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A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association
Open accessAbstract
A healthy brain is critical for living a longer and fuller life. The projected aging of the population, however, raises new challenges in maintaining quality of life. As we age, there is increasing compromise of neuronal activity that affects functions such as cognition, also making the brain vulnerable to disease. Once pathology-induced decline begins, few therapeutic options are available. Prevention is therefore paramount, and primary care can play a critical role. The purpose of this American Heart Association scientific statement is to provide an up-to-date summary for primary care providers in the assessment and modification of risk factors at the individual level that maintain brain health and prevent cognitive impairment. Building on the 2017 American Heart Association/American Stroke Association presidential advisory on defining brain health that included “Life’s Simple 7,” we describe here modifiable risk factors for cognitive decline, including depression, hypertension, physical inactivity, diabetes, obesity, hyperlipidemia, poor diet, smoking, social isolation, excessive alcohol use, sleep disorders, and hearing loss. These risk factors include behaviors, conditions, and lifestyles that can emerge before adulthood and can be routinely identified and managed by primary care clinicians.
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“Eight guidelines explicitly stated that they were prepared by, or in consultation with, people working in primary care [36, 45–51].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [45]
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“For age, some guidelines targeted patients spanning midlife and late life [37, 38, 49, 51, 52], or across the life course [45, 47].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [45]
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“Guidelines recommending the management of risk factors typically suggested that healthcare professionals follow existing clinical guidelines for individual risk factors [2, 45, 51–53, 57].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [45]
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“It would technically be possible to follow five of the included guidelines without ever mentioning dementia to patients [38, 45, 52–54].”
From Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework (2022) · cites this paper as [45]
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Metadata
- Authors
- Lazar, R. M., Howard, V. J., Kernan, W. N., Aparicio, H. J., Levine, D. A., Viera, A. J., Jordan, L. C., Nyenhuis, D. L., Possin, K. L., Sorond, F. A., White, C. L., & on behalf of the American Heart Association Stroke Council
- ORCID
- Venue
- Stroke
- Published
- 2021-06
- Volume
- 52
- Issue
- 6
- Pages
- e295-e308
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC8995075
- OpenAlex
- W3138548852
- Cited by
- 109
- References
- 155
- Citations by year
- 2026: 29 · 2025: 22 · 2024: 21 · 2023: 17 · 2022: 12 · 2021: 8
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (U10NS086728, UH3NS105557, L30 NS093634, U24NS107223)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- brain health, cognitive decline, cognitive impairment prevention, primary care, modifiable risk factors, Life's Simple 7, depression, hypertension, physical inactivity, diabetes mellitus, obesity, hyperlipidemia, unhealthy diet, smoking, social isolation, excessive alcohol use, sleep disorders, hearing loss, aging
- MeSH terms
- American Heart Association, Brain, Health Status, Humans, Hypertension, Primary Health Care, Quality of Life, Risk Factors, Social Isolation, United States, Practice Guidelines as Topic, Stroke, Risk Reduction Behavior, Cognitive Dysfunction
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