We usually preface our “Expert Insights” pieces with a nice banner that has a stylish tall cutout that allows us to put a photo of the expert in. Today we’re not doing that, because for today’s camera-shy expert, we could only find one photo, and it’s a small, grainy, square headshot that looks like it was taken some decades ago, and would not fit our template at all. You can see it here, though!

In any case, Dr. Linda Selwa is a neurologist and neurophysiologist with nearly 40 years of professional experience.

The right questions to ask

As a neurologist, she found that one of the problems that results in delayed interventions (and thus, lower efficacy of those interventions) is that people don’t know there’s anything to worry about until a degenerative brain condition has degenerated past a certain point. With that in mind, she bids us ask ourselves the following questions, and discuss them with our primary healthcare providers as appropriate:

1. Sleep: Are you able to get sufficient sleep to feel rested?
2. Affect, mood and mental health: Do you have concerns about your mood, anxiety, or stress?
3. Food, diet and supplements: Do you have concerns about getting enough or healthy enough food, or have any questions about supplements or vitamins?
4. Exercise: Do you find ways to fit physical exercise into your life?
5. Supportive social interactions: Do you have regular contact with close friends or family, and do you have enough support from people?
6. Trauma avoidance: Do you wear seatbelts and helmets, and use car seats for children?
7. Blood pressure: Have you had problems with high blood pressure at home or at doctor visits, or do you have any concerns about blood pressure treatment or getting a blood pressure cuff at home?
8. Risks, genetic and metabolic factors: Do you have trouble controlling blood sugar or cholesterol? Is there a neurological disease that runs in your family?
9. Affordability and adherence: Do you have any trouble with the cost of your medicines?
10. Infection: Are you up to date on vaccines, and do you have enough information about those vaccines?
11. Negative exposures: Do you smoke, drink more than one to two drinks per day, or use non-prescription drugs? Do you drink well water, or live in an area with known air or water pollution?
12. Social and structural determinants of health: Do you have concerns about keeping housing, having transportation, having access to care and medical insurance, or being physically or emotionally safe from harm?

You will note that some of these are well-known (to 10almonds readers, at least!) risk factors for cognitive decline, but others are more about systemic and/or environmental considerations, things that don’t directly pertain to brain health, but can have a big impact on it anyway.

About “concerns”: in the case of those questions that ask “do you have concerns about…?”, and you’re not sure, then yes, you do indeed have concerns.

About “trouble”: as for these kinds of health-related questionnaires in general, if a question asks you “do you have trouble with…?” and your answer is something like “no, because I have a special way of dealing with that problem” then the answer for the purposes of the questionnaire is yes, you do indeed have trouble.

Note that you can “have trouble with” something that you simultaneously “have under control”—just as a person can have no trouble at all with something that they leave very much out of control.

Further explanation on each of the questions

If you’re wondering what is meant by any of these, or what counts, or why the question is even being asked, then we recommend you check out Dr. Selwa et al’s recently-published paper, then all is explained in there, in surprisingly easy-to-read fashion:

Emerging Issues In Neurology: The Neurologist’s Role in Promoting Brain Health

If you scroll past the abstract, introduction, and disclaimers, then you’ll be straight into the tables of information about the above 12 factors.

Want to be even more proactive?

Check out:

How To Reduce Your Alzheimer’s Risk

Take care!

This is Kimberly Wilson. She’s a psychologist, not a doctor, and/but her speciality is neurophysiology and brain health.

Here’s what she wants us to know…

Avoid this very common killer

As you’re probably aware, the #1 killer in the US is heart disease, followed by COVID, which effectively pushed everything down a place. Thereafter, we see cancer, followed by accidental injuries, stroke, and dementia (including Alzheimer’s).

Over in the UK, where Wilson is from, dementia (including Alzheimer’s disease) is the #1 killer, followed by heart disease and then respiratory diseases (including COVID), and then stroke, then cancer.

As ever, what’s good for the heart is good for the brain, so many of the same interventions will help avoid both. With regard to some of the other differences in order, the reasons are mostly due to differences in the two countries’ healthcare systems and firearms laws.

It’s worth noting, though, that the leading cause of death in young people (aged 15–19) is suicide in the UK; in the US it’s nominally accidental injuries first (e.g. accidental shootings) with intentional suicide in the second spot.

