J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston.
Stroke. 2022 Feb;53(2):391-393. doi: 10.1161/STROKEAHA.121.034921. Epub 2022 Jan 10.
As life expectancy grows, brain health is increasingly seen as central to what we mean by successful aging-and vascular brain health as central to overall brain health. Cerebrovascular pathologies are highly prevalent independent contributors to age-related cognitive impairment and at least partly modifiable with available treatments. The current Focused Update addresses vascular brain health from multiple angles, ranging from pathophysiologic mechanisms and neuroimaging features to epidemiologic risk factors, social determinants, and candidate treatments. Here we highlight some of the shared themes that cut across these distinct perspectives: (1) the lifetime course of vascular brain injury pathogenesis and progression; (2) the scientific and ethical imperative to extend vascular brain health research in non-White and non-affluent populations; (3) the need for improved tools to study the cerebral small vessels themselves; (4) the potential role for brain recovery mechanisms in determining vascular brain health and resilience; and (5) the cross-pathway mechanisms by which vascular and neurodegenerative processes may interact. The diverse perspectives featured in this Focused Update offer a sense of the multidisciplinary approaches and collaborations that will be required to launch our populations towards improved brain health and successful aging.
随着预期寿命的增长，大脑健康越来越被视为成功老龄化的核心——而血管性大脑健康则是整体大脑健康的核心。脑血管病是与年龄相关的认知障碍的高度普遍的独立危险因素，并且至少部分可以通过现有治疗方法进行改变。本专题更新从多个角度探讨了血管性大脑健康，包括病理生理机制和神经影像学特征，以及流行病学危险因素、社会决定因素和候选治疗方法。在这里，我们强调了贯穿这些不同视角的一些共同主题：（1）血管性脑损伤发病机制和进展的终生过程；（2）将血管性大脑健康研究扩展到非白人和非富裕人群中的科学和伦理必要性；（3）需要改进工具来研究大脑小血管本身；（4）大脑恢复机制在确定血管性大脑健康和韧性方面的潜在作用；以及（5）血管和神经退行性过程相互作用的跨途径机制。本专题更新中呈现的多样化视角让我们了解到，需要采用多学科方法和合作，才能使我们的人群朝着改善大脑健康和成功老龄化的方向前进。
