Author – Phoebe Chan – BSc (Hons) Nutrition and Human Health
Brain health is often discussed in the context of ageing and dementia, but cognitive performance is influenced by factors throughout life. While certain cognitive changes may occur with age, many aspects of brain function can remain strong. Older adults can continue to learn new skills, form new memories and expand their knowledge and vocabulary well into later life.
Increasingly, healthcare professionals are recognising that brain health is shaped by a range of modifiable factors including physical health, nutrition, sleep, stress and social engagement. As a result, clinical approaches are evolving beyond the management of age-related decline to focus on supporting memory, attention, processing speed and cognitive resilience throughout the lifespan.
Understanding Brain Health Across the Lifespan
Brain health is more than memory
When people think about brain health, memory is often the first thing that comes to mind. However, brain health encompasses far more than the ability to recall information. It refers to the state of brain functioning across cognitive, sensory, social-emotional, behavioural and motor domains, allowing individuals to realise their full potential throughout life (2).
The brain is a complex organ with multiple interconnected functions that influence every aspect of daily living. These include processing sensory information and controlling movement, supporting cognitive abilities such as attention, learning and decision-making, regulating emotions and mental wellbeing, and facilitating behaviour and social interactions. As a result, changes in brain health may affect concentration, mood, communication, coordination and overall quality of life – not just memory (3).
Common cognitive challenges
There are many factors that can affect the brain regardless of an individual’s age, these include:
Sedentary lifestyles: the average adult sits for 6 ½ hours per day which has been linked to changes in a section of the brain essential for memory. Researchers used MRI scans to look at the medial temporal lobe (MTL), a brain region that makes new memories, in people aged 45 to 75. When compared with the average number of hours per day individuals sat, those who sat the longest had thinner MTL regions. This can be a precursor to cognitive decline and dementia.
Inadequate sleep: 1/3 of adults don’t get the recommended 7-8 hours of sleep each night. Research from 2018 found that cognitive skills such as memory, reasoning and problem-solving decline when individuals sleep fewer than 7 hours per night.
Chronic stress: chronic stress can kill brain cells and shrink the prefrontal cortex, which is the area responsible for memory or learning. Sensing when you are about to get upset, taking deep breaths and being flexible with your reactions can reduce overall stress levels (4).
The Importance of Early Identification
Recognising subtle cognitive changes
Paying attention to subtle changes in thinking, memory and concentration can play an important role in maintaining long-term brain health. Identifying potential issues early, before they progress, allows for timely interventions if needed, whether through lifestyle changes, medical support or further cognitive assessments. Taking a proactive approach to brain health isn’t just about detecting early cognitive impairment, but also preserving healthy cognitive function for as long as possible (5).
Individuals with mild cognitive impairment (MCI) may experience symptoms such as:
- Forgetting things more often
- Missing appointments or social events
- Losing their train of thought
- Trouble following a conversation
- Finding it hard to make decisions, finish a task or follow instructions (6)
While occasional forgetfulness is a normal part of life, persistent or worsening cognitive changes should not be ignored. Recognising these signs early can provide opportunities to implement strategies that support brain health, maintain independence and improve quality of life.
Clinical assessment
A clinical assessment may be required depending on the patient’s symptoms and observed behaviour. The specialist will determine whether assessments of cognition, motor system, sensory perception and autonomic functions are necessary. These evaluations may include tests of memory, attention, language, coordination, reflexes and sensation (7). By combining the results of these assessments with information gathered from the patient’s history and lifestyle factors, healthcare professionals can identify potential causes of cognitive symptoms and make a diagnosis where appropriate. Healthcare professionals may assess the following:
Medical history: this includes looking into the present complaint, including the history of the presenting complaint such as any treatment and referrals already arranged and provided. In addition, past medical, medication, family and social history will all be investigated (8).
Lifestyle factors: daily habits can have a significant impact on brain health. This includes physical activity levels, nutrition, mental wellbeing, substance use, alcohol consumption and social engagement (9).
Sleep quality: good quality sleepsupports mental and physical health and contributes to the overall quality of life. Assessing sleep factors such as sleep schedule, environment, drugs and snoring can help identify what might be causing cognitive symptoms (10).
Mood and stress levels: this can help a healthcare provider assess the level of an individual’s stress as well as their mental health. It is important to understand the stress triggers involved and their response to that trigger as this could affect their concentration, memory and decision making (11).
