![]() Over a decade, many investigations have suggested that marked arterial stiffness is associated with impaired cognitive function in elderly populations. Vascular aging, coupled with enhanced pulsatile hemodynamics, has been shown to be a major independent determinant of cerebral microvascular damage and cognitive function impairment. Further well-powered longitudinal studies with superior neuroimaging indicator, vascular mechanical biomarkers, and sensitive cognitive assessment tools that examine a broad range of age populations may help extend our understanding of the association between vascular aging and cognitive dysfunction throughout the life span. Key Message: Despite the recent novel findings, definite conclusions on causality between vascular aging and cognitive dysfunction cannot be drawn at present. Recent investigations have suggested that arterial stiffness is likely to trigger initial silent brain damage, possibly preceding midlife, while the manifestation of cognitive decline and deterioration can be foreseen in the subsequent life span. Stiffening of the aorta may lead to an excessive flow pulsatility in the brain that may cause microvascular structural brain damage and worse cognitive performance. Nevertheless, recent findings revealed that blood-pressure-lowering treatment in young adults might eliminate or halt the progression of the detrimental effects related to arterial stiffness, indicating that younger adults may have more favorable outcomes in cognition than their older counterparts if early intervention is conducted at the subclinical stage. Summary: Past studies inconsistently showed improved cognitive outcomes after antihypertensive therapy in elderly populations. However, few investigations have examined the relationship between arterial stiffness and cognitive impairment in midlife. There is incremental evidence that consistently implicates arterial stiffness being involved in the manifestation of cognitive impairment in the elderly. Background: Vascular aging may cause cerebral microvascular damage and cognitive dysfunction.
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