The American Heart Association has released a new scientific statement, 'Brain Health Across the Life Span: A Framework for Future Studies,' published in the journal Stroke, highlighting that brain health is determined not just by genetics but by a complex interplay of mental, physical, environmental, and lifestyle factors throughout a person's life.
According to the statement, experiences starting early in life—such as adverse childhood experiences, chronic inflammation, and gut microbiome imbalances—can have lasting effects on brain development and increase the risk of stroke, cognitive decline, and dementia in later years. The statement underscores that these factors are modifiable, presenting opportunities for early detection, prevention, and intervention to protect brain health and support healthy aging.
Dr. Elisabeth Marsh, chair of the statement's writing group and a professor of neurology at Johns Hopkins University School of Medicine, emphasized the urgency: 'As medical and scientific advancements have extended life expectancies, brain health has become increasingly important. The number of people with age-related cognitive impairment is rising rapidly, creating significant personal, emotional, and health care system burdens.'
The U.S. Census Bureau projects that the population aged 65 and older will increase from 58 million in 2022 to 82 million by 2050, a 42% rise. With stroke now the fourth leading cause of death in the U.S., and more than half of stroke survivors developing cognitive impairment within the first year, the need for a life-span approach to brain health is critical.
The statement identifies several key factors affecting brain health: mental health conditions like chronic stress, depression, and anxiety can cause inflammation and structural brain changes; adverse childhood experiences are linked to higher risks of cognitive decline; chronic inflammation from infections or stress damages brain cells; gut microbiome imbalances can increase inflammation; obesity harms brain structure; inadequate sleep disrupts cognitive function; social determinants of health, such as lower education and income, increase risk of hypertension and diabetes; and environmental exposures like air pollution and heavy metals can damage the brain.
To improve brain health, the statement recommends adopting healthy lifestyle habits as outlined in the American Heart Association's Life's Essential 8, including regular physical activity, controlling blood pressure and cholesterol, healthy sleep, avoiding smoking, and managing stress. Following a Mediterranean-style diet rich in fiber and fermented foods supports gut health, while reducing alcohol and substance use and increasing social support can improve mental health.
Dr. Mitchell Elkind, the Association's Chief Science Officer for Brain Health and Stroke, noted: 'Brain health is a lifelong journey... every stage of life offers a new opportunity to nurture our brains and minds, supporting healthier aging.' The statement urges healthcare professionals and policymakers to prioritize mental health screening, expand access to care, and support research into effective interventions for diverse communities.
The American Heart Association and the Paul G. Allen Frontiers Group have committed over $43 million to the AHA-Allen Initiative in Brain Health and Cognitive Impairment to advance understanding and improve lives.
