Your Brain Health Roadmap
- Dr Em Wong
- Mar 24
- 11 min read
Dementia is often called a disease of middle age that doesn’t show up until elderhood. That’s because changes in the brain begin 2-3 decades ahead of the first symptoms. Heart disease is similarly a disease that begins in young adulthood with atherosclerotic plaque quietly building up in arteries, only to manifest with heart attack or stroke in middle age or beyond.
The good news is that prevention studies have repeatedly found that disease trajectories can be shifted through individual lifestyle choices. When it comes to protecting ourselves against clogging of the arteries in the heart and brain, we need to pay attention to how we eat, move, and manage personal risk factors like cholesterol. Everything we do to protect our heart health will also benefit the brain. And we can further protect our cognitive function by improving sleep quality and staying intellectually challenged and socially engaged.
Research consistently shows that up to 45% of dementia cases may be preventable through lifestyle interventions—especially when they are practiced consistently over decades. Our daily lifestyle choices make a difference in long-term brain health but also benefit current cognitive function. So how can we be thoughtful about designing a strategic approach to figuring out what habits actually fit our lives?
Most of us struggle to follow through consistently with self-care
The Brain Health Roadmap is one way to organize your exploration – guiding you to figure out what to try, observing what works and what doesn’t, tweaking as needed. The goal is to incrementally develop brain-healthy routines that feel sustainable over a lifetime.
No one-size-fits-all
While it may seem appealing to be able to follow a simple one-size-fits-all plan that works for everyone, that’s just not how dementia prevention works.
We all have different biological and environmental risk profiles that include factors that range from genetics and family upbringing, to where we grew up. And because we are working to build sustainable habits, individual preferences really matter—from how we move our bodies to what time we go to bed. We each need to be willing to invest time and effort into figuring out what works best for ourselves, through trial and error.
Some folks are sufficiently motivated to take persistent action, by the science alone, while others may feel pressure to be personally responsible for their own brain health. And that makes sense, because knowledge alone is usually not enough to create enduring change. Most of us know what we need to do to take better care of ourselves, yet somehow we struggle to follow through consistently.
Results from the US Pointer Study as published in JAMA last year showed us the benefits of an intensive approach to a combination of lifestyle interventions—including physical and cognitive exercise as well as adherence to the MIND diet.
Researchers comprised a group of 2,100 participants aged 60-79 who were identified as being at risk for dementia. Their risks included being sedentary and having suboptimal diets, as well as having either family history for dementia or being at risk for heart disease or diabetes. Half the group were randomly assigned to the structured intervention program, and the other half was the self-guided control group.
The structured program group received intensive intervention through group sessions, nutritional coaching, and activities to support accountability. They had 38 team meetings and 33 other contact points, for a total of 71 contact points. By contrast, the self-guided control group only received five team meetings over the two-year study period.
Brain health sums up to whatever we have going on in our bodies
Published results showed that structured program participants had better cognitive test scores compared to the self-guided control group (see orange dots vs black triangles in Fig. 1 below). These trial results confirmed findings from other studies, looking at a holistic approach to dementia prevention involving a combination of multiple lifestyle domains.
While that confirmation was reassuring, I was amazed to learn what happened to the self-guided control group. The return on investment for control group participants was truly impressive! They managed to improve cognitive function on their own, with hardly any professional help or intervention.
The message here is both compelling and empowering, because it shows us that we can mostly do these lifestyle interventions on our own—with just a little bit of support.
The trick is to figure out what “a little bit of support” looks like, because it will be different for each of us.
Some may find it helpful to listen to podcasts or read books, while others may prefer to attend workshops or classes. I’ve developed the V100 (Vibrant to 100) Health Plan to provide a set of practical tools to support a DIY approach to improving brain health. These tools help us to design and implement our personal roadmap to better brain health.
Building your brain health roadmap
Let’s start by discussing the Brain Health Roadmap. The roadmap is a tool that helps us to lay out all the different components of evidence-based lifestyle intervention—including nutrition, exercise, sleep, stress resilience, social connection, cognitive training, and meaning. We each get to choose what areas we want to explore and when. There’s absolutely no rush. It’s simply important to know that a DIY planning tool exists for us, whenever we’re ready in future.
