Stephen J. Kiraly, MD, FRCPC

1. HEALTHY BRAIN PROGRAM: INNOVATIVE APPROACH TO HEALTH PROMOTION Stephen J. Kiraly, MD, FRCPC Clinical Associate Professor, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada THE EIGHT PILLARS OF BRAIN HEALTH: WORKSHOPS & SEMINARS OBSTACLES TO BRAIN HEALTH - lack of general knowledge about brain function - overwhelming scientific information leads to confusion - proliferation of junk science - psychological factors: anxiety, denial - resistance to change; habit - shame & stigmatization - cultural & lifestyle factors PROBLEM ADDRESSED 1. SAFETY - Childhood and adult mild traumatic brain injury (concussion) is far too common. It is a significant risk factor for delayed consequences; dementia. How can we recognize, prevent and treat such conditions? 2. NUTRITION - The usual nutrition is indequate and leads to disease. What is optimal nutrition for the brain? What are the facts, the fads, emerging concepts and dangers? 3. PHYSICAL EXERCISE - is the closest we can come to a Fountain of Youth. Exercise has indirect beneficial effects by improving cardiac and vascular health. It also has direct hormonal effects on the brain through brain derived neurotrophic factors (BDNF). 4. MENTAL EXERCISE - is vital for brain cell branching and new connections - use it or lose it! Novel stimuli are the most effective in promoting neuropasticity.What counts as mental exercise? What is too little or too much? 5. STRESS MANAGEMENT - Chronic stress shrinks parts of the brain and can kill brain cells. It also causes and/or worsens a number of conditions, such as hypertension and diabetes (and others), which are risk factors for brain disease. How do we avoid being stressed? 6. SLEEP - Most people don’t get enough sleep. Adequate sleep is essential for optimal emotional and cognitive functioning. Consolidation of what is learned takes place during the dreaming stage. Anabolic repair of body & brain and immune system functions prevail during deep stages. How do we know we are getting enough sleep? 7. HORMONE BALANCE - The brain is extremely sensitive to hormones. There are rational ways to use hormone treatments, based on assay and monitoring, which avoid hormone havoc. What are the hormone hazards we face today? What hormone replacement(s) do we need? This is a rapidly growing field - more excitement to come! 8. TREATMENT OF DISEASE - or diseases which are specific risk factors for brain disease is very important. These common disorders found in the GP’s office must be assertively diagnosed and treated in a timely manner to avoid early onset dementia. These include: diabetes, hypertension, obesity, endocrine disorders, depression and stress related disorders. Mild cognitive impairment (MCI) or early dementia itself can be treated successfully to slow progression. As clinicians we remain challenged by the treatment of degenerative diseases of the brain. Given that the brain is the weakest link in organ repair and replacement, it is astounding that prevention is not taken more seriously by our formal institutions. Clinicians, patients and all people in general, are bombarded by random information on aging and the brain, but they do not have reliable, practical guide-lines and teachers. We need a synthesis of what has proven safety and efficacy in the prevention of brain degeneration. BRAIN IS AN ORGAN OF THE BODY - made of flesh & blood weighing 3 lb. - complex, chaotic, non-linear dynamic system which does not conform to linear logic - like a neural network of computers and servo systems that can alter & repair themselves - cortex is similar to a huge computer chip - six layers - like an endocrine organ, source and target of neuropeptides, neurotransmitters and hormones OBJECTIVES Participants will be able to: - define eight major areas in their lives which will require constant attention: the Precepts of Brain Health - acquire immediate action plans - feel confident about the safety of HBP - feel confident about efficacy of the HBP - learn about clinical applications - improve patient care - grasp some of the theory and proven technologies involved in the above - be more critical of unproven “anti-aging” practices VULNERABILITYOF THE BRAIN - like any other organ, the brain can sustain injury, disease & deterioration - soft, like “jello” - very rich but fragile circulation - sensitive to specific toxins - brain degeneration is more than aging - neuroendocrine decline leads to catabolic processes - free radical damage - excess glucose damage - excess stress hormone, cortisol BRAIN HEALTH IS MORE IMPORTANT THAN EVER - life expectancy is steadily increasing - brain disease is becoming the leading cause of morbidity and mortality - biomedical knowledge about the brain is expanding exponentially - brain remains the weakest link in organ repair and replacement - optimal brain function is required for quality of life - brain disease caregiver burden is huge - economics: prevention makes sense SUGGESTED READINGS & REFERENCES STAYING POWER - huge complexity & redundancy - neuroplasticity & neurogenesis even in old age - angiogenesis - neuroprotection; antioxidants Kiraly MA, Kiraly SJ. The Effect of Exercise on Hippocampal Integrity: Review of Recent Research. Psychiatry in Medicine 2005;35(1):75-89. Kiraly SJ, Kiraly RJ. Healthy Brain Program: Prevention of Dementia. Poster Presentation. Colloquium on Dementia. Proceedings: Geriatrics Today 2003;6(3):133. Kiraly SJ. Keeping the Brain Healthy. The Canadian Journal of CME 2003;March:145-150. Kiraly SJ. The Healthy Brain Program: an Innovative Approach to Health Promotion. The Bulletin of the Canadian Association of Geriatric Psychiatry 2003;10(2):9-13. Kiraly SJ. A New Meaning for Brain Drain. Lumens: Mensa Canada’s Western Region Newsletter 2000;3(9):1-3 and 2001;4(10):2-3 and 2001;5(1)2-3. Website: www.healthybrain.org