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Clinical Manifestations.

Ana Maria Castro Laguardia1,2, Daniel Franco O'Byrne2,3, Cecilia Gonzalez Campo4,5

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Summary
This summary is machine-generated.

Cardiometabolic health impacts brain health and physical frailty in older adults. Enlarged perivascular spaces (PVS), a marker of glymphatic dysfunction, mediate this relationship, unlike white matter hyperintensities (WMH).

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Area of Science:

  • Neuroscience
  • Gerontology
  • Cardiology

Background:

  • Cardiometabolic factors (blood pressure, BMI, cholesterol, glucose) influence cardiovascular disease risk and brain health in aging populations.
  • These factors contribute to cerebral small vessel disease (cSVD), a cause of cognitive impairment, with markers like white matter hyperintensities (WMH) and enlarged perivascular spaces (PVS).
  • Enlarged PVS suggest glymphatic dysfunction, impacting waste clearance and cSVD development, and are linked to physical frailty via gait speed (GS).

Purpose of the Study:

  • To investigate the relationship between a cardiometabolic index, cSVD markers (PVS and WMH), and gait speed (GS) in healthy older adults.
  • To explore potential mediation effects of cSVD markers on the link between cardiometabolic burden and physical frailty.

Main Methods:

  • Study included 87 healthy Chilean older adults (mean age 73.5 years, 58% women).
  • Cardiometabolic index calculated from blood pressure, BMI, cholesterol, and glucose.
  • PVS volume measured using automated methods; WMH quantified using lesion segmentation tool.
  • Spearman correlations and mediation analyses were performed to assess relationships.

Main Results:

  • No significant correlation was found between PVS and WMH.
  • Mediation analysis showed significant direct and indirect effects of the cardiometabolic index on the PVS-GS relationship, indicating PVS mediates the link between cardiometabolic health and gait speed.
  • The cardiometabolic index did not mediate the relationship between WMH and GS.

Conclusions:

  • Cardiometabolic health, glymphatic dysfunction (marked by PVS), and physical frailty are intricately linked in older adults.
  • Perivascular spaces (PVS) play a mediating role in how cardiometabolic health influences physical frailty, distinct from white matter hyperintensities (WMH).
  • This highlights the differential impact of cSVD markers on physical frailty, emphasizing the importance of glymphatic function in aging.