Impact of cardiometabolic conditions on the progression from mild cognitive impairment to dementia: A large cohort study

Abstract

INTRODUCTION: This study investigates the impact of cardiometabolic conditions, including type 2 diabetes, hyperlipidemia, hypertension, and obesity, on the progression of mild cognitive impairment (MCI) to dementia. METHODS: The cohort included adults ≥ 50 years old with MCI and a cardiometabolic condition identified through electronic health records. Propensity score matching was applied to control for confounders, and Kaplan–Meier analysis was used to assess time-to-event outcomes. RESULTS: During a 7-year median follow-up, type 2 diabetes was associated with the highest risk of all-cause dementia (hazard ratio [HR] 1.18, 95% confidence interval [CI]: 1.06 to 1.31), followed by hypertension and hyperlipidemia. For vascular dementia, type 2 diabetes conferred the greatest risk (HR 1.33, 95% CI: 1.07 to 1.64). Hyperlipidemia was the sole cardiometabolic factor significantly associated with Alzheimer's disease (AD) risk (HR 1.21, 95% CI: 1.11 to 1.32). CONCLUSIONS: Hyperlipidemia is primarily associated with AD dementia risk, while type 2 diabetes is the major contributor to vascular dementia and all-cause risk in individuals with MCI. Highlights: Type 2 diabetes, hypertension, and hyperlipidemia are associated with a high risk of developing all-cause dementia in participants already diagnosed with mild cognitive impairment (MCI). Type 2 diabetes was shown to pose a high risk for the progression from MCI to vascular dementia. Hyperlipidemia was associated with Alzheimer's disease progression in individuals with MCI.