A new American Heart Association scientific statement published today in the journal Stroke emphasizes that brain health is not solely determined by genetics or late-life events, but is shaped by a combination of mental, physical, environmental, and lifestyle factors across the entire lifespan. The statement, titled “Brain Health Across the Life Span: A Framework for Future Studies,” highlights opportunities for 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 ages 65 and older is projected to increase from 58 million in 2022 to 82 million by 2050, a 42% increase, and their share of the total population is expected to rise from 17% to 23%. This aging trend is expected to increase the prevalence of brain conditions affecting memory, thinking, communication skills, 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 scientific statement’s writing group and a 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 is 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 scientific statement on cognitive impairment after stroke found 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.
The statement examines a broad range of factors affecting brain health, including mental health, adverse childhood experiences, chronic inflammation, gut microbiome, obesity, sleep, social drivers of health, and environmental exposures. For example, chronic stress, depression, and anxiety can lead to inflammation and structural brain changes that increase risk of memory loss and stroke. Children exposed to abuse or neglect may face higher risks for learning difficulties and later dementia. Poor sleep and sleep disorders like sleep apnea are linked to increased inflammation and cognitive decline.
“We’ve long focused on managing risk factors like blood pressure and cholesterol, which remain critical for heart and brain health; however, this statement spotlights research on external factors like sleep quality, the gut microbiome, and social conditions that are also linked to brain health,” Marsh said.
The statement emphasizes that healthy lifestyle habits, such as those outlined in the American Heart Association’s Life’s Essential 8, can support brain health. These include regular physical activity, controlling blood pressure and cholesterol, healthy sleep, avoiding smoking, managing stress, and following a healthy diet like the Mediterranean diet. The 2026 Dietary Guidance also emphasizes fiber-rich foods and fermented foods to support gut health.
The statement urges healthcare professionals and policymakers to prioritize mental health screening, expand access to care, and address social determinants of health to improve brain health across communities. The American Heart Association 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 in this area.
“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 Association’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.”
