Cerebral blood flow predicts multiple demand network activity and fluid intelligence across the lifespan

The preservation of cognitive function into old age is a public health priority. Cerebral hypoperfusion is a hallmark of dementia but its impact on maintaining cognitive ability across the lifespan is less clear. We investigated the relationship between baseline cerebral blood flow (CBF) and blood oxygenation level-dependent (BOLD) response during a fluid reasoning task in a population-based adult lifespan cohort (N=227, age 18-88 years). As age differences in baseline CBF could lead to non-neuronal contributions to the BOLD signal, we introduced commonality analysis to neuroimaging, in order to dissociate performance-related CBF effects from the physiological confounding effects of CBF on the BOLD response. Accounting for CBF, we confirmed that performance- and age-related differences in BOLD responses in the multiple-demand network (MDN) implicated in fluid reasoning. Differences in baseline CBF across the lifespan explained not only performance-related BOLD responses, but also performance-independent BOLD responses. Our results suggest that baseline CBF is important for maintaining cognitive function, while its non-neuronal contributions to BOLD signals reflect an age-related confound. Maintaining perfusion into old age may serve to support brain function with behavioural advantage, regulating brain health.