Cardiometabolic burden and cognitive profiles in adults 55

Objectives: Cardiometabolic risk factors are prevalent in the United States, and their association with cognitive outcomes is well-established. Opportunities to elucidate the unique and combined contributions of cardiometabolic burden to cognition are abound. Importantly, investigating the cognitive changes incurred as burden increases has scientific and clinical implications. Methods: Older adults (M = 69.3, SD = 8.35) from the National Neuropsychology Network (N = 4222) were included. Cardiometabolic burden, defined via ICD-10 diagnostic codes, and performance on cognitive measures were the primary variables. Domain-level cognitive differences were calculated using a multigroup confirmatory factor analysis. Structural equation modeling evaluated associations between cardiometabolic burden and cognition, adjusting for demographic characteristics. Results: Relative to those without cardiometabolic burden, persons with one condition performed worse on measures of attention and working memory (p < .001, d = 0.24) and visuoconstructional and visuoperceptual abilities (p < .01, d = 0.19), persons with two conditions performed worse on measures of language (p < .01, d = 0.24), attention and working memory (p < .01, d = 0.23), executive function (p < .001, d = 0.22), and visuoconstructional and visuoperceptual abilities (p < .01, d = 0.23), and persons with three or more conditions performed worse across all domains except language and immediate memory (d_range = 0.27-0.48). The impact of demographic characteristics on cognition differed by domain, but higher education was consistently associated with higher cognitive scores. Conclusions: Cognitive performance declined with increasing cardiometabolic burden. More education was associated with higher cognitive scores. Our findings contribute to the literature linking cardiometabolic risk management and cognitive health. Future studies should investigate whether targeting specific cardiometabolic risk factors would effectively improve cognitive function longitudinally.