Defining Optimal Brain Health in Adults

Authors:
Gorelick PB, Furie KL, Iadecola C, et al.
Citation:
Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association. Stroke 2017;Sep 7:[Epub ahead of print].

The following are key points to remember about this Presidential Advisory from the American Heart Association (AHA)/American Stroke Association on defining optimal brain health in adults:

  1. As life expectancy increases in developed countries and some emerging economies, the prevalence of cognitive impairment and dementia is likely to increase. There is a need for strategies to prevent cognitive impairment and delay cognitive decline to benefit individuals, families, healthcare systems, and society.
  2. Cardiovascular risk factors are associated with cognitive impairment and dementia. Many cardiovascular risk factors are modifiable, and by controlling these factors, it may be possible to maintain brain health and prevent dementia in later life. Randomized controlled trial evidence about preventing cognitive decline and dementia is incomplete; however, observational epidemiological evidence is substantially in favor of modifying key cardiovascular risks.
  3. The advisory group defined optimal brain health as the preserved capacity to “think, move, and feel,” encompassing the ability to pay attention, perceive, and recognize sensory input; to learn and remember; to communicate; to problem solve and make decisions; to have mobility; and to regulate emotional status.
  4. The advisory group selected seven modifiable factors (based on AHA’s Life’s Simple 7) to be used as metrics to define optimal brain health in adults: nonsmoking, goal physical activity, healthy diet, body mass index <25 kg/m2, untreated blood pressure <120/<80 mm Hg, untreated cholesterol <200 mg/dl, and fasting blood glucose <100 mg/dl.
  5. Additional studies are needed to test the influence of these seven factors among different racial and ethnic groups, men and women, and people from different age groups.
  6. In addition, the advisory group designated two primary outcomes – stroke and dementia – and two secondary outcomes – transient ischemic attack and subjective or mild cognitive impairment – for brain health monitoring.
  7. Future areas for study could include intrauterine, early-life, and childhood exposures affecting later-life cognition.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Geriatric Cardiology, Prevention, Lipid Metabolism, Nonstatins, Diet, Exercise, Sleep Apnea

Keywords: Blood Glucose, Blood Pressure, Body Mass Index, Brain, Coronary Artery Disease, Cholesterol, Cognition, Cognition Disorders, Dementia, Diet, Exercise, Fasting, Geriatrics, Ischemic Attack, Transient, Life Expectancy, Primary Prevention, Risk Factors, Stroke, Vascular Diseases


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