Brain health is the number one issue for future medical care and social services

Brain health is a hot topic in healthcare right now. The Lancet has devoted this month’s edition to an organ that gets surprisingly little attention – especially as it is what makes us wonderfully individual. Brain health is a fascinating subject that fits with the changing demographic of men and women living longer and better. People living longer is a good-news story, with the greatest gains in life expectancy in middle- and high-income countries. In Ireland, expected life span has risen to 81 years for a man and 84 years for a woman.

The challenging side of such positive news is the implications it has for the provision of medical care, rehabilitation and assisted-living arrangements for those living with neurological conditions. With one in three people developing a neurological illness in their lifetime, it is the main cause of death and disability combined.

This includes brain illnesses like stroke and dementia, all of which are rapidly increasing, as the world’s population expands and ages.

Medicine has raced ahead, creating gains in understanding neurological illnesses, diagnosing, developing medications and rehabilitation.

These efforts mean a patient today can expect to be offered lifestyle advice to reduce their individual risks. They will also have access to blood-pressure monitoring, lipid and glucose assessment, and medication to manage known risk factors for stroke.

If a person does have a stroke, many hospitals provide rapid access to intervention to remove a clot in the brain, and multidisciplinary rehabilitation to potentially get back to good function.

We’ve come a long way from what was almost certain death or profound disability when I was a medical student. Stroke services have received considerable funding in recent years, but as the number of strokes in Ireland is predicted to increase by 60pc by 2035, stroke services are galloping to keep up, but still falling behind.

Funding gaps in services were highlighted by the Irish Heart Foundation, which has done decades of stellar work raising awareness, researching and advocating for investment.

The World Health Organisation has a brain health unit, which is focused on research and working with health bodies to create policies to guide each country to engage and act on prioritising brain health in national agendas.

A national conversation on brain health would be a good place to start. Those topics for discussion are nearly as vast as the brain itself, and encompass mobility, exercise, diet, alcohol, cannabis, literacy, social contact, emotional wellbeing and what it is that we value about our capacity to think – each of us has aspects of cognition we value, without even thinking about it.

That favourite thinking part of our day might be a chat with a friend, tuning in to a history podcast, reading a newspaper or getting stuck into a crime series. For many, independence is a key part of brain health.

Widespread public awareness of risk factors for dementia and stroke is critical, as is funding and planning for care after diagnosis.

A huge unmet need for sustainable and fair caring arrangements was exposed during the recent referendum campaigns. This must be tackled sooner rather than later, with a multi-year funded strategy.

We need person-centred policy which is co-created using the experience of patients and their families. Policy should translate into concrete actions that will deliver State-funded care.

A dramatic increase in the number of people with dementia, stroke and other neurological illnesses over the next two decades, means an increased need for income support for carers, respite beds, community rehabilitation and a skilled workforce to provide care.

Brain health is the number one issue for future health and social services. There will be medication that will slow progression, and AI solutions will assist in maintaining independence at home. But we can’t solely rely on pharmacology and technology.

Healthcare will continue to benefit from compassion, societal support and investment in infrastructure and trained clinical staff.

This goes beyond healthcare. Public and political policy direction must be coherent. Conflicting strategies where we have an awareness campaign on tackling risk factors but at the same time reduce funding to community respite beds is cynical and demoralising.

As part of the WHO 2025 strategy for dementia, Alzheimer’s Disease International launched an awareness campaign called #WhatsYourPlan – meaning a plan to keep our brain healthy and improve our physical and mental health. That should include discussion with loved ones on what is important to us if we can no longer say what we need, or care for ourselves.

What’s your plan? Time to get the thinking cap on.