Brain Health Shaped by Lifetime of Mental, Physical, and Social Factors

Brain health is a lifelong journey shaped by mental, physical, environmental, and lifestyle factors, according to a new American Heart Association scientific statement published in Stroke. The statement, titled “Brain Health Across the Life Span: A Framework for Future Studies,” emphasizes that experiences starting in early life can influence the risk of stroke, cognitive decline, and dementia later in life. Key factors include mental health, adverse childhood experiences, chronic inflammation, gut microbiome, obesity, sleep, social drivers of health, and environmental exposures. The statement highlights that healthy lifestyle habits such as those in the American Heart Association’s Life’s Essential 8—including regular physical activity, healthy eating, adequate sleep, and stress management—can improve brain health throughout life. The aging U.S. population, projected to see a 42% increase in adults 65 and older by 2050, underscores the urgency of addressing brain health. The statement calls on healthcare professionals and policymakers to prioritize mental health screening, expand access to care, and support social conditions that promote brain health. The American Heart Association and the Paul G. Allen Frontiers Group have committed over $43 million through the AHA-Allen Initiative in Brain Health and Cognitive Impairment to advance research in this area.

The writing group, chaired by Elisabeth Marsh, M.D., FAHA, from Johns Hopkins University, reviewed evidence showing that brain health is influenced by factors across the entire lifespan. For example, chronic stress, depression, and anxiety can lead to inflammation and structural brain changes, increasing the risk of memory loss and stroke. Adverse childhood experiences are linked to learning difficulties and later cognitive decline. The gut microbiome and sleep quality also play critical roles. Social drivers such as lower socioeconomic status, limited access to healthy foods and healthcare, and environmental exposures like air pollution and microplastics can harm brain health. The statement urges a shift from solely managing traditional risk factors like blood pressure and cholesterol to also addressing these broader determinants.

Mitchell Elkind, M.D., M.S., FAHA, the Association’s Chief Science Officer for Brain Health and Stroke, noted that every stage of life offers opportunities to nurture brain health. The statement provides a framework for future research and intervention, emphasizing that healthy lifestyle behaviors, improved environmental conditions, and increased social support can reduce the burden of cognitive decline and dementia. The Association’s Strategically Focused Research Network on Inflammation in Cardiac and Neurovascular Disease has also awarded $15 million to study inflammation’s impact on brain health. This comprehensive approach aims to support healthier aging and reduce the personal, emotional, and healthcare system burdens of age-related cognitive impairment.