Keeping your brain healthy

www.stgeorges.nhs.uk

Welcome to our members event on

Keeping your brain healthy

Presented by Dr Colette Griffin

Consultant Neurologist


Local developments


A new dementia service is currently being developed at St George’s Healthcare NHS Trust

This is both academic and clinical This will enable closer working relationships between

neurology and psychiatry services Aims to improve the speed and accuracy of diagnosis of

dementia Will improve inpatient care of patients with dementia Well established stroke unit and HASU Newly established traumatic brain injury (TBI) service

15 months ago


Closer working relationships between primary care and the acute trust

“Bridging The Gap” regular meetings St George’s Hospital acute services, community

services and Queen Mary’s Hospital Roehampton are now integrating

Better outcomes for patient care and more seamless treatment throughout patient journey


Aging is a natural process…..


Alliance for Aging Research

Brain healthy diet: omega-3 fatty acids, antioxidants, vitamin B, fibre rich non processed carbohydrates

Mental activity Exercise regularly Keep socially active Sleep well


Manage stress Stay safe Watch general health Stop smoking, drinking and using illegal drugs Family history


Multiple self help “train your brain” books Expensive herbal and nutritional supplements Computerised “brain training” games Pharmaceutical companies are racing to develop the

first “memory booster” Various strategies: promote growth of new brain cells,

block hormones that promote forgetfulness, prevent brain cell loss


Studies show that thirty or so “why did I come into this room?” type memory lapses a week occur in perfectly healthy volunteers

Normal forgetfulness is in danger of being medicalised in order to increase drug company profits

Forgetting is part of how a healthy brain works Studies have shown that giving patients a placebo

memory pill does actually improve their memory


London’s rail network lost property offices report that the number of lost items rose by 33,000 every year between 2005 and 2008

Memory is affected by lack of sleep, stress, grief, being hung over, or being unwell for other reasons


Memory aids are now commercially big business Media campaigns increase population awareness Alzheimer’s disease is now more common due to the

aging population Age is the major risk factor The prevalence doubles every five years after 65 years

of age UK patients with memory problems have been shown to

take twice as long to be diagnosed than European patients


More people therefore have an affected family member More people are “worried well” Higher prevalence in patients being admitted to hospital If a memory boosting pill were developed, hundreds of

thousands of people would need to take pills every day for their entire life

Big business…………………………..


All of these drugs are very powerful and have many severe side effects

Post traumatic stress disorder (PTSD) is caused by too many intrusive memories

Memory decline is an inevitable part of the natural aging process


One study has shown that patients who did one hour of walking three times a week had brain volumes of people three years younger

Education gives us more cognitive reserve: i.e. “reservoir of strength” in the brain

“Use it or lose it” Regular social contacts important: family and friends


What can we do to help ourselves?


Education, education, education


Stroke Traumatic brain injury Role of prevention Exercise: especially team sports Smoking and alcohol cessation Control of BP, diabetes, cholesterol Weight management: childhood obesity rates increasing Role of family history Regular GP checks



Within a few seconds of inhaling cigarette smoke, it reaches the lungs

The heart has to work harder and BP rises Causes irritation and inflammation of the airways Within seven seconds of each puff, nicotine reaches the

brain and dopamine is released Dopamine is a “feel good” hormone


Carbon monoxide levels in cigarette smoke are over 600 times higher than safe levels in industrial plants

Less oxygen therefore reaches vital organs Cancer causing chemicals peak 15-30 minutes after

smoking



Alcohol

Cerebral atrophy: cerebellum Peripheral neuropathy Liver damage Financial implications Family interactions Psycho social problems Greatly increased risk of cancer when combined with

smoking


Alcohol is involved in 80% of fatal accidents


Stroke

150,000 people have a stroke in the UK each year 10,000 of these are in young people It is the third most common cause of death in the UK,

after cardiovascular disease and cancer It is the largest cause of disability in the UK At least 450,000 people in the UK are currently severely

disabled due to a stroke


Stroke

The direct cost to the NHS is £2.8 billion The cost to the wider economy is £1.8 billion The informal care cost is £2.4 billion 20% of acute medical beds are occupied by stroke

patients 25% of long term beds are occupied by stroke patients Stroke patients on stroke units have a lower mortality

rate compared to stroke patients on general wards


Prevention

Control diabetes Control blood pressure Control cholesterol Stop smoking and drinking alcohol Exercise regularly Take your tablets regularly Watch for a family history Report symptoms early


Traumatic Brain Injury (TBI) One million people attend A&E with a TBI each year in

the UK 150,000 of these are mild 10,000 of these are moderate 11,000 of these are severe 4,500 people with a TBI will need full time care for the

rest of their lives Only 15% of severe TBIs return to work within five years 120,000 people in the UK are living with the long term

effects of a severe TBI


TBI

Mostly affects males Young children and young adults Falls, assaults, RTAs Alcohol is involved in 65% of cases Many cases are preventable


Prevention

Health and safety at work Role of accident prevention: especially in young adults Childhood accidents around the home Population education: FAST campaign Early recognition of warning signs Road safety awareness campaigns: I pods Ski helmets


Seat belt campaign Speed restrictions in residential areas Car safety design and airbags Cycle helmets Road safety awareness campaigns High summer incidence of childhood road accidents High visibility cycle wear Motorway breakdown safety guidance

Prevention


Effects of a TBI can be devastating Cognitive, physical, emotional May need long term intensive rehabilitation Many people with a mild TBI still have psychological

challenges: PTSD, depression, anxiety Community psychological and counselling services

patchy In patient rehabilitation beds scare pan London London Specialist Neurorehabilitation Consortium


Further reading

www.alz.org The Healthy Brain Initiative


Thank you

Date post:	23-Dec-2014
Category:	Health & Medicine
Upload:	st-georges-healthcare-nhs-trust
View:	455 times
Download:	2 times

Keeping your brain healthy

Health & Medicine