in this field is high. Over 3 billion people live with a neurological condition, making it the leading cause of disability worldwide. This is why I believe brain health is the next major healthcare frontier. 

The impact of daily behaviors on brain health

There will no doubt be many new brain health drugs introduced in the next few years. If they work, of course, we should get them to everybody who needs them. But that’s only one kind of innovation, known as “de novo innovation,” or coming up with something completely new. “Synthetic innovation” is about taking known science and applying it in new ways. I would argue that synthetic innovation can be just as transformative because it can help us make dramatic improvements in our brain health right now.

By taking the science we have about how our behaviors—what we eat, how much we move, how we sleep, manage stress, and connect with others—impact our brains, and incorporating it into our daily lives, we can have a profound impact on our overall health.

“There probably isn’t going to be a miracle brain drug any time soon,” writes Dr. Wood in The Stimulated Mind. But “the truth is that there’s a huge amount that can be achieved simply by continuing to invest time in the activities that support our health and our brains.”

As we enter the decade of brain health, there’s a persistent myth that Alzheimer’s and cognitive decline are inevitable. “The bottom line is that memory impairment is definitely not part of the typical aging process for most of us,” writes Dr. John Randolph, a neuropsychologist, professor at Dartmouth’s Geisel School of Medicine and author of The Brain Health Book. “It’s almost the opposite: the brain continues to grow and adapt throughout life, into our eighties and beyond.”

The small miracle of neuroplasticity—the brain’s ability to change, grow, adapt and reorganize its structure and function in response to environmental changes—was once thought to be limited to the developing brains of children. But neuroplasticity is a reality throughout our entire lifespan. As Dr. Sanjay Gupta, neurosurgeon and author of Keep Sharp, puts it, “The brain can be continuously and consistently enriched throughout your life no matter your age or access to resources.”

People have a vague sense that daily habits matter, but they’re unaware of just how powerful they are—or where to begin.

Food, exercise, sleep, stress management, and connection

For instance, healthy food and a healthy brain are directly connected. We think of food as fuel for our bodies, but much of that energy goes to our brain. “Your brain is the hungriest, thirstiest organ in the body,” writes Dr. Annie Fenn, a physician and author of The Brain Health Kitchen. “It makes up just 2% of body weight, but requires 20% of your body’s primary fuel, glucose.” 

And researchers also believe that the gut-brain connection is a two-way relationship. The gut, with over 100 million neurons—a concentration second only to the brain—is often called the “second brain.” So what we feed our brain really matters.

Scientists believe the APoE4 gene variant is one of the strongest genetic risk factors for Alzheimer’s. But as Dr. Majid Fotuhi, professor at the Mind/Brain Institute at Johns Hopkins, notes in his new book The Invincible Brain, exercise is a powerful counterbalance. And getting the benefits of exercise doesn’t have to mean going to the gym. A landmark clinical trial in Alzheimer’s and Dementia found that even light-intensity stretching, balance and range of motion activities slowed cognitive decline in at-risk adults.

Similarly, sleep impacts nearly every aspect of brain health. And that’s because sleep is actually a time of intense and essential activity in the brain.

Research now shows that sleep functions as a kind of cleaning cycle for the brain. It’s when harmful proteins, which are connected to Alzheimer’s, like amyloid-beta and tau, are filtered out by the glymphatic system, the brain’s waste management system.

Meanwhile, chronic stress and anxiety are enemies of brain health. But of course, stress is a natural part of life. That's why it is so important to hone our stress management skills. 

When we have a stress response, cortisol is released. That’s what gets us ready for action. But over the long term, cortisol can kill neurons and shrink brain regions. The hippocampus, which is connected to learning and memory, and the frontal lobe, which governs executive functions like decision-making and planning, are especially sensitive to cortisol.

But as bad as chronic stress is for our brains, we also have tools to reduce it. Research shows that even short periods of mindfulness and meditation decrease stress responses like cortisol and blood pressure that are risk factors for dementia. Breathing exercises, getting out in nature for even just a few minutes, and taking “micro-breaks” during the day have also been found to reduce stress.

Connection is the other daily habit that supports brain health at any age. “Division is the enemy of brain health,” writes Dr. Ben Rein in Why Brains Need Friends. “The human brain has been shaped through evolution to reward us for connection and punish us for isolation.”

The rewards for fulfilling our deeply hard-wired need for connection are an incredible range of health benefits, including a lower risk of heart failure, diabetes, and depression. A study by researchers from Johns Hopkins found that socially isolated adults have a 27% higher risk of developing dementia than adults who are more connected. 

And of course, as Dr. Wood notes, all of our behaviors are interconnected. “When we sleep well, we’re more sociable, less stressed, more likely to engage in cognitively challenging tasks, and more likely to exercise,” he writes.

Brain health is the next frontier of healthcare, but we don’t have to wait for a miracle drug. The breakthrough at our fingertips, which is scalable and available to everyone, is applying what we already know: that daily behaviors can improve our brain health, and making even small daily changes can transform what’s possible for our brain now and decades from now.