Top Things to Know: Brain Health Across the Lifespan: A Framework for Future Studies
Updated: April 28, 2026
Prepared by Ashley Wagner MS, PA-C, Associate Science & Medicine Advisor, American Heart Association
- This Scientific Statement focuses on the role of nonvascular physical and psychological risk factors that affect brain health, ranging from the exposures experienced during early development and childhood brain maturation to the influences leading to neurodegeneration and decline in older adults.
- This statement reviews influences such as chronic medical conditions, inflammation, environmental exposures, and socioeconomic drivers that affect the developing brain as well as the impact of components such as sleep, gut microbiome, and mental health on neurodegeneration.
- Mental health conditions, including depression, anxiety, and chronic stress, influence risk of stroke, cognitive decline, and dementia through biological pathways, some of which include disrupted neuroplasticity and intracellular signaling, heightened inflammation, and decreased neuroprotective factors.
- Environmental exposure can affect brain health across the lifespan, with a greater impact on disadvantaged communities. Air pollution, heavy metals, and pesticides impact neurodegeneration through pathways like inflammation, oxidative stress, blood–brain barrier damage, vascular injury, protein buildup, microbiome disruption, and direct toxicity.
- Persistent inflammation across the lifespan affects neurodevelopment, synaptic function, and neurodegeneration, and lifestyle strategies such as physical activity, healthy diet, good sleep, and stress reduction can help lower harmful inflammation.
- The gut microbiome affects cognition, mood, neurodegenerative disease, and neurodevelopment through multiple pathways and can be supported by a healthy diet that may include fermented foods and increased fiber.
- Sleep quality and duration appear to evolve with the brain across the lifespan and affect memory consolidation, synaptic function, glymphatic clearance with poor sleep linked to dementia, cognitive decline, and neurovascular vulnerability.
- Social determinants of health, which include socioeconomic status, education, and exposure to adverse childhood experiences, affect neurobiological health, through mechanisms related to inflammatory, endocrine, metabolic, and other disruptions.
- Medical conditions beginning at birth or in childhood, such as congenital heart disease, sickle cell disease, and early life infections impact brain development, cognitive function, and mental health through cerebral perfusion, network formation, and other mechanisms.
- A holistic approach that integrates a framework encompassing biological, psychological, and social factors into traditional medical practice is essential to ensure development, testing, and implementation of interventions across the lifespan to promote brain health and mental well-being.
Citation
Marsh EB, Lavretsky H, Kasparian NA, Pike NA, Doyle KP, Aggarwal NT, Fullerton HJ, Ivy AS, Dlamini N; on behalf of the American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Clinical Cardiology. Brain health across the life span: a framework for future studies: a scientific statement from the American Heart Association. Stroke. Published online April 28, 2026. doi: 10.1161/STR.0000000000000518