An aging global population and accompanying increases in the prevalence of age-related disorders are leading to greater financial, social, and health burdens. Aging-related dementias are one such category of age-related disorders that are associated with progressive loss of physical and cognitive integrity. One proposed preventative measure against risk of aging-related dementia is improving cardiovascular fitness, which may help reverse or buffer age-related brain atrophy associated with worse aging-related outcomes and cognitive decline. However, research into the beneficial potential of cardiovascular fitness has suffered from extreme heterogeneity in study design methodology leading to a lack of cohesion in the field and undermining any potential causal evidence that may exist. In addition, cardiovascular fitness and exercise are often conflated, leading to a lack of clarity in results. Here, I review recent literature on cardiovascular fitness, brain structure, and aging with the following goals: (a) to disentangle and lay out recent findings specific to aging, cardiovascular fitness, and brain structure, and (b) to ascertain the extent to which causal evidence actually exists. I suggest that, while there is some preliminary evidence for a link between cardiovascular fitness and brain structure in older adults, more research is still needed before definitive causal conclusions can be drawn. I conclude with a discussion of existing gaps in the field and suggestions for how they may be addressed by future research.

全球人口老龄化以及随之而来的与年龄相关疾病患病率的增加正在导致更大的经济、社会和健康负担。与衰老相关的痴呆症是一类与年龄相关的疾病，与身体和认知完整性的逐渐丧失有关。一项针对与衰老相关的痴呆症风险的预防措施是改善心血管健康，这可能有助于逆转或缓冲与衰老相关的脑萎缩，而脑萎缩与衰老相关的结果和认知能力下降有关。然而，对心血管健康有益潜力的研究在研究设计方法上存在极端异质性，导致该领域缺乏凝聚力，并破坏了可能存在的任何潜在因果证据。此外，心血管健康和运动经常被混为一谈，导致结果缺乏明确性。在这里，我回顾了最近关于心血管健康、大脑结构和衰老的文献，目标如下：（a）理清并列出有关衰老、心血管健康和大脑结构的最新发现，以及（b）确定衰老的程度哪些因果证据确实存在。我认为，虽然有一些初步证据表明老年人的心血管健康与大脑结构之间存在联系，但在得出明确的因果结论之前仍需要更多的研究。最后，我讨论了该领域现有的差距，并提出了未来研究如何解决这些差距的建议。