Improving brain and vascular health at the population level: Lessons from the Norwegian success story.

ABSTRACT

Stroke, dementia and ischemic heart disease are a triple threat which combined are the leading causes of death and disability globally. Fortunately, the three diseases share similar risk factors along the vascular cascade which can be targeted for primordial and primary prevention. In Norway, during 1990-2019, the age-standardised incidence rates decreased significantly for dementia by -5.4%, ischemic heart disease by -30.0%, and stroke by -35.3%. This was possible because Norway ensured equitable income for her citizens, and committed sufficient funds to universal health coverage while implementing a semi-decentralized and responsive health system with robust primary health care. This included monitoring the burden of the triple threat and their cardinal risk factors; ensuring primordial, primary and secondary preventive interventions; implementing acute care for ischemic heart disease and stroke; and ensuring interdisciplinary rehabilitation and chronic care for the triple threat. Overall, all countries will need to develop national strategies for combating the triple threat within the context of sustainable development goals with adequate allocation and utilization of resources.