Researchers from the National University of Singapore (NUS) have led a study investigating the relationship between cardiovascular function and cognitive decline in the Singaporean elderly.
Associate Professor Helen Zhou from the Center for Sleep and Cognition, and Dr. Mitchell Lai from the Department of Pharmacology, focused on circulating cardiovascular markers and cerebrovascular function.
They found that three blood heart disease biomarkers were associated with higher levels of brain free-water, indicating a potential decline in neural function.
The research is published in the journal Neurology.
Insights from Free-Water Imaging
Brain free-water, detected by diffusion MRI, is a novel imaging marker that can help detect early and subtle cerebrovascular dysfunction.
In this study, researchers measured free-water in gray and white matter of the brain separately.
They found that cardiovascular biomarkers were associated with higher free-water in widespread regions of white matter, which transmit signals to other regions of the brain, and in specific gray matter networks.
Cardiovascular Dysfunction and Cognitive Decline
The study suggests that cardiovascular dysfunction could lead to alterations in brain vasculature, affecting small arteries, arterioles, and capillaries, causing neurovascular changes.
These changes may instigate cerebrovascular dysfunction processes, leading to neuronal damage, synaptic loss, and neurodegeneration, which can ultimately result in dementia and cognitive decline.
Free-water, as an indicator of cerebrovascular dysfunction, was found to fully explain the associations of blood biomarkers with cognitive decline over five years.
For instance, higher free-water in the executive control network was linked to executive function impairment, while free-water in the default mode network mediated the relationship with memory dysfunction.
Implications for Dementia and Precision Medicine
As the prevalence of dementia is set to double every 20 years, and with a high prevalence of cerebrovascular disease (CeVD) among patients with mild cognitive impairment (MCI) and dementia in Singapore, the study’s findings have significant implications.
The team suggests that assessing free water in specific brain networks, together with a blood test of cardiovascular biomarkers, could help predict cardiovascular and cerebrovascular disease progression and domain-specific cognitive decline.
The researchers plan to continue developing brain imaging and blood-based tests, contributing to precision and preventive medicine, particularly for middle-aged and relatively healthy Singaporeans.
If you care about dementia, please read studies about new drugs for incurable vascular dementia and high blood pressure that may lower dementia risk for some old adults.
For more information about dementia, please see recent studies that cataract removal may reduce the dementia risk by 30%, and results showing these antioxidants could help reduce the risk of dementia.
The study was published in Neurology.
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