Cardiometabolic multimorbidity, lifestyle behaviours, and cognitive function: a multicohort study

Area of Science:

• Gerontology
• Public Health
• Neuroscience

Background:

• Cardiometabolic multimorbidity, defined as the co-occurrence of two or more conditions like diabetes, heart disease, and stroke, is a growing concern in aging populations.
• The impact of lifestyle factors on cognitive decline in individuals with cardiometabolic multimorbidity remains underexplored.
• Understanding these associations is crucial for developing effective preventative strategies.

Purpose of the Study:

• To investigate the association between cardiometabolic multimorbidity and cognitive decline.
• To examine the role of lifestyle factors in modifying this association.
• To inform targeted interventions for delaying cognitive decline in older adults.

Main Methods:

• A pooled analysis of data from four large, international cohort studies (Health and Retirement Study, English Longitudinal Study of Ageing, Survey of Health, Ageing and Retirement in Europe, China Health and Retirement Longitudinal Study) involving over 160,000 participants aged 50 and older.
• Cardiometabolic multimorbidity was defined based on the presence of two or three conditions (diabetes, heart disease, stroke).
• Cognitive function was assessed across memory, numeracy, and orientation domains, with a global cognitive score derived from these measures.

Main Results:

• An increasing number of cardiometabolic diseases showed a dose-dependent association with cognitive decline (e.g., three diseases associated with a β of -0.57).
• Diabetes and stroke comorbidities had the strongest association with cognitive decline (β=-0.23).
• Physical inactivity and excessive alcohol use were found to accelerate cognitive decline associated with cardiometabolic disease, particularly with multiple conditions.

Conclusions:

• Cardiometabolic multimorbidity is a significant risk factor for accelerated cognitive decline in older adults.
• Lifestyle factors, including physical inactivity and excessive alcohol consumption, play a crucial role in exacerbating this cognitive decline.
• Integrated interventions targeting both lifestyle modifications and cardiometabolic disease management are essential for delaying cognitive decline.