Association between Choroid Plexus Volume and Cognitive Function in Community-Dwelling Older Adults without Dementia: A Population-Based Cross-Sectional Analysis

Association Between Choroid Plexus Volume and Cognitive Function in Community-Dwelling Older Adults: A Research Study

Academic Background

With the increasing global aging population, the number of dementia patients is rising annually. Early identification of older adults with declining cognitive function and guiding them toward preventive and therapeutic measures has become particularly important. However, current preventive or disease-modifying therapies for cognitive impairment in older adults remain limited, necessitating a deeper understanding of the pathophysiological mechanisms underlying cognitive decline in this population. Previous research has primarily focused on the relationship between brain parenchyma and cognitive function, with fewer studies examining the relationship between other intracranial structures (such as the choroid plexus) and cognitive function.

The choroid plexus (CP) is a highly vascularized structure located in the ventricular system of the brain, primarily responsible for cerebrospinal fluid (CSF) production, neurogenesis, metabolic waste clearance, and neuroinflammation regulation. In recent years, accumulating evidence suggests that the choroid plexus is closely related to the pathophysiology of Alzheimer’s disease (AD), and increased CP volume may be associated with the severity of cognitive dysfunction. However, research on the relationship between CP volume and cognitive decline in older adults, particularly in community-dwelling older adults at the pre-dementia stage, remains limited.

Source of the Paper

This paper was authored by Yosuke Hidaka and colleagues from several universities and research institutions in Japan, including Osaka University, Kindai University, and Kumamoto University. The study was published in 2024 in the journal Fluids and Barriers of the CNS, titled “Association between choroid plexus volume and cognitive function in community-dwelling older adults without dementia: a population-based cross-sectional analysis.”

Research Process and Results

Study Design

This study is a community-based cross-sectional analysis involving 1,577 community-dwelling older adults aged 65 and above from Arao City, Kumamoto Prefecture, Japan. Participants with dementia, incomplete or unsuitable MRI data were excluded, resulting in a final sample of 1,370 participants. The primary objective of the study was to investigate whether CP volume could serve as an imaging marker for cognitive decline in older adults and to analyze the strength of the association between CP volume and cognitive decline.

Data Collection and Processing

Data were collected through standardized questionnaires, blood tests, and cognitive function assessments (using the Mini-Mental State Examination, MMSE). Brain MRI data were used to measure CP volume, brain parenchyma volume, and CSF spaces related to idiopathic normal pressure hydrocephalus (iNPH). The study utilized FreeSurfer software (version 5.3) for automated segmentation of brain MRI images to calculate the volumes of the choroid plexus and other brain structures.

Key Findings

  1. Relationship Between CP Volume and Cognitive Function: The study found that even after adjusting for CSF spaces and brain parenchyma volumes related to iNPH, lower MMSE scores were significantly associated with higher CP volumes. The association between CP volume and MMSE scores was stronger than that of CSF spaces and brain parenchyma volumes.

  2. Factors Influencing CP Volume: The study identified age, white matter hyperintensity (WMH), enlarged perivascular spaces, body mass index (BMI), smoking history, and diabetes mellitus (DM) as factors associated with increased CP volume.

  3. Sensitivity of CP Volume: The results suggest that CP volume may be a sensitive imaging marker for cognitive decline in older adults, with its association to cognitive decline being independent of brain parenchyma and CSF volumes.

Conclusions

This study is the first to investigate the relationship between CP volume and cognitive function in community-dwelling older adults, incorporating data on CSF and brain parenchyma volumes. The findings indicate that increased CP volume is significantly associated with cognitive decline, independent of brain parenchyma and CSF volumes. This highlights the importance of CP volume in maintaining cognitive function in older adults and provides direction for future longitudinal studies.

Research Highlights

  1. Innovation: This study is the first to explore the relationship between CP volume and cognitive function in community-dwelling older adults, incorporating data on CSF and brain parenchyma volumes.
  2. Sensitivity: The association between CP volume and cognitive decline is stronger than that of CSF spaces and brain parenchyma volumes, suggesting its potential as a sensitive imaging marker.
  3. Multifactorial Analysis: The study not only examined the relationship between CP volume and cognitive function but also analyzed multiple factors influencing CP volume, such as age, smoking history, and diabetes.

Research Significance

The findings of this study provide a new imaging marker for the early identification of cognitive decline in older adults and offer potential targets for future interventions. Further research could explore the mechanisms underlying increased CP volume, particularly its relationship with neuroinflammation and CSF dynamics, thereby providing new insights for the prevention and treatment of cognitive impairment in older adults.