Association of Cardiovascular-Kidney-Metabolic Syndrome with Cognitive Decline and Dementia: The ARIC Study Insights

Background: Cardiovascular-kidney-metabolic(CKM) syndrome is a prevalent health concern, while its impact on cognitive function has not been extensively studied. Methods: We conducted a prospective analysis with Atherosclerosis Risk in Communities (ARIC) study data. CKM risk was assessed with the PREVENTTM Calculator and cognitive function was evaluated using z score from different cognitive function tests at Visit 2 and Visit 4. Dementia cases were identified through a combination of assessments and hospital records, with analyses adjusted for demographics and vascular risks during Visit 5. Results: Our study included 10,960 participants with a mean age of 56.9±5.7 years. A robust inverse relationship was observed between cognitive function and CKM risk, with the inflection point at 6.381% CKM risk for the global z score. The risk of dementia increased with higher CKM risk (HR 1.14, 95% CI 1.13-1.16). Notably, male participants exhibited a comparatively reduced risk of dementia (HR 0.72, 95% CI 0.63-0.82). A subsequent sensitivity analysis, utilizing baseline data from Visit 4 (n=4644), confirmed these results. Conclusion: Our findings indicate a significant link between CKM risk and cognitive decline, suggesting the importance of CKM syndrome management in preventing cognitive impairment and dementia.RCS of CKM risk and cognitive scoresCumulative dementia rates across different risk strata of CKM