Healthy habits in middle age may protect against neurological conditions

In middle-aged people, having risk factors like blood pressure, blood sugar and cholesterol that are not well-controlled combined with not following certain healthy habits including exercise, diet and sleep, are linked to a higher risk of stroke, dementia or depression later in life, according to a study published in the October 23, 2024, online issue of Neurology^®, the medical journal of the American Academy of Neurology. These results do not prove that not having healthy habits increases the risk of these conditions, they only show an association.

The eight cardiovascular and brain health factors, known as the American Heart Association's Life's Essential 8 are: being active; eating better; maintaining a healthy weight; not smoking; maintaining a healthy blood pressure; getting enough sleep; and controlling cholesterol and blood sugar levels.

Brain health is paramount for the optimal well-being of every person, enabling us to function at our highest level and constantly adapt in the world. Our study found that making these healthy lifestyle choices in middle age can have meaningful impacts on brain health later in life."

Santiago Clocchiatti-Tuozzo, MD, MHS, study author of Yale University in New Haven, Connecticut, and member of the American Academy of Neurology

For the study, researchers evaluated data from 316,127 people with an average age of 56. They were followed over five years.

Researchers looked at participants' scores across the eight essential cardiovascular health factors and organized them into three categories: optimal, intermediate and poor.

Of the total group, 64,474 people had optimal scores, 190,919 people had intermediate scores and 60,734 people had poor scores.

Researchers then evaluated health records to identify who developed any of the following neurological conditions: stroke, dementia or late-life depression. Poor brain health was defined as the development of any of these conditions during the follow up years.

A total of 1.2% of participants met the definition for poor brain health, with a total of 3,753 conditions. Of those with optimal Life's Essential 8 scores, 0.7% met the definition for poor brain health, compared to 1.2% of those with intermediate scores and 1.8% of those with poor scores.

After adjusting for factors that could affect the risk of these three neurological conditions, such as age, sex, race and ethnicity, researchers found that people with poor scores on the healthy lifestyle factors were more than twice as likely to develop any of the three neurological conditions compared to those people with optimal scores. Researchers also found that people who had an intermediate score had a 37% higher risk of having one of the three neurological conditions than those who had an optimal score.

"Because the risk factors we looked at are all ones that people can work to improve, our findings highlight the potential brain health benefits of using these eight cardiovascular and brain health factors to guide healthy lifestyle choices," Clocchiatti-Tuozzo said. "More research is needed to understand this link between lifestyle habits and brain health, as well as how social factors like race and ethnicity can influence this connection."

To confirm their findings, researchers repeated the study in a group of 68,407 participants followed for a total of five years and found similar results.

A limitation of the study was that the participants' scores were measured only once at the start of the study, so it does not account for potential lifestyle changes during the five-year study.

The study was supported by the National Institutes of Health.