Preventive Neurology

Photo by sk on Unsplash The stress response is hardwired into the primate genome. Clearly, the acute stress response is critical for the survival of the fittest. In comparison, a chronic stress response comes at a price. Some people like to think of stress as some subjective phenomenon that you measure on a Lickert scale from 0 (no stress) to 7 (severe or intolerable stress). However, the stress response is biological with glucocorticoid production being the biomarker of choice for measuring stress; i.e. the area-under-the-cortisol-curve over time is how we measure chronic stress. In the field study below of female baboons, chronic glucocorticoid exposure predicted life expectancy. A hypothetical female who maintained glucocorticoid levels in the top decile for her age across adulthood would be expected to lose 5.4 years of life relative to a female who maintained glucocorticoid in the bottom decile for her age. With the life expectancy of the average baboon being 35-45 years of age ...

"What is it that one wants to achieve?" 'Traditionally preventive medicine is a combination of medical practices that are designed to avoid disease and illness. It is a proactive approach to patient care with the aim of using evidence-based preventative measures to ensure that any sickness is minimised and detected early so that a patient has the best chance of recovery to optimum health.' This definition is based on a medicalised worldview of preventive medicine. Why can't we use social or political practices to avoid disease and illness? Surely the aim is better population health and is not necessarily about the individual? A healthier population will have a better quality of life, less need for healthcare and in theory should be happier and more content than an unhealthy population.  I have been criticised for jumping onto the social determinants of health bandwagon now that it is a hot topic. I counter this by stating that it is only a hot topic because COVID-...