Over two-thirds of individuals aged 65 and older are obese or overweight in the United
States. Epidemiological data show an association between the degree of adiposity and
cognitive dysfunction in the elderly. In this review, the pathophysiological roles
of microvascular mechanisms, including impaired endothelial function and neurovascular
coupling responses, microvascular rarefaction, and blood-brain barrier disruption
in the genesis of cognitive impairment in geriatric obesity are considered. The potential
contribution of adipose-derived factors and fundamental cellular and molecular mechanisms
of senescence to exacerbated obesity-induced cerebromicrovascular impairment and cognitive
decline in aging are discussed.
