Sanjula Singh wants people to know that stroke, dementia, and depression are much more preventable than they might think.<\/p>\n
\u201cThe most common misconception that a lot of people have is that Alzheimer\u2019s or depression or stroke is like a train coming down the tracks,\u201d said Singh, a principal investigator at Massachusetts General Hospital and Harvard Medical School\u2019s Brain Care Labs who has been studying brain disease for years.<\/p>\n
Though genetics plays a factor in developing these illnesses, Singh\u2019s research has helped show<\/a> that up to 80 percent of strokes, 45 percent of all instances of dementia, and 35 percent of late-life depression can be addressed through behavioral changes.<\/p>\n One of the most potent risk factors of dementia, Singh explained, is high blood pressure. Instead of focusing on treating diseases, Singh has aimed to help people avoid them in the first place.<\/p>\n \u201cI think what I communicate is a very hopeful message,\u201d she said. \u201cThere\u2019s so much you have in your own hands that you can do to remain healthy and happy. \u2026 It\u2019s so simple, but I think that\u2019s what makes it so powerful.\u201d<\/p>\n Singh, born to a family of doctors in the Netherlands, originally planned to be a singer-songwriter upon graduating from high school. But after studying at the Codarts Conservatory in Rotterdam, she felt drawn back toward science.<\/p>\n \u201cI loved the creative process, and I also loved solving complex problems. I realized I didn\u2019t have to choose \u2014 I wanted a life that made room for both.\u201d<\/p>\n \u201cThere\u2019s so much you have in your own hands that you can do to remain healthy and happy. \u2026 It\u2019s so simple, but I think that\u2019s what makes it so powerful.\u201d<\/p>\n After traveling around the world, she began at medical school the next year, at first aiming to become a neurosurgeon.<\/p>\n Hoping to make an impression on Bart Brouwers, a neurosurgeon who she thought might have room in his lab, she spent a full night during her first year of medical school trying to memorize his dissertation. He referred her to Gabri\u00ebl Rinkel, a professor of neurology at University Medical Centre Utrecht. Though Singh hadn\u2019t yet taken a course on the brain, Rinkel said she could start working on research that would later become her Ph.D. thesis.<\/p>\n As she navigated medical school in Utrecht, it was the research side that fascinated her most. She spent much of her neurosurgery Ph.D. studying the cerebellar intracerebral hemorrhage, a deadly subtype of stroke in the cerebellum.<\/p>\n The results of her research would eventually result in changes to international treatment guidance for the disease. Though that was a rewarding outcome, she also had the realization that, while her work could help a small group of people, it wouldn\u2019t stop strokes from happening.<\/p>\n \u201cI wanted to be on the forefront,\u201d she said. \u201cI wanted to prevent the suffering.\u201d<\/p>\n She got her first major exposure to some of these modifiable risk factors in grad school while working in the lab of Josh Goldstein, professor of emergency medicine at Harvard Medical School and a co-supervisor along with Rinkel. Her work covered specific neurosurgical topics, but she started seeing how influential modifiable risk factors were \u2014 even for those who had already suffered a stroke.<\/p>\n To learn how to develop questions and conduct analytical research about these risk factors, she took a year to study epidemiology and statistics during a master\u2019s degree at the University of Oxford.<\/p>\n \u201cI came across so many great datasets in which I just saw how much brain disease could be prevented,\u201d she said, \u201cbut I wasn\u2019t sure who was truly leading that work.\u201d<\/p>\n \n80%<\/p>\n \u2014Of strokes are attributable to modifiable risk factors, according to Singh\u2019s research\n<\/p>\n Singh hadn\u2019t planned to return to the U.S. after completing her Ph.D., until Jonathan Rosand, a Harvard professor of neurology and member of her Ph.D. dissertation committee, changed her mind.<\/p>\n During a walk-and-talk, Rosand shared his vision for a new lab focused on preventing brain disease, which would go on to take the name Brain Care Labs.<\/p>\n \u201cI believed in him \u2014 and in what he was building,\u201d Singh said. \u201cI told him, \u2018I want you to be my mentor. Wherever you go, I\u2019ll follow.\u2019\u201d<\/p>\n At the Brain Care Labs, Singh began spending her time exploring brain health and the factors controlling it. In 2022, she was the lead author of \u201cBrain health begins with brain care,\u201d<\/a> an article in The Lancet that called for a rapid response to what major health organizations have called a global brain-health crisis<\/a>.<\/p>\n \u201cAlthough prevention of brain disease is yet to be a focus of primary care medicine,\u201d she wrote, \u201ca crucial opportunity exists to leverage the global acceptance that more than 40 percent of dementia, stroke, and depression cases are attributable to modifiable risk factors.\u201d<\/p>\n With her new colleagues, Singh helped develop the Brain Care Score, a tool for people to gauge how their habits affect their brain health, backed by data collected from hundreds of thousands of adults followed for more than a decade.<\/p>\n Instead of simply predicting disease, the score was designed to help people modify risk factors that can increase the chance of stroke, dementia, and depression. Those risk factors span three domains: physical (e.g., blood pressure, blood sugar, cholesterol), lifestyle (diet, exercise, sleep), and social-emotional (stress, relationships, purpose in life).\u00a0<\/p>\n \u201cIt doesn\u2019t matter where you\u2019re starting. What matters is that you begin. Improving \u2014 even just a little \u2014 is the way forward.\u201d<\/p>\n Singh continues to build upon her research to strengthen the scientific link between modifiable risk factors and brain diseases.<\/p>\n Recently, she and her team identified 17 overlapping factors that affect one\u2019s risk of stroke, dementia, and late-life depression. By knowing and adjusting even one of these factors, people can reduce their risk of suffering from brain diseases long thought to be intractable.<\/p>\n \u201cStart with something small and doable,\u201d Singh said. \u201cThose first steps can create momentum \u2014 and over time, they can lead to powerful change.\u201d<\/p>\n As Singh figures out what causes brain diseases, she\u2019s also working on helping people adjust their lifestyles. \u201cWe know behavior change is really hard,\u201d she said, \u201cand, amongst other things, we know that individual health coaching can actually work.\u201d<\/p>\n