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Aging and cerebrovascular disease

J Y Choi1, J C Morris, C Y Hsu

  • 1Department of Neurology, Barnes-Jewish Hospital, Washington University, St. Louis, Missouri 63110-1093, USA.

Neurologic Clinics
|July 17, 1998
PubMed
Summary

Aging impacts cerebrovascular disease through mechanisms like impaired autoregulation and blood-brain barrier changes. This increases vulnerability to conditions such as stroke and vascular dementia in older adults.

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Area of Science:

  • Neurology
  • Gerontology
  • Vascular Biology

Background:

  • Aging alters cerebrovascular mechanisms, including cerebral autoregulation, metabolism, blood-brain barrier integrity, and autonomic function.
  • These age-related changes predispose the cerebrovascular system to injury and disease.
  • The elderly population exhibits a higher incidence of specific cerebrovascular conditions.

Purpose of the Study:

  • To elucidate the mechanisms by which aging influences the expression of cerebrovascular diseases.
  • To highlight common cerebrovascular conditions manifesting in the elderly.
  • To discuss the evolving understanding of the roles of atherosclerosis and cerebral amyloid angiopathy in Alzheimer's disease.

Main Methods:

  • Review of age-related changes in cerebrovascular regulation and function.
  • Identification of cerebrovascular diseases prevalent in the elderly.
  • Integration of findings from neuroimaging, neuropsychological, and histopathological studies.
  • Examination of the roles of atherosclerosis and cerebral amyloid angiopathy.

Main Results:

  • Age-related alterations in cerebral autoregulation, cellular metabolism, blood-brain barrier, and autonomic function increase cerebrovascular vulnerability.
  • Commonly observed cerebrovascular diseases in the elderly include atrial fibrillation, watershed infarctions, carotid artery atherosclerosis, cerebral hemorrhages, subdural hematomas, and transient global amnesia.
  • Vascular dementia and white matter disease are increasingly understood through advanced neuroimaging and detailed examinations.
  • Atherosclerosis and cerebral amyloid angiopathy are recognized as significant contributors to Alzheimer's disease pathology.

Conclusions:

  • Aging significantly impacts cerebrovascular disease expression through multiple physiological pathways.
  • Understanding these age-related vulnerabilities is crucial for diagnosing and managing cerebrovascular conditions in older adults.
  • Further research into the roles of atherosclerosis and cerebral amyloid angiopathy may refine Alzheimer's disease understanding and treatment.

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