Risk Factors, Lifestyle Behaviors, and Vascular Brain Health
Rebecca F Gottesman1, Sudha Seshadri2,3
1Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, MD (R.F.G.).
Insights
Traditional and nontraditional factors impact brain health beyond stroke. Lifestyle, genetics, and social determinants are key to understanding and improving overall brain health outcomes.
Area of Science:
- Neurology
- Vascular Biology
- Public Health
Background:
- Traditional cardiovascular risk factors are linked to stroke.
- Vascular brain injury encompasses more than clinical stroke, including covert infarcts, white matter hyperintensities, and microbleeds.
- Brain health risk involves traditional vascular factors, lifestyle, and genetics.
Purpose of the Study:
- To review evidence on traditional and nontraditional vascular risk factors and their impact on brain health.
- To examine modifiers (genes, biomarkers) influencing adverse brain health outcomes, including Alzheimer disease.
- To consider the role of social determinants of health in brain health.
Main Methods:
- Narrative review of existing scientific literature.
- Synthesis of evidence on vascular risk factors and brain health.
- Analysis of genetic and biomarker data related to Alzheimer disease.
Main Results:
- Cardiovascular risk factors contribute to various forms of vascular brain injury.
- Lifestyle, genetic predispositions, and social factors significantly modify brain health risks.
- Biomarkers and genetic factors, particularly those linked to Alzheimer disease, play a crucial role.
Conclusions:
- A comprehensive understanding of brain health requires considering factors beyond traditional cardiovascular risks.
- Interventions targeting lifestyle, genetics, and social determinants are essential for promoting brain health.
- Further research is needed to elucidate the complex interplay of these factors in preventing cognitive decline and dementia.
Abstract:
Although a relationship between traditional cardiovascular risk factors and stroke has long been recognized, these risk factors likely play a role in other aspects of brain health. Clinical stroke is only the tip of the iceberg of vascular brain injury that includes covert infarcts, white matter hyperintensities, and microbleeds. Furthermore, an individual's risk for not only stroke but poor brain health includes not only these traditional vascular risk factors but also lifestyle and genetic factors. The purpose of this narrative review is to summarize the state of the evidence on traditional and nontraditional vascular risk factors and their contributions to brain health. Additionally, we will review important modifiers that interact with these risk factors to increase, or, in some cases, reduce risk of adverse brain health outcomes, with an emphasis on genes and biomarkers associated with Alzheimer disease. Finally, we will consider the importance of social determinants of health in brain health outcomes.
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