Cognitive Function and Cardiometabolic-Inflammatory Risk Factors Among Older Indians and Americans.

TitleCognitive Function and Cardiometabolic-Inflammatory Risk Factors Among Older Indians and Americans.
Publication TypeJournal Article
Year of Publication2020
AuthorsHu, P, Lee, J, Beaumaster, S, Kim, JK, Dey, S, Weir, DR, Crimmins, EM
JournalJournal of the American Geriatrics Society
Volume68
IssueSuppl 3
PaginationS36-S44
ISSN Number1532-5415
Keywordscardiometabolic risk, Cognition, HCAP, LASI-DAD
Abstract

OBJECTIVES: To investigate how cardiometabolic-inflammatory risk factors are related to cognition among older adults in India and the United States.

DESIGN: The Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) and the Harmonized Cognitive Assessment Protocol of the Health and Retirement Study (HRS-HCAP) in the United States conducted an in-depth assessment of cognition, using protocols designed for international comparison.

SETTING: Cognitive tests were conducted in hospital or household settings in India and in household settings in the United States.

PARTICIPANTS: Respondents aged 60 years and older from LASI-DAD (N = 1,865) and respondents aged 65 years and older from HRS-HCAP (N = 2,111) who provided venous blood specimen.

MEASUREMENTS: We used total composite scores from the common cognitive tests administered. Cardiovascular risk was indicated by systolic and diastolic blood pressure, pulse rate, pro-B-type natriuretic peptide (proBNP), and homocysteine. Metabolic risk was measured by body mass index, glycosylated hemoglobin (HbA1c), high-density lipoprotein cholesterol, and lipoprotein (a) (only in India). Inflammatory risk was indicted by white blood cell count, C-reactive protein, albumin, and uric acid (only in India).

RESULTS: The distribution of both total cognition scores and of cardiometabolic risk factors differed significantly between India and the United States. In both countries, lower cognition was associated with older age, lower education, elevated homocysteine, elevated proBNP, and lower albumin levels. The associations between HbA1c levels and cognitive measures were statistically significant in both countries, but in the opposite direction, with a coefficient of 1.5 (P < .001) in India and -2.4 (P < .001) in the United States for one percentage increase in absolute HbA1c value.

CONCLUSION: Cardiometabolic-inflammatory biomarkers are associated with cognitive functional levels in each country, but the relationships may vary across countries. J Am Geriatr Soc 68:S36-S44, 2020.

DOI10.1111/jgs.16734
Citation Key11008
PubMed ID32815598
Grant ListAG051125 / AG / NIA NIH HHS / United States
AG055273 / AG / NIA NIH HHS / United States
RF1 / AG / NIA NIH HHS / United States
R01 / AG / NIA NIH HHS / United States