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First, major left side heart parts can structurally and functionally deteriorate from aging wear and tear to provoke hemodynamic instability where heart failure worsens or is initiated; second, heart failure is a major inducer of cognitive impairment and Alzheimer\u2019s disease in the elderly. In heart failure, when the left ventricular myocardium of an elderly person does not properly contract, it cannot pump out adequate blood to the brain, raising the risk of cognitive impairment due to the intensification of chronic brain hypoperfusion. Chronic brain hypoperfusion originates from chronically reduced cardiac output which progresses as heart failure worsens. Other left ventricular heart parts, including atrium, valves, myocardium, and aorta can contribute to the physiological shortfall of cardiac output. It follows that hemodynamic instability and perfusion changes occurring from the aging heart\u2019s blood pumping deficiency will, in time, damage vulnerable brain cells linked to specific cognitive regulatory sites, diminishing neuronal energy metabolism to a level where progressive cognitive impairment is the outcome. Could cognitive impairment progress be reversed with a heart transplant? Evidence is presented detailing the errant hemodynamic pathways leading to cognitive impairment during aging as an offshoot of inefficient structural and functional heart parts and their contribution to heart failure.<\/jats:p>","DOI":"10.3233\/jad-200296","type":"journal-article","created":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T11:35:39Z","timestamp":1590147339000},"page":"63-84","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Hemodynamic Instability in Heart Failure Intensifies Age-Dependent Cognitive Decline"],"prefix":"10.1177","volume":"76","author":[{"given":"Jack C.","family":"de la Torre","sequence":"first","affiliation":[{"name":"University of Texas at Austin","place":["USA"]},{"name":"University of Valencia","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,5,20]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"27","article-title":"Cardiogenic dementia","volume":"1","year":"1977","unstructured":"(1977) Cardiogenic dementia. 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