Brain Health Begins in the Community
Network of Area Agencies on Aging are delivering services such as social connection and nutrition that foster brain health
When we think about brain health, we often picture clinical settings: neurologists, MRIs and cognitive tests. But what if some of the most powerful tools for maintaining our cognitive health are already in our communities, helping millions of Americans every day?
In communities across America, a network of over 600 Area Agencies on Aging (AAAs) are quietly delivering services that science increasingly shows protect our brains. From the friendly volunteer who delivers your Meals on Wheels to the transportation service that takes you to the senior center for Tai Chi class, these everyday supports aren't just conveniences — they're building blocks for long-term brain health.
"Most people are unaware that many of the services they're already using through their local Area Agency on Aging or other community-based organizations are actually supporting their cognitive health," says Laura N. Gitlin, Ph.D., dean emerita and distinguished professor of the College of Nursing and Health Professions at Drexel University. "The social connections, nutrition support, stress reduction and physical activity these programs provide are exactly what current research shows we need for brain health."
Why Brain Health Matters
Brain health has emerged as a major public health priority, and for good reason. Over one in three people worldwide (3.4 billion total) are affected by neurological conditions at an annual cost exceeding $1 trillion. Here in the United States, dementia care alone costs $305 billion annually.
As more than 73 million Americans will be older than 65 by 2030, addressing brain health is becoming increasingly important — not just for health care systems but for families and communities. While medical interventions and research are crucial, they're only part of the solution.
Research increasingly shows that brain health is built and maintained through daily activities and community support systems. According to a 2020 AAA National Survey, AAAs deliver many of these support services:
- Social Connection: Your Brain's Best Friend
Loneliness and isolation increase the risk of cognitive decline. AAAs combat this through social engagement programs, group activities and volunteer opportunities. According to the survey, 67% of AAAs provide social engagement programs, with 55% offering telephone reassurance or friendly visiting programs. - Learning New Things at Any Age
Lifelong learning builds neural connections and cognitive reserve. Many AAAs offer digital literacy workshops, financial management courses and continuing education opportunities. Nearly 80% provide health promotion services, including specific brain health programs. - Reducing Stress Through Navigation Support
Chronic stress accelerates cognitive decline and can make managing health conditions more difficult. AAAs offer benefits counseling, care coordination and case management services (available in 86% of communities) that help reduce the stress of navigating complex health care and social service systems. - Nutrition as a Foundation for Brain Health
What we eat affects how we think. AAA-run Meals on Wheels and congregate dining programs provide balanced, nutritious meals while also offering opportunities for social interaction and wellness checks. Eighty-four percent of AAAs run nutrition programs, and 91% offer transportation services to help older adults stay engaged and active.
Improving Health, Saving Money
These community-based programs aren't just good for brain health — they're good for the bottom line. Studies show that:
- AAA-hospital partnerships lower average annual Medicare spending by $136 per beneficiary.
- Mental health partnerships cut avoidable nursing home use.
- Early intervention in cognitive health through community programs could save billions annually.
"What makes AAAs unique is their ability to bridge health care and community supports," Gitlin explains. "They are connecting the dots between medical and social care by providing opportunities to engage in activities that matter most to older adults and that actually also impact on our health outcomes."
Despite their impact, AAAs face substantial challenges. Budgets remain relatively flat despite growing service demands, and workforce issues like competitive wages and staffing shortages have reached their limit.
"We're at a critical juncture in the ability of AAAs to address the increasing needs of the communities they serve," Gitlin says. "AAAs have proven their value in supporting brain health, but they need greater recognition as key players in the brain economy to secure the stability and resources they need to serve more people."
"When we talk about brain health, we often focus on individual behaviors or medical interventions. But the reality is that our cognitive health is deeply connected to our communities."
Positioning AAAs as central players in the brain economy could attract new funding sources and ensure long-term sustainability while advancing public brain health priorities. The global market for brain health innovations represents a major opportunity, and health care systems could save billions through the early intervention and prevention services AAAs provide.
Vital Role
For brain health to be accessible to all Americans, policymakers and health care systems need to recognize and support the vital role that AAAs play. This means:
- Expanding partnerships between AAAs, health care providers and insurers
- Developing better ways to evaluate how community programs affect brain health
- Training more staff and caregivers in brain health and cognitive interventions
- Increasing public awareness about the brain-protective benefits of community services
- Ensuring stable funding for these proven, cost-effective programs
- Recognizing AAAs as key contributors to the brain economy through their work in cognitive resilience
As brain health becomes a greater priority for aging Americans, the solution isn't just in health care settings — it's in our communities. Area Agencies on Aging are already providing the daily supports that science shows protect our brains.
"When we talk about brain health, we often focus on individual behaviors or medical interventions," Gitlin says. "But the reality is that our cognitive health is deeply connected to our communities. AAAs are building brain-healthy communities every day through the vital programs they provide. We just need to recognize and strengthen their role."
You can find your local AAA by calling the Eldercare Locator at 1-800-677-1116 or visiting eldercare.acl.gov.
