Seven steps to keep your brain healthy from childhood to old age

Seven steps to keep your brain healthy from
childhood to old age


September 7, 2017


American Heart Association


A set of
simple steps that promote heart health, called Life’s Simple 7, can also foster
ideal brain health, an expert panel says. Improving your health status with
Life’s Simple 7 may reduce the risk of dementia caused by strokes, vascular
dementia and Alzheimer’s disease.


A healthy lifestyle
benefits your brain as much as the rest of your body — and may lessen the risk
of cognitive decline (a loss of the ability to think well) as you age,
according to a new advisory from the American Heart Association/American Stroke


Both the heart and brain
need adequate blood flow, but in many people, blood vessels slowly become
narrowed or blocked over the course of their life, a disease process known as
atherosclerosis, the cause of many heart attacks and strokes. Many risk factors
for atherosclerosis can be modified by following a healthy diet, getting enough
physical activity, avoiding tobacco products and other strategies.

“Research summarized
in the advisory convincingly demonstrates that the same risk factors that cause
atherosclerosis, are also major contributors to late-life cognitive impairment
and Alzheimer’s disease. By following seven simple steps — Life’s Simple 7 —
not only can we prevent heart attack and stroke, we may also be able to prevent
cognitive impairment,” said vascular neurologist Philip Gorelick, M.D.,
M.P.H., the chair of the advisory’s writing group and executive medical
director of Mercy Health Hauenstein Neurosciences in Grand Rapids, Michigan.

Life’s Simple 7 outlines
a set of health factors developed by the American Heart Association to define
and promote cardiovascular wellness. Studies show that these seven factors may
also help foster ideal brain health in adults.

The Life’s Simple 7
program urges individuals to:

Manage blood pressure

Control cholesterol

Keep blood sugar normal

Get physically active

Eat a healthy diet

Lose extra weight

Don’t start smoking or quit


A healthy brain is
defined as one that can pay attention, receive and recognize information from
our senses; learn and remember; communicate; solve problems and make decisions;
support mobility and regulate emotions. Cognitive impairment can affect any or
all of those functions.

The advisory, which is
published in the American Heart Association’s journal Stroke, stresses
the importance of taking steps to keep your brain healthy as early as possible,
because atherosclerosis — the narrowing of the arteries that causes many heart
attacks, heart failure and strokes — can begin in childhood. “Studies are
ongoing to learn how heart-healthy strategies can impact brain health even
early in life,” Gorelick said. Although more research is needed, he said,
“the outlook is promising.”

Elevations of blood
pressure, cholesterol and blood sugar can cause impairment of the large and
smaller blood vessels, launching a cascade of complications that reduce brain
blood flow. For example, high blood pressure — which affects about 1 in 3 U.S.
adults — is known to damage blood vessels that supply oxygen and nutrients to
the heart and the brain, Gorelick noted. The damage can lead to a buildup of
fatty deposits, or atherosclerosis as well as associated clotting. This narrows
the vessels, can reduce blood flow to the brain, and can cause stroke or “mini-strokes.”
The resulting mental decline is called vascular cognitive impairment, or
vascular dementia.


Previously, experts
believed problems with thinking caused by Alzheimer’s disease and other,
similar conditions were entirely separate from stroke, but “over time we
have learned that the same risk factors for stroke that are referred to in
Life’s Simple 7 are also risk factors for Alzheimer’s disease and possibly for
some of the other neurodegenerative disorders,” Gorelick said.

The advisory also
recognizes that it is important to follow previously published guidance from
the American Heart Association, Institute of Medicine and Alzheimer’s
Association, which include controlling cardiovascular risks and suggest social
engagement and other related strategies for maintaining brain health.

The action items from
Life’s Simple 7, which are based on findings from multiple scientific studies,
meet three practical rules the panel developed in pinpointing ways to improve
brain health — that they could be measured, modified and monitored, Gorelick
said. Those three criteria make it possible to translate knowledge into action
because healthcare providers can assess Life’s Simple 7 elements — like blood
pressure — easily; they can encourage proven, health-promoting steps and they
can gauge changes over time.

The AHA advisory provides
a foundation on which to build a broader definition of brain health that
includes other influential factors, Gorelick said, such as the presence of
atrial fibrillation, a type of irregular heartbeat that has been linked to
cognitive problems; education and literacy; social and economic status; the
geographic region where a person lives; other brain diseases and head injuries.

It is also a starting
point for expanding research into areas such as whether there might be
detectable markers, like genetic or brain imaging findings, that represent a
susceptibiity for cardiovascular or brain illness, Gorelick said. “At some
point in our lives, a ‘switch’ may be getting ready to ‘flip,’ or activate,
that sets us in a future direction whereby we become at-risk for cognitive
impairment and dementia.”

Dementia is costly to
treat. Direct care expenses are higher than for cancer and about the same for
heart disease, estimates show. Plus, the value of unpaid caregiving for
dementia patients may exceed $200 billion a year.

As lives stretch longer
in the U.S. and elsewhere, about 75 million people worldwide could have
dementia by 2030, according to the advisory. “Policy makers will need to
allocate healthcare resources for this,” Gorelick said. Monitoring rates
of dementia in places where public health efforts are improving heart health
“could provide important information about the success of such an approach
and the future need for healthcare resources for the elderly,” he said.

The authors of the
advisory reviewed 182 published scientific studies to formulate their
conclusions that following Life’s Simple 7 has the potential to help people
maintain a healthy brain throughout life.