Lifestyle Medicine and Cognitive Health
Physical activity
Regular physical activity may improve brain health, and short burst of physical activity can boost brain functions such as memory and thinking skills. There are many different types of physical activity you can engage in such as brisk walking, swimming, dancing and even doing household chores (12).
Sleep optimisation
Sleep is essential for cognitive function, mental acuity and the ability to concentrate and learn new information. During sleep, the brain processes information acquired during the day. Rapid Eye Movement (REM) sleep, or the dreaming phase, has been shown to support learning, memory and emotional regulation. Sleep disruptions can alter levels of neurotransmitters and stress hormones, which may negatively impact cognitive performance, concentration and emotional regulation (13).
Stress management
The body’s response to short term stress is essential for survival and triggers the “fight-or-flight” response, which allows us to respond quickly to danger. When a threat is detected, the amygdala activates the body’s main stress response system, known as the hypothalamic-pituitary-adrenal (HPA) axis. This leads to the release of stress hormones, causing glucose levels to rise, the heart rate to increase and blood flow to be redirected to essential muscles.
While this response is helpful in short bursts, problems arise when stress becomes chronic. Over time, ongoing activation of this system can place strain on the body, contributing to digestive issues, trouble sleeping and a weakened immune system (14).
Nutrition and Brain Function
The brain works 24/7, taking care of thoughts, movements, breathing and the heartbeat. This means it requires a constant supply of fuel which comes from the foods we eat. This directly affects the structure and function of the brain and, ultimately, our mood too (15).
The brain’s nutritional requirements
Nutritionists emphasise that the most important strategy is to follow a healthy dietary pattern that includes a lot of fruit, vegetables, legumes and whole foods. Try to get protein from plant sources and fish and choose healthy fats, such as olive oil or canola, rather than saturated fats.
Research shows that the best brain foods are the same ones that protect the heart and blood vessels, including: green, leafy vegetables, fatty fish, berries and walnuts (16).
Dietary patterns
The Mediterranean diet has promising research on how it affects the brain. It consists of lots of whole unprocessed plant-based foods which are high in fibre and fish as the main source of protein. Oily fish is an important source of omega-3 fatty acids, which are important for brain health. Studies have shown that in Mediterranean countries, people who follow this diet tend to have a lower risk of delevoping dementia (17).
Conclusion
The brain is a complex organ responsible for a wide range of functions, including the interpretation of sensory information, control of movement, cognitive and emotional processes, and the regulation of behaviour and social cognition. As a result, maintaining brain health should remain a lifelong priority.
Cognitive performance is influenced by several modifiable factors, including physical activity, sleep quality and stress levels. When cognitive symptoms arise, a clinical assessment may help identify underlying contributors.
By adopting proactive, evidence-informed strategies, clinicians and patients can work together to support cognitive wellbeing and build resilience for the future.
References
- https://www.nia.nih.gov/health/brain-health/how-aging-brain-affects-thinking
- https://www.who.int/health-topics/brain-health#tab=tab_1
- https://www.bmj.com/content/371/bmj.m3683
- https://www.health.harvard.edu/mind-and-mood/the-worst-habits-for-your-brain
- https://www.echelon.health/protecting-your-brain-health/
- https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/syc-20354578
- https://www.ncbi.nlm.nih.gov/books/NBK597487/
- https://patient.info/doctor/history-examination/history-taking?utm_source=gpoptin
- https://www.swissre.com/reinsurance/life-and-health/l-h-risk-trends/lifestyle-factors-new-frontier-risk-assessment.html
- https://www.sleepfoundation.org/sleep-hygiene/how-is-sleep-quality-calculated
- https://www.medicalnewstoday.com/articles/stress-measurement#measuring-stress
- https://www.cdc.gov/physical-activity/features/boost-brain-health.html
- https://www.heart.org/en/healthy-living/healthy-lifestyle/sleep/sleep-your-way-to-a-smarter-brain
- https://www.brainfacts.org/thinking-sensing-and-behaving/emotions-stress-and-anxiety/2018/the-neuroscience-of-stress-061918
- https://www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626
- https://www.health.harvard.edu/healthbeat/foods-linked-to-better-brainpower
- https://www.alzheimersresearchuk.org/news/what-should-we-eat-for-a-healthy-brain/
