Vascular‑first Alzheimer’s hypothesis

Alzheimer’s cognitive decline may be driven primarily by cerebrovascular (blood‑system) dysfunction and downstream inflammation, with amyloid and tau protein aggregates being late consequences rather than primary causes. This reframes prevention toward vascular health, blood biomarkers, and early systemic interventions instead of therapies that only clear plaques. — If validated, it would reorient research funding, clinical trials, regulatory approval criteria, and public‑health prevention strategies for dementia at population scale.