Research Spotlight: The Neurologist’s Role in Promoting Brain Health
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
Photo by Tara Winstead [1]
Brain health has become a major area of interest worldwide, as neurological conditions are a leading cause of doctor visits and disability [2]. Neurologists have an important role in promoting brain health, whether it may be through preventive measures, reducing recurrence of disease, or promoting overall quality of life. In today’s blog post, we will be discussing the different approaches clinicians may consider to improve brain health of patients, and how patients can best approach these conversations.
There are many factors associated with brain health, and the American Academy of Neurology in a new emerging research article has developed a mnemonic that defines the various domains that may support the development and maintenance of the “SAFEST BRAINS” [2]. The mnemonic is further defined in Figure 1 [2].
Figure 1. SAFEST BRAINS Mnemonic Device. Taken from Selwa et. al 2025 [2].
In the SAFEST BRAINS, there are often factors that influence brain health over a person’s life, and there is often a connection with social determinants of health that can influence a person’s health, function, and quality of life. It is vital to consider these factors to ensure that the individual’s entire well-being is taken into consideration, and how this may impact their brain health.
We will now discuss each domain individually as referenced in the SAFEST BRAINS mnemonic. Overall, the guidelines may change depending on a person’s age, coexisting medical conditions and state of their health.
Sleep: The goal is to assess appropriate sleep time, daytime sleepiness, and nighttime behaviors. For example, in adulthood, the recommendation may be to discuss shift work and screen for obstructive sleep apnea (and treat it when present).
Affect, mood, and mental health: The guidelines recommend to assess for anxiety and depression. For adulthood, clinicians may ask about engagement, motivation, changes in appetite, and access to mental health services.
Food, diet, and supplements: The guidelines recommend to ask about food sensitivities and whether there is access to fresh foods. Clinicians can further evaluate supplement use and specific dietary habits.
Exercise: The guidelines recommend to discuss daily or weekly exercise and physical activity level.
Supportive social interactions: The guidelines recommend discussing supportive family and peer interactions, and assessing for prosocial skills.
Trauma avoidance: The goal is to discuss the use of seat belts and helmets, car seats, gun safety, watercraft, or ATV safety, and fall or wheelchair safety.
Blood pressure: The goal is to measure blood pressure at all visits, promote blood pressure control, and ask about home blood pressure cuffs.
Risks – metabolic and genetic factors: The guidelines recommend considering and recognizing genetic risks, screening for and promoting control of lipids and diabetes, and promoting healthy weight.
Affordability and adherence: The goal is to ask all caregivers and patients whether they anticipate paying out-of-pocket costs for diagnostics or therapeutics.
Infection: The guidelines recommend the promotion of compliance with age-specific immunization schedules and specific epidemiological trends.
Negative exposures: Clinicians may ask about water supply, air pollution, food sources, and noise exposure.
Structural and social determinants of health: The guidelines recommend asking about access to health care, transportation, employment, and health-related social needs. In addition, it is important to address health literacy barriers, cross cultural barriers, and ensure the use of easily understandable language.
Overall, the factors mentioned above may play a role in the brain health of patients worldwide. Neurologists may include other screening tools to better guide conversations on brain health, and how best patients can optimize their brain health. Patients can also play an active role in facilitating these conversations. For instance, patients can ask their clinicians questions on what they can do to improve their brain health to start the conversation. In addition, it is important for patients to be open about their experience with any memory issues, mood changes, or cognitive changes. Further, patients can discuss with their providers how things like their environment, community, and social factors impact their overall health, as these may have a significant impact on their brain health. In conclusion, being proactive in discussing these factors may help providers to consider strategies for improving these areas and facilitating more conversations on brain health.
References:
- Winstead T (2024) Pexels.
- Selwa LM, Banwell BL, Choe M, et al (2025) The Neurologist’s Role in Promoting Brain Health: Emerging Issues in Neurology. Neurology 104:e210226. https://doi.org/10.1212/WNL.0000000000210226