Statement Highlights:
- An individual's brain health is influenced by their psychological health, environment, sleep quality, social conditions and chronic health conditions over a lifetime. Life events and experiences even in early life also affect long-term brain development and brain health.
- Healthy lifestyle habits, such as eating a healthy diet; getting adequate physical activity and sleep; avoiding smoking, heavy alcohol or illicit substance use; and reducing stress, can improve brain health throughout life.
- The new scientific statement identifies opportunities to protect brain health and reduce the risk of stroke, cognitive decline and dementia by promoting healthy lifestyle behaviors, improving environmental conditions, expanding health care access and increasing social support for mental health and well-being.
Embargoed until 4:00 a.m. CT / 5:00 a.m. ET Tuesday, April 28, 2026
DALLAS, April 28, 2026 — Brain health isn't determined only by genetics or what happens later in life. A growing body of research shows that a range of factors—from mental health and sleep to environment, lifestyle and social conditions—play a powerful role in shaping how the brain functions and ages. A new American Heart Association scientific statement highlights how experiences starting early in life and continuing through life may influence brain health and affect the risk of stroke , cognitive decline or dementia in later years, according to a new American Heart Association scientific statement, published today in the Association's peer-reviewed scientific journal Stroke.
The new scientific statement, "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 the 65-and-older age group's share of the total population is projected to rise from 17% to 23%. The aging of the U.S. population is expected to increase the prevalence of brain conditions that affect memory, thinking, communication skills and mental health.
"As medical and scientific advancements have extended life expectancies, brain health has become increasingly important," said the Chair of the scientific statement's writing group Elisabeth Marsh, M.D., FAHA, a professor of neurology and associate director of the neurology residency program at The Johns Hopkins University School of Medicine and director of the Stroke Center at Johns Hopkins Bayview Medical Center in Baltimore. "The number of people with age-related cognitive impairment is rising rapidly, creating significant personal, emotional, and health care system burdens."
According to the American Heart Association's 2026 Heart Disease and Stroke Statistics , stroke is now the #4 leading cause of death in the U.S. A 2023 American Heart Association/American Stroke Association scientific statement on cognitive impairment after stroke highlighted that more than half of people who survive a stroke develop cognitive impairment within the first year after their stroke, and as many as 1 in 3 may develop dementia within 5 years.
Previous research about brain health has considered factors that damage blood vessels and reduce blood flow to the brain, which can increase the risk of developing stroke, cognitive decline and/or dementia. Recent research has also focused on the role of psychological, environmental, lifestyle and social factors, that affect brain health over a lifetime.
"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," said Marsh.
"One of the most important messages in this scientific statement is that brain health is shaped across the entire life span. What happens early in life can matter decades later, which also means there are opportunities at every life stage to support healthier brain aging," she added.
What factors affect brain health?
Recent research shows that numerous mental, physical, environmental and social factors influence brain health across the life span.
- Mental Health: A 2021 American Heart Association scientific statement on the mind-heart-body connection stated that negative psychological factors and mental health disorders can negatively impact cardiovascular health. Over time, chronic stress, depression and anxiety may change the brain in ways that increase the risk of memory loss, dementia and stroke. These physiological and structural changes may include inflammation, stress-related damage, and loss of brain cells and connections. Long-term psychological stress that keeps stress hormones elevated contributes to atherosclerosis (buildup of plaque in arteries) and impaired glucose metabolism, both of which can have damaging effects on brain health over time.
- Adverse Childhood Experiences: Children who experience abuse, neglect, exposure to domestic violence, or parental separation or divorce, incarceration or illicit substance use or dependence, may be at increased risk for learning and attention difficulties in childhood, as well as mental health conditions and cognitive decline and dementia as they age.
- Chronic Inflammation: Long-term inflammation can damage brain cells and blood vessels over time. When inflammation begins early in life, it may interfere with healthy brain development. It can be triggered by infection during pregnancy or ongoing stress. Over time, this may increase the risk of learning, thinking and mental health challenges. In adulthood, persistent inflammation is linked to memory loss and neurodegenerative conditions, such as Alzheimer's and Parkinson's disease.
- Gut Microbiome: The gut and brain are closely connected and communicate through nerves, immune signals and hormones. Healthy gut bacteria produce substances that help protect the brain and regulate inflammation. When this balance is disrupted, inflammation can increase and place stress on the brain. Gut health may be especially important at certain stages of life, including early development, adolescence and older age, when changes in gut bacteria may have lasting effects on brain health. In later life, altered gut microbes have been linked to conditions such as Alzheimer's and Parkinson's disease.
- Obesity: Excess body weight can be harmful to overall health and is an important risk factor for brain health across the life span. Obesity can increase inflammation, disrupt hormones and damage blood vessels, which, over time, can harm brain structure and cognitive function at all stages of life.
- Sleep: Healthy sleep is essential to keeping the brain balanced and functioning well at every age. Some research has described sleep as an investment in brain health that builds over time. In children, sleep supports brain growth and long-term memory formation. In teens and adults, consistent, high-quality sleep supports memory, attention, decision-making, work performance, and long-term physical and mental health, making it an integral component in healthy development and aging. Inadequate sleep and sleep disorders like sleep apnea may increase inflammation and increase the risk of memory loss and cognitive decline.
- Social drivers of health: Current research confirms that lower socioeconomic status, including fewer years of education and lower income, is linked with a higher risk of health conditions like Type 2 diabetes and high blood pressure , both of which can contribute to memory loss, cognitive decline and dementia. Limited access to healthy foods, health care and stable housing can also increase the risk of cognitive decline over time.
- Environmental Exposures: Current research suggests that exposure to air pollution, heavy metals, microplastics and other environmental pollutants such as particulate matter from wildfires can slowly damage the brain by triggering inflammation, stressing brain cells and harming the blood vessels that supply it. Over time, this makes it harder to repair damage and may increase the risk of memory loss, dementia and stroke.
What are ways to improve brain health?
"Together, the evidence underscores that brain health is shaped throughout a person's lifetime and that healthy lifestyle behaviors can make a difference. Addressing modifiable factors such as mental health, environmental exposures, sleep and social conditions may support brain development and healthy aging," Marsh said.
Research suggests that healthy lifestyle habits such as those outlined in the American Heart Association's Life's Essential 8 may support brain health. Getting regular physical activity, controlling blood pressure and cholesterol, practicing healthy sleep habits, avoiding smoking and managing stress have shown consistent benefits. Healthy eating patterns such as those detailed in the Association's 2026 Dietary Guidance are also a key factor in shaping gut and brain health. Following a Mediterranean-style diet and eating fiber-rich, plant-based foods and fermented foods, like yogurt and kefir, support beneficial gut bacteria, while diets high in processed foods and added sugars can disrupt the gut microbiome. Avoiding heavy alcohol or substance use, increasing social support , and reducing financial stress may also improve mental health.
What should health care professionals and other leaders do to support brain health?
The statement urges health care professionals and policymakers to protect and promote optimal brain health from before birth through adulthood across all communities. Prioritizing mental health screening and support and expanding access to timely, effective health care that supports Life's Essential 8 can help to improve brain health across the life span. More research is needed to understand the approaches that may work best in different communities.
To address the growing burden of age-related cognitive impairment, the American Heart Association and the Paul G. Allen Frontiers Group have created the AHA-Allen Initiative in Brain Health and Cognitive Impairment
