Cardiorespiratory fitness and cardiometabolic health are associated with distinct cognitive domains in cognitively healthy older adults

Cardiometabolic risk and low cardiorespiratory fitness have been linked to age-related cognitive decline, but their relative contributions to different cognitive domains remain unclear. This study examined cross-sectional associations between cardiometabolic health, cardiorespiratory fitness, and cognition in cognitively healthy older adults (60-70 years). Structural equation modelling (SEM) was used to estimate latent variables for cardiorespiratory fitness (derived from physical activity, resting heart rate and BMI), cardiometabolic health (derived from blood pressure, glucose, lipids and BMI), and four cognitive domains: processing speed, executive function, verbal memory, and crystallized ability. Better cardiorespiratory fitness was significantly associated with higher executive function and processing speed, but not with verbal memory or crystallized ability. In contrast, better cardiometabolic health was significantly associated with higher crystallized ability and verbal memory, but not with executive function or processing speed. These modest but reliable relationships remained significant when both health factors were included in the same model, suggesting a double dissociation between their cognitive correlates. This study provides the first evidence that cardiorespiratory fitness and cardiometabolic health are related to distinct aspects of cognition in later life, highlighting potential targets for lifestyle-based interventions to support cognitive health in older age.