[100-Year Brain Health①] Rapid Increase in Brain Diseases, Top Cause is 'Aging'

83% of Stroke Patients Last Year Were Aged 60 and Over
High Mortality Rate and Severe Aftereffects Like Paralysis
Brain Tumor Patients Also Increased by 37% in 5 Years

Hypertension, Smoking, Obesity... Causes Are Diverse
Aging Itself Is Also Cited as a Major Cause

Severe Headache, Dizziness, Speech Impairment
Go to Hospital Immediately if Symptoms Appear
Taking Action Within 3 Hours Reduces Brain Damage

Stock photo of a stroke.

[Asia Economy Reporter Lee Gwan-ju] Since ancient times, death has meant the cessation of the ‘heart.’ However, in modern times, the meaning of death is gradually shifting to ‘brain death.’ Even if breathing continues, if all brain functions are lost, one can no longer live with self-awareness.

In the West, brain death began to be recognized as death from the 1960s, and in Korea, the Korean Medical Association announced the ‘Declaration on Brain Death’ in 1993, defining death as “either cardiopulmonary death, which is the cessation of heart and lung function, or brain death, which is the loss of all brain functions.” Although legal recognition of brain death came after the enforcement of the ‘Organ Transplant Act’ in 2000, the medical acknowledgment of brain death prior to that marked a major turning point in redefining death.

Nearly 30 years later, as we enter the full-fledged ‘100-year life era,’ brain health becomes even more important. However, in reality, various brain diseases continuously attack our brains. Stress, the root cause of many illnesses, and aging itself are cited as major causes.

4th Leading Cause of Death in Korea: Cerebrovascular Disease

The brain, often described as a ‘microcosm’ due to its complexity, has a wide variety of diseases. Over 350 brain-related diseases have been reported in academic circles to date. Among these, cerebrovascular diseases are directly life-threatening. Cerebrovascular disease generally refers to stroke, which is further divided into cerebral infarction and cerebral hemorrhage. Cerebral infarction is a condition where a blood vessel in the brain is blocked, causing brain cells and tissues to die, while cerebral hemorrhage refers to bleeding caused by the rupture of a weak part of a brain blood vessel. In 2020, 21,860 people died from cerebrovascular diseases, ranking fourth among causes of death in Korea after cancer, heart disease, and pneumonia.

The number of stroke patients is increasing every year. According to the Health Insurance Review and Assessment Service, the number rose from 577,689 in 2017 to 620,342 last year, a 7.4% increase. Specifically, there are about 500,000 cerebral infarction patients and 100,000 cerebral hemorrhage patients on average, with cerebral infarction patients being about five times more numerous. Stroke is frightening not only because it can be fatal but also because the aftereffects can be severe. Even after successful treatment, paralysis of limbs, speech disorders, and visual impairments may remain.

Brain Tumors, Mental Illnesses, Degenerative Diseases... Lifelong Threats

While cerebrovascular disease is the leading cause of death, malignant brain tumors (brain cancer) are equally or even more dangerous. Brain tumors refer to tumors that originate in or metastasize to brain tissue or the meninges. They are generally classified as benign or malignant, with benign tumors having a better prognosis than malignant ones. Malignant tumors, especially glioblastoma, known as one of the worst cancers, are practically untreatable. Even benign brain tumors such as astrocytomas, craniopharyngiomas, and tumors in the brainstem or spinal cord are known to be difficult to cure completely. The number of brain tumor patients is also rapidly increasing. The number of benign brain tumor patients rose by 37.1% over five years, from 37,815 in 2017 to 51,842 last year. Malignant brain tumors increased by 6.8% during the same period, from 11,186 to 11,945. Since the causes of brain tumors are not yet fully understood, they remain one of the unconquered diseases. However, ongoing research is gradually uncovering clues about recurrence mechanisms and chemotherapy resistance, and the medical community currently estimates the survival rate for malignant brain tumors to be about 10%.

Modern medicine treats brain diseases and mental illnesses separately, but mental illnesses can also be considered brain-related diseases. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) classifies mental illnesses into 17 categories, including psychotic disorders, mood disorders, and anxiety disorders. The symptoms and severity of mental illnesses vary widely, making it impossible to define them as a single disease, but they are very common. According to the Ministry of Health and Welfare’s ‘Mental Health Survey’ conducted last year, the lifetime prevalence of mental disorders is 27.8% for both men and women combined, meaning that one in four adults has experienced a mental illness at least once in their lifetime. However, only 12.1% of those diagnosed with mental disorders have ever used mental health services, indicating a persistent lack of external awareness and perception of mental illness.

Recently, degenerative brain diseases have attracted the most attention. These diseases involve the progressive death of brain cells and include well-known conditions such as Alzheimer’s, Parkinson’s, Lou Gehrig’s disease, and Huntington’s disease. They are commonly used interchangeably with dementia, but while dementia refers to a symptom, Alzheimer’s and others refer to specific underlying diseases. They are often referred to as ‘Alzheimer’s dementia’ or ‘Parkinson’s disease dementia.’

Various Causes Including Aging and Underlying Diseases

The primary reason for the increase in various brain diseases is aging. Last year, among stroke patients, those aged 60 and over accounted for 517,076 (83.4%). Stroke is more likely to occur in people with hypertension, diabetes, heart disease, hyperlipidemia, or those who smoke, experience stress, or are obese. Hypertension is especially important as a key underlying disease because a sudden rise in blood pressure can cause blood vessels to rupture. Chronic hypertension continuously affects brain blood vessels, and it is estimated that 70-90% of cerebral hemorrhage patients have hypertension.

Fortunately, many brain diseases can be prevented or diagnosed early and treated through regular health checkups and lifestyle modifications. For cerebrovascular diseases, managing underlying conditions is crucial. Blood pressure should be maintained between 120 and 130 mmHg, fasting blood glucose below 100 mg/dL, and body fat within normal ranges. Avoid smoking, drinking, and high-calorie foods that can affect brain blood vessels, and exercise for more than 30 minutes a day is helpful.

Additionally, it is necessary to know the main symptoms and seek prompt diagnosis and treatment if suspicious symptoms appear. The main symptoms of both stroke and brain tumors are similar. These include severe headaches unlike any experienced before, paralysis on one side, dizziness, sudden speech difficulties, double vision, and motor impairments where hands and feet do not move as intended. In the case of ischemic stroke (cerebral infarction), the time taken to diagnose is very important. If diagnosed and treated within the first three hours, the progression of brain damage can be slowed, so prompt action is essential.

Shin Sang-yeop, Senior Research Fellow at KMI Korea Medical Institute, emphasized, “If suspicious symptoms appear, contact 119 as soon as possible and visit a hospital for examination to minimize aftereffects and complications. To prevent stroke, it is most important to manage underlying causes, quit smoking and drinking, and improve lifestyle habits such as regular exercise and weight management.”