Mind Over Moment
The Science of Sticking with It.
We have all heard of the things that we should do to boost our brain health: move more, connect with others, try new activities, sleep well, eat well, and reduce stress. These six pillars fall under the umbrella of modifiable risk factors and are important across the lifespan. But we are not always motivated to prioritize what is good for us because of time, convenience, or what’s going on in our lives. Though it is obvious that it is better to prevent a problem than to treat one, unfortunately, many of us wait until symptoms appear to make health-positive shifts.
Dr. Maiya Geddes aims to address the gap between what we know we should do and what we actually do. Her research program explores how people are motivated to enhance their well-being and quality of life by engaging in things that they themselves want to do.
She is a neurologist scientist at the Montreal Neurological Institute-Hospital (The Neuro) and an associate professor in the Department of Neurology and Neurosurgery at McGill University in Montreal. Dr. Geddes was awarded a grant through Brain Canada’s Future Leaders in Canadian Brain Research program.
Positioned at the intersection of motivational neuroscience and aging, Dr. Geddes’ research looks at ways to make health-positive shifts more sustainable.
Her Future Leaders project aims to understand adherence to behaviour change within a real-world setting. Her project is a collaboration between The Kimel Family Centre for Brain Health and Wellness in Toronto and The Neuro in Montreal, where her team is measuring diet, physical activity, social engagement, and cognitive engagement in order to understand the concept of adherence in a nuanced, community-based environment.
Individuals receive a personalized dementia risk score and then choose different activities that address their values and health goals. Dr. Geddes’ team will objectively measure physical activity and diet and also use brain imaging at different time points to understand what contributes to lifestyle behaviour adherence.
As different people will follow various trajectories in the quantity and nature of their chosen behaviours, this study presents opportunities to understand those variations and the biology underlying decisions and change.
“A big part of what we do is trying to understand the neurobiological mechanisms underlying behaviour change. My thinking behind this is that if we can understand the pathways involved or the neural circuits, positive behaviours can be strengthened,” said Dr. Geddes.
TECHNOLOGICAL ADVANCES & MACHINE LEARNING
Dr. Geddes uses a combination of machine-learning approaches in neuroimaging with behavioural research so that the data generated can take previously correlational or generalizable results to the next level; that is, make inferences about existing individuals or predictions about new individuals.
“We integrate technology and statistical approaches for maximal impact,” explained Dr. Geddes. Machine learning has highlighted new avenues to address research problems and new ways that we might design change inventions. For instance, model-building and subsequent predictions have allowed researchers to shift the focus to individuals from groups and given rise to the possibility of precision medicine, an individually-tailored approach.
WE KNOW THAT ONE SIZE DOES NOT FIT ALL, AND THESE POWERFUL STATISTICAL APPROACHES HELP US TO UNDERSTAND THE BRAIN WITHIN A BODY, WITHIN AN ENVIRONMENT.
MOTIVATING HEALTHY BEHAVIOUR CHANGE
So, what stops us from doing what we know is good for us? Or better yet, what can we do to set ourselves up for success?
It turns out that behaviour change is not merely about individual willpower, it also involves social and environmental influences – context is critical. Although behaviour change has traditionally been about the individual, broader perspectives that examine the effects of our communities and societies are required if we hope to see long-term adoption of healthy behaviours.
A recent study from Dr. Geddes’ lab looked at the behavioural mechanisms of physical activity engagement. The research, which is currently under review at the journal PNAS Nexus, examined brain scans, neuropsychological factors, environmental factors, and social and structural determinants of health among a group of 300 older people within a longitudinal cohort. Her team applied machine learning methods to predict physical activity levels following a cardiovascular event.
“Interestingly, the kinds of factors that turned out to be important for physical activity were both behavioural and neural. There were neural networks important to executive function, including goal-directed behaviour. But there were also interesting contextual factors that emerged, like access to green space, the strength of the social network, and retirement status that predicted physical activity levels,” shared Dr. Geddes.
IMPORTANTLY, SOCIAL ENGAGEMENT OR SUPPORT THROUGH A SOCIAL NETWORK PREDICTED WHO WAS GOING TO BE ABLE TO BE MORE PHYSICALLY ACTIVE.
These findings converge with other emerging data and support the idea of “social prescribing.” Social prescribing refers to connecting individuals to non-medical community-based programs or group activities to enhance healthy behaviours and motivate long-term adoption.
Effective social prescriptions for physical activity could be directly related to increasing movement, like joining a walking group, or instead emphasize social interactions like arts classes and volunteer work. Either way, having a sense of belonging and connection to other people appears to motivate and sustain engagement in physical activity.
PRECISION PREVENTION
The future of dementia prevention lies in tailoring interventions based on individual risk profiles. Dr. Geddes hopes that with technological and research advances, physicians will have the tools to create individualized behavioural targets for each of their patients.
If we can tailor what we do for individuals, and create personalized recommendations, these will be more powerful than population guidelines. Risk factors are unique to individuals, so what individuals need to do to address those risk factors will also be unique.
Identifying individualized targets is a foundational step for promoting health, but to maximize the potential for changes in each person, comorbidities and contextual factors, like sex, gender, and living conditions, need to be addressed as well.
Dr. Geddes’ lab is currently leading a study to investigate how social determinants of health, including sex and gender, might be better integrated in research on aging and neuroscience. This study also aims to provide guidance for researchers on how to recruit more representative samples so that results will apply to broader segments of the population.
Overall, Dr. Geddes and her team continue to investigate whether there are similar mechanisms or a shared set of mechanisms that allows us to change, whether it is stopping addictive behaviours like smoking, or engaging in protective behaviours like physical activity.
Understanding what drives people to act – and creating systems that support positive behaviours – may be the most powerful strategy in the fight against dementia.
Source: Mind Over Matter V21