The population is ageing worldwide, thus increasing the burden of common age-related disorders to the individual, society and economy. Cerebrovascular diseases (stroke, dementia) contribute a significant proportion of this burden and are associated with high morbidity and mortality. Thus, understanding and promoting healthy vascular brain ageing are becoming an increasing priority for healthcare systems. In this review, we consider the effects of normal ageing on two major physiological processes responsible for vascular brain function: Cerebral autoregulation (CA) and neurovascular coupling (NVC). CA is the process by which the brain regulates cerebral blood flow (CBF) and protects against falls and surges in cerebral perfusion pressure, which risk hypoxic brain injury and pressure damage, respectively. In contrast, NVC is the process by which CBF is matched to cerebral metabolic activity, ensuring adequate local oxygenation and nutrient delivery for increased neuronal activity. Healthy ageing is associated with a number of key physiological adaptations in these processes to mitigate age-related functional and structural declines. Through multiple different paradigms assessing CA in healthy younger and older humans, generating conflicting findings, carbon dioxide studies in CA have provided the greatest understanding of intrinsic vascular anatomical factors that may mediate healthy ageing responses. In NVC, studies have found mixed results, with reduced, equivalent and increased activation of vascular responses to cognitive stimulation. In summary, vascular and haemodynamic changes occur in response to ageing and are important in distinguishing “normal” ageing from disease states and may help to develop effective therapeutic strategies to promote healthy brain ageing.

全球人口正在老龄化，从而增加了常见的与年龄有关的疾病对个人、社会和经济的负担。脑血管疾病（中风、痴呆）占这一负担的很大一部分，并与高发病率和死亡率有关。因此，了解和促进健康的血管脑老化正成为医疗保健系统日益优先考虑的问题。在这篇综述中，我们考虑了正常衰老对脑血管功能的两个主要生理过程的影响：脑自动调节 (CA) 和神经血管耦合 (NVC)。CA 是大脑调节脑血流量 (CBF) 并防止脑灌注压下降和激增的过程，这分别有可能导致缺氧性脑损伤和压力损伤。相比之下，NVC 是 CBF 与脑代谢活动相匹配的过程，可确保足够的局部氧合和营养输送以增加神经元活动。健康衰老与这些过程中的许多关键生理适应有关，以减轻与年龄相关的功能和结构衰退。通过多种不同的范式评估健康年轻人和老年人的 CA，产生相互矛盾的结果，CA 中的二氧化碳研究提供了对可能介导健康衰老反应的内在血管解剖因素的最大理解。在 NVC 中，研究发现结果好坏参半，血管对认知刺激的反应激活减少、等效和增加。总之，