# Megatrends One Year Later – #13: Brain and Cognitive Health – What I Predicted, and What’s Actually Happening
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“What we did for heart health in the 20th century, we will be doing for brain health in the 21st.” - Futurist Jim Carroll One year ago, in July 2025, I published Megatrend #13: Brain and Cognitive Health as part of my 30 Megatrends series. Time to grade myself. The number underneath this whole megatrend hasn't moved in the right direction: the global 60-and-over population is still on pace to roughly double to 2.1 billion by 2050, and the dementia projections have actually gotten worse, not better — updated modeling now puts cases at around 153 million by 2050, up from the 139 million estimate I cited a year ago, with a cumulative economic burden approaching $14.5 trillion. That's still the real headline, market-size charts aside. Against that backdrop, the four approaches I named are each moving. Brain-computer interfaces had their most consequential regulatory year yet: China approved the world's first commercial BCI medical device in March 2026, Neuralink's PRIME study has now implanted around 21 people across four countries, and Motif Neurotech got FDA approval in April to begin its RESONATE feasibility study. Focused ultrasound — the pillar that gets the least press — quietly proved out blood-brain-barrier opening as a delivery method: safety trials show the barrier reliably reopens and reseals within three days, Alzheimer's biomarkers showed up in blood afterward, and a six-patient follow-on trial begins this August. Digital therapeutics and lifestyle-intervention programs remain the least glamorous pillar, still assembling into the biomarker-to-public-campaign pipeline I compared to the heart-health playbook — real, but a decade behind the neurotech headlines. Verdict: Underway, but the urgency is outrunning the interventions. The tech pillars are genuinely advancing; the demographic wave they're supposed to meet is arriving faster than any of them will scale.

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Source: https://jimcarroll.com/2026/08/megatrends-one-year-later-13-brain-and-cognitive-health/