Primary care clinics can play an important role in preserving patients’ brain health using the American Heart Association’s Life’s Simple 7 as a guide, as well as addressing six other factors associated with cognitive decline, according to a new American Stroke Association/American Heart Association Scientific Statement. “A Primary Care Agenda for Brain Health,” published recently in the Associations’ journal, Stroke.
Preserving brain health in an aging population is a growing concern in the U.S. An estimated one in five Americans 65 years and older has mild cognitive impairment, and one in seven has dementia. By 2050, the number of Americans with dementia is expected to triple, the statement authors note.
“Primary care is the right home for practice-based efforts to prevent or postpone cognitive decline. Primary care professionals are most likely to identify and monitor risk factors early and throughout the lifespan,” said Chair of the scientific statement writing group Ronald M. Lazar, Ph.D., FAHA, 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. “Prevention doesn’t start in older age; it exists along the health care continuum from pediatrics to adulthood. The evidence in this statement demonstrates that early attention to these factors improves later life outcomes.”
Life’s Simple 7 focuses on seven lifestyle targets to achieve ideal cardiovascular health: managing blood pressure, healthy cholesterol levels, reducing blood sugar, increasing physical activity, eating better, losing weight, and not smoking. The new statement suggests primary care professionals also consider assessing risk factors to address cognitive health. The six risk factors to consider, in addition to Life’s Simple 7, that impact optimal brain health are depression, social isolation, excessive alcohol use, sleep disorders, less education, and hearing loss. The statement lists risk factors for cognitive impairment, prevention strategies, and best practices to integrate brain health prevention into primary care.
“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,” said Lazar, who is also a professor of neurology and neurobiology at the University of Alabama at Birmingham.
The statement uses cognition to define brain health, referring to the spectrum of intellectual-related activities, such as memory, thinking, reasoning, communication, and problem solving that enables people to thrive and navigate the world on an everyday basis. The ability to think, solve problems, remember, perceive, and communicate are crucial to successful living; their loss can lead to helplessness and dependency.
“Studies have shown that these domains are impacted by factors that are within our control to change,” Lazar said. “Prevention and mitigation are important, because once people have impaired cognition, the current treatment options are very limited.”
“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. Patients might be more likely to pay attention to the importance of addressing modifiable risk factors if they understood the links,” Lazar said. “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.”
For more information, visit heart.org.
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