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Longitudinal Associations Between Cardiometabolic Risk Markers and Cognitive Function in Middle-Aged and Older
Sooyeun Choi1, Taeyoung Park2, Youjin Je1
1Department of Food and Nutrition, Kyung Hee University, Seoul, South Korea.
Insights
Increases in insulin resistance and blood pressure are linked to cognitive decline in adults over 50. These cardiometabolic risk factors particularly affect middle-aged individuals and may impact specific cognitive functions like memory.
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.
Objectives:
Dementia and cardiometabolic diseases are both characterized by long prodromal phases, which may complicate the assessment of their temporal relationships. Associations between cardiometabolic risk markers and cognition remain inconsistent. We examined the associations between cardiometabolic risk markers and cognitive function in middle-aged and older adults.
Methods:
A longitudinal analysis was conducted using data from a population-based cohort (2007-2014) of 1255 cognitively normal Koreans aged ≥ 50 years at baseline. Cardiometabolic risk markers and Korean Mini-Mental State Examination (K-MMSE) scores were repeatedly assessed through health examinations and interviewer-administered questionnaires. Multivariable linear regression (LR) and generalized estimating equation (GEE) models were used to investigate the associations between cardiometabolic risk markers and K-MMSE scores.
Results:
After full adjustment for covariates, increases in the homeostasis model assessment of insulin resistance (HOMA-IR) and fasting insulin levels were associated with larger percent declines in K-MMSE scores and with lower K-MMSE scores in LR and GEE models (log-transformed HOMA-IR: β = -1.03, 95% CI: -1.87 to -0.20 for LR; β = -0.25, 95% CI: -0.41 to -0.08 for GEE). By age group, increases in HOMA-IR and blood pressure were associated with declines in K-MMSE scores among adults aged ≤ 65 years. By cognitive domain, increases in blood pressure were associated with declines in memory, while increases in HOMA-IR were marginally associated with declines in visuospatial ability (p = 0.052). High-density and low-density lipoprotein cholesterol levels were not significantly associated with cognitive function across all analyses.
Conclusions:
Our findings suggest that longitudinal increases in insulin resistance and blood pressure are associated with cognitive decline, particularly among middle-aged adults (≤ 65 years), and may differentially influence cognitive domains.
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