The 10 tenets of Brain Health for clinical practice in the era of technology.

Main Article Content

Joyce Gomes-Osman, PT, PhD Alvaro Pascual-Leone, MD, PhD

Abstract

Advancements in public health and medicine have increased global life expectancy, but most added years are spent in illness and disability, mainly due to brain diseases. A different approach is needed with a focus on the prevention of disease and the promotion of brain health and resilience to enhance each individual brain’s ability to cope with and minimize the functional consequences of any brain stressor, insult, injury, or disease. We propose a focus on brain health to address the threat of brain-related disability and promote human healthspan and well-being. We have outlined 10 key principles for optimizing brain health. Technology developments enable their implementation in clinical practice. Leveraging technology can help reach more people, provide personalized care, and improve access to essential brain health services.

Keywords: Brain Health, Technological Interventions in Healthcare, Brain Disorder Prevention, Lifespan Brain Health Monitoring, Personalized Brain Health Care

Article Details

How to Cite
GOMES-OSMAN, Joyce; PASCUAL-LEONE, Alvaro. The 10 tenets of Brain Health for clinical practice in the era of technology.. Medical Research Archives, [S.l.], v. 12, n. 9, sep. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5668>. Date accessed: 22 dec. 2024. doi: https://doi.org/10.18103/mra.v12i9.5668.
Section
Review Articles

References

1. Feigin VL, Roth GA, Naghavi M, et al. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol. 2016;15(9):913-924. doi:10.1016/S1474-4422(16)30073-4

2. Walker ER, McGee RE, Druss BG. Mortality in Mental Disorders and Global Disease Burden Implications. JAMA Psychiatry. 2015;72(4):334-341. doi:10.1001/jamapsychiatry.2014.2502

3. Optimizing brain health across the life course: WHO position paper. Accessed July 24, 2024. https://www.who.int/publications/i/item/9789240054561

4. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442. doi:10.1371/journal. pmed.0030442

5. Gooch CL, Pracht E, Borenstein AR. The burden of neurological disease in the United States: A summary report and call to action. Ann Neurol. 2017;81(4):479-484. doi:10.1002/ana.24897

6. Chisholm D, Sweeny K, Sheehan P, et al. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry. 2016;3(5):415-424. doi:10.1016/S2215-0366(16)30024-4

7. Schlueter M, Chan K, Lasry R, Price M. The cost of cancer - A comparative analysis of the direct medical costs of cancer and other major chronic diseases in Europe. PloS One. 2020;15(11):e0 241354. doi:10.1371/journal.pone.0241354

8. Bazargan-Hejazi S, Dehghan K, Edwards C, et al. The health burden of non-communicable neurological disorders in the USA between 1990 and 2017. Brain Commun. 2020;2(2):fcaa097. doi:10.1093/braincomms/fcaa097

9. Pascual-Leone A, Bartres-Faz D. Human Brain Resilience: A Call to Action. Ann Neurol. 2021;90(3):336-349. doi:10.1002/ana.26157

10. Stern Y, Albert M, Barnes CA, Cabeza R, Pascual-Leone A, Rapp PR. A framework for concepts of reserve and resilience in aging. Neurobiol Aging. 2023;124:100-103. doi:10.1016/ j.neurobiolaging.2022.10.015

11. Chen Y, Demnitz N, Yamamoto S, Yaffe K, Lawlor B, Leroi I. Defining brain health: A concept analysis. Int J Geriatr Psychiatry. 2022;37(1). doi:10. 1002/gps.5564

12. National Academies of Sciences E, Division H and M, Practice B on PH and PH, Nicholson A. Brain Health Across the Life Span. In: Brain Health Across the Life Span: Proceedings of a Workshop. National Academies Press (US); 2020. Accessed July 24, 2024. https://www.ncbi.nlm.nih.gov/books/NBK556452/

13. World Health Organization. Nurturing Care for Early Childhood Development: A Framework for Helping Children Survive and Thrive to Transform Health and Human Potential. World Health Organization; 2018. Accessed July 24, 2024. https://iris.who.int/handle/10665/272603

14. Grigorenko EL. Brain Development: The Effect of Interventions on Children and Adolescents. In: Bundy DAP, Silva N de, Horton S, Jamison DT, Patton GC, eds. Child and Adolescent Health and Development. 3rd ed. The International Bank for Reconstruction and Development / The World Bank; 2017. Accessed July 23, 2024. http://www.ncbi.nlm.nih.gov/books/NBK525261/

