Abstract
Background: Alzheimer's disease (AD), a leading neurodegenerative disorder, is an
increasing worldwide health concern because of its increasing prevalence and substantial
impact on society. Marked by characteristic pathologies such as amyloid-beta plaques,
neurofibrillary tangles, and synaptic dysfunction, AD pathology is the product of intricate
interactions between genetic, biochemical, and environmental elements.
Objective: To review the relationship between the heart–brain axis, cardiovascular fitness,
and AD pathology, with emphasis on potential preventive and therapeutic implications.
Methods: A narrative literature review was conducted using published studies addressing the
heart–brain axis, cardiovascular risk factors, physical fitness, vascular dysfunction,
biomarkers, and emerging therapeutic strategies for AD. Molecular, clinical and lifestyle
studies relevant to the research question were critically analyzed and synthesized.
Results: Increasing evidence indicates that cardiovascular dysfunction, impaired cerebral
perfusion, endothelial abnormalities, inflammation, and metabolic disturbances may
contribute to AD development and progression. New drugs that target amyloid-β and tau could
enable earlier detection and tailored treatment, while new biomarker, proteomic, and
metabolomic techniques could help ensure that treatment is tailored to the individual. Regular
exercise and a Mediterranean-style diet can positively impact heart health and could help lower
the risk for cognitive decline.
Conclusion: The heart–brain axis is an important link between cardiovascular disease and
AD pathogenesis. Combining cardiovascular risk management, physical fitness, molecular
biomarkers, and new pharmacological treatments might lead to more comprehensive research
on how to prevent and manage AD. More integrated and longitudinal research is required to
better understand the association of cardiovascular fitness with neurodegeneration as well as
to define therapeutic cardiovascular interventions for AD.