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The vascular contribution to cognitive decline in ageing and dementia

Silvia Anderle1,2, Michael Dixon1,2, Tania Quintela-Lopez1,2

  • 1BHF/UK-DRI Centre for Vascular Dementia Research, University College London, London, UK.

Nature Reviews. Neuroscience
|August 5, 2025
PubMed

Insights

Vascular dysfunction, including reduced cerebral blood flow (CBF) and blood-brain barrier (BBB) issues, contributes to cognitive decline in aging and dementia. Therapies targeting CBF maintenance are crucial for these conditions.

Area of Science:

  • Neuroscience
  • Gerontology
  • Cardiovascular Science

Background:

  • Vascular dysfunction is increasingly linked to cognitive decline in aging and dementia.
  • This dysfunction involves reduced cerebral blood flow (CBF) and impaired blood-brain barrier (BBB) function.
  • The interplay and causality between CBF and BBB changes in cognitive decline are not fully understood.

Purpose of the Study:

  • To assess the evidence for vascular contributions to dementia.
  • To compare vascular changes in dementia with those in normal aging.
  • To explore initiating cells and signaling mechanisms in vascular-related cognitive decline.

Main Methods:

  • Review and synthesis of existing evidence on vascular dysfunction and cognitive decline.
  • Comparative analysis of vascular changes in aging and dementia.
  • Discussion of cellular and molecular mechanisms.

Main Results:

  • Significant evidence supports vascular dysfunction as a contributor to cognitive decline.
  • Parallels exist between vascular changes in normal aging and dementia.
  • Specific cells and signaling pathways are implicated in initiating these changes.

Conclusions:

  • Vascular dysfunction plays a critical role in cognitive decline associated with aging and dementia.
  • Understanding these mechanisms opens new therapeutic avenues.
  • Strategies aimed at maintaining or restoring CBF are essential for future treatments.

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