Association between triglyceride–glucose index and vascular dementia in ICU patients with cerebrovascular disease: a retrospective study based on the MIMIC-IV database

Vascular dementia (VaD) is the second most common type of dementia after Alzheimer’s disease. Previous studies have confirmed a significant correlation between white matter changes and cognitive dysfunction, especially in patients with metabolic syndrome, suggesting that silent vascular risk factors may promote cerebrovascular pathology with advancing age. The Triglyceride-Glucose (TyG) Index, a novel metabolic indicator calculated based on fasting triglyceride and glucose levels, reflects insulin resistance (IR). Our research aimed to analyze data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, using logistic regression analysis and constructing restricted cubic spline (RCS) curves to evaluate the association between the TyG index and VaD in patients with cerebrovascular disease (CVD). Subgroup analyses were performed, but no statistically significant associations were observed within individual strata. Additionally, univariate and multivariate logistic regression analyses were conducted to identify factors associated with VaD. Exploratory analyses were also performed. After the implementation of the inclusion criteria, a total of 1,754 patients with CVD were enrolled. Among them, 13.91% were diagnosed with VaD. Logistic regression showed that patients in the highest TyG quartile had significantly higher odds of VaD compared with the lowest quartile (Model 3: OR = 2.315, 95% CI: 1.437–3.776, p < 0.001). RCS showed a significant linear association (P = 0.046). No statistically significant subgroup effects were observed. Exploratory association analyses were performed, but formal validation was not conducted. Higher TyG levels were independently associated with increased odds of VaD in patients with CVD after adjusting for potential confounders. Future prospective studies are needed to confirm these associations and explore their clinical implications.