Taking Steps to Better Brain Health: “Now I Have a Plan”

By now you know: better sleep, exercise, a Mediterranean diet, meditation, and more lifestyle changes (see Dr. Tanzi’s SHIELD plan) can improve brain health. But what if your family history includes risk of Parkinson’s or dementia?

Recently, when 78-year old Allen* began having occasional word-retrieval issues, his genetic risk and experience working in medicine and psychiatry spurred him to visited the McCance Clinic to get the full picture. He hoped that despite his family history, he could learn what steps to take now to prevent decline, and to improve his acuity today.

We sat down with him recently to talk about his experience at the McCance Clinic, as well as follow-up steps he’s taken since his initial visit.

What was the original impetus for your visit?
Well, from time to time, I had found myself searching for words. This isn’t like me. I’m in great health, I’m devoted to exercise, and I’m still active professionally, despite my 78 years, in a field where I need to be sharp.

I was concerned, because my father had dementia and Parkinson’s, as did one of his brothers. I decided to get a comprehensive evaluation. I live more than an hour from Boston, but my family and I have always travelled into the city for anything medically significant, and the McCance Clinic’s mission was directly aligned with what I was looking for – a comprehensive brain health evaluation and follow-up options.

What was your experience when you reached out to the McCance Clinic?
I called at the height of the pandemic in 2021, and was not optimistic about scheduling an appointment quickly, but I was pleasantly surprised. The intake experience was very smooth, and within a month I had my initial evaluation.

What did the evaluation entail?
I knew from my professional background what to expect, but of course I had never been on the receiving end. The evaluation was coordinated by McCance Clinic Medical Director Dr. Zeina Chemali who saw me personally, but there was a team approach that was very well coordinated across the system.

The evaluation process included a mix of virtual and face to face clinical visits. It was the most complete evaluation I could have imagined. The first interview was with Dr. Chemali. She was empathic, clear, and very structured in her approach – it was a terrific interview. She was patient, thoughtful, and made me comfortable to be fully engaged and disclosing in the interview. We walked through the McCance Brain Care Score^™ and there were a lot of lifestyle and medication questions.

Right off the bat she offered preventative suggestions about things I could be doing, or stop doing, that would help my memory problems. She recommended some initial medication changes, and one of my follow-up steps was to see a psychopharmacologist.

What were the next steps in your evaluation?
Next step was a brain MRI to test for any evidence of a disease process. In addition, Dr. Chemali recommended extensive psychological testing, which was excellent. I visited the MGH Multicultural Assessment and Research Center, in Chelsea, to provide an assessment of what was going on in my cognition, and the experience was the most patient and carefully thought-out psychological assessment I could imagine. Again, because of my professional background, I wasn’t necessarily confident to start with but was very impressed.

Where are you today in your journey?
I had a wrap-up meeting with Dr. Chemali where we went over all the findings. She explained everything in a lot of detail – no holding back, no sugar coating. I have a clear understanding of where I stand and what I have to do, and because of the thoroughness and empathic quality of all the interactions I feel confident in what I’ve heard.

From here, I will continue to have follow-up visits every six months, and Dr. Chemali has said she is available to meet any time I need anything, either general neurology or medicine. Dr. Chemali also offered suggestions including a program I plan to start shortly on lifestyle changes. I liked the idea of a science-based, evidence-based course on brain health, with all the elements of behavior: diet, stress management, and more.

It’s not all good news by any means, but I know where I stand and how to best manage my situation. I feel optimistic, and I feel like I have a plan.

*Allen is a pseudonym for our patient, who prefers to remain anonymous.