Impact of Cardiovascular Hemodynamics on Cognitive Aging

Abstract

It is well known that cardiovascular disease and related vascular risk factors are associated with cognitive decline and worse brain health outcomes among aging adults. Recently, subtle age-related changes in cardiac hemodynamics have been proposed as an emerging risk factor for abnormal brain aging, even in the absence of cardiovascular disease. Changes in cardiac function, vital for determining the total amount of blood available for perfusing the body, and arterial stiffness, important for regulating blood flow delivery, have been associated with compromised brain structure and function among older adults. Such alterations in cardiac output and arterial stiffening may directly affect brain health through blood-brain barrier breakdown or oligemia or may interact with Alzheimer disease and concomitant pathologies common in aging adults to accelerate cognitive decline. This review examines how age-related alterations in cardiovascular integrity contribute to abnormal brain aging, emphasizing that changes in systemic hemodynamics may compromise brain health before or concurrently with the development of neurodegenerative processes that are common in aging.

Chronic cerebral hypoperfusion and blood-brain barrier disruption in uninjured brain areas of rhesus monkeys subjected to transient ischemic stroke

“…These normal aging processes are accelerated and occur in MCI and AD patients. 51 Similar to the monkeys of the current study, dysregulated and decreased CBF is visible in various brain areas, particularly in the cortex, hippocampus, thalamus, and parahippocampal gyrus. 49 In some patients, microbleeds have been observed in their brains.…”

The connection between heart rate variability (HRV), neurological health, and cognition: A literature review

“…The heart pumps blood which provides oxygen and nutrients to the brain; conversely, deoxygenated blood flows back to the heart from the brain for reoxygenation through the pulmonary circulation. Reduced cardiac function, as occurs in heart failure secondary to conditions such as myocardial infarction, cardiomyopathy, or valvular heart disease, can result in reduced cerebral blood flow, affecting cognitive function, and contributing to dementia risk (Havakuk et al, 2017;Moore and Jefferson, 2021). Reduction of forward cardiac output due to arrhythmias including chronic atrial fibrillation can reduce cerebral blood flow, leading to cognitive dysfunction (Madhavan et al, 2018).…”

The association of proBNPage with manifestations of age-related cardiovascular, physical, and psychological impairment in community-dwelling older adults

“…With the intermediation of endothelial dysfunction, hypertension is a relevant cause of cardiovascular damage, and both hypertension and endothelial dysfunction have been found to be associated with cognitive impairment [56,57]. The impact on cognitive aging of even subtle alterations of cardiovascular hemodynamics, including both cardiac output and arterial stiffening, has recently been reviewed [58]. Thus, as an important marker of cardiovascular damage, NT-proBNP might also be indirectly associated with some manifestations of cognitive impairment.…”

“…Despite that, we believe that proBNPage should not be considered a false indicator of biological age for the following reasons. (1) The impairment of cardiac and circulatory function is both an important consequence and a cause of the aging process [58,[62][63][64].…”