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Article Abstract
Background: Cognitive decline in postmenopausal women is a growing public health concern, with estrogen deficiency linked to brain aging. However, the role of the brain's lymphatic-like system-assessed via the diffusion tensor imaging along the perivascular space (DTI-ALPS) index-in mediating estrogen-cognitive associations remains unclear. This study investigated whether the DTI-ALPS index mediates the relationship between estrogen levels and cognitive function in postmenopausal women.
Methods: Data from 55 women recruited from outpatient clinics were analyzed. A combination of traditional and advanced statistical methods was used. These included MANOVA, non-linear correlation analysis, structural equation modeling, and machine learning algorithms.
Results: Postmenopausal women exhibited lower right and mean ALPS indices ( < 0.05) and worse cognitive performance on reaction time tasks ( < 0.05). The mean ALPS index fully mediated the relationship between estrogen and cognitive accuracy (e.g., Stroop: = 0.588, < 0.01), with machine learning ranking ALPS index and estrogen as top predictors of cognitive function.
Conclusions: Reduced brain lymphatic function (lower ALPS index) is associated with cognitive decline in postmenopausal women, and this relationship is mediated by estrogen levels. The DTI-ALPS index may serve as a novel biomarker for menopause-related cognitive health.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235314 | PMC |
| http://dx.doi.org/10.3389/fnagi.2025.1593366 | DOI Listing |
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