In other words… Young or old, mental health is a serious health category that kills literally the most people in the UK, and also makes the top spots in the US.

Avoid the early killer

Given the demographics of most of our readership, chances are you’ve already lived past your teens and twenties. That’s not to say that suicide is no longer a risk, though, and it’s also worth noting that while mental health issues are invisible, they’re still physical illnesses (the brain is also an organ, after all!), so this isn’t something where you can simply “decide not to” and that’s you set, safe for life. So, please do continue to take good care in that regard.

We wrote about this previously, here:

How To Stay Alive (When You Really Don’t Want To)

Avoid the later killer

Wilson talks about how a recent survey found that…

• while nearly half of adults say dementia is the disease they fear most,
• only a third of those thought you could do anything to avoid it, and
• just 1% could name the 7 known risk factors.

Quick test: can you name the 7 known risk factors?

Please take a moment to actually try (this kind of mental stimulation is good in any case), and count them out on your fingers (or write them down), and then…

When you’re ready: click here to see the answer!

How many did you get? If you got them all, well done. If not, then well, now you know, so that’s good.

So, with those 7 things in mind, the first obvious advice is to take care of those things.

Taking an evidence-based medicine approach, Wilson recommends some specific interventions that will each improve one or more of those things, directly or indirectly:

Eating right

Wilson is a big fan of “nutritional psychiatry” and feeding one’s brain properly. We wrote about this, here:

The 6 Pillars Of Nutritional Psychiatry

As well as agreeing with the obvious “eat plenty of fiber, different-colored plants, and plenty of greens and beans”, Wilson specifically also champions getting enough of vitamins B9, B12, and D, as well as getting a healthy dose of omega-3 fatty acids.

She also recommends intermittent fasting, if that’s a reasonable option for you—but advocates for not worrying about it, if it’s not easy for you. For example, if you are diabetic, or have (or have a history with) some kind of eating disorder(s), then it’s probably not usefully practicable. But for most people, it can reduce systemic inflammation, which means also reducing neuroinflammation.

Managing stress right

Here she advocates for three main things:

1. Mindful meditation (see: Evidence-Based, No-Frills Mindfulness)
2. Psychological resilience (see: Building Psychological Resilience)
3. Mindful social media use (see: Making Social Media Work For Your Mental Health)

Managing money right

Not often we talk about this in a health science publication as opposed to a financial planning publication, but the fact is that a lot of mental distress, which goes on to have a huge impact on the brain, is rooted in financial stresses.

And, of course, it’s good to be able to draw on financial resources to directly fund one’s good health, but that is the secondary consideration here—the financial stress is the biggest issue, and you can’t CBT your way out of debt, for example.

Therapists often face this, and what has been referred to informally by professionals in the field as “Shit Life Syndrome”—and there’s only so much that therapy can do about that.

We’re not a financial publication, but one recommendation we’ll drop is that if you don’t currently have budgeting software that you use, this writer personally uses and swears by YNAB (You Need A Budget), so maybe check that out if you don’t already have everything covered in that regard. It’s not free, but there is a 34-day free trial.

Therapy can be very worthwhile nonetheless

Wilson notes that therapy is like non-invasive brain surgery (because of neuroplasticity, it’s literally changing physical things in your brain).

It’s not a magic bullet and it’s not the right choice for everyone, but it’s worth considering, and even self-therapy can yield benefits for many:

The Gym For Your Mental Health: Getting The Most Out Of Therapy

Sleeping right

Sleep is not only critical for health in general and brain health in particular, it’s also most of when our glymphatic system does clean-up in the brain (essential for avoiding Alzheimer’s & Parkinson’s, amongst other diseases):

How To Clean Your Brain (Glymphatic Health Primer)

Want to know more from Kimberley Wilson?

We reviewed a book of hers recently, here:

Unprocessed: What your Diet Is Doing To Your Brain – by Kimberley Wilson

However, much of what we shared today was sourced from another book of hers that we haven’t reviewed yet but probably will do one of these days:

How to Build a Healthy Brain: Reduce stress, anxiety and depression and future-proof your brain – by Kimberley Wilson

Enjoy!