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Vascular risk factors and cognitive decline: An integrated perspective from epidemiology to precision intervention
Bin Jiang, Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Author contributions: Jiang B completed all the work for this manuscript independently.
AI contribution statement: During the preparation of this manuscript, DeepSeek R1 was used as an auxiliary tool. The author led and completed the core research work, including literature review, conceptualization, and revision of the initial draft. DeepSeek R1 only provided supportive assistance during this process. Therefore, the role of DeepSeek R1 in this paper is that of a supportive tool and it did not participate in core academic aspects such as study design, data analysis, or conclusion formation.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Bin Jiang, MD, Professor, Senior Research Fellow, Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Road West, Fengtai District, Beijing 100070, China.
Received: February 3, 2026
Revised: March 6, 2026
Accepted: May 18, 2026
Published online: September 22, 2026
Processing time: 230 Days and 7 Hours
Revised: March 6, 2026
Accepted: May 18, 2026
Published online: September 22, 2026
Processing time: 230 Days and 7 Hours
Core Tip
Core Tip: Vascular pathology is a core driver of cognitive decline (often coexisting with Alzheimer’s disease pathology). Midlife (40-65 years) is the critical prevention window. Key mechanisms include cerebral small vessel disease, blood-brain barrier disruption, neurovascular unit dysfunction, and neuroinflammation. Hypertension (including blood pressure variability) is the primary intervention target. Lifestyle interventions (e.g., FINGER model) are the most effective broad prevention strategy. Current challenges include diagnostic difficulties and insufficient personalized interventions. The core message is that maintaining vascular health maintains brain health.