In a Pharmacy Times®interview, Beth Malow, MD, MS, FAAN, professor, departments of neurology and pediatrics, Vanderbilt University Medical Center, discussed the impact of climate change on brain health, specifically noting PM2.5 as a potential risk factor for conditions such as stroke, dementia, and autism. She emphasized the pharmacist’s role in helping patients, particularly during extreme heat, which can impact patients if they are taking certain medications. Additionally, Malow also stressed the importance of being educated on climate change and its impacts to help patients better understand and offset any risks that may occur.

She will be moderating the 2025 American Academy of Neurology Annual Meeting event entitled “Climate Change and Brain Health: What Do We Know and What Can We Do?” and will be presenting the session “Advocacy—What Actions can Neurologists Take?”

Pharmacy Times: How does climate change affect brain health overall, and what are the most significant neurological consequences?

Beth A. Malow, MD, MS, FAAN: Climate change affects brain health in multiple ways. We like to talk about, for example, air pollution as a major driver of stroke, dementia, [and] even neurodevelopmental conditions, like autism, have been linked to air pollution. There’s a particle called PM2.5, and it’s particulate matter that can cross the blood-brain barrier; it can get into your lungs, it can get into your blood vessels, so that’s something that we definitely want to highlight.

And then another big area is extreme heat. We know that the planet is warming; what people aren’t always aware of is it’s those heat waves…[they] can be very devastating to people, particularly those who might be taking medicines for certain conditions, like having sleepiness during the day, or they may have narcolepsy, or they may have attention deficit hyperactivity disorder. As pharmacists, we know that some of these medicines can be really powerful, right? And we want to be careful if [patients] are out in the heat that they’re not going to get into trouble with taking a medicine that, [for example,] affects blood pressure [which] could then be worse if they’re in the heat.

Pharmacy Times: How can pharmacists contribute to policy discussions and public health efforts related to climate change?

Malow: I think health care professionals definitely have a role to play. It’s definitely in our lane, meaning that we should feel that we can speak up on behalf of our patients. I think that pharmacists certainly have a role to play in terms of the medications that we use and being careful, particularly—as I mentioned—heat, extreme heat, and some of these stimulants and other medicines. But just more broadly, I think that remembering that pharmacists are health care professionals and they have a lot of interaction with the public, and you have to feel comfortable with what you say. But I think it’s so important because people really trust their health care professionals; we’re a group of high trust, and patients may ask a question about how heat might be affecting their medicines or whatever, and I think it’s totally fine to try to bring up climate if you’re comfortable doing that; it’s definitely in our lane.

Pharmacy Times: Any final or closing thoughts?

Malow: If I wanted to emphasize anything, it would be the importance of educating yourself, understanding what’s going on, trying not to get too nihilistic about it, really trying to keep hope alive, and recogniz[ing] that even if we reduce some emissions, it’s going to make a difference. It’s kind of like the starfish story, where there are starfish on the beach and you can’t throw them all back in the ocean, but if you can throw 1 back, you’ve done something. And it’s like a ripple effect: if everybody throws 1 starfish back in the ocean, we’re going to save a lot of starfish.

I [also] wanted to leave people with 1 website that is free and has a lot of articles on it, and we also have a quarterly meeting. It’s called nichebrainhealth.com, and we welcome you to join and be part of that group and come to our webinars, and literally, you can go [to the website], and there’ll be a button to join. So, we hope to see you there.