Vascular dysfunction in health disparities – unraveling contributions to dementia and Alzheimer’s disease in South Alabama

It is estimated that nearly 100,000 Alabamians have Alzheimer’s disease (AD). There is strong evidence that neurovascular uncoupling, cerebral blood flow reductions and dysregulation, and breakdown of the blood‐brain barrier (BBB), including the loss of pericytes, are early events in the AD pathophysiological cascade. Health, lifestyle, and socioeconomic risk factors across racial groups, and/or genetic risk factors, may account for this increased AD risk. Aged Black Americans have twice the risk of experiencing AD or other dementias compared to aged Whites. 26.8% of the Alabama population is Black American. Furthermore, over a million people in Alabama live in rural areas (USDA‐ERS), leading to healthcare professional shortages, and in designated medically underserved areas. Relatively little is known about the role of cerebrovascular mechanisms in the pathogenesis of dementia and AD and potential therapeutic targets within the neurovascular system, especially as they relate to health disparities. Thus, determining whether health disparities via vascular or genetic risk factors leads to neurovascular dysfunction and ultimately AD is essential.