Decreased blood flow to the brain in humans is associated with altered Alzheimer's disease (AD)-related pathology, although the underlying mechanisms by which hypoperfusion influences AD neuropathology remains unknown. To try to address this question, we developed an oligemic model of cerebral hypoperfusion in the 3xTg-AD mouse model of AD. We bilaterally and transiently occluded the common carotid artery and then examined the molecular and cellular pathways by which hypoperfusion influenced tau and amyloid- proteins. We report the novel finding that a single , mild, transient hypoperfusion insult acutely increases A levels by enhancing -secretase protein expression. In contrast, transient hypoperfusion markedly decreases total tau levels, coincident with activation of macroautophagy and ubiquitin-proteosome pathways. Furthermore, we find that oligemia results in a significant increase specifically in tau phosphorylated at serine 212 and threonine 214 , a tau epitope associated with paired helical filaments in AD patients. Despite the mild and transient nature of this hypoperfusion injury, the pattern of decreased total tau, altered phosphorylated tau, and increased amyloid- persisted for several weeks postoligemia. Our study indicates that a single, mild, cerebral hypoperfusion event produces profound and long lasting effects on both tau and amyloid-. This finding may have implications for the pathogenesis of AD, as it indicates for the first time that total tau and amyloid- are differentially impacted by mild hypoperfusion. Alzheimer's Disease (AD), a progressive, age-related neurodegenerative disorder, currently affects more than 5.3 million people in the United States.1 Pathologically, AD is characterized by the accumulation of two hallmark brain lesions: amyloid- (A) deposits, which can accumulate intracellularly but mainly occur as plaques composed of fibrillar aggregates of the 40-to 42-amino acid A peptide, and intraneuronal neurofibrillary tangles, consisting of hyperphosphorylated and insoluble species of the microtubule-binding protein tau. The causes of sporadic AD are poorly understood, as are the factors that affect disease progression. A combination of lifestyle, environmental, dietary, and genetic and epigenetic factors, in concert with natural changes occurring in the aged brain, all likely influence the development and progression of sporadic AD. These factors can be broadly considered risk factors if they influence the initiation of disease, and co-morbidities when they influence the progression of AD.The effect of mild hypoperfusion on A has been largely unstudied, however, it is known that major hypoperfusion injuries up-regulate A.2-6 Although the underlying mechanism remains unclear, positron emission tomography scans show that patients exhibit cerebral hypometabolism many years before being diagnosed with AD. 7,8 Work in rodent models of AD indicates that severe ischemic insults, such as middle cerebral artery occlusion, increase both A 9 -11 and phosphotau levels.12-14 Althou...