Age-related changes in cerebrovascular health and their effects on neural function and cognition: A comprehensive review

Benjamin Zimmerman, Bart Rypma, Gabriele Gratton, Monica Fabiani

Research output: Contribution to journalArticlepeer-review


The process of aging includes changes in cellular biology that affect local interactions between cells and their environments and eventually propagate to systemic levels. In the brain, where neurons critically depend on an efficient and dynamic supply of oxygen and glucose, age-related changes in the complex interaction between the brain parenchyma and the cerebrovasculature have effects on health and functioning that negatively impact cognition and play a role in pathology. Thus, cerebrovascular health is considered one of the main mechanisms by which a healthy lifestyle, such as habitual cardiorespiratory exercise and a healthful diet, could lead to improved cognitive outcomes with aging. This review aims at detailing how the physiology of the cerebral vascular system changes with age and how these changes lead to differential trajectories of cognitive maintenance or decline. This provides a framework for generating specific mechanistic hypotheses about the efficacy of proposed interventions and lifestyle covariates that contribute to enhanced cognitive well-being. Finally, we discuss the methodological implications of age-related changes in the cerebral vasculature for human cognitive neuroscience research and propose directions for future experiments aimed at investigating age-related changes in the relationship between physiology and cognitive mechanisms.

Original languageEnglish (US)
Article numbere13796
Issue number7
StatePublished - Jul 2021


  • aging
  • cerebrovascular health
  • cerebrovascular reactivity
  • cognitive aging
  • dementia
  • neurovascular coupling

ASJC Scopus subject areas

  • General Neuroscience
  • Neuropsychology and Physiological Psychology
  • Experimental and Cognitive Psychology
  • Neurology
  • Endocrine and Autonomic Systems
  • Developmental Neuroscience
  • Cognitive Neuroscience
  • Biological Psychiatry


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