A study published on October 23, 2024, in the online edition of Neurology®, a journal of the American Academy of Neurology, suggests that middle-aged individuals with poorly controlled risk factors such as blood pressure, blood sugar, and cholesterol, combined with a lack of adherence to healthy practices including exercise, diet, and adequate sleep, may face an increased risk of stroke, dementia, or depression later in life. However, it is crucial to note that the study does not establish a causal relationship but merely indicates an association between these factors.
The research highlights the American Heart Association’s Life’s Essential 8, which comprises critical cardiovascular and brain health factors: physical activity, healthy eating, maintaining an average weight, abstaining from smoking, keeping blood pressure at healthy levels, ensuring adequate sleep, and managing cholesterol and blood sugar. Dr. Santiago Clocchiatti-Tuozzo, MD, MHS, from Yale University and a member of the American Academy of Neurology, emphasised the importance of brain health for overall well-being and optimal functioning. He noted that adopting these healthy lifestyle choices in middle age could significantly benefit brain health in later years.
The study involved analysing data from 316,127 individuals with an average age of 56 who were monitored over five years. The participants’ adherence to Life’s Essential 8 was assessed, and they were categorised into three groups based on their scores: optimal, intermediate, and poor. Out of the total participants, 64,474 had optimal scores, 190,919 had intermediate scores, and 60,734 were categorised as having poor scores.
The follow-up involved reviewing health records to identify the onset of neurological conditions such as stroke, dementia, or late-life depression. The definition of poor brain health was the development of any of these conditions during the study period. Results showed that 1.2% of the participants were categorised as having poor brain health, with 3,753 individuals diagnosed with one of the conditions. The incidence of poor brain health was significantly lower among those with optimal scores at 0.7%, compared to 1.2% for those with intermediate scores and 1.8% for those with poor scores.
Further analysis, adjusted for variables such as age, sex, race, and ethnicity, indicated that individuals with poor scores on the lifestyle factors were more than twice as likely to develop one of the neurological conditions compared to those with optimal scores. Those with intermediate scores had a 37% higher risk than those with optimal scores.
Dr Clocchiatti-Tuozzo pointed out that the elastic nature of the risk factors underscores the potential brain health benefits of adopting Life’s Essential 8 as a guide for healthy lifestyle choices. He also stressed the need for further research to explore the link between lifestyle habits and brain health and to understand how social factors like race and ethnicity might influence this relationship.
To validate their findings, the researchers conducted a repeat study with 68,407 participants over five years, which confirmed the initial results. One limitation noted was that the participants’ scores were measured only once at the beginning of the study, not accounting for any lifestyle changes that might have occurred during the five years. This highlights the importance of continuous monitoring and intervention to maximise the potential health benefits.
More information: Santiago Clocchiatti-Tuozzo et al, Life’s Essential 8 and Poor Brain Health Outcomes in Middle-Aged Adults, Neurology. DOI: 10.1212/WNL.0000000000209990
Journal information: Neurology Provided by American Academy of Neurology
