The heart of the matter

Press/Media: Research


Double page spread in NZ's largest lifestyle magazine (2018 circulation = 240,000;, following Cox et al., (2019) Associations between vascular risk factors and brain MRI indices in UK Biobank. European Heart Journal.

Period11 May 2019

Media coverage


Media coverage

  • TitleThe heart of the matter
    Degree of recognitionNational
    Media name/outletNew Zealand Listener
    Media typePrint
    Duration/Length/Size~650 words / double page spread
    Country/TerritoryNew Zealand
    Description34 LISTENER MAY 11 2019 MAY 11 2019 LISTENER
    by Nicky Pellegrino

    The heart of the matter.

    The healthier your heart, the healthier
    your brain, according to the latest
    science. There is increasing evidence
    to show that older people who are in
    bad cardiovascular shape have a greater
    chance of developing dementia. And
    now we are beginning to get a clearer
    picture of exactly why this is.

    At the Centre for Cognitive Ageing and Cognitive
    Epidemiology at the University of Edinburgh,
    researchers have been examining the MRI scans
    of thousands of people, aged between 44 and 79,
    enrolled in the UK Biobank Study. This large-scale
    project aims to scan the vital organs of 100,000
    participants and supply researchers with a valuable
    resource to increase knowledge and help improve
    the health of future generations.

    “I’m really interested in characterising brain
    ageing,” says principal investigator Simon Cox.
    “How is it that some people arrive in
    their seventies having brains that
    look like they could be 40 years
    old, whereas others have pretty
    stark levels of brain shrinkage?
    What are the factors that determine
    that? And how do you
    end up being one of the people
    who has virtually no brain change?”

    What Cox has been looking at,
    specifically, is the effect on the brain
    of a number of factors that influence
    the health of our blood vessels, such
    as smoking, high blood pressure, obesity
    and diabetes. These have all been
    linked to complications in blood flow
    to the brain.

    A healthy, young brain fits neatly
    white matter, which is the connective
    tissue of the brain and basically its
    communications system. The more risk factors a participant
    had, the poorer their brain health.
    Those at highest risk had about 18ml
    less grey matter (Cox compares that
    to a little less than a travel-sized
    toothpaste tube) and one and a half
    times the damage to white matter.
    inside the cranial cavity, cushioned
    by a layer of cerebrospinal fluid. As
    we age, the cortex or outer layer of
    the brain thins and its gyri (hills) and
    sulci (valleys) recede to be replaced by
    more spinal fluid.

    Cox found shrinkage of grey
    matter was greater in those with high
    vascular-risk factors. Those same
    people also had more damage to their
    The areas affected were mainly those that have
    been linked to more complex thinking skills and
    that show changes as a result of dementia and
    Alzheimer’s disease.

    Cox stresses there are likely to be a large number
    of things that affect the way our brains age.
    Some we can do nothing about, such as our
    genes. If you have the APOE4 allele, which is linked
    to increased risk and earlier onset of Alzheimer’s,
    unfortunately you are stuck with it.
    “But there’s a lot of interest in malleable lifestyle
    factors, the things you can do something about.”
    He advocates a marginal gains approach, getting
    big results from lots of small changes, as popularised
    by British cycling coach Dave Brailsford, who
    helped his team to victory by making hundreds of
    small improvements. Maintaining healthy blood
    pressure, body weight and blood sugar, and not
    smoking, should be just some of the things we do
    to stave off dementia.

    “Because the associations were just as strong in
    midlife as they were in later life, it suggests that
    addressing these factors early might mitigate future
    negative effects,” says Cox.
    More evidence for the far-reaching benefits of
    a healthy heart was provided last year by a large
    French study of people aged over 65. It used
    the American Heart Association’s Life’s Simple 7
    prevention strategy, which covers diet, smoking,
    cholesterol, blood sugar, blood pressure, physical
    exercise and weight. Those with the best cardiovascular
    scores had the lowest rates of cognitive
    decline and dementia.

    And, last year, US researchers working with mice
    found that exercise to improve cardiovascular
    fitness improves blood flow to white
    matter and protects against dementia.
    “There are lots of other excellent
    reasons to ensure we’re in good
    cardiovascular health,” says
    Cox. “This is perhaps another
    Producer/AuthorNicky Pellegrino
    PersonsSimon Cox