Brain Health and Cognition in Older Adults: Roadmap and Milestones towards the Implementation of Preventive Strategies.
Federico Emanuele PozziGiulia RemoliLucio TremolizzoIldebrando AppollonioCarlo FerrareseLuca CuffaroPublished in: Brain sciences (2024)
In this narrative review, we delve into the evolving concept of brain health, as recognized by the WHO, focusing on its intersection with cognitive decline. We emphasize the imperative need for preventive strategies, particularly in older adults. We describe the target population that might benefit the most from risk-based approaches-namely, people with subjective cognitive decline. Additionally, we consider universal prevention in cognitively unimpaired middle-aged and older adults. Delving into multidomain personalized preventive strategies, we report on empirical evidence surrounding modifiable risk factors and interventions crucial in mitigating cognitive decline. Next, we highlight the emergence of brain health services (BHS). We explain their proposed role in risk assessment, risk communication, and tailored interventions to reduce the risk of dementia. Commenting on ongoing BHS pilot experiences, we present the inception and framework of our own BHS in Monza, Italy, outlining its operational structure and care pathways. We emphasize the need for global collaboration and intensified research efforts to address the intricate determinants of brain health and their potential impact on healthcare systems worldwide.
Keyphrases
- cognitive decline
- mild cognitive impairment
- healthcare
- physical activity
- white matter
- resting state
- public health
- risk assessment
- mental health
- risk factors
- human health
- functional connectivity
- health information
- quality improvement
- cerebral ischemia
- primary care
- palliative care
- randomized controlled trial
- study protocol
- depressive symptoms
- clinical trial
- subarachnoid hemorrhage
- multiple sclerosis
- climate change
- sleep quality
- blood brain barrier