2011). More importantly, ASL directly assesses CBF through the use of a magnetically labeled arterial blood water endogenous tracer (Aslop et al. 2010; Austin et al. 2011). The technological and also economic benefits of ASL may be advantageous over other imaging modalities that assess cerebral perfusion (e.g., PET, single-photon emission computed tomography (SPECT)), though future studies should examine ASL versus PET versus

SPECT measured blood flow in older adult CVD patients as they relate to cognition Inhibitors,research,lifescience,medical and adverse brain changes. The generalizability of the current findings is limited in several ways. First, the current study consisted of cross-sectional analyses and prospective studies are needed to determine whether cerebral hypoperfusion leads to cognitive decline and accelerated brain atrophy and cortical thinning in older adults. However, the suggested direction of these effects over time is supported by past work (Kitagawa et al. 2009). In addition, the current study found Inhibitors,research,lifescience,medical no association between brain volume or cortical thickness and cognitive function, and additional work is needed to clarify this pattern. Indeed, range restriction may

have limited the current findings, as this sample exhibited relatively intact cognition and future studies with larger more diverse samples would Inhibitors,research,lifescience,medical increase the external validity. Consistent with this notion, the current study attempted to Pemetrexed cell line control for key medical covariates that influence neurocognitive outcomes, though larger sample sizes are needed to confirm our findings through increased statistical power and subsequent Inhibitors,research,lifescience,medical adjustment of other important possible confounds (e.g., white matter lesions, medication side effects). Similarly, prospective studies should examine the role of CBF in the development of white matter lesions, Inhibitors,research,lifescience,medical as recent work in CVD patients shows that WMH may be a key contributor to cognitive

impairment (Alosco et al. 2013). Likewise, it is also possible that WMH leads to reduced CBF to exacerbate brain injury and cognitive impairment, as suggested by past work using ASL imaging in elderly subjects with diffuse confluent WMH (Bastos-Leite et al. 2008). Consistent with this notion, future work should also quantify and examine the contribution of silent infarcts and brain microbleeds to neurocognitive outcomes Nature Reviews Microbiology in aging CVD populations, particularly as they affect cerebral perfusion and subsequent neurocognitive outcomes. Lastly, cerebral perfusion may also be a more sensitive marker of early cognitive impairment relative to subclinical cerebral atrophy in the context of the normal aging process. In brief summary, the current study found that reduced cerebral perfusion as measured by ASL is associated with poorer neurocognitive function in older adults, including reduced cognitive function, smaller TBV, and reduced cortical thickness.