Dr Thomas E Cope [pictured above], who is a consultant neurologist at healthcare centre, Welbeck Cambridge, reminds Business Advice readers about the importance of brain health.
For founders, cognitive performance is not a nice-to-have; it directly affects revenue, hiring decisions, risk management, and long-term strategy. Yet brain health is often treated reactively, only addressed when something starts to go wrong. As with any aspect of business, timing is everything. The earlier you identify and act on potential issues, the more options you have and the better the outcomes tend to be.
Brain health monitoring
There has been a shift toward proactive brain health monitoring. Early identification of vascular wear and tear, or other signs of brain ageing, allows for tailored strategies to maintain brain health, but more importantly, the early detection of neurodegenerative processes like Alzheimer’s disease, which is caused by the build-up of abnormal amyloid and tau proteins in the brain.
One of the most significant developments is the emergence of treatments for Alzheimer’s disease that can slow its progression. While not curative, they represent meaningful progress. But their effectiveness depends heavily on timing, as these treatments work best in the early stages of the disease. Once dementia becomes moderate to severe, the window for meaningful intervention is gone.
Get your timing right
Intervention can be a challenge for founders who act too late, and options are limited. But if they act without proper guidance, they risk making poor decisions. These treatments are currently licensed for people who are already experiencing memory symptoms, not those who are simply at risk, and there are important reasons for this. They can have side effects, require regular infusions, and come with a high financial cost, around £100,000 for a full 18-month course.
Patients also require ongoing MRI monitoring, and even with careful oversight, there is a small but real risk of serious side effects, estimated at around one in 50. For a founder used to weighing investment decisions, this is a classic risk–reward calculation, but one that requires expert guidance.
The danger of data without context
Diagnostic tools are advancing quickly. There is now a blood test for Alzheimer’s disease that can help identify underlying pathology. On the surface, this sounds like a simple solution, but in practice, it is often misunderstood. The test is most useful when there is already a clinical suspicion of Alzheimer’s disease. Used in isolation, particularly in people who are otherwise well, it can create more confusion than clarity.
This is a pattern frequently seen among high-performing individuals: a tendency to seek out data without the framework to interpret it. In business, more data is only useful if it improves decision-making; the same is true in medicine. A common mistake is pursuing scans or blood tests without expert input, assuming they will provide reassurance or early answers. In reality, they rarely do. Without context, results can be misleading, inconclusive, or anxiety-provoking, and often lead to further unnecessary testing. Tests are most useful when there is a clear plan in advance.
Investigating the issues
My view is that a structured, face-to-face clinical assessment remains the most valuable starting point. Understanding the full picture, symptoms, history, lifestyle, and expectations allows for a far more targeted and efficient approach.
In practice, this often means investigating less but doing it more intelligently. For example, in older individuals where the features of dementia are already clear, a detailed clinical assessment may be sufficient to reach a diagnosis. At that point, the focus shifts quickly to what matters most: planning, support, and maintaining quality of life.
In younger individuals or those with milder symptoms, further investigation may be appropriate. This can include MRI brain imaging and targeted biomarker testing, which help clarify the underlying cause and guide next steps. Crucially, these tests are used selectively, not as a blanket screening tool, but as part of a considered strategy.
Another important consideration is that not every founder will choose, or be suitable for, the newer infusible therapies. The cost, time commitment, and potential side effects mean that many decide against them. That is not a failure to act; it is a rational decision based on individual priorities.
There is still a range of established treatments and strategies that can help manage symptoms and maintain function.
Treatments and strategies
Introduced early, these can have a meaningful impact on day-to-day performance and quality of life. These include lifestyle measures such as regular aerobic exercise (getting out of breath for 30 minutes twice a week has excellent evidence for improving brain health), medications to boost neurotransmitters implicated in focus (acetylcholine) and mood (serotonin, noradrenaline), and optimising blood pressure, blood sugar and cholesterol.
A strategic approach
The broader lesson for founders is this: brain health should be managed with the same discipline as any other critical business asset. That means avoiding reactive decisions, resisting the urge to chase quick answers, and focusing instead on informed, expert-led strategy. It also means recognising that early action is not about overreacting; it is about preserving optionality.
If you are over 50 and have concerns about your memory or cognitive performance, seeking a specialist assessment is a highly worthwhile step. It provides clarity, direction, and, in most cases, reassurance. Just as importantly, it ensures that any further decisions, whether to investigate, monitor, or treat, are grounded in evidence rather than assumption.
Founders spend years building businesses designed to last. Applying that same long-term thinking to brain health is not just sensible, it is essential. Because in the end, your ability to think clearly, decide confidently, and adapt under pressure is not just part of the business, it is the business.
Dr Thomas E Cope [pictured above], who is a consultant neurologist at healthcare centre, Welbeck Cambridge, reminds Business Advice readers about the importance of brain health.
For founders, cognitive performance is not a nice-to-have; it directly affects revenue, hiring decisions, risk management, and long-term strategy. Yet brain health is often treated reactively, only addressed when something starts to go wrong. As with any aspect of business, timing is everything. The earlier you identify and act on potential issues, the more options you have and the better the outcomes tend to be.