15. Pascual-Leone A, Taylor MJ. A developmental framework of brain and cognition from infancy to old age. Brain Topogr. 2011;24(3-4):183-186. doi:10.1007/s10548-011-0197-7

16. Pascual-Leone A, Amedi A, Fregni F, Merabet LB. The plastic human brain cortex. Annu Rev Neurosci. 2005;28:377-401. doi:10.1146/annurev .neuro.27.070203.144216

17. Feldman DE. Synaptic Mechanisms for Plasticity in Neocortex. Annu Rev Neurosci. 2009; 32:33-55. doi:10.1146/annurev.neuro.051508.135516

18. Kloos A, Gomes-Osman J, Boyd L. Harnessing Neuroplasticity for Functional Recovery. J Neurol Phys Ther JNPT. 2020;44(2):119-120. doi:10.1097/ NPT.0000000000000307

19. Bliss TVP, Gardner-Medwin AR. Long-lasting potentiation of synaptic transmission in the dentate area of the unanaesthetized rabbit following stimulation of the perforant path. J Physiol. 1973;2 32(2):357-374.

20. Bear MF, Abraham WC. Long-Term Depression in Hippocampus. Annu Rev Neurosci. 1996;19(Volume 19, 1996):437-462. doi:10.1146/ annurev.ne.19.030196.002253

21. Gomes-Osman J, Indahlastari A, Fried PJ, et al. Non-invasive Brain Stimulation: Probing Intracortical Circuits and Improving Cognition in the Aging Brain. Front Aging Neurosci. 2018;10 :177. doi:10.3389/fnagi.2018.00177

22. Hallett M. Transcranial magnetic stimulation: a primer. Neuron. 2007;55(2):187-199. doi:10.1016/j .neuron.2007.06.026

23. Jannati A, Oberman LM, Rotenberg A, Pascual-Leone A. Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 2023;48(1):191-208. doi:10.1038/s41386-022-01453-8

24. Valero-Cabré A, Pascual-Leone A, Rushmore RJ. Cumulative sessions of repetitive transcranial magnetic stimulation (rTMS) build up facilitation to subsequent TMS-mediated behavioural disruptions. Eur J Neurosci. 2008;27(3):765-774. doi:10.1111/j .1460-9568.2008.06045.x

25. Gomes-Osman J, Cabral DF, Hinchman C, Jannati A, Morris TP, Pascual-Leone A. The effects of exercise on cognitive function and brain plasticity - a feasibility trial. Restor Neurol Neurosci. 2017;35(5):547-556. doi:10.3233/RNN-170758

26. Cabral DF, Fried PJ, Bigliassi M, Cahalin LP, Gomes-Osman J. Determinants of exercise adherence in sedentary middle-aged and older adults. Psychophysiology. Published online April 17, 2024:e14591. doi:10.1111/psyp.14591

27. Cabral DF, Fried P, Koch S, et al. Efficacy of mechanisms of neuroplasticity after a stroke. Restor Neurol Neurosci. 2022;40(2):73-84. doi:10.3233/ RNN-211227

28. Freitas C, Farzan F, Pascual-Leone A. Assessing brain plasticity across the lifespan with transcranial magnetic stimulation: why, how, and what is the ultimate goal? Front Neurosci. 2013;7. doi:10.3389/fnins.2013.00042

29. Park DC, Reuter-Lorenz P. The adaptive brain: aging and neurocognitive scaffolding. Annu Rev Psychol. 2009;60:173-196. doi:10.1146/annurev. psych.59.103006.093656

30. Petersen SE, van Mier H, Fiez JA, Raichle ME. The effects of practice on the functional anatomy of task performance. Proc Natl Acad Sci U S A. 1998;95(3):853-860. doi:10.1073/pnas.95.3.853

31. Raz N, Gunning-Dixon F, Head D, Rodrigue KM, Williamson A, Acker JD. Aging, sexual dimorphism, and hemispheric asymmetry of the cerebral cortex: replicability of regional differences in volume. Neurobiol Aging. 2004;25(3):377-396. doi:10.1016/S0197-4580(03)00118-0

32. DeCarli C, Massaro J, Harvey D, et al. Measures of brain morphology and infarction in the framingham heart study: establishing what is normal. Neurobiol Aging. 2005;26(4):491-510. doi:10.1016/j.neurobiolaging.2004.05.004

33. Dong C, Nabizadeh N, Caunca M, et al. Cognitive correlates of white matter lesion load and brain atrophy. Neurology. 2015;85(5):441-449. doi:10.1212/WNL.0000000000001716

