Commentary Highlights:
- Increasing numbers of people affected by stroke, dementia and late-life depression – the three major disorders of the aging brain – portend a "gray tsunami" that requires a new national commitment to address brain health through research, awareness, education, advocacy and investment.
- The emerging concept of "brain capital" expands the focus on the societal benefits of preventing brain disorders to include the economic benefits of promoting positive cognitive skills and healthy brain behaviors that maximize productivity.
- An advocacy agenda for brain health and capital should emphasize robust science, account for changes over the life course, address brain health disparities and incorporate an interdisciplinary and multisectoral approach.
DALLAS, January 24, 2025—An estimated 3.4 billion people – 43% of the world population – had a condition affecting the nervous system in 2021, leading to 11.1 million deaths. Increasing numbers of people affected by stroke, dementia and late-life depression – the three major disorders of the aging brain – foreshadow a "gray tsunami" that requires a new national commitment to address brain health, according to a new commentary published this week in Circulation, the flagship scientific journal of the American Heart Association, a global force devoted to changing the future of health for all.
"Ambitious efforts have led to tremendous advances in our understanding of neuroscience and the treatment of neurological illness, including the inextricable link between the heart and the brain," said Mitchell S.V. Elkind, M.D., M.S., FAAN, FAHA, co-author of the commentary, chief clinical science officer, stroke neurologist and past volunteer president of the American Heart Association. "To leverage these advances for the greatest impact on public health, we need a national commitment that focuses on advancing scientific research, improving public awareness, educating the health care workforce and advocating for public policies that improve brain health."
The commentary states the need to move beyond the health care system's current focus on preventing brain disorders. The authors describe the emerging concept of "brain capital," which focuses more broadly on the economic benefits of promoting positive cognitive skills and healthy brain behaviors – including creativity, social adaptability and entrepreneurship – that maximize productivity.
A greater emphasis on brain capital, the commentary authors state, is needed to combat the "brain-negative" economy in regions of the world with poor education, limited teaching of the arts and inadequate nutrition for healthy brain development.
A focus on brain capital could maximize the conditions that enhance neurological and mental wellness, while yielding substantial returns on investment from youth to adulthood.
The commentary calls for a shift from the narrow association of brain health with disease to a more positive conception of brain health that focuses on optimizing brain development in children and adolescents and prevents cognitive decline late in life. The commentary emphasizes the importance of public policy to achieve this goal.
"A public policy agenda for brain health and brain capital must be rooted in robust, interdisciplinary science and account for changes over the course of an individual's life," said commentary co-author Harris Eyre, M.D., PhD, lead of the Neuro-Policy Program and Harry Z. Yan and Weiman Gao Senior Fellow, Baker Institute for Public Policy, Rice University. "The advocacy agenda also should address disparities in brain health and incorporate a multisectoral approach that reaches beyond science and medicine and includes stakeholders from throughout the health care system."
"A national commitment to brain health and greater brain capital would yield enormous benefits to society," said Cheryl Pegus, M.D., M.P.H., co-author of the commentary, American Heart Association volunteer and member of the Association's volunteer Board of Directors, chair of the Association's Advocacy Coordinating Committee, executive chair of FlyteHealth and president of Caluent LLC. "The American Heart Association, with its focus on advancing scientific research, patient awareness, education among health care professionals and advocacy at all levels of government, is at the forefront of these efforts."
The views contained in the commentary are those of the individual authors and do not necessarily reflect the official position of the American Heart Association.
