Life's Crucial 9 Score and Cognitive Performance in Older Adults: The Mediating Role of Biological Aging.

IF 2.5 4区医学 Q3 CLINICAL NEUROLOGY

Dementia and Geriatric Cognitive Disorders Pub Date : 2026-01-01 Epub Date: 2025-10-16 DOI:10.1159/000548982

Qiuran Zheng, Mei Luo, Zhengyun Ren, Yang Guo

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Abstract

Introduction: Cognitive decline is a pressing public health concern in older adults. The recently proposed Life's Crucial 9 (LC9) score, which integrates cardiovascular and mental health metrics, may offer a novel framework for predicting cognitive impairment.

Methods: We analyzed data from 2,180 participants aged ≥60 years from 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). LC9 was computed based on eight cardiovascular health metrics and depressive symptoms. Cognitive performance was assessed using the Animal Fluency Test (AFT), Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, and Digit Symbol Substitution Test (DSST). Biological age (BA) and biological age acceleration (BAcel) were derived using a validated algorithm. Weighted logistic regression, receiver operating characteristic (ROC), restricted cubic spline (RCS) models, and mediation analyses were performed to evaluate the associations.

Results: Higher LC9 scores were significantly associated with lower odds of poor performance on the AFT (p = 1.5 × 10-2) and DSST (p = 1.4 × 10-2), but not CERAD (p = 1.2 × 10-1). ROC analysis showed that LC9 significantly outperformed Life's Essential 8 (LE8) in predicting low AFT and DSST performance (AUC: 0.599 vs. 0.588 for AFT; 0.632 vs. 0.614 for DSST). The RCS models indicated no statistically significant nonlinear relationship between the LC9 and cognitive performance. Mediation analysis revealed that BA and BAcel accounted for 7.48% and 4.53% of the total effect of LC9 on DSST performance, respectively. The subgroup and sensitivity analyses confirmed the robustness of these findings.

Conclusion: LC9 is significantly associated with cognitive performance in older adults. This association with DSST is partially mediated by biological aging.

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Life'老年人的关键9分与认知表现：生物衰老的中介作用。

背景：认知能力下降是老年人面临的一个紧迫的公共卫生问题。最近提出的生命关键9 （LC9）评分，整合了心血管和心理健康指标，可能为预测认知障碍提供一个新的框架。方法：我们分析2011 - 2014年国家健康与营养调查（NHANES）中2180名年龄≥60岁的参与者的数据。LC9是根据8项心血管健康指标和抑郁症状计算的。采用动物流利性测试（AFT）、阿尔茨海默病注册协会（CERAD）测试和数字符号替代测试（DSST）评估认知表现。生物年龄（BA）和生物年龄加速（BAcel）采用验证算法推导。采用加权逻辑回归、受试者工作特征（ROC）、受限三次样条（RCS）模型和中介分析来评估相关性。结果：较高的LC9评分与较低的AFT （P = 1.5 x 10-2）和DSST （P = 1.4 x 10-2）表现不佳的几率显著相关，但与CERAD无关（P = 1.2 x 10-1）。ROC分析显示，LC9在预测低AFT和DSST表现方面显著优于Life's Essential 8 (LE8) （AUC: 0.599对0.588 AFT； 0.632对0.614 DSST）。RCS模型显示LC9与认知表现之间没有统计学上显著的非线性关系。中介分析显示，BA和BAcel分别占LC9对DSST绩效总影响的7.48%和4.53%。亚组分析和敏感性分析证实了这些发现的稳健性。结论：LC9与老年人认知能力显著相关。这种与DSST的关联部分是由生物衰老介导的。

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

Dementia and Geriatric Cognitive Disorders 医学-精神病学

CiteScore

4.70

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： As a unique forum devoted exclusively to the study of cognitive dysfunction, ''Dementia and Geriatric Cognitive Disorders'' concentrates on Alzheimer’s and Parkinson’s disease, Huntington’s chorea and other neurodegenerative diseases. The journal draws from diverse related research disciplines such as psychogeriatrics, neuropsychology, clinical neurology, morphology, physiology, genetic molecular biology, pathology, biochemistry, immunology, pharmacology and pharmaceutics. Strong emphasis is placed on the publication of research findings from animal studies which are complemented by clinical and therapeutic experience to give an overall appreciation of the field.