The brain allows us to walk, speak, recognise a familiar face, feel emotions and store memories. It also controls judgment and decision-making, which are qualities worth protecting in citizens and encouraging in politicians. When something goes wrong, it spreads through families, workplaces and communities.
World Brain Day was on July 22, and this year’s theme was “Brain Health: Access for All.” More than 3.4 billion people are living with neurological conditions. Yet only about one-third of countries have a national policy for such disorders, and dedicated funding is a distant dream in resource-poor settings.
“Access” means recognising a stroke quickly enough for treatment to matter. It means having a CT scanner available and functioning. It means a reliable supply of anti-seizure medication, blood thinners, statins, rehabilitation, physiotherapy, speech therapy, hearing aids, mental health care and support for exhausted carers.
A person cannot exercise safely where there are no pavements. An older adult cannot remain connected if transport is unreliable. A patient cannot control blood pressure if medicines are unavailable.
High blood pressure, diabetes, smoking, high cholesterol, inactivity, excess alcohol, air pollution and obesity are not only risk factors for “heart problems.” They raise the risk of stroke and cognitive decline. The WHO reports that most of the global stroke burden is linked to modifiable risks, with hypertension the leading contributor. This is a “silent killer”, and regular monitoring of blood pressure is wise. Ensure that your blood sugar remains under immaculate control, adhere to a healthy diet of fruits, vegetables, legumes and fish such as salmon, and keep active for at least 30 minutes daily. Protect your head during sports or cycling. Try to get enough uninterrupted sleep instead of “doomscrolling” at night. Stress reduction techniques include exploring the great outdoors, music, meditation and yoga. It’s never too late to quit smoking, and there are treatments to battle nicotine addiction.
Up to 45 per cent of dementia risk may be prevented or delayed by addressing those risk factors. Treating hearing loss, staying socially connected and continuing to stimulate the mind also matter. Vitamin B12 deficiency, an underactive thyroid, syphilis and certain structural disorders of the brain should be excluded when evaluating a patient for dementia. Vitamins and omega-3 supplements are not routinely recommended for dementia prevention unless a deficiency has been formally diagnosed.
Of course, people can do everything “right” and still develop neurological disease. Genetics, age, infections, injuries and chance remain real.
Some people with long COVID develop “brain fog” and have difficulty concentrating, remembering words or planning simple tasks. The mechanisms are still being studied, but inflammation, immune disruption and injury to small blood vessels are postulated. This is exacerbated by stress, anxiety and depression.
For stroke, remember
BE FAST
Balance suddenly lost. Eyesight suddenly affected. Face drooping. Arm weakness. Speech becoming slurred or strange. Time to seek emergency help.
Do not wait to see whether it improves. A transient ischaemic attack may resolve, but it can warn that a larger stroke is coming. During a stroke, minutes matter, and it is often said that “time is brain”!
Modern stroke treatment should not depend on one’s bank balance, time of arrival or luck in finding the right hospital. Every major emergency department in this country should have a clear stroke pathway, round-the-clock access to brain imaging, and a system for rapidly transferring eligible patients to a centre that can provide clot-busting treatment or clot removal.
For a seizure, keep the person safe. Move dangerous objects away, cushion the head, turn the individual gently onto one side and time the seizure. Do not restrain them. Do not force a spoon, finger, cloth, water or medicine into the mouth.
Call for emergency help if the seizure lasts more than five minutes, repeats without recovery, causes breathing difficulty, occurs in water or is the person’s first known seizure.
Never dismiss fever, severe headache, stiff neck, confusion, vomiting, sensitivity to light or a concerning rash. Meningitis can deteriorate quickly and requires urgent medical care. There is no time for bush medicines or left-over antibiotics.
After a stroke, someone may need months of physiotherapy to walk, speech therapy to swallow safely, occupational therapy to dress or bathe, and psychological support to cope with a life altered overnight.
A person with Parkinson disease may need medication adjusted repeatedly. A child with cerebral palsy or autism may need coordinated care across school, home and clinic. A family caring for someone with dementia may need practical help rather than another pamphlet.
Stroke, diabetes, hypertension, dementia, migraine, epilepsy and neuropathy are already inside our homes. Patients wait for lengthy periods to be seen in Casualty or clinics. Rehabilitation can be difficult to access. Families become the ambulance, nurse, physiotherapist, pharmacist and prayer warriors.
Neurological illnesses are not shameful. A seizure does not require an exorcist. Dementia is not simply “getting silly.” Depression after a stroke is not weakness. A child with developmental differences is not badly behaved simply because adults have failed to understand the situation.
Language can either open the door to care or keep it shut. Protecting the brain begins with ordinary acts: checking blood pressure, treating diabetes, staying active, preserving hearing, sleeping properly, remaining connected and seeking help early.
Brain health for all requires access for all.
Not when the damage has already been done.
