Everyone has brain health and a significant proportion of people are affected by brain disorders (Norwegian Government, 2023). If relatives are included, most of the population of Norway is probably affected by brain disorders. It is therefore important to raise awareness of brain health and prioritise it, not only at individual level, but also at system level and societal level. This awareness will be particularly important going forward, given demographic trends such as increased life expectancy (Avan & Hachinski, 2024). According to the World Health Organization (2023b), to make real progress in improving brain health for all, the term ‘brain health’ must be included in public health strategies and policies. It is therefore essential that Norway has a national brain health strategy.
There are various models which show how the brain and brain health are affected throughout life, thus illustrating action areas for promoting brain health.
Sabayan et al. (2023) state that brain health is affected through three mechanisms: (1) damage (exposure to risk factors), (2) resistance to damage (active repair) and (3) inherent functional resilience (ability to adapt to adversity/damage). The model emphasises the necessity of prevention strategies aimed at the entire life course and includes protecting the brain from damage that the brain itself is unable to repair.
The model that Bassetti et al. (2022) refer to can be viewed in conjunction with the mechanisms explained by Sabayan et al. (2023), but includes factors that can promote or protect brain health to a greater extent. The model categorises factors that affect the brain and brain health into three levels: (1) preserving – promoting factors linked to an individual’s mental and physical activity; (2) protecting and preventing – reducing risk factors; and (3) planning – factors at societal level that must be addressed by decision-makers.
Protective factors for brain health
At a general level, a healthy lifestyle is beneficial to the health of the brain. According to the World Health Organization (WHO), health promotion is a process that allows individuals to gain better control over and improve their own health (World Health Organization, 1998). Promoting brain health is about improving and maintaining brain function and well-being throughout life (ibid.). Looking after the brain throughout life can provide significant benefits and enable people to preserve important abilities, even when faced with brain disease (DeCarli, 2018). Factors that can help preserve good brain health include social contact, reducing mental stress, a healthy diet and protecting the head from injury (Bassetti et al., 2022). Sleep is another factor that is important for promoting brain health (Bassetti et al., 2022; Lewis, 2021).
Physical activity is also an important factor in promoting brain health (Bassetti et al., 2022; Tari et al., 2025). A systematic umbrella review and meta-meta analysis by Singh et al. (2025) indicates that physical activity and movement can have positive effects on general cognition, memory and executive function (which is a collective term for, among other things, problem-solving ability, planning and self-regulation of behavior). The brain is probably the organ that is most affected by physical activity (Hjelle, 2018). Wisløff and Tari (2025) argue that physical activity accounts for about 50% of the positive health effects achieved through a healthy lifestyle. They point out that, despite this, about 97% of health budgets in Norway are spent on treating diseases, while only 3% are used for preventive measures (ibid.).
Risk factors for brain health
Preventing brain diseases is about reducing the risk of developing disease, identifying signs of disease and challenges and preventing, delaying or reducing the consequences of disease (Gammersvik & Larsen, 2018). Repeated alcohol consumption is an example of a risk factor for brain diseases (Singh et al., 2025b). Reducing or avoiding drug consumption, especially during adolescence, is therefore important for promoting brain health (Chikritzhs et al., 2024). Other possible risk factors include high blood pressure and cholesterol (Aamodt et al. 2024). Limiting risk factors for brain diseases can also have a positive impact on other diseases, such as heart disease (ibid.).
Lack of sufficient good-quality sleep is another risk factor for developing brain diseases (Palma et al., 2013). Adolescents in particular do not appear to get enough sleep (Saxvig et al., 2021). Evanger et al. (2024) conducted a longitudinal study concerning the relationship between sleep patterns, sleep difficulties, depression, anxiety and academic grades among students at a sample of upper secondary schools in Norway. The results of the study indicated that there was a correlation between shorter sleep duration on school days and lower average grades, irrespective of symptoms of depression and anxiety (ibid.). The results may indicate that sleep is crucial for adolescent brain health.
There is increasing evidence to suggest that air pollution could have an impact on the incidence of certain brain diseases (Aamodt et al. 2024; Huang et al., 2025; Wilker et al., 2023). Other important factors include avoiding pollutants and living healthily during pregnancy in order to provide good conditions for good brain health. People should also avoid smoking and maintain a healthy weight. Risk factors for some brain diseases may also be linked to impaired vision and hearing loss (World Health Organization, 2022). A Norwegian study by Myrstad et al. (2025) shows a link between impaired hearing and cognitive impairment. The study concludes that the early treatment of hearing loss may be crucial in reducing the risk of cognitive impairment.
The impact of risk factors can build up over time, eventually becoming too much for the brain’s repair mechanisms to cope with, leading to physical and functional changes in the brain (Sabayan et al., 2023). In turn, these changes can lead to symptoms and irreparable deterioration of brain function (ibid.). To prevent brain diseases, initiatives should be targeted at all three levels of prevention. These are as follows: 1) primary prevention, which is the prevention of brain diseases occurring, 2) secondary prevention, which is the prevention of new events or deterioration and finally, 3) tertiary prevention. Tertiary prevention is about maintaining the best possible function and quality of life in the event of brain disease and preventing the condition from becoming more severe.
