Lifetime influences on imaging markers of adverse brain health and vascular disease

Ellen V Backhouse; Sarah Bauermeister; Joanna M Wardlaw

doi:10.1016/j.cccb.2023.100194

Lifetime influences on imaging markers of adverse brain health and vascular disease

Cereb Circ Cogn Behav. 2023 Dec 15:6:100194. doi: 10.1016/j.cccb.2023.100194. eCollection 2024.

Authors

Ellen V Backhouse^{1

2}, Sarah Bauermeister^{3

4}, Joanna M Wardlaw^{1

2

5}

Affiliations

¹ Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
² MRC UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
³ Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK.
⁴ MRC UK Dementia Research Institute, University of Oxford, Oxford OX3 7JX, UK.
⁵ Edinburgh Imaging, University of Edinburgh, Edinburgh, UK.

Abstract

Cerebral small vessel disease (cSVD) is highly prevalent in the general population, increases with age and vascular risk factor exposure, and is a common cause of stroke and dementia. There is great variation in cSVD burden experienced in older age, and maintaining brain health across the life course requires looking beyond an individual's current clinical status and traditional vascular risk factors. Of particular importance are social determinants of health which can be more important than healthcare or lifestyle choices in influencing later life health outcomes, including brain health. In this paper we discuss the social determinants of cerebrovascular disease, focusing on the impact of socioeconomic status on markers of cSVD. We outline the potential mechanisms behind these associations, including early life exposures, health behaviours and brain reserve and maintenance, and we highlight the importance of public health interventions to address the key determinants and risk factors for cSVD from early life stages.

Keywords: Childhood; Cognition; Education; Epidemiology; Small vessel disease; Socioeconomic status.