ArticleEuropean journal of neurology2025
The Relationship Between Cerebral Small Vessel Disease, Sleep Quality, and Cognitive Impairment Among Community-Dwelling Older Adults: Exploring the Role of Glymphatic Function.
Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Left-lateralized glymphatic dysfunction is associated with MoCA-measured cognitive impairment in cerebral small vessel disease: A DTI-ALPS study.IBRO neuroscience reports · 2026Article
- Modifiable Physiological Factors Associated With Human Glymphatic and Interstitial Fluid Dynamics-Related Measures: A Scoping Review.The European journal of neuroscience · 2026Article
- Association between obstructive sleep apnea severity and glymphatic-related DTI-ALPS alterations in newly diagnosed, Drug-Naïve Alzheimer's disease.The journal of prevention of Alzheimer's disease · 2026Article
- Perivascular diffusion and white matter free water improve identification of cognitive impairment in cerebral small vessel disease.Frontiers in neurology · 2026Article
- Vascular cognitive impairment in China: Epidemiology, risk factors, healthcare system, management challenges, therapeutic modalities, and prevention strategies.Cerebral circulation - cognition and behavior · 2026Review
- Recognizing, managing, and preventing cognitive sequelae after stroke. A narrative review.Cerebral circulation - cognition and behavior · 2026Review
- The Sleep Puzzle: Linking Glymphatic Function to Cognitive Decline.European journal of neurology · 2025Article
- The Relationship Between Cerebral Small Vessel Disease, Sleep Quality, and Cognitive Impairment Among Community-Dwelling Older Adults: Exploring the Role of Glymphatic Function.European journal of neurology · 2025Article
- Mapping neurodegeneration with diffusion MRI: biomarkers, mechanisms, and clinical translation.Frontiers in neurologyReview
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Authors and funding
13 authors.
Funding
Abstract
backgroundSleep disorders co-existing with cerebral small vessel disease (CSVD) are prevalent in older adults, both of which are established risk factors for cognitive decline. Here, we aimed to explore the role of glymphatic function in linking CSVD and sleep quality to cognitive decline in community-dwelling older adults from a new perspective.
methodsThis cohort study included participants from the Shanghai Aging Study (SAS) who underwent clinical interviews, neuroimaging, and neuropsychological assessments. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was employed to evaluate the glymphatic function. Mediation and interaction analyses were performed to investigate the potential mediating role of DTI-ALPS in the associations between CSVD burden/sleep quality and cognitive impairment, as well as their interaction effects.
results258 participants were included in cross-sectional analysis (mean age 68.5 years, 54.7% female), with 133 followed up after a 7-year interval. At baseline, DTI-ALPS index simultaneously mediated the associations between CSVD score/PSQI and cognitive impairment. Interaction analyses revealed that poor sleep quality had a more significant impact on cognitive impairment among participants at high risk of CSVD. Longitudinally, while no significant mediating effect was observed, both baseline DTI-ALPS and CSVD burden were significantly correlated with longitudinal MMSE changes.
conclusionsOur study suggested that glymphatic function, as assessed by DTI-ALPS, may play a crucial role in linking CSVD burden and sleep quality to cognitive decline in community-dwelling older adults. We also emphasized the importance of individualized sleep management for individuals at high risk of CSVD.
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