Preeclampsia and its relationship to pathological brain aging

Abstract

The development of preeclampsia during pregnancy may have long-term effects on brain aging in women. Associations between preeclampsia and vascular dementia have been established, however the connection between preeclampsia and Alzheimer's disease has not been as thoroughly explored. Both preeclampsia and Alzheimer's disease have been associated with misfolded amyloid beta proteins and inflammation; due to these similarities, in this minireview, we examined the potential links between a history of preeclampsia and the development of dementia. We also discussed how hypertensive disorders of pregnancy may relate to both normal brain aging and dementia to highlight the need for additional research regarding the long-term cognitive effects of preeclampsia on the brain.

Keywords: Alzheimer’s disease; brain aging (normal); dementia; preeclampsia; vascular dementia.

FIGURE 1

Is a model of the how women’s reproductive life events unmask different cardiovascular, metabolic, brain risk trajectories illustrating the relationship between cardiovascular stress and maternal age. The first clinical event identifying an individual’s increased risk profile is the development of preeclampsia in pregnancy. Then as aging continues, these same risk factors influence long term health consequences such as heart disease and Alzheimer’s Disease (AD). Three patterns are represented. There is variability round each of these patterns and not all women are symptomatic for cardiovascular stress. The red line illustrates women who have underlying cardiovascular and metabolic risk factors who then have a pregnancy. These women are highly likely to experience preterm preeclampsia during pregnancy with clinically significant symptoms of preeclampsia such as hypertension and proteinuria. After a first pregnancy there is some short-term protection for subsequent pregnancies represented by the undershoot, but this protection is time limited and the risks for poor health outcomes increase as aging continues. The green line represents a woman with cardiac and metabolic risk factors who does not have a pregnancy but still is at increased risk for poor cardiac, metabolic, and brain outcomes. The blue line represents a woman with no risk factors and a normal pregnancy. As each woman ages, the long term consequences of events that occur earlier in life become increasingly relevant for brain health.