To investigate whether blood–brain barrier (BBB) disruption is a potential mechanism of usual age-related cognitive decline, we conducted dynamic contrast–enhanced (DCE) MRI to measure BBB leakage in a healthy sample, and investigated the association with longitudinal cognitive decline. In a sample of neurologically and cognitively healthy, older individuals, BBB leakage rate in the white and grey matter and hippocampus was measured using DCE MRI with pharmacokinetic modelling. Regression analysis was performed to investigate whether the leakage rate was associated with decline in cognitive performance (memory encoding, memory retrieval, executive functioning and processing speed) over 12 years. White and grey matter BBB leakages were significantly associated with decline in memory retrieval. No significant relations were found between hippocampal BBB leakage and cognitive performance. BBB disruption already being associated with usual cognitive ageing, supports that this neurovascular alteration is a possible explanation for the cognitive decline inherent to the ageing process. More insight into BBB leakage during the normal ageing process could improve estimation and interpretation of leakage rate in pathological conditions. The current results might also stimulate the search for strategies to maintain BBB integrity and help increase the proportion people experiencing successful ageing. Netherlands Trial Register number: NL6358, date of registration: 2017-03-24.

为了调查血脑屏障 (BBB) 破坏是否是常见的与年龄相关的认知衰退的潜在机制，我们进行了动态对比增强 (DCE) MRI 来测量健康样本中的 BBB 渗漏，并研究了与纵向认知衰退的关联。在神经和认知健康的老年人样本中，使用 DCE MRI 和药代动力学模型测量白质、灰质和海马体的 BBB 渗漏率。进行回归分析以调查泄漏率是否与 12 年来认知能力（记忆编码、记忆检索、执行功能和处理速度）下降相关。白质和灰质 BBB 渗漏与记忆提取能力下降显着相关。海马 BBB 渗漏与认知能力之间没有发现显着关系。血脑屏障破坏已经与通常的认知衰老相关，这支持这种神经血管改变可能是衰老过程固有的认知能力下降的解释。对正常老化过程中血脑屏障渗漏的更多了解可以改善对病理条件下渗漏率的估计和解释。目前的结果也可能会刺激人们寻找维持血脑屏障完整性的策略，并有助于提高成功老龄化的人数比例。荷兰试验注册号：NL6358，注册日期：2017-03-24。