Dove Abigail, Marseglia Anna, Shang Ying, Grande Giulia, Vetrano Davide Liborio, Laukka Erika J, Fratiglioni Laura, Xu Weili
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Department of Neurobiology, Care Sciences, and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.
Alzheimers Dement. 2023 Mar;19(3):821-830. doi: 10.1002/alz.12708. Epub 2022 Jun 16.
Cardiometabolic diseases (CMDs) have been individually associated with adverse cognitive outcomes, but their combined effect has not been investigated.
A total of 2577 dementia-free participants 60 years of age or older were followed for 12 years to observe changes in cognitive function and to detect incident cognitive impairment, no dementia (CIND) and dementia. CMDs (including type 2 diabetes, heart disease, and stroke) were assessed at baseline through medical records and clinical examinations. Cardiometabolic multimorbidity was defined as the presence of two or more CMDs. Data were analyzed using multi-adjusted linear mixed-effects models, Cox regression, and Laplace regression.
CMD multimorbidity was associated with cognitive decline, CIND (hazard ratio [HR] 1.73; 95% confidence interval CI 1.23 to 2.44), and its progression to dementia (HR 1.86; 95% CI 1.17 to 2.97). CMD multimorbidity accelerated the onset of CIND by 2.3 years and dementia by 1.8 years.
CMD multimorbidity accelerates cognitive decline and increases the risk of both CIND and its conversion to dementia.
We explored the combined impact of cardiometabolic diseases (CMDs) on cognition. An increasing number of CMDs dose-dependently accelerated cognitive decline. CMD multimorbidity increased the risk of both cognitive impairment and dementia. Co-morbid CMDs could be ideal targets for interventions to protect cognitive health.
心血管代谢疾病（CMDs）已被分别证明与不良认知结果相关，但其综合影响尚未得到研究。
对2577名60岁及以上无痴呆症的参与者进行了为期12年的随访，以观察认知功能的变化，并检测新发的认知障碍、非痴呆型认知障碍（CIND）和痴呆症。通过医疗记录和临床检查在基线时评估心血管代谢疾病（包括2型糖尿病、心脏病和中风）。心血管代谢共病被定义为存在两种或更多种心血管代谢疾病。使用多校正线性混合效应模型、Cox回归和拉普拉斯回归对数据进行分析。
心血管代谢共病与认知衰退、CIND（风险比[HR]1.73；95%置信区间[CI]1.23至2.44）及其向痴呆症的进展（HR 1.86；95%CI 1.17至2.97）相关。心血管代谢共病使CIND的发病提前2.3年，使痴呆症的发病提前1.8年。
心血管代谢共病会加速认知衰退，并增加CIND及其转化为痴呆症的风险。
我们探讨了心血管代谢疾病（CMDs）对认知的综合影响。越来越多的心血管代谢疾病呈剂量依赖性地加速认知衰退。心血管代谢共病增加了认知障碍和痴呆症的风险。合并的心血管代谢疾病可能是保护认知健康干预措施的理想目标。
