A recent Cognitive Vitality blog post discussed a study suggesting that hypertension in mid-life (age 50) was associated with late-life dementia. In fact, most individuals with Alzheimer's disease also have problems with the blood vessels in their brain [1]. A question that has received less attention, however, is at what age does cardiovascular health begin to impact brain health? A recent study in the Journal of the American Medical Association (JAMA) suggested that even in our 20s and 30s, poor cardiovascular health may impact the brain's blood vessels.
Researchers from the University of Oxford assessed the cardiovascular health of 125 young adults (ages 18-40) [2]. The young adults underwent measurements for body mass index (BMI), cardiovascular fitness and/or physical activity, alcohol consumption, smoking, ambulatory blood pressure, total cholesterol, and fasting glucose. They received one point for each category where they met the recommended level for cardiovascular health for a total cardiovascular health score of up to eight points: BMI under <25, being in the top third for cardiovascular fitness and/or physical activity, less than 8 drinks per week, no smoking for at least 6 months, blood pressure under 130/80, total cholesterol under 200 mg/dL, and fasting glucose under 100 mg/dL.
The young adults then underwent a brain scan from which information on blood vessels in the brain was obtained. For each additional point on the cardiovascular health score, individuals had increased blood vessel density in the brain, increased blood vessel size, fewer brain lesions, and increased blood flow into the brain. For specific measurements, increased blood vessel density was associated with not smoking, lower blood pressure, and lower BMI; increased blood vessel size was associated with not smoking and lower blood pressure; and fewer brain lesions were associated with not smoking, less alcohol, and lower blood pressure [2].
The changes in the brain's blood vessels that were associated with differences in cardiovascular health score were small, reflecting the fact that this is a young, healthy population. Also, this was an observational study, and it is not known whether certain cardiovascular risk factors cause a change in the brain's blood vessels. Finally, these results do not imply that young adults with more cardiovascular risk factors will eventually develop Alzheimer's disease. However, these results provide more evidence that what is good for your heart is also good for your brain.
Most of these cardiovascular risk factors can be improved with non-drug interventions such as stopping smoking, reducing alcohol, exercising, and eating a healthy diet. We know that Alzheimer's disease develops over a lifetime (and amyloid can even be present in young adults). Even if you are in your 20s or 30s it is never too early to start protecting your heart and your brain.
Nick McKeehan is a member of the ADDF's Aging and Alzheimer's Prevention program. He evaluates the scientific evidence for and against therapies to promote brain health and/or prevent Alzheimer's disease at our website CognitiveVitality.org and contributes regularly to the site's blog. Mr. McKeehan previously served as Chief Intern at Mid Atlantic Bio Angels (MABA) and was a research technician at Albert Einstein College of Medicine investigating repair capabilities of the brain. Mr. McKeehan received a bachelor of science degree in biology from Purdue University, where he was awarded a Howard Hughes Scholarship. He also writes about the biotechnology industry for 1st Pitch Life Science.
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