34. Mukherjee J, Christian BT, Dunigan KA, et al. Brain imaging of 18F-fallypride in normal volunteers: blood analysis, distribution, test-retest studies, and preliminary assessment of sensitivity to aging effects on dopamine D-2/D-3 receptors. Synap N Y N. 2002;46(3):170-188. doi:10.1002 /syn.10128

35. Nyberg L. Intact frontal memory effect in older age and dementia. Neuron. 2004;42(5):701-702. doi:10.1016/j.neuron.2004.05.016

36. Hsieh H, Boehm J, Sato C, et al. AMPAR removal underlies Abeta-induced synaptic depression and dendritic spine loss. Neuron. 2006; 52(5):831-843. doi:10.1016/j.neuron.2006.10.035

37. Mitchell TW, Mufson EJ, Schneider JA, et al. Parahippocampal tau pathology in healthy aging, mild cognitive impairment, and early Alzheimer’s disease. Ann Neurol. 2002;51(2):182-189. doi:10.1 002/ana.10086

38. Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med. 2013;29 (4):737-752. doi:10.1016/j.cger.2013.07.002

39. Salthouse T. Consequences of age-related cognitive declines. Annu Rev Psychol. 2012;63:201 -226. doi:10.1146/annurev-psych-120710-100328

40. Jeste DV, Ardelt M, Blazer D, Kraemer HC, Vaillant G, Meeks TW. Expert consensus on characteristics of wisdom: a Delphi method study. The Gerontologist. 2010;50(5):668-680. doi:10.10 93/geront/gnq022

41. Blanchflower DG. Is happiness U-shaped everywhere? Age and subjective well-being in 145 countries. J Popul Econ. 2021;34(2):575-624. doi:1 0.1007/s00148-020-00797-z

42. Thomas ML, Kaufmann CN, Palmer BW, et al. Paradoxical Trend for Improvement in Mental Health With Aging: A Community-Based Study of 1,546 Adults Aged 21-100 Years. J Clin Psychiatry. 2016;77(8):e1019-1025. doi:10.4088/JCP.16m10671

43. Levy BR, Zonderman AB, Slade MD, Ferrucci L. Age stereotypes held earlier in life predict cardiovascular events in later life. Psychol Sci. 2009;20(3):296-298. doi:10.1111/j.1467-9280.200 9.02298.x

44. Levy BR, Ferrucci L, Zonderman AB, Slade MD, Troncoso J, Resnick SM. A Culture-Brain Link: Negative Age Stereotypes Predict Alzheimer’s-disease Biomarkers. Psychol Aging. 2016;31(1):82-88. doi:10.1037/pag0000062

45. Levy BR, Slade MD, Pietrzak RH, Ferrucci L. Positive age beliefs protect against dementia even among elders with high-risk gene. PloS One. 2018; 13(2):e0191004. doi:10.1371/journal.pone.0191004

46. Levy BR, Slade MD, Kunkel SR, Kasl SV. Longevity increased by positive self-perceptions of aging. J Pers Soc Psychol. 2002;83(2):261-270. doi:10.1037//0022-3514.83.2.261

47. Ardelt M, Pridgen S, Nutter-Pridgen KL. The Relation Between Age and Three-Dimensional Wisdom: Variations by Wisdom Dimensions and Education. J Gerontol B Psychol Sci Soc Sci. 2018;7 3(8):1339-1349. doi:10.1093/geronb/gbx182

48. Sinha R, Lacadie CM, Constable RT, Seo D. Dynamic neural activity during stress signals resilient coping. Proc Natl Acad Sci U S A. 2016;11 3(31):8837-8842. doi:10.1073/pnas.1600965113

49. McEwen BS, Bowles NP, Gray JD, et al. Mechanisms of stress in the brain. Nat Neurosci. 2015;18(10):1353-1363. doi:10.1038/nn.4086

50. McEwen BS, Nasca C, Gray JD. Stress Effects on Neuronal Structure: Hippocampus, Amygdala, and Prefrontal Cortex. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 2016;41(1): 3-23. doi:10.1038/npp.2015.171

51. Adriano F, Caltagirone C, Spalletta G. Hippocampal volume reduction in first-episode and chronic schizophrenia: a review and meta-analysis. Neurosci Rev J Bringing Neurobiol Neurol Psychiatry. 2012;18(2):180-200. doi:10.1177/1073 858410395147

