‘Prevention doesn’t start in older age’

This scientific statement actually provides guidelines for primary care clinicians, instructing them on what to look out for when they advise their patients on maintaining or improving their brain health.

“Primary care is the right home for practice-based efforts to prevent or postpone cognitive decline,” notes Dr. Lazar. He goes on to explain:

“Primary care professionals are most likely to identify and monitor risk factors early and throughout the lifespan. Prevention doesn’t start in older age; it exists along the healthcare continuum from pediatrics to adulthood. The evidence in this statement demonstrates that early attention to these factors improves later life outcomes.”

In addition to Life’s Simple 7, the authors of the statement argue that six other factors are crucial when it comes to brain health.

These factors influence cognitive ability over time. They are depression, social isolation, alcohol use, sleep disorders, insufficient education, and hearing loss.

“Studies have shown that these domains are impacted by factors that are within our control to change. Prevention and mitigation are important because once people have impaired cognition, the current treatment options are very limited,” explains Dr. Lazar.

The authors of the scientific statement write that research has linked depression to dementia and that isolation and loneliness are proven factors that contribute to cognitive decline.

“Excessive and prolonged alcohol use,” they write, “can lead to brain injury through neurotoxicity, nutritional deficiency, neuroinflammation, and changes in neurotransmitter systems.” Neurotransmitter systems ensure communication between brain cells and contribute to communication between the brain and other cells throughout the body.

Poor sleep, which can result from various sleep disorders, also has ties to different forms of cognitive decline. The experts state that many observational studies have confirmed this association, giving the example of research showing that insomnia can contribute to vascular dementia.

In another study, “age-related hearing loss was associated with both cognitive impairment and dementia,” the statement notes.

Experts have also identified a link between less education and cognitive decline. Conversely, a higher level of education appears to help protect and maintain cognitive abilities, and there has even been some evidence to suggest that it might “lead to greater cognitive reserve, which enables people to maintain cognitive function despite brain pathology.”