Study Challenges Traditional Risk Factors for Brain Health in the Very Old

A study conducted by the University of California, Irvine, has found that cardiovascular diseases such as high blood pressure and diabetes, which are known to contribute to damage to blood vessels in the brain in younger populations, cannot be linked to an increased risk of such damage in people over 90 years of age. The work, published online in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, suggests that the relationship between blood pressure, vascular health and brain aging is more complex than previously thought.

“For decades, we have known that factors such as high blood pressure and diabetes can damage blood vessels in the brain and increase the risk of cognitive decline and dementia. However, our research suggests that these patterns may change with age,” said corresponding author Dr. Ravi Rajmohan, clinical lecturer in neurology at UC Irvine. “Even more intriguing, antihypertensive medication use was associated with a lower likelihood of certain types of brain damage in this group of individuals over 90 years of age.”

More Personalized Advice for Controlling Blood Pressure and Improving Brain Health

The team members analyzed the relationship between cardiovascular changes in the brain and self-reported vascular risk factors or use of heart medication 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 population group. They applied statistical models that took into account age, gender and education and found that the presence of brain changes was not related to traditional risk factors such as high blood pressure or diabetes.

In addition, they found that certain medications may have a potential preventive effect. Diuretics were associated with a lower likelihood of atherosclerosis, also known as “hardening of the arteries,” and beta-blockers and vasodilators were associated with a lower likelihood of cerebral amyloid angiopathy, the deposition of a type of protein in the blood vessels of the brain. “Our findings challenge the assumption that traditional vascular risk factors are always detrimental to brain health in people over 90,” Rajmohan said. ”

These results may reflect the effectiveness of treatment for these conditions, or they may be influenced by survival bias, as individuals with untreated or severe risk factors may not live to be 90 years old. Further research is needed to explore whether antihypertensive medications can directly reduce the risk of cerebral vascular damage and dementia under certain circumstances. This knowledge could lead to more personalized advice on blood pressure control and to improved brain health outcomes.