Affiliation:
1. School of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy
2. Neurology Department & Brain Health Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
3. Milan Center for Neuroscience (Neuro-MI), University of Milano-Bicocca, 20126 Milan, Italy
Abstract
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.
Funder
Next Generation EU in the context of the National Recovery and Resilience Plan, Investment PE8–Project Age-It: “Ageing Well in an Ageing Society”
Next Generation EU
Reference107 articles.
1. (2022). Optimizing Brain Health across the Life Course, World Health Organization.
2. Defining brain health: A concept analysis;Chen;Int. J. Geriatr. Psychiatry,2022
3. Direct and indirect effects of socioeconomic status and discrimination on subjective cognitive decline: A longitudinal study of African American women;Simons;J. Gerontol. B. Psychol. Sci. Soc. Sci.,2023
4. Subjective cognitive decline in Brazil: Prevalence and association with dementia modifiable risk factors in a population-based study;Borelli;Alzheimer’s Dement. Diagn. Assess. Dis. Monit.,2022
5. The role of population-level preventive care for brain health in ageing;Sabayan;Lancet Healthy Longev.,2023