Raising awareness and advocating for brain health on World Brain Day
· Toronto Sun
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Even though the World Health Organization (WHO) recently updated its guidelines on reducing the risk of cognitive decline and dementia, a Toronto-based doctor says preventative measures go a long way too.
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“The best medicine is always prevention,” Dr. Howard Chertkow told the Toronto Sun. “(We need to emphasize) education, lifestyle and motivation programs, while educating the public on what they can do to preserve brain function as they get older.”
Chertkow is the scientific director at Toronto-based Baycrest’s Kimel Family Centre for Brain Health and Wellness.
World Brain Day is July 22, and its main purpose is to raise awareness about neurological disorders and advocate for brain health.
According to the Alzheimer’s Association, about 747,000 Canadians live with Alzheimer’s disease or other forms of dementia. Dementia is caused by brain diseases and affects memory, thinking and the ability to function.
There is no cure for dementia, but the WHO study says that up to 45% of dementia risk could be prevented or delayed.
“At the top of the list is exercise,” Chertkow said. “When you exercise, you are reducing the risk the heart disease, reducing the risk of stroke and depression and reducing the risk of dementia. Getting people to stop being a couch potato at any age and getting them to do 150 minutes a week of vigorous exercise, if we could do that for every Canadian that would be one of the biggest steps we could do to preserve people’s brains.”
The doctor went on to emphasize that simple adjustments in everyday life, things like diet, social interaction, playing games, doing intellectually demanding activities, avoiding toxins like alcohol or cannabis, or addressing sleep apnea issues can help with overall brain health.
Apparently, flossing your teeth helps, too.
“The bacteria that grow in your gums accumulate bio germs and flossing your teeth once a day decreases the bacterial load and helps protect the brain,” Chertkow said.
New and expensive
There is a drug on the market called Lecanemab. The Canadian Drug Agency (CDA) rejected it initially “because their analysis suggested the benefit simply wasn’t strong enough to bring it into the country,” Chertkow said.
It works by targeting and clearing toxic clumps of amyloid-beta proteins in the brain, thereby reducing cognitive decline and allowing patients to maintain independence for a longer period.
It was approved last October by the CDA. It is expensive, about $40,000-$50,000 for a 12- to 18-month treatment. Currently, the drug is not covered in Ontario by OHIP.
“When it is given to people who have mild Alzheimer’s, they don’t get better and return to being normal, they don’t stabilize and stop progressing, but they progress more slowly, maybe 30% more slowly,” Chertkow said. “It is not nothing, but it is not a cure.”
Coming down the pipe
Last week, at the Alzheimer’s Association International Conference in London, topics on the docket included new insights into Alzheimer’s blood tests for improving diagnosis in primary care and for predicting future cognitive decline.
And much more, the doctor said.
“There are a lot of things coming down the pipe,” Chertkow said. “Some are at the earliest stages and some more advanced. Medication against brain inflammation and prevention strategies against inflammation is another big area. Other things being pursued, in which we don’t have the final results. There was talk about Viagra and Cialis and these drugs appear to have a benefit for the brain, as well. They appear to be protective and prevent Alzheimer’s and degenerative diseases.”
There are many months and years ahead in clinical trials before anything comes on the market that could have a measurable impact straight away.
“Every potential drug has to get over some stringent and expensive and time demanding hurdles before they get to market.” Chertkow said. “There is a lot of excitement and a lot of potential drugs coming, but there was no home run in terms of a new, effective drug to stop Alzheimer’s and that is what we want. It is going to take more years or research and study to get to that point.”
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