52. McEwen BS. Protective and damaging effects of stress mediators: central role of the brain. Dialogues Clin Neurosci. 2006;8(4):367-381. doi:10 .31887/DCNS.2006.8.4/bmcewen

53. Gómez-Isla T, Frosch MP. Lesions without symptoms: understanding resilience to Alzheimer disease neuropathological changes. Nat Rev Neurol. 2022;18(6):323-332. doi:10.1038/s41582-022-00642-9

54. Seeman TE, McEwen BS, Rowe JW, Singer BH. Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proc Natl Acad Sci U S A. 2001;98(8):4770-4775. doi:10. 1073/pnas.081072698

55. Bartrés-Faz D, Cattaneo G, Solana J, Tormos JM, Pascual-Leone A. Meaning in life: resilience beyond reserve. Alzheimers Res Ther. 2018;10(1): 47. doi:10.1186/s13195-018-0381-z

56. Lewis NA, Turiano NA, Payne BR, Hill PL. Purpose in life and cognitive functioning in adulthood. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2017;24(6):662-671. doi:10. 1080/13825585.2016.1251549

57. Boyle PA, Buchman AS, Wilson RS, Yu L, Schneider JA, Bennett DA. Effect of purpose in life on the relation between Alzheimer disease pathologic changes on cognitive function in advanced age. Arch Gen Psychiatry. 2012;69(5):4 99-505. doi:10.1001/archgenpsychiatry.2011.1487

58. Saunders S, Gomes-Osman J, Jannati A, et al. Towards a lifelong personalized brain health program: empowering individuals to define, pursue, and monitor meaningful outcomes. Front Neurol. 2024;15:1387206. doi:10.3389/fneur.2024.1387206

59. Freeman M. The World Mental Health Report: transforming mental health for all. World Psychiatry. 2022;21(3):391-392. doi:10.1002/wps.21018

60. Hakamata Y, Suzuki Y, Kobashikawa H, Hori H. Neurobiology of early life adversity: A systematic review of meta-analyses towards an integrative account of its neurobiological trajectories to mental disorders. Front Neuroendocrinol. 2022;65: 100994. doi:10.1016/j.yfrne.2022.100994

61. Posadzki P, Pieper D, Bajpai R, et al. Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews. BMC Public Health. 2020;20(1):1724. doi:10.1186/s1288 9-020-09855-3

62. Braithwaite I, Zhang S, Kirkbride JB, Osborn DPJ, Hayes JF. Air Pollution (Particulate Matter) Exposure and Associations with Depression, Anxiety, Bipolar, Psychosis and Suicide Risk: A Systematic Review and Meta-Analysis. Environ Health Perspect. 2019;127(12):126002. doi:10.128 9/EHP4595

63. Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. JAMA. 2009;301(21):2252-2259. doi: 10.1001/jama.2009.754

64. Boyce WT, Levitt P, Martinez FD, McEwen BS, Shonkoff JP. Genes, Environments, and Time: The Biology of Adversity and Resilience. Pediatrics. 202 1;147(2):e20201651. doi:10.1542/peds.2020-1651

65. McEwen BS. Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007;87(3):873-904. doi:10.1152/ physrev.00041.2006

66. Hendrix CL, Dilks DD, McKenna BG, Dunlop AL, Corwin EJ, Brennan PA. Maternal Childhood Adversity Associates With Frontoamygdala Connectivity in Neonates. Biol Psychiatry Cogn Neurosci Neuroimaging. 2021;6(4):470-478. doi: 10.1016/j.bpsc.2020.11.003

67. Moog NK, Entringer S, Rasmussen JM, et al. Intergenerational Effect of Maternal Exposure to Childhood Maltreatment on Newborn Brain Anatomy. Biol Psychiatry. 2018;83(2):120-127. doi: 10.1016/j.biopsych.2017.07.009

68. Kwak S, Joo WT, Youm Y, Chey J. Social brain volume is associated with in-degree social network size among older adults. Proc Biol Sci. 2018; 285(1871):20172708. doi:10.1098/rspb.2017.2708

69. Blumen HM, Verghese J. Gray matter volume covariance networks associated with social networks in older adults. Soc Neurosci. 2019;14 (5):559-570. doi:10.1080/17470919.2018.1535999

70. Cotton K, Verghese J, Blumen HM. Gray Matter Volume Covariance Networks, Social Support, and Cognition in Older Adults. J Gerontol B Psychol Sci Soc Sci. 2020;75(6):1219-1229. doi:10.1093/geronb/gbz023

