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Dr Thomas Leung Wai-hong is the principal investigator in the brain health study at the Chinese University of Hong Kong. Research from this study will be compared to population data from the United States.

Lifelong brain disease study hopes to safeguard Hongkongers’ health with help of American researchers

  • A study by Chinese University of Hong Kong and Boston’s Centre for Brain Health will track 5,000 Hongkongers’ brain health
  • Research from this study will be compared to data from the United States and hopes to change how Hong Kong deals with brain disease
Wellness

Preventive approaches to brain disease are advancing in scientific communities around the world, including Hong Kong, where a new study aims to explore how lifestyle changes can affect brain health. Results from the study will be used to develop a programme tailor-made to safeguard the brain health of Hongkongers.

The Chinese University of Hong Kong (CUHK) study will track the brain health of 5,000 permanent residents. It will examine participants’ lifestyle and environmental factors throughout the rest of their lives.

Research from this study will be compared to data from the United States, with the help of the Henry and Allison McCance Centre for Brain Health at Boston’s Massachusetts General Hospital.

This comparison “will be of great interest given the disparity in ethnicity, demographics, culture, socio-economic status and disease prevalence between Hong Kong and Boston,” says the study’s principal investigator Dr Thomas Leung Wai-hong, an associate professor of neurology at CUHK.

A patient’s eye being checked as part of the Chinese University of Hong Kong brain health study.
Hong Kong pipped Japan last year as the place with the longest life expectancy in the world, at 87.3 years for women and 81.2 years for men. However, Dr Jonathan Rosand, the co-founder and co-director of the Boston-based brain centre, says people are generally living longer, but their brain health may deteriorate long before they die.
Many experts are warning of the city’s lack of preparation for a “dementia tsunami” projected by 2050 that will afflict around a third of Hongkongers aged 80 or over. However, preventive practices in midlife can reduce the risk of affliction, says Dr Rosand.

The ‘dementia tsunami’ and why Hong Kong isn’t ready to cope with expected surge in cases

“We are operating on the theory that there are things you can do when you’re young that will have a substantial impact on whether you will get dementia when you’re older. We want to figure out what they are,” explains Dr Rosand, also a neurology professor at Harvard Medical School.

Measuring the impact of an individual’s lifestyle choices, such as taking drugs or drinking alcohol, long before he or she is likely to get dementia, can help put people on the right track, he adds.

The absence of such lifestyle data in Hong Kong means it is not possible to customise lifestyle changes for the local population, something the researchers hope to achieve.

“A big contributor to [brain health] is hypertension in Hong Kong, which is poorly controlled in the city compared to, say, Boston,” explains Dr Rosand, adding that simply modifying one’s behaviours can safeguard the brain against premature ageing. “In Boston, challenges include obesity. So there are different lifestyle issues [affecting these two populations]. They need to be studied in their context,” he says.

A big contributorto [brain health] is hypertension in Hong Kong, which is poorly controlled in the city compared to, say, Boston.
Dr Jonathan Rosand

The study is recruiting permanent Hong Kong residents aged between 40 and 74. Researchers will be seeking people who are healthy or are at risk of developing a brain disease. Those who have a brain disease will not be eligible to participate in the study.

Participants will be asked to fill out questionnaires on their physical and psychological health, and undergo a physical check up, including blood tests and imaging tests for markers of brain health and cardiovascular diseases.

Anyone diagnosed with a brain disease during this process will be referred to appropriate medical specialists, but will not be part of the study.

Dr Jonathan Rosand (left) and Dr Leung in Hong Kong, in July. Photo: Jonathan Wong

Individuals selected for the study will meet experts to get advice and counselling on strategies to change bad lifestyle habits and to reduce stress such as through mindfulness and yoga.

Follow-ups will be conducted once every six months to a year. If tests show a participant has developed a condition such as high blood pressure, the check-ups will become more frequent. Participants will be tracked over their lifetime, Dr Leung says.

The study will also explore participants’ exposure to environmental factors. Dr Leung’s preliminary data found a link between indoor pollution (such as burning incense) and impaired cognition function in the elderly. “It could [affect cognitive function], but we need more data,” he says.

How dementia is caused by mini strokes, how to detect it early and nine ways to reduce your risk

In the US, the recent legalisation of marijuana in Massachusetts means the Boston-based brain centre will look at the impact cannabis has on brain health.

Dr Rosand anticipates that exposure to marijuana and types of indoor pollution will have some impact on the chemical-sensitive brain. “Whether the impact is ultimately expressed in higher risk of disease, we don’t know, but because the brain is so sensitive we need to understand the impact of all these exposures,” he says.

The study will explore the impact stress has on the brain, too. In Hong Kong, many in the labour force endure long working hours and live in small living spaces. All of this affects one’s psychological well-being.

Dr Leung is the principal investigator in the study.

Dr Rosand says research shows that there’s a link between meditation and a reduction in stress. “Stress is associated with a host of diseases and one of them is stroke, so why not meditate?” says Dr Rosand, adding he hopes the research will help to establish why this practice is beneficial.

The study will also explore more novel risks factors such as the microbiome – or the gut-brain connection – as recent research shows gut health affects all manner of well-being, from moods to cognitive functions.

“There is some evidence that the spectrum of microbiota affects how you secrete toxins and your metabolism. This affects [one’s ability to metabolise] fat … and all this affects obesity,” explains Dr Leung. Obesity is linked to hypertension and diabetes, among other illnesses. The study will explore how these linked risk factors affect brain health.

How to hold off ageing and dementia with the power of positive thought

The researchers hope this study will have an impact on how the medical community view and treat brain health, in the same way the Framingham Heart Study changed opinions about heart health. That cardiovascular study, which began in 1948, is now researching its third generation of participants in Framingham, Massachusetts.

Findings from the study helped shed light on cardiovascular risk factors and found that high cholesterol and high blood pressure are major risk factors for heart disease. The study helped to lower mortality rates associated with heart disease.

Dr Rosand hopes that findings from the brain health study can be applied to the general population in five to 10 years.

To learn more about the brain health study, and to enrol, visit bit.ly/cuhkbraincare.

This article appeared in the South China Morning Post print edition as: Hong Kong and US join forces for brain exploration
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