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Introduction

In his welcoming remarks, Admiral Brett Giroir, assistant secretary for health at the Department of Health and Human Services (HHS), underscored the importance of improving brain health across the life span, from birth through old age. Brain health affects Americans across all ages, genders, races, and ethnicities. Enriching the body of scientific knowledge around brain health and cognitive ability has the potential to improve quality of life and longevity for many millions of Americans and their families. The Centers for Disease Control and Prevention estimate that as many as 5 million Americans were living with Alzheimer’s disease in 2014. That same year, more than 800,000 children were treated for concussion or traumatic brain injuries in U.S. emergency departments. Each year, more than 795,000 people in the United States have a stroke. Developing more effective treatment strategies for brain injuries and illnesses is essential, but brain health is not focused exclusively on disease, disorders, and vulnerability. It is equally important to better understand the ways our brains grow, learn, adapt, and heal. Addressing all of these domains to optimize brain health will require consideration about how to define brain health and resilience and about how to identify key elements to measure those concepts. Understanding the interactions between the brain, the body, and socioenvironmental forces is also fundamental to improving brain health.

To promote the improvement of brain health for all Americans, this conversation must extend beyond the realm of public health. It is critical to bring together expertise across sectors—including researchers, health

care providers, mental health experts, the business community, educators, first responders, military, law enforcement personnel, and athletes—to explore how the brain develops and changes throughout the life span. HHS is currently tackling issues related to brain health through its work in many different offices, including several projects within the Office of the Assistant Secretary for Health (see Box 1-1). Giroir said that HHS will work with the National Academies of Sciences, Engineering, and

Medicine to host a companion workshop focused on bringing these voices to the table and outlining ways that key sectors of society can apply the latest scientific evidence to educate the public about brain health. This work will help to ensure that America is positioned to lead the world in advancing the science, policies, and programs to improve brain health across the age spectrum, from premature infancy through old age.

WORKSHOP OBJECTIVES

To explore issues related to brain health throughout the life span, from birth through old age, a public workshop titled Brain Health Across the Life Span was convened on September 24 and 25, 2019, by the Board on Population Health and Public Health Practice in the Health and Medicine Division of the National Academies. The workshop was sponsored by the Office of the Assistant Secretary for Health. The workshop was structured into seven sessions held over 2 days, featuring invited presentations and discussions that focused on the following questions:

• What are accepted definitions of brain health and resilience?
• What are the key elements to measure the status of brain health and its resilience across the life span?
• What additional research questions can be addressed to increase our understanding of brain plasticity throughout the life span?

In accordance with the policies of the National Academies, the workshop did not attempt to establish any conclusions or develop recommendations about needs and future directions, focusing instead on issues identified by the speakers and workshop participants. In addition, the organizing committee’s role was limited to planning the workshop. This workshop proceedings was prepared by workshop rapporteur Anna Nicholson as a factual summary of what occurred at the workshop.

ORGANIZATION OF THE PROCEEDINGS

This Proceedings of a Workshop is organized into seven chapters based on the order of topics presented at the workshop. The overall workshop was structured to begin with definitions and then broaden the scope to discuss brain health in various contexts. Throughout the workshop, participants generated definitions and ways to measure brain health and resilience, which are discussed throughout the Proceedings. Chapter 2 provides an overview of the fundamentals of brain health and resilience, specifically focused on how to define these terms. Recognizing

that brain health and resilience cannot be defined in isolation, Chapter 3 looks at the role of brain–body interactions in brain health, while Chapter 4 explores the convergence of biology and behavior. Chapter 5 provides methodological insights for measuring brain health at many levels, and describes possible pathways toward precision neuroscience. Chapter 6 broadens the discussion further, examining brain health in the social context. Chapter 7 explores brain health across the life span, with a focus on ways forward in brain health measurement and research. The planning committee biographies can be found in Appendix A, the agenda for the workshop is in Appendix B, and the references are found in Appendix C.