Cerebromicrovascular aging

Cerebromicrovascular aging refers to the progressive structural and functional decline of the small blood vessels within the brain, including arterioles, capillaries, and venules. It is characterized by the impairment of the neurovascular unit, leading to reduced cerebral blood flow, compromised blood-brain barrier (BBB) integrity, and neurovascular uncoupling (the inability to match blood supply to neural activity). This aging process is a critical driver of age-related neurological conditions such as vascular cognitive impairment (VCI), cerebral small vessel disease (CSVD), and Alzheimer's disease. At the molecular level, it involves endothelial cell senescence, mitochondrial oxidative stress, and chronic inflammation, which are often exacerbated by systemic factors like hypertension and age-related IGF-1 deficiency. While not a single molecular target, therapeutic interventions for cerebromicrovascular aging focus on pathways such as senolysis to remove aged endothelial cells and the activation of longevity-associated pathways like SIRT1 to restore vascular reactivity.

Other names

Brain microvascular agingAge-related cerebromicrovascular dysfunctionCerebromicrovascular senescenceAging of the neurovascular unit

Therapeutic strategies focus on restoring endothelial function by increasing nitric oxide bioavailability, clearing senescent vascular cells via senolytics, reducing oxidative stress through antioxidant or SIRT1 activation, and maintaining neurovascular unit integrity to preserve cerebral blood flow and the blood-brain barrier.