Brain Health-Curbing Stroke, Heart Disease, and Dementia: The 2020 Wartenberg Lecture

Area of Science:

• Neurology
• Public Health
• Gerontology

Background:

• Brain health is essential, with stroke, ischemic heart disease, and dementia posing significant threats, particularly dementia as the fastest-growing challenge.
• Current Alzheimer disease drug development faces hurdles due to the multifactorial nature of cognitive impairment in the elderly, involving interactive pathologies, fragility, and resilience.
• Vascular cognitive impairment (VCI) provides a pragmatic framework, defining cognitive impairment linked to vascular factors, ranging from subclinical deficits to dementia.

Discussion:

• The vascular component is the sole major treatable and preventable contributor to dementia, offering opportunities for delay, mitigation, or prevention.
• Joint prevention strategies for stroke and dementia are crucial, as these conditions share common protective and treatable risk factors.
• A comprehensive, targeted, and valued investment approach is necessary to address environmental, socioeconomic, healthcare, and individual factors influencing brain health.

Key Insights:

• Vascular cognitive impairment (VCI) is a key concept for understanding and managing dementia.
• Addressing vascular risk factors is paramount for preventing dementia and other cerebrovascular diseases.
• Collaborative, multi-faceted prevention programs are essential to combat the 'triple threat' of stroke, heart disease, and dementia.

Outlook:

• The World Stroke Organization and numerous international organizations advocate for joint prevention programs for stroke and dementia.
• Developing and implementing integrated prevention programs can significantly curb the rising incidence of the 'triple threat'.
• Prioritizing brain health through VCI-focused strategies is vital for millions globally.