Abstract
Purpose of ReviewPrecision Aging® is a novel concept that we have recently employed to describe how the model of precision medicine can be used to understand and define the multivariate risks that drive age-related cognitive impairment (ARCI). Hypertension and cardiovascular disease are key risk factors for both brain function and cognitive aging. In this review, we will discuss the common mechanisms underlying the risk factors for both hypertension and ARCI and how the convergence of these mechanisms may be amplified in an individual to drive changes in brain health and accelerate cognitive decline.Recent FindingsCurrently, our cognitive health span does not match our life span. Age-related cognitive impairment and preventing and treating ARCI will require an in-depth understanding of the interrelated risk factors, including individual genetic profiles, that affect brain health and brain aging. Hypertension and cardiovascular disease are important risk factors for ARCI. And, many of the risk factors for developing hypertension, such as diabetes, smoking, stress, viral infection, and age, are shared with the development of ARCI. We must first understand the mechanisms common to the converging risk factors in hypertension and ARCI and then design person-specific therapies to optimize individual brain health.SummaryThe understanding of the convergence of shared risk factors between hypertension and ARCI is required to develop individualized interventions to optimize brain health across the life span. We will conclude with a discussion of possible steps that may be taken to decrease ARCI and optimize an individual’s cognitive life span.
Highlights
Precision Aging® is the application of precision medicine to the identification of the individual risk profiles and geneticThis article is part of the Topical Collection on Secondary Hypertension: Nervous System MechanismsTucson, AZ, USA 4 Neurogenomics Division, TGen, Phoenix, AZ, USA 5 Center for Innovative Brain Sciences, University of Arizona, Tucson, AZ, USA characteristics that link cognitive health span to life span
Many of the identified risk factors for the development of hypertension and cardiovascular disease are common to those identified for age-related cognitive impairment (ARCI), Alzheimer’s disease (AD), and AD-related dementias (ADRD) [2]
An additional recent risk is contracting the SARS-COV-2 virus and complications from COVID-19 which include activation of cytokine release syndrome (CRS) which is known to result in the release of proinflammatory cytokines from macrophages and endothelial cells leading to extensive lung, heart, and vascular injury [10,11,12]
Summary
Precision Aging® is the application of precision medicine to the identification of the individual risk profiles and genetic. We have identified key drivers of brain health and disease that can be altered by the risk factors for ARCI [2] These drivers include brain inflammation [3, 4], compromised brain blood flow [5], increased neuropathology [6], and detrimental changes in synaptic function and synaptic connectivity [7]. Each of these drivers can be affected by known risk factors that accumulate and interact to alter neuronal function and cognition. The ultimate prevention and treatment of ARCI will require in-depth mechanistic
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