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Cognition in Cardiovascular Disease
Arash Salardini, Sayena Azarbar. Current Neurology and Neuroscience Reports, 2026-09-24
Topic: Risk, prevention and care in population studies
PURPOSE OF REVIEW: Acute cerebrovascular events once dominated efforts to protect the brain from cardiovascular disease. As stroke prevention and treatment have advanced, attention has broadened to the more continuous vascular processes that contribute to cognitive decline across later life. This review organizes cardiovascular brain injury by route, direct structural injury versus indirect mediated pathways, and tempo, acute events versus chronic processes, with vessel caliber determining lesion topography. RECENT FINDINGS: Vascular and Alzheimer pathology commonly coexist in older adults with cognitive impairment, and their relationship appears bidirectional but asymmetric: Alzheimer pathology can directly injure the cerebral vasculature, while vascular dysfunction may facilitate Alzheimer pathology and, more clearly, accumulated vascular injury lowers the threshold at which Alzheimer pathology becomes clinically expressed. Covert infarction, microbleeds, white matter disease, and blood-brain barrier disruption accumulate into a cumulative vascular substrate that erodes cognition over decades without requiring a recognized clinical event, and the clinical syndrome follows the lesion, with the subcortical dysexecutive phenotype the modal presentation. Evidence from SPRINT MIND, FINGER, US POINTER, BRAIN-AF, LACI-2, CREST-2, and Mendelian randomization identifies blood pressure control as the best-established intervention, uses discordant and null findings to refine presumed mechanisms, and frames the emerging dilemma of anti-amyloid therapy in patients with substantial vascular disease. In the mixed vascular and Alzheimer disease that dominates late-life dementia, the vascular component is often the more modifiable, and cardiovascular risk management remains among the most actionable strategies for preserving cognition.
Key findings
- This review organizes cardiovascular brain injury by route, direct structural injury versus indirect mediated pathways, and tempo, acute events versus chronic processes, with vessel caliber determining lesion topography.
Why it matters
This review describes how vascular injury and Alzheimer pathology commonly coexist and how accumulated vascular damage may lower the threshold at which Alzheimer pathology becomes clinically expressed. It discusses blood pressure evidence from several trials but reports no treatment that cures or prevents Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 30/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 29 of the 96 points we could judge it on, which is 30 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Current Neurology and Neuroscience Reports) |
| Journal's citation record | 1 / 4 | Current Neurology and Neuroscience Reports: journal h-index 124 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Sayena Azarbar holds only 4 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | The University of Texas at San Antonio Health Science Center: institution h-index 883 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42782577) |
| Free to read | 2 / 2 | Free to read |
| Points | 29 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 29 of the 96 points we could judge it on is 30 out of 100. |
| Total | 30 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1007/s11910-026-01519-w
- PubMed: 42782577
- Original source →
- Free full text: Current Neurology and Neuroscience Reports →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Salardini, A., & Azarbar, S. (2026). Cognition in Cardiovascular Disease. Current Neurology and Neuroscience Reports. https://doi.org/10.1007/s11910-026-01519-w
Vancouver
Salardini A, Azarbar S. Cognition in Cardiovascular Disease. Current Neurology and Neuroscience Reports. 2026. doi:10.1007/s11910-026-01519-w. PMID: 42782577.
BibTeX
@article{salardini2026-42782577,
author = {Salardini, Arash and Azarbar, Sayena},
title = {{Cognition in Cardiovascular Disease}},
journal = {Current Neurology and Neuroscience Reports},
year = {2026},
doi = {10.1007/s11910-026-01519-w},
pmid = {42782577},
url = {https://doi.org/10.1007/s11910-026-01519-w}
}
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