Maintaining cognitive sharpness as one ages is closely linked to heart health, and the sooner one begins to take better care of their heart, the better the outcomes, according to a recent scientific statement released by the American Heart Association (AHA). Dr. Fernando Testai, a professor of neurology and rehabilitation at the University of Illinois College of Medicine in Chicago, stated, "Dementia is often perceived as an incurable and progressive disease that cannot be prevented. However, evidence suggests that adopting a healthy lifestyle and addressing vascular risk factors early on may help maintain normal brain function and reduce the impact of Alzheimer's disease and other related dementias." Dr. Testai led the group that authored the statement.

Approximately 130 million adults in the United States are affected by some form of heart disease, as reported by the AHA. Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, emphasized that adopting a heart-healthy lifestyle should begin early in life, even prior to birth. "This call to action is particularly crucial now because a significant number of Americans suffer from heart disease, and people are becoming ill at increasingly younger ages," Dr. Freeman said. He continued, "The typical American pattern is that we work hard throughout our lives, save money, prepare for retirement, and then face the prospect of heart attacks, strokes, and dementia—conditions that could potentially be avoided if we act early enough and modify our lifestyles."

Coronary heart disease, characterized by the accumulation of plaque in the arteries, is the leading cause of death globally, according to the World Health Organization (WHO). The WHO reported that deaths from coronary artery disease have increased from 6.4 million in 2000 to 9.1 million in 2021. This disease also adversely affects the brain. The AHA explained that the constriction of arteries associated with coronary heart disease and high blood pressure can decrease blood flow and cause damage to the brain's small blood vessels, leading to cognitive impairment. High blood pressure and type 2 diabetes can also reduce blood flow to the brain and increase inflammation, contributing to cognitive decline and dementia. The AHA statement indicated that having coronary heart disease raises the risk of future dementia by 27% compared to individuals without heart disease. The disease can onset in one's 40s and 50s, often without noticeable symptoms to alert the individual to the risk.

Heart attacks and heart failure occur frequently in the United States, with the AHA estimating that someone experiences a heart attack approximately every 40 seconds. Following a heart attack, up to 50% of survivors may experience a loss of brain function, with some experiencing a more significant decline into cognitive impairment, according to the AHA statement. Heart failure, a more severe form of heart disease, occurs when the heart is too weak to pump sufficient blood and oxygen to the body's organs. The new scientific statement revealed that up to 81% of individuals with heart failure may experience some form of cognitive decline affecting their memory, language, or thinking and planning abilities.

Dr. Testai noted in an email, "Emerging evidence suggests that the bidirectional relationship between the heart and the brain is more profound than previously thought. Vascular risk factors associated with cardiac diseases, such as diabetes, can increase the levels of beta-amyloid in the brain, which is recognized as a key marker of Alzheimer's disease. Conversely, beta-amyloid has been found in the heart and is associated with cardiac dysfunction. These findings suggest a fundamental biochemical connection between the heart and the brain." Atrial fibrillation, commonly known as A-fib, is an irregular heartbeat that many describe as a "quiver," "flutter," or "flip-flop" sensation in the chest. Atrial fibrillation is the leading cause of stroke in the United States, and strokes related to A-fib tend to be more severe than those with other underlying causes, according to the US Centers for Disease Control and Prevention. The new scientific statement also indicated that small brain bleeds, known as microhemorrhages, which can lead to cognitive decline, are more common in individuals with atrial fibrillation. In fact, people with A-fib have a 39% increased risk of memory or thinking problems. The prevalence of atrial fibrillation in the United States is increasing, with estimates suggesting that up to 16 million people will have A-fib by 2050.

Modern medicine offers remarkable drugs, such as statins and cholesterol-lowering medications, that can prevent or slow the progression of heart disease, especially if detected early, according to Dr. Freeman. Regular checkups and adherence to prescribed medications are essential for achieving this, he added. However, there are limits to what drugs can accomplish. For instance, the AHA statement mentioned that aggressively treating high blood pressure has shown promise in reducing mild cognitive impairment but not dementia.

Dr. Freeman emphasized, "Humans were designed to live very differently than we live today, and it's imperative that people understand the incredible importance of lifestyle." The key lifestyle factors that enhance brain health are well-known: getting adequate rest improves mood, increases energy, and sharpens the brain. A study from January found that people who experienced more interrupted sleep in their 30s and 40s were more than twice as likely to have memory and thinking problems a decade later. The "sweet spot" for restorative sleep is when one can sleep continuously through the four stages of sleep four to six times each night. Since each cycle is approximately 90 minutes long, most people need seven to eight hours of relatively uninterrupted sleep to achieve this goal.

Eating a healthier plant-based diet, such as the award-winning Mediterranean diet, is also crucial. An August study found that consuming an anti-inflammatory diet of whole grains, fruits, and vegetables instead of an inflammatory diet focused on red and processed meats and ultraprocessed foods, such as sugary cereals, sodas, fries, and ice cream, reduced the risk of dementia by 31%. This benefit was observed even among individuals with existing diagnoses of cardiometabolic conditions such as type 2 diabetes, heart disease, and stroke.

High levels of cortisol, the so-called stress hormone, were associated with damage to the parts of the brain that move and manage information, according to an October 2018 study. Another study published in March 2023 found that people with elevated stress levels were 37% more likely to have poor cognition. Stress is not inherently detrimental, and experts suggest adopting ways to view stressors as healthy challenges. Other strategies include getting plenty of sleep, eating healthy foods, limiting exposure to news or social media, staying connected with others, and employing calming practices such as meditation and deep breathing. However, physical activity is one of the most successful tools. Dr. Freeman advised, "If there is only one lifestyle change you can make, focus on exercise." Adults should engage in 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity each week, along with strength training, according to the CDC. Moderate exercise is characterized by heavy breathing and the inability to sing a song, but still being able to talk. Vigorous activities, such as jogging, swimming laps, or playing basketball, make it difficult to speak at all. Increased activity benefits the entire body, including the brain, as studies have shown. A September 2022 study found that people who walked at a very brisk pace of 112 steps per minute for 30 minutes a day reduced their risk of dementia by 62%. Dr. Freeman stated, "Physical activity is just absolutely magnificent. And when you combine that with eating a more plant-based diet, de-stressing, getting enough sleep, and connecting with others—that's your magic recipe. It's the fountain of youth, if you will."