Work

Cardiovascular–kidney–metabolic syndrome stages 0–3 and cognitive decline in Chinese adults: a longitudinal analysis from the China health and retirement longitudinal study

Year: 2026

Type: article

Abstract: BACKGROUND: Cardiovascular–kidney–metabolic (CKM) syndrome is increasingly linked to cognitive impairment, yet its association with cognitive trajectories at early stages remains unclear in Chinese adults. METHODS: We analyzed 6,982 adults (≥ 45 years) without baseline clinical cardiovascular disease from the China Health and Retirement Longitudinal Study. Participants were classified into early CKM stages (0–3). Cognitive trajectories (standardized z-scores) over 7 years were evaluated using linear mixed-effects models. Cox proportional hazards models assessed the risk of substantial cognitive decline (≥ 1 SD decrease from baseline). RESULTS: Individuals in stage 3 showed significantly lower baseline cognitive scores than those in stage 0. All groups experienced cognitive decline during follow-up, but decline was faster in stage 3, whereas stages 1–2 showed trajectories similar to stage 0. Stage 3 was also associated with a higher, borderline significant risk of substantial cognitive decline after adjustment for demographic, behavioral, and clinical factors. CONCLUSIONS: CKM stage 3 was associated with poorer cognitive performance and accelerated cognitive decline. Early identification and comprehensive management of CKM syndrome may help preserve cognitive health.

Source: BMC Cardiovascular Disorders

DOI: 10.1186/s12872-026-05835-4