Volume 68, Issue S3 p. S36-S44
Clinical Investigation

Cognitive Function and Cardiometabolic-Inflammatory Risk Factors Among Older Indians and Americans

Peifeng Hu MD, PhD

Corresponding Author

Peifeng Hu MD, PhD

Division of Geriatric Medicine, University of California, Los Angeles, Los Angeles, California, USA

Address correspondence to Peifeng Hu, MD, PhD, Division of Geriatric Medicine, University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Log Angeles, CA 90095-1687. E-mail: [email protected]Search for more papers by this author
Jinkook Lee PhD

Jinkook Lee PhD

Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA

Department of Economics, University of Southern California and RAND Corporation, Santa Monica, California, USA

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Sidney Beaumaster BA

Sidney Beaumaster BA

Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA

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Jung Ki Kim PhD

Jung Ki Kim PhD

Davis School of Gerontology, University of Southern California, Los Angeles, California, USA

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Sharmistha Dey PhD

Sharmistha Dey PhD

Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India

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David Weir PhD

David Weir PhD

Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA

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Eileen M. Crimmins PhD

Eileen M. Crimmins PhD

Davis School of Gerontology, University of Southern California, Los Angeles, California, USA

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First published: 20 August 2020
Citations: 11

Abstract

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.