Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association.
Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association.
复制标题
DOI：
10.1161/str.0000000000000148
复制
发表时间：
2017-10
期刊：
影响因子：
8.3
通讯作者：
American Heart Association/American Stroke Association
中科院分区：
文献类型：
--
作者：
Gorelick PB;Furie KL;Iadecola C;Smith EE;Waddy SP;Lloyd-Jones DM;Bae HJ;Bauman MA;Dichgans M;Duncan PW;Girgus M;Howard VJ;Lazar RM;Seshadri S;Testai FD;van Gaal S;Yaffe K;Wasiak H;Zerna C;American Heart Association/American Stroke Association
认知功能是衰老的重要组成部分，并预测生活质量，功能独立性和机构化风险。我们对心血管风险作用的理解的进展表明，心血管风险与认知障碍和痴呆密切相关。由于许多心血管风险是可以改变的，因此有可能保持大脑健康并预防晚年痴呆症。美国心脏协会（AHA）/美国中风协会主席咨询的目的是提供成人最佳大脑健康的初步定义，以及如何保持大脑健康的指导。我们确定指标，以定义最佳的大脑健康的成人的基础上，包括可以测量，监测和修改的因素。从这些实际考虑出发，我们确定了7个指标来定义成人的最佳大脑健康，这些指标来自AHA的生活简单7：4理想的健康行为（不吸烟，身体活动达到目标水平，健康饮食符合当前指南水平，体重指数<25 kg/m2）和3个理想健康因素（未治疗的血压<120/<80 mm Hg，未治疗的总胆固醇<200 mg/dL，和空腹血糖<100 mg/dL）。此外，在维持认知健康方面，我们建议遵循AHA/美国中风协会、医学研究所和阿尔茨海默病协会先前发表的指南，其中包括控制心血管风险，并建议社会参与和其他相关策略。我们定义最佳的大脑健康，但认识到真正理想的情况可能是罕见的，因为有一个连续的大脑健康所证明的AHA的生活的简单7。因此，有机会通过原始预防和其他干预措施改善大脑健康。此外，尽管心血管风险与大脑健康密切相关，但我们承认，与心血管健康相关的其他因素可能会推动认知健康。定义成人的最佳大脑健康及其维持与AHA的战略影响目标一致，即到2020年将所有美国人的心血管健康改善20%，并将心血管疾病和中风导致的死亡减少20%。这项定义成人最佳大脑健康的工作为AHA/美国中风协会提供了一个基础，为心血管健康促进和疾病预防提供了一个新的战略方向。
Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health. We identify metrics to define optimal brain health in adults based on inclusion of factors that could be measured, monitored, and modified. From these practical considerations, we identified 7 metrics to define optimal brain health in adults that originated from AHA’s Life’s Simple 7: 4 ideal health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent with current guideline levels, and body mass index <25 kg/m2) and 3 ideal health factors (untreated blood pressure <120/<80 mm Hg, untreated total cholesterol <200 mg/dL, and fasting blood glucose <100 mg/dL). In addition, in relation to maintenance of cognitive health, we recommend following previously published guidance from the AHA/American Stroke Association, Institute of Medicine, and Alzheimer’s Association that incorporates control of cardiovascular risks and suggest social engagement and other related strategies. We define optimal brain health but recognize that the truly ideal circumstance may be uncommon because there is a continuum of brain health as demonstrated by AHA’s Life’s Simple 7. Therefore, there is opportunity to improve brain health through primordial prevention and other interventions. Furthermore, although cardiovascular risks align well with brain health, we acknowledge that other factors differing from those related to cardiovascular health may drive cognitive health. Defining optimal brain health in adults and its maintenance is consistent with the AHA’s Strategic Impact Goal to improve cardiovascular health of all Americans by 20% and to reduce deaths resulting from cardiovascular disease and stroke by 20% by the year 2020. This work in defining optimal brain health in adults serves to provide the AHA/American Stroke Association with a foundation for a new strategic direction going forward in cardiovascular health promotion and disease prevention.