Abstract
Arterial stiffness is a risk factor for accelerated brain aging, cognitive dysfunction, and dementia through its associations with various cerebral pathologies (e.g., cerebral small vessel disease, stroke, β-amyloid deposition, and brain atrophy) and cerebral hemodynamic changes underlying age-related cognitive decline and dementia. Arterial stiffness directly relates the detrimental effects of aging and hypertension to peripheral organs with adverse consequences for blood flow in the extensive microvasculature structure of the kidneys and brain. In this chapter, we discuss the epidemiologic evidence linking arterial stiffness to various neurologic pathologies, cognitive function, and dementia in older adults, including study limitations and knowledge gaps. We reflect on the potentially causal role of arterial stiffness in dementia and its associated neuropathology by applying a standard of causal inference to the potential role of arterial stiffness in Alzheimer's disease and related dementias.
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