71. Salinas J, O’Donnell A, Kojis DJ, et al. Association of Social Support With Brain Volume and Cognition. JAMA Netw Open. 2021;4(8):e212 1122. doi:10.1001/jamanetworkopen.2021.21122

72. Inc G. Meta-Gallup Global State of Social Connections. Gallup.com. Accessed July 26, 2024. https://www.gallup.com/analytics/509675/state-of-social-connections.aspx

73. Finley AJ, Schaefer SM. Affective Neuroscience of Loneliness: Potential Mechanisms underlying the Association between Perceived Social Isolation, Health, and Well-Being. J Psychiatry Brain Sci. 2022;7(6):e220011. doi:10. 20900/jpbs.20220011

74. Lam JA, Murray ER, Yu KE, et al. Neurobiology of loneliness: a systematic review. Neuropsychopharmacology. 2021;46(11):1873-1887. doi:10.1038/s41386-021-01058-7

75. Read “Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System” at NAP.Edu. doi:10.17226/25663

76. Salinas J, Beiser AS, Samra JK, et al. Association of Loneliness With 10-Year Dementia Risk and Early Markers of Vulnerability for Neurocognitive Decline. Neurology. 2022;98(13):e 1337-e1348. doi:10.1212/WNL.0000000000200039

77. Sutin AR, Stephan Y, Luchetti M, Terracciano A. Loneliness and Risk of Dementia. J Gerontol B Psychol Sci Soc Sci. 2020;75(7):1414-1422. doi:10. 1093/geronb/gby112

78. Terracciano A, Luchetti M, Karakose S, Stephan Y, Sutin AR. Loneliness and Risk of Parkinson Disease. JAMA Neurol. 2023;80(11) :1138-1144. doi:10.1001/jamaneurol.2023.3382

79. Konrath S, Fuhrel-Forbis A, Lou A, Brown S. Motives for volunteering are associated with mortality risk in older adults. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2012;31 (1):87-96. doi:10.1037/a0025226

80. Thoits PA, Hewitt LN. Volunteer work and well-being. J Health Soc Behav. 2001;42(2):115-131.

81. Borgonovi F. Doing well by doing good. The relationship between formal volunteering and self-reported health and happiness. Soc Sci Med 1982. 2008;66(11):2321-2334. doi:10.1016/j.socscimed.2008.01.011

82. Yeung JWK, Zhang Z, Kim TY. Volunteering and health benefits in general adults: cumulative effects and forms. BMC Public Health. 2017;18:8. doi:10.1186/s12889-017-4561-8

83. Jenkinson CE, Dickens AP, Jones K, et al. Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers. BMC Public Health. 2013;13(1):773. doi:10.1186/1471-2458-13-773

84. Yeung JWK, Zhang Z, Kim TY. Volunteering and health benefits in general adults: cumulative effects and forms. BMC Public Health. 2017;18:8. doi:10.1186/s12889-017-4561-8

85. Dauwan M, Begemann MJH, Slot MIE, Lee EHM, Scheltens P, Sommer IEC. Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials. J Neurol. 2021;26 8(4):1222-1246. doi:10.1007/s00415-019-09493-9

86. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet Lond Engl. 2020;396(10248):413-446. doi:10.1016/S014 0-6736(20)30367-6

87. Yu JT, Xu W, Tan CC, et al. Evidence-based prevention of Alzheimer’s disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry. 2020;91(11):1201-1209. doi:10.1136/jnnp-2019-321913

88. Dhana K, Evans DA, Rajan KB, Bennett DA, Morris MC. Healthy lifestyle and the risk of Alzheimer dementia. Neurology. 2020;95(4):e374-e383. doi:10.1212/WNL.0000000000009816

89. Owolabi MO, Thrift AG, Mahal A, et al. Primary stroke prevention worldwide: translating evidence into action. Lancet Public Health. 2022;7(1):e74-e85. doi:10.1016/S2468-2667(21)00230-9

90. Kivipelto M, Solomon A, Ahtiluoto S, et al. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): Study design and progress. Alzheimers Dement. 2013;9(6):657-665. doi:10.1016/j.jalz.2012.09.012

91. Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022; 146(5):e18-e43. doi:10.1161/CIR.0000000000001078

92. Carver RB, Fredheim NAG, Ljøsne ISB, Bodorkos Friedman B. What Motivates People to Look after Their Brain Health? Insights from the Global Brain Health Survey. Universitetet i Oslo; 2022. Accessed July 23, 2024. https://fhi.brage.unit.no/fhi-xmlui/handle/11250/2988451

