Greater choroid plexus volume is linked to poor sleep, neurodegeneration, and cognitive deficits in older adults: Evidence from the IGNITE Study

INTRODUCTION: Poor sleep is associated with neurodegenerative disease, but mechanisms are unclear. Greater volume of the choroid plexus (ChP), a brain structure supporting neurotoxic waste clearance, is linked to neurodegeneration and cognitive decline. We tested whether poor sleep promotes neurodegeneration and cognitive deficits via ChP dysfunction. METHODS: Baseline magnetic resonance imaging (MRI) -derived ChP, hippocampal, ventricular, and gray matter volumes from 635 cognitively unimpaired older adults were analyzed. Sleep was measured with the Pittsburgh Sleep Quality Index and accelerometry. Confirmatory factor analysis generated cognitive domain scores. RESULTS: Poorer self-reported sleep quality was associated with greater ChP volume, while accelerometry measures were not. Greater ChP volume was associated with smaller hippocampi and gray matter, and larger ventricles. ChP mediated relationships between sleep quality and hippocampal and ventricular volumes. Gray matter mediated associations between ChP and cognitive domains. DISCUSSION: Altered ChP morphology may link poor sleep to neurodegeneration and cognitive decline in older adults.