Brain Reserve Index can assess risk for Alzheimer's disease

Herald Health CorrespondentMay 14, 2013 

20130506 Brain mapping

McCLATCHY TRIBUNE ILLUSTRATION

MATAMOROS — MCT

What's your Brain Reserve Index? According to Michael Mullan, president and CEO of the Roskamp Institute in Sarasota, it's a number that can help measure your risk of developing Alzheimer's disease by the time you're 85.

The Brain Reserve Index, or BRI, was developed at the Roskamp Institute based on large-scale studies about how diet and exercise habits affect Alzheimer's risk.

It is the centerpiece of Sci-Brain, a new company based in Sarasota that promises not only to evaluate your lifestyle and determine the likelihood of Alzheimer's but also help you make changes to build a healthier brain.

Sci-Brain is a partnership between Mullan representing the Roskamp Institute and Nicci Kobritz, owner of a Sarasota home health-care agency who several years ago began incorporating cognitive exercises into services for elderly home-health clients.

Today, Alzheimer's disease affects an estimated 5 million Americans. By 2025, that number is expected to have climbed to 7 million and keep going up as the average age gets older, according to the Alzheimer's Association.

There is more to that prediction, however.

"Even though the population as a whole is at increased risk as we age, it's clear that we're not equally at risk," said Mullan.

"Some people are more at risk than others and quite a lot of that risk has to do with lifestyle choices."

Scientists haven't found a cure for Alzheimer's but more is becoming known as to what is protective or harmful for the brain, said Mullan.

"There have been a lot of studies that look at different aspects of lifestyle. We now have a good idea of the diet that protects us from Alzheimer's and those that don't," he said.

"It's the same thing for physical exercise. We now have a good idea of what type of exercise and how much you need to do and for how long."

The BRI quantifies risk after a detailed evaluation of what you eat, how you exercise, whether you're mentally active and how well any diseases like diabetes are controlled.

A score of 100 is average; the higher above 100, the lower projected risk of Alzheimer's. The opposite is true as the scale moves downward below 100.

Someone with a BRI of 50 has about a 20 percent chance of developing Alzheimer's by age 85. That's double the risk of someone with a BRI of 150.

Like changing cholesterol level numbers, the BRI number can be improved through a better diet and exercise, according to the Sci-Brain premise.

The Mediterranean diet, rich in fruit, vegetablesand olive oil, a vigorousexercise program, braintraining exercises and improving any harmful medical conditions are recommended.

These changes will help build "cognitive reserve," the goal of the Sci-Brain program. Cognitive reserve means the brain has built an increased numbers of neurons and connective pathways.

Mullan compares this increase to having more than one road between two towns.

If a single neural pathway between two parts of the brain is blocked by even slight damage from some-thing like a small bloodclot, those parts of the brain won't be able to communicate.

Through cognitive reserve, multiple pathways are created and the brain doesn't have to rely on the pathway that is damaged.

Sci-Brain debuted earlier this year and now has 22 clients ranging from ages 35 to 75, including four attorneys from a law practice.

Maintaining their mental edge will be important for some, especially baby boomers, said Kobritz.

"We have more people wanting to stay in the workforce longer, whether they have to for economic reasons and for other reasons," she said.

"Memory becomes anissue as you get older … memory declines or you just feel like you're not at the top of your game anymore and you want to be the best you can be for as long as possible."

The cost for an evaluation at Sci-Brain is $1,500. Anextensive medical historyis taken and clients then see a dietitian, exercise phys-iologist and neurologist Michel Hoffmann, the medical director of Sci-Brain and director of the Stroke and Cognitive Neurology Program at James A. Haley VA Hospital.

Once the assessment is completed, evaluators create a "brain health plan." Joining the program for a year costs $1,200 with access to the program's health professionals who serve as lifestyle coaches and information sources.

"It's highly customized -- it's not just 'go away and exercise and eat better.'It's very specific data andvery specific guidelineson how to lower the risk for each individual, " said Mullan.

The BRI number is changed to show improvement as soon as new lifestyle habits begin.

Susan Hemmingway, Herald health correspondent can be reached at shemmingway@hotmail.com.

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