<p class="first" id="P1">Cognitive function is an important component of aging and
predicts quality of life,
functional independence, and risk of institutionalization. Advances in our understanding
of the role of cardiovascular risks have shown them to be closely associated with
cognitive impairment and dementia. Because many cardiovascular risks are modifiable,
it may be possible to maintain brain health and to prevent dementia in later life.
The purpose of this American Heart Association (AHA)/American Stroke Association presidential
advisory is to provide an initial definition of optimal brain health in adults and
guidance on how to maintain brain health. We identify metrics to define optimal brain
health in adults based on inclusion of factors that could be measured, monitored,
and modified. From these practical considerations, we identified 7 metrics to define
optimal brain health in adults that originated from AHA’s Life’s Simple 7: 4 ideal
health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent
with current guideline levels, and body mass index <25 kg/m
<sup>2</sup>) and 3 ideal health factors (untreated blood pressure <120/<80
mm Hg, untreated total
cholesterol <200 mg/dL, and fasting blood glucose <100 mg/dL). In addition,
in relation
to maintenance of cognitive health, we recommend following previously published guidance
from the AHA/American Stroke Association, Institute of Medicine, and Alzheimer’s Association
that incorporates control of cardiovascular risks and suggest social engagement and
other related strategies. We define optimal brain health but recognize that the truly
ideal circumstance may be uncommon because there is a continuum of brain health as
demonstrated by AHA’s Life’s Simple 7. Therefore, there is opportunity to improve
brain health through primordial prevention and other interventions. Furthermore, although
cardiovascular risks align well with brain health, we acknowledge that other factors
differing from those related to cardiovascular health may drive cognitive health.
Defining optimal brain health in adults and its maintenance is consistent with the
AHA’s Strategic Impact Goal to improve cardiovascular health of all Americans by 20%
and to reduce deaths resulting from cardiovascular disease and stroke by 20% by the
year 2020. This work in defining optimal brain health in adults serves to provide
the AHA/American Stroke Association with a foundation for a new strategic direction
going forward in cardiovascular health promotion and disease prevention.
</p>