Life's Essential 8: Essential for Brain and Cognitive Health

Cognitive impairment and Alzheimer disease and related dementias are increasingly prevalent and carry significant morbidity. Growing evidence has highlighted the complex interactions between cardiovascular and brain health, implicating vascular dysfunction in the pathogenesis of many forms of cognitive impairment. The American Heart Association (AHA) and the American Stroke Association have outlined a comprehensive framework, known as Life's Essential 8, that includes 4 behavioral health factors (healthy dietary pattern, physical activity, avoidance of nicotine, and healthy sleep) and 4 health factors (cholesterol, blood glucose, blood pressure, body mass index) that collectively define optimum cardiovascular health. Modifiable risk factors account for an estimated 40% of worldwide dementia. Adherence to Life's Essential 8 principles may also help individuals mitigate the risk of cognitive impairment via improved cardiovascular health. However, a comprehensive understanding of the causal relationships between vascular and behavioral risk factors and Alzheimer disease and related dementias remains unclear and requires further study. This narrative review summarizes well-established data and highlights new data for how health and behavioral factors included in Life's Essential 8 also promote optimal brain and cognitive health.