Vascular Health at 36 tied to Dementia at 60

[mike]

A more current article showing importance of starting prevention early, and suggests again that issues with Vascular Health are the early causes of Neuron death and later dementia, and not beta-amyloid.

https://www.medpagetoday.com/neurology/ ... definition

"There is increasing evidence that vascular risk factors impact on an individual's risk for developing dementia and may be modifiable," Schott said. "This study provides yet more evidence that midlife cardiovascular risk has negative consequences on brain health many years later, but may not do so via the deposition of beta-amyloid."

[Kenny4/4]

I agree except for the part about beta amyloid. Beta amyloid can be a vascular risk factor in and of itself. Cerebral Amyloid Angiopathy plays a role in stroke and dimentia
Here is an article discussing it https://medlineplus.gov/ency/article/000719.htm
In CAA it obviously plays a large role. As for us ApoE 4’s it probably has to play a supporting role just as cholesterol does in stroke and heart disease. Us 4’s snip our APP (amyloid precursor protein) into a greater number of pieces that are smaller than ApoE 2’s and 3’s. We also clear it less effectively. This may have the same effect as having a higher total , particle counts, and smaller size does in cholesterol. The Analogy being that Amyloid has endothelial accumulation properties that can act like we know cholesterol does in macro vascular ischemia.

It all makes you wonder -is this amyloid causing an increased risk in damaging the micro-vascular health of the brain by shutting off blood supply and nutrients to neurons. Perhaps a percentage of dementia is microvascular disease that is difficult to see on imaging tests or angios as macro vascular CHD and Stroke are easy to see and fix with stents etc. ?

I do agree that general vascular health is super important but I wonder are micro and macro vascular health one of the same? Or do they both have unique factors that influence them specifically. Peter Attia has brought this question up on his podcast when discussing insulin and glucose. I wished he would have “deep dived” into this a little further.