Magnetic Resonance Imaging Findings Suggest that Cortical Thickness Mediates Glymphatic Effects on Cognitive Function in Alzheimer’s Disease

Motivation: Glymphatic function, which eliminates soluble proteins from the brain, is positively associated with cognitive function for patients with Alzheimer’s disease (AD). Goal(s): To analyze whether the associations between glymphatic function and cognitive function were mediated by regional cortical thickness (CTh) for patients with AD. Approach: Mediator analysis was conducted to explore the ALPS index as a predictor, regional CThs as mediators, and cognitive test scores as outcomes. Results: Mediation analysis showed that regional CTh was a significant mediator between ALPS index and executive function. Impact: CTh is a key mediator between impaired glymphatic function and cognitive decline. Our findings provide insights regarding associations between decreased glymphatic function and cognitive decline in patients with AD.