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Joint Associations of Cardiometabolic Multimorbidity and Depressive Symptoms on Cognitive Function Among Chinese
Zhiyao Xin1, Li Wang2, Keying Wu1
1Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, 510080, People's Republic of China.
Insights
Cardiometabolic multimorbidity (CMM) and depressive symptoms significantly impair cognitive function in Chinese adults. Integrated management of physical and mental health is crucial for preserving cognition.
Area of Science:
- Gerontology and Public Health
- Neuroscience and Cognitive Science
- Cardiology and Mental Health Research
Background:
- Cognitive decline is a major health concern for aging populations worldwide.
- Cardiometabolic multimorbidity (CMM) and depressive symptoms are significant risk factors for cognitive impairment.
- Understanding the combined impact of CMM and depression on cognition is vital for targeted interventions.
Purpose of the Study:
- To investigate the independent, joint, and interactive effects of CMM and depressive symptoms on cognitive function.
- To examine cognitive performance in Chinese middle-aged and older adults.
- To provide evidence for integrated health management strategies.
Main Methods:
- Cross-sectional study of 341 adults aged 45+ from a memory clinic in Shenzhen.
- Global cognition assessed using Trail Making Tests (A and B) and Animal Verbal Fluency Test (AFT).
- Cardiometabolic multimorbidity (CMM) defined as ≥2 cardiometabolic diseases; depressive symptoms measured by CES-D scale; linear regression used for analysis.
Main Results:
- CMM was significantly associated with lower global cognitive scores (β = -0.37).
- Higher CMM severity correlated with greater cognitive impairment (β = -1.08).
- Depressive symptoms were inversely associated with cognitive scores (β = -0.66).
- Co-existing CMM and depressive symptoms showed the lowest cognitive scores (β = -1.31).
Conclusions:
- Combined CMM and depressive symptoms significantly predict poorer cognitive function in Chinese older adults.
- Integrated management of physical (CMM) and mental (depression) health is essential for cognitive preservation.
- Findings underscore the importance of a holistic approach to brain health in aging populations.
Purpose:
Cognitive decline in middle-aged and older adults globally is a pressing health concern, linked to two significant factors: cardiometabolic multimorbidity (CMM) and depressive symptoms. This study aimed to investigate the independent, joint, and interactive effects of CMM and depressive symptoms on cognitive function in Chinese middle-aged and older adults.
Patients And Methods:
A total of 341 middle-aged and older adults were enrolled from the memory clinic at Qianhai Shekou Free Trade Zone Hospital in Shenzhen between May 2022 and June 2025 for this cross-sectional study. A composite z-score, computed based on performance on the Trail Making Test-A (TMT-A), Trail Making Test-B (TMT-B), and Animal Verbal Fluency Test (AFT), served as the measure of global cognition. CMM describes a constellation of at least two cardiometabolic diseases, including diabetes, stroke, and heart disease. Assessment of depressive symptoms was conducted using the Center for Epidemiological Studies-Depression Scale (CES-D). Linear regression was used.
Results:
This study enrolled 341 individuals over 45 years of age. The sample had a mean age of 62.4 years (SD 9.1), and 52.8% were male. A significant link was observed between CMM and lower global cognitive scores (β= -0.37, 95% CI = -0.57 to -0.17). A higher number of CMDs was positively associated with the severity of cognitive impairment (β=-1.08, 95% CI=-0.28 to -0.08). Depressive symptoms were inversely associated with cognitive scores (β=-0.66, 95% CI=-1.03 to -0.30). Participants with co-existing CMM and depressive symptoms exhibited the lowest cognitive scores (β=-1.31, 95% CI=-2.11 to -0.52) relative to those without either condition. This pattern remained consistent in all subgroups.
Conclusion:
In this cross-sectional study, the association between co-existing CMM and depressive symptoms and poorer cognitive function highlights the need for integrated management of physical and mental health to preserve cognition in Chinese middle-aged and older adults.
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