697. Psychiatric neuroscience: improving brain health, cognition and mental health

Abstract

Abstract Background There is currently a global crisis in mental health. The World Health Organisation (WHO) has reported that over 1 billion people have a mental health disorder, with conditions such as anxiety and depression causing suffering to individuals and an economic burden to society1. In addition, the WHO reported that 57 million people are living with dementia2. Factors such as social isolation and loneliness are very common, with 1 in 4 older adults being socially isolated and 5-15% of adolescents feeling lonely3. Our studies have shown that loneliness, through depression, and social isolation increase the risk of dementia. Aims & Objectives As psychiatrists, psychologists and healthcare professionals, we need to move to preventive psychiatry whereby governments and individuals take action to reduce the risk of developing mental health disorders. We also need to detect mental health disorders earlier and treat effectively in order to ensure better functional outcomes and greater wellbeing for people. Method Environmental factors are modifiable and by improving lifestyle habits such as exercise, diet, sleep, social support systems, and learning throughout life we can improve both our brain structure and mental health4. Using large scale databases, including the UK Biobank5, the ABCD Cohort6 and IMAGEN7, we can identify evidenced-based ways to deliver preventive psychiatry. These large cohorts provide detailed information, including measures of cognition, mental health, genetics, and neuroimaging. In addition, these cohorts include children, adolescents, and middle to older aged adults. Results Establishing good evidenced-based lifestyle habits can improve brain health, cognition, mental health and wellbeing4. They also reduce the risk of depression and dementia. Research has shown that even with genetic vulnerabilities, these lifestyle factors are still beneficial. Our diet8,9, our sleep10 and our social support systems11,12,13 are key to improving brain health, cognition and wellbeing. For example, a diet with high cereal and low caffeine was associated with better cognitive performance, body mass index (BMI), and other metabolic measures8. We have also shown that in middle to older aged adults, getting 7-8 hours of sleep per night consistently was associated with better cognition, brain health and mental health10. Similarly, we have found that social isolation and loneliness can detract from our brain health and wellbeing11. In this older age group social isolation can actually increase the risk of dementia by 26%11. In addition, proteins linked to these factors were associated with inflammation, antiviral response and immune function13. Our study found that having a healthy lifestyle can reduce the risk of depression by 57% compared to having an unhealthy lifestyle and may even help mitigate the effects of genetic risk factors14. Discussion & Conclusions It is hoped that in future through increasing resilience and cognitive reserve, preventive psychiatry will reduce the risk of neurodegenerative diseases, such as Alzheimer's disease and psychiatric disorders, such as depression. Resilience can mitigate the effects of stress and cognitive reserve can provide a buffer against cognitive decline with ageing. In addition, encouraging healthy lifestyle habits will increase wellbeing and help individuals realise their potential, both at work and in their home life, and lead to a more flourishing society.