Impact of cardiometabolic conditions on the progression from mild cognitive impairment to dementia: A large cohort study

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-09-15 DOI:10.1002/alz.70692

Filippos Anagnostakis, Michail Kokkorakis, Christos Asvestis, Ilias Papadimopoulos, Shrihari Nagarajan, Konrad Talbot, Lu Li, Yong Chen, Ilya M. Nasrallah, Junhao Wen, Christos Davatzikos

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Abstract

INTRODUCTION

This study investigates the impact of cardiometabolic conditions, including type 2 diabetes, hyperlipidemia, hypertension, and obesity, on the progression of mild cognitive impairment (MCI) to dementia.

METHODS

The cohort included adults ≥ 50 years old with MCI and a cardiometabolic condition identified through electronic health records. Propensity score matching was applied to control for confounders, and Kaplan–Meier analysis was used to assess time-to-event outcomes.

RESULTS

During a 7-year median follow-up, type 2 diabetes was associated with the highest risk of all-cause dementia (hazard ratio [HR] 1.18, 95% confidence interval [CI]: 1.06 to 1.31), followed by hypertension and hyperlipidemia. For vascular dementia, type 2 diabetes conferred the greatest risk (HR 1.33, 95% CI: 1.07 to 1.64). Hyperlipidemia was the sole cardiometabolic factor significantly associated with Alzheimer's disease (AD) risk (HR 1.21, 95% CI: 1.11 to 1.32).

CONCLUSIONS

Hyperlipidemia is primarily associated with AD dementia risk, while type 2 diabetes is the major contributor to vascular dementia and all-cause risk in individuals with MCI.

Highlights

Type 2 diabetes, hypertension, and hyperlipidemia are associated with a high risk of developing all-cause dementia in participants already diagnosed with mild cognitive impairment (MCI).
Type 2 diabetes was shown to pose a high risk for the progression from MCI to vascular dementia.
Hyperlipidemia was associated with Alzheimer's disease progression in individuals with MCI.

Abstract Image

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心脏代谢状况对轻度认知障碍发展为痴呆的影响：一项大型队列研究

本研究探讨了包括2型糖尿病、高脂血症、高血压和肥胖在内的心脏代谢状况对轻度认知障碍（MCI）发展为痴呆的影响。方法该队列包括≥50岁的MCI和通过电子健康记录确定的心脏代谢状况的成年人。倾向得分匹配用于控制混杂因素，Kaplan-Meier分析用于评估时间到事件的结果。结果在7年的中位随访中，2型糖尿病与全因痴呆的风险最高（风险比[HR] 1.18, 95%可信区间[CI]: 1.06至1.31），其次是高血压和高脂血症。对于血管性痴呆，2型糖尿病的风险最大（HR 1.33, 95% CI: 1.07 - 1.64）。高脂血症是唯一与阿尔茨海默病（AD）风险显著相关的心脏代谢因素（HR 1.21, 95% CI: 1.11至1.32）。结论：高脂血症主要与AD痴呆风险相关，而2型糖尿病是MCI患者血管性痴呆和全因风险的主要因素。2型糖尿病、高血压和高脂血症与已经诊断为轻度认知障碍（MCI）的参与者发生全因痴呆的高风险相关。2型糖尿病具有从轻度认知损伤发展为血管性痴呆的高风险。MCI患者高脂血症与阿尔茨海默病进展相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.