CULTIVATING BRAIN HEALTH FOR ALL
WHAT IS THE BRAIN HEALTH ADVOCACY MISSION (BHAM) AND ITS PURPOSE?
Launched winter of 2022 and led by Ronald M. Lazar, Ph.D., FAHA, FAAN, BHAM is a first-of-its-kind, individualized brain health program, IRB-approved by the University of Alabama at Birmingham (UAB), under the direction of the Evelyn F. McKnight Brain Institute. BHAM is executed in collaboration with faculty and investigators from across the University and in partnership with the UAB Department of Family and Community Medicine (UAB Highlands and UAB Hoover primary care clinics.
BHAM aims to help people improve and maintain their brain health for both the present and for the future, starting young (ages 18+), which is important for preventing age-related cognitive decline and memory loss.
HOW DOES BHAM WORK?
BHAM is focused on engaging, empowering, and educating all individuals about their brain health for healthy aging and memory loss prevention through meaningful connections in primary care clinics (“clinic-within-a clinic” model) and in the community. We engage ongoing, two-way conversations with participants with a brain health champion that puts the program participant first.
BHAM incorporates evidence-based modifiable risk factors and lifestyle behaviors (expansion of Life’s Simple 7) that impact the brain as early as adolescence (Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association), our impetus for BHAM. A brain care score tool, which incorporates these elements, is used to assess participant brain health. A nurse investigator, experienced faculty, and other trained brain health members make up the BHAM team. The BHAM “coaching” supplements care and information offered by the primary care provider and thereby helps reduce the provider’s burden.
BHAM personalizes brain health care for each participant; the participant and a BHAM team member develop healthy target(s) based on what is important to the participant with feasible starting points. Targets take into consideration any shared personal or other obstacles to help optimize their brain health goal(s) while engaging and motivating participants to achieve and personally benefit.
WHY BHAM?
With definitive evidence that a lifelong, proactive approach to risk factors and lifestyle management prevents later-life cognitive decline, our partnership with primary care clinics represents an ideal mechanism to implement BHAM into our community. Once cognition and memory begin to decline with age, there are few therapeutic options to stop/reverse this process. Therefore, BHAM team members educating patients can play a key role in improving brain health outcomes for healthy aging.
WHAT’S NEXT FOR BHAM?
In August 2023, we launched a larger study, the BHAM Registry, in which participants are followed long-term. The Registry includes a revised brain care score tool, with measures reflecting – 12 risk factors, lifestyle behaviors, and social-emotional elements. We have also added additional measures of stress and anxiety because 25% of our original BHAM pilot study cohort reported a history of treatment for anxiety and/or depression. Unfortunately, access to mental health services in our region is lacking. When an individual scores on the poorer end of our metrics for social determinants of health and elects to address stress or anxiety as a brain health target, we now can offer them a stress management consultation session.
The BHAM Registry will be leveraged as a platform from which to enroll participants into future research studies to improve and maintain brain health; the first is a clinical trial evaluating optimal exercise to reduce blood pressure, the PEDAL study (i.e., An Exercise Intervention to Improve Overall Brain Health: PEDAL (Physical Education for an Active Lifestyle) Study). Launched In January 2024, we received a $150,000 grant from the McCance Center for Brain Health at Mass General Brigham, matched with funds from the UAB McKnight Endowment. The aim of this project, under the direction of BHAM Clinical Director, Dr. Pamela Bowen (UAB Nursing), is to determine whether high- or moderate-intensity aerobic exercise is more effective at increasing retinal vascular density, assessed by Optical Coherence Tomography Angiography, and reducing hypertension, the most prominent vascular risk factor for age-related cognitive decline.
HOW CAN YOU HELP?
The BHAM program team seeks to better serve the Birmingham-metro area, Alabama, and beyond by improving health outcomes through brain health care. You can help us accomplish our goal by:
