Association between baseline cardio-kidney-metabolic syndrome, its transition and cognitive impairment: result from
Yuanyue Zhu1,2, Xuejie Wang3, Kan Wang4,5
1Department of Geriatrics, Ruijin hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Cardiovascular-Kidney-Metabolic (CKM) syndrome increases cognitive impairment risk. Higher CKM stages and disease progression elevate this risk, while improvement may reduce it.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
- Neurology
Background:
- Cardiovascular-Kidney-Metabolic (CKM) syndrome integrates diabetes, obesity, cardiovascular disease, and chronic kidney disease.
- The relationship between CKM syndrome and cognitive impairment is not well understood.
Purpose of the Study:
- To investigate the association between CKM syndrome stages and transitions with the risk of cognitive impairment.
Main Methods:
- Longitudinal observational study using data from the China Health and Retirement Longitudinal Study (2011-2018).
- Participants were categorized into 5 CKM stages; transitions were classified as improved, stable, or progressed.
- Logistic regression analysis explored associations between CKM status and cognitive impairment risk.
Main Results:
- Higher CKM stages (1-4) were associated with significantly increased odds of cognitive impairment compared to stage 0.
- Progression of CKM stages showed a higher risk (aOR 1.61) of cognitive impairment compared to stable stages.
- Improvement in CKM stages suggested a potentially reduced risk (aOR 0.44).
Conclusions:
- CKM syndrome stages are incrementally associated with cognitive impairment risk.
- CKM stage progression elevates cognitive impairment hazards; stage reversion may decrease risk.
Aims:
Cardiovascular-Kidney-Metabolic (CKM) syndrome is an integrated context encompassing diabetes, obesity, cardiovascular, and chronic kidney diseases. The impact of CKM syndrome on cognitive impairment remained unclear.
Methods:
This longitudinal, observational study used data from the China Health and Retirement Longitudinal Study waves 1 and 4 (2011 to 2018). In total, 8,833 participants were included for the analysis between baseline CKM and cognitive impairment, and 4,230 were included for the analysis between CKM transition and cognitive impairment. Baseline CKM were classified into 5 consecutive stages according to the AHA statement, and transitions in CKM stages were classified as improved, stable, or progressed based on the difference in states between 2011 and 2015. Logistic regressions were used to explore the associations between CKM stages, transitions and the risk of subsequent cognitive impairment.
Result:
Compared with those in stage 0, the adjusted odds ratio [95% confidence intervals] (aOR [95% CI]) of incident cognitive impairment were 1.74 (1.00-3.18) for stage 1, 2.05 (1.17-3.81) for stage 2, 2.09 (1.27-3.66) for stage 3, and 3.91 (2.33-6.99) for stage 4, respectively. The odds ratios were higher among male and elder participants. In the transition analysis, the aOR (95% CI) was 0.44 (0.19-1.03) for improved group and 1.61 (1.01-2.59) for progressed group, compared with the those maintaining stable CKM stages.
Conclusions:
Higher CKM stages are associated with incrementally elevated risk of cognitive impairment. Additionally, the progression of CKM stages corresponded with greater hazards of cognitive impairment, while stage reversion might be associated with reduced risk.
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