Counseling patients on brain health

In this article:

• How to promote brain health
• The bottom line

In this article

• How to promote brain health
• The bottom line

Brain health refers to how well the brain functions, and it can affect so many parts of life, including cognition, emotions, movement, and sensation, according to the National Institute on Aging. As people age, certain parts of the brain can shrink, communication within the brain can diminish, blood flow in the brain can decrease, and inflammation may occur. These changes can affect mental function. Therefore, keeping the brain healthy is crucial as you age. 

According to a 2020 study published in Neurology, lifestyle factors, such as physical activity, avoiding smoking and alcohol, and diet, have important benefits for brain health. As frontline healthcare providers, pharmacists have the opportunity not only to counsel patients on these lifestyle changes, but also to educate patients on medications and their impact on brain health. 

How to promote brain health

Many factors affect brain health, including physical activity, certain chronic health conditions, injuries, and sleep. Pharmacists can play a key role in promoting brain health by educating patients about these factors and identifying situations that warrant further evaluation by a healthcare provider. 

Encourage healthy lifestyle choices

Healthy lifestyle choices can greatly impact brain health and the risk of Alzheimer’s disease. These can include: 

• Increasing physical activity
• Limiting alcohol consumption
• Quitting smoking
• Following a Mediterranean or DASH diet
• Engaging in mentally stimulating activities 

One study found that engaging in two to three of these activities lowered the risk of Alzheimer’s dementia by 37%, and participating in four to five activities lowered the risk by 60%. 

With this in mind, pharmacists can encourage patients to make healthy lifestyle modifications to promote brain health. You can provide guidance on how to incorporate regular physical activity into daily life and how to maintain a Mediterranean diet. You can also explain the negative impact of smoking and excessive alcohol use on the brain and provide resources on how to quit. 

Advise on cognitive side effects

As medication experts, pharmacists can help patients identify drugs that impact brain health. Many prescription and over-the-counter (OTC) medications affect cognition, mood, behavior, and memory, especially when they are combined with certain substances or other drugs. Examples include benzodiazepines, opioids, and anticholinergic medications. Pharmacists can help identify these medications and educate patients on their potential cognitive side effects, interactions, or other risks. You can also provide strategies to minimize cognitive effects, such as recommending alternative treatment options or adjusting dosages. 

Educate patients on health conditions

Similarly, certain chronic health conditions, including diabetes and hypertension, can affect brain health, as studies suggest that their effects on the vascular system can contribute to the development of dementia. Pharmacists can provide insight into the proper management of these conditions. For example, you can ensure patients know how to monitor their blood pressure at home and encourage them to make heart-healthy lifestyle changes. It’s also important to educate them on the importance of medication adherence in managing their chronic condition and provide ways to improve medication adherence. 

Perform cognitive assessments

Pharmacists are also in a unique position to help patients assess their cognitive health. They can perform cognitive assessments in the pharmacy setting and refer patients who are at risk to their primary care providers. In one study published in the International Journal of Clinical Pharmacy, 12 chain community pharmacies within the United States implemented a memory screening assessment and referral program for patients with risk factors of cognitive memory decline. About 44% of patients experienced at least one cognitive deficiency that led to a referral to a physician, and 98% of respondents were satisfied with this program. 

Pharmacy-based memory assessments support the early detection of cognitive decline, which is incredibly valuable because it gives patients time to make choices for their future and access treatments that can help alleviate symptoms and preserve their level of function. 

Recommend brain-supporting supplements

There is insufficient evidence supporting the use of dietary supplements to improve brain health. Nevertheless, it’s important for pharmacists to be familiar with dietary supplements that claim to boost brain function, as patients may ask questions about the use of these products. According to the National Center for Complementary and Integrative Health, common supplements that claim to improve cognitive function include: 

• Ginkgo biloba
• Omega-3 fatty acids
• Vitamin E
• Curcumin
• B vitamins

The NCCIH website summarizes the current research about several dietary supplements that have been studied for cognitive function, dementia, and Alzheimer’s disease.  

Referral to a physician

Patients often report medication side effects, unusual behaviors, or other issues to pharmacists. As a frontline healthcare provider, pharmacists should know when these events require further medical evaluation. 

Here are some examples of when a patient should seek evaluation from a healthcare professional for cognitive issues:

• Asking the same questions over and over again
• Having trouble following recipes or directions
• Becoming confused about time, people, and places
• Getting lost in familiar places

The bottom line

Pharmacists play a key role in promoting brain health. They can encourage healthy lifestyle choices, educate patients about their medications and health conditions, perform cognitive assessments, recommend dietary supplements that improve brain function, and know when to refer to a physician. These interventions may improve patients’ cognitive well-being and empower patients to take better care of their brain health.