Healthy heart can protect brain from cognitive decline

Many of the same things people should do for a healthy heart, like exercising, eating well and avoiding cigarettes, can also help protect the brain from cognitive decline and dementia, according to the American Heart Association and the American Stroke Association.

Both the heart and brain need adequate blood flow. But blood vessels can narrow and harden over time, increasing the risk of heart attacks and strokes as well as cognitive decline, according to an advisory the organizations published in the journal Stroke.

The odds of this type of blood vessel damage, known as atherosclerosis, can be minimized by a healthy lifestyle and keeping blood pressure as well as sugars and cholesterol levels in the blood within safe range, the advisory authors note.

“Most health care providers are comfortable recommending healthy lifestyle and cardiovascular risk factor control measures to prevent heart attack and stroke,” said lead author Dr. Philip Gorelick, a researcher at Michigan State University College of Human Medicine in Grand Rapids.

“Many, however, are not aware of or knowledgeable about the possibility that many of the same basic factors that prevent heart attack and stroke may also prevent or delay the onset of cognitive impairment and dementia,” Gorelick said by email.

As lives stretch longer in the US\. and elsewhere, about 75 million people worldwide could have dementia by 2030, according to the advisory.

The document stresses the importance of taking steps to keep the brain healthy as early as possible, because atherosclerosis can begin in childhood.

Elevated blood pressure, cholesterol and blood sugar, for example, can damage blood vessels, triggering complications that eventually reduce blood flow to the brain.

Although these conditions can be managed with medications, the advisory stresses that the largest benefit to brain health and cognitive function may not always be found in pills.

“Although it is extremely important to control blood pressure and cholesterol with medications, there is the largest benefit to cognitive and brain health if the blood pressure and cholesterol can be maintained at healthy levels through things that everyone can do such as engaging in aerobic exercise, eating a Mediterranean diet, and keeping a healthy weight,” said Dr. Andrew Budson, a researcher at Boston University and author of “Seven Steps to Managing Your Memory: What’s Normal, What’s Not, and What to Do About It.”

A Mediterranean diet typically includes lots of fruits, vegetables, whole grains, legumes and olive oil. This diet also tends to favor lean sources of protein like chicken or fish over red meat, which contains more saturated fat.

Too often, a modern Western diet consists of a lot of processed food, refined sugar and flour, and is paired with a lifestyle devoid of exercise, Budson, who wasn’t involved in the advisory, said by email.

Adopting a Mediterranean diet, along with other heart-healthy habits, are best done as early in life as possible to get the most benefit, the advisory emphasizes.

“The advice is not new,” said Dr. Hannah Gardener, a neurology researcher at the University of Miami Medical School in Florida who wasn’t involved in the advisory.

“The time to act to reduce your risk of stroke and dementia is many decades before these health outcomes occur or are diagnosed,” Gardener said by email.

If people can’t manage to address all of the seven risk factors for heart and brain problems at once, eating well and exercising a lot is a good place to start, said Dr. Rebecca Gottesman of Johns Hopkins University School of Medicine in Baltimore.

“Exercising and eating a healthy diet are not only important on their own, but may lead to reductions in blood pressure, cholesterol and (blood sugar), as well as weight,” Gottesman, who wasn’t involved in the advisory, said by email. “People who are active are also less likely to smoke, which is harmful for a number of aspects of health.”