Short-term associations between metabolic heterogeneity of obesity and cognitive frailty transitions: An ongoing Chinese elderly cohort study.

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2025-07-15 DOI:10.1111/dom.16613

Qianfeng Liu, Fuzhi Wang, Li Huang, Xinrui Zhao, Xinru Wei, Xinyue Yu, Yunqin Zheng, Jiaxin Xiao, Jiayan Xue, Yiran Feng, Xingzhao Tian, Shiji Qiu, Zequn Fu, Zhuang Cui, Meilin Zhang, Huan Liu

{"title":"Short-term associations between metabolic heterogeneity of obesity and cognitive frailty transitions: An ongoing Chinese elderly cohort study.","authors":"Qianfeng Liu, Fuzhi Wang, Li Huang, Xinrui Zhao, Xinru Wei, Xinyue Yu, Yunqin Zheng, Jiaxin Xiao, Jiayan Xue, Yiran Feng, Xingzhao Tian, Shiji Qiu, Zequn Fu, Zhuang Cui, Meilin Zhang, Huan Liu","doi":"10.1111/dom.16613","DOIUrl":null,"url":null,"abstract":"Aims: To clarify the association between metabolic heterogeneity of obesity and cognitive frailty (CF) progression and assess the reversibility of CF through early identification of reversible cognitive frailty (RCF).Materials and methods: This ongoing community-based cohort (Tianjin, China; 2023-2024) included 3048 older adults (mean age 68.0 years, 56.9% female) with annual cognitive assessments. Multistate Markov models quantified transition probabilities and hazard ratios between non-CF (NCF), RCF and CF across four metabolic phenotypes of obesity: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obesity (MHOO), and metabolically unhealthy overweight/obesity (MUOO).Results: Over 12 months of follow-up, RCF showed bidirectional transitions with 0.535 reversion to NCF and 0.066 progression to CF. The transition probabilities of NCF progressing to RCF and CF were 0.232 and 0.055, respectively. MUOO demonstrated the highest probability of direct progression from NCF to CF (0.079). MHOO showed elevated short-term transition risk, with the higher probability from NCF to RCF (0.209) and RCF to CF (0.086) than MHNW. Compared with MHNW, MHOO increased the risk of transitioning from NCF to RCF (HR, 1.65, 95% CI, 1.00-2.73), while MUOO significantly amplified the risk from NCF to CF (HR, 3.15, 95% CI, 1.46-6.80).Conclusions: These preliminary findings emphasize the bidirectional nature of RCF transitions in Chinese older adults, highlighting its importance as an intervention window. Metabolic status demonstrates a strong association with obesity-related CF progression. MUOO correlates with irreversible decline, whereas MHOO is linked to accelerated early stage transitions. Tailored interventions targeting metabolic health in obese older adults may mitigate cognitive frailty risks and optimize outcomes.","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes, Obesity & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dom.16613","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Aims: To clarify the association between metabolic heterogeneity of obesity and cognitive frailty (CF) progression and assess the reversibility of CF through early identification of reversible cognitive frailty (RCF).

Materials and methods: This ongoing community-based cohort (Tianjin, China; 2023-2024) included 3048 older adults (mean age 68.0 years, 56.9% female) with annual cognitive assessments. Multistate Markov models quantified transition probabilities and hazard ratios between non-CF (NCF), RCF and CF across four metabolic phenotypes of obesity: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obesity (MHOO), and metabolically unhealthy overweight/obesity (MUOO).

Results: Over 12 months of follow-up, RCF showed bidirectional transitions with 0.535 reversion to NCF and 0.066 progression to CF. The transition probabilities of NCF progressing to RCF and CF were 0.232 and 0.055, respectively. MUOO demonstrated the highest probability of direct progression from NCF to CF (0.079). MHOO showed elevated short-term transition risk, with the higher probability from NCF to RCF (0.209) and RCF to CF (0.086) than MHNW. Compared with MHNW, MHOO increased the risk of transitioning from NCF to RCF (HR, 1.65, 95% CI, 1.00-2.73), while MUOO significantly amplified the risk from NCF to CF (HR, 3.15, 95% CI, 1.46-6.80).

Conclusions: These preliminary findings emphasize the bidirectional nature of RCF transitions in Chinese older adults, highlighting its importance as an intervention window. Metabolic status demonstrates a strong association with obesity-related CF progression. MUOO correlates with irreversible decline, whereas MHOO is linked to accelerated early stage transitions. Tailored interventions targeting metabolic health in obese older adults may mitigate cognitive frailty risks and optimize outcomes.

查看原文本刊更多论文

肥胖症代谢异质性与认知衰弱转变之间的短期关联：一项正在进行的中国老年队列研究。

目的：阐明肥胖代谢异质性与认知衰弱（CF）进展之间的关系，并通过早期识别可逆性认知衰弱（RCF）来评估CF的可逆性。材料和方法：正在进行的社区队列研究(中国天津；2023-2024)纳入3048名老年人（平均年龄68.0岁，56.9%为女性），每年进行认知评估。多状态马尔可夫模型量化了四种肥胖代谢表型（代谢健康正常体重（MHNW）、代谢不健康正常体重（MUNW）、代谢健康超重/肥胖（MHOO）和代谢不健康超重/肥胖（MUOO））中非CF （NCF）、RCF和CF之间的转移概率和风险比。结果：随访12个月，RCF呈双向转变，向NCF的逆转概率为0.535，向CF的进展概率为0.066，NCF向RCF和CF的转变概率分别为0.232和0.055。MUOO表现出从NCF直接发展为CF的最高概率（0.079）。MHOO表现出较高的短期过渡风险，从NCF到RCF的概率（0.209）和从RCF到CF的概率（0.086）高于MHNW。与MHNW相比，MHOO增加了NCF向RCF转变的风险（HR, 1.65, 95% CI, 1.00-2.73），而MUOO显著增加了NCF向CF转变的风险（HR, 3.15, 95% CI, 1.46-6.80）。结论：这些初步发现强调了中国老年人RCF转变的双向性，强调了其作为干预窗口的重要性。代谢状态与肥胖相关的CF进展密切相关。muo与不可逆转的衰退相关，而MHOO与早期加速转变有关。针对肥胖老年人代谢健康的量身定制的干预措施可能减轻认知衰弱风险并优化结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.