Impaired brain health encompasses a range of clinical outcomes, including stroke, dementia, vascular cognitive impairment, cognitive ageing, and vascular functional impairment. Conditions associated with poor brain health represent leading causes of global morbidity and mortality, with projected increases in public health burden as the population ages. Many vascular risk factors are shared predictors for poor brain health. Moreover, subclinical brain MRI markers of vascular damage are risk factors shared between stroke and dementia, and can be used for risk stratification and early intervention. The broad concept of brain health has resulted in a conceptual shift from vascular risk factors to determinants of brain health. Global campaigns to reduce cardiovascular diseases by targeting modifiable risk factors are necessary and will have a broad impact on brain health. Research is needed on the distinct and overlapping aetiologies of brain health conditions, and to define MRI markers to help clinicians identify patients who will benefit from aggressive prevention measures.
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The authors are supported by grants from the National Institute of Neurological Disorders and Stroke (R01 NS29993) and the Evelyn F. McKnight Brain Institute at the Miller School of Medicine.
C.B.W. receives royalties for two chapters on vascular dementia in UptoDate.com. The other authors declare no competing interests.
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Gardener, H., Wright, C., Rundek, T. et al. Brain health and shared risk factors for dementia and stroke. Nat Rev Neurol 11, 651–657 (2015). https://doi.org/10.1038/nrneurol.2015.195
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