I encourage you to meet yourself where you are on this journey, without judgment. Perhaps you’ve already done a lot of research and have everything all dialed in. Or maybe your life feels super-crazy at the moment, and you aren’t yet ready to begin. Chances are you’re already doing a lot to take care of your brain health, and the last thing you need is yet another thing to stress out about.
A key skill for long-term brain health is learning to build our stress resilience, which requires us to be mindful of what drains our energy. Notice what happens to your stress level when you think, “We are all just doing our best, when it comes to self care,” as opposed to, “I should be doing better.”
Taking the Brain Health Quiz is an ideal place to start. It will give you a sense of how you’re feeling about the different components of a brain-healthy lifestyle and how to move forward.
The 3 key pillars for body and brain health are:
Eat
Move
Sleep
We start here, because these are the areas where the scientific evidence is strongest for dementia prevention. Focusing on these basics will yield the most immediate gains in cognitive function and productivity, so it makes sense to lay out our roadmap by choosing which of these 3 areas to target first.
I recommend following your intuition when deciding where to begin. There is no wrong answer, because you can always change your mind, or choose to circle back and revisit any given area.
And if you don’t have time to plan things out systematically just now, that’s okay. It turns out that most of our daily habits connect back to brain health, because brain health sums up to whatever’s going on in our bodies. So feel free to dive in at random to explore that which strikes your fancy at the moment.
The V100 Brain Health Plan is about learning to take back authority over your body and brain health, which means relearning how to tune into your body’s signals.
Our bodies have an innate intelligence and healing properties that are tied into sensitive inner signalling systems. Unfortunately, we spend too much of our lives doubting our own judgment and thinking that experts know better than we do. The reality: While experts may be informed by research or clinical experience, you are the authority of your own body and brain. Only you have access to the insider information from your body’s signals.
The V100 Brain Health Toolkit
The V100 Brain Health Toolkit is designed to help you reflect on what matters most for your body. Using those values to guide our choices rather than acting on autopilot. The tools help you rewire lifestyle habits through your brain’s neuroplasticity, helping you remove obstacles through Mindset Dexterity and tune into your personal dashboard through Feelings Fluency.
Neuroplasticity - The first step in rewiring habits through neuroplasticity is to become aware of existing autopilot habits. We begin by noticing which habits we like and want to keep doing. For example, you probably have daily habits that run on autopilot (like brushing your teeth). Maybe you like how clean and fresh your mouth feels after brushing. Brushing reduces gum inflammation and periodontal disease, which in turn lowers the risk of cognitive decline and dementia. So connecting the dots between brushing and brain health could make that habit even stickier. Now, we get to feel good about taking care of our brain, as well as our teeth.
Habit change can be approached with curiosity as n-of-1 experiments. N-of-1 experiments are where you are the scientist, as well as the lab rat. You get to design and explore different parameters around the new habit, while also observing your own response. For example, let’s say that Sally decides she wants to get up earlier in the morning so she can walk before work. She sets her alarm for 30 minutes earlier than usual. The first morning, she wakes up with her alarm and enjoys a brisk morning stroll. But the next day, she hits the snooze button when her alarm goes off and tells herself she’ll walk later in the week. Sounds familiar?
In Sally’s n-of-1 experiment, she needs to decide how to tweak her experiment, which depends on whether she considers the walking or getting up early part as being more important. If she’s habitually going to bed too late and chronically sleep deprived, getting more sleep may actually be more beneficial to her overall health. And so it may make sense to tweak her experiment by working on going to bed earlier or shifting her exercise to later in the day (like during her lunch break).
Mindset dexterity - Hitting the snooze button can feel like an impossible habit to break, but notice how believing, “It’s impossible to break this habit!” is a habitual thought. Fixed beliefs or mindsets are thoughts that have been repeated so often that they have become automatic. So creating new habits requires us to explore habitual thought patterns as well as habitual behaviors.
Mindset dexterity begins by gently examining beliefs to see what other thoughts and habits might be linked, keeping us stuck in a kind of familiar and automatic comfort zone. Maybe when growing up, Sally would get in trouble for sleeping through her alarm and getting to school late, so now she feels like it’s fun and rebellious to have the luxury of hitting snooze. Perhaps Sally and her friends believed that cool people stay up late and only ‘nerds’ get up early.
We play the long game with brain health through caring attention
Shifting mindset often requires an incremental approach, so rather than jumping to a new belief like, “It’s easy to get up without hitting the snooze button.” Sally could try to shift her mindset to an intermediate belief like, “It’s sometimes possible to get up without hitting the snooze button.” In order for this intermediate belief to feel true and believable to her, she would need to recall times when she got up without hitting the snooze button.
