Huang Xinghe, Liang Jie, Zhang Junyu, Fu Jiayi, Chen Yige, Xie Wuxiang, Zheng Fanfan
School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.
J Alzheimers Dis. 2025 Apr;104(4):1270-1280. doi: 10.1177/13872877251324093. Epub 2025 Mar 17.
BackgroundPoor cardiovascular-kidney-metabolic (CKM) health is becoming prevalent; however, sparse data exist regarding the association of CKM health with incident dementia and all-cause mortality.ObjectiveThis study aimed to examine whether poor CKM health is associated with a higher risk of dementia and all-cause mortality, regardless of carrier status.MethodsIn this prospective cohort study, 352,364 participants from the UK Biobank were included. CKM syndrome was identified as a medical condition with the presence of metabolic risk factors, cardiovascular disease, and chronic kidney disease, and was classified into five stages (stage 0 to 4). Cox proportional hazards models were applied to explore the association of CKM health with incident dementia and all-cause mortality.ResultsParticipants in stage 2-3 and stage 4 had 1.12-fold (95% CI: 1.02-1.23, p = 0.023) and 2.18-fold (95% CI: 1.96-2.43, p < 0.001) increased risk of incident all-cause dementia compared with those in stage 0. Similarly, participants in stage 4 also had an increased risk of Alzheimer's disease (HR = 1.51, 95% CI: 1.28-1.78, p < 0.001) and vascular dementia (HR = 4.62, 95% CI: 3.54-6.03, p < 0.001). Participants in later stages were at higher risk of all-cause mortality. We found an interaction between CKM health and carrier status (p for interaction <0.001), and the relationship between CKM health and dementia was more pronounced in non- carriers. Moreover, there were significant additive interactions between carrier status and CKM health on the risk of dementia.ConclusionsPoor CKM health is independently associated with an increased risk of dementia, regardless of carrier status, and all-cause mortality. These findings imply that promoting CKM health may help to reduce the risk of subsequent dementia and mortality.
心血管-肾脏-代谢（CKM）健康状况不佳正变得普遍；然而，关于CKM健康与新发痴呆症和全因死亡率之间关联的数据却很少。
本研究旨在探讨无论携带状态如何，CKM健康状况不佳是否与痴呆症和全因死亡率的较高风险相关。
在这项前瞻性队列研究中，纳入了来自英国生物银行的352364名参与者。CKM综合征被确定为一种存在代谢危险因素、心血管疾病和慢性肾脏病的疾病状况，并分为五个阶段（0至4期）。应用Cox比例风险模型来探讨CKM健康与新发痴呆症和全因死亡率之间的关联。
与0期参与者相比，2-3期和4期参与者发生全因痴呆症的风险分别增加了1.12倍（95%CI：1.02-1.23，p = 0.023）和2.18倍（95%CI：1.96-2.43，p < 0.001）。同样，4期参与者患阿尔茨海默病（HR = 1.51，95%CI：1.28-1.78，p < 0.001）和血管性痴呆（HR = 4.62，95%CI：3.54-6.03，p < 0.001）的风险也增加。后期阶段的参与者全因死亡风险更高。我们发现CKM健康与携带状态之间存在相互作用（交互作用p < 0.001），并且CKM健康与痴呆症之间的关系在非携带者中更为明显。此外，携带状态和CKM健康在痴呆症风险上存在显著的相加相互作用。
无论携带状态如何，CKM健康状况不佳均与痴呆症风险增加和全因死亡率独立相关。这些发现意味着促进CKM健康可能有助于降低后续痴呆症和死亡率的风险。
