Brain Health Shaped by Lifetime Mental, Physical, Environmental and Lifestyle Factors, New AHA Statement Says
A new American Heart Association scientific statement highlights that brain health is influenced by a range of factors across the entire lifespan, including mental health, sleep, environment, and social conditions, offering opportunities for early intervention to reduce the risk of stroke, cognitive decline, and dementia.
The American Heart Association (AHA) released a new scientific statement today emphasizing that brain health is determined not just by genetics or later-life factors, but by a complex interplay of mental, physical, environmental, and social influences throughout a person's lifetime. Published in the AHA's peer-reviewed journal Stroke, the statement, titled “Brain Health Across the Life Span: A Framework for Future Studies,” underscores the importance of early detection, prevention, and intervention to protect brain health and support healthy 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 demographic is expected to heighten the prevalence of brain conditions affecting memory, thinking, communication, 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 a professor of neurology at Johns Hopkins University. “The number of people with age-related cognitive impairment is rising rapidly, creating significant personal, emotional, and health care system burdens.”
The statement highlights that stroke is now the #4 leading cause of death in the U.S., according to the AHA's 2026 Heart Disease and Stroke Statistics. A 2023 AHA/American Stroke Association scientific statement noted that more than half of stroke survivors develop cognitive impairment within the first year, and up to 1 in 3 may develop dementia within five years.
While previous research focused on factors damaging blood vessels and reducing blood flow to the brain, the new statement spotlights external factors such as sleep quality, the gut microbiome, and social conditions. “We’ve long focused on managing risk factors like blood pressure and cholesterol, which remain critical,” Marsh said. “However, this statement spotlights research on external factors like sleep quality, the gut microbiome, and social conditions that are also linked to brain health.”
Key factors influencing brain health include 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 change the brain over time, increasing the risk of memory loss, dementia, and stroke. Adverse childhood experiences may raise the risk of learning difficulties, mental health conditions, and cognitive decline later in life. The statement also notes that exposure to air pollution, heavy metals, and microplastics can slowly damage the brain by triggering inflammation and harming blood vessels.
To improve brain health, the statement recommends healthy lifestyle habits outlined in the AHA's Life’s Essential 8, including regular physical activity, controlling blood pressure and cholesterol, healthy sleep, avoiding smoking, and managing stress. A Mediterranean-style diet rich in fiber and fermented foods supports gut health, while avoiding heavy alcohol or substance use reduces risk.
The statement urges healthcare professionals and policymakers to prioritize mental health screening, expand access to care, and address social determinants of health. “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, the AHA’s Chief Science Officer for Brain Health and Stroke. “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.”
The AHA and the Paul G. Allen Frontiers Group have committed more than $43 million through the AHA-Allen Initiative in Brain Health and Cognitive Impairment to advance research. Additionally, the AHA's Strategically Focused Research Network on Inflammation in Cardiac and Neurovascular Disease awarded $15 million to study inflammation’s impact on brain health.