Association between cardiovascular-kidney-metabolic syndrome and risk of low cognitive function in older adults: Data from the NHANES 2011-2014

J Alzheimers Dis. 2025 Jun 27:13872877251352204. doi: 10.1177/13872877251352204. Online ahead of print.

Abstract

BackgroundCardiovascular-kidney-metabolic (CKM) syndrome was associated with high risk of adverse health outcomes. However, the relationship between CKM syndrome and risk of low cognitive function remains underexplored.ObjectiveTo evaluate the association between CKM syndrome and low cognitive function risk among older adults.MethodsThis study included 2158 participants aged 60 years or older from the NHANES 2011-2014. Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, Digit Symbol Substitution Test (DSST), and Animal Fluency Test. Weighted multivariable logistic regression models were used to examine the association between different stages of CKM syndrome and low cognitive function risk.ResultsAmong the 2158 participants, 486 (22.5%) for the CERAD test, 492 (22.8%) for the DSST, and 456 (21.1%) for the Animal Fluency Test were diagnosed with low cognitive function. Compared with participants at CKM syndrome Stage 0, the multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) for low cognitive function assessed by CERAD test in Stages 1 to 4 were 0.76 (0.23, 2.98), 1.56 (0.79, 3.72), 1.72 (1.02, 4.10), and 2.97 (1.15, 5.42), respectively. For the DSST, the OR and 95% CI in Stages 1-4 were 0.75 (0.34, 3.42), 1.21 (0.65, 2.95), 1.30 (1.04, 3.23), and 2.21 (1.05, 4.92), respectively. No significant association was found between CKM syndrome and low cognitive function for the Animal Fluency Test.ConclusionsOlder adults at CKM stages 3-4 showed poorer cognitive performance, particularly in episodic memory, processing speed, and attention, compared to those at stage 0.

Keywords: Alzheimer's disease; cardiovascular-kidney-metabolic syndrome; cognitive function; cross-sectional study; older adults.