Brain health is shaped over a lifetime, not just by genetics or aging but also by a complex mix of mental, physical, environmental, and social factors, many of which are modifiable, the American Heart Association (AHA) said in a new scientific statement.

Experiences starting in early life and continuing throughout life may influence brain health and affect the risk for stroke, cognitive decline, or dementia in later years, the statement notes.

“We’ve long focused on managing risk factors like blood pressure and cholesterol, which remain critical for heart and brain health; however, this statement spotlights research on external factors like sleep quality, the gut microbiome, and social conditions that are also linked to brain health,” Elisabeth Marsh, MD, chair of the writing group and professor of neurology at Johns Hopkins in Baltimore, said in a news release.

“One of the most important messages in this scientific statement is that brain health is shaped across the entire lifespan. What happens early in life can matter decades later, which also means there are opportunities at every life stage to support healthier brain aging,” Marsh said.

The statement was published online on April 28 in Stroke.

Factors That Affect Brain Health

Research has shown that multiple factors such as sleep quality, psychological health, environmental exposures, and social conditions can significantly influence brain aging. For example:

• Mental health conditions such as chronic stress, depression, and anxiety can alter the brain structure and increase the risk for memory loss, dementia, and stroke, as outlined in a 2021 AHA scientific statement on the mind-heart-body connection.
• Adverse childhood experiences, including abuse, neglect, exposure to domestic violence, parental divorce, incarceration, or illicit substance use, have been linked to long-term risks for cognitive decline and mental health disorders.
• Chronic inflammation can damage brain cells and blood vessels over time and has been linked to neurodegenerative diseases such as Alzheimer’s and Parkinson’s diseases.
• The gut microbiome appears to play an important role in brain function, with imbalances linked to inflammation and neurodegeneration.
• Poor sleep can impair memory, increase inflammation, and raise the risk for cognitive decline.
• Social and economic factors, including income, education, and access to healthcare, influence long-term brain health outcomes.
• Environmental exposures such as air pollution and toxins can damage the brain over time and increase dementia risk.

The writing group noted that healthy lifestyle habits, such as regular physical activity, good nutrition, adequate sleep, and stress management, can help protect brain health at every stage of life. Efforts to reduce smoking, limit alcohol use, and improve social support systems are also key components of a comprehensive prevention strategy.

To address the growing burden of age-related cognitive impairment, the AHA and The Paul G. Allen Frontiers Group have created the AHA-Allen Initiative in Brain Health and Cognitive Impairment. The two organizations, along with other contributors, have committed more than $43 million toward research to advance the understanding of brain health and improve lives.

“Brain health is a lifelong journey, influenced by our mental well-being, environment, and lifestyle choices from childhood through late adulthood,” Mitchell S.V. Elkind, MD, AHA chief science officer for brain health and stroke, said in the news release.

“This scientific statement comes at a timely moment, just as the [AHA] is increasing its focus, research, and programming in brain health. The exciting science in this area reminds us that every stage of life offers a new opportunity to nurture our brains and minds, supporting healthier aging and reducing the risk of cognitive decline, dementia, stroke, depression, and other brain disorders,” Elkind said.

This research had no commercial funding. Disclosures for the writing group are available with the original publication.