How can arteriosclerosis complicate age-related brain atrophy?

Arteriosclerosis—the thickening and hardening of arterial walls—can significantly complicate and exacerbate age-related brain atrophy.

While normal aging involves structural changes such as the shrinkage of neurons and the narrowing of cerebral ridges (gyri), these processes are often compounded by the presence of arteriosclerosis. By narrowing the arterial lumen, arteriosclerosis reduces the vascular supply to the brain, leading to ischemia, or insufficient blood flow.12

Because the central nervous system requires a consistent, liberal blood supply to maintain its high metabolic rate and clear waste products, this restricted circulation can accelerate or worsen the degenerative changes associated with senescence. Consequently, it is often difficult for clinicians to distinguish between the mental deterioration caused by natural aging and that resulting from the impaired blood flow caused by atherosclerosis of the cerebral arteries.234