The negative effects of vascular health on long-term brain structure and function in middle age
The authors of a research study, published in the journal Neurology, reported that having certain vascular risk factors in midlife correlated with decreased brain structure and decreased cognitive function. The vascular risk factors they looked at were high blood pressure, diabetes, smoking, and obesity. As we age, we can develop these risk factors, which could have a negative influence on our brain health. The results of this study also have important implications related to dementia.
In this study, the researchers used several tests known to be predictors of dementia. To examine brain structure, they used various MRI markers of aging: they measured total brain volume, hippocampus volume - a brain structure important for memory, and they measured a type of brain injury that is a marker of vascular disease and may indicate cognitive dysfunction, particularly in older populations. To test cognitive ability, the researchers used a number of psychological tests of verbal and visual memory, and some tests of cognitive function. The researchers then analyzed the data statistically to estimate the relationships between each of the vascular risk factors and changes in brain structure and people's performance on cognitive tests. More than 1,300 people without dementia participated in this study.
In general, there were larger changes in brain structure and cognitive abilities as study participants aged. The participants were around 54 years old when the scientists measured their vascular risk factors. It was a longitudinal study conducted over a decade, so participants were between the ages of 61 and 67, on average, when the scientists next measured changes in their brain structure and cognitive abilities. The researchers reported that there were larger changes in brain structure in participants aged 65 and older: the rate at which they developed vascular damage was much higher in these people.
Having vascular risk factors in midlife predicted a decrease in the size of the hippocampus - a brain structure important for memory.
Differences in results between men and women
There were differences in the results of brain structure between women and men. About an equal number of women and men participated in the study. The average decrease in total brain volume each year was significantly greater for men than for women. Additionally, research has suggested that men have a greater drop in hippocampal volume than women.
Vascular risk factors affect brain structure and cognitive function
Each of the vascular risk factors was associated with an unfavorable change in brain structure or cognitive function and, in some cases, with unfavorable changes in brain structure and cognitive abilities.
High blood pressure in midlife was associated with unwanted changes in brain structure. Specifically, it was associated with an increased rate of development of vascular brain injury, which is a marker of vascular disease and cognitive dysfunction. High blood pressure in midlife was also associated with impaired cognitive abilities in people. In these study participants, scientists found a decline in executive function, which is a set of cognitive processes that we use to manage ourselves and resources in order to achieve a goal.
Researchers also reported that diabetes or smoking in middle age was associated with a decrease in brain structure, especially a greater decrease in the size of the hippocampus. Smoking in your 40s was associated with other changes in brain structure - it predicts a greater decrease in total brain volume. The study also reported that smoking in midlife was associated with an increased risk of having greater expansion of vascular damage in the brain.
Being obese in your 40s was associated with a higher risk of declining cognitive abilities. Specifically, obesity was associated with an increased risk of being in the top 25% of study participants who had a decline in executive function. In addition, having a higher waist-to-hip ratio was associated with a decrease in brain structure, especially a reduction in total brain volume.
Summary of findings
Overall, the researchers reported that having vascular risk factors in midlife predicted a decrease in total brain volume, decrease in hippocampal size, decline in cognitive function, and decrease in size of the hippocampus. increase in the rate at which vascular brain damage progresses.
It is important to know that vascular risk factors affect brain structure and cognitive abilities, as many of these risk factors can be alleviated through lifestyle choices and medical treatments.
Risk of developing dementia
In previous research studies, scientists have reported that middle-aged people who have high blood pressure or diabetes, who smoke, or who are obese may be at a higher risk of developing dementia. It was not known which parts of the brain, in particular, were affected. The researchers wondered whether these vascular risk factors affect brain structure or cognitive function. This study advances our understanding by providing evidence that brain structure and cognitive function are negatively affected in middle-aged participants who have these vascular risk factors.
Another way this study adds to our knowledge concerns the longitudinal nature of the study design, which took place over a decade. For example, previous studies have reported associations between smoking and decreased brain volume at any given time. In this study, data was collected from the same subjects over a period of 10 years. This study also expands our understanding of the presence of vascular risk factors in a middle-aged population and its association with cognitive ability. While other studies have found associations between vascular risk factors and cognitive ability, risk factors were measured at the time of cognitive assessment and not at midlife.
This study contributes to a body of scientific knowledge that suggests associations between having cardiovascular risk factors and unwanted changes in brain structure, cognitive function, and an increased risk of developing dementia.
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