Longitudinal Associations Between Cardiometabolic Risk Markers and Cognitive Function in Middle-Aged and Older...

Area of Science:

• Gerontology
• Neuroscience
• Cardiology

Background:

• Dementia and cardiometabolic diseases share long prodromal phases, making temporal relationship assessment challenging.
• Existing research on cardiometabolic risk markers and cognitive function yields inconsistent findings.
• Understanding these associations is crucial for early intervention strategies.

Purpose of the Study:

• To investigate the longitudinal associations between cardiometabolic risk markers and cognitive function in middle-aged and older adults.
• To identify specific risk markers that predict cognitive decline.
• To explore age- and domain-specific effects on cognition.

Main Methods:

• Longitudinal analysis of a population-based cohort of 1255 cognitively normal Koreans aged ≥50 years.
• Repeated assessments of cardiometabolic risk markers and Korean Mini-Mental State Examination (K-MMSE) scores.
• Multivariable linear regression and generalized estimating equation models were employed.

Main Results:

• Increased homeostasis model assessment of insulin resistance (HOMA-IR) and fasting insulin levels were associated with cognitive decline (lower K-MMSE scores).
• These associations were more pronounced in adults aged ≤65 years, with increased HOMA-IR and blood pressure linked to K-MMSE score declines.
• Blood pressure increases correlated with memory decline, while HOMA-IR increases showed a marginal association with visuospatial ability decline.

Conclusions:

• Longitudinal increases in insulin resistance and blood pressure are significant predictors of cognitive decline.
• Middle-aged adults (≤65 years) appear particularly vulnerable to these cardiometabolic influences on cognition.
• Cardiometabolic risk factors may differentially impact specific cognitive domains, highlighting the need for targeted interventions.