The connection between your genes and your brain health: how modifiable factors can prevent cognitive decline

This study has revealed how our genes and the environment in which we live work together to influence our brain health and risk of cognitive decline. Thanks to research combining genetic data, brain imaging and tissue gene analysis, we better understand how genetics and factors such as depression or cardiovascular disease can directly impact our mental and cognitive health.

We have identified 367 specific regions of DNA, called genetic loci, related to the thickness of the brain and another 13 that have to do with the appearance of lesions in the white matter of the brain, an indicator of damage to the cerebral blood vessels, and many of these genes appear to interact with factors that we can modify, such as keeping hypertension under control or treating depression appropriately.

Our genes interact with the environment:

1. Genes and brain thickness

They identified 220 genetic loci directly related to cortical thickness, an important measure of brain health. Of these, 95 showed specific interactions with conditions such as depression and cardiovascular disease. These interactions may make some people more vulnerable to brain thinning in those circumstances.

2. Influence on cognitive performance

Genetic effects on cortical thickness were also related to functions such as memory and decision-making ability (executive function). However, these cognitive abilities were found to be maintained only in people with good cardiovascular health, highlighting the importance of keeping hypertension under control.

3. Most affected brain regions

Depression and cardiovascular disease had a particularly strong impact on cortical thickness in areas such as the insula, a crucial region for emotional processing and decision-making. This impact is amplified in people with specific genetic variants, suggesting that some genes may worsen the effects of these conditions.

4. Key genes for brain health

A prominent example is the STMN4 gene, which plays a central role in maintaining cortical thickness. This gene, along with others such as LRRC37A and ARL17A, is linked to essential brain functions such as memory formation and neural plasticity, which is the brain’s ability to adapt to change.

While our genes play an important role, factors we can control, such as early treatment of hypertension or depression, have the power to significantly alter our risk of cognitive decline. This means that taking care of our health in midlife not only has immediate benefits, but also protects our brains in the long term.
For example, in people with genetic variants that favour greater cortical thickness, the benefits in memory and decision-making are clear. However, when these same people develop hypertension, the benefits disappear, underlining the importance of controlling such conditions.

Another revealing finding is that lesions in the white matter of the brain, which are related to blood vessel damage, not only affect brain connectivity, but also increase the risk of cognitive decline. However, timely intervention can mitigate this effect, again highlighting the importance of a preventive approach.

We now understand that, although our genetics may predispose us to certain risks, many of them can be prevented or significantly reduced with the right health choices. This knowledge opens the door to a new era of personalised medicine, where each person could benefit from prevention plans based on their genetic profile.

Imagine a future where a genetic test can tell you whether you are at increased risk of cortical thinning or cognitive decline, and where your doctor can create a personalised plan that combines diet, exercise and management of diseases such as hypertension to protect your brain. This approach would not only prevent problems with memory and other cognitive functions in old age, but also improve the quality of life for millions of people.

Cognitive decline and neurodegenerative diseases, such as Alzheimer’s, do not have to be an inevitable sentence – early interventions, such as maintaining healthy blood pressure and properly treating depression, can make a big difference. In addition, adopting healthy habits, such as regular physical activity, eating a balanced diet and maintaining an active social life, can enhance the protective effects of our genetics.

In short, the brain is a surprisingly adaptable but also vulnerable organ. This balance between genetics and environment reminds us that our daily choices have a profound impact on our brain health. Now more than ever, it is time to prioritise prevention and embrace a more personalised and proactive approach to caring for our brains and ensuring a healthier future for all.

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