The last time Sally woke up without hitting snooze was when she was excited about going on a camping trip. She remembers waking up right away after the alarm went off. That memory gives Sally some clues about structuring her morning so that she can look forward to waking up, instead of dreading it. Was she looking forward to camping because she loves the outdoors or because she was going to see her friends? In her n-of-1 experiment, Sally might decide to get a neighbor to walk with her. Or she could try charging her phone next to the coffee machine, so that when she gets up to silence the alarm she can also look forward to having coffee.
Facilitating self-care is about building systems of reward, rather than punishment. Motivation that’s driven by fear is temporary at best. We want to play the long game with brain health through caring attention. I call this, “momming your brain” or taking care of your brain the way that a good mom would.
Whatever is sustainable is what wins the day, when it comes to rewiring neural pathways through repeated action.
Feelings fluency - Our bodies are constantly signalling to us all day, every day—often just in whispers and nudges—like the nagging ache between the shoulder blades. But most of us have been socialized to override these signals. We ignore that ache or put off going to the bathroom, because we’re “too busy right now.” We’ve been trained to sideline our bodies in favor of convenience or productivity.
It turns out that our body’s signals provide incredibly valuable data to help us in our n-of-1 experiments. These signals comprise a kind of personal dashboard or instrument panel, giving us intel that only we are privy to – intel like your alertness, energy or stress levels.
Instead of judging our body or trying to control it, we can learn to treat our creature selves as a child or beloved pet, with curiosity and care. Our body’s creature component communicates its needs in whispers that we can only hear if we’re paying close attention. Those whispers will become shouts, if we ignore them for long enough. The problem then is that they become much more difficult to manage—as that ache becomes pain that interferes with our ability to function. The goal is to build a working dialogue with our bodies so that we don’t ever have to get to that point.
Feelings fluency is simply about re-learning how to tune in to what the body is saying to us, and deciding how to respond. Maybe a little stretching could help that back pain. Suppressing the urge to pee can be completely legitimate when you are driving on a freeway and are looking for a rest stop.
The V100 Brain Health Toolkit is designed to help us reshape lifestyle habits by tapping into our brain’s natural ability to change and adapt, by building flexibility into how we think, so obstacles don’t derail us. We can learn to tune in to our body’s signals, using them to inform better lifestyle choices.
Because knowledge only isn’t sufficient to create lasting lifestyle habits, a bit of structure can help us to follow through on our best intentions. That’s how building lasting lifestyle change begins to feel habitual as each day becomes filled by mindful moments as we observe the miracle of our own bodies and brains at work.
Dr Em coaching tips
Take a sheet of paper and write “Point A - age ___” (insert your age) on the top line. Draw an arrow across to the right and write “Point B” (being healthy of mind and body at age 100). Now, fold your paper down the middle lengthwise.
On the left side of the page, write down a list of obstacles that come up for you as you think about what it would take to get from Point A to Point B. (For example: “no time to work out” - “can’t walk right now until my knee gets better” and so on.) Write for at least 3 minutes.
Now, on the right side of the paper, across from those obstacles, brainstorm potential solutions to try. They don’t have to be practical, or even logical, but the more you come up with, the better. (e.g. For “no time,” try, “Take 5 minutes to walk up and down the stairwell at the office during water break.” Or, “Get a dog, so I can walk with her each morning and evening.” For “knee pain.” try, “Google swimming pool locations near work or school.” Or, “Try riding my daughter’s bike for fun.”) Anything goes!
On a separate sheet of paper, write down whatever judgments or feelings come up for you as you are doing this exercise. (For example: “This feels weird.” - “That’s lame.” - “I’m already stretched to the max and barely hanging in here.”)
Next, read each of these judgments and feelings aloud, as if you were hearing your best friend say them to herself. What would you say to her in response?
If you were to design your own brain health roadmap, where would you want to start? Would you choose one of the 3 key pillars (eat, move, sleep)? Why or why not? How would you lay out other key brain-healthy lifestyle components (e.g.. cardiometablic risk factors, social connection, cognitive training, purpose)?
For more catered help, take my free Brain Health Check (here). You’ll learn about your current brain function and personal risk factors for dementia and get personalized recommendations based on your answers.
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