Cardiovascular Aging Contributes to Brain Aging

The brain is an energy-hungry organ, and is sensitive to reductions in the blood supply of oxygen and nutrients. Cardiovascular aging can reduce that supply, whether through conditions such as heart failure, or the progressive loss of density in capillary networks that occurs throughout the body with advancing age, or an accelerated pace of rupture of tiny vessels in the brain, or disruption of the blood-brain barrier, allowing unwanted molecules and cells to enter the brain. Thus, as researchers here note, we would expect to see correlations between cardiovascular disease, or risk factors for cardiovascular disease, and damage and dysfunction in the brain.

Age-related changes in the cerebrovascular system include structural reorganization of the vascular beds, reduced vessel elasticity, and disintegration of the blood-brain barrier. Further observations include reduced cerebral perfusion, and increased lesion burden in the cerebral white matter. Lesions can be observed as white-matter hyperintensities (WMHs) upon magnetic resonance imaging (MRI). They arise from ischemia, hypoperfusion, blood-brain-barrier breakage, and inflammation and are considered manifestations of cerebral small-vessel disease. WMHs are highly prevalent in aging and predictive of broad-ranged cognitive decline, dementia, and mortality.

Dopamine (DA) has been identified as an important modulator of cognitive functions. Maladaptive DA signaling typically gives rise to cognitive impairment, whereas increased DA transmission, if not excessive, may improve performance. Numerous positron emission tomography (PET) studies have demonstrated reduced availability of DA constituents in older individuals, with links to reduced cognitive performance. The age sensitivity of the DA system has therefore been suggested to modulate cognitive trajectories in aging. Research suggests relationships among vascular function, DA status, and atrophy in pathological and normal aging. Cognitive impairments in Parkinson's disease (PD) have been related to deficits in perfusion and DA decline, which are exacerbated in presence of WMHs. Increased WMH burden in normal aging is paralleled by decreased grey-matter and white-matter volume, and has been associated with reduced DA transporter and D1 receptor availability.

Thus we evaluated the interrelation among WMH burden, cerebral perfusion, DA D2-receptor (D2DR) availability, grey- and white-matter structure, and cognition in 181 healthy, older adults aged 64-68 years. Higher cardiovascular risk as assessed by treatment for hypertension, systolic blood pressure, overweight, and smoking was associated with lower frontal cortical perfusion, lower putaminal D2DR availability, smaller grey-matter volumes, a larger number of white-matter lesions, and lower episodic memory performance. Taken together, these findings suggest that reduced cardiovascular health is associated with poorer status for brain variables that are central to age-sensitive cognitive functions, with emphasis on DA integrity.

Link: https://doi.org/10.1002/acn3.50927

Comments

I have a brilliant friend with recent hypertension ( controlled with drugs), recently diagnosed stage 2 heart failure, and lifelong afib ( no longer well controlled despite ablation and cardio version- taking rhythm control drugs now) At only 56 years old he is more concerned about mental deterioration than physical. Mainstream medicine offers little hope for stopping or reversing heart failure other than taking 7 drugs and suggesting a pacemaker. Are there any promising bio hacks or upcoming treatments? Senolytic therapy? Stem cell therapy in Panama? Any suggestions appreciated.

Posted by: August at November 11th, 2019 11:46 AM

Yes. Late phase 111 stem cell trial for class 11/111 CCF/ congestive cardiac failure by Mesoblast.
Application for licensing due 1Q 2020.

They also have a late phase 11 trial using the same cells for end stage heart failure funded by the National Institutes of Health.

Posted by: JLH at November 11th, 2019 3:03 PM

Off topic but I hope all is ok on this blog. I have ALWAYS seen 3 articles every week day whether its a holiday or not, so I hope all is well here.

Posted by: Robert at November 12th, 2019 12:14 AM

@ Robert

Reason is extremely busy. He runs his new company, goes on conferences and provides articles for FA. Sometimes I don't have enough time to read it, so imagine how much more time is required to write quality content.

Posted by: Cuberat at November 12th, 2019 1:00 AM

Cuberat, yea it crossed my mind. Just concerned cause Reason (to my memory for nearly 2 decades) always been able to do 3 blogs per weekday. Talk about dedication! I see he just posted the 3rd one.

Posted by: Robert at November 12th, 2019 1:17 AM

@August, a low dose, 1-month protocol of fluvastatin and valsartan has been shown to rejuvenate the arterial wall (likely via ROCK inhibition and an increase in the number of endothelial progenitors)

https://www.ncbi.nlm.nih.gov/pubmed/26214555

Treatment can be repeated every 6 months as required.

Posted by: Mark at November 12th, 2019 4:30 AM

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