Is An Online Brain Health Check-Up For You?
My takeaways (and surprises) from enrolling in BetterBrain
A few months ago I went in for my first brain health check-up. I’ve been excited to tell you about it ever since! I wasn’t having thinking or memory problems, but given my mom’s diagnosis of Alzheimer’s I know I am at increased risk. This was purely a baseline evaluation of how healthy my brain is now, with some tests to determine if I have any factors that could increase my risk of dementia later.
It was easy, fun even! I had my blood drawn for a long list of biomarkers and did the rest of the assessment online. This included a quick cognitive test, a medical and family history form, and evaluations that covered everything from alcohol to menopause to sleep. Then I met with a brain health expert from the company—BetterBrain—to go over my results and take action on anything that was off. I had been doing some research on BetterBrain to see if it’s a company I would recommend to BHK subscribers. So when the company’s founder Cedric Gousseau contacted me to check out their program, I jumped at the chance for a free trial.
How is my brain, you may be wondering? Well, there were a few surprises! For today’s newsletter, I’ll walk you through how an online brain health check-up works, and how I am using my results to reduce risk factors for Alzheimer’s. Paying subscribers, I have a discount code for you, too (just after the paywall), in case you want to try it for yourself.
But first, isn’t it curious that having a brain check-up is not a routine thing?
The case for having a brain health check up
I see the dentist twice a year for cleanings, get my mammogram each fall, and see my family medicine and dermatology physicians annually, too. This year, I’ve added a trip to the audiologist to my health care prevention plan given the link between hearing loss and dementia. But when it comes to brain health, people don’t usually seek out screening unless they are having symptoms.
That’s crazy because we already know that it is far better to detect and treat cognitive problems as early as possible. Consider this:
Alzheimer’s starts in the brain 20 to 30 years before symptoms are apparent.
Alzheimer’s goes through a “preclinical” stage that lasts years. During this time, biomarkers like amyloid and tau protein are on the rise in the absence of symptoms of cognitive impairment.
Treating Alzheimer’s with medication in middle or late stages—when most people seek care—has been largely disappointing.
Treating early stage Alzheimer’s, such as mild cognitive decline, however, is promising. The TRAILBLAZER-ALZ 2 Randomized Clinical Trial showed that using donanemab, a drug that removes amyloid from the brain, significantly slowed clinical progression in those with MCI by 76 weeks. Now, researchers are looking at treating those who are at high risk for Alzheimer’s before symptoms appear.
In 2025, lifestyle intervention programs are more promising than drugs, as we saw with Dr. Dean Ornish’s clinical trial: a statistically significant number of participants with MCI were able to improve their cognitive function after a 20-week program of a brain healthy diet, exercise, stress mitigation, and community support.
People who carry one or two copies of ApoE4, an Alzheimer’s risk gene, can reduce their risk with lifestyle interventions; the earlier in life this happens, the better their outcomes.
Even though we have all of this knowledge of how dementia develops over decades, it’s still not commonplace to have a brain health check-up just to be proactive about brain health. This is starting to change thanks to online programs like BetterBrain.
My BetterBrain Check Up
In my BetterBrain dashboard, I am able to see the results of my assessment under these brain health categories: cognitive reserve, gut health, hormonal, mental health, and others. My cognitive reserve assessment, for example, included questions about my educational backgrounds, hobbies, and whether I spoke more than one language. My musculoskeletal health was determined by how many push-ups I can do in a row. We’ve talked a lot here on BHK about the importance of staying strong with age and how getting enough dietary protein may help fend off dementia.
I was relieved to see that most of my factors were in the green, or at an optimal level. But still, there were a few things marked yellow and orange, meaning there was room for improvement. Here’s what I learned:
My folate level is borderline low. Folate comes from eating vegetables, especially leafy green vegetables. Since I eat a generous salad every day, this one surprised me!
My homocysteine is borderline high, which puts me in the orange for inflammation. This also surprised me, as I have tested low for this biomarker in the past.
At first I was concerned that these biomarkers were out of the normal range. Then I deduced, with the help of the BetterBrain team, that my body has difficulty methylating B vitamins. This glitch in metabolism prevents folate from being converted to its active form, which in turn leads to a build-up of homocysteine. This is important for brain health because elevated homocysteine levels have been associated with poor cognitive aging and lower brain volumes over time.
Fortunately, this is one genetic glitch that is easily remedied by taking a supplement for methylated B vitamins. After three months of taking my methylated Bs, I’ll go back to BetterBrain and get retested. In fact, the program is designed to be an ongoing assessment rather than a once a year check up—each brain health factor is followed by science-backed recommendations, and a repeat check every few months. It’s a brilliant way to stay on top of one’s overall brain health.
Checking the p-Tau blood test
BetterBrain offers the p-Tau blood test as an optional add-on to the brain health check-up. As I’ve written about before, p-Tau is a highly accurate blood test for detecting the buildup of amyloid and tau proteins in the brain. It’s an important breakthrough in the very early diagnosis of impending Alzheimer’s—it can be detected in the blood up to 20 years before symptoms are apparent. A positive p-Tau is not diagnostic of Alzheimer’s, and a negative one doesn’t mean you’re totally in the clear. But p-Tau is a biomarker that can be reduced with brain-healthy lifestyle interventions. Learn more in this post:
To be clear, BetterBrain doesn’t aim to diagnose and/or treat brain health problems
It’s an assessment that can be used to bring any risk factors to light, while providing a clear path for brain health improvement. Ideally, participants would share the results with his or her health care team, and possibly use it as a conversation starter about brain health.
Even though I mostly enrolled in BetterBrain because I was curious to see if it would be a valid recommendation for you, the BHK subscribers, I’m grateful I was able to learn about my homocysteine level. I am on it! I look forward to seeing this come down, and with it, my risk for developing dementia down the road.
I reached out to BetterBrain for a discount code for paid BHK subscribers. They graciously agreed.