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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.
Insights
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.
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.
Abstract:
Aging influences cerebrovascular disease expression by a variety of mechanisms. Age-related changes in cerebral autoregulation, cellular metabolism, the blood-brain barrier, and autonomic function may leave the cerebrovascular system vulnerable to injury. Certain cerebrovascular disease, such as atrial fibrillation, watershed infarctions, carotid artery atherosclerosis, cerebral hemorrhages, subdural hematomas, and transient global amnesia manifest in the elderly. Vascular dementia and white matter disease are better understood with newer neuroimaging studies, careful neuropsychological and histopathologic examinations. Atherosclerosis and cerebral amyloid angiopathy may have larger roles than previously understood in Alzheimer's disease.