In this interview, Dr. Tatjana Rundek, Director of the Evelyn F. McKnight Brain Institute at the University of Miami, offers insights on how individuals can work with their healthcare providers to monitor their cognition over time and optimize their brain health.
Q: What would you like patients and people in general to know about cognitive assessments?
A: We would like patients and people of all ages to know there are cognitive assessment tools available – both online that you can do at home and that you can do with your doctor. The assessments help determine if someone has or is at-risk for a memory problem. Anyone concerned about their memory, especially if it’s affecting their ability to complete everyday activities or if the problems are getting worse with time, can ask their healthcare provider for an assessment to check their memory and problem-solving skills. Assessments help us determine what’s causing and/or contributing to a patient’s memory loss and figure out the best method of treatment.
Q: Is there a right age for patients to ask their doctor for a cognitive assessment?
A: More important than determining an age for cognitive assessments that will work for all patients, I think we need to look at each patient’s age, family history, job status, profession, etc. to determine their individual risk for cognitive decline and when to start with a baseline assessment. If we, in the brain health field, worked together to create an effective algorithm to identify those at low, medium and high risk for cognitive decline, along with specific recommendations on what they can do to prevent or mitigate the effects of cognitive aging, we could significantly reduce the burden on primary care.
Q: What do you recommend to patients as the most important things they can be doing to protect their brain and cognitive health?
A: I believe everyone should be following the American Heart Association’s Essential 8 – eating well, being physically active, not smoking, getting the recommended amount of sleep, maintaining a healthy weight, managing their blood pressure and blood sugar, and controlling their cholesterol. We believe these are the most important steps to stay healthy and active as you age, but very few people are doing this. We’ve actually found that very few, if any, of our patients are following all eight strategies.
Encouraging the general public to change their behavior is one of the hardest things to do. But to help with this challenge, I’m excited to be part of the Precision Aging Network, an initiative to predict individual brain health risks and offer personalized solutions to help individuals optimize their brain health throughout the lifespan. With this initiative, we’re looking to attract one million participants to extend participant diversity and learn more about age-related brain diseases. Anyone interested in learning more and participating can start by taking an online memory test at mindcrowd.org.
Q: What are the most exciting advances you’re seeing in the field of cognitive aging, especially as it relates to healthy aging and preserving cognition?
A: Precision medicine is coming rapidly. It will come in all aspects and there will be pressure on PCPs and cognitive neurologists to determine what to do with the new genetic markers, for example. People already come in with their 23 and Me test results and we need to figure out what to do with this information. There are genetic variants that we know expose people to risk and we need to figure out what to do with that information. We have traditional ways of assessing risk and the standard risk factors to look at, but with all this new information existing, we need to learn exactly what it means and how it translates to diagnoses. This new information and the impact it will have on precision medicine is very exciting and has the potential to really change how we help people address all of their risk factors in order to preserve their cognition with age.