Brain Health, not Brain Disease

By Dr Dylan Wint, MD

As the physical health of older people improves, a greater emphasis must be placed on ensuring that their brains stay in shape, too.  The Cleveland Clinic Lou Ruvo Center for Brain Health uses a multidisciplinary scientific approach to detect and treat cognitive decline.  More importantly, though, the Center strives to prevent cognitive decline by producing and utilizing the most up-to-date knowledge about maintaining optimal brain function.

Multidisciplinary assessment

The experts at the Center for Brain Health work together to preserve cognition.  The team was assembled specifically for its interest and expertise in degenerative brain diseases and includes:

• Neurologists
• Psychiatrists
• Nurses
• Psychologists
• Social workers

The members of the team do not think simply in terms of diagnoses and medications.  The Center’s goals are to improve quality of life for patients affected by neurodegeneration and their loved ones, and to prevent cognitive decline by maximally supporting brain health.  When a patient comes to the Center, the first step is identifying aspects of cognition that may be of concern.  If there is evidence of neurologic impairment, the team works to determine what is interfering with normal brain function.  This determination may include techniques such as:

• Detailed cognitive testing
• Neuroimaging with MRI, CT, or PET scans
• Blood tests
• Spinal fluid analysis

The team meets with the patient to discuss the results of testing.  This meeting emphasizes the fact that healthy cognition means much more than not having a specific disease.  By the same token, treating impaired cognition means much more than prescribing anti-Alzheimer medications.  While we explain what has gone wrong with the brain, we focus our energies on protecting and enhancing the parts that remain strong.  Treatment at the Center consists of a multi-pronged, comprehensive effort that not only includes patients, but also incorporates their families, medical providers, and communities.  Depending on the physical and cognitive status of the patient, recommendations could include:

• Treatment for previously undetected diabetes
• Aggressive control of blood pressure and other vascular risk factors
• A physical exercise program
• Treatment for depression or other psychiatric illness
• A customized program of cognitive rehabilitation

In addition, social workers provide supportive, therapeutic, and educational services for individuals and groups.

We are learning more about our ability to control some of the factors that put our brains at risk.  The Cleveland Clinic Lou Ruvo Center for Brain Health is dedicated to using all the means at our disposal to minimize or eliminate these factors.  We are working to bring about a day when patients and their families will no longer have to suffer the devastating effects of cognitive deterioration.