MRI‐derived glymphatic‐related composite captures brain and cognitive vulnerability associated with cardiovascular risk in older adults
Zhan Wang, Guojun Lin, Fang Fang, Jing YuAbstract
INTRODUCTION
We evaluated a multimodal magnetic resonance imaging (MRI)‐derived glymphatic‐related composite and examined its associations with cardiovascular risk, brain structural integrity, and cognition in older adults.
METHODS
Ninety‐two participants were included in the baseline analyses and 68 in the 6‐month reassessment analyses. Cardiovascular risk was estimated using the Prediction for ASCVD Risk in China 10‐year atherosclerotic cardiovascular disease score. The glymphatic‐related composite integrated six MRI‐derived measures: choroid plexus volume, choroid plexus free‐water fraction, diffusion tensor image analysis along the perivascular space index, blood oxygen level–dependent signal–cerebrospinal fluid coupling, basal ganglia perivascular spaces, and deep white matter perivascular spaces. Outcomes included cortical thickness in Alzheimer's disease (AD)‐vulnerable regions, peak width of skeletonized mean diffusivity, and cognitive performance.
RESULTS
Higher cardiovascular risk was associated with lower glymphatic‐related composite scores and lower cortical thickness in AD‐vulnerable regions at baseline and the 6‐month reassessment. Higher cardiovascular risk was also indirectly associated with poorer flanker task performance through the glymphatic‐related composite at both assessments.
DISCUSSION
The MRI‐derived glymphatic‐related composite showed consistent associations with cardiovascular risk and cognitive vulnerability across repeated assessments and may serve as a summary measure of glymphatic‐related MRI features in older adults.