Cardiometabolic determinants of early and advanced brain alterations

Cardiometabolic risk factors may be of key importance in the development of future brain diseases like dementia or depression. However, it remains unclear how these risk factors exactly affect the brain. Advanced MR imaging methods such as, diffusion weighted and functional MRI, can provide detailed insights into subtle brain changes, and potentially into early development of disease. In this narrative review, we summarize the available evidence on the associations of cardiometabolic risk factors with subtle changes in brain MRI measures. We found clear evidence that hyperglycemia, physical inactivity, central obesity, and hypertension are associated with both structural and functional brain alterations, while the role of dyslipidemia is far less clear. However, longitudinal evidence that assesses temporality of the associations with more advanced and thus more precise brain imaging methods is needed to improve our insights into the complex etiology of brain diseases.