Summary: Brain health is not just a concern for older adults; it is shaped across a lifetime by experiences, biology, and environment. A new scientific statement from the American Heart Association presents a broad framework for understanding how factors from early childhood through late adulthood influence brain aging, stroke risk, cognitive decline and dementia.
Moving beyond conventional cardiovascular risks such as high blood pressure, the statement emphasizes “external” drivers—mental health, sleep quality, the gut microbiome, and social and environmental conditions—as important determinants of long-term brain health.
Key Facts
- Whole-life perspective: Brain health develops over the entire lifespan. Early adversity, chronic inflammation in youth, or prolonged stress can create biological changes that may increase the risk of dementia or stroke decades later.
- Mental-physiological link: Chronic stress, anxiety, and depression produce measurable structural and inflammatory changes in the brain that accelerate cognitive aging.
- Gut-brain axis: The gut microbiome acts as a major regulator of brain health. Beneficial gut bacteria generate immune and metabolic signals that protect the nervous system, while an imbalanced microbiome can promote systemic inflammation.
- Environmental exposures: Air pollution, microplastics, wildfire smoke and other pollutants act like slow-acting neurotoxins. They can injure the blood-brain barrier, provoke inflammation and gradually impair brain cells.
- Sleep as an investment: Sleep builds and restores the brain across life stages. In children it supports development; in adults it clears metabolic waste. Chronic sleep disorders, including sleep apnea, are increasingly recognized as major risks for memory problems.
Source: American Heart Association
Brain health is shaped by more than genetics or events late in life. A growing volume of research shows that mental health, sleep, environment, lifestyle and social conditions all influence how the brain functions and ages.
The American Heart Association’s new scientific statement, “Brain Health Across the Life Span: A Framework for Future Studies,” summarizes current evidence on how lifetime experiences influence neurodevelopment, cognition and risk of stroke and dementia. It highlights opportunities for earlier detection, prevention and intervention to protect brain health at every stage of life.
As the U.S. population ages, the prevalence of conditions affecting memory, thinking, communication and mental health is expected to rise. The number of adults 65 and older is projected to grow substantially over the coming decades, increasing the personal and health system burden of age-related cognitive impairment.
Elisabeth Marsh, M.D., FAHA, chair of the writing group, notes that while managing traditional vascular risks such as blood pressure and cholesterol remains essential, the statement draws attention to nonvascular influences—sleep quality, the gut microbiome, mental health and social conditions—that also affect brain aging. Importantly, the statement emphasizes that brain health can be influenced across the entire life span and that interventions at any age can make a difference.
Factors that affect brain health
Current evidence identifies multiple mental, physical, environmental and social factors that interact across life stages to influence brain development, resilience and degeneration.
- Mental health: Chronic stress, depression and anxiety are associated with inflammation, neuronal loss and impaired neural connectivity. Prolonged psychological stress elevates hormones like cortisol, which over time contribute to vascular disease and metabolic dysfunction that harm the brain.
- Adverse childhood experiences (ACEs): Childhood abuse, neglect, household instability or exposure to substance use and violence can increase the risk of learning and attention problems in youth and raise the likelihood of mental health issues and cognitive decline later in life.
- Chronic inflammation: Long-term inflammation—triggered by infections, persistent stress or other causes—can damage brain cells and cerebral blood vessels. When inflammation occurs early, it may disrupt normal brain development; when persistent in adulthood, it is linked to neurodegenerative diseases.
- Gut microbiome: The gut communicates with the brain through immune signals, hormones and neural pathways. A healthy microbiome produces anti-inflammatory compounds and metabolites that support brain function; an imbalanced microbiome can promote inflammation and has been associated with neurodegenerative conditions.
- Obesity: Excess body fat increases inflammation, alters hormones and damages blood vessels, all of which can undermine brain structure and cognitive performance across the lifespan.
- Sleep: Quality sleep supports neurodevelopment, memory consolidation and metabolic waste clearance. Chronic insufficient sleep or disorders like sleep apnea elevate inflammation and increase the risk of cognitive decline.
