Central Obesity, Cardiometabolic Risk, and Cognitive Change in the Study of Latinos - Investigation of Neurocognitive Aging

J Alzheimers Dis. 2021;82(3):1203-1218. doi: 10.3233/JAD-210314.

Abstract

Background: The relationships between obesity and cognitive decline in aging are mixed and understudied among Hispanics/Latinos.

Objective: To understand associations between central obesity, cognitive aging, and the role of concomitant cardiometabolic abnormalities among Hispanics/Latinos.

Methods: Participants included 6,377 diverse Hispanics/Latinos enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL-Investigation for Neurocognitive Aging (SOL-INCA). Participants were 45 years and older at the first cognitive testing session (Visit 1). Cognitive outcomes (z-score units) included global composite and domain specific (learning, memory, executive functioning, processing speed) measures at a second visit (SOL-INCA, on average, 7 years later), and 7-year change. We used survey linear regression to examine associations between central obesity (waist circumference≥88 cm and≥102 cm for women and men, respectively) and cognition. We also tested whether the relationships between obesity and cognition differed by cardiometabolic status (indication of/treatment for 2 + of the following: high triglycerides, hypertension, hyperglycemia, low high-density lipoprotein cholesterol).

Results: Central obesity was largely unassociated with cognitive outcomes, adjusting for covariates. However, among individuals with central obesity, cardiometabolic abnormality was linked to poorer cognitive function at SOL-INCA (ΔGlobalCognition =-0.165, p < 0.001) and to more pronounced cognitive declines over the average 7 years (ΔGlobalCognition = -0.109, p < 0.05); this was consistent across cognitive domains.

Conclusion: Central obesity alone was not associated with cognitive function. However, presence of both central obesity and cardiometabolic abnormalities was robustly predictive of cognition and 7-year cognitive declines, suggesting that in combination these factors may alter the cognitive trajectories of middle-aged and older Hispanics/Latinos.

Keywords: Aging; Hispanics; Latinos; cardiometabolic risk factors; cognition; diabetes mellitus; hyperlipidemias; hypertension; obesity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / metabolism
  • Aging / psychology
  • Cardiometabolic Risk Factors*
  • Cognitive Aging / physiology*
  • Cognitive Aging / psychology
  • Cognitive Dysfunction / ethnology
  • Cognitive Dysfunction / metabolism*
  • Cognitive Dysfunction / psychology
  • Cohort Studies
  • Female
  • Hispanic or Latino* / psychology
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Obesity, Abdominal / ethnology
  • Obesity, Abdominal / metabolism*
  • Obesity, Abdominal / psychology
  • Prospective Studies