A new scientific statement from the American Heart Association highlights that brain health is shaped by a range of factors throughout life, from early childhood experiences to sleep quality and social conditions. Published in the Association's peer-reviewed journal Stroke, the statement titled "Brain Health Across the Life Span: A Framework for Future Studies" underscores that genetics and later-life factors are not the sole determinants of brain function and aging.
According to the U.S. Census Bureau, the number of U.S. adults aged 65 and older is projected to increase from 58 million in 2022 to 82 million by 2050, a 42% rise. This aging population is expected to increase the prevalence of brain conditions affecting memory, thinking, and mental health. "As medical and scientific advancements have extended life expectancies, brain health has become increasingly important," said Dr. Elisabeth Marsh, chair of the statement's writing group and professor of neurology at Johns Hopkins University School of Medicine. "The number of people with age-related cognitive impairment is rising rapidly, creating significant personal, emotional, and health care system burdens."
Stroke remains a major concern, now the #4 leading cause of death in the U.S. according to the American Heart Association's 2026 Heart Disease and Stroke Statistics. A 2023 AHA/ASA scientific statement on cognitive impairment after stroke noted that more than half of stroke survivors develop cognitive impairment within the first year, and up to one in three may develop dementia within five years.
The statement identifies multiple factors affecting brain health, including mental health, adverse childhood experiences, chronic inflammation, gut microbiome, obesity, sleep, social drivers of health, and environmental exposures. For instance, chronic stress, depression, and anxiety can cause inflammation and stress-related damage, increasing risks of memory loss and stroke. Adverse childhood experiences are linked to higher risks of cognitive decline later in life. Sleep is described as an investment in brain health, with inadequate sleep and sleep apnea increasing inflammation and cognitive decline risk.
"We’ve long focused on managing risk factors like blood pressure and cholesterol, which remain critical for heart and brain health," said Marsh. "However, this statement spotlights research on external factors like sleep quality, the gut microbiome and social conditions that are also linked to brain health."
Healthy lifestyle habits such as those outlined in the American Heart Association’s Life’s Essential 8—including regular physical activity, controlling blood pressure and cholesterol, healthy sleep, avoiding smoking, and managing stress—can support brain health. Eating patterns like the Mediterranean diet and fiber-rich, plant-based foods also benefit gut and brain health.
The statement urges healthcare professionals and policymakers to prioritize mental health screening, expand access to care, and support social conditions to improve brain health across communities. "Brain health is a lifelong journey, influenced by our mental well-being, environment and lifestyle choices from childhood through late adulthood," said Dr. Mitchell Elkind, Chief Science Officer for Brain Health and Stroke at the American Heart Association. "Every stage of life offers a new opportunity to nurture our brains and minds."
To address the growing burden, the AHA and the Paul G. Allen Frontiers Group created the AHA-Allen Initiative in Brain Health and Cognitive Impairment, committing over $43 million to research. Additionally, the Strategically Focused Research Network on Inflammation in Cardiac and Neurovascular Disease awarded $15 million to study inflammation’s impact on heart and brain health.
