Evaluation of the ALPS Index as a Glymphatic System Biomarker Across the Alzheimer's Disease Continuum

A moderate negative correlation between age and the ALPS index supports age-dependent dysfunction in the glymphatic system. Unlike previous studies, our analysis revealed no significant differences in the ALPS index across the AD continuum. One potential explanation is that the participants in this study had relatively preserved cognitive function (Table 1) and were at early stages of AD pathophysiology compared with those in previous studies. These early stages may have limited the ability of the DTI-ALPS method to detect the glymphatic dysfunction. Further research is warranted to evaluate the applicability of the DTI-ALPS method in detecting early-stage glymphatic dysfunction within the AD continuum.