Central Obesity, Cardiometabolic Risk, and Cognitive Change in the Study of Latinos – Investigation of Neurocognitive Aging

Article type: Research Article

Authors: Stickel, Ariana M.^a | Tarraf, Wassim^b | Gonzalez, Kevin A.^a | Isasi, Carmen R.^c | Kaplan, Robert^c | Gallo, Linda C.^d | Zeng, Donglin^e | Cai, Jianwen^e | Pirzada, Amber^f | Daviglus, Martha L.^f | Goodman, Zachary T.^g | Schneiderman, Neil^g | González, Hector M.^{a; *}

Affiliations: [a] Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA, USA | [b] Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA | [c] Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA | [d] Department of Psychology, San Diego State University, San Diego, CA, USA | [e] Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA | [f] Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA | [g] Department of Psychology, University of Miami, Miami, FL, USA

Correspondence: [*] Correspondence to: Hector M. González, PhD, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, USA. Tel.: +1 858 534 5361; E-mail: [email protected].

Abstract: Background:The relationships between obesity and cognitive decline in aging are mixed and understudied among Hispanics/Latinos. Objective:To understand associations between central obesity, cognitive aging, and the role of concomitant cardiometabolic abnormalities among Hispanics/Latinos. Methods:Participants included 6,377 diverse Hispanics/Latinos enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL-Investigation for Neurocognitive Aging (SOL-INCA). Participants were 45 years and older at the first cognitive testing session (Visit 1). Cognitive outcomes (z-score units) included global composite and domain specific (learning, memory, executive functioning, processing speed) measures at a second visit (SOL-INCA, on average, 7 years later), and 7-year change. We used survey linear regression to examine associations between central obesity (waist circumference≥88 cm and≥102 cm for women and men, respectively) and cognition. We also tested whether the relationships between obesity and cognition differed by cardiometabolic status (indication of/treatment for 2 + of the following: high triglycerides, hypertension, hyperglycemia, low high-density lipoprotein cholesterol). Results:Central obesity was largely unassociated with cognitive outcomes, adjusting for covariates. However, among individuals with central obesity, cardiometabolic abnormality was linked to poorer cognitive function at SOL-INCA (ΔGlobalCognition =–0.165, p < 0.001) and to more pronounced cognitive declines over the average 7 years (ΔGlobalCognition = –0.109, p < 0.05); this was consistent across cognitive domains. Conclusion:Central obesity alone was not associated with cognitive function. However, presence of both central obesity and cardiometabolic abnormalities was robustly predictive of cognition and 7-year cognitive declines, suggesting that in combination these factors may alter the cognitive trajectories of middle-aged and older Hispanics/Latinos.

Keywords: Aging, cardiometabolic risk factors, cognition, diabetes mellitus, Hispanics, hyperlipidemias, hypertension, Latinos, obesity

DOI: 10.3233/JAD-210314

Journal: Journal of Alzheimer's Disease, vol. 82, no. 3, pp. 1203-1218, 2021