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Cognitive Function and Cardiometabolic‐Inflammatory Risk Factors Among Older Indians and Americans
Author(s) -
Hu Peifeng,
Lee Jinkook,
Beaumaster Sidney,
Kim Jung Ki,
Dey Sharmistha,
Weir David,
Crimmins Eileen M.
Publication year - 2020
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16734
Subject(s) - medicine , homocysteine , body mass index , cognition , cognitive decline , blood pressure , dementia , gerontology , risk factor , physical therapy , demography , psychiatry , disease , sociology
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.