Brain health from a gender perspective
Women can experience different symptoms of brain disease compared with men (Ministry of Health and Care Services, 2024b). Studies show that hormones shape women’s brain health and risk of developing brain diseases throughout their lives. It is therefore important to understand the complex interaction between risk factors and protective factors for women’s brain health (Barth et al., 2023; de Lange et al., 2020).
There are also knowledge gaps regarding the health challenges that men face, their causes and how brain health can be improved. Men do not live as long as women and are over-represented in risk factors such as smoking, alcohol consumption, poor diet, inactivity, obesity and high blood pressure. These risk factors affect the incidence of brain diseases and other non-communicable diseases (NOU 2024:8).
Socioeconomic status and brain health
A study of socioeconomic status and brain health found that people with higher socioeconomic status throughout life had better cognitive function (Krueger et al., 2025). This is consistent with other studies which show that resources in both childhood and adulthood are important for brain health (ibid.).
Hamza et al. (2024) also believe that low socioeconomic status, and poverty in particular, can lead to poor nutrition, high stress levels in caregivers and children and exposure to high-risk environments. These factors can harm the development of the brain, which in turn can lead to mental health problems and poorer performance at school. This can create a “vicious cycle”, in which children with low socioeconomic status who grow up in poverty continue to experience poverty and health problems in adulthood. To break this cycle, Hamza et al. (2024) believe that financial support alone will not be sufficient. It is also important to target measures at improving brain health and development in children from families with low socioeconomic status and poverty (ibid.).
Farah (2018) notes that our understanding of how socioeconomic status affects the brain is still limited. Many questions remain, such as which findings will be valid over time and which mechanisms link socioeconomic status to the brain. It is also unclear whether these findings depend on specific factors such as income or neighbourhood, or whether there are other causes (ibid.).
In order to address differences in brain health, it is important to understand the relationship between socioeconomic status and brain health (Hamza et al., 2024; Krueger et al., 2025).
Brain health at system level
Societal planning can help promote brain health among the entire population. Contextual factors such as the environment in which a person lives, security, what they learn throughout life and what services they have access to also affect brain health. Facilitating and planning at societal level are important because brain health is affected by health determinants (in other words, impactors on health, such as income and education), which in turn creates social inequalities in health, including brain health (Hilal & Brayne, 2022). Risk factors can increase gradually from early in life and lead to differences in brain health through life (ibid.). Brain health thus becomes a shared responsibility across sectors, requiring a holistic approach in which both individual and societal factors throughout life are taken into account.
Among other things, the health and care services are responsible for treating, preventing and facilitating the management of illness, injury, suffering and disability. These services have also been tasked with contributing to cross-sector public health work and cooperating with other public, private and voluntary sector stakeholders. Although the brain health strategy is specifically aimed at the health and care services, it should be noted that health-promoting and preventive measures are being implemented in all sectors.
Health behaviour and lifestyles are greatly influenced by socially created conditions for good health. Public health measures should be designed to even out social health inequalities. Universal and structural measures such as economic instruments and regulations appear to have a positive impact on improving public health in a way that evens out social health inequalities (Meld. St. 15 (2022-2023)).
Türken et al. (2024) note that health-promoting measures should be communicated in a way that does not make the population feel guilty if they do not make good lifestyle choices or implement measures to promote brain health. It is important to recognise that major societal and economic factors also come into play. Those in need should get help and guidance to understand and change their lifestyle choices, ideally in collaboration with others (ibid.).
Universal design is an important prerequisite for good brain health, because it enables activity and mastery to feel safe and readily available (Ministry of Culture, 2021). Good planning is about enabling everyone to participate, regardless of functional capacity or injury.
The relational model of impairment views health as a product of the interaction between individual circumstances and societal needs. The model stresses that brain health is not only about the presence or absence of brain diseases, but also the structure of society. By removing barriers and creating inclusive environments, the brain health of everyone in the population can be supported. The health and care services must be available at the right time and place and to an appropriate extent. Furthermore, the services must be provided in a safe manner, which entails minimising the risk of injury and promoting positive health outcomes (NOU 2016:17, 2016).
Universal design can remove barriers and structure society in a way that is accessible for everyone, regardless of their functional capacity (ibid.). This is especially important as many brain diseases can affect a person’s ability to, for example, inform themselves, interact with their environment, perform work and participate in democratic processes (Strand et al., 2021).
It is important to be conscious of promoting positive attitudes and increasing social awareness of people with functional impairments, as well as respecting their rights and dignity. This is part of Norway’s obligations under the Convention on the Rights of Persons with Disabilities (CRPD), which is to be incorporated into Norwegian law.
Good brain capital – an important investment
A healthy lifestyle can help prevent or reduce the risk of brain diseases (Bassetti et al., 2022; Clocchiatti-Tuozzo et al., 2024; Hachinski et al., 2024), symptom burden and functional impairment. Looking after brain health does not simply help to reduce health costs by promoting overall health and reducing the incidence of chronic health problems associated with brain diseases. It also offers significant societal and economic benefits throughout life. Good brain capital is therefore crucial for brain function, both for every individual and for society as a whole (World Health Organization, 2022). The term ‘brain capital’ is about prioritising brain health and making it an important part of how progress and prosperity are measured in society. This will enable a stronger and more resilient society to be built (Eyre et al., 2021).