- Social determinants: Lower socioeconomic status, limited education, food insecurity, unstable housing and poor access to health care are linked to higher rates of diabetes, hypertension and other conditions that contribute to cognitive decline.
- Environmental exposures: Long-term exposure to air pollution, heavy metals, microplastics and wildfire particulate matter can provoke inflammation, damage brain cells and impair the vascular system that nourishes the brain.
Ways to support brain health
The evidence supports a life-course approach: many aspects of brain health are modifiable through healthier behaviors and better social and environmental policies. Interventions that address mental health, reduce harmful exposures, improve sleep and promote social supports can help build resilience and preserve cognition.
Healthy habits consistent with the American Heart Association’s Life’s Essential 8—regular physical activity, blood pressure and cholesterol control, healthy sleep, no smoking and stress management—are linked to better brain outcomes. Nutrition also matters: Mediterranean-style, plant-forward diets rich in fiber and fermented foods support a beneficial gut microbiome, whereas diets high in processed foods and added sugars can disrupt it. Limiting heavy alcohol or substance use, strengthening social connections and reducing financial stress can further protect mental and cognitive health.
Action for clinicians, policymakers and communities
The statement calls on clinicians, public health leaders and policymakers to promote brain health from before birth through older adulthood. This includes expanding access to mental health screening and services, supporting preventive care that addresses Life’s Essential 8, and investing in research to identify effective interventions across diverse communities.
To accelerate research, the American Heart Association and partners have committed substantial funding to study brain health and cognitive impairment, including programs focused on inflammation’s role in cardiac and neurovascular disease.
Mitchell Elkind, M.D., M.S., FAHA, the Association’s Chief Science Officer for Brain Health and Stroke, summarizes the central takeaway: brain health is a lifelong journey influenced by mental well-being, environment and lifestyle from childhood into late adulthood. Each stage offers opportunities to nurture cognitive resilience and reduce the risk of dementia, stroke and other brain disorders.
This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association’s Stroke Council and several other AHA councils. Scientific statements summarize current knowledge, identify gaps and suggest directions for future research; they are not clinical practice guidelines, which provide specific treatment recommendations.
Co-authors include vice chair Helen Lavretsky, M.D., M.S., and others listed in the published manuscript. Authors’ disclosures are available in the original paper.
Key Questions Answered:
A: No. Early stress increases risk but does not determine destiny. The statement emphasizes that interventions at any life stage—improving sleep, managing blood pressure and cholesterol, addressing mental health and strengthening social ties—can reduce risk and improve long-term brain outcomes.
A: The gut produces immune signals, metabolites and neurotransmitter precursors that influence brain function. A balanced microbiome supports anti-inflammatory pathways; a disrupted microbiome can promote inflammation and metabolic changes linked to neurodegeneration.
A: Chair Elisabeth Marsh highlights sleep and mental health as critically important. High-quality sleep helps clear metabolic waste from the brain, while good mental health prevents chronic stress responses that damage blood vessels and neurons.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The underlying journal paper was reviewed in full.
- Additional context was added by editorial staff for clarity.
About this brain health research news
Author: Amanda Ebert
Source: American Heart Association
Contact: Amanda Ebert – American Heart Association
Image: Image credited to Neuroscience News
Original Research: Open access. “Brain Health Across the Life Span: A Framework for Future Studies: A Scientific Statement From the American Heart Association” by Elisabeth Breese Marsh, MD, FAHA, chair, and colleagues, on behalf of the AHA Stroke Council and partner councils. Stroke. DOI: 10.1161/STR.0000000000000518
Abstract
Brain Health Across the Life Span: A Framework for Future Studies: A Scientific Statement From the American Heart Association
Brain health refers to optimal cognitive, emotional and behavioral functioning throughout life, and cognitive resilience is the brain’s ability to recover after injury. As populations age, maintaining brain health and resilience has become a public health priority. This statement reviews nonvascular physical and psychological variables—including chronic conditions, inflammation, environmental exposures, sleep and the gut microbiome—that influence brain development and neurodegeneration. It evaluates the strength of evidence for biological mechanisms and potential strategies to improve resilience, offering a framework to guide future research.