Introduction
The relationship between variability in cardiometabolic and inflammatory parameters
and cognitive changes is unknown. This study investigates the association of visit-to-visit
variability in BMI, mean arterial pressure, total cholesterol, triglycerides, HbA1c,
high-sensitivity C-reactive protein, ferritin, and fibrinogen with cognitive decline.
Methods
This population-based cohort study included 2,260 individuals (mean age=63.0 [SD=7.5]
years) free of cognitive diseases who underwent ≥3 clinical measurements from 2004
to 2019. Variability was expressed as variability independent of the mean across visits.
Participants were divided on the basis of quartiles of variability score, a scoring
system generated to explore the composite effect of parameter variability (range=0−24),
where 0 points were assigned for Quartile 1, 1 point was assigned for Quartile 2,
2 points were assigned for Quartile 3, and 3 points were assigned for Quartile 4,
each for the variability of 8 parameters measured as variability independent of the
mean. Linear mixed models evaluated the longitudinal associations with cognitive decline
in memory and verbal fluency. All analyses were conducted in 2020−2021.
Results
Higher BMI, mean arterial pressure, total cholesterol, HbA1c, and ferritin variability
were linearly associated with cognitive decline irrespective of their mean values.
In addition, participants in the highest quartile of variability score had a significantly
worse cognitive decline rate in memory (−0.0224 points/year, 95% CI= −0.0319, −0.0129)
and verbal fluency (−0.0088 points/year, 95% CI= −0.0168, −0.0008) than those in the
lowest quartile.
Conclusions
A higher variability in cardiometabolic and inflammatory parameters was significantly
associated with cognitive decline. Stabilizing these parameters may serve as a target
to preserve cognitive functioning.
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Article Info
Publication History
Published online: June 15, 2021
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
