The same risk factors that contribute to making heart disease the leading cause of death worldwide also impact the rising global prevalence of brain disease, including stroke, Alzheimer's disease and dementia, according to the American Heart Association's Heart Disease and Stroke Statistics -- 2022 Update, published today in the Association's flagship, peer-reviewed journal Circulation. Experts say maintaining a healthy weight, managing your blood pressure and following other heart-healthy lifestyle behaviors can also support good brain health.
Optimal brain health includes the functional ability to perform all the diverse tasks for which the brain is responsible, including movement, perception, learning and memory, communication, problem solving, judgment, decision making and emotion. Cognitive decline and dementia are often seen following stroke and cerebrovascular disease and indicate a decline in brain health. Conversely, studies show maintaining good vascular health is associated with healthy aging and retained cognitive function.
The global death rate from Alzheimer's disease and other dementias is increasing considerably -- even more than the rate of heart disease death:
Because prevalence and mortality data are tracked differently by the Centers for Disease Control and Prevention, in the U.S. compared to other countries, the Statistical Update does not offer comparable national data for 2020. However, nearly 2.9 million people in the U.S. were reported to have Alzheimer's disease and other dementias in 2017. Alzheimer's disease and other dementias combined were the leading cause of death among all neurological disorders, including stroke.
"The global rate of brain disease is quickly outpacing heart disease. The rate of deaths from Alzheimer's disease and other dementias rose more than twice as much in the past decade compared to the rate of deaths from heart disease, and that is something we must address," said Mitchell S.V. Elkind, M.D. M.S., FAHA, the immediate past president of the American Heart Association, a professor of neurology and epidemiology at Columbia University Vagelos College of Physicians and Surgeons and attending neurologist at New York-Presbyterian/Columbia University Irving Medical Center, New York, NY. "We are learning more about how some types of dementia are related to the aging, and how some types are due to poor vascular health. Many studies show that the same healthy lifestyle behaviors that can help improve a person's heart health can also preserve or even improve their brain health. It's becoming more evident that reducing vascular disease risk factors can make a real difference in helping people live longer, healthier lives, free of heart disease and brain disease."
The 2022 Statistical Update highlights some of that research:
Having cardiovascular disease also increases the chances of developing brain disease:
There are also significant differences in the gender, race/ethnicity and socioeconomic status of people who are more likely to develop brain disease and dementia, an indication that social determinants of health also play a role:
Estimated U.S spending on dementias more than doubled from $38.6 billion in 1996 to $79.2 billion in 2016. Spending on dementias was among the top 10 health care costs in the United States in 2016.
"Like cardiovascular disease, Alzheimer's disease, dementia and other cognitive ailments are a tremendous emotional and economic burden across the globe," said Connie W. Tsao, M.D., M.P.H., FAHA, chair of the Statistical Update writing group, assistant professor of medicine at Harvard Medical School and attending staff cardiologist at Beth Israel Deaconess Medical Center in Boston. "This new chapter on brain health was a critical one to add. The data we've collected brings to light the strong correlations between heart health and brain health and makes it an easy story to tell -- what's good for the heart is good for the brain."
Over the past several years, the American Heart Association has supported more than $46 million in research funding focused on brain health. In a $43 million collaboration with The Paul G. Allen Frontiers Group, the Association is funding three projects that are now underway to find innovative ways to understand and improve brain health and cognitive impairment science. A $3.3 million grant in collaboration with global philanthropist and technology visionary Bill Gates is committed to advancing the scientific evidence base related to brain health and dementia. The project supports a new brain health and dementia technology research center at Boston University. Additionally, it will support the global exchange of research data to help scientists around the world collectively work in accelerating new discoveries related to heart and brain health, including the early detection and treatment of Alzheimer's disease and related dementias.
"Advancing brain science through innovative research will help scientists shed new light on the causes and contributors to cognitive impairment and dementia, particularly as it relates to heart and vascular health. This is an important step in the Association's ongoing commitment to better understand how our brains age and how vascular health impacts brain health and overall well-being," said Elkind, who is a member of the Statistical Update writing committee. "Additionally, it's critical that as a society and as individuals we understand and make the changes needed to improve health outcomes from brain disease and, more importantly, prevent them to begin with."
Along with new information on brain health, the 2022 Statistical Update provides the latest available data on key factors related to heart disease and stroke:
Tracking such trends is one of the reasons the American Heart Association publishes the definitive statistical update annually, providing a comprehensive resource of the most current data, relevant scientific findings and assessment of the impact of cardiovascular disease nationally and globally.
The U.S. data is gathered in conjunction with the National Institutes of Health and other government agencies, while the global trends are provided by the Global Burden of Disease Study from the Institute for Health Metrics and Evaluation at the University of Washington.
The annual update represents a compilation of the newest, most relevant statistics on heart disease, stroke and risk factors impacting cardiovascular health. It tracks trends related to ideal cardiovascular health, social determinants of health, global cardiovascular health, cardiovascular health genetics and health care costs. Tsao emphasized the importance of this surveillance as a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates and others seeking the best available data on these factors and conditions.
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