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CNS Neuroscience & Therapeutics

Impaired brain fluid clearance linked to cognitive decline

Among older adults with narrowed brain arteries, impaired versus preserved fluid clearance was linked to cognitive worsening, with hazard ratios of 1.35 to 2.96.

Paper by Weizhuang Yuan, Xingyang Niu, Linfang Lan, Xinran Chen · Sun Yat-sen University
Figure 1. Overview of glymphatic marker analysis.
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Figure 1. Overview of glymphatic marker analysis.Overview of glymphatic marker analysis.Yuan et al.
Cohort study of 291 older adults, median 5.7 years, against adults with stenosis and high DTI-ALPSMechanisms

346 participants

Limit: Brain atrophy can confound DTI-ALPS, the marker used to infer fluid clearance

Edited by Boris Djordjevic · AgingResearch.News

Paper
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In an observational cohort study of 346 older adults, researchers used brain scans to measure artery narrowing and estimate glymphatic function—the movement of fluid that helps clear waste from the brain. They assessed cognition with a thinking test and a dementia rating scale. Among participants, 87 (25.1%) had at least one narrowed brain artery.

A greater burden of narrowed arteries was associated with poorer results on both imaging measures of glymphatic function. In statistical analyses, these measures accounted for 13.06% to 17.19% of the association between narrowing and initial thinking-test scores. During follow-up, participants with narrowing and impaired glymphatic function also had a higher risk of worsening dementia-rating scores than those without narrowing, with hazard ratios of 3.27 to 4.70.

Why it matters

The study addressed whether the brain’s waste-clearing system may help account for the relationship between narrowed arteries and declining cognition in older age.

Caveats

The observational study could not establish cause and effect, and the brain scans provided indirect measures of glymphatic function. The findings concerned older adults.

From the paper

Participants

The final cohort consisted of 346 participants (Figure S2).

Results, 3.1 Participants Characteristics

Result

For MMSE, participants with stenosis and low DTI-ALPS exhibited the fastest annual decline (−0.42 points/year, 95% CI −0.64 to −0.19) …

Results, 3.5 Accelerated Longitudinal Cognitive Decline in Participants With Cerebral Artery Stenosis and Glymphatic Dysfunction

Quoted word for word from the full text on onlinelibrary.wiley.com.

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