93. Yegambaram M, Manivannan B, Beach TG, Halden RU. Role of environmental contaminants in the etiology of Alzheimer’s disease: a review. Curr Alzheimer Res. 2015;12(2):116-146. doi:10.2174/ 1567205012666150204121719

94. Muñoz-Quezada MT, Lucero BA, Barr DB, et al. Neurodevelopmental effects in children associated with exposure to organophosphate pesticides: a systematic review. Neurotoxicology. 2013;39:158-168. doi:10.1016/j.neuro.2013.09.003

95. US EPA O. Risk Management for Trichloroethylene (TCE). Published February 23, 2015. Accessed July 25, 2024. https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/risk-management-trichloroethylene-tce

96. Costa LG, Chang YC, Cole TB. Developmental Neurotoxicity of Traffic-Related Air Pollution: Focus on Autism. Curr Environ Health Rep. 2017;4(2):156-165. doi:10.1007/s40572-017-0135-2

97. Costa LG, Cole TobyB, Dao K, Chang YC, Garrick JM. Developmental impact of air pollution on brain function. Neurochem Int. 2019;131 :104580. doi:10.1016/j.neuint.2019.104580

98. Guxens M, Garcia-Esteban R, Giorgis-Allemand L, et al. Air Pollution During Pregnancy and Childhood Cognitive and Psychomotor Development: Six European Birth Cohorts. Epidemiology. 2014;25(5):636. doi:10.1097/EDE. 0000000000000133

99. Saez M, Barceló MA, Farrerons M, López-Casasnovas G. The association between exposure to environmental factors and the occurrence of attention-deficit/hyperactivity disorder (ADHD). A population-based retrospective cohort study. Environ Res. 2018;166:205-214. doi:10.1016/j.envr es.2018.05.009

100. White A, Kanninen K, Malm T, Schins R. Editorial: Air pollution and brain health. Neurochem Int. 2020;141:104900. doi:10.1016/j .neuint.2020.104900

101. Lee KK, Miller MR, Shah ASV. Air Pollution and Stroke. J Stroke. 2018;20(1):2-11. doi:10.5853/jos .2017.02894

102. Lubczyńska MJ, Muetzel RL, El Marroun H, et al. Air pollution exposure during pregnancy and childhood and brain morphology in preadolescents. Environ Res. 2021;198:110446. doi:10.1016/j.envr es.2020.110446

103. Beckwith T, Cecil K, Altaye M, et al. Reduced gray matter volume and cortical thickness associated with traffic-related air pollution in a longitudinally studied pediatric cohort. PLoS ONE. 2020;15(1):e0228092. doi:10.1371/journal.pone.0228092

104. Neiman J, Haapaniemi HM, Hillbom M. Neurological complications of drug abuse: pathophysiological mechanisms. Eur J Neurol. 2000;7(6):595-606. doi:10.1046/j.1468-1331.2000.00045.x

105. Gordon E, Devinsky O. Alcohol and marijuana: effects on epilepsy and use by patients with epilepsy. Epilepsia. 2001;42(10):1266-1272. doi:10 .1046/j.1528-1157.2001.19301.x

106. Meade RD, Akerman AP, Notley SR, et al. Physiological factors characterizing heat-vulnerable older adults: A narrative review. Environ Int. 2020; 144:105909. doi:10.1016/j.envint.2020.105909

107. Baniassadi A, Lipsitz LA, Sailor D, Pascual-Leone A, Manor B. Heat Waves, Climate Change, and Implications for an Aging Population. J Gerontol Ser A. 2023;78(12):2304-2306. doi:10.10 93/gerona/glad230

108. Jimenez MP, Elliott EG, DeVille NV, et al. Residential Green Space and Cognitive Function in a Large Cohort of Middle-Aged Women. JAMA Netw Open. 2022;5(4):e229306. doi:10.1001/jama networkopen.2022.9306

109. Klompmaker JO, Laden F, Browning MHEM, et al. Associations of Greenness, Parks, and Blue Space With Neurodegenerative Disease Hospitalizations Among Older US Adults. JAMA Netw Open. 2022;5(12):e2247664. doi:10.1001/ja manetworkopen.2022.47664

110. Gomes-Osman J, Solana-Sánchéz J, Rogers E, et al. Aging in the Digital Age: Using Technology to Increase the Reach of the Clinician Expert and Close the Gap Between Health Span and Life Span. Front Digit Health. 2021;3:755008. doi:10.3389/ fdgth.2021.755008