Dr Richard Horton FRCP FMedSci , editor-in-chief of The Lancet, introduced Professor Carol Brayne CBE, Professor of Public Health Medicine and Co-Director of Cambridge Public Health Interdisciplinary Centre at the University of Cambridge. 

Professor Brayne has pioneered the study of dementia in population. Since the mid-80s Carol’s principal area of research has been longitudinal studies of the health of older people, with a focus on the brain, from a public health perspective. This included pioneering work bringing biology to populations including the creation of brain banks for medical research from population studies.

She also leads The Public Health of Ageing Research Unit, an involved team of specialised dementia researchers whose work includes specific risk reduction trials, studies of ageing and technology, age-friendly cities, plus the impact of ageing and dementia in the populations of low and middle-income countries. A fellow of the Academy of Medical Sciences, Carol was awarded a CBE for services to public health medicine in the Queen’s 2017 Honours.

Professor Brayne's lecture "“The relevance of social and commercial determinants for neurological health: The Lancet Neurology lecture” gave a public health perspective on influences on manifestation of neurological disorders. 

Carol began by thanking her co-authors Sebastian Walsh and Richard Merrick. She put their work in the context of celebrating 20 years of Lancet Neurology, directions of neurological science over that period, and the importance of epidemiology. She highlighted the Global Burden of Neurological Diseases, including changing patterns in stroke, epilepsy and meningitis, and the WHO intersectional global action plan's goals for epilepsy and other neurological diseases.

Carol then discussed societal trends, e.g. increasing ageing and inequalities, as well as climate change, and their significance in shaping neurological disease. She gave example case studies, demonstrating the impact of inequalities on risk and protective factors, supporting the key messages of frameworks for social and commercial determinants of health and tiers of prevention, and the impact of individual behaviour vs policy change. She showed how these determinants cluster and influence our lifecourse and pathways to neurological disease, e.g. stroke, and provided a Framework for brain health optimisation. Carol highlighted the challenges for neurological science in reflecting societal experiences, and meeting Sustainable Development Goals.

Carol concluded by looking to the future, and actions we can take as leaders, mentors and influencers, in clinical practice, teaching and research, to advocate and raise awareness. 

The introduction and closing remarks were given by Professor Gipi Schiavo, IoN Deputy Director, who celebrated Carol's lecture in the context of recent developments in neurological science and public health.

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Image: Professor Gipi Schiavo, Professor Alan Thompson, Professor Carol Brayne, Dr Richard Horton, and Elena Becker-Barroso