Healthy Brain Initiative

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Risk Factors in Greendale
Greendale Healthy Brain Initiative Action Plan

What is the Healthy Brain Initiative?

In October 2022, Greendale Health Department received the Health Brain Initiative grant, along with seven other health departments nationwide. This opportunity gives the health department the ability to prioritize brain health as a strategic objective. Our chosen focus area is risk reduction, and our approach includes infusing a brain health lens into our current programs, services, CHA and CHIP.  

Shifting Your Mindset and Approach
The greatest impact from a public health perspective cannot be achieved if the focus is only on older adults in regard to dementia. Risk reduction efforts must include a younger audience. Addressing risk factors and brining awareness to protective factors for brain health needs to start earlier in life. 

What is Dementia? 
Dementia is a general term for a decline in cognitive functioning, affecting thinking, remembering, and reasoning enough to interfere with daily life. It is not a specific disease but describes various symptoms associated with memory decline. Dementia can result from factors like age, brain injury, other conditions, heredity, or a combination. Many dementias are progressive, starting slowly and worsening over time. Alzheimer's disease is the most common cause, but other types include Lewy body dementia, frontotemporal disorders, and vascular dementia.

Dementia Health Disparities

The number of people with Alzheimer's and other memory problems shows that some groups of people are affected more than others. Even though most people with Alzheimer's in the U.S. are White, African Americans and Hispanics have more of these memory issues compared to people of different backgrounds. In the U.S., older African Americans are about two times more likely than older white people to have Alzheimer's. Also, African Americans are less likely to be told they have Alzheimer's than white people. Older Hispanics are about one and a half times more likely than older white people to have these memory problems. More people in these groups might have these memory issues because they often have other health problems like high blood pressure and diabetes, which are thought to make Alzheimer's more likely. Money and how well-off a person is might also affect their chances of having these memory issues.

Caregiver Challenges
Being a caregiver for a person with dementia or other health conditions puts the caregiver at a greater risk for developing dementia themselves. The majority of Alzheimer’s patients live in home settings, receiving care from family and friends. Caregivers face physical, psychological, and social challenges, leading to additional healthcare costs and emotional stress. Many caregivers delay attending to their own health care needs, impacting their well-being and work commitments.

Public Health Role and Risk-Reduction Strategies
Public health plays a crucial role in primary prevention, intervening before health effects occur. The causes of Alzheimer’s are not fully understood, but primary prevention strategies can reduce the risk of cognitive decline. Traumatic brain injury is linked to a higher dementia risk, emphasizing the importance of encouraging injury prevention and cardiovascular health promotion.

It's important to use safety gear such as seat belts in cars and helmets while biking or engaging in certain sports. These measures help protect us in different situations and reduce the risk of injuries.

Another crucial aspect of prevention involves minimizing the risk of falls, particularly among older adults. This can be achieved by making homes safer environments. Simple steps like removing tripping hazards, adding grab bars in the bathroom, and improving overall lighting contribute to creating a safer living space. Additionally, engaging in regular exercise that focuses on improving balance and coordination is beneficial. It's also advisable to discuss medications and vision with healthcare providers to ensure they align with overall safety.

Beyond these safety measures, there is a growing understanding of the connection between heart health and brain health. Conditions that increase the risk of cardiovascular diseases, such as high blood pressure, heart disease, stroke, and diabetes, are also associated with a higher likelihood of developing Alzheimer's disease. Studies indicate that a significant percentage of individuals with Alzheimer's also have cardiovascular disease.

Many of the risk factors for cardiovascular disease are modifiable, meaning they can be changed to reduce the likelihood of developing heart-related problems. Experts suggest that controlling these cardiovascular risk factors is a cost-effective and beneficial approach to safeguarding brain health and lowering the risk of cognitive decline. This emphasis on heart health is particularly crucial in midlife (40s-50s) when early changes in the brain associated with Alzheimer's may begin. Therefore, taking proactive steps to address and manage cardiovascular risk factors becomes especially important during this stage of life.

Below is an infographic highlighting the Lancet Commision Risk factors for dementia throughout the life course.
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Risk Factors from the Alzheimer's Association

The following are short summaries on the current state of the evidence on a variety of possible risk factors, including the implications for public health: