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  • George Wang, MD, PhD

Blood vessel health in midlife predicts memory function 20 years later

Having healthy blood vessels is a critical foundation for lifelong health. Blocked arteries in the heart (coronary arteries) can lead to angina and heart attacks, while blocked arteries in the brain can lead to strokes.

A new study that followed more than 1800 people showed that having smaller and larger infarctions (cell death resulting from blocked blood vessels) in the brain, in middle age, is associated with cognitive decline over the next 20 years (1). In this study, researchers used magnetic resonance imaging (MRI) of the brain to evaluate the brains of people in midlife and see how blood vessel disease in the brain affected their cognitive function later in life. Smaller brain infarctions are often seen on brain images in people who had no symptoms or no recollections of symptoms related to neurological function, and these findings on brain images are often ignored. Larger brain infarctions, on the other hand, may or may not be associated with stroke symptoms. This study followed only people who never had a stroke. The presence of both smaller and larger infarctions in the brain indicates blood vessel disease there, even though the study participants may have felt no symptoms. The study showed that having such silent blood vessel disease in midlife can result in cognitive impairment later in life. What this means is that keeping blood vessels healthy earlier in life may reduce late-life cognitive impairment or dementia. How can one maintain healthy blood vessels in the brain (and in the heart, in the legs, and throughout the body)? Dietary and lifestyle choices play a critical role in blood vessel health. (More details about these choices are covered in past blogs, and will be discussed in future blogs as well.) In addition, other risk factors, such as smoking, high blood sugar, high blood pressure, high cholesterol, chronic stress (and suboptimal management of it), and sedentary habits, all contribute to blood vessel health also.

In other words, what we choose to eat and how we choose to live our lives affect our memory function later in life. So, choose healthy foods, stay physically active, and live mindfully!

(And if you smoke, be open to quitting or receiving help to quit smoking.)


1. Windham, B.G., et al., Midlife Smaller and Larger Infarctions, White Matter Hyperintensities, and 20-Year Cognitive Decline: A Cohort Study. Ann Intern Med, 2019.

Doctor and brain


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