- The American Heart Association (AHA) have outlined a list of factors that primary care clinicians should take into consideration when looking after their patients’ brain health.
- The guidelines now name 13 crucial factors that affect the maintenance of cognitive abilities.
- All of these factors are modifiable, meaning that individuals have control over them and thus are able to improve their own brain health under the guidance of their healthcare practitioner.
When they think about brain health, people may often worry about conditions such as Alzheimer’s disease, the most common form of dementia, which an estimated 6.2 million older adults in the United States are living with in 2021.
The risk of neurodegenerative conditions should not be the only reason to look after our brains throughout our lives, though.
As we age, our brains naturally age with us, leading to effects such as patchy memory and reduced brain mass.
However, there are ways to help keep the brain “in shape” for longer and slow down its inevitable aging. There are also some key factors that influence how healthy the brain remains throughout life.
There is strong evidence that brain health and cardiovascular health are closely connected, so damage to the heart and vascular system can negatively affect the brain.
The AHA came up with Life’s Simple 7 in 2017. This brief guide names seven key factors to look out for when it comes to cardiovascular health.
According to the AHA, hypertension (high blood pressure), high cholesterol, high blood sugar, a sedentary lifestyle, a poor diet, a high body mass index (BMI), and smoking all place cardiovascular health at risk.
However, the good news is that these are all environmental factors that individuals may be able to take steps to modify.
Now, in a new scientific statement that appears in the journal Stroke, the AHA reiterate the importance of these seven factors to maintain the health of not only the cardiovascular system but also the brain.
“Many people think of high blood pressure, type 2 diabetes, and other risk factors as affecting only heart health, yet these very same risk factors affect our brain health,” says Dr. Ronald M. Lazar, Ph.D., the Evelyn F. McKnight Endowed Chair for Learning and Memory in Aging and director of the Evelyn F. McKnight Brain Institute at the University of Alabama at Birmingham School of Medicine.
Dr. Lazar, who is the first author of the scientific statement, also notes, “Patients might be more likely to pay attention to the importance of addressing modifiable risk factors if they understood the links.”
This scientific statement actually provides guidelines for primary care clinicians, instructing them on what to look out for when they advise their patients on maintaining or improving their brain health.
“Primary care is the right home for practice-based efforts to prevent or postpone cognitive decline,” notes Dr. Lazar. He goes on to explain:
“Primary care professionals are most likely to identify and monitor risk factors early and throughout the lifespan. Prevention doesn’t start in older age; it exists along the healthcare continuum from pediatrics to adulthood. The evidence in this statement demonstrates that early attention to these factors improves later life outcomes.”
In addition to Life’s Simple 7, the authors of the statement argue that six other factors are crucial when it comes to brain health.
“Studies have shown that these domains are impacted by factors that are within our control to change. Prevention and mitigation are important because once people have impaired cognition, the current treatment options are very limited,” explains Dr. Lazar.
The authors of the scientific statement write that research has linked depression to dementia and that isolation and loneliness are proven factors that contribute to cognitive decline.
“Excessive and prolonged alcohol use,” they write, “can lead to brain injury through neurotoxicity, nutritional deficiency, neuroinflammation, and changes in neurotransmitter systems.” Neurotransmitter systems ensure communication between brain cells and contribute to communication between the brain and other cells throughout the body.
Poor sleep, which can result from various sleep disorders, also has ties to different forms of cognitive decline. The experts state that many observational studies have confirmed this association, giving the example of research showing that insomnia can contribute to vascular dementia.
In another study, “age-related hearing loss was associated with both cognitive impairment and dementia,” the statement notes.
Experts have also identified a link between less education and cognitive decline. Conversely, a higher level of education appears to help protect and maintain cognitive abilities, and there has even been some evidence to suggest that it might “lead to greater cognitive reserve, which enables people to maintain cognitive function despite brain pathology”.
“Scientists are learning more about how to prevent cognitive decline before changes to the brain have begun. We have compiled the latest research and found Life’s Simple 7 plus other factors, like sleep, mental health, and education, are a more comprehensive lifestyle strategy that optimizes brain health in addition to cardiovascular health,” says Dr. Lazar.
Efforts and interventions with the goal of maintaining brain health are so important, the authors of the statement write, because cognitive impairment can have a strong negative effect on a person’s quality of life.
They also cite data suggesting that as many as 1 in 5 people in the U.S. aged 65 years or older have mild cognitive impairment, which is a risk factor for dementia.
More than anything, however, there is the reality that each of us identifies with our mind, meaning that brain health is one of the most crucial aspects of conscious individual integrity and well-being.
“I’ve given lectures, and what people tell me is: The one thing they do not want to lose during the course of their lives is their mind,” says Dr. Lazar.