Brain health begins with brain care

Primary prevention strategies have led to a decline of at least 20% in deaths from heart disease and cancer over the past 30 years.1,2 Although prevention of brain disease is yet to be a focus of primary care medicine, a crucial opportunity exists to leverage the global acceptance that more than 40% of dementia, stroke, and depression cases are attributable to modifiable risk factors.3–5 We and our colleagues at the McCance Center for Brain Health have developed and tested a prototype Brain Care Score as a straightforward, motivational, and multidimensional tool for use in primary care. Four are physical components (blood pressure, haemoglobin A1c, cholesterol, and body-mass index), five are lifestyle elements (nutrition, alcohol intake, smoking, physical activity, and sleep), and three are social factors (stress, relationships, and meaning in life; see appendix). Applicability of the Brain Care Score further extends to cardiovascular health, as it incorporates all of the Life's Essential Eight, the American Heart Association's key measures for improving and maintaining cardiovascular health.