The findings suggest that specific medications may play a crucial role in preventing dementia.
A study conducted by researchers at the University of California, Irvine, has revealed that cardiovascular conditions like high blood pressure and diabetes, which are known to cause damage to brain blood vessels in younger individuals, do not appear to increase the risk of such damage in people aged 90 and older.
The findings, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, highlight the complexity of the relationship between blood pressure, vascular health, and brain aging, suggesting it may be more intricate than previously understood.
Shifting Patterns in Aging and Brain Health
“For decades, we’ve known that factors like high blood pressure and diabetes can injure blood vessels in the brain, increasing the risk for cognitive decline and dementia. However, our research found that these patterns may change as people age,” said corresponding author Dr. Ravi Rajmohan, UC Irvine clinical instructor of neurology.
“Even more intriguing, the use of blood pressure-lowering medication in this 90-plus group was linked to a lower likelihood of specific types of brain damage.”
Team members analyzed the relationship between cardiovascular-related changes in the brain and self-reported vascular risk factors or use of heart-related medications by examining data from 267 participants in the National Institute on Aging’s 90+ Study, one of the largest and most comprehensive research projects on the oldest-old population. They applied statistical models that accounted for age, sex, and education and found that the presence of brain changes was not linked to traditional risk factors like high blood pressure or diabetes.
In addition, they discovered that certain medications showed potential proactive effects. Diuretics were linked to a lower likelihood of atherosclerosis, commonly called “hardening of the arteries,” and beta blockers and vasodilators were associated with reduced odds of cerebral amyloid angiopathy, the buildup of a type of proteins in brain blood vessels.
Implications and Future Research
“Our findings challenge the idea that traditional vascular risk factors are always harmful to brain health in the 90-plus population,” Rajmohan said.
“Our findings may reflect the effectiveness of treatment for those conditions, or they could be influenced by survival bias, as individuals with untreated or severe risk factors may not live into their 90s. Further research is needed to explore whether blood pressure-lowering medications could directly reduce the risk of brain blood vessel damage and dementia under specific circumstances. Such knowledge could lead to more personalized advice for managing blood pressure and improving brain health outcomes.”
Reference: “Vascular risk factors and cerebrovascular pathologic changes on autopsy: The 90+ Study” by Ravi Rajmohan, Zeinah Al-Darsani, Chu-Ching Ho, Joey Wong, Annlia Paganini-Hill, Thomas Montine, Maria Corrada and Claudia Kawas, 7 January 2025, Alzheimer’s & Dementia.
DOI: 10.1002/alz.14454
Team members also included Dr. Claudia Kawas, professor of neurology and neurobiology & behavior; Maria Corrada, professor in residence of neurology; Annlia Paganini Hill, project scientist in neurology; and biochemistry graduate student Joey Wong – all from UC Irvine – as well as Dr. Thomas Montine, chair pathology at Stanford University; Zeinah Al-Darsani, epidemiology and biostatistics graduate student at Temple University’s College of Public Health; and Chu-Ching Ho, computer science graduate student at the University of Illinois Urbana-Champaign.
This work was supported by the National Institute on Aging under grant AG021055 and the Alzheimer’s Disease Research Consortium under grant P30AGO66519.
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