4 Brain Health Questions to Ask at Your Annual Physical

Your annual physical is your chance to ask your doctor questions about your health — and that includes how well your brain is functioning. 

There’s no single lab test that scores cognition. But the familiar markers your primary care physician already tracks (such as A1C, cholesterol and other lipids, vitamin levels and blood pressure) say a lot about your brain health, explains Jasdeep S. Hundal, Psy.D., ABPP-CN, a board-certified clinical neuropsychologist and Director at the Center for Memory & Healthy Aging at Jersey Shore University Medical Center. 

Here’s how your overall health impacts your brain, plus brain health questions to ask at your next physical. 

Why a Healthy Heart Means a Healthier Brain

Your brain is an organ, and like your heart, it needs nutrition, oxygen and steady blood flow, says Adel A. Ahmed Aziz, M.D., FAAN, a cognitive neurologist at the Hackensack Meridian Neuroscience Institute at JFK University Medical Center.

That means the choices that protect your cardiovascular system also safeguard your mind.

Blood pressure, blood sugar and cholesterol are key risk factors for “both vascular and neurodegenerative brain changes,” Dr. Aziz says. In other words, what’s hard on your heart is hard on your brain, too.

And it matters earlier than you’d think. Early-onset Alzheimer’s disease and other dementia cases among adults ages 40 to 64 more than doubled worldwide from 1990 to 2021. The good news: A recent study found that nearly half of dementia cases worldwide are tied to lifestyle factors such as how you move, eat, sleep and socialize, which means a lot of that risk could potentially be prevented or delayed.

How to Turn Your Physical Into a Brain Health Checkup

Book an annual physical with your primary care physician and bring this checklist:

1. Ask about your numbers

Ask your doctor to walk you through your A1C, cholesterol and other lipids, vitamin levels and blood pressure, and treat a creeping number as a cue to act. Manage chronic conditions like hypertension and diabetes closely, Dr. Aziz urges.

2. Bring up brain health directly

Dr. Hundal suggests raising the topic explicitly with your primary care physician starting in your mid-40s to early 50s. Even a simple question works: “Is there anything in my results I should keep an eye on for my brain?”

3. Request a medication review

Ask your doctor to go over your prescriptions every three to six months, especially if you take psychoactive drugs such as stimulants or anticholinergic medications such as benztropine, Dr. Aziz says. That’s because anticholinergic drugs block acetylcholine, a chemical messenger the brain relies on for memory and attention.

4. Talk about your sleep

Sleep apnea is one of the main culprits behind brain fog, forgetfulness and difficulty with multitasking, says Kamal C. Wagle, M.D., a geriatrician at Hackensack University Medical Center. 

If you snore, breathe irregularly at night or wake unrested, ask your doctor about getting a sleep evaluation. 

When Your Numbers Creep Up, Move Fast

Dr. Wagle has followed his own advice. When his blood sugar and cholesterol edged up in his early 40s, he and his wife overhauled their diet, exercise, sleep and stress-relief strategies.

These changes pay off in energy and focus that you’ll feel quickly, Dr. Aziz says, and research shows that people who address lifestyle factors retain more cognitive function as they age.

When It’s Time to See a Doctor

Some forgetfulness is normal aging, Dr. Aziz explains: processing slows and sporadic lapses happen, but your insight and problem-solving stay intact.

With dementia, the person is often the last to notice. Driving, keeping track of medications and following a conversation gradually get harder to manage on your own.

Either way, don’t wait for a big change to say something. Your primary care physician can order tests, adjust medications and refer you to a specialist if needed.

Next Steps & Resources:

• Meet our sources: Adel A. Ahmed Aziz, M.D., Jasdeep S. Hundal, Psy.D.,  and Kamal C. Wagle, M.D.
• Learn more about our primary care services.