Care Providers Can Help Preserve Brain Health by Addressing Risk Factors for Cognitive Decline

A new scientific report from the American Heart Association (AHA) highlights how primary care physicians can play an important role in helping to preserve brain health by encouraging healthy behaviors and addressing risk factors associated with cognitive decline, according to a press release.

Outlined in the journal Stroke, there are 7 lifestyle targets and 6 risk factors for brain health that primary care physicians should address in adults of all ages, with this statement being endorsed by the American Academy of Neurology as an educational tool for neurologists.

"Primary care is the right home for practice-based efforts to prevent or postpone cognitive decline," said Ronald Lazar, chair of the scientific statement writing group, in a press release."Prevention doesn't start in older age; it exists along the health care continuum from pediatrics to adulthood. The evidence in this statement demonstrates that early attention to these factors improves later life outcomes."

The statement from AHA asks primary care physicians to integrate brain health into their treatment of adults guided by the AHA’s Life’s Simple 7, which is a collection of lifestyle targets shown to help achieve ideal heart and brain health. This includes managing blood pressure/cholesterol/blood sugar levels, increasing physical activity, and losing weight, according to the press release.

Additionally, the statement asks caregivers to assess their patients’ risk factors for cognitive health, including depression, social isolation, excessive alcohol use, sleep disorders, lower education levels, and hearing loss.

"Scientists are learning more about how to prevent cognitive decline before changes to the brain have begun," Lazar said in a press release. "We have compiled the latest research and found Life's Simple 7 plus other factors like sleep, mental health and education are a more comprehensive lifestyle strategy that optimizes brain health in addition to cardiovascular health."

"For example, lower blood pressure levels reduce the risk of cognitive impairment and dementia in older adults," said study co-author Deborah Levine, MD, in a press release. "In adults of all ages, the metrics in Life's Simple 7 prevent stroke, and stroke increases the risk of dementia by more than twofold."

Levine added that primary care doctors can help their patients reduce dementia risk by identifying and aggressively treating vascular risk factors like high blood pressure.

“Black and Hispanic individuals, women and individuals with lower educational levels appear at higher risk for dementia, so these high-risk groups are a top priority," Levine said in a press release.

The statement notes that recent research shows high blood pressure, diabetes, and smoking in adulthood and midlife increase the odds of cognitive decline in middle age.

"Many people think of high blood pressure, type 2 diabetes and other risk factors as affecting only heart health, yet these very same risk factors affect our brain health," Lazar said in a press release. "Patients might be more likely to pay attention to the importance of addressing modifiable risk factors if they understood the links."

Additionally, the statement defines brain health using the term cognition, which includes memory, thinking, reasoning, communication, and problem-solving. Together, the ability to do these things are crucial to a successful life, with their loss leading to helplessness and dependency, according to the press release.

"Studies have shown that these domains are impacted by factors that are within our control to change," Lazar said in a press release. "Prevention and mitigation are important, because once people have impaired cognition, the current treatment options are very limited."

REFERENCE

Primary care doctors can help preserve brain health. American Heart Association. https://www.heart.org/en/news/2021/03/15/primary-care-doctors-can-help-preserve-brain-health/. Published March 15, 2021. Accessed March 15, 2021.